No Health without Mental Health: European Clinical Psychology Takes Responsibility
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Psychotherapy

   
Shortcut: PS-03
Date: Friday, 1 November, 2019, 1:00 p.m.
Room: Foyer
Session type: Poster

Contents

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PS-03-01

Interaction and Presence in Virtual Reality (#32)

J. Diemer1, 2, M. Sich1, B. Lange3, M. Müller3, G. Meixner4, P. Zwanzger1, 5

1 kbo-Inn-Salzach-Hospital, Wasserburg am Inn, Germany
2 LMU, Department of Psychology, Munich, Germany
3 VTplus GmbH, Würzburg, Germany
4 Heilbronn University of Applied Sciences, UniTyLab, Heilbronn, Germany
5 LMU, Department of Psychiatry and Psychotherapy , Munich, Germany

Structured Poster Abstract

Introduction: Virtual reality (VR) is increasingly applied in psychotherapy research, especially as a medium of exposure to emotionally relevant stimuli. The subjective experience of presence in the virtual world is considered an important process variable, and is known to correlate with emotional activation. However, the effects on presence of the interaction with the real-world experimenter or therapist during VR exposure have hardly been investigated.

Methods: As part of a larger research project funded by the Federal Ministry of Education and Research (BMBF), we investigated the effects of interaction with the experimenter on presence ratings. Healthy participants (N=66) were randomly assigned to one of two conditions: (1) instructions given by the real-world experimenter or (2) instructions delivered by previously recorded audio messages.

Results: We report the results of two experiments into the effects of two forms of interaction on presence during different VR scenarios, as well as differential effects of participant age.

Conclusions: The significance of design features (e.g., interaction) of VR should not be underestimated. Such features should be studied in more detail, especially with regard to their effects on emotional experience.

Keywords: Virtual Reality, Exposure Therapy, Presence
PS-03-02

Tell me something good! The Influence of Experience Reports on Attitudes towards Psychotherapy (#73)

M. Atzor1, M. Krysen1, C. Weise1

1 University of Marburg, University of Marburg, Marburg, Hesse, Germany

Structured Poster Abstract

Introduction: The prevalence of mental disorders among people with migration background is high. Studies show that access to psychotherapy is more difficult. Barriers include a lack of knowledge about mental disorders and respective treatments, language issues, but also differing illness conceptualizations and fear of stigmatization. The current study investigates whether reports of positive experiences with psychotherapy can strengthen positive attitudes towards psychotherapy.

Method: In the online experiment, participants with migration background are randomly assigned to one of two conditions: The experimental group (EG) watches short video sequences in which simulated, culturally diverse patients report about their culturally related concerns regarding psychotherapy (e.g. language barriers) and their actual positive experiences. Each simulated patient refers to a diagnosis and relevant major symptoms. Participants assigned to the control group (CG) watch video sequences in which the same patients report neutral daily routines. As primary outcome, participants answer questionnaires on attitudes towards psychotherapy after watching the videos. In addition, concerns about psychotherapy, acculturation characteristics, general health and demographic data are assessed.

Results: It is hypothesized that participants in the EG show better attitudes towards psychotherapy after watching the video than the CG. In addition, other influencing factors (e.g. experience in the health-care system, migration status, level of acculturation) are analyzed.

Conclusion: This study aims to investigate whether positive experience reports from culturally diverse patients on how to deal with treatment-related fears improve attitudes towards psychotherapy. If the perceived barriers towards psychotherapy can be reduced by psychoeducation, mental health care utilization can be increased and thus mental health of patients with migration background can be improved in the long run.

Keywords: transcultural psychotherapy, migration, online-experiment, psychotherapy experience
PS-03-03

Intervention targeting motivational deficits in schizophrenia: a case study using ecological momentary assessment. (#170)

B. Thonon1, M. - N. Levaux2, F. Larøi1, 3, 4

1 University of Liège, Psychology and Neuroscience of Cognition Research Unit, Liège, Belgium
2 Intercommunale de Soins Spécialisés de Liège, Liège, Belgium
3 University of Bergen, Department of Biological and Medical Psychology, Bergen, Norway
4 University of Oslo, NORMENT – Norwegian Center of Excellence for Mental Disorders Research, Oslo, Norway

Structured Poster Abstract

Negative symptoms, particularly motivational deficits, strongly affect the daily functioning and quality of life of people diagnosed with schizophrenia. A new intervention, called Switch, was developed based on a theoretical model of motivation in schizophrenia. Switch encourages goal directed behaviors by enhancing motivation, pleasure, coping with dysfunctional beliefs, problem resolution, planning, and action initiation. The aim of this case study is to evaluate the effect of Switch on the motivation factor of negative symptoms and explore how different underlying processes of motivation evolve and interact. Switch is currently being provided via individual sessions (2 months, around 14 sessions). The evaluation includes traditional pre and post assessment of negative symptoms, functional outcomes and quality of life, as well as ecological momentary assessment techniques (daily questionnaires via smartphone and step count). Data will be collected in the coming months. Results will be presented and discussed.

