Psychische Erkrankungen in der Lebensspanne ... - DGPPN

Topic 7 G Persönlichkeitsstörungen, F6 // Personality disorders F6
Mittwoch, 25. 11. 2009, 08.30 – 10.00 Uhr, Saal Prag
S-008 Symposium
New developments in Dialectical Behavior Therapy: Applications
across disorders and settings
Vorsitz: M. Bohus (Mannheim), T. Kienast (Berlin)
001
Entwicklung und Evaluation der DBT für komorbide Suchterkrankungen
Thorsten Kienast (PUK Charité im SHK, Berlin)
002
Dialectical Behavior Therapy for Eating Disorders (DBT-E). Rationales
and Development of a Treatment Manual.
Ulrich Schweiger (Universität zu Lübeck, Psychiatrie und Psychotherapie)
K. Heinecke, V. Sipos
Dialectical behavior therapy (DBT) is one of the important methodological
developments within cognitive-behavioral therapy and
has been shown to be highly effective in patients with borderline
personality disorder and severe behavioral dysregulation. The application
of the method is now extended to other mental disorders.
The central assumption for the application of DBT to eating disorders
is that disturbed eating behavior is a natural consequence of
adverse life events and traumatization, and that difficulties with
emotion regulation are at the center of the maintenance of the eating
disorder. DBT-E adapts core strategies of DBT (practicing
mindfulness skills, distress tolerance skills, emotion regulation
skills and interpersonal skills) to the special needs of patients with
eating disorders. The presentation gives an overview on the state of
manual development and presents first results.
003
Evaluation der DBT im Kinder- und Jugendbereich
Kristin von Auer (Vorwerker Diakonie, Lübeck)
004
DBT für PTBS und schwere Störungen der Emotionsregulation
Martin Bohus (ZI Mannheim, Psychosomatik)
Mittwoch, 25. 11. 2009, 08.30 – 10.00 Uhr, Raum 43
S-017 Symposium
Shame and mental disorders
Vorsitz: C. Scheel (Freiburg), B. Renneberg (Berlin)
001
The construct of shame: development and validation of a questionnaire
on three facets of shame
Corinna Scheel (Uniklinik Freiburg, Psychiatrie und Psychotherapie)
Introduction: Shame proneness of course differs individually, but
some mental disorders, such as Borderline Personality Disorder
(BPD), seem to go along with systematically higher shame-proneness.
Based on the meaning of shame on different mental disorders a
questionnaire was constructed to make several facets of shame
measurable.
Method: Affiliated from literature and interviews with healthy controls
and BPD patients a concept of shame was created. Re cording
to this three subscales were operationalized; body related shame,
cognitive shame and existential shame. This structure of factors was
supported by item-analysis. At the moment the revised questionnaire
is validated on a sample from the registration of address office
(2000 addresses) and several clinical groups.
Discussion / Results: As expected we seem to find more body related
and cognitive shame in the control group, existential shame is
increased for BPD.
002
Shame and social rejection in borderline personality disorder
Babette Renneberg (FU Berlin, Klinische Psychologie)
Introduction: Shame plays an important role in the development
and maintenance of borderline personality disorder. In self-reports,
patients with BPD consistently show very high levels of shame.
However, research on the nonverbal expression of shame is largely
lacking. Aims of the study were twofold: a) to develop an instrument
for the assessment of nonverbal shame expressions and b) to
investigate the nonverbal shame reactions in an experimentally
induced situation of social exclusion.
Method: Based on the emotional facial action coding system
(EMFACS), a coding system for nonverbal reactions of shame was
developed and used to analyse n=49 videotapes of BPD patients
and control participants playing Cyberball, a virtual ball tossing
game to experimentally induce social exclusion.
Discussion / Results: The coding system will be presented and described.
Patients with BPD tended to show more nonverbal shame
reactions than healthy controls. The potential and the limitations of
the nonverbal assessment of shame will be discussed.
003
Shame-prone self-concept in Narcissistic Personality Disorder
Kathrin Ritter (Charité Berlin)
A. Vater, A. Schütz, T. Fydrich, C.-H. Lammers, S. Roepke
Introduction: Shame is considered to be a central emotion in narcissistic
personality disorder (NPD). However, shame-proneness in
NPD is based solely on clinical observation. Its level and impact on
NPD are largely unknown, and empirical evaluation is scarce. The
aim of this study was to empirically assess shame in patients with
NPD.
Method: Fifty-eight patients with NPD and 34 healthy controls
were included in the study. Thirty-one patients with borderline personality
disorder (BPD) served as the clinical comparison group.
Implicit shame-related self-concept (relative to anxiety) was assessed
by the Implicit Association Test (IAT). Participants completed
self-rating (explicit) measures of shame- and guilt-proneness,
state shame, state anxiety, state and trait anger, self-esteem, selfconcept
clarity, and clinical symptoms.
Discussion / Results: The implicit self-concept (IAT) was more
shame-prone (relative to anxiety-prone) in NPD than in healthy
comparison subjects and patients with BPD. Individuals with NPD
reported higher levels of shame-proneness, state shame, and anxiety
than healthy controls, but lower levels on self-rated (explicit)
shame measures than patients with BPD. NPD patients displayed
higher scores on implicit shame compared to BPD patients, whereas
explicit shame measures were lower in NPD patients compared
to BPD patients. These discrepancies and clinical implications for
psychotherapeutic approaches will be discussed.
004
Implicit shame and perceived legitimacy of discrimination: A longitudinal
study among people with mental illness
Nicolas Rüsch (Uniklinik Freiburg, Psychiatrie und Psychotherapie)
Introduction: Perceived legitimacy of discrimination is a key determinant
of personal reactions to mental illness stigma among
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