Refine
Year of publication
Document Type
- Doctoral Thesis (35)
- Article (19)
Has Fulltext
- yes (54)
Is part of the Bibliography
- no (54)
Keywords
- - (11)
- Kohärenzgefühl (6)
- Depression (3)
- Gesundheit (3)
- Gesundheitsverhalten (3)
- Alexithymie (2)
- Alter (2)
- Barrieren (2)
- COVID-19 (2)
- Inanspruchnahme (2)
Institute
- Institut für Medizinische Psychologie (54) (remove)
Publisher
- Frontiers Media S.A. (7)
- MDPI (4)
- BMJ Publishing Group (3)
- Springer Nature (2)
- BioMed Central (BMC) (1)
- JMIR Publications (1)
- SAGE Publications (1)
In den Studien dieser kumulativen Dissertationsarbeit wurde im Rahmen der Posttraumatic
Growth and Depreciation Study (GRODES) der Universitätsmedizin Greifswald der Einfluss
von Coping und Rumination auf posttraumatisches Wachstum (posttraumatic growth, PTG)
und posttraumatische Minderung (posttraumatic depreciation, PTD) untersucht.
Das Phänomen PTG bezeichnet die während oder nach der Verarbeitung eines
traumatischen Ereignisses subjektiv als positiv bewerteten Veränderungen, die von der
jeweiligen Person für sich als Bereicherung, als Gewinn angesehen werden. Diese
Veränderungen manifestieren sich in den Dimensionen ‚persönliche Stärke‘, ‚Möglichkeiten
im Leben‘, ‚Beziehung zu anderen Menschen‘, ‚Wert des Lebens‘ und ‚spirituell-existentielle
Aspekte‘ (Tedeschi et al., 2018). Dem gegenüber steht das Konstrukt der posttraumatischen
Minderung, das die infolge einer Traumaerfahrung negativ bewerteten Veränderungen auf
denselben fünf Dimensionen bezeichnet (Baker et al., 2008). PTG und PTD sind nicht
bidirektional zu verstehen. Sie können gleichzeitig erlebt werden; die Erfahrung von Zugewinn
auf der einen Seite mindert nicht notwendigerweise das Empfinden von Verlust auf der anderen.
PTG und PTD unterliegen verschiedenen Einflussfaktoren, wie Bewältigungsstil,
Rumination, Selbstoffenbarung, Infragestellen von Grundüberzeugungen oder Zentralität des
Ereignisses. Diese Faktoren werden ebenso wie die Zusammenhänge zwischen PTG und PTD
selbst sowie zwischen PTG/PTD und PTBS-Symptomen in der vorliegenden
Dissertationsarbeit untersucht.
Um den entsprechenden Fragestellungen nachgehen zu können, war die vorherige
Entwicklung eines Fragebogens, das Posttraumatic Growth and Depreciation Inventory –
Expanded (PTGDI-X, Taku et al., 2021), zur simultanen Erfassung von PTG und PTD sowie
die Überprüfung der psychometrischen Eigenschaften des Instrumentes und dessen
interkulturelle Anwendbarkeit erforderlich. In einem weiteren Schritt wurde eine Kurzversion
des Fragebogens, das Posttraumatic Growth and Depreciation Inventory – Expanded – Short
Form (PTGDI-X-SF, Platte, Wiesmann, Tedeschi, Taku, et al., 2022), entwickelt und validiert,
welche die Erhebung von PTG und PTD durch je zehn Fragen ermöglicht.
