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In order to investigate the psychobiological consequences of acute stress under laboratory conditions, a wide range of methods for socially evaluative stress induction have been developed. The present dissertation is concerned with evaluating a virtual reality (VR)-based adaptation of one of the most widely used of those methods, the Trier Social Stress Test (TSST). In the three empirical studies collected in this dissertation, we aimed to examine the efficacy and possible areas of application of the adaptation of this well-established psychosocial stressor in a virtual environment. We found that the TSST-VR reliably incites the activation of the major stress effector systems in the human body, albeit in a slightly less pronounced way than the original paradigm. Moreover, the experience of presence is discussed as one potential factor of influence in the origin of the psychophysiological stress response. Lastly, we present a use scenario for the TSST-VR in which we employed the method to investigate the effects of acute stress on emotion recognition performance. We conclude that, due to its advantages concerning versatility, standardization and economic administration, the paradigm harbors enormous potential not only for psychobiological research, but other applications such as clinical practice as well. Future studies should further explore the underlying effect mechanisms of stress in the virtual realm and the implementation of VR-based paradigms in different fields of application.
Why they rebel peacefully: On the violence-reducing effects of a positive attitude towards democracy
Under the impression of Europe’s drift into Nazism and Stalinism in the first half of the 20th century, social psychological research has focused strongly on dangers inherent in people’s attachment to a political system. The dissertation at hand contributes to a more differentiated perspective by examining violence-reducing aspects of political system attachment in four consecutive steps: First, it highlights attachment to a social group as a resource for violence prevention on an intergroup level. The results suggest that group attachment fosters self-control, a well-known protective factor against violence. Second, it demonstrates violence-reducing influences of attachment on a societal level. The findings indicate that attachment to a democracy facilitate peaceful and prevent violent protest tendencies. Third, it introduces the concept of political loyalty, defined as a positive attitude towards democracy, in order to clarify the different approaches of political system attachment. A set of three studies show the reliability and validity of a newly developed political loyalty questionnaire that distinguishes between affective and cognitive aspects. Finally, the dissertation differentiates former findings with regard to protest tendencies using the concept of political loyalty. A set of two experiments show that affective rather than cognitive aspects of political loyalty instigate peaceful protest tendencies and prevent violent ones. Implications of this dissertation for political engagement and peacebuilding as well as avenues for future research are discussed.
Internet interventions have gained popularity and the idea is to use them to increase the availability of psychological treatment. Research suggests that internet interventions are effective for a number of psychological disorders with effect sizes comparable to those found in face-to-face treatment. However, when provided as an add-on to treatment as usual, internet interventions do not seem to provide additional benefit. Furthermore, adherence and dropout rates vary greatly between studies, limiting the generalizability of the findings. This underlines the need to further investigate differences between internet interventions, participating patients, and their usage of interventions. A stronger focus on the processes of change seems necessary to better understand the varying findings regarding outcome, adherence and dropout in internet interventions. Thus, the aim of this dissertation was to investigate change processes in internet interventions and the factors that impact treatment response. This could help to identify important variables that should be considered in research on internet interventions as well as in clinical settings that make use of internet interventions.
Study I (Chapter 5) investigated early change patterns in participants of an internet intervention targeting depression. Data from 409 participants were analyzed using Growth Mixture Modeling. Specifically a piecewise model was applied to model change from screening to registration (pretreatment) and early change (registration to week four of treatment). Three early change patterns were identified; two were characterized by improvement and one by deterioration. The patterns were predictive of treatment outcome. The results therefore indicated that early change should be closely monitored in internet interventions, as early change may be an important indicator of treatment outcome.
Study II (Chapter 6) picked up on the idea of analyzing change patterns in internet interventions and extended it by using the Muthen-Roy model to identify change-dropout patterns. A sligthly bigger sample of the dataset from Study I was analyzed (N = 483). Four change-dropout patterns emerged; high risk of dropout was associated with rapid improvement and deterioration. These findings indicate that clinicians should consider how dropout may depend on patient characteristics as well as symptom change, as dropout is associated with both deterioration and a good enough dosage of treatment.
