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Biomedical subjects

W Tress

Publications and source records attributed to W Tress.

At least 55 records · Page 3Linked to original sources
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↗
PubMed1984

[The Mannheim Cohort Project--prevalence of psychogenic diseases in cities].

For the purpose of our research project the term 'psychogenetic disorders' covers psychoneuroses , character neuroses in a broader sense, and functional-vegetative as well as psychosomatic affections. So far information concerning basic descriptive-epidemiological data, especially the frequency of occurrence and the dependence upon demographic variables of the above mentioned disorders, is insufficient and controversial. Even less satisfactory is our information on the progress of these disorders. The specific difficulty with the diagnostic apperception of these disorders in particular requires field research within the entire population. Only by means of such a very expensive procedure can valid information on the true prevalence or incidence of the above mentioned disorders be obtained. Moreover, for a follow-up design each test subject must be examined several times by highly qualified experts, each examination requiring his personal presence. The "Mannheimer Kohortenprojekt" involves six hundred test subjects, two hundred each born in 1935, 1945, and 1955, selected at random from the 'normal' general population. They were examined with the aid of a structured interview schedule oriented on psychoanalytic principles and with other instruments (lists of complaints, inventories of life events, FPI-tests, etc.). Results from the first three-year investigation period include: Out of the total of six hundred test subjects twenty-five per cent are "cases". Women are significantly in the majority. Apparent is an obvious connection between different types of complaints and the social class of the test subject. Identified disorders show correlations with life events on the one hand and with early childhood disturbances on the other.

Adult↗
PubMed1981

[The psychological consequences of prognathism (author's transl)].

In a prospective study of 54 prognathic patients the psychological effects of this condition, which occurs typically at puberty, were investigated in postoperative follow-up examinations and the psychological effect of a corrective operation investigated. For this purpose standardized questionnaires and a semistructured psychiatric interview were used. The hypothetically expected personality disturbance of a "dysmorphophobia" was found in only some of our patients. With an inconspicuous premorbid personality they reacted to the psychological trauma of their facial deformity with depressive crises of self-assessment in the occupational and private spheres. Here, convincing postoperative improvements occur beside which the "psychological scars" are still recognizable owing to the earlier deformity.

Adult↗
PubMedDate not supplied

Improving screening for mental disorders in the primary care setting by combining the GHQ-12 and SCL-90-R subscales.

Most of patients with mental disorders are cared for in the primary care sector, rather than in the mental health sector. Self-report questionnaires can be used as screening instruments to identify mental disorders in primary care. The 12-item General Health Questionnaire (GHQ-12) is a widely used screening questionnaire for common mental disorders. Unfortunately, the GHQ-12 generates many false presumptive positives and forces the employer to expend resources on confirmatory testing. Therefore, the aim of the present report was to investigate a two-stage questionnaire screening design in a primary care setting. The GHQ-12 was used as an initial screening test followed by the Symptom Checklist (SCL-90-R). A randomly selected sample of adult outpatients (N = 408) from 18 primary care offices was screened using the two questionnaires. A structured diagnostic interview and an impairment rating were used as standards. Subjects were classified into true-positives and false-positives based on their GHQ-12 score and the clinical interview. Logistic regression and receiver operating characteristic analysis were performed to determine whether the SCL-90-R increased accuracy in screening for mental disorders by discriminating between true-positive and false-positive cases. The SCL-90-R subscales Depression, Obsessive-Compulsive, and Somatization were identified as factors associated with the GHQ-12 classification. Therefore, a significant improvement in screening performance of the GHQ-12 is obtained by combination of the test results. The approach may reduce artifact due to high scoring tendencies not associated with psychological disorder.

Adolescent↗