Validation of a German Version of the Grief Cognitions Questionnaire and Establishment of a Short Form

Background: Whereas the majority of bereaved persons recover from their grief without professional assistance, a minority develops pathological grief reactions. Etiological models postulate that dysfunctional cognitions may perpetuate such reactions. The Grief Cognitions Questionnaire (GCQ) assesses thoughts after bereavement in nine interrelated domains. A short form (GCQ-SF) with four domains is often used. However, an evaluation of the psychometric properties of the GCQ-SF and its utility compared to the GCQ is lacking and these instruments have not been validated in German. Method: German bereaved persons (time since loss 35.3 ± 34.6 months) responded to an online survey containing the GCQ, measures of grief severity, grief rumination, symptoms of depression and anxiety, and optimism and pessimism. 585 participants (18–78 years, 88% women) were included. Item analyses and confirmatory factor analyses were conducted. Correlations between the GCQ and GCQ-SF and grief rumination, optimism and pessimism assessed construct validity. Criterion-related validity was assessed by comparing whether the correlation of the GCQ (and the GCQ-SF) with grief severity was higher than with anxious and depressive symptoms. Logistic regression and receiver-operator characteristics (ROC) compared the questionnaires on their ability to predict probable prolonged grief ‘caseness’ (ICG ≥ 25, time since loss ≥6 months). Results: Internal consistencies for both questionnaires were identical and excellent (α = 0.96). Confirmatory factor analyses obtained a satisfactory fit for models with nine and four correlated subscales and respective higher-order factor models. The GCQ and the GCQ-SF correlated higher with grief severity than with other measures of psychopathology. The logistic regression showed a significant association between the GCQ-SF and prolonged grief ‘caseness’. Of the remaining subscales of the GCQ, only one subscale (‘Others’) contributed to the prediction. The ROC analyses showed nearly identical areas under the curve. Conclusion: The translated GCQ and GCQ-SF demonstrated very good psychometric properties. The correlations with grief severity highlight the questionnaires’ clinical relevance. The questionnaires possessed identical diagnostic specificity and sensitivity. Whenever a timesaving assessment of the most typical grief-specific cognitions is important, the GCQ-SF represents an alternative to the GCQ. The original GCQ may still be superior when a more detailed description of a bereaved person’s cognitions is desirable

Adult attachment and prolonged grief:A systematic review and meta-analysis

Diagnoses characterized by severe, persistent and disabling grief have recently been added to the ICD-11 and DSM-5-TR as prolonged grief disorder. Adult attachment is widely assumed critical in the development, persistence, and treatment of prolonged grief, yet a meta-analysis on this topic is lacking. We conducted a systematic review (PROSPERO: CRD42021220511) searching PsycInfo, Web of Science, and PubMed (final search: August 2022) to identify and summarize quantitative research examining relationships between adult attachment (i.e., attachment anxiety, attachment avoidance, secure attachment, disorganized attachment) and prolonged grief symptoms. Thirty-one studies including 8347 bereaved adults were included. Attachment anxiety (r = 0.28, 95 % CI:0.23–0.32, k = 15) and attachment avoidance (r = 0.15, 95 % CI:0.05–0.26, k = 15) related positively to prolonged grief symptoms concurrently. We found no evidence of publication bias but did detect heterogeneity in effect sizes. Ten longitudinal analyses showed no evidence that insecure attachment styles increase prolonged grief symptoms. Attachment anxiety predicted better therapy outcomes. Insecure attachment styles are concurrently positively related to prolonged grief symptoms but do not increase grief severity. The role of adult attachment in contemporary grief theories may need reconsideration. Intensive longitudinal research should aim to clarify how dynamic changes in attachment to the deceased and others relate to changes in prolonged grief symptoms.</p

Development of an Instrument to Assess Parents’ Excessive Web-Based Searches for Information Pertaining to Their Children’s Health : the “Children’s Health Internet Research, Parental Inventory” (CHIRPI)

