Nexhmedin Morina

University of Münster | WWU · Department of Psychology

Background: Since current therapies for depression are effective but not for all patients alike, we need to further improve available treatments. Existing research suggests that Acceptance and Commitment Therapy (ACT) may effectively treat Major Depressive Disorder (MDD). We compared ACT with Cognitive Behavioral Therapy (CBT) for depression, testi...

People’s self-concept contributes to their sense of identity over time. Yet self-perception is motivated and serves survival and thus does not reflect stable inner states or accurate biographical accounts. Research indicates that different types of comparison standards act as reference frames in evaluating attributes that constitute the self. Howev...

Background Research indicates that higher study quality may be associated with smaller treatment effects. Yet, knowledge about the association between study quality and treatment efficacy for posttraumatic stress disorder (PTSD) is limited. We aimed at evaluating the efficacy of psychological interventions for adult PTSD and the association between...

Judgment of well-being is formed on the spot, and we know little about its foundations. We aimed at examining the role of comparison standards in informing evaluations of well-being in a clinical and a nonclinical sample. In a semi-structured face-to-face interview, individuals seeking psychological treatment and healthy control individuals rated h...

Imagery rescripting (ImRs) is frequently applied to treat different psychological complaints. We conducted an updated meta-analysis based on randomised controlled trials on the efficacy of ImRs for mental disorders associated with aversive memories. Medline, PsycInfo, and Web of Science were searched up to May 2023. Seventeen trials were included w...

Patients with an implantable cardioverter-defibrillator (ICD) often report psychological distress. However, both physical disease severity and psychological adjustment are variable. The role of social comparison in illness coping has not been studied in these patients yet. We theorize that relative to patients without experienced shock (ICD-), thos...

Background: Comparative thinking about one's well-being is ubiquitous. Comparisons that threaten an individual's self-motives are aversive and interact with rumination and depression. Aversive well-being comparisons include upward social, past temporal, counterfactual, and criteria-based comparisons, as well as downward prospective temporal compar...

Importance: Social anxiety disorder (SAD) can be adequately treated with cognitive behavioral therapy (CBT). However, there is a large gap in knowledge on factors associated with prognosis, and it is unclear whether symptom severity predicts response to CBT for SAD. Objective: To examine baseline SAD symptom severity as a moderator of the associ...

Purpose Aversive appearance-related comparisons (i.e., threatening one’s own motives) show stronger associations with depression, psychological well-being, and self-esteem than appetitive comparisons (i.e., consonant with or challenging one’s motives). However, the relevance of their congruent (i.e., equal) and incongruent (i.e., unequal) presence...

The large and growing number of published meta-analyses on the efficacy of psychological interventions for PTSD make a comprehensive integration of available treatment evidence challenging. We conducted a systematic search in five databases for meta-analyses of randomised controlled trials (RCTs) on the treatment efficacy of specific psychological...

People can easily rate and express their current affect levels, but the cognitive foundations for such judgments are poorly understood. We examined whether comparisons to varying standards underlie fluctuating affect judgments within-person (i.e., throughout daily episodes) and between-person (i.e., high vs. low levels of psychopathology). Clinical...

Sudden gains, defined as large and stable improvements in symptom severity during psychological treatment, have consistently been found to be associated with better outcomes across treatments and diagnoses. Yet, insights on coherent predictors of sudden gains and on emotional changes around sudden gains in post-traumatic stress disorder (PTSD) are...

Pairing a cue (e.g., an image of a geometrical figure) with an outcome (e.g., an image with aversive content) can result in the cue eliciting thoughts of that outcome (i.e., thought conditioning). Previous research suggests an advantage of counterconditioning over extinction in reducing thoughts of (aversive) outcomes. However, it is unclear how ro...

Sampling theories suggest that quantitative judgments are comparison-based and, therefore, fundamentally relative, and susceptible to continuous revision based on information sampled from our environment. Body satisfaction and weight judgment in women are a domain of clinical relevance in this context, as they have been shown to be related to unfav...

