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Only few previous studies used ecological momentary assessments to explore the time-of-day-dependence of tinnitus. The present study used data from the mobile application “TrackYourTinnitus” to explore whether tinnitus loudness and tinnitus distress fluctuate within a 24-h interval. Multilevel models were performed to account for the nested structure of assessments (level 1: 17,209 daily life assessments) nested within days (level 2: 3,570 days with at least three completed assessments), and days nested within participants (level 3: 350 participants). Results revealed a time-of-day-dependence of tinnitus. In particular, tinnitus was perceived as louder and more distressing during the night and early morning hours (from 12 A.M. – 8 A.M.) than during the upcoming day. Since previous studies suggested that stress (and stress-associated hormones) show a circadian rhythm and this might influence the time-of-day-dependence of tinnitus, we evaluated whether the described results change when statistically controlling for subjectively reported stress-levels. Correcting for subjective stress-levels, however, did not change the result that tinnitus (loudness and distress) was most severe at night and early morning. These results show that time-of-day contributes to the level of both tinnitus loudness and tinnitus distress. Possible implications of our results for the clinical management of tinnitus are that tailoring the timing of therapeutic interventions to the circadian rhythm of individual patients (chronotherapy) might be promising.
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The development of depressive symptoms in childhood and adolescence can follow different pathways. This study examined heterogeneity in the development of self-reported depressive symptoms and the predictive influence of mothersʼ depressive symptoms, the number of life events, and loss events via growth mixture modeling over a four-year period in a large community sample of German children and adolescents (N = 3,902; mean age 11.39 years; 49.6 \% female). This procedure was conducted for the total sample as well as for separate samples of girls and boys. Four different classes of trajectories for the total and the girlsʼ model were identified, but only three classes for the boys. Girls showed higher intercepts and stronger increases in symptoms over time, whereas boys displayed stronger decreases. In the total model, mothersʼ depressive symptoms and the number of life events significantly increased the level of depressive symptoms. In the gender models, only mothersʼ depressive symptoms showed significant influence on the level of symptoms in girls and boys, whereas for life events this was only true for boys. In every model, the significant predictors discriminated at least between some classes. Loss events showed no significant influence in any model. In sum, there are meaningful differences in the development of depressive symptoms in girls and boys. These results have several implications for prevention and future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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After a first outcome study (RCT) carried out within a university setting supported the efficacy of a newly developed headache treatment for children and adolescents, a study within a 'naturalistic setting' of psychotherapeutic practice was conducted to investigate its effectiveness. 23 psychotherapists from different regions of Germany took part in the study, and presented data on 234 children who were included in the 8-session group training. After treatment the children (mean age 11 yrs) decreased the frequency of days with headache from 9.1 days/month by three days as documented by a headache diary. According to the parents their headache frequency was even reduced by 50\% based on a three months estimation. Further headache parameters did not change to the positive. The general well being of the children improved significantly after therapy and (as a statistical trend) at follow-up. Very distinct changes were found regarding the children's appraisal of headache and their self efficacy beliefs regarding headache. Children reported much better coping with their headache without the support of their parents. Parents' reports underlined these positive changes. The training was very well accepted by the children and their parents. One limitation regarding our findings is the large number of dropouts regarding diary data. Nevertheless we come to the conclusion that the headache training program can be appropriately implemented in an outpatient therapeutic setting and its use can be recommended for the sake of the children's well being and health. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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Introduction: Given that recurrent sexual interest in prepubescent children is one of the strongest single predictors for pedosexual offense recidivism, valid and reliable diagnosis of pedophilia is of particular importance. Nevertheless, current assessment methods still fail to fulfill psychometric quality criteria. Aims: The aim of the study was to evaluate the diagnostic accuracy of eye-movement parameters in regard to pedophilic sexual preferences. Method: Eye movements were measured while 22 pedophiles (according to ICD-10 F65.4 diagnosis), 8 non-pedophilic forensic controls, and 52 healthy controls simultaneously viewed the picture of a child and the picture of an adult. Fixation latency was assessed as a parameter for automatic attentional processes and relative fixation time to account for controlled attentional processes. Main Outcome Measures: Receiver operating characteristic (ROC) analyses, which are based on calculated age-preference indices, were carried out to determine the classifier performance. Cross-validation using the leave-one-out method was used to test the validity of classifiers. Results: Pedophiles showed significantly shorter fixation latencies and significantly longer relative fixation times for child stimuli than either of the control groups. Classifier performance analysis revealed an area under the curve (AUC) = 0.902 for fixation latency and an AUC = 0.828 for relative fixation time. The eye-tracking method based on fixation latency discriminated between pedophiles and non-pedophiles with a sensitivity of 86.4\% and a specificity of 90.0\%. Cross-validation demonstrated good validity of eye-movement parameters. Conclusions: Despite some methodological limitations, measuring eye movements seems to be a promising approach to assess deviant pedophilic interests. Eye movements, which represent automatic attentional processes, demonstrated high diagnostic accuracy. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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Background: Headache is the most common pain disorder in children and adolescents and is associated with diverse dysfunctions and psychological symptoms. Several studies evidenced sex-specific differences in headache frequency. Until now no study exists that examined sex-specific patterns of change in paediatric headache across time and included pain-related somatic and (socio-)psychological predictors. Method: Latent Class Growth Analysis (LCGA) was used in order to identify different trajectory classes of headache across four annual time points in a population-based sample (n = 3 227; mean age 11.34 years; 51.2 \% girls). In multinomial logistic regression analyses the influence of several predictors on the class membership was examined. Results: For girls, a four-class model was identified as the best fitting model. While the majority of girls reported no (30.5 \%) or moderate headache frequencies (32.5 \%) across time, one class with a high level of headache days (20.8 \%) and a class with an increasing headache frequency across time (16.2 \%) were identified. For boys a two class model with a ‘no headache classʼ (48.6 \%) and ‘moderate headache classʼ (51.4 \%) showed the best model fit. Regarding logistic regression analyses, migraine and parental headache proved to be stable predictors across sexes. Depression/anxiety was a significant predictor for all pain classes in girls. Life events, dysfunctional stress coping and school burden were also able to differentiate at least between some classes in both sexes. Conclusions: The identified trajectories reflect sex-specific differences in paediatric headache, as seen in the number and type of classes extracted. The documented risk factors can deliver ideas for preventive actions and considerations for treatment programmes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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Recent studies have shown that the development of externalizing behavior in childhood and adolescence can be described through different developmental pathways. However, knowledge about differences between the sexes regarding the trajectories is limited. This study focused on potential differences by examining the trajectories of self-reported externalizing symptoms for girls and boys separately. In addition, the relationships of several familiar and child-specific variables with those developmental courses were assessed. The study was conducted on a large community sample of German youths (N = 3,893; mean age 11.38 years; 50 \% girls) over 4 years. Using growth mixture modeling, three different classes of trajectories were found for both sexes. The classes differed with regard to the level and the course of symptoms ('low', 'moderate', 'high-decreasing'). Girls were overrepresented in the 'low' class, whereas boys were predominant in the 'moderate' and 'high-decreasing' classes. The multiple group analysis revealed that the girls and boys differed significantly in their level and linear course of symptoms with regard to the 'high-decreasing' class. In contrast, no sex differences were found in the growth factors of the 'low' and 'moderate' classes. The regression analyses showed that the childrenʼs depressive symptoms, dysfunctional parenting style, and negative family climate were associated significantly with the level and course of symptoms as well as the class membership of girls and boys. Life events predicted class membership only for boys, whereas maternal depressive symptoms and family conflict did not demonstrate any significant relationship. The sizes of the predictive associations with the growth factors were similar for both sexes. The results are discussed with regard to existing developmental models and their possible implications for prevention and future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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Outcome prediction in alcoholism therapy is of major sociopolitical and economic significance. Instruments based on psychotherapeutic processes are lacking. Therefore, treatment processes of 64 chronic alcohol dependent patients have been investigated at three time-points, t₁ (week 