When humans encounter attitude objects (e.g., other people, objects, or constructs), they evaluate them. Often, these evaluations are based on attitudes. Whereas most research focuses on univalent (i.e., only positive or only negative) attitude formation, little research exists on ambivalent (i.e., simultaneously positive and negative) attitude formation. Following a general introduction into ambivalence, I present three original manuscripts investigating ambivalent attitude formation. The first manuscript addresses ambivalent attitude formation from previously univalent attitudes. The results indicate that responding to a univalent attitude object incongruently leads to ambivalence measured via mouse tracking but not ambivalence measured via self-report. The second manuscript addresses whether the same number of positive and negative statements presented block-wise in an impression formation task leads to ambivalence. The third manuscript also used an impression formation task and addresses the question of whether randomly presenting the same number of positive and negative statements leads to ambivalence. Additionally, the effect of block size of the same valent statements is investigated. The results of the last two manuscripts indicate that presenting all statements of one valence and then all statements of the opposite valence leads to ambivalence measured via self-report and mouse tracking. Finally, I discuss implications for attitude theory and research as well as future research directions.

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.

COVID-19 was a harsh reminder that diseases are an aspect of human existence and mortality. It was also a live experiment in the formation and alteration of disease-related attitudes. Not only are these attitudes relevant to an individual’s self-protective behavior, but they also seem to be associated with social and political attitudes more broadly. One of these attitudes is Social Darwinism, which holds that a pandemic benefits society by enabling nature “to weed out the weak”. In two countries (N = 300, N = 533), we introduce and provide evidence for the reliability, validity, and usefulness of the Disease-Related Social Darwinism (DRSD) Short Scale measuring this concept. Results indicate that DRSD is meaningful related to other central political attitudes like Social Dominance Orientation, Authoritarianism and neoliberalism. Importantly, the scale significantly predicted people’s protective behavior during the Pandemic over and above general social Darwinism. Moreover, it significantly predicted conservative attitudes, even after controlling for Social Dominance Orientation.

The COVID-19 pandemic has affected schooling worldwide. In many places, schools closed for weeks or months, only part of the student body could be educated at any one time, or students were taught online. Previous research discloses the relevance of schooling for the development of cognitive abilities. We therefore compared the intelligence test performance of 424 German secondary school students in Grades 7 to 9 (42% female) tested after the first six months of the COVID-19 pandemic (i.e., 2020 sample) to the results of two highly comparable student samples tested in 2002 (n = 1506) and 2012 (n = 197). The results revealed substantially and significantly lower intelligence test scores in the 2020 sample than in both the 2002 and 2012 samples. We retested the 2020 sample after another full school year of COVID-19-affected schooling in 2021. We found mean-level changes of typical magnitude, with no signs of catching up to previous cohorts or further declines in cognitive performance. Perceived stress during the pandemic did not affect changes in intelligence test results between the two measurements.

Objective: Attunement is a novel measure of nonverbal synchrony reflecting the duration of the present moment shared by two interaction partners. This study examined its association with early change in outpatient psychotherapy. Methods: Automated video analysis based on motion energy analysis (MEA) and cross-correlation of the movement time-series of patient and therapist was conducted to calculate movement synchrony for N = 161 outpatients. Movement-based attunement was defined as the range of connected time lags with significant synchrony. Latent change classes in the HSCL-11 were identified with growth mixture modeling (GMM) and predicted by pre-treatment covariates and attunement using multilevel multinomial regression. Results: GMM identified four latent classes: high impairment, no change (Class 1); high impairment, early response (Class 2); moderate impairment (Class 3); and low impairment (Class 4). Class 2 showed the strongest attunement, the largest early response, and the best outcome. Stronger attunement was associated with a higher likelihood of membership in Class 2 (b = 0.313, p = .007), Class 3 (b = 0.251, p = .033), and Class 4 (b = 0.275, p = .043) compared to Class 1. For highly impaired patients, the probability of no early change (Class 1) decreased and the probability of early response (Class 2) increased as a function of attunement. Conclusions: Among patients with high impairment, stronger patient-therapist attunement was associated with early response, which predicted a better treatment outcome. Video-based assessment of attunement might provide new information for therapists not available from self-report questionnaires and support therapists in their clinical decision-making.