Study III (Chapter 7) compared adherence and outcome in different participant groups and investigated the impact of adherence to treatment components on treatment outcome in an internet intervention targeting anxiety symptoms. 50 outpatient participants waiting for face- to-face treatment and 37 self-referred participants were compared regarding adherence to treatment components and outcome. In addition, outpatient participants were compared to a matched sample of outpatients, who had no access to the internet intervention during the waiting period. Adherence to treatment components was investigated as a predictor of treatment outcome. Results suggested that especially adherence may vary depending on participant group. Also using specific measures of adherence such as adherence to treatment components may be crucial to detect change mechanisms in internet interventions. Fostering adherence to treatment components in participants may increase the effectiveness of internet interventions.
Results of the three studies are discussed and general conclusions are drawn.
Implications for future research as well as their utility for clinical practice and decision- making are presented.
Auf der Grundlage einer Fragebogenstudie wurden unterschiedliche Elemente eines förderlichen Umgangs mit Gesundheitsinformationen betrachtet und ihre Zusammenhänge mit personspezifischen Merkmalen analysiert. Als zentrale Aspekte der Informationsprozesse wurden die drei Elemente Gesundheitsinformationskompetenz, Gesundheitsinteresse und gesundheitsspezifische Informationsgewohnheiten konzeptuell voneinander getrennt. Auf der Basis des bisherigen Forschungsstands wurde zunächst ein theoretisches Modell des Umgangs mit Gesundheitsinformationen entwickelt, das die Bedeutung der Kompetenz und des Interesses für gesundheitsbezogene Informationsgewohnheiten hervorhebt, individuelle Ausprägungen dieser drei Elemente mit soziodemografischen Faktoren, Persönlichkeitseigenschaften, Überzeugungen und dem Gesundheitszustand in Beziehung setzt sowie Verbindungen zu gesundheitsrelevanten Verhaltensweisen beschreibt. Dieses Modell wurde anschließend an einer Stichprobe von 352 Berufsschülerinnen und -schülern aus drei Berufsbereichen (Wirtschaft/Verwaltung, Technik und Gesundheit) empirisch überprüft. Über multiple Regressionsanalysen wurden bedeutsame Prädiktoren für die drei Hauptelemente Kompetenz, Interesse und Informationsgewohnheiten identifiziert, über logistische Regressionen und Korrelationen ihre Zusammenhänge mit dem Gesundheitsverhalten überprüft. Darüber hinaus wurden lineare Strukturgleichungsmodelle zur Vorhersage des Informationsverhaltens entwickelt. Die Ergebnisse bestätigen die konzeptionelle Trennung der drei Faktoren, die jeweils mit unterschiedlichen Prädiktoren verbunden waren. Auf der Basis der Befunde werden Ansatzpunkte für die weitere Forschung und die Förderung eines kompetenten Umgangs mit Gesundheitsinformationen diskutiert.
Die publikationsbasierte Dissertation untersucht die Bedeutung sozialer Bewegungen für die Entwicklung der Sozialen Arbeit am Ende des 19. und den ersten Jahrzehnten des 20. Jahrhunderts als Profession und Disziplin in den USA und in Deutschland. Dabei wird die entstehende Soziale Arbeit als ‚Formbildung‘ sozialer Bewegungen verstanden und gefragt, wie sich die Bewegungen in die sich etablierende und institutionalisierende Profession und Wissenschaft Soziale Arbeit einschreiben, welche Anliegen dabei verfolgt werden und wie dadurch Wissen in der Sozialen Arbeit auch über nationalstaatliche Grenzen hinweg zirkuliert.