Keywords: Psychotherapy, Motivation, Negative symptoms, Ecological Momentary Assessment
PS-03-04

CBT TRAINING IN LITHUANIA ENTERS A NEW STAGE (#184)

G. Zalyte1, N. Mickuviene1, J. Neverauskas1

1 Lithuanian University of Health Sciences, Department of Behavioral Medicine , Kaunas, Lithuania

Structured Poster Abstract

Cognitive Behavioural Therapy was introduced in Lithuania in 2007 when the first cohort of 25 CBT therapists consisting of 33 participants started their training. The teaching was mostly delivered by experienced CBT practitioners from Poland, Czech Republic, Argentina and the US.

Since 2014, a 3-year postgraduate training programme in CBT has been taught at the Lithuanian University of Health Sciences. At the moment, 136 professionals (medical doctors and psychologists) are enrolled in the programme, while another 147 have already graduated from it. The teaching is still to a large degree delivered by foreign CBT experts; however, local teachers are nowadays playing an increasingly important role, delivering more than 50% of the teaching.

In 2018 a cohort of 10 supervisors started the training in CBT supervision at the Odyssea institute from Czech Republic.

In 2016, Lithuanian University of Health Sciences also introduced a one-year postgraduate training programme in mindfulness-based cognitive therapy (MBCT) as an evidence-based alternative to the classical CBT. By now 133 mental health professionals have graduated from this course and 48 are currently in training.

This year, the history of CBT in Lithuania entered a new stage. Following the successful example from the UK and Norway, Lithuanian Ministry of Health is planning to train the first cohort of 30 wellbeing practitioners who will be offering CBT based interventions for people suffering from mild to moderate mood and anxiety disorders. All professionals will be trained in a very structured way and to a high standard. This service hopefully will make effective psychological help even more accessible.

Keywords: Cognitive Behavioral Therapy, Training, Wellbeing Practitioners
PS-03-05

Therapeutic approach to Complicated Grief – an example of Group Psychotherapy in psychiatric patients (#189)

J. I. Soares1, A. F. Oliveira1, J. C. Rocha1

1 Cespu, Psychology , Gandra, Portugal

Structured Poster Abstract

Introduction: Complicated Grief(CG) affects 7-10% of the grieving individuals in the general population. However, the incidence is much higher in psychiatric patients, reaching 70% in most samples. These individuals present many risk factors for such condition, demanding a particular attention and treatment approach. Most studies have shown that pharmacological treatment may help relieving depressive and anxiety symptoms, although they do not promote a consistent improvement of the grieving scenario. Several meta-analyses have recognized different psychological interventions as effective in dealing with the loss, decreasing psychological suffering and promoting adaptation. It is accepted that the benefits of the intervention overcome any possible harm.

Objectives: To evaluate the impact of a group intervention (12 sessions) in pharmacologically stabilized psychiatric patients presenting with CG.

Methods: Patient selection was performed through a clinical interview and the fulfilment of the following psychometric tests: Complicated Grief Inventory; the Impact of Events Scale; Beck Depression Inventory; Social Support Scale. These assessment tools were also used to evaluate the impact of the intervention performed.

Results: After the psychotherapeutic intervention, there were significant differences in the levels of Depressive and Post-traumatic Stress symptoms.

Conclusion: Group intervention in CG has proven effective in this population, specially regarding depression and post-traumatic stress levels.