3), t₂ (month 6), and t₃ (month 12) during the first year of a comprehensive outpatient treatment program, guaranteeing strictly controlled alcohol abstinence. Main focus of the study was the prediction of cumulative abstinence probability over a follow-up period of up to 4 years based on these treatment processes. One hundred and seventy-five video recordings of therapy sessions were analyzed with the behavior observational system VAMP (Video-Assisted Monitoring of Psychotherapeutic Processes in Chronic Psychiatric Disease). Patients' self-rating of treatment processes was measured with questionnaires for self-efficacy, abstinence confidence, self-consciousness and stress coping. Prediction of cumulative abstinence probability was determined with Cox regression analysis. By integrating the observer rated process variables with the highest predictive validity, the composite score TOPPS (Therapy Orientation by Process Prediction Score) was constructed. It includes the process variables experience of resources, abstinence self-efficacy, implicit craving, relapse alertness, relapse risk, disease concept, dysfunctional therapeutic engagement, and dysfunctional problem solving of current problems. Whereas patients' self-rating of treatment processes was insufficiently predictive, the TOPPS strongly predicted four-year abstinence probability at any of the 3 time-points (p < 0.001). The results suggest to validate the item combination described in the TOPPS in addiction therapy as a treatment guideline of individual relapse prevention strategies. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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The body is central in many mindfulness-based interventions. Body mindfulness has been defined as observing body experiences and as a consequence appreciating body experiences. Since only a few psychometrically sound questionnaires are available to measure the observing aspect of body mindfulness and no scale specifically addresses the appreciating aspect of body mindfulness, the Body Mindfulness Questionnaire (BMQ) was created. This study presents the development and the psychometric evaluation of the BMQ. Exploratory and confirmatory factor analyses suggested two scales: ``Experiencing Body Awareness'' and ``Appreciating Body Awareness''. Evidence for the reliability (internal consistency and retest reliability), validity (factorial validity and construct validity), and sensitivity to change is reported. The findings suggest that the BMQ is a valid and reliable instrument that allows assessment of essential facets of body mindfulness.
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Background: The best way to describe the development of depression are multifactorial models in which volitional processes, i.e. regulation processes that transform cognitions into actions, play a central part. However, there are very few approaches to investigate such models among inhabitants of old people's residencies. Objective: Several variables related to depression were divided into two sets of predictors of depression: (1) predispositions of depression, (2) variables concerning the state of increased self-awareness. Methods: 100 inhabitants of old people's residencies have been questioned with a structured interview which included the tests ADS (german version of the Epidemiological Studies Depression Scala), FKK-SKI (self-efficacy), HAKEMP-90 (volitional self-regulation) and a newly developed questionnaire about perceived freedom. For one week subjects kept a diary of activities for self-observation. Results: Perceived freedom has proven to be independent of self-efficacy and volitional self-regulation. Depression was predicted by low physical fitness, little social support, a low degree of perceived freedom and a low degree of volitional self-regulation.Conclusions: Therapy and prevention of depression among inhabitants of old people's residencies should include both, promotion of volitional self-regulation and improvement of perceived freedom, because each of these factors contribute independently to the explanation of depression. Several possibilities to promote freedom in old people's residencies and in the therapy of depression with old people are proposed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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50 children (aged 8–14 yrs) with tension-type or combined headaches took part in the study. 40 Ss were randomly assigned to the 4 different treatment conditions, and 10 Ss participated in the self-monitoring control group. The training comprised of 6 1-hr sessions in the relaxation treatment and 12 1.5-hr sessions in the biofeedback group. Headache diaries were kept by children and their parents for a 4-wk period prior to therapy, and for a similar length of time at post-treatment and 6-mo follow-up. Multivariate analyses of variance on the headache diary data found no significant main or interaction effects of treatment format or of parent involvement. A main effect of period was found, indicating a general efficacy of the 4 treatment conditions. At follow-up the reduction of headache activity was even more prominent. A different evaluative approach points to the superiority of biofeedback revealing a mean effect size for biofeedback training that reflects a good to excellent improvement rate. Correlations between headache data from children and parents were high. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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In the history of tinnitus research and treatment, many attempts have been directed toward abolishing or minimizing tinnitus. Despite all these efforts, until now no treatment has been found to successfully eliminate tinnitus permanently. As a consequence, increasing efforts have been undertaken by behavioral scientists and psychologists to eliminate or at least ameliorate psychological symptoms associated with tinnitus. The aim of psychological interventions is not to 'cure' or to eliminate the inner noise but to reduce tinnitus-related distress and increase quality of life. If patients are no longer bothered by their inner noises and the question of how tinnitus can be removed, they might become secondary. As long as tinnitus itself cannot be eliminated, the main intention of all therapeutic interventions is to alleviate suffering from tinnitus. Cognitive behavioral interventions are the most widely used psychological strategies for coping with tinnitus. The goal of the therapy is to alter maladaptive cognitive, emotional, and behavioral responses to tinnitus and not to abolish the sound itself. There are two main components to this approach: (a) Cognitive restructuring and (b) Behavioral modification. Treatment programs are comprised of techniques like relaxation training, cognitive restructuring, attention control techniques, imagery training, and exposure to difficult situations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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Background: In general, chronic pain is categorized into two mechanism-based groups: nociceptive and neuropathic pain. This dichotomous approach is questioned and a dimensional perspective is suggested. The present study investigated neuropathic characteristics in different syndromes of chronic pain. We also examined the association of neuropathic characteristics with various pain related and psychological variables. Methods: From April 2010 to January 2012, 400 patients suffering from a chronic pain condition enrolled for multidisciplinary pain treatment were considered for inclusion in the study. Criteria for inclusion were age over 18 years and having chronic pain according to ICD-10 (F45.41) criteria. The pain DETECT questionnaire was used to assess neuropathic characteristics of pain. Results: Thirty-seven percent of patients with different pain diagnoses demonstrated distinct neuropathic characteristics. The diagnostic groups for neuropathic pain, musculoskeletal pain and post traumatic or surgical pain showed the most neuropathic features. The level of depression, pain chronicity and intensity, disability and length of hospital stay were significantly higher in patients suffering from neuropathic symptoms. A high level of depression and pain chronicity as well as high intensity of pain explained most of the variance in the neuropathic scores. Disability and length of hospital stay significantly predicted neuropathic characteristics only when examined separately, but not if included in a common regression model. Conclusions: Any type of chronic pain may have more or less neuropathic characteristics. The pain-related parameters of high intensity and chronicity as well as negative affectivity and functional disability strongly correlate with neuropathic characteristics of pain. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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The main treatment approaches to chronic pain are introduced and the potential mechanisms of action are discussed. Empirical evidence is analyzed on the basis of meta-analytic and original studies. A wealth of randomized controlled studies supports the efficacy of psychological treatment, while effect sizes are small to moderate. No statistically supported differences between treatment approaches were found. In spite of the limitations psychological interventions are of high relevance in chronic pain, since they have the potential to install the patient as the guardian of his own health and moreover there is little empirical evidence for quite a number of medical interventions of which some also have adverse effects. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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Purpose of review: Treatment of chronic pain has become a multidisciplinary endeavour including psychological interventions. Databases for life science journals were searched for citations from 2007 and 2008 to determine the current focus of research and the state of evidence. Recent findings: Several reviews on systematic research studies confirm that psychological interventions are efficacious in the treatment of chronic musculoskeletal pain, especially back pain, though effect sizes are small and, in some cases, moderate. Findings from clinical practices and treatment centres corroborate these conclusions. The integration of psychological treatment into primary care has not yet proven its utility. Cost-effective interventions to reduce relapse are currently being examined. Psychological headache treatment has again become a topic of research. Evidence is inconsistent, with improvement ranging from an extraordinary size to none at all. Hypnotherapy in children and adolescents with recurrent gastrointestinal pain, examined in a study of high methodological quality, achieved an exceptional level of symptom relief. The aim of two studies on therapy for fibromyalgia and temporomandibular disorder was the identification of mediators and moderators of treatment outcome. Summary: Regarding different pain syndromes such as chronic back pain, headache, fibromyalgia, and temporomandibular disorder, as well as gastrointestinal pain in children, psychological interventions proved their significance for the achievement of favorable treatment outcome. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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Objective: To analyze the development of recurrent pain in 3 body locations in children and adolescents (baseline age, 9 to 14 years) in a 4-year period. Study design: In a large population-based longitudinal epidemiological study data was collected through annual postal questionnaires (longitudinal, n = 2025). Descriptive statistics and generalized estimating equations were used. Results: Girls were more likely to report recurrent pain, demonstrated a steeper development during the 4-year period, and reported multiple pain more often than boys. Younger children reported less recurrent pain, but displayed a steeper trend of increasing prevalence rates as they grew older. Older children illustrated a more stable development of recurrent pain and reported multiple pain more often. Disability experienced because of recurrent pain was related strongest to pain intensity. Stable patterns of pain were related to higher intensity and disability reports. The children experienced headache as the most disabling of the 3 pains. Conclusion: The results show that boys and girls report recurrent pain in different patterns in the years. To identify risk factors, analysis should be performed separately for boys and girls. Furthermore, it is recommended to include children before the age of 9 years in a prevention study. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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Objective: The study aims at identifying biopsychosocial risk factors for headache in children and adolescents aged 9 to 14. Methods: An epidemiological survey was conducted in a randomly drawn population sample of families with children in the above age group. Questionnaires were mailed to parents and children (n = 6400), on whose data this report is based. The objective of the study was to establish a profile of risk factors regarding the occurrence of headache. Headache, as the criterion variable, was ranked according to its frequency in the last 6 months (no, rare, monthly, weekly). Independent variables came from 6 domains: health, socioeconomic, family, school, leisure/peers, and psychological factors. Data analysis was conducted via multinomial regression analyses in a 4-step strategy: (1) analysis of age and sex as control variables; (2) analysis of single variables from each of the 6 domains (controlled for age and sex); (3) domain analyses; and (4) comprehensive analysis including all significant variables from the domain analyses. Results: Age and sex explained a small but significant proportion of the variance in headache frequency (3.5\%). All health variables, several socioeconomic, and most family- and school-related as well as the psychological variables demonstrated a significant association with the criterion in the single variable models. However, only a few of the variables related to leisure/peer activities reached significance. The domain model comprising health variables explained 27\% of the variance, achieving the best model fit, followed by the psychological model with 13\%. Conclusions: The comprehensive model was able to explain one third of the total variance in headache occurrence. Contrary to our hypothesis, the addition of psychosocial variables to health-related predictors did not markedly improve model fit. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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Studied the effects of various biofeedback strategies in terms of learning-related changes in physiological parameters of chronic headache. The main assumption was that biofeedback leads to specific learning processes that modify the physiological variables in the direction of reduced pain intensity and duration. Human subjects: 92 male and female German adults (mean age 41 yrs) (chronic headache). The Ss were randomly assigned to 1 of 5 biofeedback training programs or to a false-feedback control group. Physiological parameters included electrodermal response, heart and respiratory rates, and electromyogram (EMG) findings. (English abstract) (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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Studied the effectiveness of coping strategies in the Stre–Sverarbeitungsfragebogen (SVF) ('Stress-Coping Questionnaire') of W. Janke et al (1985), and the importance of situational variables in evaluating the effectiveness of coping behavior. Human Ss: 37 male and female West German adults (psychologists) (Study I); 32 male and female West German adults (nonpsychologist academics) (Study I); 79 male and female West German adults (nonacademic university employees) (Study I); 24 male and female West German adults (22–36 yrs) (university students) (Study II); 24 male and female West German adults (28–57 yrs) (university employees) (Study II). In Study I, Ss rated the effectiveness of 19 coping strategies assessed by the SVF. In Study II, Ss rated stories in which a stressful situation varied with regard to 4 dimensions (content, proximity, predictability, and controllability) in order to suggest an effective coping strategy. (English abstract) (PsycINFO Database Record (c) 2016 APA, all rights reserved)
