Universität Konstanz

Background: A comorbidity between Borderline Personality Disorder (BPD) and Posttraumatic Stress Disorder (PTSD) is common, severely disabling, and hard to treat. The choice of an optimal psychotherapy based on patient characteristics remains challenging.Objective: This study develops models to predict the outcome of two psychotherapies for comorbid BPD and PTSD.Method: Data from two trials comparing Narrative Exposure Therapy (NET, N = 40) with Dialectical Behavior Therapy-based treatment (DBT-bt, N = 40) was analysed. A cross-validated genetic algorithm was used to detect baseline predictors of change in PTSD symptoms.Results: In the NET group higher education, more baseline PTSD symptoms, more traumatic experiences, fewer baseline BPD symptoms, and not taking antipsychotic medication predicted better treatment outcome. This model (RMSE = 8.98) outperformed the prediction of PTSD symptom reduction with baseline PTSD symptoms alone (RMSE = 10.07) or with all available predictor variables (RMSE = 12.97). Only more baseline PTSD symptoms were selected to predict a better treatment outcome after DBT-bt. This model (RMSE = 9.41) outperformed the prediction of change in PTSD symptoms with all available predictor variables (RMSE = 14.43).Conclusion: Differences in treatment outcome between NET and DBT-bt may be predictable at baseline, to identify which one of both treatments may be most beneficial for individual patients. The small sample size may restrict the generalizability of the results.

Situations characterized by uncontrollability and critical social evaluation frustrate basic psychological needs, as outlined in Self-Determination Theory (SDT). Uncontrollability and social evaluation are central elements of the Trier Social Stress Test (TSST), leading to the hypothesis that the TSST, in addition to increasing self-reported stress and cortisol responses, also frustrates the needs for autonomy, competence, and social relatedness. Participants (N = 195) reported elevated stress and reduced need satisfaction, and increased cortisol responses during the TSST. The roles of assessed physical activity and experimentally-induced social support were also examined. Indeed, in time-sensitive and specific manner, the TSST frustrated basic psychological needs. Social support however mitigated frustration of social relatedness. Physical activity buffered against self-reported stress, the frustration of competence and the cortisol response. Further research is recommended to explore more differentiated interventions that can counteract the negative effects of psychosocial stressors.

Apraxia typically involves impairments in gesture production and tool use, affecting daily life activities. This article reviews current conceptualizations and developments in diagnostic and therapy.

Apraxia has been studied in various neurological conditions, particularly stroke and dementia, but recent studies show gesturing deficits in psychiatric populations as well. Promising results have emerged from integrative treatment approaches involving intensive practice of gestures or daily activities. However, several reviews have noted the only marginal progress in apraxia therapy research despite new technologies, like virtual reality and brain stimulation, offering fresh opportunities for assessment and therapy.

Advances in lesion-symptom mapping and connectivity analyses led to more detailed neuroanatomical models emphasizing parallel and gradual processing. These models facilitate the understanding of underlying mechanisms of motor cognitive performance and its decline. Finally, the digital era prompts the need to study digital tool use in apraxia, with initial efforts underway.