Schließlich wurde auf Grundlage des PTGDI–X, der Impact of Event Scale – Revised
(IES-R), des Rumination Inventory (ERRI) und des Brief COPE Inventory eine Online-
Befragung durchgeführt. Die Antworten von 253 Erwachsene der deutschen
Allgemeinbevölkerung wurden anschließend hinsichtlich der beschriebenen Fragestellungen
untersucht. Alles in allem bestätigen die im Rahmen der vorliegenden Dissertationsarbeit
gewonnenen Ergebnisse die Eignung des PTGDI-X und der zugehörigen Kurzform zur
simultanen Erfassung von PTG und PTD in der Allgemeinbevölkerung Deutschlands. Dabei
konnte gezeigt werden, dass PTG durch einen selbstständigen Coping-Stil und durch einen
sozialen Coping-Stil begünstigt wird, wohingegen ein vermeidender Coping-Stil zu mehr PTD
führt. Weiterhin war PTG mit positiver Selbstoffenbarung, Erschütterung von
Grundüberzeugungen und bewusster Rumination assoziiert. Es zeigte sich ferner ein positiver
Zusammenhang von PTD mit negativer Selbstoffenbarung, PTBS-Symptomen und kürzlichem
intrusivem Ruminieren.
Die vorliegende Dissertationsarbeit leistet einen wichtigen Beitrag in der Erforschung
posttraumatischer Veränderungen und bei der Entwicklung der entsprechenden
Erhebungsinstrumente. Es konnte nicht nur der bedeutsame Einfluss von Coping, Rumination
und Selbstoffenbarung auf posttraumatische Veränderungen hervorgehoben werden, sondern
auch die kulturelle Variabilität dieser Zusammenhänge verdeutlicht werden. Gewonnene
Ergebnisse und damit zusammenhängende weiterführende Studien können zu klinischen
Interventionen führen, die persönliches Wachstum fördern und negativ bewertete
Veränderungen mildern. Untersuchungen zu der Beziehung zwischen PTG und PTD und den
Einflussfaktoren auf PTG und PTD, insbesondere im interkulturellen Kontext, bieten sich als
ergiebiges Feld für weitere Forschung an. Darüber hinaus sollte in zukünftigen Studien eine Übertragung der vorliegenden Untersuchungsbefunde auf klinische Stichproben überprüft werden.
In Zeiten des demographischen Wandels liegt mit dieser Arbeit eine weitere Analyse im Bereich der gerontologischen Forschung zum erfolgreichen Altern vor. Mit dem Hintergrund des salutogenetischen Modells wurde das körperliche Wohlbefinden in den Fokus der Analyse gestellt. Die Studienteilnehmer*innen waren Teil der Greifswalder Altersstudie „Gesund und bewegt ins Alter“ aus dem Jahr 2006. Die Proband*innen wurden über lokale Medien und Flyer rekrutiert. Insgesamt nahmen 387 Personen im Alter von 57 bis 96 Jahren an der Studie teil.
Die Prüfung der Dimensionalität des Fragebogens zur Erfassung körperlichen Wohlbefindens (FEW-16) ergab mittels explorativer Faktorenanalyse eine Extraktion von drei Faktoren, die 72 Prozent der Gesamtvarianz erklärten. Unter der Vorgabe von vier Faktoren zeigte sich mithilfe der konfirmatorischen Faktorenanalyse eine erklärte Gesamtvarianz von 78 Prozent. Weiterhin war das körperliche Wohlbefinden in der Greifswalder Altersstudie geschlechtsunabhängig und altersabhängig mit geringeren Werten im vierten Lebensalter.
Es erfolgte zudem die empirische Prüfung der Zusammenhänge zwischen körperlichem Wohlbefinden, Kohärenzgefühl und ausgewählten Widerstandsressourcen. Zwischen dem körperlichen Wohlbefinden und dem Kohärenzgefühl konnte ein positiver Zusammenhang nachgewiesen werden. Sowohl das Kohärenzgefühl als auch das körperliche Wohlbefinden zeigten sich ressourcenabhängig. Die Widerstandsressourcen erklärten jeweils 48 Prozent des Kohärenzgefühls und des körperlichen Wohlbefindens. Die allgemeine Selbstwirksamkeitserwartung, das Selbstwertgefühl, die Alltagsaktivitäten, die erwartete soziale Unterstützung, die internale sowie die sozial externale Kontrollüberzeugung zu Krankheit und Gesundheit stellten sich als wichtige Ressourcen heraus. Das Kohärenzgefühl erklärte unter Kontrolle der Ressourcen eine zusätzliche Varianz von fünf Prozent am körperlichen Wohlbefinden. Die Mediatorfunktion des Kohärenzgefühls zwischen den Widerstandsressourcen und dem körperlichem Wohlbefinden konnte ebenso belegt werden. Die Ergebnisse bestätigen die Relevanz des Kohärenzgefühls und verdeutlichen die Notwendigkeit der Förderung des Kohärenzgefühls im Alter mit Hinblick auf das körperliche Wohlbefinden.
