Harald Dressing

Universität Heidelberg, Heidelburg, Baden-Württemberg, Germany

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Publications (98)158.45 Total impact

  • Dreßing H., Bumb J.M., Whittaker C.
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    ABSTRACT: Mit einer Lebenszeitprävalenz von etwa 11 % ist Stalking ein weit verbreitetes Phänomen. Fachleute unterschiedlicher Disziplinen müssen sich zunehmend mit der Risikoeinschätzung und Therapie von Stalkern beschäftigen. Wie wichtig es ist, dieser Aufgabe sorgfältig und mit der nötigen Kompetenz nachzugehen, wird durch tragische Tötungsdelikte verdeutlicht, denen Stalking vorausging. Die deutsche Übersetzung des Stalking Risk Profile bietet eine praxisnahe, wissenschaftlich fundierte dynamische Risikoeinschätzung und vermittelt praxisorientierte Vorschläge für Therapie- und Managementstrategien. In einem umfassenden Einleitungskapitel werden die für die Interventionsstrategien relevanten rechtlichen Rahmenbedingungen in Deutschland dargestellt.
    11/2014; Kohlhammer., ISBN: 3170230638
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    ABSTRACT: The assessment of legal capacity and testamentary capacity require thorough knowledge of the legal framework and the relevant case law. This paper explains the concept of the legal capacity to contract and the concept of testamentary capacity with respect to German civil law. The relevance of major mental disorders for the assessment of legal capacity and testamentary capacity is discussed.
    Der Nervenarzt 09/2014; DOI:10.1007/s00115-014-4138-z · 0.86 Impact Factor
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    Jan Malte Bumb, Klaus Förster, Harald Dressing
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    ABSTRACT: Objectives: Highlighting practical implications and research aspects of forensic-psychiatric assessments in the context of the new law on strengthening the rights of victims of sexual abuse. Methods: Based on a clinical case we report implications for the forensic-psychiatric assessment. Results: The new law now requires an expert to evaluate the necessity and the subject's motivation to receive a given treatment. Up to now, the majority of sexual offenders were assumed to be responsible for their actions and in most cases a forensic-psychiatric assessment was not required. For this reason, guidelines for forensic-psychiatric assessments are urgently needed. Conclusion: The number of forensic-psychiatric assessments is likely to increase substantially and a relevant-case law is still lacking.
    Psychiatrische Praxis 07/2014; 41(05):274-277. DOI:10.1055/s-0034-1370001 · 1.64 Impact Factor
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    ABSTRACT: Objectives. Psychopathy is characterized by severe deficits in emotion processing and empathy. These emotional deficits might not only affect the feeling of own emotions, but also the understanding of others' emotional and mental states. The present study aims on identifying the neurobiological correlates of social-cognitive related alterations in psychopathy. Methods. We applied a social-cognitive paradigm for the investigation of face processing, emotion recognition, and affective Theory of Mind (ToM) to 11 imprisoned psychopaths and 18 healthy controls. Functional magnetic resonance imaging was used to measure task-related brain activation. Results. While showing no overall behavioural deficit, psychopathy was associated with altered brain activation. Psychopaths had reduced fusiform activation related to face processing. Related to affective ToM, psychopaths had hypoactivation in amygdala, inferior prefrontal gyrus and superior temporal sulcus, areas associated with embodied simulation of emotions and intentions. Furthermore, psychopaths lacked connectivity between superior temporal sulcus and amygdala during affective ToM. Conclusions. These results replicate findings of alterations in basal face processing in psychopathy. In addition, they provide evidence for reduced embodied simulation in psychopathy in concert with a lack of communication between motor areas and amygdala which might provide the neural substrate of reduced feeling with others during social cognition.
    The World Journal of Biological Psychiatry 05/2014; 15(6). DOI:10.3109/15622975.2014.902541 · 3.57 Impact Factor
  • H Dressing, K Foerster
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    ABSTRACT: The assessment of trauma-related disorders is becoming increasingly more important in forensic psychiatric expert opinions. The most important diagnosis in this context is posttraumatic stress disorder. The essential diagnostic criteria of this disorder are outlined. Differential diagnostic considerations are often necessary with respect to less specific symptom complexes, such as the complex posttraumatic stress disorder or diagnoses which as a rule cannot etiologically be causally associated with trauma alone, such as depression or anxiety disorders. Furthermore, the significance of symptom validity tests is critically discussed. Test results have to be considered carefully in the medicolegal context and require a thorough clinical assessment.