Die Untersuchung konzentriert sich auf Prozesse der Pädagogisierung, also unterschiedliche ‚Formbildungen des Pädagogischen‘, die die Bewegungsanliegen zum Thema von Aufklärung, (Selbst)Bildung und Pädagogik machen, und auf solche der Verwissenschaftlichung, die sich auf den Aufbau einer Wissensgrundlage zur Bearbeitung von sozialen Problemen richten und dabei alternative Formen der Wissensproduktion ausbilden. Diese Prozesse werden in drei Teilstudien – zur Charity Organization Movement und der Settlement House Movement in den USA sowie der bürgerlichen Frauenbewegung in Deutschland – in sieben Einzelbeiträgen näher untersucht. Im Mittelpunkt stehen dabei die Handlungsmethoden und das Praxisverständnis sowie Forschungskonzepte und –projekte exemplarisch ausgewählter sozialbewegter Initiativen der Sozialen Arbeit. Dabei werden unter anderem nicht-intendierte Effekte untersucht, die zum Beispiel in Konservierungen normativer Vorstellungen und Ideologien in als demokratisierend angelegten Ansätzen, aber auch in ‚differenzverstärkenden‘ Effekten bestehen können.
A huge number of clinical studies and meta-analyses have shown that psychotherapy is effective on average. However, not every patient profits from psychotherapy and some patients even deteriorate in treatment. Due to this result and the restricted generalization of clinical studies to clinical practice, a more patient-focused research strategy has emerged. The question whether a particular treatment works for an individual case is the focus of this paradigm. The use of repeated assessments and the feedback of this information to therapists is a major ingredient of patient-focused research. Improving patient outcomes and reducing dropout rates by the use of psychometric feedback seems to be a promising path. Therapists seem to differ in the degree to which they make use of and profit from such feedback systems. This dissertation aims to better understand therapist differences in the context of patient-focused research and the impact of therapists on psychotherapy. Three different studies are included, which focus on different aspects within the field:
Study I (Chapter 5) investigated how therapists use psychometric feedback in their work with patients and how much therapists differ in their usage. Data from 72 therapists treating 648 patients were analyzed. It could be shown that therapists used the psychometric feedback for most of their patients. Substantial variance in the use of feedback (between 27% and 52%) was attributable to therapists. Therapists were more likely to use feedback when they reported being satisfied with the graphical information they received. The results therefore indicated that not only patient characteristics or treatment progress affected the use of feedback.
Study II (Chapter 6) picked up on the idea of analyzing systematic differences in therapists and applied it to the criterion of premature treatment termination (dropout). To answer the question whether therapist effects occur in terms of patients’ dropout rates, data from 707 patients treated by 66 therapists were investigated. It was shown that approximately six percent of variance in dropout rates could be attributed to therapists, even when initial impairment was controlled for. Other predictors of dropout were initial impairment, sex, education, personality styles, and treatment expectations.
Study III (Chapter 7) extends the dissertation by investigating the impact of a transfer from one therapist to another within ongoing treatments. Data from 124 patients who agreed to and experienced a transfer during their treatment were analyzed. A significant drop in patient-rated as well as therapist-rated alliance levels could be observed after a transfer. On average, there seemed to be no difficulties establishing a good therapeutic alliance with the new therapist, although differences between patients were observed. There was no increase in symptom severity due to therapy transfer. Various predictors of alliance and symptom development after transfer were investigated. Impacts on clinical practice were discussed.
Results of the three studies are discussed and general conclusions are drawn. Implications for future research as well as their utility for clinical practice and decision-making are presented.
Academic achievement is a central outcome in educational research, both in and outside higher education, has direct effects on individual’s professional and financial prospects and a high individual and public return on investment. Theories comprise cognitive as well as non-cognitive influences on achievement. Two examples frequently investigated in empirical research are knowledge (as a cognitive determinant) and stress (as a non-cognitive determinant) of achievement. However, knowledge and stress are not stable, what raises questions as to how temporal dynamics in knowledge on the one hand and stress on the other contribute to achievement. To study these contributions in the present doctoral dissertation, I used meta-analysis, latent profile transition analysis, and latent state-trait analysis. The results support the idea of knowledge acquisition as a cumulative and long-term process that forms the basis for academic achievement and conceptual change as an important mechanism for the acquisition of knowledge in higher education. Moreover, the findings suggest that students’ stress experiences in higher education are subject to stable, trait-like influences, as well as situational and/or interactional, state-like influences which are differentially related to achievement and health. The results imply that investigating the causal networks between knowledge, stress, and academic achievement is a promising strategy for better understanding academic achievement in higher education. For this purpose, future studies should use longitudinal designs, randomized controlled trials, and meta-analytical techniques. Potential practical applications include taking account of students’ prior knowledge in higher education teaching and decreasing stress among higher education students.
