Catholic University of Eichstätt-Ingolstadt

Background Greater therapeutic alliance has been associated with an improved treatment outcome in various clinical populations. However, there is a lack of evidence for this association in posttraumatic stress disorder (PTSD) in young patients. We therefore investigated the development of the therapeutic alliance during Developmentally adapted cognitive processing therapy (D-CPT) in adolescents and young adults with PTSD following abuse to answer the question whether there was a connection between the therapeutic alliance and symptom reduction. Methods Weekly assessments of therapeutic alliance, rated by patients and their therapists, as well as PTSD symptom severity from a randomized controlled trial (RCT) of D-CPT were analyzed with multilevel modelling. The sample consisted of n = 39 patients aged 14–21 with a history of sexual and/or physical abuse. Results Therapeutic alliance increased during D-CPT. The ratings of the therapeutic alliance by patients and therapists were strongly correlated (r = .512, p < .01); however, at session level, there was a significant difference between the patients’ and their therapists’ alliance assessments. Patients with a higher perceived therapeutic alliance showed a greater reduction in self-reported symptoms over the course of therapy, compared to patients with lower alliance ratings. However, this only applied to the therapeutic alliance assessed by the patients. Discussion The therapeutic alliance plays a crucial role in D-CPT with young patients, contributing to a reduction in symptom severity over the course of treatment. It is essential that therapists prioritize the development of a strong alliance and seek feedback from their patients. The results suggest that patients’ perceptions, which often differ from therapists’ assessments, were more important in determining treatment success in the sample. Studies with larger samples sizes and additional independent ratings of alliance are needed to further examine the alliance-outcome link. Trial registration The trial was registered at the German Clinical Trial Registry, DRKS00004787, 18 March 2013, https://www.drks.de/DRKS00004787.

Recently, there has been significant progress in understanding the convergence and generalization properties of gradient-based methods for training overparameterized learning models. However, many aspects including the role of small random initialization and how the various parameters of the model are coupled during gradient-based updates to facilitate good generalization remain largely mysterious. A series of recent papers have begun to study this role for non-convex formulations of symmetric Positive Semi-Definite (PSD) matrix sensing problems which involve reconstructing a low-rank PSD matrix from a few linear measurements. The underlying symmetry/PSDness is crucial to existing convergence and generalization guarantees for this problem. In this paper, we study a general overparameterized low-rank matrix sensing problem where one wishes to reconstruct an asymmetric rectangular low-rank matrix from a few linear measurements. We prove that an overparameterized model trained via factorized gradient descent converges to the low-rank matrix generating the measurements. We show that in this setting, factorized gradient descent enjoys two implicit properties: (1) coupling of the trajectory of gradient descent where the factors are coupled in various ways throughout the gradient update trajectory and (2) an algorithmic regularization property where the iterates show a propensity towards low-rank models despite the overparameterized nature of the factorized model. These two implicit properties in turn allow us to show that the gradient descent trajectory from small random initialization moves towards solutions that are both globally optimal and generalize well.

Introduction Lateral temporal neural measures (Na and T-complex Ta and Tb) of the auditory evoked potential (AEP) index auditory/speech processing and have been observed in children and adults. While Na is already present in children under 4 years of age, Ta emerges from 4 years of age, and Tb appears even later. The T-complex has been found to be sensitive to language experience in Spanish-English and Turkish-German children and adults. In particular, Ta elicited to a vowel has been found to be sensitive to language experience in bilingual preschool children. This paper examines neural responses in 4-to-6-year-old Italian-German bilingual and German monolingual children using language-specific phonetic cues for voicing. Methods We tested children's processing of voicing features in bilabial stop consonants in relation to (1) their language status (i.e., being monolingual vs. bilingual) as well as to (2) their relative amount of current exposure to the heritage (Italian) and the societal language (German). Italian-German bilingual and German monolingual children were hypothesized to encode the temporal properties of a set of Voice Onset Time (VOT) stimuli differently as indexed by Ta and Tb. Results The results revealed no main effects of language group, but interactions of group with hemisphere and stimulus. In particular, bilingual children showed less hemispheric differentiation and an attenuated (less positive) response at the right site (T8) for the 0 ms VOT stimulus during the Ta-Tb time window. Children with more German (and consequently, less Italian) input showed a more positive T8 response for the Na, Ta and Tb time intervals. Discussion These findings partially replicated previous studies, but also revealed that stimulus factors modulate the response. They suggest that a delay in commitment is found only in bilinguals with less input in the target language, and those who are strongly dominant in one of the two languages will resemble monolinguals in the development of T-complex responses. However, the finding of greater Na positivity for German-dominant bilinguals suggests that their specific experience also influences processing, but perhaps via a different mechanism than found for the more balanced bilinguals.

