Blended Interventions: die Bedeutung menschlicher Unterstützung für die Adhärenzförderung. Ergebnisse einer Untersuchung im Rahmen der Multi-Center-Studie „Gesundbleiben Online“

Menschliche Begleitung fördert die Teilnahme an internetbasierten Therapieprogrammen. Welche spezifischen Aspekte der therapeutischen Beziehung dabei relevant sind, ist bisher kaum bekannt. In diesem Zusammenhang zielt die vorliegende Arbeit darauf ab, die Rolle der menschlichen Unterstützung bei der Teilnahme an einem internetbasierten Nachsorgeprogramm zu untersuchen. Konkret wurde geprüft, ob sowohl das Konstrukt Therapiebeziehung als auch das speziell für internetbasierte Interventionen entwickelte Modell der Supportive Accountability (Mohr et al., 2011) die Adhärenz vorhersagen können und dabei Supportive Accountability einen inkrementellen Beitrag zur Varianzaufklärung leistet. Als Vorbereitung auf die Untersuchung wurde die bisherige Literatur zu kombinierten Interventionen in einem systematischen Review aufgearbeitet und konzeptualisiert sowie der Patient Health Questionnaire (PHQ-9) als Fragebogen der als Adhärenzmaß verwendeten wöchentlichen Monitorings hinsichtlich seiner digitalen Version validiert. In der Hauptuntersuchung wurden N = 110 Teilnehmende des Online-Nachsorgeprogramms „Gesundbleiben Online“ vier Wochen nach der Entlassung aus der stationären Depressionsbehandlung mit dem Supportive Accountability Questionnaire (SAQ) sowie dem Working Alliance Inventory Short Form (WAI-S) untersucht und Zusammenhänge zu zwei Adhärenzmaßen hergestellt. Die Regressionsanalysen bestätigten die WAI-Unterskala Bond für die Gesamtanzahl der Forenbeiträge sowie die WAI-Unterskala Task für die Anzahl ausgefüllter Monitorings als signifikante Prädiktoren. Wahrgenommener Rechtfertigungsdruck war negativ mit beiden Adhärenzmaßen assoziiert. Mögliche Interpretationen (negativer Einfluss von Rechtfertigungsdruck auf die Adhärenz vs. der Einfluss einer moderierenden Drittvariable) sowie Implikationen für Forschung und Praxis (gezielte experimentelle Untersuchung der Auswirkung von Rechtfertigungsdruck) werden diskutiert

Femtosecond Transfer and Manipulation of Persistent Hot-Trion Coherence in a Single CdSe/ZnSe Quantum Dot

Ultrafast transmission changes around the fundamental trion resonance are studied after exciting a p-shell exciton in a negatively charged II-VI quantum dot. The biexcitonic induced absorption reveals quantum beats between hot trion states at 133 GHz. While interband dephasing is dominated by relaxation of the P-shell hole within 390 fs, trionic coherence remains stored in the spin system for 85 ps due to Pauli blocking of the triplet electron. The complex spectro-temporal evolution of transmission is explained analytically by solving the Maxwell-Liouville equations. Pump and probe polarizations provide full control over amplitude and phase of the quantum beats

Value of children in childless adults with and without depression

Value of children (VOC) as individually perceived costs and benefits of children may help explain fertility behavior. Depressive cognitive styles may influence these perceptions. Based on the data of waves two, four, six, eight, and ten of the German Family Panel pairfam, this study examined the differences between adults with and without depression concerning various aspects of their VOC using pooled ordinary least squares regression analyses. The sample consisted of N = 5,525 men and women aged 18-47 years either with depression (STDS ≥ 25) or without depression (STDS < 25) who did not have children yet. All aspects of perceived costs were significantly higher in subjects with depression. Concerning benefits, persons with depression showed significantly lower values in affection, stimulation, and comfort, and there was no significant difference concerning esteem as a possible benefit. As such, depression seems to negatively influence VOC in almost all aspects except for esteem benefits. Since social esteem as a benefit of VOC in parents predicts depression in offspring, this might be a cause for the intergenerational transmission of depression. To support individuals of childbearing age with depression in therapy, more research about the influence of depressive cognitions on VOC and fertility intentions is needed

Interformat reliability of the patient health questionnaire: Validation of the computerized version of the PHQ-9

Background: Computerized versions of well-established measurements such as the PHQ-9 are widely used, but data on the comparability of psychometric properties are scarce. Objective: Our objective was to compare the interformat reliability of the paper-and-pen version with a computerized version of the PHQ-9 in a clinical sample. Methods: 130 participants with mental health disorders were recruited during psychotherapeutic treatment in a mental health clinic. In a crossover design, they all completed the PHQ-9 in both the computerized and paper-and-pen versions in randomized order. Results: The internal consistency was comparable for the computer (α = 0.88) and paper versions (α = 0.89), and highly significant correlations were found between the formats (r = 0.92). PHQ-9 total scores were not significantly different between the paper and the computer delivered versions. There was a significant interaction effect between format and order of administration for the PHQ-9, indicating that the first administration delivered slightly higher scores. Limitations: In order to reduce the required effort for the participants, we did not ask them to fill out anything but the PHQ-9 once in paper and once in computer version. Conclusions: Our findings suggest that the PHQ-9 can be transferred to computerized use without affecting psychometric properties in a clinically meaningful way

