[Childhood-onset versus acute, adult-onset traumatized patients in the light of amnestic tendencies and derealisation]. / Mimisch-affektive Beziehungsregulation von früh- versus akuttraumatisierten Patienten unter Berücksichtigung amnestischer Tendenzen und Derealisation.

OBJECTIVES: In the present study we examined the facial affective behaviour of acute adult-onset traumatized patients versus childhood-onset traumatized patients. Furthermore, we analyzed whether a decrease in emotional numbing results from a reduction of symptoms. We used amnestic tendencies as a moderator variable. METHODS: The facial affective behaviour was coded with the Emotional Facial Acting Coding System, an instrument for the registration of facial movements with emotional relevance. The facial affective behaviour of the patient's first and last EMDR sessions was compared. RESULTS: Childhood-onset and acute adult-onset traumatized patients showed the same reduction of overall facial activity. We found significantly higher psychic complaints (global severity index) (SCL-90-R) in childhood-onset traumatized patients and no difference in amnestic tendencies (FDS) between the two groups. Childhood-onset traumatized patients showed higher values of derealisation (FDS). CONCLUSIONS: The facial affective reduction remains constant over time. Also childhood-onset traumatized patients developed more psychic complaints and greater derealisation.

[Metaphors and affect: their interrelation in the therapeutic process]. / Metaphern und Affekt: Zusammenwirken im therapeutischen Prozess.

OBJECTIVES: In accordance with Freud's hypothesis about the nature of primary process thinking we analysed metaphors as possible tools for the integration of unconscious affective und cognitive representational processes which, besides being complementary to affective interactive dyadic behaviour, may be of curative value. METHODS: Using videotapes of 10 fifteen-hour short-term therapies by very experienced therapists treating an unselected group of patients, facial affect and metaphoric language of the therapist and the patient as well as the temporal distance between the two was recorded. RESULTS: The density of metaphors was not significantly correlated with symptom reduction but with treatment satisfaction. However, symptom reduction correlated significantly with the frequency of interactive metaphors used by both the therapist and the patient. CONCLUSIONS: It could be shown that there is an optimal time window between facial affect and metaphor production beyond the here and now, but not as a long term memory.

Dyadic facial affective indicators of severity of symptomatic burden in patients with panic disorder.

BACKGROUND: Based on the results of research on facial affective behaviour in different psychological disorders, as well as on available findings on the specific behaviour of patients with panic disorder in interaction with their therapists, hypotheses about dyadic facial affective behaviour and its correlation with symptomatic burden of female panic patients are formulated. SAMPLING AND METHODS: The facial affective behaviour of 20 patients with panic disorder and their therapists, coded with the Emotional Facial Action Coding System, in the first treatment session is analyzed regarding interactive enmeshment, and for a subgroup of 15 dyads these data are correlated with those on symptomatic burden before treatment. RESULTS: A high degree of interactive enmeshment between patient and therapist correlates positively with the severity of symptomatic burden. All dyadic enmeshment indicators show highly significant positive correlations with body-related symptoms, but not with more general variables like global severity index of the SCL-90R or general anxiety (State Trait Anxiety Inventory). CONCLUSIONS: These results are discussed against the background of specific psychodynamics of panic patients and show that, on the one hand, therapists practise an interactive abstinence, but on the other hand, they tend to be pulled into a specific interactive enmeshment by patients with greater symptomatic burden. Limitations of the study arise from the small sample and the lack of a comparison group, therefore the question if the results are disorder specific or more general cannot be answered.

[On the relationship between traumatization, amnesia and symptom stress--an empirical pilot study]. / Uber das Verhältnis von Traumatisierungen, Amnesie und Symptombelastung--eine empirische Pilotstudie.

OBJECTIVES: In the present study we examined facial affective behavior in acutely traumatized patients undergoing EMDR therapy. Furthermore, we analyzed whether a decrease in emotional numbing was due to a reduction of symptoms. Amnestic tendencies were used as a moderator variable. METHODS: The facial affective behaviour was coded using the Emotional Facial Acting Coding System, an instrument for the registration of facial movements with emotional relevance. The facial affective behavior of the patient's first and last EMDR session was compared. RESULTS: A significant increase in facial affective behavior as well as an increase in mental complaints were found. Furthermore, the reduction in amnestic tendencies did not result in a reduction of symptoms. CONCLUSIONS: Under the influence of the treatment it is possible to improve access to episodic affective memory. Nevertheless, a positive influence cannot be denoted at the end of the treatment.

Facial affective relationship offers of patients with panic disorder.