Objective: Numerous randomized controlled trials (RCTs) demonstrate the efficacy of cognitive behavioral therapy (CBT), metacognitive therapy (MCT), and methods to reduce intolerance of uncertainty (IU-CBT) in the treatment of generalized anxiety disorder (GAD). However, few studies have investigated these treatments under conditions of routine cl...

Background: Many refugees report high levels of psychopathology. As a countermeasure, some psychological interventions aim at targeting mental health difficulties in refugees transdiagnostically. However, there is a lack of knowledge about relevant transdiagnostic factors in refugee populations. Objective: To inform intervention efforts empirically...

We aimed at mapping the meta-analytic evidence base on the efficacy of psychological treatments for posttraumatic stress disorder (PTSD) in specific populations. We conducted a systematic search until January 2022 in MEDLINE, PsycINFO, PTSDpubs, Web of Science, and the Cochrane Database of Systematic Reviews for metaanalyses of randomized controlle...

Objectives: Individuals frequently engage in comparisons on how they are doing relative to different standards. According to the general comparative-processing model, comparisons can be perceived as aversive (appraised as threatening the motives of the comparer) or appetitive (appraised as consonant with, or positively challenging the motives). Re...

Background: Two systematic reviews indicated that higher treatment frequency of psychological interventions for adult PTSD may lead to higher efficacy and less dropout. Yet, a quantitative review is missing. Methods: We conducted a thorough systematic literature search and included trials meeting the following criteria: a) random allocation, 2)...

Objective: A comprehensive quantitative summary of the efficacy and acceptability of psychological interventions (PIs) for adult posttraumatic stress disorder (PTSD) is lacking. Method: We conducted a systematic literature search to identify randomized controlled trials (RCTs) examining the efficacy and acceptability (all-cause dropout) of psych...

Background: People are constantly preoccupied with how they are doing compared to different standards. This preoccupation influences judgments of well-being, including depression. However, research on well-being comparisons is scarce, also due to a lack of a measure of multi-standard comparisons. Methods: Our research goals were twofold. First, we...

Background: Previous meta-analyses of psychotherapies for children and adolescents with PTSD did not investigate whether treatment efficacy is diminished when patients report multiple (vs. single) traumas. Aims: The present work aimed to close this gap. Method: We systematically searched PsycINFO, MEDLINE, Web of Science and PTSDpubs on April 21st...

Background: Participants are allowed to stay on their prescribed psychotropic medication in most trials examining psychological interventions for adult post-traumatic stress disorder (PTSD). Objectives: We aimed to conduct the first meta-analysis investigating the potential influence of such concurrent medication on efficacy. Method: To this e...

Numerous randomized controlled trials have shown cognitive behavior therapy (CBT) to be effective in treating social anxiety disorder (SAD). Yet, less is known about the effectiveness of CBT for SAD conducted by psychotherapists in training in routine clinical practice. In this study, 231 patients with SAD were treated with CBT under routine condit...

We introduce a novel approach to assess habitual comparison processes, while distinguishing between different types of comparison standards. Several comparison theories (e.g., social) suggest that self-evaluations use different standards to inform self-perception and are associated with wellbeing and personality. We developed the Comparison Standar...

Traumatic events often lead to counterfactual comparison (CFC), defined as comparing one’s current attributes to that of a hypothetical mentally simulated alternative that might have occurred but is counter to the facts. CFC can differ in its direction and in terms of the referent of action. The mentally simulated alternative may be evaluated as mo...

Zusammenfassung: Imagery Rescripting (ImRs) erhält zunehmend Aufmerksamkeit als eine innovative und effektive Methode zur Behandlung der Posttraumatischen Belastungsstörung (PTBS). Die PTBS gehört zu den häufigsten psychischen Störungen bei geflüchteten Menschen. ImRs stellt einen vielver-sprechenden Behandlungsansatz für diese Indikation bei Geflü...