This study explored the evidence of validity of internal structure of the 12-item Functional Assessment of Chronic Illness Therapy—Spiritual Wellbeing Scale (FACIT-Sp-12) in Brazilian adolescents with chronic health conditions. The study involved 301 Brazilian adolescents with cancer, type 1 diabetes mellitus, or cystic fibrosis. Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and Item Response Theory (IRT) were used to test the internal structure. Reliability was determined with Cronbach’s Alpha and McDonald’s Omega. The EFA suggested a one-dimensional scale structure in contrast to the original 2-factor model or the 3-factor model which were not reproduced in the current CFA. All quality indicators for the EFA one-factor exceeded the required criteria (FDI = 0.97, EAP = 0.97, SR = 3.96 and EPTD = 0.96, latent GH = 0.90. and the observed GH = 0.85). The FACIT-Sp-12 for adolescents yielded strong evidence for a 1-factor model and with good reliability.
This study investigated whether tobacco smoking affected outcomes of brief alcohol interventions (BAIs) in at-risk alcohol-drinking general hospital patients. Between 2011 and 2012 among patients aged 18–64 years, 961 patients were allocated to in-person counseling (PE), computer-based BAI containing computer-generated individual feedback letters (CO), and assessment only. PE and CO included contacts at baseline, 1, and 3 months. After 6, 12, 18, and 24 months, self-reported reduction of alcohol use per day was assessed as an outcome. By using latent growth curve models, self-reported smoking status, and number of cigarettes per day were tested as moderators. In PE and CO, alcohol use was reduced independently of smoking status (IRRs ≤ 0.61, ps < 0.005). At month 24, neither smoking status nor number of cigarettes per day moderated the efficacy of PE (IRR = 0.69, ps > 0.05) and CO (IRR = 0.85, ps > 0.05). Up to month 12, among persons smoking ≤ 19 cigarettes per day, the efficacy of CO increased with an increasing number of cigarettes (ps < 0.05). After 24 months, the efficacy of PE and CO that have been shown to reduce drinking did not differ by smoking status or number of cigarettes per day. Findings indicate that efficacy may differ by the number of cigarettes in the short term.
Background:
Social equity in the efficacy of behavior change intervention is much needed. While the efficacy of brief alcohol interventions (BAIs), including digital interventions, is well established, particularly in health care, the social equity of interventions has been sparsely investigated.
Objective:
We aim to investigate whether the efficacy of computer-based versus in-person delivered BAIs is moderated by the participants’ socioeconomic status (ie, to identify whether general hospital patients with low-level education and unemployed patients may benefit more or less from one or the other way of delivery compared to patients with higher levels of education and those that are employed).
Methods:
Patients with nondependent at-risk alcohol use were identified through systematic offline screening conducted on 13 general hospital wards. Patients were approached face-to-face and asked to respond to an app for self-assessment provided by a mobile device. In total, 961 (81% of eligible participants) were randomized and received their allocated intervention: computer-generated and individually tailored feedback letters (CO), in-person counseling by research staff trained in motivational interviewing (PE), or assessment only (AO). CO and PE were delivered on the ward and 1 and 3 months later, were based on the transtheoretical model of intentional behavior change and required the assessment of intervention data prior to each intervention. In CO, the generation of computer-based feedback was created automatically. The assessment of data and sending out feedback letters were assisted by the research staff. Of the CO and PE participants, 89% (345/387) and 83% (292/354) received at least two doses of intervention, and 72% (280/387) and 54% (191/354) received all three doses of intervention, respectively. The outcome was change in grams of pure alcohol per day after 6, 12, 18, and 24 months, with the latter being the primary time-point of interest. Follow-up interviewers were blinded. Study group interactions with education and employment status were tested as predictors of change in alcohol use using latent growth modeling.
