Harald Gündel’s research while affiliated with Ulm University and other places

Objective Slow-paced breathing (SPB) with prolonged exhalation is assumed to stimulate vagal reflexes, which is represented by increased heart rate variability (HRV) values. However, most trials were conducted in healthy participants. We sought to evaluate the feasibility of SPB in hospitalized patients with confirmed bilateral COVID-19 pneumonia with major respiratory impairment and to investigate if SPB shows acute increasing effects on HRV measures in these severely ill patients with distinctly reduced vagal tone. Methods This single-center randomized controlled clinical trial enrolled 23 patients in the intervention (4-second inhalation, 6-second exhalation for 20 minutes 3× daily) and 23 patients in the control group (IG/CG). The effects of SPB on HRV were calculated using post-hoc likelihood ratio tests. Baseline HRV measures between the groups over time were compared using multilevel mixed-effect linear regression models with random slope including the covariates relevant comorbidities, COVID-19 medication, and age. Results HRV values at baseline were significantly decreased in all patients. During SPB, HRV parameters increased significantly (ln(SDNN), ln(LF), ln(TP); all p < .001). Higher breathing rate at baseline correlated with lower LF during SPB ( p < .045). IL-6 morning levels were associated with lower HRV measures ( p < .001). Resting HRV measures as well as subjective health increased over hospitalization time with no differences between IG and CG (comparing random slope with random slope interaction models: all LR χ ² (5) < 4.5; p > .48). Conclusion SPB is feasible and safe in patients with bilateral COVID-19 pneumonia and appears to be an effective self-performed intervention to acutely increase HRV measures. This observation was independent of comorbidities and comedication. Further trials should corroborate these findings and extend it to other severely ill populations. Registration German Clinical Trials Register under ID DRKS00023971 (https://drks.de/search/en/trial/DRKS00023971), with a Universal Trial Number (UTN) U1111-1263-8658

Recent systematic reviews have shown that emotional competencies can be improved through training. In the workplace, such training has become increasingly popular over the last decade. These programs aim to enhance emotional intelligence, empathy or emotion regulation. This study wants to assess the training effects and potential moderators of these workplace interventions. To our knowledge, this is the first systematic review that focuses on the workplace context and integrates emotional intelligence, empathy, and emotion regulation training interventions. This study has been preregistered with PROSPERO and a protocol has been published before the review was conducted (CRD42021267073). We conducted a systematic literature search using Embase, PsycInfo, PSYNDEX, Web of Science and the Cochrane Central Register of Controlled Trials. The included studies were analyzed in two metaanalyses. In the primary analysis, we analyzed standardized mean changes in emotional competencies before and after the training for 50 included studies, depending on (a) training construct and (b) participants’ profession (teachers, health professionals, managers, and others). To determine the efficacy of the trainings, we conducted a separate metaanalysis of controlled trials only (k = 27). Both metaanalyses yielded moderate overall effect sizes that also persisted more than three months after the training end: (1) SMDpre-post = 0.44 (95% CI [0.29, 0.59]), (2) SMDEG-CG = 0.46 (95% CI [0.30, 0.63]). All professions benefited equally from the interventions and we observed no significant differences in the effectiveness of emotional intelligence, empathy, and emotion regulation trainings. Overall, our results suggest that workplace interventions effectively train emotional competencies, regardless of profession or specific training focus. Limitations are the high heterogeneity and the low methodological quality of the studies analyzed. Our study shows the need for more high-quality studies, like randomized controlled trials. Additionally, companies may consider incorporating emotional competence training into their employee and leadership development programs routinely. This study was preregistered on PROSPERO (CRD42021267073). Supplementary Information The online version contains supplementary material available at 10.1186/s40359-024-02198-3.

Objective For leaders of small and medium-sized enterprises (SMEs) grappling with diverse tasks and stressors, personality functioning can play a key role on stress perception and building and managing professional relationships. We investigated the relationship between SME leaders’ personality functioning on the dimensions of self-perception and self-regulation on perceived stress reactivity (PSR), and symptoms of anxiety and depression. Methods A cross-sectional sub analysis of a multi-centre RCT project was performed. A sample of N = 174 SME leaders from various sectors in southern Germany were examined on their self-rated levels of personality functioning (OPD-SQ), involving self-perception (facets: self-reflection, affect differentiation, sense of identity) and self-reflection (facets: impulse control, affect tolerance, regulation of self-esteem), with higher scores indicating lower levels of personality functioning. The outcome variables were perceived stress reactivity (PSRS) and symptoms of depression and anxiety (HADS). Results The mean score for symptoms of anxiety was M = 6.13 (SD = 3.34), depression M = 4.40 (SD = 3.35), and for PSRS M = 21.39 (SD = 8.04). The mean sum score for self-perception was M = 7.71 (SD = 7.19) and for self-regulation M = 10.50 (SD = 7.09). The results of three regression models showed that higher scores for affect differentiation (rsp = .13), impulse control (rsp = .14) and regulation of self-esteem (rsp = .29) were associated with higher scores for PSR. Higher scores for affect differentiation (rsp = .17) and affect tolerance (rsp = .20) were significantly associated with higher scores for anxiety. A higher score for regulation of self-esteem (rsp = .17) was associated with higher depression scores. Conclusion This study highlights the association between core dimensions of SME leaders’ personality functioning and mental distress. The findings can be applied on interventions and health promotion and the establishment of high-quality professional relationships and leadership skills.