Introduction Since a high proportion of refugees in Germany suffer from mental disorders, culturally adapted treatments are needed that target a broad range of symptoms. There is much evidence for the efficacy of culturally adapted cognitive behavioural therapy (CA-CBT). Given the promising results of CA-CBT, the combination with problem solving tr...

Background: Guilt and shame regulate basic human processes such as social cognition and relations. Both emotions are also involved in the aetiology and maintenance of trauma-related mental disorders such as posttraumatic stress disorder (PTSD). However, a concise scale that adequately captures these constructs is currently lacking, impeding researc...

Background Humans constantly compare their attributes to different reference frames. According to the theoretical framework of the general comparative-processing model, such comparisons may be perceived as aversive (i.e., appraised as threatening the motives of the comparer) or appetitive (i.e., appraised as consonant with, or positively challengin...

Background: Academic self-concept (ASC) is a prominent predictor of educational achievement and plays a critical role in student mental health. Although it is widely accepted that ASC is fundamentally comparative, little is known about the comparison types driving students’ ASC construal and its impact on mental health. Therefore, we examined wheth...

Although well-established therapies exist for post-traumatic stress disorder (PTSD), barriers to seek mental health care are high. Technology-based interventions may play a role in improving the reach of efforts to treat, especially when therapist availability is low. The goal of the current randomized controlled trial was to pilot the efficacy of...

Background Humans constantly compare their attributes to different reference frames. According to the theoretical framework of the general comparative-processing model, such comparisons may be perceived as aversive (i.e., appraised as threatening the motives of the comparer) or appetitive (i.e., appraised as consonant with, or positively challengin...

Background: People are constantly preoccupied with how they are doing compared to different standards. This preoccupation influences judgments of well-being, including depression. However, research on well-being comparisons is scarce, also due to a lack of a measure of multi-standard comparisons. Methods: Our research goals were twofold. First, we...

Background Attention on harmful effects of psychological interventions for adult post-traumatic stress disorder (PTSD) has increased, yet a comprehensive meta-analysis is lacking. Aims To summarise incidences and relative risks of deterioration, adverse events (AEs) and serious adverse events (SAEs) in trials of psychological interventions for adu...

The implantation of cardiac devices significantly reduces morbidity and mortality in patients with cardiac arrhythmias. Arrhythmias as well as therapy delivered by the device may impact quality of life of patients concerned considerably. Therefore we aimed at conducting a systematic search and meta-analysis of trials examining the impact of the imp...

The implantation of cardiac devices significantly reduces morbidity and mortality in patients with cardiac arrhythmias. Arrhythmias as well as therapy delivered by the device may impact quality of life of patients concerned considerably. Therefore we aimed at conducting a systematic search and meta-analysis of trials examining the impact of the imp...

Syncopes are a very common phenomenon and have a high recurrence rate. The differentiation between the psychogenic and physical, especially of arrhythmic origin, remains difficult. In many cases, an implantable loop recorder is used for the detection of possible arrhythmias, leading to syncopes. Yet, the existing literature suggests that psychologi...

The perceptual Self-Prioritization effect (SPE) refers to an advantage in attending to stimuli associated with the self relative to those associated with another individual. In the perceptual matching task, arbitrary pairings between oneself and other persons, and a geometric shape need to be learned. Apart from the SPE, this task also produces hig...

Background Self-discrepancy theory posits that greater discrepancy between the actual and ideal self is related to dysphoria and greater discrepancy between the actual and ought self to anxiety. Despite both being transdiagnostically associated with psychopathology, differential effects of actual:ideal and actual:ought discrepancies have not been c...

Posttraumatic stress disorder (PTSD) is a severe condition that is associated with trauma-related guilt. We aimed at providing a comprehensive quantitative systematic review on the relationship between trauma-related guilt and adult PTSD. Database searches in Medline, PsycINFO, PTSDpubs and Web of Knowledge resulted in the inclusion of 163 eligible...

Trauma-focused CBT (Tf-CBT) has shown efficacy in RCTs and routine clinical care. However, predictors and mechanisms of treatment outcomes in naturalistic settings remain unclear. In a study of 85 patients with PTSD, Tf-CBT was administered by therapists in training at German outpatient centers. Treatment phases included preparation, trauma-focused...

