My Sadness – Our Happiness: Writing About Positive, Negative, and Neutral Autobiographical Life Events Reveals Linguistic Markers of Self-Positivity and Individual Well-Being

Objective: Narratives of autobiographical events contain rich information about an individual’s private experience, his/her deepest thoughts, feelings, and emotions. The present study investigates linguistic markers of emotion expression and subjective well-being in adults during one session of positive, negative, and neutral expressive writing. Participants (N = 28 healthy participants, N = 7 adults with depressive symptoms), all native speakers of German were instructed to write expressively about personally relevant autobiographical life events of negative, positive, and neutral content.Methods: Quantitative text analysis was performed to determine the amount of emotional words, first person pronouns (singular vs. plural), and cognitive function words used in positive, negative, and neutral narratives and to examine the potency of these classes of words as linguistic markers of positivity/negativity, self-reference, and cognitive reappraisal. Additionally, the relationship between expressive writing and subjective well-being was explored by assessing changes in self-reported psychosomatic symptoms and in bodily and emotional awareness immediately after positive, negative, and neutral writing.Results: Regarding healthy participants, negative narratives contained significantly more negative emotional words than positive or neutral narratives. However, negative narratives also contained more positive emotional words compared to negative emotional words in positive narratives. Moreover, negative narratives contained more cognitive function words than positive narratives, suggesting that healthy participants tried to reappraise negative experiences while writing about negative personal life events. Positive narratives were characterized by an increased use of positive words and of pronouns of the first person plural (“we”), supporting a positivity bias and an extension of self-reference from first person singular to plural (we-reference) during positive expressive writing. Similarly, writing about neutral events was characterized by a positivity bias. Although based on descriptive analysis only, preferential use of positive words and cognitive function words in negative narratives was absent in participants reporting depressive symptoms. Positive, negative, and neutral expressive writing was accompanied by differential changes in bodily sensations, emotional awareness, and self-reported psychosomatic symptoms in all participants.Discussion: The findings are discussed with respect to previous research, a self-positivity bias, and a universal positivity bias in language use highlighting the relevance of these biases as markers of subjective well-being

Comparison Between Rigid Double Upright and Lace-up Ankle Braces on Ankle Range of Motion, Functional Performance, and User Satisfaction of Brace Characteristics

Background: Braces are often used before returning to activity following ankle sprains and also prophylactically in sports considered the high risk for ankle sprains. The purpose of this study was to compare range of motion (ROM) limitations, functional performance, and satisfaction of rigid double upright and lace-up braces. Subjects: In total, 30 healthy adults \u3e18 years of age (Mean, 22.6 6 2.7 years) without lower extremity injury and involved in regular physical activity participated in this study. Materials/Methods: Ankle ROM assessment and lower extremity performance testing (figure-of-8 hop, side hop, 6-m single-limb crossover, and square hop) was administered under the following 3 conditions: unbraced, rigid braces, and lace-up braces. A questionnaire was completed following the test protocol on brace characteristics and satisfaction. Repeated-measures ANOVA was used to determine the main effects on outcome variables of ROM, hop performance, and satisfaction. Tukey LSD post hoc comparisons were conducted on significant main or interaction effects (P \u3c .05) to determine differences between group by condition means. Results: In total, 30 participants completed the study. The lace-up brace limited plantarflexion and inversion ROM more than the rigid brace. When compared to the unbraced condition, both braced conditions resulted in better performance times, although not statistically significant. Higher satisfaction was reported with the lace-up brace on appearance, fit, prevention, and overall satisfaction. Conclusions and Clinical Relevance: The ankle braces primarily limited ankle plantarflexion and inversion ROM, which are motions related to common reported mechanisms of ankle sprains. The braces did not negatively affect hop performance, and user satisfaction indicated a slight preference for the lace-up brace

Study protocol of a randomised controlled trial on SISU, a software agent providing a brief self-help intervention for adults with low psychological well-being

Introduction Only a minority of people living with mental health problems are getting professional help. As digitalisation moves on, the possibility of providing internet/mobile-based interventions (IMIs) arises. One type of IMIs are fully automated conversational software agents (chatbots). Software agents are computer programs that can hold conversations with a human by mimicking a human conversational style. Software agents could deliver low-threshold and cost-effective interventions aiming at promoting psychological well-being in a large number of individuals. The aim of this trial is to evaluate the clinical effectiveness and acceptance of the brief software agent-based IMI SISU in comparison with a waitlist control group.Methods and analysis Within a two-group randomised controlled trial, a total of 120 adult participants living with low well-being (Well-being Scale/WHO-5) will be recruited in Germany, Austria and Switzerland. SISU is based on therapeutic writing and acceptance and commitment therapy-based principles. The brief intervention consists of three modules. Participants work through the intervention on 3 consecutive days. Assessment takes place before (t1), during (t2) and after (t3) the interaction with SISU, as well as 4 weeks after randomisation (t4). Primary outcome is psychological well-being (WHO-5). Secondary outcomes are emotional well-being (Flourishing Scale), psychological flexibility (Acceptance and Action Questionnaire-II), quality of life (Assessment of Quality of Life -8D), satisfaction with the intervention (Client Satisfaction Questionnaire-8) and side effects (Inventory for the assessment of negative effectsof psychotherapy). Examined mediators and moderators are sociodemographic variables, personality (Big Five Inventory-10), emotion regulation (Emotion Regulation Questionnaire), alexithymia (Toronto Alexithymia Scale-20), centrality of events (Centrality of Events Scale), treatment expectancies (Credibility Expectancy Questionnaire) and technology alliance (Inventory of Technology Alliance–Online Therapy). Data analysis will be based on intention-to-treat principles. SISU guides participants through a 3-day intervention.Ethics and dissemination This trial has been approved by the ethics committee of the Ulm University (No. 448/18, 18.02.2019). Results will be submitted for publication in a peer-reviewed journal and presented at conferences.Trial registration The trial is registered at the WHO International Clinical Trials Registry Platform via the German Clinical Trials Register (DRKS): DRKS00016799 (date of registration: 25 April 2019). In case of important protocol modifications, trial registration will be updated. This is protocol version number 1

