1,720,959 research outputs found
Therapieziele und ihr Zusammenhang mit frühem Therapiefortschritt im ambulanten kognitiv-verhaltenstherapeutischen Setting
No full text<jats:p> Zusammenfassung. Hintergrund. Der Zusammenhang zwischen Inhalt und Ausrichtungsfokus von Therapiezielen und erfolgreichem Therapieverlauf ist wenig erforscht, wobei insbesondere eine mögliche Assoziation von Inhalt und Fokus vernachlässigt wurde. Fragestellung. Untersucht wurde die Assoziation von Therapiezielinhalt und -fokus und deren Zusammenhang mit frühem Therapiefortschritt. Methode. 716 Therapieziele von 163 Patientinnen und Patienten in ambulanter KVT wurden nach Inhalt und Fokus (Annäherung vs. Vermeidung) kategorisiert und der Zusammenhang von Zielart und Zielerreichung sowie Symptomreduktion nach 12 Sitzungen analysiert. Ergebnisse. Zielinhalt und –fokus waren assoziiert. Die fremdbeurteilte Zielerreichung war bei problembezogenen Annäherungszielen am höchsten. Die Symptomreduktion war dagegen am höchsten, wenn problembezogene Vermeidungsziele vorlagen. Schlussfolgerung. Therapiefortschritt steht im Zusammenhang mit den gesetzten Therapiezielen. Welche Therapiezielart, insbesondere welcher Fokus Therapiefortschritt und -erfolg begünstigt, bleibt weiterer zu erforschen. Dabei sollten zukünftig Zielinhalt und –fokus gemeinsam untersucht werden. </jats:p>
Early developments in general change mechanisms predict reliable improvement in addition to early symptom trajectories in cognitive behavioral therapy
No full textIdentifying cognitive‐affective mechanisms underlying disability in episodic migraine: Using the fear avoidance model to examine interactions
No full textAbstract Objective Using the fear‐avoidance model (FAM) as a theoretical framework, this study examined the interactions between empirical factors contributing to disability in episodic migraine. It was tested whether pain catastrophizing, fear of attacks, and depressiveness mediate the relationship between pain experience and disability. Background Migraine is a prevalent primary headache disorder associated with significant impairment in daily life. Biological and psychosocial factors contribute to its impact; however, a comprehensive model explaining the mechanisms underlying migraine‐related disability is still lacking. Methods A cross‐sectional online survey was conducted between October 2023 and March 2024 to collect sociodemographic and clinical characteristics of patients with episodic migraine. To evaluate the proposed links within the FAM, two confirmatory path analyses were performed. In Model 1, the Pain Disability Index was used to quantitatively measure subjective aspects of disability. In Model 2, the Migraine Disability Assessment questionnaire was used to assess quantitative aspects of disability. Mediators derived from the FAM included: pain experience (attack frequency and pain intensity), dysfunctional cognitive pain processing (pain catastrophizing), and dysfunctional cognitive‐affective response to pain (fear of attacks and depressiveness). Results Both path analyses demonstrated good model fit. The explained variance of migraine‐related disability was 28% (adjusted R 2 = 0.28) in both models, indicating large effect sizes. Attack frequency (standardized path coefficient [β] = 0.21, p < 0.001; β = 0.45, p < 0.001), pain intensity (β = 0.27, p < 0.001; β = 0.16, p < 0.001), fear of attacks (β = 0.12, p = 0.006; β = 0.13, p = 0.004), and depressiveness (β = 0.34, p < 0.001; β = 0.12, p = 0.006), were identified as independent predictors of disability in both models (Model 1; Model 2). Consistent with the hypothesis, an indirect pathway from attack frequency and pain intensity to disability via pain catastrophizing, fear of attacks, and depressiveness was observed in both models. Conclusion This study emphasizes the important role of (potentially modifiable) dysfunctional cognitive pain processing and provides empirical evidence for the theoretical assumptions of the