Background The efficacy of virtual reality exposure therapy (VRET) for fear of flying has been well established. Yet, little is known about the extent to which anxiety sensitivity and self-efficacy predict the efficacy of VRET. We aimed at investigating these cognitive predictors as well as the contribution of the therapeutic alliance to treatment...

Posttraumatic stress disorder (PTSD) is among the most prevalent mental disorders in refugees. Imagery Rescripting (ImRs) has gained growing interest as an innovative and effective treatment for several disorders, including PTSD. The technique aims to change the meaning of traumatic memories by asking the patient to imagine a different outcome of a...

While dozens of randomized controlled trials (RCTs) have examined psychological interventions for adult posttraumatic stress disorder (PTSD), no network meta-analysis has comprehensively integrated their results for all interventions and both short and long-term efficacy. We conducted systematic searches in bibliographical databases to identify RCT...

Somatic symptoms are common among Syrian refugees. To quantify somatic symptom load, sum score models derived from the Patient Health Questionnaire (PHQ-15) have been frequently applied without psychometric justification. Across two studies (total N = 776), we (a) tested different PHQ-15 factor solutions in Syrian refugees, (b) investigated measure...

Previous research suggests that the effect of therapist factors on patient outcomes is significant. Yet, to date, no reviews have explored the potential effects of therapist characteristics on treatment outcomes for children and youth with posttraumatic stress disorder (PTSD). This systematic review and meta‐analysis aimed to summarize the professi...

Both social and temporal comparison information can be used to guide self-assessment of performance. In student and professional samples, false feedback about performance relative to participants’ peer group was found to inform self-assessment over feedback about participants’ change in performance over time. This "overpowering effect of social com...

The psychosocial environment is pivotal for the adjustment to traumatic experiences, yet the role of social cognition in the development of post-traumatic stress disorder (PTSD) remains obscure. We theorize that comparison with other trauma survivors reporting high or low levels of stress-related symptomatology might attenuate or amplify the develo...

Many war survivors suffer from chronic posttraumatic stress disorder (PTSD). Unraveling the complexities of PTSD symptoms over time is crucial for understanding this condition. Going beyond a common pathogenic pathway perspective , we applied the network approach to psychopathology to analyze longitudinal data from war survivors with PTSD in five B...

Background Individuals with posttraumatic stress disorder (PTSD) often report intrusive memories that appear to lack the appropriate spatio-temporal context. Objective We examined whether focusing on the spatio-temporal context of aversive autobiographical memories reduces negative emotions, appraisals, and re-experiencing symptoms. Methods We re...

Objective: Despite elevated mental health problems, refugees tend to hold more negative attitudes toward psychological help seeking than residents of receiving countries. Therefore, we examined variables expected to be related to different aspects of psychotherapy motivation (psychological distress, knowledge about therapy, and denial of psycholog...

Background Trauma-focused treatments for posttraumatic stress disorder (PTSD) are commonly delivered either once or twice a week. Initial evidence suggests that session frequency affects treatment response, but very few trials have investigated the effect of session frequency. The present study’s aim is to compare treatment outcomes of twice-weekly...

Introduction Despite high levels of mental distress, accessing psychological treatment is difficult for asylum seekers in Western host countries due to a lack of knowledge about mental disorders, and the health system, as well as due to cultural and language barriers. This study aims to investigate whether brief culturally sensitive and transdiagno...

Objective: Positive psychotherapy (PPT) aims at increasing positive affect, meaning and engagement. We aimed to synthesise the available evidence on PPT efficacy. Design: We conducted a preregistered systematic literature search and meta-analysis of randomised controlled trials examining the efficacy of PPT for increasing positive (eg, satisfactio...

Background Childhood maltreatment is relatively common and is related to a range of negative consequences, such as Posttraumatic Stress Disorder (PTSD). There are indications that various maltreatment types are related to PTSD severity, although not all types, such as emotional abuse, meet the PTSD Criterion-A. Objective The aim of the present stu...

