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Biomedical subjects

W Tress

Publications and source records attributed to W Tress.

At least 19 recordsLinked to original sources
PubMed1992

[Psychogenesis of the course of Sudeck's disease--a case report].

Several authors have already pointed out the significance of personality, subjectively stressful life events and relevant conflicts for the course of reflex sympathetic dystrophy. Psychodynamic hypotheses are demonstrated by two patients who had psychotherapeutic treatment and were observed over a longer stretch of time. A therapeutic concept which is enriched by this knowledge may obtain the patients' better compliance with orthopaedists, surgeons and physiotherapists and may influence duration of illness and treatment results favorably.

Adaptation, Psychological↗
PubMed1992

[Psychosomatic medicine between natural science and psychological science--tertium non datur?].

Psyche and soma are open to scientific-causal analysis for biomedicine as well as for social-empirical studies. Both are furthermore accessible to the ideographic discourse of subjective meanings and intentional acts. The German language marks this difference with the terms of "Körper" (body) and "Leib" (embodied soul--spirited body). The Bieri-trilemma demonstrates the resulting epistemological calamity. Neither the so-called behavioral medicine as variation of an ontologic-methodological materialism nor pure phenomenology of the sick subject lead the way out of such inconsistencies. Attempts of systemtheoretical mediation usually only prove their poor reviewing of traditional discussion. This paper outlines some of the currently interesting positions towards the so-called body-soul-problem in the field of psychosomatic medicine, at the same time warning against hasty expectations. We discuss the intentional-biographic approach, the biomedical approach (including the simultaneity correlation (Schultz-Hencke) as well as the brain-soul-correlationism (Kurthen and Linke). As our result we maintain the complementarity of a double discourse for psychosomatic medicine, namely the complementarity of hermeneutic analysis of meaningful processes and of bio-psycho-social casualties. The complementary discourse levels occasionally find their counterparts on an intersubjective-objective time-space-axis. For this we suggest the concept of socialempiric and biomedical markers. Attempts of mediation, be it from systemic-emergence-theoretical or from hermeneutic perspective of interaction forms and their interaction engrams corresponding to their central nervous substratum, turn out to be mystifications of actual incompatibilities, namely of the inevitably double discourse. For this the theory of absolute processes (W. Sellars) promises mediation, but so far no more.(ABSTRACT TRUNCATED AT 250 WORDS)

Arousal↗
PubMed1992

[Affective-cognitive coping with attacks and illness behavior in patients with bronchial asthma].

The purpose of this study was to investigate attack-related cognitive coping styles in 80 patients with bronchial asthma and to relate them to outcome parameters of illness behaviour. All patients had participated in a 5-day-lasting asthma treatment and teaching programme (ATTP). Outcome variables to be predicted were: The number of days in hospital due to asthma during the year following the training programme and the patients' adherence to the recommendations of the programme one year later. Independent predictor variables were: pre-training attack frequency, hospitalization due to asthma, medication intensity, pulmonary function, asthma symptom anxiety, trait anxiety and attack-related cognitive coping styles. Multiple regression analyses show the importance of a "minimizing/self-confident" coping style in predicting days in hospital, while a "diverting" style predicts best a poor management of attacks in patients on oral steroids.

Adaptation, Psychological↗
PubMed1991

[Psychogenic illness and social mobility between generations].

A representative epidemiological survey on psychogenic disorders confirms the often reported result, that these disorders are more common in lower socioeconomic classes. However, in looking for the socioeconomic origin of the subjects (parental class position), it could be shown that "cases" were equally distributed over social classes. Therefore, it seems to be unlikely that low social class as macrosocial factor in its own right has causative influence on the subjects' later mental health or illness. It seems more likely that microsocial aspects of primary and secondary socialization are of decisive importance. After the "breeding-hypothesis" as an explanation of the inverse relationship between social class and mental illness could be ruled out, the rival hypotheses of social stress and social selection (drift-hypothesis) are discussed. A research design which might test these alternatives is outlined.

Cohort Studies↗
PubMed1991

[Psychosomatic specificity--newly reflected by psychoanalytic epidemiology].

The issue of whether there are specific constellations of intrapsychic conflicts, personality structures and symptom patterns within the general population is investigated by means of a representative epidemiological field cohort study. Out of a population of 600 adults three groups are compared: probands who are suffering from functional cardiac symptoms, those who are suffering from headaches and a sample of 'healthy' probands. The interview protocols of these probands were examined to identify typical conflict patterns. Finally the raters had to give a 'blind' overall diagnosis. Six criteria differentiating the 3 samples were identified and the 'blind' overall ratings were compared with the actual diagnosis. The results are discussed with regard to a hypothesis from the literature.

Adult↗
PubMed1990

[Structural analysis of social behavior in training and research. A contribution to the "functional histology" of the psychotherapy process].

To be able to identify qualitative differences in the results of psychotherapeutic activity and to establish a relationship between those results and the particularities of the treatment process involved, the problems of the patient, the relevant events during therapy, and therapeutic results must be interrelatable both terminologically and theoretically (P-T-O congruence; Strupp et al., 1989). If, therefore, the relevant qualities of the relationships involved in interpersonal transactions during the therapeutic process are to be represented adequately and independently of schools, an appropriate instrument is required for both clinical and research use. This instrument is introduced here in the form of the Structural Analysis of Social Behavior (SASB) after Lorna Smith Benjamin by means of the key question: Who acts how toward whom and how does the latter react to this?

Follow-Up Studies↗
PubMed1989

[Markers of schizophrenic language. A comparative patholinguistic study of dialogues with schizophrenic, manic, depressive and brain-damaged patients].