BACKGROUND: People often search the internet to obtain health-related information not only for themselves but also for family members and, in particular, their children. However, for a minority of parents, such searches may become excessive and distressing. Little is known about excessive web-based searching by parents for information regarding their children's health. OBJECTIVE: This study aimed to develop and validate an instrument designed to assess parents' web-based health information searching behavior, the Children's Health Internet Research, Parental Inventory (CHIRPI). METHODS: A pilot survey was used to establish the instrument (21 items). CHIRPI was validated online in a second sample (372/384, 96.9% mothers; mean age 32.7 years, SD 5.8). Item analyses, an exploratory factor analysis (EFA), and correlations with parents' perception of their children's health-related vulnerability (Child Vulnerability Scale, CVS), parental health anxiety (modified short Health Anxiety Inventory, mSHAI), and parental cyberchondria (Cyberchondria Severity Scale, CSS-15) were calculated. A subset of participants (n=73) provided retest data after 4 weeks. CHIRPI scores (total scores and subscale scores) of parents with a chronically ill child and parents who perceived their child to be vulnerable (CVS+; CVS>10) were compared with 2×2 analyses of variances (ANOVAs) with the factors Child's Health Status (chronically ill vs healthy) and perceived vulnerability (CVS+ vs CVS-). RESULTS: CHIRPI's internal consistency was standardized alpha=.89. The EFA identified three subscales: Symptom Focus (standardized alpha=.87), Implementing Advice (standardized alpha=.74) and Distress (standardized alpha=.89). The retest reliability of CHIRPI was measured as rtt=0.78. CHIRPI correlated strongly with CSS-15 (r=0.66) and mSHAI (r=0.39). The ANOVAs comparing the CHIRPI total score and the subscale scores for parents having a chronically ill child and parents perceiving their child as vulnerable revealed the main effects for perceiving one's child as vulnerable but not for having a chronically ill child. No interactions were found. This pattern was observed for the CHIRPI total score (η2=0.053) and each subscale (Symptom Focus η2=0.012; Distress η2=0.113; and Implementing Advice η2=0.018). CONCLUSIONS: The psychometric properties of CHIRPI are excellent. Correlations with mSHAI and CSS-15 indicate its validity. CHIRPI appears to be differentially sensitive to excessive searches owing to parents perceiving their child's health to be vulnerable rather than to higher informational needs of parents with chronically ill children. Therefore, it may help to identify parents who search excessively for web-based health information. CHIRPI (and, in particular, the Distress subscale) seems to capture a pattern of factors related to anxious health-related cognitions, emotions, and behaviors of parents, which is also applied to their children

Treatment for Complicated Grief : State of the Science and Ways Forward

Peer reviewedPostprin

Psychologische Aspekte der Bluthochdruckbehandlung - Einstellungen, Placebo- und Noceboeffekte

Bluthochdruck ist eine weit verbreitete Erkrankung, die häufig eine medikamentöse Kontrolle des Blutdrucks erfordert, um Folgeerkrankungen vorzubeugen (Kearney et al., 2005). Die Adhärenz bei Bluthochdruckmedikamenten, also in wie weit Patienten dem Behandlungsplan folgen, ist niedrig (Naderi, Bestwick, & Wald, 2012). Zur Verbesserung der Behandlung sollten erwünschte, unspezifische Effekte der Bluthochdruckmedikation, sog. Placeboeffekte, maximiert werden. Gleichzeitig sollten Noceboeffekte (z.B. die Intensivierung von Nebenwirkungen) minimiert werden (Rief, Bingel, Schedlowski, & Enck, 2011). Dabei spielen negative Behandlungserwartungen eine wichtige Rolle, die u.a. als Einstellungen gegenüber Medikamenten operationalisiert werden können und zudem direkt mit Adhärenz assoziiert sind (Foot, La Caze, Gujral, & Cottrell, 2016). Um unspezifische Effekte in der Behandlung von Bluthochdruck zu optimieren, muss zunächst ein möglicher Placeboeffekt nachgewiesen werden. Daher wurde eine Meta-Analyse aller verfügbaren Beta-Blockerstudien mit paralleler Placebokontrollgruppe durchgeführt (23 Studien, 11.067 Patienten mit Bluthochdruck). Dabei zeigten sich robuste, blutdrucksenkende Effekte, die bereits 34% (systolisch) bzw. 47% (diastolisch) des medikamentös bedingten Blutdruckabfalls in den Beta-Blockergruppen erklärten. In der zweiten Studie wurden Noceboeffekte mithilfe einer wahrheitsgemäßen verbalen Informationsgabe adressiert. Dabei wurden 80 gesunde Probanden in eine von zwei Informationsgruppen randomisiert: die Positivbedingung erhielt die wahrheitsgemäße Information, dass Schwindel ein Zeichen ist, dass das Medikament anschlägt. Die Kontrollbedingung erhielt die Standardinformation (Schwindel als bekannte Nebenwirkung). Nach der Einnahme von 100 mg Metoprolol bewertete die Positivbedingung auftretende spezifische Nebenwirkungen als signifikant weniger bedrohlich. Probanden, die Medikamente eher als schädlich einstuften, unterschieden sich auch in Auftretenshäufigkeit und Intensität spezifischer Nebenwirkungen zwischen den Gruppen, zugunsten der Positivbedingung. In der dritten Studie wurde durch eine Onlinebefragung von 273 Bluthochdruckpatienten die zentrale Rolle von Einstellungen gegenüber der verschriebenen Medikation (Notwendigkeit und Sorgen) bzgl. der Adhärenz zu Antihypertensiva in einem Strukturgleichungsmodell mit akzeptablen Fitindizes aufgezeigt. Insgesamt konnten 23% der Varianz in Adhärenz durch Einstellungen zu Medikamenten und verschiedenen Hintergrundvariablen (z.B. emotional unterstützende Arzt-Patient Kommunikation) aufgeklärt werden. Die Ergebnisse der Dissertation zeigen, dass es für die Bluthochdruckbehandlung bedeutsam ist, erwünschte, unspezifische Effekte zu fördern und gleichzeitig personalisiert auf negative Erwartungen einzugehen. Eine Möglichkeit dazu bietet die Verbesserung der verbalen Arzt-Patient Kommunikation