With the advent of highthroughput sequencing (HTS), profiling immunoglobulin (IG) repertoires has become an essential part of immunological research. The dissection of IG repertoires promises to transform our understanding of the adaptive immune system dynamics. Advances in sequencing technology now also allow the use of the Ion Torrent Personal Genome Machine (PGM) to cover the full length of IG mRNA transcripts. The applications of this benchtop scale HTS platform range from identification of new therapeutic antibodies to the deconvolution of malignant B cell tumors. In the context of this thesis, the usability of the PGM is assessed to investigate the IG heavy chain (IGH) repertoires of animal models. First, an innovate bioinformatics approach is presented to identify antigendriven IGH sequences from bulk sequenced bone marrow samples of transgenic humanized rats, expressing a human IG repertoire (OmniRatTM). We show, that these rats mount a convergent IGH CDR3 response towards measles virus hemagglutinin protein and tetanus toxoid, with high similarity to human counterparts. In the future, databases could contain all IGH CDR3 sequences with known specificity to mine IG repertoire datasets for past antigen exposures, ultimately reconstructing the immunological history of an individual. Second, a unique molecular identifier (UID) based HTS approach and network property analysis is used to characterize the CLLlike CD5+ B cell expansion of A20BKO mice overexpressing a natural short splice variant of the CYLD gene (A20BKOsCYLDBOE). We could determine, that in these mice, overexpression of sCYLD leads to unmutated subvariant of CLL (UCLL). Furthermore, we found that this short splice variant is also seen in human CLL patients highlighting it as important target for future investigations. Third, the UID based HTS approach is improved by adapting it to the PGM sequencing technology and applying a custommade data processing pipeline including the ImMunoGeneTics (IMGT) database error detection. Like this, we were able to obtain correct IGH sequences with over 99.5% confidence and correct CDR3 sequences with over 99.9% confidence. Taken together, the results, protocols and sample processing strategies described in this thesis will improve the usability of animal models and the Ion Torrent PGM HTS platform in the field if IG repertoire research.
Early life adversity (ELA) poses a high risk for developing major health problems in adulthood including cardiovascular and infectious diseases and mental illness. However, the fact that ELA-associated disorders first become manifest many years after exposure raises questions about the mechanisms underlying their etiology. This thesis focuses on the impact of ELA on startle reflexivity, physiological stress reactivity and immunology in adulthood.
The first experiment investigated the impact of parental divorce on affective processing. A special block design of the affective startle modulation paradigm revealed blunted startle responsiveness during presentation of aversive stimuli in participants with experience of parental divorce. Nurture context potentiated startle in these participants suggesting that visual cues of childhood-related content activates protective behavioral responses. The findings provide evidence for the view that parental divorce leads to altered processing of affective context information in early adulthood.
A second investigation was conducted to examine the link between aging of the immune system and long-term consequences of ELA. In a cohort of healthy young adults, who were institutionalized early in life and subsequently adopted, higher levels of T cell senescence were observed compared to parent-reared controls. Furthermore, the results suggest that ELA increases the risk of cytomegalovirus infection in early childhood, thereby mediating the effect of ELA on T cell-specific immunosenescence.
The third study addresses the effect of ELA on stress reactivity. An extended version of the Cold Pressor Test combined with a cognitive challenging task revealed blunted endocrine response in adults with a history of adoption while cardiovascular stress reactivity was similar to control participants. This pattern of response separation may best be explained by selective enhancement of central feedback-sensitivity to glucocorticoids resulting from ELA, in spite of preserved cardiovascular/autonomic stress reactivity.