Transcripts of dialogues with patients showing schizophrenic, manic, depressive or organic syndromes, 15 persons in each group, were analyzed in order to determine their degree of cohesion and coherence. The cohesion of a text is defined by the grammatical and lexical relation between its elements. Coherence, however, means that the sequence of sentences appears reasonable in the context of communicative action. There is a significantly higher incidence of incoherences in dialogues with schizophrenic patients than in dialogues with patients who show manic, depressive or organic syndromes. Schizophrenic language is conceived as a disorder in the implicitly dialogical structure of texts. This can be proven by these patients' inability to find communicative solutions for misunderstandings emerging during the interview.

Bipolar Disorder↗
PubMed1989

The epidemiology of psychogenic disorders and consequences for prevention.

After discussing social issues of epidemiologic research on neurotic, character and psychosomatic disorders, we outline the main results of a field cohort study on 600 representative adults of Mannheim, a West German industrial city. According to ICD 300-307 (WHO 8th revision) and to a quantitative case definition clinically based on the severity of the symptoms we find an overall case rate of 26% in which females prevail over men by a ratio of approximately 2:1 and the rate of lower social class members over that of higher ones. We then turned to conclusions of our research for matters of primary and secondary prevention. Concerning primary prevention of psychogenic diseases life circumstances during childhood proved to be relevant as predisposing variables and risk factors often indicating poor emotional relationships between the child and its caretakers. Furthermore, we deal with protective factors preserving mental and physical health in spite of heavy burdens during childhood. Turning to secondary prevention we examine risk factors in present life, the importance of the lay system, and the influence of life events as well as the true demand for psychotherapy.

Adult↗
PubMed1989

Specificity concepts reflected by psychoanalytic epidemiology.

The issue of whether there are specific constellations of intrapsychic conflicts, personality structures and symptom patterns within the general population is investigated by means of a representative epidemiological field cohort study. Out of a population of 600 adults three groups are compared: probands who are suffering from functional cardiac symptoms, those who are suffering from headaches and a sample of 'healthy' probands. The interview protocols of these probands were examined to identify typical conflict patterns. Finally the raters had to give a 'blind' overall diagnosis. Six criteria differentiating the 3 samples were identified and the 'blind' overall ratings were compared with the actual diagnosis. The results are discussed with regard to a hypothesis from the literature.

Adult↗
PubMed1988

[Inpatient psychoanalytic treatment of patients with structural ego disorders].

Psychoneurotic and psychosomatic patients with severe personality disorders suffer from structural defects of their ego-functions and are in need of specific treatment techniques which can be supplied by the differentiated strategies of inpatient psychoanalysis. The experiences of a specific inpatient ward of the Psychosomatic department at the Central Institute of Mental Health in Mannheim are summarized whereby the use of the inward setting to initiate long term psychotherapeutic processes is emphasized. According to an integrative treatment concept various verbal and non-verbal modalities of experience and working through represented by different members of the therapeutic team co-operate within their well defined functions. The main task of the team is to identify the various splitting mechanisms of the patients with personality disorders and to combine all the walled off ways of experiencing and social behavior into a complete picture of his person. To this end close attention is payed to the dynamics within the group of the patients as well as with the group of the therapists. As a precondition the setting of the ward and its rules of conduct for inpatient group life have closely to be watched and the respective behavior of the patients and the team has to be monitored. We describe our setting, the time phases of treatment, the tasks of the different therapists, and explicitely emphasize sociotherapeutic aspects for the final therapy phase. At last, we mention special emotional difficulties waiting for therapists who work in this setting.

Adult↗
PubMed1987

[Inpatient psychoanalytic treatment of sever personality disorders].

Highlighting the development of in-patient psychoanalytical therapy the insufficiency of traditional therapeutical conceptions ("out-patient psychoanalysis in the hospital", "bipolar model of in-patient psychotherapy") in view of increasing numbers of patients with ego-structural disorders in psychosomatoses and borderline pathologies become clear. Their manifold splitting tendencies toward any conceptual distinction of the psychoanalytical session with its transferential processes on the one hand and the "actual" milieu of the ward on the other hand. This fact will be taken into account only by the integrative inpatient psychoanalytical therapy which contrasts the group of patients with the therapeutical team. Only this theoretical constellation may grasp the dynamic processes which the individual patient as well as the whole group of patients but also the individual therapist and his team are undergoing. On this basis interventions will become particularly effective. - The method is illustrated by a description of the setting and a casuistry. A necessary broadening in view of the patients' environment outside the ward and of the bounds of the procedure are described. - Summing up we can say that the integrative inpatient psychoanalytical treatment for the first time provides an approach to the group of severe personality disorders which up to now could not be treated and at best were exposed to an expert rating.

Adult↗
PubMed1987

[Love and partnership in adulthood: a continuation or correction of early childhood experiences? A review of theoretical concepts].

In this survey of literature on the subject, we discuss the question of whether or not and if so to what extent a mature, adult ability to love depends on relevant early experience, or whether it functions as a corrective to unfavorable emotional experience in early childhood. There is no compelling connection between certain disturbances of partner relations and concrete family circumstances in the first years of life. Such disturbances are regarded by traditional psychoanalysis as the result of an unresolved infantile conflict; however, since there is no psychoanalytical interaction theory for the description and explanation of interpersonal phenomena, recent discussions have drawn increasingly on a systematic approach. From a historical point of view, psychoanalytical discussions reflect essential changes in theories about the ability to love. More recent empirical studies point to a possible involvement of corrective and compensatory mechanisms for unfavorable early experiences of a medium degree of seriousness. Nevertheless, warm affection based on needs during the first years of life (at best from loving parents with a partner-oriented relationship) provides a basis for the adult's ability to love and form partnerships.

Adaptation, Psychological↗