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When do anorexic patients perceive their body as too fat? Aggravating and ameliorating factors
(2019)
Objective
Our study investigated body image representations in female patients with anorexia nervosa
and healthy controls using a size estimation with pictures of their own body. We also
explored a method to reduce body image distortions through right hemispheric activation.
Method
Pictures of participants’ own bodies were shown on the left or right visual fields for 130 ms
after presentation of neutral, positive, or negative word primes, which could be self-relevant
or not, with the task of classifying the picture as “thinner than”, “equal to”, or “fatter than”
one’s own body. Subsequently, activation of the left- or right hemispheric through right- or
left-hand muscle contractions for 3 min., respectively. Finally, participants completed the
size estimation task again.
Results
The distorted “fatter than” body image was found only in patients and only when a picture of
their own body appeared on the right visual field (left hemisphere) and was preceded by
negative self-relevant words. This distorted perception of the patients’ body image was
reduced after left-hand muscle contractions (right hemispheric activation).
Discussion
To reduce body image distortions it is advisable to find methods that help anorexia nervosa
patients to increase their self-esteem. The body image distortions were ameliorated after
right hemispheric activation. A related method to prevent distorted body-image representations
in these patients may be Eye Movement Desensitization and Reprocessing (EMDR)
therapy.
Background: The body-oriented therapeutic approach Somatic Experiencing® (SE) treats posttraumatic symptoms by changing the interoceptive and proprioceptive sensations associated with the traumatic experience. Filling a gap in the landscape of trauma treatments, SE has attracted growing interest in research and therapeutic practice, recently.
Objective: To date, there is no literature review of the effectiveness and key factors of SE. This review aims to summarize initial findings on the effectiveness of SE and to outline methodspecific key factors of SE.
Method: To gain a first overview of the literature, we conducted a scoping review including studies until 13 August 2020. We identified 83 articles of which 16 fit inclusion criteria and were systematically analysed.
Results: Findings provide preliminary evidence for positive effects of SE on PTSD-related symptoms. Moreover, initial evidence suggests that SE has a positive impact on affective and somatic symptoms and measures of well-being in both traumatized and non-traumatized
samples. Practitioners and clients identified resource-orientation and use of touch as methodspecific key factors of SE. Yet, an overall studies quality assessment as well as a Cochrane analysis of risk of bias indicate that the overall study quality is mixed.
Conclusions: The results concerning effectiveness and method-specific key factors of SE are promising; yet, require more support from unbiased RCT-research. Future research should focus on filling this gap.
Mixed-Integer Optimization Techniques for Robust Bilevel Problems with Here-and-Now Followers
(2025)
In bilevel optimization, some of the variables of an optimization problem have to be an optimal solution to another nested optimization problem. This specific structure renders bilevel optimization a powerful tool for modeling hierarchical decision-making processes, which arise in various real-world applications such as in critical infrastructure defense, transportation, or energy. Due to their nested structure, however, bilevel problems are also inherently hard to solve—both in theory and in practice. Further challenges arise if, e.g., bilevel problems under uncertainty are considered.
In this dissertation, we address different types of uncertainties in bilevel optimization using techniques from robust optimization. We study mixed-integer linear bilevel problems with lower-level objective uncertainty, which we tackle using the notion of Gamma-robustness. We present two exact branch-and-cut approaches to solve these Gamma-robust bilevel problems, along with cuts tailored to the important class of monotone interdiction problems. Given the overall hardness of the considered problems, we additionally propose heuristic approaches for mixed-integer, linear, and Gamma-robust bilevel problems. The latter rely on solving a linear number of deterministic bilevel problems so that no problem-specific tailoring is required. We assess the performance of both the exact and the heuristic approaches through extensive computational studies.
