Læknablaðið : fylgirit - 01.08.2003, Blaðsíða 13

ABSTRACTS / 27TH NORDIC PSYCHIATRIC CONGRESS I
to account for only a relatively small amount of outcome variance.
Nevertheless, environmental factors account for about 50% of the
variability in borderline features. It is suggested that environmental
factors primarily modulate the way genetic predispositions are
expressed. Particularly important are the effects of adversity on the
expression of the affective traits that form the core component of
borderline pathology. Psychosocial adversity appears to amplify the
expression of genetic predispositions towards anxiousness and
affective lability and hinder the acquisition of affect regulating
strategies and skills. This view of the etiology and pathogenesis of
borderline personality disorder suggests the importance of a treat-
ment approach using biological and psychological interventions
targeted initially towards improving affective and impulse regula-
tion, and subsequently on facilitating the acquisition of more effec-
tive interpersonal skills.
ri “ D Friday 15/8, 10:00-10:30
New perspectives in depression
Lars von Knorring. Professor, MD, PhD, Dept. of Neuroscience, Psychiatry University
nospital, Uppsala University, SE-751 85 Uppsala, Sweden
Although the depressive disorders have been well known since the
time of Hippocrates, there are still successive changes in our view of
the depressive disorders. Today it is well established that depressive
disorders are the most expensive disorders to society, at least in the
industrialised world. It is also clear that the prevalence is increasing
and at present the lifetime risk of depressive disorders seems to be
-3 /o in men and 45% in women. Furthermore, the age of onset is
gradually decreasing and depressive disorders are now found in
around 5 /0 of teenage girls. We are also increasingly aware that
depressive disorders are serious, life-threatening disorders. There is
a high comorbidity between somatic and depressive disorders. The
mortality is increased almost 20 times in suicides, almost 10 times in
infectious disorders, almost twice in respiratory disorders, and
around 15% in circulatory disorders. The complex immunological
and metabolic changes occurring during depressive episodes are
better elucidated.
Effective antidepressant treatments have been known for many
decades. We now have effective psychotherapeutic treatments such
as cognitive psychotherapy and interpersonal psychotherapy as
well as effective biological treatments, including ECT, TCA, and
SSRI. As a result of the more available and more effective treat-
ments, it seems that suicide rate is decreasing. It seems likely that in
the near future new treatment strategies will become available,
probably including CRH blockers and substance P antagonists.
' Saturday 16/8,10:00-10:30
The psychology of false confessions
Gísli H. Guðjónsson. Department of Psychology, Institute of Psychiatry, De Crespigny
Park Denmark Hill, London SE5 8AF, England
sPJtghg@iop. kcl. ac. uk
The focus of this paper is on false confessions within the context of
police interviewing. There is growing evidence that false confes-
sions, even to serious crimes such as murder, do occur on occasions.
No judicial system should ignore this reality and take steps to
prevent and deal satisfactorily with false confessions, whether given
voluntarily for some instrumenta! gains (e.g. to protect a peer, to
seek notoriety, inability to distinguish facts from fantasy) or coerced
by police (e.g. coercive interview tactics, threat or fear of deten-
tion). There are different ways of conceptualising false confessions.
Munsterberg (1908) construed false confessions as arising out of
unusual circumstances, whereas Kassin and Wrightsman (1985),
Ofshe and Leo (1997) and Gudjonsson (2003) argue that false con-
fessions are associated with distinct psychological types, such as:
Voluntary, Pressured-compliant, and pressured-internalised. Each
type has a distinctive set of antecedents, conditions and psycho-
logical consequences. In recent years much research has been
carried out into these three groups of false confessions. The re-
search demonstrates the importance of considering a combination
of custodial, situational, vulnerability, and support factors. What is
clear is that false confessions occur largely in absence of mental
illness. Personality factors, such as anxietv proneness, suggestibility,
compliance, and on occasions antisocial personality traits, are often
found to be present and of importance.
Reference
Guðjónsson GH (2003). The psychology of interrogations and confessions. A
handbook. Chichester: John Wiley & Sons.
Pl — 8 Saturday 16/8, 10:30-11:00
Mental health promotion
Ville Lehtinen. Research Professor, National Research and Development Centre for
Welfare and Health STAKES, Kanervatie 18, FIN-20540 TURKU, Finland
ville.lehtinen@stakes. fi
Mental health promotion uses a broad concept of mental health,
including not only a negative but also a positive dimension. Mental
health promotion works mainly by tackling the different compo-
nents and determinants of positive mental health, which can be
grouped into: 1) individual biological and psychological factors, 2)
social interactions, 3) societal structures and resources, and 4) cul-
tural values. Mental health promotion uses different entry points,
operates on different levels, in different settings and with different
methods of action. Increasing amount of evidence exists about the
effectiveness of mental health promotion activities. Elements of
successful mental health promotion programmes include: 1) appro-
priate theoretical base and needs/context assessment in programme
development, 2) targeting appropriate determinants, using a multi-
professional and multi-dimension approach and considering cul-
tural context as its characteristics and 3) using appropriate training
and supervision, manuals and programme fidelity in its implemen-
tation. Some examples of effective promotive interventions will be
presented.
LÆKNABLAÐIÐ / FYLGIRIT 48 2003/89 13