Objective: Extensive research has demonstrated high prevalences of posttraumatic stress disorder (PTSD) and major depression (MD) in war-surviving populations. However, absolute estimates are lacking, which may additionally inform policy making, research and health care. We aimed at estimating the absolute global prevalence and disease burden of ad...

Many refugees have been exposed to potentially traumatic events and report elevated levels of psychological distress. However, refugees vary greatly in the severity of mental health problems. Intra- and interpersonal factors help some refugees to cope effectively. To shed light on these factors, we scrutinized how potentially traumatic events, resi...

The perceptual Self Prioritization effect (SPE) refers to an advantage in attending to stimuli associated with the self relative to those associated with another individual. In the perceptual matching task, arbitrary pairings between oneself and other persons, and a geometric shape need to be learned. Apart from the SPE, this task also produces hig...

Introduction Refugees and asylum seekers are vulnerable to common mental disorders, including post-traumatic stress disorder (PTSD). Using a network meta-analysis (NMA) approach, the present systematic review compared and ranked psychosocial interventions for the treatment of PTSD in adult refugees and asylum seekers. Methods Randomised studies of...

In recent years the development of new virtual environments has been qualitatively high and fast at the same time, but the dissemination of virtual reality (VR) in clinical practice is still scarce. The aim of this review is to give an insight into the state of the art of the use of VR as an assessment tool and treatment intervention in anxiety and...

Background: War survivors often report symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, and somatization. Hence, understanding symptom constellations among different populations of war survivors is critical. Methods: Using the network approach to psychopathology, we examined symptom centrality for these conditions in war sur...

Refugee populations show considerably high rates of mental health problems. Yet, many mental health professionals may have reservations to work with refugees due to suspected cultural differences, language barriers, and the need to provide additional services. However, little is known about psychotherapists’ readiness to work with refugees. In a sa...

The perceptual self-prioritization effect (SPE) is the observation that an arbitrary pairing of a geometric shape with a label can be matched more easily when said label refers to one’s own self, rather than another person or object. This perceptual matching task also produces comparatively high performance when labels denote a close other. While c...

Background: The imperative for physical distancing (mostly referred to as social distancing) during COVID-19 pandemic may deteriorate physical and mental health. We aimed at summarising the strength of evidence in the published literature on the association of physical and mental health with social connection via social isolation, living alone and...

Background: Many refugees have experienced multiple traumatic events in their country of origin and/or during flight. Trauma-related disorders such as posttraumatic stress disorder (PTSD) or complex PTSD (CPTSD) are prevalent in this population, which highlights the need for accessible and effective treatment. Imagery Rescripting (ImRs), an imagery...

The association between posttraumatic stress disorder (PTSD) and counterfactual comparisons (CFC) is poorly understood and CFC-measures are missing. We developed and applied the Posttraumatic Counterfactual Comparisons Scale (P-CFC-S), which measures frequency, intensity and affective impact of trauma-related CFC. We further measured trauma history...

Objectives The role of physical activity (PA) in the promotion of mental wellbeing and prevention of psychological disorders in population groups at increased risk for mental health conditions, such as migrant populations, has never been systematically investigated. Methods We conducted a systematic review and meta-analysis according to the Prefer...

Background: Existing therapies for depression are effective, but many patients fail to recover or relapse. To improve care for patients, more research into the effectiveness and working mechanisms of treatments is needed. We examined the long-term efficacy of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for Major D...

Effective psychological interventions for anxiety disorders often include exposure to fearful situations. However, individuals with low self-efficacy may find such exposure too overwhelming. We created a vicarious experience in virtual reality, which enables observation of one's experience from a first person perspective without actual performance...

Screening tools developed for Western populations have produced heterogeneous prevalence estimates for depression and anxiety disorders among refugees. The use of these instruments assumes that psychopathological symptoms are manifested similarly across different cultural groups. Here, we scrutinized whether depressive and anxiety symptoms are mani...