In addition, we study the problem of determining optimal tolls in a traffic network in which the network users hedge against uncertain travel costs in a robust way. The overall toll-setting problem can be seen as a single-leader multi-follower problem with multiple robustified followers. We model this setting as a mathematical problem with equilibrium constraints, for which we present a mixed-integer, nonlinear, and nonconvex reformulation that can be tackled using state-of-the-art general-purpose solvers. We further illustrate the impact of considering robustified followers on the toll-setting policies through a case study.
Finally, we highlight that the sources of uncertainty in bilevel optimization are much richer compared to single-level optimization. To this end, we study two aspects related to so-called decision uncertainty. First, we propose a strictly robust approach in which the follower hedges against erroneous observations of the leader's decision. Second, we consider an exemplary bilevel problem with a continuous but nonconvex lower level in which algorithmic necessities prevent the follower from making a globally optimal decision in an exact sense. The example illustrates that even very small deviations in the follower's decision may lead to arbitrarily large discrepancies between exact and computationally obtained bilevel solutions.
It is well known that bilevel optimization problems are hard to solve both in theory and practice. In this paper, we highlight a further computational difficulty when it comes to solving bilevel problems with continuous but nonconvex lower levels. Even if the lower-level problem is solved to -feasibility regarding its nonlinear constraints for an arbitrarily small but positive , the obtained bilevel solution as well as its objective value may be arbitrarily far away from the actual bilevel solution and its actual objective value. This result even holds for bilevel problems for which the nonconvex lower level is uniquely solvable, for which the strict complementarity condition holds, for which the feasible set is convex, and for which Slater’s constraint qualification is satisfied for all feasible upper-level decisions. Since the consideration of -feasibility cannot be avoided when solving nonconvex problems to global optimality, our result shows that computational bilevel optimization with continuous and nonconvex lower levels needs to be done with great care. Finally, we illustrate that the nonlinearities in the lower level are the key reason for the observed bad behavior by showing that linear bilevel problems behave much better at least on the level of feasible solutions.
Developing solution methods for discrete bilevel problems is known to be a challenging task—even if all parameters of the problem are exactly known. Many real-world applications of bilevel optimization, however, involve data uncertainty. We study discrete min-max problems with a follower who faces uncertainties regarding the parameters of the lower-level problem. Adopting a Γ-robust approach, we present an extended formulation and a multi-follower formulation to model this type of problem. For both settings, we provide a generic branch-and-cut framework. Specifically, we investigate interdiction problems with a monotone Γ-robust follower and we derive problem-tailored cuts, which extend existing techniques that have been proposed for the deterministic case. For the Γ-robust knapsack interdiction problem, we computationally evaluate and compare the performance of the proposed algorithms for both modeling approaches.
The gender wage gap in labor market outcomes has been intensively investigated for decades, yet it remains a relevant and innovative research topic in labor economics. Chapter 2 of this dissertation explores the pressing issue of gender wage disparity in Ethiopia. By applying various empirical methodologies and measures of occupational segregation, this chapter aims to analyze the role of female occupational segregation in explaining the gender wage gap across the pay distribution. The findings reveal a significant difference in monthly wages, with women consistently earning lower wages across the wage distribution.
Importantly, the result indicates a negative association between female occupational segregation and the average earnings of both men and women. Furthermore, the estimation result shows that female occupational segregation partially explains the gender wage gap at the bottom of the wage distribution. I find that the magnitude of the gender wage gap in the private sector is higher than in the public sector.
In Chapter 3, the Ethiopian Demography and Health Survey data are leveraged to explore the causal relationship between female labor force participation and domestic violence. Domestic violence against women is a pervasive public health concern, particularly in Africa, including Ethiopia, where a significant proportion of women endure various forms of domestic violence perpetrated by intimate partners. Economic empowerment of women through increased participation in the labor market can be one of the mechanisms for mitigating the risk of domestic violence.
This study seeks to provide empirical evidence supporting this hypothesis. Using the employment rate of women at the community level as an instrumental variable, the finding suggests that employment significantly reduces the risk of domestic violence against women. More precisely, the result shows that women’s employment status significantly reduces domestic violence by about 15 percentage points. This finding is robust for different dimensions of domestic violence, such as physical, sexual, and emotional violence.