Keywords: Complicated Grief, Group Therapy;, psychiatric patients
PS-03-06

Parental factors for internet gaming disorder, in children, adolescents and emergent adults: a quantitative meta-analysis (#399)

I. M. Coșa1, A. Dobrean1

1 Bábes Bolyai University, Department of Clinical Psychology and Psychotherapy, Cluj-Napoca, Romania

Structured Poster Abstract

Gaming disorder (GD) (online and offline) was added recently in the 11th Revision of the International Classification of Diseases (ICD-11) and creates a possible line of research. Prevalence for GD is reported especially among children, adolescence and emergent adulthood. Research suggests that parental factors are predictors for addictive disorder in children and adolescence. The most recent literature review shows that there are familial influences known to affect the possibility that an adolescent may become a problematic gamer. The aim of this quantitative meta-analysis is to identify the relationship between parental factors and gaming disorder symptoms (problematic gaming use) in children, adolescence and emergent adults. Mainly the following parental factors are taken in to consideration: parental attachment style, parent-child relationship, parenting style. Also we have tested different possible moderators of this relationship.A computer database search of PubMed, PsycINFO, Proquest, Scopus, Web of Science, and Cochrane, was conducted in April 2019, and we have identified 4 942 studies. The main inclusion criteria were: 1) Studies main focus was on internet gaming disorder or symtomes of problematic internet gaming use (online and offline), 2) Studies measured at least 1 parental factor that was of interest 3) Peer reviewed journal 4) written in English or in German 5) Population of interest: children, adolescence, emerging adults (≤25 years old) 6) Studies offer information useful to measure effect size. The effect size was computed with Comprehensive Meta-analysis. The main focuse of this meta-analysis was to identify the degree of association between parental factors and gaming disorder symptoms (problematic gaming use) in children, adolescence, emergent adults. This study is the first meta-analysis that looks at this relationship and propose posible parental predictors to be taken in to consideration in intervention when it comes to gaming disorder.

Keywords: gaming disorder, parental factors, problematic gaming use, meta-analysis
PS-03-07

Experience Versus Report: Where Are Changes Seen After Exposure-Based Cognitive-Behavioral Therapy? A Randomized Controlled Group Treatment of Childhood Social Anxiety Disorder (#22)

J. Asbrand1, N. Heinrichs2, S. Schmidtendorf3, K. Nitschke1, B. Tuschen-Caffier1

1 University of Freiburg, Department of Clinical Psychology and Psychotherapy, Freiburg, Germany
2 University of Bremen, Department of Psychology, Bremen, Germany
3 University of Braunschweig, Department of Psychology, Braunschweig, Germany

Structured Poster Abstract

Introduction: Social anxiety disorder (SAD) is a highly prevalent disorder in children and youths leading to tremendous impairment. It is characterized by extensive negative cognitions, safety behaviors and a perceived lack of social skills as well as tonic physiological arousal (e.g. heart rate). Despite its high relevance, treatment for SAD in children is not effective in all patients. Introducing exposure as a primary treatment component, this study aimed to measure treatment success by not only social anxiety reports but also social stress to assess cognitive, behavioral, and physiological components.

Methods: The study examined treatment success for an exposure-based SAD-specific group cognitive behavioral therapy (CBT) in a randomized controlled trial (N = 67, age 9 to 13 years, blind randomized allocation to treatment [CBT; n = 31] and waitlist control [WLC; n = 36] groups). Success was operationalized by SAD-specific questionnaires, diagnostic interviews, and response to the Trier Social Stress Test (TSST).

Results: Compared to WLC children, children in the CBT group reported a trend-significant increase in positive cognitions in the TSST after treatment (d = 0.37), while positive cognitions decreased in the WLC group (d = 0.40). No significant results appeared for behavior and physiology. Children in the CBT group, but not parents, further reported less social anxiety in one questionnaire from pre-treatment to posttreatment (d = 0.89). A structured interview confirmed a decrease in severity of SAD in the CBT group.

Conclusions: An exposure-based treatment approach in a group setting was shown to be a partly effective but cost-efficient intervention for childhood SAD. A strong focus on exposure proved to change cognitions during socially stressful situations. However, modifications of both the treatment group setting and the assessment of outcomes, including the use of multiple measures of social anxiety and experimental paradigms, warrant further research.

Keywords: social stress, physiology, cognitions, behavior
PS-03-08

The interplay of treatment goal themes and approach vs. avoidance focus. (#86)

M. Kuhlencord1, Y. Hagmayer1

1 University of Göttingen, Institute of Psychology, Göttingen, Lower Saxony, Germany

Structured Poster Abstract

Introduction: Individual treatment goals are relevant for all psychotherapy settings and orientations. In research, treatment goals are usually either categorized by themes or by focus (avoidance vs. approach). Theme and focus have separately been shown to be associated with patient characteristics and to be related to treatment outcome and goal achievement. The aim of the present study was to investigate the interplay of theme and focus. We hypothesized (1) that theme and focus of therapy goals are related and that (2) their combinations can be predicted by patient characteristics.