Effekte des psychologischen Gesellschaftsspiels „That’s me“ als Selbsterfahrungsangebot im (Psychologie)‌Studium

Theoretischer Hintergrund: Das als Tutorium angebotene Gesellschaftsspiel That’s me kann bereits Psychologiestudierenden einen niederschwelligen Einstieg in die Selbsterfahrung bieten. Bisher ist nichts darüber bekannt, ob durch das Spiel messbare Veränderungen in Bereichen auftreten, in denen Selbsterfahrung wirken kann. Fragestellung: Wir erwarteten positive Veränderungen in den Bereichen Emotionale Kompetenz, Emotionsregulation, interpersonelle Probleme und motivationale Inkongruenz durch die Teilnahme am Tutorium. Methode: Wir verglichen die Werte vor und nach der Teilnahme an That’s me (EG) und mit einer unbehandelten Kontrollgruppe (KG). Ergebnisse: In der EG zeigten sich signifikante Verbesserungen in allen erhobenen Skalen mit kleinen Effektstärken. Die KG zeigte keine Veränderungen. Schlussfolgerungen: Mit Hilfe des niederschwelligen, ökonomischen Angebots That’s me konnten signifikante Veränderungen in Bereichen erzielt werden, in denen Selbsterfahrung wirken kann

Playing smartphone games while studying : An experimental study on reading interruptions by a smartphone game

In this study, we investigated whether the use of smartphone games while reading a text reduces learning performance or reading speed. We also examined whether this is affected by push notifications. Ninety-three students were randomly assigned to three learning conditions. In the gaming group (G), participants played a game app for 20 s at 2-min intervals while reading. In one subgroup, the game app sent push notifications (GN+); in the other subgroup, no notifications (GN−) were sent. In the control group (C), participants did not play a game. After the reading, participants took a multiple-choice quiz. We compared quiz scores and reading times of the groups (G) and (C) and within the gaming group (GN+, GN−) and observed no differences. Since the statistical non-significance of these tests does not entail the absence of an effect, we conducted equivalence tests, which did not demonstrate equivalence either. The experiment ensured high internal validity, yet remained inconclusive. Reasons for the similarity of performance in all groups could be non-specific exercise effects (all participants owned a smartphone), low similarity between the tasks, low variance of participants’ ability and motivation (high achieving, low ADHD scores) or low game complexity. Future research should address these questions

Receiving push-notifications from smartphone games reduces students learning performance in a brief lecture : an experimental study

Many university students use mobile phones during study tasks for unrelated activities. It is known that using social networking while studying reduces the learning performance. The objective of the present study was to investigate whether using smartphone games during a lecture reduces the learning performance, and whether this is influenced by receiving push notifications. Ninety-three students were randomized to three conditions: In two gaming conditions (G), participants played a custom-made gaming-app (20 s) at 2-min intervals while watching a video mimicking a lecture. In one subgroup (GN+), the game app sent push notifications; in the other (GN-), no notifications were sent. Participants in the control group (C) watched the lecture without playing. Subsequently, participants answered multiple choice questions and estimated their own quiz performance. Comparing the quiz scores and subjective performance estimates of the three groups showed that the learning performance in GN+ was lower than in C (d = 0.51); no other differences were observed. Participants’ subjective performance estimations remained unaffected by the experimental condition. Possible implications of the divergence of the subjective estimate and objective performance are discussed, as well as limitations, such as the low complexity of the game used and the short lecture duration, not reflective of typical lectures

Open-label placebo treatment : Outcome expectations and general acceptance in the lay population

Background Most physicians sometimes apply therapies without specific active ingredients. Although patients seem to judge such placebo treatments as acceptable under certain circumstances, deception is still an ethical problem. Open-label placebos (OLPs) might be a promising approach to solve this dilemma. This study compared general acceptance and outcome expectations of OLPs and deceptive placebos (DPs). Methods In an experimental online study, 814 participants read a case vignette of a person with insomnia receiving a pill. The participants were then randomly allocated into two groups, where the second part of the vignette described the pill as either a deceptive placebo (DP group) or as an open-label placebo (OLP group). The Credibility/Expectancy Questionnaire (CEQ) assessed outcome expectations after the first (pre-assessment) and the second (post-assessment) parts of the vignette. Treatment acceptance was measured at post-assessment. Data from 798 participants were analyzed by a mixed multivariate analysis of variance (MANOVA), t-tests, and post-hoc mediation analyses. Results The MANOVA revealed a significant group main effect and a significant time × group interaction effect. At post-assessment, outcome expectations were higher in the DP group than in the OLP group. Acceptance of the placebo treatment was also higher in the DP group than in the OLP group. Mediation analyses confirmed that higher acceptance in the DP group was mediated by higher expectations. Conclusions When laypersons read about placebo treatment, their outcome expectations toward DPs were higher than toward OLPs. Surprisingly, the application of DPs was rated as more acceptable than OLPs. This result might be explained by indirect effects of treatment expectations