Tanja Braungardt

The effects of shift work on physical and mental health

Occupational engagement is a pre-requisite for continuous income opportunities. Among the changing social circumstances work-related conditions play an increasingly eminent role in psychological and mental well-being. The public discusses the question of a possible association between the demands of modern work life and the increases of psychological, psychosomatic and cardiovascular disorders. Given the socioeconomic implications of psychiatric and psychosomatic suffering in the general population, there is a need to further elucidate the causes of their increasing incidence. From a medical point of view, any organization of work disrupting the phased circadian rhythms for bio-psycho-social processes and functioning of the individual are interesting against the background of clock genes and certain biological functions that are organized in a circadian fashion. The authors review the influence of shift work as a form of systematic desynchronization of inner clock systems on the endocrine, the physical, and the mental level. The significance of the findings in the field is discussed along with future directions of conclusive research.

Detachment, Compartmentalization, and Schizophrenia: Linking Dissociation and Psychosis by Subtype

To explain the phenomenological overlap between dissociation and schizophrenia, a dissociative subtype of schizophrenia has been proposed as a possibility. Dissociation is often believed to be organized on a continuum, although 2 qualitatively different phenomena can be distinguished in theory, research, and clinical practice: (a) states of separation from self or environment (detachment dissociation) and (b) inaccessibility of normally accessible mental contents (compartmentalization dissociation). This study used the Positive and Negative Syndrome Scale (PANSS) and the Association for Methodology and Documentation in Psychiatry module for the interview assessment of dissociation to investigate the relationships between PANSS subscales, detachment dissociation, and compartmentalization dissociation in a sample of 72 patients with schizophrenia. A confirmatory factor analysis sustained the bipartite model, yielding factors that grouped dissociative items around amnesia and depersonalization/derealization. The latter factor also contained identity disturbances and was therefore not entirely consistent with the theoretical formulations of detachment dissociation. It is important to note that the structure of those factors may be influenced by the symptoms of schizophrenia to which they were specifically linked: The factor containing depersonalization/derealization was connected to the positive symptoms subscale of the PANSS, whereas the factor containing amnesia was associated with the negative subscale. Hence, a dichotomy of dissociation is confirmed inasmuch as its subtypes are as distinguishable as PANSS subscales. This has implications on theoretical and clinical levels.

Attrition and Outcome in Group Psychotherapy among Traumatized and Non-Traumatized Inpatients

Objective: To examine the impact of correlates of trauma on the appropriateness for group therapy (GT) in 60 participants based on the similarity of the exclusion criteria for GT to the features of posttraumatic disturbances and borderline personality. Method: We assessed the correlates of trauma (PTSD, complex PTSD, dissociation), features of BPD, psychopathological distress and the readiness for GT. Results: There were inverse correlations between the motivation for GT and multiple symptoms, as well as weak associations with the correlates of trauma. Pessimistic expectations of GT and dissociative amnesia were linked to worse outcomes, while phobic anxiety predicted continuation of therapy. Conclusion: Dissociative amnesia and the expectation of GT are potential targets for pre-group preparation for trauma-related disorders.

PSYCHOTHERAPY INTERVENTION FOR FAMILY CAREGIVERS: DOES EARLY INTERVENTION MATTER?

and differences. Results: The participants’ ratings of the effect of the program ranged from no benefit to an improvement of self-efficacy and coping strategies. Some participants found the intervention easy to access, others have had difficulty participating. The rating depended on the actual health status of both the carer and the care recipient and on the anticipated effect of a psychotherapeutical intervention in general. Some participants had initially expected only information and advice for their daily life or someone to talk with. Consequently, they were not open towards active participation, self-reflection and developing strategies to relief the burden of care. More detailed results will be presented at the conference. Conclusions: Our results show a high variability in the valuation of the intervention. Interestingly, participants favour more homogeneity within the psychotherapy group to increase the efficacy of the intervention, whereas from a psychotherapeutical perspective a certain degree of heterogeneity is potentially helpful to advance group processes. Based on the participants’ responses, adaptations of the program should consider a stronger emphasis on the relief of caregiver burden and strengthening coping skills rather than on the care recipient.