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- 2016 (4) (entfernen)
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- Psychologie (4) (entfernen)
The efficacy and effectiveness of psychotherapeutic interventions have been proven time and again. We therefore know that, in general, evidence-based treatments work for the average patient. However, it has also repeatedly been shown that some patients do not profit from or even deteriorate during treatment. Patient-focused psychotherapy research takes these differences between patients into account by focusing on the individual patient. The aim of this research approach is to analyze individual treatment courses in order to evaluate when and under which circumstances a generally effective treatment works for an individual patient. The goal is to identify evidence based clinical decision rules for the adaptation of treatment to prevent treatment failure. Patient-focused research has illustrated how different intake indicators and early change patterns predict the individual course of treatment, but they leave a lot of variance unexplained. The thesis at hand analyzed whether Ecological Momentary Assessment (EMA) strategies could be integrated into patient-focused psychotherapy research in order to improve treatment response prediction models. EMA is an electronically supported diary approach, in which multiple real-time assessments are conducted in participants" everyday lives. We applied EMA over a two-week period before treatment onset in a mixed sample of patients seeking outpatient treatment. The four daily measurements in the patients" everyday environment focused on assessing momentary affect and levels of rumination, perceived self-efficacy, social support and positive or negative life events since the previous assessment. The aim of this thesis project was threefold: First, to test the feasibility of EMA in a routine care outpatient setting. Second, to analyze the interrelation of different psychological processes within patients" everyday lives. Third and last, to test whether individual indicators of psychological processes during everyday life, which were assessed before treatment onset, could be used to improve prediction models of early treatment response. Results from Study I indicate good feasibility of EMA application during the waiting period for outpatient treatment. High average compliance rates over the entire assessment period and low average burdens perceived by the patients support good applicability. Technical challenges and the results of in-depth missing analyses are reported to guide future EMA applications in outpatient settings. Results from Study II shed further light on the rumination-affect link. We replicated results from earlier studies, which identified a negative association between state rumination and affect on a within-person level and additionally showed a) that this finding holds for the majority but not every individual in a diverse patient sample with mixed Axis-I disorders, b) that rumination is linked to negative but also to positive affect and c) that dispositional rumination significantly affects the state rumination-affect association. The results provide exploratory evidence that rumination might be considered a transdiagnostic mechanism of psychological functioning and well-being. Results from Study III finally suggest that the integration of indicators derived from EMA applications before treatment onset can improve prediction models of early treatment response. Positive-negative affect ratios as well as fluctuations in negative affect measured during patients" daily lives allow the prediction of early treatment response. Our results indicate that the combination of commonly applied intake predictors and EMA indicators of individual patients" daily experiences can improve treatment response predictions models. We therefore conclude that EMA can successfully be integrated into patient-focused research approaches in routine care settings to ameliorate or optimize individual care.
Phase-amplitude cross-frequency coupling is a mechanism thought to facilitate communication between neuronal ensembles. The mechanism could underlie the implementation of complex cognitive processes, like executive functions, in the brain. This thesis contributes to answering the question, whether phase-amplitude cross-frequency coupling - assessed via electroencephalography (EEG) - is a mechanism by which executive functioning is implemented in the brain and whether an assumed performance effect of stress on executive functioning is reflected in phase-amplitude coupling strength. A huge body of studies shows that stress can influence executive functioning, in essence having detrimental effects. In two independent studies, each being comprised of two core executive function tasks (flexibility and behavioural inhibition as well as cognitive inhibition and working memory), beta-gamma phase-amplitude coupling was robustly detected in the left and right prefrontal hemispheres. No systematic pattern of coupling strength modulation by either task demands or acute stress was detected. Beta-gamma coupling might also be present in more basic attention processes. This is the first investigation of the relationship between stress, executive functions and phase-amplitude coupling. Therefore, many aspects have not been explored yet. For example, studying phase precision instead of coupling strength as an indicator for phase-amplitude coupling modulations. Furthermore, data was analysed in source space (independent component analysis); comparability to sensor space has still to be determined. These as well as other aspects should be investigated, due to the promising finding of very robust and strong beta-gamma coupling for all executive functions. Additionally, this thesis tested the performance of two widely used phase-amplitude coupling measures (mean vector length and modulation index). Both measures are specific and sensitive to coupling strength and coupling width. The simulation study also drew attention to several confounding factors, which influence phase-amplitude coupling measures (e. g. data length, multimodality).
