Education and mental health: Do psychosocial resources matter?

Prevalence rates for mental health problems are higher when an individual's socioeconomic status (SES) is low, but the underlying mechanisms are not clearly understood. We investigated associations between education as indicator for SES and depressive symptoms as well as positive mental health (PMH). Moreover, we hypothesized that low education is associated with a lack of psychosocial resources and more daily hassles, which in turn mediate the relationships between education and mental health. In a German representative sample (N = 7937), we cross-sectionally first examined whether a person's educational level was associated with depressive symptoms and PMH. Educational level was defined as the highest academic qualification achieved. Second, we investigated whether also sense of control, resilience, delay of gratification, cultural activity and daily hassles followed gradients along the educational level. Third, we investigated whether they mediated the relationship between education and mental health. Results showed that depressive symptoms measured by items from the DASS-42 depression subscale were more prevalent for persons with a low educational level, PMH operationalized by the Positive Mental Health Scale was equally distributed, and all psychosocial characteristics followed the gradient of educational level. In addition, the group with a high school diploma was particularly burdened. Structural equation modeling indicated that the associations between education and mental health were mediated by all psychosocial characteristics and daily hassles, apart from the delay of gratification. In the group with the lowest educational level the model fit indices for depressive symptoms and PMH were acceptable (χ2 = 10007.243 (627), CFI = 0.869, RMSEA = 0.04 (90% CI [0.04, 0.04], SRMR = 0.05; and χ2 = 12779.968 (741), CFI = 0.86, RMSEA = 0.05 (90% CI [0.05, 0.05], SRMR = 0.05), respectively). The effect size Pm refers to the proportion of the total effect that is mediated by one or more variables (“M”), and the effect size of all indirect effects in the model for depressive symptoms was Pm = .80 and for PMH it was Pm = .68. The results support our hypotheses that low education is associated with less psychosocial resources, which in turn serve together with daily hassles as pathways between education and depressive symptoms as well as PMH. Building on these findings, longitudinal studies are necessary to investigate causality

Beliefs about appearance. Validation of a questionnaire

Grocholewski A, Tuschen-Caffier B, Margraf J, Heinrichs N. Überzeugungen über das Erscheinungsbild - Eine Fragebogenvalidierung. Zeitschrift für Klinische Psychologie und Psychotherapie. 2011;40(2):85-93.Background: The Appearance Schemas Inventory-Revised (ASI-R) is an instrument to rate ones self-appearance. It consists of two scales: the self-evaluative and the motivational salience. The ASI-R form is valid and reliable in its original. Objective: Does the German version of the questionnaire show acceptable test statistics (reliability and validity)? Methods: We gave the ASI-R and other self-report instruments to different samples (Students, individuals with eating disorders, individuals who want to get cosmetic medical treatment, total population, psychotherapeutic outpatient group; total sample N = 1256) for validation. Results: The ASI-R is reliable (cronbach's alpha = .72-. 89), the convergent validity ranges between .51 -. 68 (EDE), and -.07 -.33 (RSE), the divergent validity of the total score between .28 (ADS-K), .35 (GSI SCL-90-R), and .44 (GSI BSI). The ASI-R discriminates valid between sex and specific mental disorders. Component analysis confirm construct validity for a sample of students and a sample of persons who want cosmetic-medical treatment. Conclusions: The German version of ASI-R is suitable to asses attitudes concerning self-appearance. But the sub-division into two subscales selfevaluative salience and motivational salience are only valid for students, individuals with body dysmorphic disorder and individuals who want to get cosmetic-medical treatment.Theoretischer Hintergrund: Das Appearance Schemas Inventory-Revised (ASI-R) ist ein Selbstbeurteilungsinstrument, das die Überzeugungen im Sinne der selbstevaluativen Salienz bzw. die motivationale Salienz bezüglich des eigenen Erscheinungsbildes misst. Das ASI-R hat sich an einer US-amerikanischen Stichprobe (N = 603) als valide und reliabel erwiesen. Fragestellung: Ist das Konstrukt auch in der deutschen Version valide und reliabel? Methode: Stichproben aus unterschiedlichen Populationen (Studierende, Patientinnen mit der Diagnose einer Essstörung, Personen mit medizinisch-kosmetischem Behandlungswunsch, Bevölkerungsstichprobe, Psychotherapiestichprobe) bekamen das ASI-R und weitere Instrumente zur Feststellung von Reliabilität und konvergenter und divergenter Validität vorgelegt, Gesamtstichprobe N = 1.256). Ergebnisse: Die Reliabilität des Instruments liegt bei Cronbachs α = .72–.89. Die konvergente Validität bewegt sich zwischen .51–.68 (EDE), und –.07––.33 (RSE), die divergente Validität für die Gesamtskala zwischen .28 (ADS-K), .35 (GSI SCL-90-R) und .44 (GSI BSI). Das ASI-R ist diskriminant valide in Bezug auf Geschlecht und spezifische psychische Störungen. Faktorenanalysen bestätigen die Konstruktvalidität in einer studentischen Stichprobe und einer Stichprobe von Personen mit kosmetisch-medizinischem Behandlungswunsch. Schlussfolgerung: Das ASI-R ist geeignet, Überzeugungen über das Erscheinungsbild reliabel und valide zu erfassen. Die Unterteilung in selbstevaluative und motivationale Aspekte scheint nur für Studierende, Personen mit körperdysmorphen Störungen und Personen mit einem Wunsch nach kosmetisch-medizinischer Behandlung relevant zu sein