Results:
The efficacy of CO and PE did not differ by level of education (P=.98). Employment status did not moderate CO efficacy (Ps≥.66). Up to month 12 and compared to employed participants, unemployed participants reported significantly greater drinking reductions following PE versus AO (incidence rate ratio 0.44, 95% CI 0.21-0.94; P=.03) and following PE versus CO (incidence rate ratio 0.48, 95% CI 0.24–0.96; P=.04). After 24 months, these differences were statistically nonsignificant (Ps≥.31).
Conclusions:
Computer-based and in-person BAI worked equally well independent of the patient’s level of education. Although findings indicate that in the short-term, unemployed persons may benefit more from BAI when delivered in-person rather than computer-based, the findings suggest that both BAIs have the potential to work well among participants with low socioeconomic status.
Introduction
Privacy concerns are an important barrier to adoption and continued use of digital technologies, particularly in the health sector. With the introduction of mobile health applications (mHealth apps), the construct of app information privacy concerns has received increased attention. However, few validated measures exist to capture said concerns in population samples, although they can help to improve public health efforts.
Methods
Using a cross-sectional survey of German adults (mean age = 35.62; 63.5% female), this study examined psychometric properties of the app information privacy concerns scale (AIPC). Analyses comprised confirmatory factor analysis, factorial validity (exploratory factor analysis), internal consistency, convergent validity (i.e., correlations with privacy victimhood, and app privacy concerns), and discriminant validity (i.e., daily app use, adoption intentions, and attitudes toward COVID-19 contact tracing app use).
Results
The analysis did not support the proposed three-factor structure of the AIPC (i.e., anxiety, personal attitude, and requirements). Instead, a four-factor model was preferable that differentiated requirements regarding disclosure policies, and personal control. In addition, factors mirroring anxiety and personal attitude were extracted, but shared a significant overlap. However, these factors showed good reliability, convergent and discriminant validity.
Discussion
The findings underline the role of app information privacy concerns as a significant barrier to mHealth app use. In this context, anxiety and personal attitudes seemed particularly relevant, which has implications for health communication. Moreover, the observed differentiation of external (disclosure) and internal (control) requirements aligns with health behavior change models and thus is a promising area for future research.
Background
Fear of abandonment and aloneness play a key role in the clinical understanding interpersonal and attachment-specific problems in patients with borderline personality disorder (BPD) and has been investigated in previous functional Magnet Resonance Imaging (fMRI) studies. The aim of the present study was to examine how different aspects of attachment representations are processed in BPD, by using for the first time an fMRI attachment paradigm including personalized core sentences from the participants’ own attachment stories. We hypothesized that BPD patients would show increased functional involvement of limbic brain regions associated with fear and pain (e.g., the amygdala and the anterior cingulate cortex) when presented personalized attachment relevant stimuli representing loneliness compared to healthy controls (HC).
Methods
We examined the attachment classifications of 26 female BPD patients and 26 female HC using the Adult Attachment Projective Picture System (AAP). We used an fMRI-adapted attachment paradigm to investigate the neural correlates of attachment. All participants were presented three personalized (vs. neutral) sentences extracted from their AAP attachment narrative, combined with standardized AAP pictures representing being alone (monadic) or in interactive (dyadic) attachment situations.
Results
As expected, the classification of unresolved attachment was significantly greater in BPD compared to HC. BPD patients showed increased fMRI-activation in brain areas associated with fear, pain, and hyperarousal than HC when presented with personalized attachment-relevant alone stimuli. In particular, pictures with monadic attachment situations induced greater anterior medial cingulate cortex, anterior insula, amygdala, thalamus and superior temporal gyrus activation in the patient group.
