Harald Dressing

Universität Heidelberg, Heidelburg, Baden-Württemberg, Germany

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Publications (128)202.94 Total impact

  • J M Bumb · M Schredl · H Dreßing
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    ABSTRACT: Parasomnias represent a category of disorders that involve complex behaviors or emotional experiences, arising from or occurring during sleep, which might be also associated with (incomplete) awakening. These phenomena are classified as REM- or Non-REM-parasomnias. In particular the latter, including confusional arousal, sleepwalking and sleep terrors but also REM-sleep behavior disorder might result in criminal consequences. Using polysomnography, the pathophysiological mechanisms of these disorders have been investigated thoroughly. Nevertheless, in German literature, forensic implications of complex behaviors arising from sleep disorders have only been described insufficiently. Here we describe the most relevant parasomnias and also how to proceed in the context of forensic assessments.
    No preview · Article · Dec 2015 · Fortschritte der Neurologie · Psychiatrie
  • H. Dreßing · K. Foerster
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    ABSTRACT: The assessment of trauma-related disorders is increasingly important in forensic psychiatric expert opinion. The most important diagnosis in this context is posttraumatic stress disorder. Diagnostic criteria of this disorder are outlined. Differential diagnostic considerations with regard to less specific symptom complexes, such as the complex posttraumatic stress disorder are discussed. Furthermore 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.
    No preview · Article · Oct 2015 · Fortschritte der Neurologie · Psychiatrie
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    Johannes Fuss · Harald Dressing · Peer Briken
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    ABSTRACT: Background Prominent court decisions and recent research suggest that introduction of neurogenetic evidence, for example, monoamine oxidase A alleles, may reduce the sentence of convicted psychopaths. Here, we are aiming to demonstrate that judges’ response to neurogenetic evidence is highly influenced by the legal system in which they operate. Methods Participating German judges (n=372) received a hypothetical case vignette of aggravated battery, and were randomly assigned to expert testimonies that either involved a neurogenetic explanation of the offender’s psychopathy or only a psychiatric diagnosis of psychopathy. Testimonies were presented either by the prosecution or defence. Results Neurogenetic evidence significantly reduced judges’ estimation of legal responsibility of the convict. Nevertheless, the average prison sentence was not affected in the German legal system. Most interestingly, analysis of judges’ reasoning revealed that neurogenetic arguments presented by the prosecution significantly increased the number of judges (23% compared with ∼6%) ordering an involuntary commitment in a forensic psychiatric hospital. Such an involuntary commitment due to diminished or absent legal responsibility may last much longer than a prison sentence in the German legal system. Conclusions Our data, thus, demonstrate the socially contingent nature of legal responses to neurogenetic evidence in criminal cases.
    Full-text · Article · Aug 2015 · Journal of Medical Genetics
  • W Gronau · A Meyer-Lindenberg · H Dreßing
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    ABSTRACT: Assessment of trauma disorders is becoming increasingly important. A major problem here is that trauma disorders are extremely heterogeneous. Moreover, they are often associated with comorbid disorders, such as borderline personality disorder. The valid diagnostic systems ICD-10 and DSM-5 poorly represent trauma disorders. The so-called complex post-traumatic stress disorder or DESNOS (disorders of extreme stress not otherwise specified) are listed .in either of the ICD-10 or DSM-5. The distinctiveness is not generally scientifically accepted. In addition, the assessment of trauma disorders is complicated because there are often multiple traumas of varying degrees of severity.
    No preview · Article · Mar 2015 · Versicherungsmedizin / herausgegeben von Verband der Lebensversicherungs-Unternehmen e.V. und Verband der Privaten Krankenversicherung e.V
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    ABSTRACT: The aim of the research project is to bring transparency in the causes and context of sexual abuse of minors within the Catholic Church in Germany. The project requires an interdisciplinary approach which includes criminological, psychological, sociological and forensic-psychiatric expertise. Key figures will be determined regarding quantitative extent of abuse. Therefore personnel records of priests and files of the penal law will be scrutinized. Interviews with abused persons, offenders and responsible persons of the Catholic Church will be used to work out structural aspects of the institution that foster abuse.
    No preview · Article · Jan 2015
  • 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.
    No preview · Book · Nov 2014
  • Andrea Dressing · Harald Dressing
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    ABSTRACT: An increasing number of brain imaging studies and genetic studies is revealing structural and functional impairments or genetic risk factors in criminal offenders. This review outlines some recent neurobiological findings on offenders with antisocial personality disorder. With regard to these studies the implications of neurobiological research for forensic psychiatry and criminology are discussed. The increasing knowledge in neurosciences provides a better understanding of the biological underpinnings of delinquent behaviour. Nevertheless, it has to be kept in mind that antisocial behaviour undoubtedly arises from a complex pattern of biological, psychological, social, and situative factors.
    No preview · Article · Oct 2014 · Monatsschrift für Kriminologie und Strafrechtsreform
  • H Dreßing · K Foerster · J Leygraf · F Schneider
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    ABSTRACT: Die Beurteilung der Geschäfts- und Testierunfähigkeit ist eine der schwierigsten forensisch-psychiatrischen Tätigkeiten. Um diese Aufgabe korrekt durchführen zu können, ist eine gründliche Kenntnis der rechtlichen Rahmenbedingungen und der einschlägigen Rechtsprechung unerlässlich. Die vorliegende Arbeit erläutert die Begriffe der Geschäftsunfähigkeit, der partiellen Geschäftsunfähigkeit sowie der Testierunfähigkeit. Das praktische gutachtliche Vorgehen wird am Beispiel der wichtigsten psychischen Störungen erläutert.
    No preview · Article · Sep 2014 · Der Nervenarzt
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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.
    Full-text · Article · Jul 2014 · Psychiatrische Praxis
  • H. Dreßing · J. Leygraf · F. Schneider