FAM. Attack frequency, pain intensity, fear of attacks, and depressiveness were found to be independent predictors of subjectively and quantitatively measured disability in episodic migraine. Pain catastrophizing was identified to be a crucial cognitive‐affective factor mediating the relationship between pain experience and disability.Plain Language Summary Migraine is a common condition that can affect daily life, even between attacks. However, it is unclear which mechanisms lead to this impairment, and a comprehensive explanatory model is lacking. This study found that pain catastrophizing, a way of thinking where people expect the worst and feel helpless about pain, as well as fear of attacks and depressiveness, may be important mediators between the pain experience and disability.Abstract Objective Using the fear‐avoidance model (FAM) as a theoretical framework, this study examined the interactions between empirical factors contributing to disability in episodic migraine. It was tested whether pain catastrophizing, fear of attacks, and depressiveness mediate the relationship between pain experience and disability. Background Migraine is a prevalent primary headache disorder associated with significant impairment in daily life. Biological and psychosocial factors contribute to its impact; however, a comprehensive model explaining the mechanisms underlying migraine‐related disability is still lacking. Methods A cross‐sectional online survey was conducted between October 2023 and March 2024 to collect sociodemographic and clinical characteristics of patients with episodic migraine. To evaluate the proposed links within the FAM, two confirmatory path analyses were performed. In Model 1, the Pain Disability Index was used to quantitatively measure subjective aspects of disability. In Model 2, the Migraine Disability Assessment questionnaire was used to assess quantitative aspects of disability. Mediators derived from the FAM included: pain experience (attack frequency and pain intensity), dysfunctional cognitive pain processing (pain catastrophizing), and dysfunctional cognitive‐affective response to pain (fear of attacks and depressiveness). Results Both path analyses demonstrated good model fit. The explained variance of migraine‐related disability was 28% (adjusted R 2 = 0.28) in both models, indicating large effect sizes. Attack frequency (standardized path coefficient [β] = 0.21, p < 0.001; β = 0.45, p < 0.001), pain intensity (β = 0.27, p < 0.001; β = 0.16, p < 0.001), fear of attacks (β = 0.12, p = 0.006; β = 0.13, p = 0.004), and depressiveness (β = 0.34, p < 0.001; β = 0.12, p = 0.006), were identified as independent predictors of disability in both models (Model 1; Model 2). Consistent with the hypothesis, an indirect pathway from attack frequency and pain intensity to disability via pain catastrophizing, fear of attacks, and depressiveness was observed in both models. Conclusion This study emphasizes the important role of (potentially modifiable) dysfunctional cognitive pain processing and provides empirical evidence for the theoretical assumptions of the FAM. Attack frequency, pain intensity, fear of attacks, and depressiveness were found to be independent predictors of subjectively and quantitatively measured disability in episodic migraine. Pain catastrophizing was identified to be a crucial cognitive‐affective factor mediating the relationship between pain experience and disability.Plain Language Summary Migraine is a common condition that can affect daily life, even between attacks. However, it is unclear which mechanisms lead to this impairment, and a comprehensive explanatory model is lacking. This study found that pain catastrophizing, a way of thinking where people expect the worst and feel helpless about pain, as well as fear of attacks and depressiveness, may be important mediators between the pain experience and disability
Therapeutic interventions and treatment goals in cognitive-behavioral therapy practice.