The circular structure of values: The case of China

This study examined the circular structure of values in China. The circular structure is a central element of Schwartz value theory and visualises the idea that some values are similar while others conflict with one another. Whereas numerous studies addressed the question whether the circular structure of values can be generalised cross-culturally, results for China are inconclusive. In this paper, we argue that taking a closer look at China provides a challenge to the circular structure and allows for drawing conclusions regarding the limits versus generalizability of Schwartz' theory. For this purpose, we first conduct a re-analysis of Chinese data from a former meta-analysis (Study 1) and second, present results from a large study of 10,652 Chinese college students (Study 2). Results of Study 1 revealed that graphical representation of the circular structure matched theoretical expectations but five out of six samples showed relatively bad fit to the theorised structure. By contrast, data in Study 2 showed a good model fit. As an overall conclusion, the circular structure is well supported in the Chinese context, and small sample sizes in previous studies might have caused the imperfect match to the prototypical circular structure

Physical activity, mental and physical health during the Covid-19 outbreak: longitudinal predictors of suicide ideation in Germany

Aim Suicide ideation has increased since the outbreak of Covid-19 in many countries. The present longitudinal study inves- tigated potential predictors of suicide ideation. Subject and methods Data of 406 participants from Germany (age M = 27.69, SD = 6.88) were assessed via online surveys in spring 2020 (baseline, BL) and in spring 2021 (follow-up, FU). Results The current results reveal a significant increase in symptoms of depression, anxiety, and stress between 2020 and 2021. Positive mental health (PMH), sense of control, and physical health significantly decreased. Depression symptoms (BL), PMH (BL), and consciously enhanced physical activity since the pandemic outbreak (FU) significantly predicted 12-month suicide ideation (FU). In a moderated mediation analysis, the positive relationship between depression and suicide ideation was significantly mediated by PMH. Consciously enhanced physical activity significantly moderated the negative association between PMH and suicide ideation. Conclusion The context of Covid-19 could negatively impact mental health and physical health. This might increase the risk for suicide ideation. However, PMH and physical activity might serve as protective factors. The protective effect of physical activity could be especially important in people with high depression symptoms and low PMH, such as clinical patients. Potential ways of how PMH and physical activity could be enhanced in the Covid-19 context to prevent suicide ideation are discussed

Validity of the "Diagnostisches Interview bei psychischen Störungen" (DIPS fur DSM-IV-TR)

