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Schittenhelm, Jan Marius ; Borell, Christoph von ; Clément, Celina ; Schüller, Johanna ; Stangier, Ulrich ; Hoyer, Jürgen
Background:
There is growing evidence that Internet-based cognitive behavioral therapy (ICBT) is as effective as a stand-alone treatment and helps facilitating access to treatment. Given the complexity of the treatment, we argue that the effect of ICBT could be even greater if guided by a therapist, as this could increase treatment adherence. We modified an established and well-evaluated treatment approach and developed a mobile application for treating social anxiety disorder (SAD). In the present study, we compare the efficacy of app use alone (APP) with video-based, therapist-guided app use (TG-APP) and with a wait-list control group (WLC) in terms of symptom reduction, and various secondary outcomes such as increase in quality of life or decrease of general psychological distress.
Methods/design:
A within-between interaction design with randomization to one of three conditions will be used. In the APP condition, patients receive only the app without any additional contact with therapists, while in the TG-APP condition, therapists provide 8 sessions of video-based treatment in addition to using the app. The study will be conducted in two university outpatient treatment centers with reliably diagnosed SAD patients. The primary outcome will be defined as change in SAD symptoms, as measured by the Liebowitz Social Anxiety Scale (expert rating). Furthermore, a wide range of self-reports and clinician ratings for other symptoms (depression, general psychopathology) or quality of life will be used. A simulation-based power analysis for a 3 × 2 interaction effect (group × time) on the primary outcome in a linear mixed model resulted in a total sample size of N = 165.
Discussion:
The present study will be one of the first to examine the additional benefit of therapist-guided video sessions regarding the use of an app treating SAD. Study results are pivotal to future treatment application in SAD.
Introduction: Due to an inhibited tryptophan resorption, patients with fructose malabsorption are expected to experience decreased serotonin synthesis. A deficiency of serotonin may cause internalizing mental disorders like depression and anxiety, and a fructose-oriented eating behavior may affect these symptoms.
Methods: The parents of 24 children and adolescents with a currently diagnosed fructose malabsorption aged 4;00–13;02 years (M = 8.10, SD = 2.05), the parents of 12 patients with a currently confirmed combination of fructose and lactose malabsorption aged 4;00–12;11 years (M = 8.07, SD = 2.11) and the parents of a comparative sample of 19 healthy participants aged 5;00 to 17;07 years (M = 9.06, SD = 3.04) were interviewed. The interviews were conducted using a screening questionnaire of the German “Diagnostic System of Mental Disorders in children and adolescents based on the ICD-10 and DSM-5 DISYPS-III” and a self-developed questionnaire on eating, leisure and sleeping behavior.
Results: On standardized scales parents of children with fructose malabsorption reported higher levels of Depression compared to symptoms of Attention-Deficit/Hyperactivity Disorders (ADHD) and Oppositional Defiant and Conduct Disorders (ODD/CD). Compared to healthy controls, for patients with fructose malabsorption, higher symptom levels of Depression and Anxiety were reported. With regard to eating behavior, within the group with a combination of fructose and lactose malabsorption, a strong positive association between an increased fruit sugar consumption and higher levels of Anxiety and Obsessive-Compulsive Disorders/Tics were found.
Discussion: These results suggest a close association between fructose malabsorption and elevated internalizing psychological symptoms in children and adolescents.
Clinical trial registration: https://drks.de/search/en/trial/DRKS00031047, DRKS-ID [DRKS00031047].
The more difficult it is to access a research field, the more substantial the need to develop creative methodological models. Investigating the psychosocial impact of migration-related carceral spaces constitutes one such research field. To shed light on these spaces and counter the challenges of opacity, harm, and power asymmetries, we propose a psycho-geographical counter-mapping as a mixed methods approach based on grounded theory (MM-GT). Applying it to immigration detention and refugee confinement sites in Mexico and Samos, our analysis proposes a fully integrated and sequential design that can be adapted to a range of carceral spaces and subjectivation in transdisciplinary research.
Social identification is health-beneficial as social groups provide social support (i.e., the social cure effect). We study this social cure effect in diabetes patients by focusing on two relevant sources of social support, namely medical practitioners (MP) and fellow patients. As both groups have diabetes-specific knowledge, we predict that sharing an identity with them provides access to specific support, which, in turn, optimizes individuals’ diabetes management and reduces diabetes-related stress. We further predict that identifying with their MP or fellow patients will be more strongly related to perceived social support among individuals with lower diabetes-specific resilience because they pay more attention to supportive cues. We tested this moderated mediation model in a two-wave study with n = 200 diabetes patients. Identification with the MP related to more support, which, in turn, was related to better diabetes management and less diabetes-specific stress. Identification with fellow patients related to more support; however, social support was unrelated to diabetes management and stress. Resilience only moderated the relationship between MP identification and support, as people with lower resilience levels reported more support from their MP. This study shows the importance of social identification with the MP and other diabetes patients, especially for people with lower resilience levels.
Abstract
In serial dependence, perceptual decisions are biased towards stimuli encountered in the recent past. Here, we investigate whether and how serial dependence is affected by the availability of visual working memory (VWM) resources. In two experiments, participants reproduced the orientation of a series of stimuli. On alternating trials, we included an additional VWM task with randomly varying levels of load. Serial dependence was not only affected by the additional load task but also clearly modulated by the level of load: a high load in the previous trial reduced serial dependence while a high load in the present increased it. These results were independent of the effects of VWM load on the precision of reproduction responses. Our findings provide new insights into the mechanisms that may regulate serial dependence, revealing its intimate link with VWM resources.