Full text linkIm Kontext unterschiedlicher Forschungsansätze wurde in einer Vielzahl von Studien untersucht, wodurch erfolgreiche Psychotherapieverläufe bedingt sind. Daraus resultierende Evidenzen stellen die Basis für eine Verbesserung von psychotherapeutischen Behandlungen in der Praxis dar. Allerdings zeigt sich eine Forschungslücke in Bezug auf die differenzierte Erforschung des tatsächlichen Vorgehens in der Praxis: Zum einen wurde erst in Ansätzen untersucht, welche therapeutischer Interventionen in der Praxis Anwendung finden und wie dies mit Therapiefortschritt in Verbindung steht. Hierbei mangelt es auch an geeigneten Instrumenten zur Erfassung des Einsatzes therapeutischer Interventionen im therapeutischen Prozess. Zum anderen wurde wenig untersucht, welche Therapieziele in der therapeutischen Praxis gesetzt werden sowie die Assoziation unterschiedliche Therapiezielarten mit Fortschritt in der Therapie. Inwiefern die Anwendung von Interventionen und die Formulierung von Therapiezielen in der Praxis Empfehlungen aus der Literatur entsprechen, ist bislang ebenfalls unbeantwortet geblieben. Diese Fragestellungen wurden in dieser Dissertation im Rahmen von drei Studien adressiert, wobei Daten aus der psychotherapeutischen Routineversorgung ausgewertet wurden. In Studie 1 wurde mittels eines neu entwickelten Fragebogens die Anwendung einzelner allgemeiner und KVT-spezifischer Interventionen im Zusammenhang mit Therapiefortschritt in der Praxis untersucht. Basierend auf einer Analyse (deutschsprachiger) Leitlinien und Behandlungsmanuale zur Behandlung von Depression und Angststörungen wurde geprüft, ob die Anwendung von Interventionen den Empfehlungen entsprach und ob konsistent empfohlene Interventionen positiv mit Therapiefortschritt assoziiert waren. In Studie 2 wurde untersucht, welche Themen freiformulierte Therapieziele in der Praxis zum Inhalt hatten, wie sie formuliert waren (Annäherungs- vs. Vermeidungsfokus) und ob Inhalt und Fokus assoziiert waren. Zudem wurde untersucht, ob sich die Arten der Ziele von Patient*innen mit einer Angststörung von denen anderer Patient*innen unterschieden. In Studie 3 wurde in einer erweiterten Stichprobe die Assoziation zwischen Inhalt und Fokus freiformulierter Therapieziele repliziert und der Zusammenhang der verschiedener Therapiezielarten mit dem Therapiefortschritt untersucht.
Die Ergebnisse zeigten, dass ein großes Spektrum allgemeiner und KVT-spezifischer Interventionen angewendet wurde, wobei die Anwendungshäufigkeiten der verschiedenen Interventionen deutlich variierten (Studie 1). Ebenso hatten die Therapieziele vielfältige Themen zum Inhalt, welche mit dem Ausrichtungsfokus assoziiert waren (Studie 2 & Studie 3). Die Zielarten von Patient*innen mit einer Angststörung unterschieden sich nicht von denen anderer Patient*innen (Studie 2). Sowohl die Anwendung der Interventionen als auch die Formulierung der Ziele war insgesamt grob an den Empfehlungen aus der Literatur orientiert, wobei teilweise auch Abweichungen deutlich wurden (Studie 1-3). In Bezug auf den Therapiefortschritt wurden Assoziationen einzelner Interventionen sowie der Art der gesetzten Therapieziele deutlich. Die Ergebnisse variierten jedoch je nach Outcome. Dass der Einsatz von konsistent empfohlenen Interventionen bzw. eine positive Formulierung von Therapiezielen entsprechend der Empfehlungen klar positiv mit dem Therapiefortschritt assoziiert war, zeigte sich nicht einheitlich (Studie 1 & 3). Insgesamt ergab sich eine große Heterogenität der angewendeten therapeutischen Interventionen und gesetzten Therapieziele in der Praxis. Die vorgestellten Studien liefern Hinweise darauf, dass diese Therapieelemente auf komplexe Weise mit dem Therapiefortschritt in Zusammenhang zu stehen scheinen. Da der Einsatz von Interventionen und die Art der Therapiezielformulierung in der Praxis direkt durch die Therapeut*innen adaptiert werden können, liefert ein genaueres Verständnis, darüber wie diese einzelnen Therapieelemente mit einem erfolgreichen Therapieverlauf in Verbindung stehen, konkrete Implikationen für die Praxis. Für eine genaueres Erforschung dieser Zusammenhänge sind weitere Studien nötig, die auf Grund der Komplexität der Zusammenhänge und des Umfangs der zu untersuchenden Variablen große Stichproben einbeziehen sollten. In the context of different research approaches, a large number of studies have investigated what conditions successful psychotherapy outcomes. The resulting evidence provides the basis for improving psychotherapeutic treatments in practice. However, a research gap exists concerning the differentiated research of the actual procedure in practice: First, there is a lack of knowledge on which therapeutic interventions are used in practice and their relation to the therapy