By examining the employment outcomes of immigrants in the labor market, Chapter 4 extends the dissertation's inquiry to the dynamics of immigrant economic integration into the destination country. Drawing on data from the German Socio-Economic Panel, the chapter scrutinizes the employment gap between native-born individuals and two distinct groups of first-generation immigrants: refugees and other migrants. Through rigorous analysis, Chapter 4 aims to identify the factors contributing to disparities in employment outcomes among these groups. In this chapter, I aim to disentangle the heterogeneity characteristic of refugees and other immigrants in the labor market, thereby contributing to a deeper understanding of immigrant labor market integration in Germany.
The results show that refugees and other migrants are less likely to find employment than comparable natives. The refugee-native employment gap is much wider than other migrant-native employment gap. Moreover, the findings vary by gender and migration categories. While other migrant men do not differ from native men in the probability of being employed, refugee women are the most disadvantaged group compared to other migrant women and native women in the probability of being employed. The study suggests that German language proficiency and permanent resident permits partially explain the lower employment probability of refugees in the German labor market.
Chapter 5 (co-authored with Uwe Jirjahn) utilizes the same dataset to explore the immigrant-native trade union membership gap, focusing on the role of integration in the workplace and into society. The integration of immigrants into society and the workplace is vital not only to improve migrant's performance in the labor market but also to actively participate in institutions such as trade unions. In this study, we argue that the incomplete integration of immigrants into the workplace and society implies that immigrants are less likely to be union members than natives. Our findings show that first-generation immigrants are less likely to be trade union members than natives. Notably, the analysis shows that the immigrant-native gap in union membership depends on immigrants’ integration into the workplace and society. The gap is smaller for immigrants working in firms with a works council and having social contacts with Germans. Moreover, the results reveal that the immigrant-native union membership gap is decreasing in the year since arrival in Germany.
There is no longer any doubt about the general effectiveness of psychotherapy. However, up to 40% of patients do not respond to treatment. Despite efforts to develop new treatments, overall effectiveness has not improved. Consequently, practice-oriented research has emerged to make research results more relevant to practitioners. Within this context, patient-focused research (PFR) focuses on the question of whether a particular treatment works for a specific patient. Finally, PFR gave rise to the precision mental health research movement that is trying to tailor treatments to individual patients by making data-driven and algorithm-based predictions. These predictions are intended to support therapists in their clinical decisions, such as the selection of treatment strategies and adaptation of treatment. The present work summarizes three studies that aim to generate different prediction models for treatment personalization that can be applied to practice. The goal of Study I was to develop a model for dropout prediction using data assessed prior to the first session (N = 2543). The usefulness of various machine learning (ML) algorithms and ensembles was assessed. The best model was an ensemble utilizing random forest and nearest neighbor modeling. It significantly outperformed generalized linear modeling, correctly identifying 63.4% of all cases and uncovering seven key predictors. The findings illustrated the potential of ML to enhance dropout predictions, but also highlighted that not all ML algorithms are equally suitable for this purpose. Study II utilized Study I’s findings to enhance the prediction of dropout rates. Data from the initial two sessions and observer ratings of therapist interventions and skills were employed to develop a model using an elastic net (EN) algorithm. The findings demonstrated that the model was significantly more effective at predicting dropout when using observer ratings with a Cohen’s d of up to .65 and more effective than the model in Study I, despite the smaller sample (N = 259). These results indicated that generating models could be improved by employing various data sources, which provide better foundations for model development. Finally, Study III generated a model to predict therapy outcome after a sudden gain (SG) in order to identify crucial predictors of the upward spiral. EN was used to generate the model using data from 794 cases that experienced a SG. A control group of the same size was also used to quantify and relativize the identified predictors by their general influence on therapy outcomes. The results indicated that there are seven key predictors that have varying effect sizes on therapy outcome, with Cohen's d ranging from 1.08 to 12.48. The findings suggested that a directive approach is more likely to lead to better outcomes after an SG, and that alliance ruptures can be effectively compensated for. However, these effects
were reversed in the control group. The results of the three studies are discussed regarding their usefulness to support clinical decision-making and their implications for the implementation of precision mental health.