Background Religiousness has been consistently linked to positive health outcomes and flourishing, yet the underlying mechanisms are complex and not well-understood. The forgiveness and relational spirituality model offers a framework to explore the moderated mediation among religious commitment, health, and forgiveness by God. Understanding these relationships among university students and community residents in Trinidad and Tobago can provide valuable insights into the role of religiousness in promoting wellbeing. Materials and methods This cross-sectional study involved 254 religious Afro-Trinidadians aged 18–78 from Trinidad and Tobago. Participants completed measures assessing religious commitment, proneness to guilt/shame, forgiveness by God, and health outcomes. Modeling using 5,000 bootstrap confidence intervals was used to analyze the hypothesized associations among variables. Results A significant positive relationship between religious commitment and health encompassed both physical and mental aspects. Feeling forgiven by God mediated the link between religious commitment and health outcomes (B = 0.019; SE = 0.007; 95% CI = 0.007, 0.034; R² = 0.12). Proneness to guilt or shame moderated the association between religious commitment and forgiveness by God. This relationship was significant primarily among individuals with high levels of proneness to guilt (B = 0.075, SE = 0.019, p < 0.001) and shame (B = 0.074, SE = 0.018, p < 0.001). Conclusions This study highlights the importance of religiousness in promoting human flourishing among Afro-Trinidadians residing in Trinidad and Tobago. Religious commitment and forgiveness by God were effective resilience resources that contributed to positive health outcomes. However, the nuanced role of proneness to guilt or shame underscores the need for a deeper understanding of individual differences in emotional responses within religious contexts. Future longitudinal research is warranted to elucidate the dynamic nature of these relationships and inform targeted interventions aimed at enhancing wellbeing in religious communities.

The purpose of this study is to assess the relationship between emotional forgiveness (presence of positive emotions towards the offender and reduction of negative emotions towards the offender) and personality traits (agreeableness, neuroticism, conscientiousness, openness to experience and extraversion) in the perspective of a longitudinal study among juveniles referred by family courts to a probation centre or youth educational centre. This investigation included 553 juveniles between the ages of 11 and 18. Our findings indicate that agreeableness (T1) is the predictor significantly associated with emotional forgiveness (presence of positive emotions towards the offender, T2). In contrast, neuroticism (T1) was negatively associated with a reduction in negative emotions towards the perpetrator (T2). Agreeableness and neuroticism have an important role in developing forgiveness, which has practical implications in the area of intervention and parenting for juveniles referred by the courts to educational institutions. As a result, juveniles struggling with problems related to their lack of forgiveness skills and abilities may suppress anger and negative emotions. Therefore, such individuals should be systematically motivated to express their emotions in order to learn the skills to regulate and control them, but also to pay attention and take the point of view of others.

Within psychological research, the concept of forgiveness has gained recognition for its potential impact on health, underlining the need for culturally adapted assessment tools and longitudinal studies to substantiate its effects. In this two-phase research project, we initially adapted the Rye Forgiveness Scale (RFS) to measure state forgiveness in the Polish context with 740 participants. Reliability analysis and confirmatory factor analysis confirmed the RFS's structure and internal consistency (absence of negative α = 0.87, presence of positive α = 0.86, full scale α = 0.84). Positive associations with other measures of forgiveness, religiosity, connection to nature, and mental well-being validated the scale's efficacy. The second phase evaluated the impact of state forgiveness on the mental health of 214 HIV-positive Polish individuals across three 6-month intervals. Utilizing the stress-and-coping model, this phase investigated forgiveness as a protective factor against negative mental health outcomes. The findings indicated that forgiveness could positively influence mental health, underscoring its importance in promoting well-being among vulnerable groups. This research provides a culturally validated tool for measuring forgiveness and illuminates its health benefits, emphasizing its significance for diverse populations.