Blending face-to-face and internet-based interventions for the treatment of mental disorders in adults: Systematic review

Background: Many studies have provided evidence for the effectiveness of Internet-based stand-alone interventions for mental disorders. A newer form of intervention combines the strengths of face-to-face (f2f) and Internet approaches (blended interventions). Objective: The aim of this review was to provide an overview of (1) the different formats of blended treatments for adults, (2) the stage of treatment in which these are applied, (3) their objective in combining face-to-face and Internet-based approaches, and (4) their effectiveness. Methods: Studies on blended concepts were identified through systematic searches in the MEDLINE, PsycINFO, Cochrane, and PubMed databases. Keywords included terms indicating face-to-face interventions (“inpatient,” “outpatient,” “face-to-face,” or “residential treatment”), which were combined with terms indicating Internet treatment (“internet,” “online,” or “web”) and terms indicating mental disorders (“mental health,” “depression,” “anxiety,” or “substance abuse”). We focused on three of the most common mental disorders (depression, anxiety, and substance abuse). Results: We identified 64 publications describing 44 studies, 27 of which were randomized controlled trials (RCTs). Results suggest that, compared with stand-alone face-to-face therapy, blended therapy may save clinician time, lead to lower dropout rates and greater abstinence rates of patients with substance abuse, or help maintain initially achieved changes within psychotherapy in the long-term effects of inpatient therapy. However, there is a lack of comparative outcome studies investigating the superiority of the outcomes of blended treatments in comparison with classic face-to-face or Internet-based treatments, as well as of studies identifying the optimal ratio of face-to-face and Internet sessions. Conclusions: Several studies have shown that, for common mental health disorders, blended interventions are feasible and can be more effective compared with no treatment controls. However, more RCTs on effectiveness and cost-effectiveness of blended treatments, especially compared with nonblended treatments are necessary

Oral health: global research performance under changing regional health burdens

Objectives: Inadequate oral hygiene still leads to many serious diseases all over the world. Therefore, this study aimed to analyze scientific research in the field of oral health in order to be able to comprehend their relevant subject areas, research connections, or developments. Methods: This study aimed to assess the global publication output on oral hygiene to create a world map that provides background information on key players, trends, and incentives of research. For this purpose, established bibliometric parameters were combined with state-of-the-art visualization techniques. Results: This study shows the actual key players of research on oral hygiene in high-income economies with only marginal participation from lower economies. This still corresponds to the current burden situations, but they are more and more shifting to the disadvantage of the low-income countries. There is a clear North–South and West–East gradient, with the USA and the Western European nations being the most publishing nations on oral hygiene. As an emerging country, Brazil plays a role in the research. Conclusions: The scientific power players were concentrated in high-income countries. However, the changing epidemiological situation requires a different scientific approach to oral hygiene. This requires an expansion of the international network to meet the demands of future global oral health burdens, which are mainly related to oral hygiene

Digital Interventions for Mental Disorders:Key Features, Efficacy, and Potential for Artificial Intelligence Applications

Mental disorders are highly prevalent and often remain untreated. Many limitations of conventional face-to-face psychological interventions could potentially be overcome through Internet-based and mobile-based interventions (IMIs). This chapter introduces core features of IMIs, describes areas of application, presents evidence on the efficacy of IMIs as well as potential effect mechanisms, and delineates how Artificial Intelligence combined with IMIs may improve current practices in the prevention and treatment of mental disorders in adults. Meta-analyses of randomized controlled trials clearly show that therapist-guided IMIs can be highly effective for a broad range of mental health problems. Whether the effects of unguided IMIs are also clinically relevant, particularly under routine care conditions, is less clear. First studies on IMIs for the prevention of mental disorders have shown promising results. Despite limitations and challenges, IMIs are increasingly implemented into routine care worldwide. IMIs are also well suited for applications of Artificial Intelligence and Machine Learning, which provides ample opportunities to improve the identification and treatment of mental disorders. Together with methodological innovations, these approaches may also deepen our understanding of how psychological interventions work, and why. Ethical and professional restraints as well as potential contraindications of IMIs, however, should also be considered. In sum, IMIs have a high potential for improving the prevention and treatment of mental health disorders across various indications, settings, and populations. Therefore, implementing IMIs into routine care as both adjunct and alternative to face-to-face treatment is highly desirable. Technological advancements may further enhance the variability and flexibility of IMIs, and thus even further increase their impact in people’s lives in the future