Methods: 716 treatment goals of 163 patients in outpatient cognitive behavioral treatment were analyzed. Their focus was classified as approach vs. avoidance following criteria of former studies. Themes were categorized based on the Bern Inventory for Treatment Goals (BIT-T), which differentiates between symptom-related, interpersonal, well-being, existential issues, and personal growth goals. The predictive value of diagnoses, symptom severity and demographic variables for frequency of goal categories was analyzed by regression analyses.

Results: There as a clear relation of theme and focus. Symptom-related goals were most frequent and had an avoidance focus slightly more often than an approach focus. For all other categories of themes an approach focus was way more frequent. Analyses showed that depending on the theme and focus of the goal other variables were predictive. For example, while diagnosis and gender predicted well-being goals, the number of comorbid diagnoses predicted an avoidance focus. Combinations of theme and focus were predicted by other variables.

Conclusions: The results showed that the theme and focus of therapy goals as well as their interplay needs to be considered in research. Further investigations of the predictive value of theme, focus and their interaction for treatment outcome are desirable.

Keywords: treatment goals, themes, approach, avoidance
PS-03-09

Predictors of preference and engagement when learning mindfulness and kindness-based meditation (#110)

C. T. Müller1, P. Kanske1, 2

1 Technische Universität Dresden, Clinical Psychology and Behavioral Neuroscience, Dresden, Saxony, Germany
2 Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Saxony, Germany

Structured Poster Abstract

Introduction: Mindfulness and kindness-based meditations are core elements of meditation-based interventions. They are often combined implicitly or explicitly. So far, little is known about for whom and in what order the techniques are most effective. Here, we examine the extent to which trait-mindfulness, self-compassion, fears of compassion, and gender predict inter-individual differences in technique preference and meditation engagement.


Methods: 100 meditation novices were introduced to both techniques. Subsequently, they practiced both techniques independently for seven days each in randomized order. Afterwards, they had another 14 days in which they formed their meditation practice at their own will. The meditation duration, frequency, and type of meditation were recorded objectively via an online meditation platform. The data was analyzed with generalized linear models.


Results: Mindfulness meditation was more preferred than loving-kindness meditation. Men more often preferred mindfulness meditation than kindness-based meditation compared to women. In addition, both fears of compassion and pronounced trait-mindfulness led to a stronger preference for kindness-based meditation over time. Men who started with kindness-based meditation reacted especially in case of fears of compassion with reactance to kindness-based meditation and dropout. Pre-intervention self-compassion led to higher maintenance of meditation engagement.


Conclusion: This study is the first to suggest determinants of inter-individual differences of meditation preferences and engagement. The results are discussed in the light of practical implications for providers of meditation-based interventions. Early training in mindfulness meditation may increase the intervention adherence for some meditators, while others may benefit from the earliest possible integration of kindness-based meditation.

 

Keywords: meditation, mindfulness, kindness, predictors
PS-03-10

Cognitive Motivation as a resource for occupation-related coping strategies in patients in rehabilitation (#123)

I. H. Hoff1, A. Steiger1, U. Melicherova2, V. Köllner2, 3, J. Hoyer4, A. Strobel4, A. Strobel1

1 Chemnitz University of Technology, Chemnitz, Germany
2 Charité Universitätsmedizin Berlin, Berlin, Germany
3 Rehazentrum Seehof der Deutschen Rentenversicherung, Teltow, Germany
4 Technische Universität Dresden, Dresden, Germany

Structured Poster Abstract

Introduction: Chronic mental disorders constitute a challenge for patients and society causing individual burden, absenteeism at work or early retirement. Psychosomatic rehabilitation focuses on maintenance of occupation-related skills and enhancement of social participation. Identifying personal resources of individuals is a key aspect of therapeutical work. Cognitive motivation(COM), an individual’s tendency to engage in and enjoy effortful cognitive endeavors, is positively associated with affective adjustment, with an active, problem-oriented coping style and well-being, and inversely with depression. Accordingly, COM might serve as a resource for mental health and coping. This study aimed at examining the potential of COM in the context of rehabilitation and especially the relation between occupation-related behavioral patterns and COM in patients in psychosomatic rehabilitation.

Methods: The Occupation Stress and Coping Inventory (AVEM) and the Abridged Cognitive Effort Scale (ACES) were administered as part of a larger study to 1060 patients of a psychosomatic rehabilitation clinic at two points of time. A subsample of 178 patients(122 females, mean age=51.83) was already analyzed for T1.