Significance statement
Our perception, thoughts, and behavior are continuously influenced by recent events. For instance, the way we process and understand current visual information depends on what we have seen in the preceding seconds, a phenomenon known as serial dependence. The precise mechanisms and factors involved in serial dependence are still unclear. Here, we demonstrated that working memory resources are a crucial component. Specifically, when we are currently experiencing a heavy memory load, the influence of prior stimuli becomes stronger. Conversely, when prior stimuli were shown under a high memory load, their influence was reduced. These findings highlight the importance of working memory resources in shaping our interpretation of the present based on the recent past.
Mexico’s role in the US-Central American migration regime is threefold: not only is it a country of origin, and a transit country, but also increasingly becoming a receiving country for migrants who flee from violence, insecurity and poverty. The Mexican state responds with detention enforcement. Clinical research usually puts emphasise on the negative impact of detention enforcement on the detainees‘ mental health. Yet, it often disregards the spatial configurations of detention centres and their socio-political context. This study aims to fill this gap by analysing how such factors create harmful environments that affect both the detainees‘ mental health and their social life in Mexico’s migration detention centres. The study’s mixed method approach builds on semi-structured interviews with a sample of N = 56 migrants of diverse nationalities and varying socioeconomic status of whom 22 were still detained while 34 had been released. The interviews include the Torturing Environment Scale (TES), a novel instrument for the analysis of detention environments, as well as clinical psychological measures of emotional distress. Additional n = 10 in-depth interviews with human rights advocates to explore the interconnections between the detention environments, their impact on mental health, and Mexican migration politics. Facultative counter-mappings of the detention centres complement the interviews. Without exception, all interviews of detainees underline that the manipulation of detention conditions creates torturing environments that cause harm to basic physiological and psychological needs. A comparison between detained vs. released interviewees revealed lasting feelings of fear and shame. The study emphasises that immigration detention immobilises migrants in a necropolitical limbo, which destroys hope as much as human integrity. It indicates that detention is part of deterrence politics, which perpetuates harm and inequality through detention and deportation. Highlighting structural human rights violations, the findings stress the need to review current migration policies.
Frenzel, Svenja Beatrice ; Junker, Nina Mareen ; Avanzi, Lorenzo ; Erkens, Valerie A. ; Haslam, S. Alexander ; Haslam, Catherine ; Häusser, Jan ; Knorr, Daniel ; Meyer, Ines ; Mojzisch, Andreas ; Monzani, Lucas ; Reicher, Stephen David ; Schuh, Sebastian C. ; Steffens, Niklas K. ; Zyl, Llewellyn E. van ; Dick, Rolf van
The purpose of this study was to investigate which social groups are perceived as a threat target and which are perceived as a threat source during the COVID-19 outbreak. In a German sample (N = 1454) we examined perceptions of social groups ranging from those that are psychologically close and smaller (family, friends, neighbors) to those that are more distal and larger (people living in Germany, humankind). We hypothesized that psychologically closer groups would be perceived as less affected by COVID-19 as well as less threatening than more psychologically distal groups. Based on social identity theorizing, we also hypothesized that stronger identification with humankind would change these patterns. Furthermore, we explored how these threat perceptions relate to adherence to COVID-19 health guidelines. In line with our hypotheses, latent random-slope modelling revealed that psychologically distal and larger groups were perceived as more affected by COVID-19 and as more threatening than psychologically closer and smaller groups. Including identification with humankind as a predictor into the threat target model resulted in a steeper increase in threat target perception patterns, whereas identification with humankind did not predict differences in threat source perceptions. Additionally, an increase in threat source perceptions across social groups was associated with more adherence to health guidelines, whereas an increase in threat target perceptions was not. We fully replicated these findings in a subgroup from the original sample (N = 989) four weeks later. We argue that societal recovery from this and other crises will be supported by an inclusive approach informed by a sense of our common identity as human beings.
Steil, Regina ; Müller-Engelmann, Meike ; Stangier, Ulrich ; Priebe, Kathlen ; Fydrich, Thomas ; Weiß, Judith ; Dittmann, Clara
Background: The assessment of therapeutic adherence and competence is essential to understand mechanisms that contribute to treatment outcome. Nevertheless, their assessment is often neglected in psychotherapy research.
Aims/Objective: To develop an adherence and a treatment-specific competence rating scale for Dialectical Behaviour Therapy for Posttraumatic Stress Disorder (DBT-PTSD), and to examine their psychometric properties. Global cognitive behavioural therapeutic competence and disorder-specific therapeutic competence were assessed using already existing scales to confirm their psychometric properties in our sample of patients with PTSD and emotion regulation difficulties.
Method: Two rating scales were developed using an inductive procedure. 155 videotaped therapy sessions from a multicenter randomised controlled trial were rated by trained raters using these scales, 40 randomly chosen videotapes involving eleven therapists and fourteen patients were doubly rated by two raters.
Results: Both the adherence scale (Patient-level ICC = .98; αs = .65; αp = .75) and the treatment-specific competence scale (Patient-level ICC = .98; αs = .78; αp = .82) for DBT-PTSD showed excellent interrater – and good reliability on the patient level. Content validity, including relevance and appropriateness of all items, was confirmed by experts in DBT-PTSD for the new treatment-specific competence scale.
Conclusion: Our results indicate that both scales are reliable instruments. They will be useful to examine possible effects of adherence and treatment-specific competence on DBT-PTSD treatment outcome.