"Never meant to break your heart" Adult attachment and cardiovascular regulatory capacity

Although theoretically and clinically important, research on attachment-related cardiovascular function in adults has just started to unfold over the last decade, and methods and results differ substantially. A central shortcoming of previous studies concerns attachment theory itself: There are several pathways on when and how the attachment system may influence stress physiology, and these interactions have been largely neglected. One area of particular significance is the dynamic conceptualization of insecure attachment strategies as defensive processes. This dissertation aims at testing a possible approach to address these issues. As many of the existing studies use self-report data for the assessment of attachment, we first translated and validated the Experiences in Close Relationships - Revised questionnaire (ECR-R) in two large samples. The German version performed well with regard to reliability and validity, and was therefore used in all other studies. The second study describes the rationale and validation of a newly developed, attachment-related short-term stressor, the separation recall (SR) task. The SR was compared to an achievement-oriented stressor, and correlated with attachment style. Both stressors elicited cardiovascular and emotional reactions, but patterns differed between the tasks. Blood pressure down-regulation after the SR but not the other stressor was related to attachment avoidance. The third study deals with factors leading to the activation of attachment-related defensive processes. It probes whether there is a lower threshold of personal significance of attachment-related memory content which triggers attachment-related defensive functioning as measured by psychophysiological response. Differences in personal significance of the reported separation experience moderated the influence of attachment avoidance on heart rate reactivity. The fourth study concentrates on whether psychological distress in general, and life-stress more specifically, are able to distract and change the impact of attachment defensive functioning on psychophysiological stress reaction; in other words, it explores the upper boundaries and vulnerability of insecure attachment strategies. Results indicate that especially life-stress may moderate the impact of attachment avoidance on the reactivity of high-frequency heart rate variability. The overall findings are discussed with regard to their impact on psychosomatic medicine and health psychology

Experience-Based Competency Training in Child and Adolescent Psychotherapy

Background: Compared to adult psychotherapy training, there is little knowledge about the use of standardized actor-patients (SPs) for the development of professional competencies for younger patient populations. Objective: We assessed the effectiveness of two university-based training programs for diagnostic as well as intervention skills in child and adolescent psychotherapy. Methods: Psychology students took part in two courses on the development of diagnostic competencies (NÂ =Â 59) and on intervention skills (NÂ =Â 51). We applied active and experience-based learning strategies, including exercises on self-awareness, mindfulness, peer role-play, and the use of SPs. Competence gain as well as a general evaluation of the seminars were assessed by self-report. Results: For both seminars, self-reported competence increased significantly with a large effect. The retrospective evaluation of learning success and acceptance ratings of the didactic formats were high. Conclusions: Experience-based trainings that include SPs are a feasible option for child and adolescent psychotherapy. The findings are discussed from a conceptual as well as a practical perspective.Hintergrund: Im Vergleich zur Psychotherapieausbildung für Erwachsene fehlt es an Wissen über den Einsatz von standardisierten Schauspielpatient_innen (SP) für die Entwicklung professioneller Kompetenzen für jüngere Patient_innenpopulationen. Fragestellung: Wir untersuchten die Effektivität zweier universitärer Trainings zu diagnostischen und interventionellen Fertigkeiten in der Kinder- und Jugendlichenpsychotherapie. Methoden: Psychologiestudierende nahmen an zwei Kursen zur Entwicklung diagnostischer Kompetenzen (N = 59) und Interventionsfertigkeiten (N = 51) teil. Wir setzten aktive, erfahrungsbasierte Lernstrategien ein, darunter Übungen zur Selbstwahrnehmung, Achtsamkeit, Peer-Rollenspiele und Schauspielpatient_innen. Subjektiver Kompetenzgewinn wurde im Fragebogen sowie durch eine allgemeine Bewertung des Seminars erfasst. Ergebnisse: In beiden Seminaren stieg das subjektive Kompetenzerleben signifikant mit einem großen Effekt an. Retrospektive Bewertung des Lernerfolgs und Akzeptanz der didaktischen Formate waren hoch. Schlussfolgerungen: Erfahrungsbasierte Trainings unter Einbeziehung von SPs für die Kinder- und Jugendlichenpsychotherapie sind machbar. Die Ergebnisse werden unter konzeptuellen und anwendungsbezogenen Aspekten diskutiert

Structural impairment and conflict load as vulnerability factors for burnout – A cross-sectional study from the German working population