    Der Nervenarzt 02/2014; 85(3). DOI:10.1007/s00115-013-3903-8 · 0.86 Impact Factor
  • H Dreßing
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    ABSTRACT: Stalking is a widespread phenomenon describing a pattern of intrusive and threatening behavior that leads to the victim's perception of being harassed, threatened and frightened. Physical assault and even homicide may sometimes occur in the context of stalking. For psychiatry the following tasks result: (1) diagnosis and classification of stalking cases, (2) risk assessment of stalking cases, (3) counselling and treatment of victims of stalking and, (4) treatment and assessment of stalkers. Empirical findings and instructions are presented for these four areas.
    Der Nervenarzt 10/2013; 84(11). DOI:10.1007/s00115-013-3881-x · 0.86 Impact Factor
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    ABSTRACT: Abstract The aim of this study was to determine the prevalence of cyberstalking victimization, characteristics of victims and offenders, and the impact of cyberstalking on the victims' well-being and mental health. An online survey of 6,379 participants was carried out, involving users of the German social network StudiVZ. Subjective mental health status was assessed with the WHO-5 well-being index. The prevalence of cyberstalking was estimated at 6.3%. In various aspects, cyberstalking was comparable to offline stalking: cyberstalking occurred most often in the context of ex-partner relationships; most of the victims were female and the majority of the perpetrators were male. Compared to non-victims, victims of cyberstalking scored significantly poorer on the WHO-5 well-being index. The prevalence of cyberstalking is considerable. However, if stringent definition criteria comparable to those of offline stalking are applied, it is not a mass phenomenon. The negative impact of cyberstalking on the victims' well-being appears similar to that of offline stalking. Hence, cyberstalking should be taken as seriously as offline variants of stalking by legal authorities and victim assistance professionals.
    Cyberpsychology, Behavior, and Social Networking 10/2013; 17(2). DOI:10.1089/cyber.2012.0231 · 2.41 Impact Factor
  • Klaus Foerster, Harald Dressing
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    ABSTRACT: Sozialrechtliche Begutachtungen sind außerordentlich häufig. Dabei dient das psychiatrische Gutachten dem Auftraggeber häufig als maßgebliche Grundlage der Entscheidung über die beantragte Sozialleistung. Die Bedeutung der sozialrechtlichen Begutachtung für die Betroffenen und für die Gesellschaft ist erheblich, und der psychiatrische Sachverständige trägt eine hohe Verantwortung. Um dieser Verantwortung gerecht werden zu können, muss der psychiatrische Sachverständige über Expertenwissen sowohl bezüglich der aktuellen wissenschaftlichen Diskussion seines Faches als auch die einzelnen Sozialrechtsbereiche und ihre unterschiedlichen Probleme betreffend verfügen. Im vorliegenden Beitrag werden Ablauf und Gestaltung der Begutachtung dargestellt. Das Problem der „zumutbaren Willensanspannung“ wird ebenso erörtert wie die Problematik vorgetäuschter Beschwerden. Die wichtigsten sozialrechtlichen Bereiche werden skizziert. Abstract Expert opinions in social law are extraordinarily frequent. The expert opinion is the decisive basis for a decision whether a social benefit has to be granted. The importance of social legal assessment for those affected and for society in general is substantial and psychiatric experts carry a high responsibility for the expert opinions in social law. In order to be able to justify this responsibility, psychiatric experts must possess expert knowledge with respect to the current scientific debate in the respective field as well as the individual fields of social law and the various problems associated with them. This article describes the examination and structure of expert opinions. The problem of the so-called critical examination of the will and the problem of malingering are discussed. The important fields in social law are described.