    No preview · Article · Jun 2014
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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.
    Full-text · Article · May 2014 · The World Journal of Biological Psychiatry
  • 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.
    No preview · Article · Feb 2014 · Der Nervenarzt
  • Article: Stalking
    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.
    No preview · Article · Oct 2013 · Der Nervenarzt
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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.
    No preview · Article · Oct 2013 · Cyberpsychology, Behavior, and Social Networking
  • 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.
    No preview · Article · Feb 2013 · Forensische Psychiatrie Psychologie Kriminologie
  • Harald Dreßing · Claudia Dreßing

    No preview · Article · Jan 2013 · Psychiatrische Praxis
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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.
    No preview · Article · Sep 2012 · BMC Psychiatry
  • 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.
    No preview · Conference Paper · Aug 2012
  • Article: Pedophilia
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    ABSTRACT: Sexual abuse of children is an important societal problem: up to 20% of children have been approached by an adult in a sexual context or have been victims of sexual abuse. Approximately half of sex offenses against children are perpetrated by individuals with a diagnosis of pedophilia. The identification, management and treatment of sexual offenders with pedophilia are key tasks in forensic psychiatry. Pedophilia can be divided into several subtypes, based on factors such as the age of the preferred target. Recent research has begun to elucidate possible psychological and neurobiological mechanisms underlying pedophilia. Neuroimaging studies have identified abnormalities in the emotional processing of sexual stimuli in pedophilic offenders. In the future, findings such as these may assist forensic psychiatrists in classifying sexual offenders, and perhaps in developing therapeutic interventions and assessing treatment response.
    No preview · Article · Mar 2012
  • Hans Joachim Salize · Harald Dressing

    No preview · Article · Jan 2012

Publication Stats

1k Citations
202.94 Total Impact Points

Institutions

  • 2005-2015
    • Universität Heidelberg
      • • Central Institute of Mental Health
      • • Department of Psychiatry and Psychotherapy
      Heidelburg, Baden-Württemberg, Germany
  • 1990-2015
    • Central Institute of Mental Health
      • • Klinik für Abhängiges Verhalten und Suchtmedizin
      • • Klinik für Psychiatrie und Psychotherapie
      Mannheim, Baden-Württemberg, Germany
  • 2010
    • University of Tuebingen
      • Department of Psychiatry and Psychotherapy
      Tübingen, Baden-Wuerttemberg, Germany
  • 1994
    • University of Freiburg
      • Institute of Psychology
      Freiburg, Baden-Württemberg, Germany