Neuropsychological characteristics of highly dissociative healthy individuals.

OBJECTIVE: Dissociative disorders are characterized by disturbances in several neuropsychological domains, especially attention, memory, and consciousness. As a tendency to dissociate can also be observed in healthy individuals, and may be a risk factor for the development of dissociative disorders and posttraumatic stress disorder (PTSD), we were interested in the neuropsychological characteristics of these participants. METHOD: We examined attention, memory, and executive control functions in 17 high and 17 low dissociators without any psychiatric or neurological disorder and without prior experiences of trauma. RESULTS: High dissociators showed relative performance deficiencies in tasks of memory for associative, context-dependent verbal material, visuospatial working memory, and executive control functions in terms of a heightened perseveration tendency and false positive errors. CONCLUSION: These cognitive deficits are consistent with models of dissociative disorders and dissociation in PTSD assuming a hippocampal and prefrontal dysfunction as a core factor. Mild cognitive impairments in otherwise healthy high dissociators may constitute a risk factor for the development of later PTSD or dissociative disorders.

The Diffusion of Evidence-Based Practice: Reviewing the Evidence-Based Practice Networks in the United States and German-Speaking Countries.

Evidence-based practice (EBP) has had a major influence on U.S. social work while it has rarely been adapted in German-speaking countries. This study investigates how knowledge about EBP is diffused within and across geographical contexts. Network analysis methods reveals different diffusion patterns and provide reasons for these differences. For example, the U.S. discourse is self-contained and based on a more homogeneous knowledge base, while the German discourse is more heterogeneous and focuses on a notion of reflexive professionalism. The different conceptual influences within the U.S. and German discourses are discussed in light of future directions of disciplinary social work.

Crisis intervention after the Tsunami in Phuket and Khao Lak.

After the Tsunami disaster in Southeast Asia, India, Sri Lanka, and Africa, the German government set up a crisis task force that implemented crisis-intervention teams covering Thailand (Phuket and Khao Lak), Sri Lanka, and Sumatra. Two crisis teams were sent to Phuket; the first one on 28 December 2004, and the second one on 3 January 2005, each for an average of 1 week. This intervention was primarily for the benefit of German citizens and their expatriates and relatives caught up in a major catastrophe as well as the German helpers. This article describes the organizational structures of the German crisis intervention, protective factors for the helpers, psychiatric syndromes--often acute traumata, the problems of the identification process for relatives, and crisis intervention itself. Consequences for further crisis intervention after natural disasters are discussed.

[Psychiatric crisis-consultation with a focus on the working relationship]. / Krisenberatungsgespräche unter besonderer Berücksichtigung der Arbeitsbeziehung - Feldstudie zur Evaluation des psychiatrischen Bereitschaftsdiensts im Elisenhof, München -

OBJECTIVE: Evaluation of a psychiatric emergency service in Munich that was implemented in spring 2000. METHOD: Socio-demographic and clinical data as well as the working relationship between patients and psychiatrists were documented. 92 psychiatrists rated 137 crisis consultations. 58 patients were able to answer a questionnaire in the acute crisis situation. RESULTS: The largest diagnostic group consists of patients with affective disorders, followed by patients with neurotic, stress, and somatoform disorders. The results indicate an overall high satisfaction of patients and psychiatrists concerning the efficacy of the crisis consultations. As to be expected from psychotherapy research, socio-demographical factors are hardly of any consequence, whereas relationship-based factors have a considerable influence. CONCLUSIONS: Directivity and giving structure on the psychiatrist's part can clearly enhance the patient's confidence.