    Forensische Psychiatrie Psychologie Kriminologie 02/2013; 8(1):17-25. DOI:10.1007/s11757-013-0246-z
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    ABSTRACT: Background The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients. However, the effectiveness of such interventions in terms of more robust criteria (e.g., admission rates) has not been sufficiently analysed in larger study samples. The current study aims to evaluate an intervention programme for patients at high risk of compulsory admission to psychiatric hospitals. Effectiveness will be assessed in terms of a reduced number of psychiatric hospitalisations and days of inpatient care in connection with involuntary psychiatric admissions as well as in terms of cost-containment in inpatient mental health care. The intervention furthermore intends to reduce the degree of patients’ perceived coercion and to increase patient satisfaction, their quality of life and empowerment. Methods/Design This paper describes the design of a randomised controlled intervention study conducted currently at four psychiatric hospitals in the Canton of Zurich. The intervention programme consists of individualised psycho-education focusing on behaviours prior to and during illness-related crisis, the distribution of a crisis card and, after inpatient admission, a 24-month preventive monitoring of individual risk factors for compulsory re-admission to hospital. All measures are provided by a mental health care worker who maintains permanent contact to the patient over the course of the study. In order to prove its effectiveness the intervention programme will be compared with standard care procedures (control group). 200 patients each will be assigned to the intervention group or to the control group. Detailed follow-up assessments of service use, psychopathology and patient perceptions are scheduled 12 and 24 months after discharge. Discussion Innovative interventions have to be established to prevent patients with mental disorders from undergoing the experience of compulsory admission and, with regard to society as a whole, to reduce the costs of health care (and detention). The current study will allow for a prospective analysis of the effectiveness of an intervention programme, providing insight into processes and factors that determine involuntary placement. Trial registration Current Controlled Trials ISRCTN63162737.
    BMC Psychiatry 09/2012; 12(1):136. DOI:10.1186/1471-244X-12-136 · 2.24 Impact Factor
    This article is viewable in ResearchGate's enriched format
  • Hans Joachim SALIZE, Harald DRESSING
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    ABSTRACT: Alongside great advantages, the shift from hospital based to community mental health care has also caused problems, e.g. a high frequency of involuntary re-admissions to psychiatric hospitals. To analyse whether or not the process of deinstitutionalisation in general psychiatry might have gone too far, studies are needed that cover general psychiatry, forensic psychiatry, and penitentiaries and analyse the interdependencies among these sectors. We combined epidemiological and service utilization data from three recent European studies that explored legal frameworks and practices of involuntary treatment in general mental health care, the care of mentally disordered offenders in forensic care and the care of mentally ill inmates in the European prison systems. Time series from several European Union Member States suggest that intrastate civil detention rates remained more or less stable during the 1990s, although on varying levels across countries. Admissions to forensic psychiatric facilities have increased during the same period. Data on the mental state (or on rates of psychiatric morbidity) in European prison populations are hardly available – aside from the prison suicide rate. Cross-sectional data from selected countries suggest that changes to the legal framework in one sector may considerably affect admission rates in others. Better national data-bases and more international studies are needed to analyse the linkage between sectors and to identify inappropriate detention or patient shifting, as pathways to these sectors are strongly affected by legislation and the overall frameworks of national health care and criminal justice systems.
    Second ISA Forum of Sociology 2012; 08/2012
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    ABSTRACT: Adult ADHD is characterised by a plethora of comorbid conditions. However, the comorbidity of schizophrenia and ADHD does not seem to be a typical feature and is therefore under-researched. To identify adult patients with schizophrenia and comorbid ADHD and compare their symptomatology with schizophrenic patients without ADHD. Performance in specific neuropsychological tests (set shifting, selective and sustained attention, cognitive performance, and speed of information processing) was determined. Additionally, important demographic data and information about the patients' history such as the number of suicide attempts were gathered. Twenty-seven patients were involved in this study (14 male and 13 female). Fifteen patients were diagnosed with schizophrenia/no ADHD and twelve had both schizophrenia/ADHD. We report here an increase in suicidal behaviour of patients with both schizophrenia and ADHD compared to schizophrenia only. A significant underperformance of the patients with ADHD comorbidity compared to patients with schizophrenia only was also determined. The increased suicidal behaviour in patients with schizophrenia and ADHD suggests the need of further studies on mood regulation and suicidal ideations in these patients.
