Die Dialectical Behavior Therapy Ways of Coping Checklist (DBT-WCCL)

Zusammenfassung. Ziel dieser Arbeit war die Erprobung und Validierung einer deutschen Version der Dialectical Behavior Therapy Ways of Coping Checklist (DBT-WCCL, Neacsiu, Rizui, Vitaliano, Lynch & Linehan, 2010 ), einem Fragebogen zur Erhebung der Häufigkeit der Nutzung von Skills, wie sie im Rahmen der Dialektisch-Behavioralen Therapie (DBT) vermittelt werden. Hierzu bearbeiteten 150 Patientinnen mit Borderline Persönlichkeitsstörung eine deutschsprachige Übersetzung, sowie Fragebögen zur Symptomschwere. Weitere 40 Patientinnen füllten die DBT-WCCL im Rahmen einer stationären DBT zu 5 Messzeitpunkten aus. Die drei Faktoren der Originalversion ließen sich replizieren. Weiterführende Analysen zeigten gute interne Konsistenzen und Retest-Reliabilitäten. Erwartungsgemäße Zunahmen auf der Subskala zur Erfassung von Skillsanwendung während der stationären DBT sowie erwartungsgemäße Zusammenhänge der DBT-WCCL mit der Skills- und DBT-Erfahrung geben erste Hinweise auf die Validität des Verfahrens.

[Dialectical Behavior Therapy (DBT)--developments and empirical evidence]

OBJECTIVE

Dialectical Behavior Therapy has been initially designed and evaluated as an outpatient-treatment program for chronic suicidal female patients. Within the last years, several adaptations of DBT for specific comorbidities, other settings or other disorders related to emotion dysregulation have been developed. This report reviews conceptual aspects and the scientific evidence of initially designed Dialectical Behavior Therapy and the adaptations.

METHODS

Systematic literature search and systematic review.

RESULTS

Recently, two meta-analyses which are based on randomized controlled trials conclude robust and stabile effects of DBT Evidence from further RCTs and other studies show promise for the properties of many DBT adaptations.

CONCLUSION

The current review of the literature suggests a good effectiveness of DBT, especially on complex disorders with deficits in the field of emotion regulation.

Emotional priming of facial affect identification in schizophrenia

Twenty-three schizophrenia subjects were compared with healthy and clinical control subjects on an emotional priming task. Positive and negative emotional facial expressions were presented as primes, followed by a neutral pattern mask, then an emotionally neutral face as target. The prime-mask-target sequence was arranged to allow conscious perception of only the targets. Subjects had to judge if they had seen a pleasant or an unpleasant facial expression. All subjects judged the neutral target as significantly more unpleasant when negative emotional facial expressions were presented as primes as compared with positive or neutral facial expressions as primes. This judgment shift was significantly stronger in schizophrenia subjects than in control subjects. The stronger priming of schizophrenia subjects may reflect a stronger influence of automatically processed emotional stimuli on judgments. We suggest that increased spreading activation of emotional information might be related to low social/emotional functioning of the individual with schizophrenia.

Increased benzodiazepine receptor density in the prefrontal cortex in patients with panic disorder

There are published studies concerning a regionally changed function of GABA-benzodiazepine-receptor-complexes in anxiety disorder. These studies implicate the limbic lobe, the brainstem and the prefrontal cortex. Using 123I-Iomazenil and single photon emission tomography (SPET) we investigated the benzodiazepine receptor density in twelve patients with panic disorder who had never been treated with benzodiazepines before. Nine age- and sex-matched volunteers who were free of mental illness served as controls. Patients with panic disorder showed a significant increase of benzodiazepine receptor binding in the right supraorbital cortex and a trend to an increased uptake in the right temporal cortex. There was no correlation between receptor density and scores on Spielberger's State Trait Anxiety Inventory in the patient group. Since the findings cannot be explained by benzodiazepine exposure we hypothesize an upregulation due to functional or neuroanatomic changes (at least) in the frontotemporal cortex.

[Psychopathologic symptoms and cognitive test performance in schizophrenic patients]

Psychopathological symptoms and cognitive test performance were examined in 34 acute schizophrenic patients. The results of a clusteranalytic approach in order to distinguish groups of patients with different syndromes were disappointing. Three dimensions of negative, hallucinatory-delusional, and disorganised symptoms could be established by factor analysis. The disorganised symptom dimension showed strong and significant relations to mnestic and intellectual impairments of the patients. Hallucinatory-delusional symptoms were related to deficits in tests of visual memory and visual search. Negative symptoms were not related to cognitive impairments of the patients. The results are discussed in respect of other studies reporting correlations of schizophrenic symptoms and cognitive disturbances, and with regard to hypotheses of brain dysfunction in schizophrenia. In future research, consideration of the three main dimensions of schizophrenic symptoms could be useful to reduce the heterogeneity of schizophrenic samples.