This paper explores the presence of the poetic word in contemporary urban settings: from “Poetry in Motion,” displayed in the New York City subway at the very place where one usually finds ads, to fluid xenon light projections of huge verse on the exterior of buildings in Basel or Zurich by visual artist Jenny Holzer, who presents poems of the Nobel Laureate Wisława Szymborska together with her own short “Truisms.” Or from single poems permanently written on walls – e.g. a much-discussed concrete poem by Eugen Gomringer at the facade of a Berlin college of education – to the technically enhanced spoken word, audible from far away as a side effect of gigantic poetry slam events in stadiums, e.g. the Trabrennbahn (race-course) in Hamburg and even performative events such as Ulrike Almut Sandig’s „augenpost“ in which poems are ‘published’ on posters, flyers and free postcards in the urban space of Leipzig or declaimed on public squares in Indian metropolises through a megaphone. Such presentations of poetry in urban space are still uncommon, thus creating an aesthetic experience that differs strongly from reception in private settings or even in readings or public poetry festivals, as the poem relates to its urban surroundings.
Striving for sustainable development by combating climate change and creating a more social world is one of the most pressing issues of our time. Growing legal requirements and customer expectations require also Mittelstand firms to address sustainability issues such as climate change. This dissertation contributes to a better understanding of sustainability in the Mittelstand context by examining different Mittelstand actors and the three dimensions of sustainability - social, economic, and environmental sustainability - in four quantitative studies. The first two studies focus on the social relevance and economic performance of hidden champions, a niche market leading subgroup of Mittelstand firms. At the regional level, the impact of 1,645 hidden champions located in Germany on various dimensions of regional development is examined. A higher concentration of hidden champions has a positive effect on regional employment, median income, and patents. At the firm level, analyses of a panel dataset of 4,677 German manufacturing firms, including 617 hidden champions, show that the latter have a higher return on assets than other Mittelstand firms. The following two chapters deal with environmental strategies and thus contribute to the exploration of the environmental dimension of sustainability. First, the consideration of climate aspects in investment decisions is compared using survey data from 468 European venture capital and private equity investors. While private equity firms respond to external stakeholders and portfolio performance and pursue an active ownership strategy, venture capital firms are motivated by product differentiation and make impact investments. Finally, based on survey data from 443 medium-sized manufacturing firms in Germany, 54% of which are family-owned, the impact of stakeholder pressures on their decarbonization strategies is analyzed. A distinction is made between symbolic (compensation of CO₂-emissions) and substantive decarbonization strategies (reduction of CO₂-emissions). Stakeholder pressures lead to a proactive pursuit of decarbonization strategies, with internal and external stakeholders varying in their influence on symbolic and substantial decarbonization strategies, and the relationship influenced by family ownership.
This article discusses the high regard for Danish poet Inger Christensen in Germany and her connection to the Künstlerhaus [Artists’ Residence] in Edenkoben, located in Rhineland-Palatinate. The Künstlerhaus serves as a cultural institution where international artists from various fields can reside and collaborate. Inger Christensen had strong connections with the Künstlerhaus Edenkoben and participated in its German-Danish poetry project. During her visits to Edenkoben, she wrote several poems. In an essay, the poet described Edenkoben’s landscape as paradise-like. This article, on the one hand, examines these texts in the context of Inger Christensen’s stay in Edenkoben. On the other, it sheds light on “Weg der Gedichte”, a project that stages Inger Christensen’s poem “Erinnerung an Edenkoben” in a public space around the Künstlerhaus, showcasing the role of poetry in rural settings and its ability to enhance the experience of nature and hiking.