    The World Journal of Biological Psychiatry 09/2011; 12 Suppl 1:52-6. DOI:10.3109/15622975.2011.599212 · 3.57 Impact Factor
  • Christine Kuehner, Peter Gass, Harald Dressing
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    ABSTRACT: Studies suggest that stalking victimization may have a serious mental health impact. The present article investigates gender differences in mental health and possible mediating effects of stalking victimization in a community sample. The study includes a postal survey of 665 German community residents on the experience of stalking and various mental health indicators. In a majority of mental health scales, women score poorer than men, and a higher percentage of women fulfill criteria for a current mental disorder and used psychotropic medication. However, effects of gender decrease to a nonsignificant level when stalking victimization is entered into the respective models. Furthermore, associations of stalking victimization with poor mental health, psychosocial functioning, and use of medication are largely comparable across gender.
    Journal of Interpersonal Violence 08/2011; 27(2):199-221. DOI:10.1177/0886260511416473 · 1.64 Impact Factor
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    ABSTRACT: The present study was designed to investigate prevalence and types of cyberstalking and its impact on mental health. Internet survey of 6379 participants in the Web-based social network Studi-VZ. The prevalence of cyberstalking was 6.3 %. Cyberstalking appears to be a frequently occurring phenomenon. Contrary to earlier assumptions, not based on empirical studies, there are striking similarities of cyberstalking and stalking in the real world. The gender distribution is comparable to real life stalking: Most of the victims are female and most of the perpetrators are male. Like other forms of stalking in the real world, cyberstalking occurs most often in the context of ex-partner relationships and contacts with friends, acquaintances and work colleagues. Compared to non-victims, victims of cyberstalking scored significantly poorer on the WHO-5 well-being index. Due to the increasing use of web-based social networks psychiatrists and psychotherapists have to become experts in the issue of cyberstalking since victims will frequently ask them for help. As cyberstalking does not appear to be a separate diagnostic entity, similar counselling techniques that are applied for other forms of stalking should be provided.
    Psychiatrische Praxis 08/2011; 38(7):336-41. DOI:10.1055/s-0031-1276860 · 1.64 Impact Factor
  • Harald Dressing, Klaus Foerster, Peter Gass
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    ABSTRACT: Although stalking is a widespread phenomenon that can be caused by different motives, consideration of the psychopathological underpinnings of stalking behaviour is scarce. In rare cases, stalking can be an expression of mental disorder. Psychotic stalking, for example, can occur as a symptom of schizophrenia or erotomania. Psychotic stalkers are criminally not responsible for their acts and have to be treated in a psychiatric hospital. The majority of stalkers, however, do not suffer from a disorder in need of treatment, and therefore their criminal responsibility is not diminished. Although legislative approaches to protecting victims of stalking differ widely in the European Union, mentally not severely disturbed stalkers can be prosecuted and punished according to criminal law in most countries. In some cases, the differentiation between mentally sane and mentally disturbed stalkers is difficult. This paper focuses on the psychopathology of such 'borderline cases', using the example of a court decision in Germany.
    Psychopathology 06/2011; 44(5):277-82. DOI:10.1159/000325060 · 1.56 Impact Factor
  • H Dressing, B Widder, K Foerster
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    ABSTRACT: Neuropsychological symptom validity testing is increasingly used even in psychiatric expert assessment. Low scores on symptom validity tests can only demonstrate exaggerated symptoms. However, symptom validity tests do not address the question of whether the result is intentionally produced or motivated by internal incentives. Therefore, symptom validity tests cannot differentiate between malingering and somatoform disorder. Test results have to be considered carefully in the medicolegal context and require thorough clinical assessment.
    Versicherungsmedizin / herausgegeben von Verband der Lebensversicherungs-Unternehmen e.V. und Verband der Privaten Krankenversicherung e.V 12/2010; 62(4):163-7.