The "Diagnostisches Interview bei psychischen Störungen" (DIPS fur DSM-IV-TR; Schneider & Margraf, 2006) is a structured interview that has been expanded and adapted to DSM-IV-TR criteria. Objective: The purpose of this study was to validate the DIPS for DSM-IV-TR. Methods: The validity of the DIPS diagnoses was verified using a questionnaire battery on a sample of 194 patients from various clinical facilities. Results: Results indicate good validity in the categories of anxiety disorders, mood disorders, somatoform disorders, eating disorders, substance disorders, and for the exclusion of mental disorders. Inadequate validity was found solely for sleep disorders and generalized anxiety disorder. Conclusions: The DIPS for DSM-IV-TR has proven to be a valid tool (except for generalized anxiety disorder and sleep disorders) for use with outpatients and inpatients from psychiatric facilities

Pathological network changes in patients with social anxiety disorder before and after an Internet-based CBT

A network perspective may shed light on the understanding of Internet-based CBT efficacy for social anxiety disorder. Previous cross-sectional evidence revealed a densely interconnected network for individuals with social anxiety. Yet, longitudinal network changes before and after ICBT are lacking. This study aimed to investigate pathological network changes with Graphical Gaussian Model among patients with social anxiety disorder (n = 249). Social phobia scale (SPS) and Social interaction anxiety scale (SIAS) were measured before and after 8 weeks Internet-based CBT. Results revealed the connection between symptom tension when speaking and symptom awkward when being watched was the most robust edges during ICBT interventions. The pathological network benefited from ICBT and exhibited modification in several prominent interconnections. The overall network connectivity continues to exhibit comparable strength after ICBT. This study represents the first examination of social anxiety network changes after patients with SAD completed a systematic ICBT. Changes in critical edges and nodes provide valuable insights for the design and efficacy assessment of ICBT interventions

Method Paper of a Project for Coordinating Research at the University Outpatient Clinics for Psychotherapy in Germany

Velten J, Margraf J, Benecke C, et al. Methodenpapier zur Koordination der Datenerhebung und -auswertung an Hochschul- und Ausbildungsambulanzen für Psychotherapie (KODAP). ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE. 2017;46(3):169-175.University outpatient clinics are important facilitators of psychological treatments for children, adolescents, and adults with diverse mental disorders and are important contributors to psychotherapy research in Germany. Since 2013, a steering committee has initiated and realized a project aiming to coordinate research efforts in these clinics. In 2016, unith. ev, a network of university training centers for psychotherapy, took over the sponsorship of this project. The main goal of the project is to aggregate and analyze longitudinal treatment data - including patient, therapist, and treatment characteristics - across all participating outpatient clinics. The start of data assessment is planned for 2018. This paper describes legal, methodological, and technical challenges, the current state of the project, as well as a pilot study planned for 2017

KODAP Research Network: Pilot Data of a Project for Coordinating Research at University Outpatient Psychotherapy Clinics for Children and Adolescents in Germany