Background There is a vicious cycle between unemployment and mental health issues. Unemployed individuals with mental health issues require individualized support at multiple levels in order to promote their mental health, and obtain and retain employment. The 3for1-intervention program aims to provide such support with three components (short-term psychotherapy, job coaching based on the Individual Placement and Support approach, and peer support). This study protocol outlines how the effectiveness of this three-component intervention program in terms of re-employment, mental health, and psychosocial outcomes will be evaluated. Methods The 3for1-intervention program will be evaluated with a non-randomized controlled trial design in a multi-center study. 500 eligible participants aged between 18 and 60 years from six job centers in Southern Germany will be allocated to a control group or an intervention group. Allocation is time-based, with the control group being recruited first, followed by recruitment of the intervention group. The control group will receive treatment as usual, whereas the intervention group will receive treatment as usual as well as access to the three intervention components over a period of 12 months. Assessment will be conducted at baseline (t0), and 12 (t1) and 18 (t3) months later. The primary outcome will be the proportion of participants who are in employment subject to social insurance contributions at t1. Differences between control and intervention group will be tested with logistic regression analysis, controlling for relevant covariates. Analyses of secondary outcomes will relate to group differences regarding re-employment, health and well-being, social integration, help-seeking, and self-stigma at t1 and t2, applying logistic regression analysis or analysis of covariance. Additionally, usage of health services will be measured to evaluate the intervention program’s cost effectiveness. Discussion The 3for1-intervention aims to improve employability and mental health outcomes of a vulnerable population with high need for assistance. Improvements for this population would benefit the German welfare state as well. This study could provide valuable insights into the feasibility, implementation, and sustainability of this individualized, multi-level support program within German job centers. Trial registration This trial is registered with the German Clinical Trials Register: DRKS00029002 (registered on 11 May 2022).

One of the fascinating challenges in adult-child interaction is found in the fine-grained coordination of joint activities in the real time of play-interactions. In this contribution we take a closer look at caregiving activities that are jointly carried out by mothers and their five-year-old children. At this age, changing diapers, feeding, and comforting a crying baby (doll) is a challenging activity. The focus of our empirical study is on responses to crying. The investigation is innovative in so far as in prior research it was always the reaction by the mother (or the father or, not so often, by the sibling) that was under scrutiny. Here, we analyse sequentially how children comfort a lifelike doll together with their mother.

Symposia IV-2: MEASURE FOR MEASURE: COMPARATIVE UTILITY OF HEART RATE VARIABILITY INDICES OF CARDIAC VAGAL CONTROL Slow-paced breathing (SPB) is a long-known, noninvasive, and inexpensive method to stimulate vagal fibers known to directly decrease heart rate (HR) and increase indicators of HR variability (HRV). The aim of the present analysis is to investigate the direct effects of SPB in C19-pneumonia patients on commonly used HRV. Patients from the BeatCOVID RCT intervention group (DRKS00023971) wore bidaily holter monitors (Faros 180) during 5min-Rest, 4x5min SPB, and 5min recovery, processed in Kubios for HRV calculation. SPB effect on HRV-parameters were analyzed using multilevel fixed-effect linear regression models.

Randomized controlled trials are routinely used to assess the efficacy of psychotherapy. To date, our knowledge about how patients experience participation in such a trial is scant. Therefore, the present analysis aims at an in-depth exploration of patients’ perspectives on how a trial environment affects them. This study was conducted within the framework of the ENHANCE study, a large randomized controlled trial comparing two trauma-focused treatments, that is, psychodynamic and cognitive behavioral therapy, for patients diagnosed with posttraumatic stress disorder resulting from childhood maltreatment. We analyzed 17 posttherapy interviews with trial participants, employing an extended version of the Client Change Interview and grounded theory methodology for analysis. Analysis yielded one core category, revolving around the extent to which participants needed to conform to the external research framework to obtain personal benefits. This ambivalence was intertwined with trauma-related characteristics specific to this patient group. Three clusters fed into the core category: (1) positive and negative fantasies aroused by the research framework, (2) basic needs of patients colliding with the study conditions, and (3) inner and outer confrontations prompted by participation in the study. Study participation affects patients at various intrapsychic levels, resulting in specific dilemmas. Participation primarily serves as a means to obtain a therapy spot. Patients willingly accept the challenges associated with the study setting, viewing them as the trade-off for treatment access. Due to a positive therapy experience, participants maintain a favorable attitude toward study participation at large. Implications for integrating our findings in future studies are discussed.

Zusammenfassung Unter Rückgriff auf die Theory of Planned Behavior (TPB) trägt unsere Studie zu einem besseren Verständnis der Mechanismen handlungsleitender Bedingungen „gesunder Führung“ bei. Die Unterstützung durch Führungskräfte ist für die erfolgreiche Umsetzung von gesundheitsförderlichen Arbeitsgestaltungsmaßnahmen in Organisationen von entscheidender Bedeutung. Es gibt bislang nur wenige Erkenntnisse darüber, welche Bedingungen Führungskräfte dazu veranlassen, sich für die Gestaltung gesünderer Arbeitsbedingungen für die Beschäftigten einzusetzen. Die übergeordnete Rolle von Organisationsnormen und deren Wechselwirkungen mit anderen TPB-Prädiktoren konnte mithilfe von Regressionsanalysen mit paralleler Mediation empirisch bestätigt werden. Basierend auf längsschnittlich herhobenen Daten konnte gezeigt werden, dass gesundheitsbezogene Organisationsnormen von Bedeutung sind, um Führungskräfte für die Gestaltung gesundheitsförderlicher Arbeitsbedingungen zu gewinnen. Zudem liefern die Ergebnisse Hinweise darauf, warum sich diese Normen auf ein gesundheitsförderliches Führungsverhalten auswirken. Die Ergebnisse der Studie lassen sich zur theoretischen Weiterentwicklung des Prozessmodells „gesunder Führung“ nutzen, indem sie wesentliche handlungsleitende Bedingungen aufzeigen, die Führungskräfte dazu veranlassen gesundheitsförderlich zu führen.