Conclusion
The results point to increased fMRI-activation in areas processing emotional distress and painful experiences in BPD patients. In particular, the emotional cascade reflecting attachment distress was evoked by combining monadic pictures, representing abandonment and aloneness, with the patients’ personalized narrative material. Our results confirmed and replicated previous results that illustrate once again the high relevance of aloneness and feelings of abandonment for BPD in the context of attachment trauma. Moreover, our results support the hypothesis of hypermentalization in response to attachment distress as a core feature of social-cognitive impairment in BPD associated with common treatment implications across different therapeutic orientations.
Self-regulated learning (SRL) is critical for learning across tasks, domains, and contexts. Despite its importance, research shows that not all learners are equally skilled at accurately and dynamically monitoring and regulating their self-regulatory processes. Therefore, learning technologies, such as intelligent tutoring systems (ITSs), have been designed to measure and foster SRL. This paper presents an overview of over 10 years of research on SRL with MetaTutor, a hypermedia-based ITS designed to scaffold college students’ SRL while they learn about the human circulatory system. MetaTutor’s architecture and instructional features are designed based on models of SRL, empirical evidence on human and computerized tutoring principles of multimedia learning, Artificial Intelligence (AI) in educational systems for metacognition and SRL, and research on SRL from our team and that of other researchers. We present MetaTutor followed by a synthesis of key research findings on the effectiveness of various versions of the system (e.g., adaptive scaffolding vs. no scaffolding of self-regulatory behavior) on learning outcomes. First, we focus on findings from self-reports, learning outcomes, and multimodal data (e.g., log files, eye tracking, facial expressions of emotion, screen recordings) and their contributions to our understanding of SRL with an ITS. Second, we elaborate on the role of embedded pedagogical agents (PAs) as external regulators designed to scaffold learners’ cognitive and metacognitive SRL strategy use. Third, we highlight and elaborate on the contributions of multimodal data in measuring and understanding the role of cognitive, affective, metacognitive, and motivational (CAMM) processes. Additionally, we unpack some of the challenges these data pose for designing real-time instructional interventions that scaffold SRL. Fourth, we present existing theoretical, methodological, and analytical challenges and briefly discuss lessons learned and open challenges.
The effects of climate change lead to increasing social injustice and hence justice is intrinsically linked to a socio-ecological transformation. In this study, we investigate whether justice sensitivity motivates pro-environmental intention (PEI) and behavior (PEB) and, if so, to what extent emotions and moral disengagement determine this process. For this purpose, we conducted two quota-sampling surveys (Study 1: N = 174, Study 2: N = 880). Multiple regression analyses in both studies suggest that a higher perception of injustice from a perpetrator’s, beneficiary’s, and observer’s perspective is associated with an increased PEI. However, moral disengagement best predicted PEB and PEI. Guilt and authentic pride were found to be emotional predictors of PEI. Additionally, mediation analyses demonstrated that guilt mediates the connection between both perpetrator and beneficiary sensitivity and PEI. These results suggest that when the predominant originators of climate change (i.e., individuals from industrialized countries) perceive global climate injustice from the perspective of a beneficiary or a perpetrator, they experience guilt and have a higher PEI. Based on this mechanism, it seems promising to render global injustice more salient to those responsible for activities that lead to climate change to motivate them to adapt their behavior. The role of moral disengagement and victim sensitivity as barriers to pro-environmental behavior is discussed in this context.
Emotional Feelings: Evaluative Perceptions or Position-Takings? Introduction to the Special Section
(2022)
This special section of Emotion Review is devoted to the discussion of a recent philosophical emotion theory, the theory of emotions as affective position-takings (Jean Moritz Müller, The World-Directedness of Emotional Feeling: On Affect and Intentionality, Palgrave MacMillan, 2019). The aims of the special section are to provide readers with a spotlight view of recent research in the philosophy of emotion, to advance emotion theory, and support the interdisciplinary dialogue. To increase the accessibility of the special section texts to a nonphilosophical readership, we first discuss the relationship between the philosophy and the psychology of emotions and give a brief review the main types of theories of emotional experience.