In-Albon T, Christiansen H, Imort S, et al. Forschungsnetzwerk KODAP Pilotdaten zur Inanspruchnahmepopulation universitärer Psychotherapie-Ambulanzen für Kinder und Jugendliche. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE. 2019;48(1):40-50.Zusammenfassung. Theoretischer Hintergrund: Die Anzahl universitärer psychotherapeutischer Ambulanzen für Kinder und Jugendliche an psychologischen Instituten ist in nur wenigen Jahren deutlich angestiegen. Diese erfreuliche Entwicklung ist potentiell für die Versorgung von Kindern und Jugendlichen mit psychischen Störungen, die praxisnahe Lehre im Psychologiestudium, die qualifizierte Psychotherapieausbildung und die klinisch-psychologische Forschung äußerst relevant. Der Wissensstand bezüglich Diagnostik, Ätiologie und psychotherapeutischer Behandlung von psychischen Störungen im Kindes- und Jugendalter steht für viele Störungsbilder deutlich hinter dem umfangreichen Forschungs- und Wissensstand psychischer Störungen des Erwachsenenalters. Vor diesem Hintergrund ist die Initiative, Daten der universitären Psychotherapieambulanzen für Kinder und Jugendliche zusammenzuführen, ein wesentlicher Schritt, um der Altersgruppe der Kinder und Jugendlichen gleich gut begründete und evaluierte Behandlungsansätze zukommen zu lassen. KODAP – die Koordination der Datenerhebung und -auswertung an Forschungs-‍, Lehr- und Ausbildungsambulanzen für psychologische Psychotherapie – übernimmt dabei die Koordination dieses komplexen Vorhabens sowohl für den Kinder- und Jugend- als auch den Erwachsenenbereich. Fragestellung / Methode: Es werden die soziodemographischen und klinischen Daten der im Jahr 2016 behandelten Patient_innen, deren Eltern und jeweiligen Therapeut_innen von sieben Ambulanzen beschrieben. Hierzu werden die deskriptiven Angaben zu Diagnosehäufigkeiten, Altersstruktur, Anzahl komorbider Störungen der Patient_innen und eine soziodemographische Beschreibung der Therapeut_innen und Eltern vorgestellt und diskutiert. Ergebnisse: Für das Jahr 2016 stehen Daten von 568 Kindern und Jugendlichen zwischen 3 und 20 Jahren (Malter = 11.89, SD = 3.68; 46.6 % weiblich) zur Verfügung. Die häufigsten Diagnosen stellten die Angststörungen (F40, F41, F93) mit 317 Diagnosen (35.30 %), gefolgt von den hyperkinetischen Störungen und den Störungen des Sozialverhaltens (F90, F91, F92) mit 195 Diagnosen (21.71 %) dar. Bei 45.6 % der Patient_innen wurde mehr als eine Störungsdiagnose festgestellt. Des Weiteren lagen die Daten von 257 Müttern bzw. 228 Vätern und 126 Therapeut_innen, davon 83.1 % weiblich, vor. Schlussfolgerungen: Die Studie zeigt die Machbarkeit der Zusammenführung und Aufbereitung der Daten aus universitären Psychotherapieambulanzen für Kinder und Jugendliche. Zudem geben die Pilotdaten einen ersten Einblick in diese Inanspruchnahmepopulation. Schlüsselwörter:Hochschulambulanzen für Kinder und Jugendliche, Versorgungsforschung, PsychotherapieforschungBackground: In recent years, the number of university outpatient psychotherapy clinics for children and adolescents in Germany has substantially increased. This is of potential importance not only for the health care of young people affected by mental disorders but also for teaching and mental health research. Knowledge about certain disorders in children and adolescents, predictors of treatment success, and treatment trajectories is still in its early stages. Objective: Therefore, in 2013 an initiative was launched to aggregate data from university outpatient psychotherapy clinics for children and adolescents in order to create a German-wide research data platform. KODAP short for the coordination of data collection and evaluation at research and training outpatient clinics for psychotherapy - is responsible for the coordination of this complex project for children/adolescents and adults. Method: The patient population treated in seven university outpatient psychotherapy clinics for children and adolescents in 2016 is described. Descriptive data on the diagnoses as well as on the age, frequency of comorbid disorders of the patient population, their parents, and their therapists are presented. Results: For the year 2016, data of 568 children and adolescents between 3 and 20 years of age (M = 11.89, SD = 3.68; 46.6% female) were available. The most frequent diagnoses were anxiety disorders (F40, F41, F93; n = 317, 35.30%) followed by attention-deficit hyperactivity disorders and conduct disorders (F90, F91, F92; n = 195, 21.71 %). In 45.6% of the patients, there was at least one additional comorbid diagnosis. The data of 257 mothers, 228 fathers, and 126 therapists, of these 83.1 % female, are described. Conclusion: The present study indicates the feasibility of consolidating and evaluating research data across university outpatient psychotherapy clinics for children and adolescents. This KODAP pilot study provides the first description of this patient population