progress. Additionally, there is a lack of suitable instruments for recording the use of therapeutic interventions in the therapeutic process. Second, little research has been done on what therapeutic goals are set in therapeutic practice but also the association of their different types with progress in therapy. Consequently, the extent to which both, the use of interventions and the formulation of therapeutic goals in practice, correspond to recommendations from the literature also remains unanswered. These questions were addressed in this dissertation in the context of three studies analyzing the data from routine psychotherapeutic care. In study 1, a newly developed questionnaire was used to examine the use of individual general and CBT-specific interventions in relation to therapy progress in practice. Based on an analysis of (German-language) guidelines and treatment manuals for the treatment of depression and anxiety disorders, it was examined whether the application of interventions was in line with recommendations and whether consistently recommended interventions were positively associated with therapy progress. Study 2 examined the topics of free-formulated treatment goals in practice, how they were framed (approach vs. avoidance focus), and whether content and focus were associated. In addition, it was examined whether the types of goals set by patients with an anxiety disorder differed from those followed by other patients. Study 3 replicated the association between content and focus of free-formulated treatment goals in an expanded sample and examined the association of different goal types with therapy progress.
Results showed that a wide range of general and CBT-specific interventions were applied, with significant variation in the frequencies of application of the different interventions (Study 1). Similarly, treatment goals had multiple themes, which were associated with the focus (Study 2 & Study 3). The goal types of patients with an anxiety disorder did not differ from those of other patients (Study 2). Both the application of interventions and the framing of goals were overall roughly aligned with recommendations from the literature, although deviations were also evident in some cases (Study 1-3). In terms of therapy progress, associations between the application of single interventions as well as the type of treatment goals became apparent. However, results differed between outcomes. A positive association between therapy progress and the use of consistently recommended interventions or a positive framing of treatment goals didn’t clearly appear (study 1 & 3). Overall, there was a large heterogeneity of applied therapeutic interventions and set treatment goals in practice. The studies presented provide evidence that these therapy elements appear to be associated with therapy progress in complex ways. Because the use of interventions and the way of framing treatment goals in practice can be directly adapted by therapists, a more detailed understanding of how these individual therapy elements are related to successful therapy progress provides concrete implications for practice. Further studies are needed to explore these relationships in more detail, and these should involve large samples due to the complexity of the potential relationships of the numerous variables under investigation. 2021-12-2
Effects of change in dysfunctional beliefs in avatar-based cognitive therapy for depressive symptoms: a randomized parallel trial
No full textAbstract This study evaluated the effect of an avatar-based intervention on depressive symptoms and self-esteem. Participants (N = 151) with subclinical depressive symptoms were instructed to challenge an avatar over three sessions. While participants within the intervention group challenged their personal dysfunctional beliefs, participants in the control group challenged nonsense statements. Allocation to treatment groups was randomized. Data collection took place pre-intervention and post-intervention. Statistical analysis revealed a significant decrease in depressive symptoms, which was more pronounced for the intervention group (p < .01), as well as a significant group × time interaction for self-esteem (p < .05). The effect on depression symptom strength was large in the experimental group (d = − 1.19) and medium (d = − 0.72) in the control group, while the effect on self-esteem was moderate (d = 0.54) in the intervention and small (d = 0.29) in the control group. Our findings on symptom reduction align with prior research, while positive effects on self-esteem are a novelty. These results demonstrate the intervention’s potential for reducing the symptoms of mental illness
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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