Adverse life events and chronic psychological distress before and during pregnancy have frequently been associated with preterm birth but the biological underpinnings remain unclear. We investigated the association between corticosteroid levels in pre-pregnancy and first-trimester hair and the risk of preterm birth. We followed N = 1,807 pregnant women from a prospective pre-birth cohort study in Lima, Perú. Hair samples were taken at the end of the first pregnancy trimester. The two most proximal 3 cm segments to the scalp (representing pre-pregnancy and first-trimester) were analyzed to obtain hair cortisol and cortisone concentrations (HCC and HCNC). Preterm birth was defined as birth < 37 completed gestational weeks. We constructed four generalized propensity scores for pre-pregnancy and first-trimester HCC and HCNC to create corresponding inverse probability weights before fitting marginal structural models for estimating the effect of HCC and HCNC on preterm birth risk. Pre-pregnancy Log HCC was not independently associated with preterm birth risk (RR = 0.97; 95%CI: 0.79, 1.19), nor was pre-pregnancy Log HCNC (RR = 0.84; 95%CI: 0.58, 1.20). In the first trimester, a one SD increase in Log HCC was associated with a 37% increased risk of preterm birth (95%CI: 1.11, 1.69), whereas Log HCNC was not significantly associated with preterm birth risk (RR = 1.20; 95%CI: 0.87, 1.65). Our findings show that chronic corticosteroid levels in early pregnancy are causally linked to preterm birth risk in pregnant Peruvian women. This finding contributes to understanding the biological underpinnings of preterm birth better to enhance its prevention.

Background Work satisfaction is associated with fewer employee turnover intentions, increased job engagement and interest, and has a greater impact on employee well-being than environmental factors, such as workload. In workplace learning, clinical supervisors promote student satisfaction by meeting students’ supervision needs in providing safe practice opportunities, training, and guidance in the social field. To quantitatively investigate this relationship, we proposed a supervision deficit index as a measure of learner-centered supervision received and explored its correlation with satisfaction in workplace learning. Method In total, 1017 Austrian medical students (2015–2017) in year 6 selected the 5 most helpful supervisory activities (from 26 options) and rated their experience levels of these activities during surgery and internal medicine placement. A supervision deficit index was then created (range 0–3; 0 = no deficit). Results Students with no, minor or moderate supervision deficits reported higher overall satisfaction with their placements than those experiencing considerable deficits. Students’ gender, clinical experience, hospital size, placement year, and clinical field did not influence the relationship. The deficit index’s psychometric qualities were good. Training activities supporting competence, such as discussing patients, planning disease management, and practicing skills, were selected more often than activities supporting autonomy, such as an appropriate level of clinical duties, and social relatedness. Discussion Students favored competence support. Highlighting the importance of autonomy support to students and encouraging supervisors to engage in learner-centered supervision may improve the supervision experience and work satisfaction for both. The deficit index can be used to evaluate the effects of such interventions.

Introduction The spread and implementation of digital synchronous video communication in telecare and teletherapy has recently increased significantly, not just because of COVID-19 but also due to a global trend towards more digital healthcare services in the last two decades. This shift prompts the question of how digital telesetting differs from a face-to-face setting and which aspects are fundamental. Methods As the first part of a mixed-method study, qualitative interviews (n = 20) were conducted from July 2021 to January 2022. Health professionals (n = 13) and patients (n = 7) from occupational therapy, physiotherapy, speech therapy, and nursing were interviewed. All interviewees came from Germany, Austria, and Switzerland. The results were categorized using structured content analysis. Results Six main categories and 20 sub-categories were summarized, which can act as barriers or resources in a telesetting. Both sides described a high level of acceptance and approval of telesetting. Motivation and digital skills were of great importance. Furthermore, special features in communication and interaction were described, as well as changes in organizational procedures and a specific process flow in telesetting. Including relatives was more feasible, although several environmental factors should be considered. Discussion A number of specific changes in a telesetting compared to a face-to-face setting show the need for a structured guide for interested parties. Appropriate basic principles must be taught in training and further education to support the spread of this new form of care. Furthermore, it is crucial to adapt the methodological and content-related aspects of telesetting and develop new approaches that specifically integrate audio-visual possibilities.