Blended Care in In-Patient Acute Psychiatric Care. The Example of a Group Training for Social Competences in Adults—A Pretest–Posttest Feasibility Study

Introduction: Deficits in social skills can be an important modulating factor in the development and progress of various mental disorders. However, limited resources in inpatient care often impede effective social skills training. This study investigates the feasibility of a blended group training for social skills (SST) in an inpatient psychiatric setting. Methods and Analysis: For this one-group pretest–posttest trial, inpatients with a diagnosed mental disorder were recruited. Participation in the blended SST lasted four weeks and took place within usual inpatient psychiatric care. The blended intervention comprised four face-to-face group sessions and three complementary online modules within four weeks. Assessments took place before (t1) and after (t2) the training. Feasibility outcomes (use, acceptance, satisfaction, implementability into usual psychiatric inpatient care) and effectiveness outcomes regarding social skills were assessed. Results: N = 15 participants were recruited. Most patients completed all questionnaires (93%) and all modules of the blended SST concept (60%). All participants (100%) would recommend the blended intervention to a friend. Regarding social skills, exploratory analyses revealed a non-significant medium-sized effect (Cohen’s d = 0.5 95%CI 0.3 to 1.25, p = 0.08). Discussion: This trial shows that a blended care SST is feasible for the use in acute psychiatric inpatient care setting. Although the wards were acute, with high turnover and change of inpatients, 60% of participants were treated per protocol over four weeks. Overall, the evidence on blended care concepts in psychiatric care settings is extremely poor to date. Hence, this trial should encourage intensified blended inpatient psychiatric care research

übersichtsarbeit: Internetbasierte Interventionen bei chronischen körperlichen Erkrankungen

BACKGROUND: Clinical guidelines recommend psychosocial care as an integral part of medical treatment, but access is often limited. Technology-based approaches provide an attractive opportunity to optimize health outcomes and quality of life in people with chronic somatic diseases e.g. by means of Internet- and mobile-based interventions (IMIs). The present article provides an overview on the basics of IMIs, applications and their evidence base for people living with chronic somatic diseases. METHODS: We conducted a selective literature search in the PubMed and Cochrane databases. Reviews which included randomized controlled trials investigating psychological IMIs were discussed pertaining to their relevance for the population described. RESULTS: IMIs lead to a change in unfavorable behavior connected to chronic somatic diseases. IMIs can foster protective factors like balanced physical activity or risk factors like smoking or alcohol consumption. However, studies reveal small effect sizes of d=0.25 for physical activity and an averaged effect size of d=0.20 for smoking and alcohol consumption. Additionally, IMIs can be used for the (co-)treatment of chronic somatic diseases, for instance to increase disease-specific selfefficacy in patients with diabetes (d=0.23). Studies included in meta-analyses are often highly heterogenous and are investigated in research contexts with limited health care services relevance. CONCLUSION: IMIs are potentially effective when aiming at lifestyle changes and supporting medical treatment in people with chronic somatic diseases. However, results are still heterogenous and the evidence base is limited regarding specific settings, compounding the discussion of possible ways of implementing IMIs into our healthcare systems

Lessons learned from an attempted randomized-controlled feasibility trial on “WIDeCAD” - An internet-based depression treatment for people living with coronary artery disease (CAD)

Background: Despite the high prevalence of comorbid depression in people living with coronary artery disease (CAD), uptake of psychological treatment is generally low. This study was designed to investigate the feasibility of an internet-based cognitive-behavioral (iCBT) depression intervention for people with CAD and depressive symptoms. Methods: People with CAD and depressive symptoms (PHQ-9 ≥ 5) were randomly assigned to the eight modules comprising iCBT (N = 18), or waitlist-control (N = 16). Measures were taken at baseline (t1) and at post-treatment (eight weeks after randomization, t2). Feasibility-related outcomes were recruitment strategy, study attrition, intervention dropout, satisfaction, negative effects as well as the potential of the intervention to affect likely outcomes in a future full-scale trial (depression, anxiety, quality of life, fear of progression). Data analyses were based on intention-to-treat principles. Linear regression models were used to detect between group differences. Linear Mixed Models were used to model potential changes over time. Results: This trial was terminated prior to a-priori defined sample size has been reached given low recruitment success as well as high intervention dropout (88%) and study attrition (23%). On average, participants in the intervention group completed M = 2.78 (SD = 3.23) modules. Participants in the waitlist control group barely started one module (M = 0.82, SD = 1.81). The satisfaction with the intervention was low (M = 20.6, SD = 0.88). Participants reported no negative effects attributed to the iCBT. Differences between groups with regard to depression, anxiety, fear of progression and quality of life remained non-significant (p > 0.05). Conclusion: This trial failed to recruit a sufficient number of participants. Future work should explore potential pitfalls with regards to the reach and persuasiveness of internet interventions for people living with CAD. The study gives important indications for future studies with regard to the need for new ideas to reach and treat people with CAD and depression