Cognitive performance is contingent upon multiple factors. Beyond the impact of en-vironmental circumstances, the bodily state may hinder or promote cognitive processing. Af-ferent transmission from the viscera, for instance, is crucial not only for the genesis of affect and emotion, but further exerts significant influences on memory and attention. In particular, afferent cardiovascular feedback from baroreceptors demonstrated subcortical and cortical inhibition. Consequences for human cognition and behavior are the impairment of simple perception and sensorimotor functioning. Four studies are presented that investigate the mod-ulatory impact of baro-afferent feedback on selective attention. The first study demonstrates that the modulation of sensory processing by baroreceptor activity applies to the processing of complex stimulus configurations. By the use of a visual masking task in which a target had to be selected against a visual mask, perceptual interference was reduced when target and mask were presented during the ventricular systole compared to the diastole. In study two, selection efficiency was systematically manipulated in a visual selection task in which a target letter was flanked by distracting stimuli. By comparing participants" performance under homogene-ous and heterogeneous stimulus conditions, selection efficiency was assessed as a function of the cardiac cycle phase in which the targets and distractors were presented. The susceptibility of selection performance to the stimulus condition at hand was less pronounced during the ventricular systole compared to the diastole. Study one and two therefore indicate that inter-ference from irrelevant sensory input, resulting from temporally overlapping processing traces or from the simultaneous presentation of distractor stimuli, is reduced during phases of in-creased baro-afferent feedback. Study three experimentally manipulated baroreceptor activity by systematically varying the participant- body position while a sequential distractor priming task was completed. In this study, negative priming and distractor-response binding effects were obtained as indices of controlled and automatic distractor processing, respectively. It was found that only controlled distractor processing was affected by tonic increases in baro-receptor activity. In line with study one and two these results indicate that controlled selection processes are more efficient during enhanced baro-afferent feedback, observable in dimin-ished aftereffects of controlled distractor processing. Due to previous findings that indicated baro-afferent transmission to affect central, rather than response-related processing stages, study four measured lateralized-readiness potentials (LRPs) and reaction times (RTs), while participants, again, had to selectively respond to target stimuli that were surrounded by dis-tractors. The impact of distractor inhibition on stimulus-related, but not on response-related LRPs suggests that in a sequential distractor priming task, the sensory representations of dis-tractors, rather than motor responses are targeted by inhibition. Together with the results from studies one through three and the finding of baroreceptor-mediated behavioral inhibition tar-geting central processing stages, study four corroborates the presumption of baro-afferent signal transmission to modulate controlled processes involved in selective attention. In sum, the work presented shows that visual selective attention benefits from in-creased baro-afferent feedback as its effects are not confined to simple perception, but may facilitate the active suppression of neural activity related to sensory input from distractors. Hence, due to noise reduction, baroreceptor-mediated inhibition may promote effective selec-tion in vision.
Educational assessment tends to rely on more or less standardized tests, teacher judgments, and observations. Although teachers spend approximately half of their professional conduct in assessment-related activities, most of them enter their professional life unprepared, as classroom assessment is often not part of their educational training. Since teacher judgments matter for the educational development of students, the judgments should be up to a high standard. The present dissertation comprises three studies focusing on accuracy of teacher judgments (Study 1), consequences of (mis-)judgment regarding teacher nomination for gifted programming (Study 2) and teacher recommendations for secondary school tracks (Study 3), and individual student characteristics that impact and potentially bias teacher judgment (Studies 1 through 3). All studies were designed to contribute to a further understanding of classroom assessment skills of teachers. Overall, the results implied that, teacher judgment of cognitive ability was an important constant for teacher nominations and recommendations but lacked accuracy. Furthermore, teacher judgments of various traits and school achievement were substantially related to social background variables, especially the parents" educational background. However, multivariate analysis showed social background variables to impact nomination and recommendation only marginally if at all. All results indicated differentiated but potentially biased teacher judgments to impact their far-reaching referral decisions directly, while the influence of social background on the referral decisions itself seems mediated. Implications regarding further research practices and educational assessment strategies are discussed. The implications on the needs of teachers to be educated on judgment and educational assessment are of particular interest and importance.