IntroductionIndividual vulnerability and resilience factors are increasingly studied in burnout research. This is especially true for clinical variables that translate directly into intervention programs from a psychodynamic perspective. For example, few studies have examined the relationship between structural impairment and the individual spectrum of motivational conflicts according to the Operationalized Psychodynamic Diagnosis system (OPD) in relation to burnout. To substantiate previous findings, we hypothesized that structural impairment as well as motivational conflicts are related to burnout, but that structural impairment explained additional variance and mediated a possible relationship between conflicts and burnout.MethodThe present cross-sectional study was carried out on a sample of the German working population (N = 545). Questionnaires were used to measure structural impairment (OPD-SQS), the conflict-modes along with the category K0 (OPD-CQ), as well as burnout (BOSS-I/-II).ResultsStructural impairment, a number of conflict modes, and burnout were significantly associated. Moreover, structural impairment explained additional variance in burnout. The requirements for the conflict-specific mediation models were given for 9 of the 12 OPD conflict modes. In these models the impact of the conflict modes on burnout was mediated by structural impairment.DiscussionThe current study broadens the comprehension of the relations between structural impairment, the conflict modes and burnout. In addition it higlights the role of structural impairment in predicting burnout risk and possible prevention approaches

Measuring personality functioning with the 12-item version of the OPD-Structure Questionnaire (OPD-SQS): reliability, factor structure, validity, and measurement invariance in the general population

BackgroundThe assessment of personality functioning is at the core of current dimensional models of personality disorders. A variety of measures from different clinical and research traditions aim to assess basic psychological capacities regarding the self and others. While some instruments have shown reliability and validity in clinical or other selected samples, much less is known about their performance in the general population.MethodsIn three samples representative of the German adult population with a total of 7,256 participants, levels of personality functioning were measured with the short 12-item version of the Operationalized Psychodynamic Diagnosis – Structure Questionnaire (OPD-SQS). We addressed questions of factor structure, reliability, validity, factorial invariance, and provide norm values.ResultsConfirmatory factor analysis indicated a satisfactory to good model fit. OPD-SQS models were mostly unaffected by variables such as gender, age, or measurement time. As expected, personality functioning was associated with general psychopathology as well as indices of occupational functioning.ConclusionThe OPD-SQS is a viable measure to assess personality functioning in the general population

Day clinic and inpatient psychotherapy of depression (DIP-D): qualitative results from a randomized controlled study

Objective: Depressive disorders are among the most common psychiatric disorders. For severely depressed patients, day clinic and inpatient settings represent important treatment options. However, little is known about patients’ perceptions of the different levels of care. This study aimed to obtain an in-depth analysis of depressive patients’ experiences of day clinic and inpatient treatment in a combined clinical setting. Methods. Following a randomized controlled trial comparing day clinic and inpatient psychotherapy for depression (Dinger et al. in Psychother Psychosom 83:194–195, 2014), a sample of depressive patients (n = 35) was invited to participate in a semi-structured interview during an early follow up 4 weeks after discharge. A qualitative analysis of interview transcripts was performed following the principles of constructivist thematic analysis. Results: Following analysis, 1355 single codes were identified from which five main categories and 26 themes were derived for both groups. In regard to patient group integration and skill transfer to everyday life, distinct differences could be observed between the day clinic and inpatient group. Conclusion: While adjustment to therapeutic setting and patient group integration seem to be facilitated by inpatient treatment, the day clinical setting appears to promote treatment integration into patients’ everyday contexts, aiding treatment-related skill transfer to everyday life as well as alleviating discharge from clinic treatment. Further studies on depressive subject groups in day clinic and inpatient treatment should investigate aspects of group cohesion and treatment integration in relation to therapeutic outcome

Response to responsible research assessment I and II from the perspective of the DGPs working group on open science in clinical psychology

We comment on the papers by Schönbrodt et al. (2022) and Gärtner et al. (2022) on responsible research assessment from the perspective of clinical psychology and psychotherapy research. Schönbrodt et al. (2022) propose four principles to guide hiring and promotion in psychology: (1) In addition to publications in scientific journals, data sets and the development of research software should be considered. (2) Quantitative metrics can be useful, but they should be valid and applied responsibly. (3) Methodological rigor, research impact, and work quantity should be considered as three separate dimensions for evaluating research contributions. (4) The quality of work should be prioritized over the number of citations or the quantity of research output. From the perspective of clinical psychology, we endorse the initiative to update current practice by establishing a matrix for comprehensive, transparent and fair evaluation criteria. In the following, we will both comment on and complement these criteria from a clinical-psychological perspective