Results: Significant positive associations were found between COM and the subscales proactive problem-solving(r=.62, p<.001) and satisfaction(r=.50, p<.001) of AVEM while COM was negatively correlated with inner resignation(r=-.48, p<.001). Concerning behavioral patterns, COM was strongly positively associated with type G (mental health, r=.58, p<.001) and inversely to type B (chronic exhaustion and resignation,r=-.58, p<.001) of the AVEM.

Conclusions: The findings suggest COM as a relevant personality trait in coping with everyday stresses and demands of working life. The results for the total sample and first analyses concerning underlying mechanisms of the relations are presented and discussed. An outlook on comparable findings in a healthy sample is given.

Keywords: cognitive motivation, rehabilitation, coping
PS-03-11

From Assessment to Psychological Treatments: the Portuguese Trauma and Grief experience (#151)

J. Rocha1, 2

1 CESPU, IINFACTS, Porto, Portugal
2 CPTL, Vila Nova de Gaia, Portugal

Structured Poster Abstract

Since 1997 successive efforts have been deployed to measure, to recognize and to treat negative consequences of several types of losses, consolidating evidence and providing highly effective intervention for the community. To measure symptoms using psychometric models, predicting outcomes and clarifying consequences on health and work productivity, recognizing the specific individual and social impact of prolonged grief, posttraumatic stress and complex trauma. This sequence of objectives and results are part of the Portuguese Trauma and Grief Experience.

The methods are quantitative, mixed psychometric, epidemiological and with focus on treatments efficacy. A multistudy approach is presented based on samples with traumatic perinatal losses, widows with prolonged grief, crisis intervention after loss, prolonged grief in psychiatric context and complex traumatic stress in intimate partner violence victims. The interventions were manualized based on narrative, meaning and decision-making theoretical models.

The results from the pathway are presented listing the psychological assessment instruments adapted and the randomized trials results are summarized using between-groups effect-sizes.

A critical appraisal of the evidence and the new challenges for more informed choices of treatment for patients facing critical events are discussed. The actual rational has provided a unprecedented political support to provision of services, however, there is need for trauma and grief-informed contexts, not only in health settings, but also at workplaces and schools using a diversity of media closing the gap between research and provision of services. 

Keywords: Grief, Trauma, RCT, Assessment
PS-03-12

Neurophysiological changes in depressed patients with unresolved attachment trauma during psychotherapy (#182)

A. Buchheim1, H. Kessler2, S. Taubner3, H. Kächele4, G. Roth5, O. Pogarell7, S. Karch7, R. Viviani9, K. Labek9

1 University Innsbruck, Innsbruck, Austria
2 University Bochum, Bochum, Germany
3 University Heidelberg, Heidelberg, Germany
4 University Ulm, Ulm, Germany
5 University Bremen, Bremen, Germany
6 University Munich, Munich, Germany
7 University Innsbruck, Innsbruck, Austria

Structured Poster Abstract

IntroductionNeurophysiological studies on depression confirm that successful psychotherapy leads to changes in specific neural circuits involved in emotional processing. Previous findings of increased sustained gamma-band responses to negative stimuli were  found in depressed individuals, who elaborated specifically on negative stimuli. Several studies report that insecure, especially unresolved attachment is overrepresented in depression. The present EEG study focused on electrophysiological responses to attachment-related emotional information in depressed patients with unresolved attachment and their potential change during long-term psychotherapy. 

Methods:The study included unmedicated patients with a history of recurrent major depression(n=17) and healthy participants (n=13). Attachment representations were measured using the Adult Attachment Interview (AAI). Participants’ electrophysiological responses to pictures of the Adult Attachment Projective Picture Systemcombined with personalized attachment related sentences were contrasted with neutral descriptions at the beginning (t1) and after 15 months of psychodynamic psychotherapy (t2).

ResultsAt baseline, patients showed significantly more unresolved trauma than controls (p=0.005). After treatment, patients’ unresolved classifications improved to organized patterns (p=0.016). Effects of attachment pattern were sought in the difference in gamma-band activity between time 2 and time 1. As expected the contrast personalized vs. neutral description trials revealed a significant effect of unresolved attachment (t = -2.28, p = 0.04) in a model including sex and age as confounding covariates

ConclusionsNormalization of gamma band activity associated with improved attachment status may be interpreted as a remission from a state of sustained and prolonged elaboration of emotional material. Our data may provide further evidence on the effectiveness of long-term psychotherapy in depressed patients

Keywords: Depression, attachment, psychotherapy, EEG