Abstract The psychodynamic of patients with panic disorder is most often characterized by a domination of autonomy-dependency conflicts, including an ambivalent need for a positive relationship toward a significant object and an incapacity to express negative feelings because of fear of losing this relationship. Affective facial behavior can be considered as a tool for relationship regulation. The authors investigated facial affective indicators of this conflict in 20 women with panic disorder in their first psychotherapy session. A preponderance of facial smile and a lack of negative affective facial signals were expected. This was not confirmed for the total sample. A cluster analysis identified two subgroups of panic patients. One subgroup confirmed the assumption precisely. The other did as well but only insofar as the patients smiled more often than was seen in a mixed clinical control group that excluded panic disorders. In addition, the panic patients of this cluster showed much negative affect. The patients of the two panic clusters did not differ in panic and other symptoms but did so in their descriptions of their interpersonal behavior.

[Initial affective facial behaviour and outcome satisfaction in the psychotherapy of patients with panic disorder]. / Initiales mimisch-affektives Verhalten und Behandlungszufriedenheit in der Psychotherapie von Patientinnen mit Panikstörungen.

OBJECTIVES: On the basis of characterizations of the psychodynamics of panic patients and previous findings on their affective facial behavior in first psychotherapy sessions, hypotheses are made on affective facial behavior of the therapist and its relationship to outcome satisfaction. METHODS: Affective facial behaviour in 20 female patients with panic disorder and their male therapists in the first session of psychotherapy was coded with EMFACS. The data of facial behaviour was correlated with outcome ratings at the end of treatment. RESULTS: Therapists show less affective facial behaviour than panic patients; particularly, they smile less frequently. The frequency of smiling in the first session correlated negatively with outcome ratings. Therapists adapted their interactive behaviour to the relationship offers of their patients. CONCLUSIONS: The results are discussed on the background of the psychodynamics of panic disorders. Considering the different relationship offers, the results indicate that the interactive dialogue should be formed very specifically in order to create a helpful therapeutic relationship.

Comportamiento expresivo de afectos en varones y mujeres adultos sanos y enfermos de colitis ulcerosa / Gender specific differences in expressive behavior between healthy persons and patients suffering from ulcerative colitis

En este trabajo se investiga si los pacientes que sufren de colitis ulcerosa son facialmente menos activos que los sujetos sanos. Además, se estudia si la actividad facial en los hombres es reducida comparada con la de las mujeres, a la vez que los posibles efectos de interacción de sexo y enfermedad sobre el comportamiento expresivo. El método empleado consiste en la observación de video filmación de 20 pacientes, en interacción con sus compañeros sanos, durante 20 minutos de conversación. La interpretación de los datos se realiza mediante el EMFACS (Emotional Facial Action Coding System). Cuarenta sujetos sanos de ambos sexos interactuando entre sí constituyen el grupo control. Los pacientes psicosomáticos fueron menos activos en sus rostros, pero las diferencias no alcanzaron significancia excepto para alegría sentida. Con la excepción de enojo y sonrisa social, las mujeres mostraron más intensidad y afectividad en sus expresiones. Los compañeros de los pacientes redujeron sus comportamientos expresivos y pudo encontrarse significativa interacción entre sexo y reacción a la enfermedad del compañero.(AU)

Comportamiento expresivo de afectos en varones y mujeres adultos sanos y enfermos de colitis ulcerosa / Gender specific differences in expressive behavior between healthy persons and patients suffering from ulcerative colitis

En este trabajo se investiga si los pacientes que sufren de colitis ulcerosa son facialmente menos activos que los sujetos sanos. Además, se estudia si la actividad facial en los hombres es reducida comparada con la de las mujeres, a la vez que los posibles efectos de interacción de sexo y enfermedad sobre el comportamiento expresivo. El método empleado consiste en la observación de video filmación de 20 pacientes, en interacción con sus compañeros sanos, durante 20 minutos de conversación. La interpretación de los datos se realiza mediante el EMFACS (Emotional Facial Action Coding System). Cuarenta sujetos sanos de ambos sexos interactuando entre sí constituyen el grupo control. Los pacientes psicosomáticos fueron menos activos en sus rostros, pero las diferencias no alcanzaron significancia excepto para alegría sentida. Con la excepción de enojo y sonrisa social, las mujeres mostraron más intensidad y afectividad en sus expresiones. Los compañeros de los pacientes redujeron sus comportamientos expresivos y pudo encontrarse significativa interacción entre sexo y reacción a la enfermedad del compañero.