  • K. Foerster, H. Dreßing
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    ABSTRACT: Bei der Einschätzung von „Willensanspannung“ und „Zumutbarkeit“ im Rahmen der sozialmedizinischen Beurteilung geht es nicht um abstrakte oder philosophische Erörterungen, sondern um die empirische Erfassung konkreter psychopathologischer und/oder körperlich-funktioneller Symptome und deren Relevanz für die Erwerbsfähigkeit. Für den Umgang mit diesen komplexen Begriffen wird als psychiatrischer Lösungsvorschlag ein mehrschrittiges Vorgehen bei der Begutachtung vorgeschlagen. The assessment of „effort of will“ and „reasonableness“ in the social medical expert opinion needs the empirical recording of concrete psychopathological and/or physical symptoms and its connection to fitness for work. The discussion of abstract, philosophical problems is not necessary. From the psychiatric point of view, a proposal for handling these complex terms is presented. The expert assessment should be carried out in several steps. SchlüsselwörterSozialmedizinische Beurteilung-Willensanspannung-Neurotische Störungen-Zumutbarkeit-Mehrschrittiger Ablauf der Begutachtung KeywordsAssessment in social medicine-Effort of will-Neurotic disorder-Reasonableness-Course of the expert assessment in several steps
    Der Nervenarzt 09/2010; 81(9):1092-1096. DOI:10.1007/s00115-010-2990-z · 0.86 Impact Factor
  • Harald Dressing, Peter Gass
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    ABSTRACT: Study of the lifetime prevalence of stalking and types of stalking in a sample of psychiatric inpatients. A total of 300 patients consecutively admitted to the psychiatric hospital of the Central Institute of Mental Health (Zentralinstitut für Seelische Gesundheit) in Mannheim were studied by means of the Stalking Behaviour Questionnaire (Stalking-Verhaltens-Fragebogen). Of the sample, 21% at some time in their lives had been the victim of stalking. Men were affected as often as women were. The course of stalking was more difficult and more violent in this sample than in a sample taken from the general population in Mannheim. In the majority of the cases the mental disorder had manifested itself before the first stalking incident. In only four out of 64 cases did the responsible physicians know of the previous or ongoing stalking victimization of their patients. Mentally ill individuals are more often affected by stalking than the general population. The topic of stalking should thus be addressed more frequently when taking the case histories of mentally ill patients, in order to provide them with the appropriate type of medical care and support.
    Australian and New Zealand Journal of Psychiatry 08/2010; 44(8):736-41. DOI:10.3109/00048671003742543 · 3.77 Impact Factor
  • H Dressing, K Foerster
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    ABSTRACT: There is a high prevalence of post-traumatic stress disorder in community-based samples.Therefore, psychiatric assessment and expert opinion are often required. Professional standards for psychiatric expert opinion in the assessment of post-traumatic stress disorder are outlined. The significance of symptom validity tests is critically discussed. Test results have to be considered carefully in the medicolegal context and require thorough clinical assessment.
    Fortschritte der Neurologie · Psychiatrie 08/2010; 78(8):475-8. · 0.85 Impact Factor
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    ABSTRACT: Treatment resistance in schizophrenia often leads to add-on of atypical antipsychotics to clozapine. In a randomized trial, we recently obtained evidence for comparable efficacy and differential side effects of clozapine in combination with ziprasidone (CZ, N=12) versus risperidone (CR, N=12). Here, we present the open-label, long-term evaluations of these patients after 26 and 52 weeks. Sustained improvements of psychopathology as assessed by PANSS (positive and negative syndrome scale), SANS (scale for the assessment of negative symptoms), and HAMD (Hamilton depression scale) were documented in both subsamples being treated according to protocol, while dropouts reduced the study sample after 26 (CZ: reduced by -4; CR: -2) and 52 weeks (CZ: -0; CR: -5). We observed a slight increase of akathisia in the CZ group whereas general clozapine-associated side effects improved. The combinations of clozapine with ziprasidone or risperidone exhibit long-term efficacy, but the level of evidence is limited. Further head-to-head comparisons of atypical antipsychotics as add-on to clozapine are necessary.
    Pharmacopsychiatry 08/2010; 43(6):216-20. DOI:10.1055/s-0030-1254089 · 2.17 Impact Factor
  • Harald Dressing, Klaus Foerster
    Forensische Psychiatrie Psychologie Kriminologie 08/2010; 4(3):155-159.

Publication Stats

778 Citations
158.45 Total Impact Points

Institutions

  • 2005–2014
    • Universität Heidelberg
      • Central Institute of Mental Health
      Heidelburg, Baden-Württemberg, Germany
  • 2004–2013
    • Central Institute of Mental Health
      • Klinik für Abhängiges Verhalten und Suchtmedizin
      Mannheim, Baden-Württemberg, Germany
  • 2010
    • University of Tuebingen
      • Department of Psychiatry and Psychotherapy
      Tübingen, Baden-Wuerttemberg, Germany
  • 2006
    • Gesellschaft für wissenschaftliche Datenverarbeitung mbH Göttingen
      Göttingen, Lower Saxony, Germany