Klaus Michael Reininger’s research while affiliated with University Medical Center Hamburg - Eppendorf and other places

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Publications (43)


Figure 1 Comparison of Evaluation of Liberals, Tolerance Toward Liberals, Extended Tolerance Toward Other Groups, and Democratic Intentions (i.e., Commonality, Cooperation, and Compromise With Liberals) Between the Conditions (No Treatment vs. Education vs. Metacognitive Training)
Figure 2 Comparison of Feeling Thermometer With Regard to Liberals Between the Conditions (No Treatment vs. Education vs. Metacognitive Training)
Figure 3 Comparison of Positive Stereotypes Toward Liberals (z-Standardized) Between the Conditions (No Treatment vs. Education vs. Metacognitive Training)
Demographic Data of Participants by Condition
continued)
Metacognitive Training in U.S. Republican Leaners Reduces Polarization and Fosters Democratic Behavior–Intentions With Liberals: Evidence From a Randomized-Controlled Trial
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February 2025

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15 Reads

Peace and Conflict Journal of Peace Psychology

Klaus Michael Reininger

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Theresa F. P. Brückner

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Hannah M. Biel

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[...]

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Steffen Moritz

Reducing bipartisan animosity via correcting misperceptions of outgroup members lacks evidence to foster democratic behavior–intentions. We developed a short metacognitive training (MCT) for U.S. Republican leaners intended to induce identification-based metacognitive doubt. We expected this MCT to reduce indicators of cognitive and affective polarization and to foster democratic behavior–intentions compared to an education and a no-treatment control condition. We randomly assigned 908 U.S. Republican leaners to an MCT condition comprising 15 question–answer option items and feedbacks (n = 295) versus an education control condition (n = 299) versus a no-treatment control condition (n = 314). We observed that Republican leaners in the MCT condition were less cognitively and affectively polarized with regard to Liberals compared to the no-treatment control condition (ds between 0.23 [p = .006] and 0.34 [p ≤ .001]). We also observed that Republican leaners in the MCT condition were more tolerant toward Liberals (ds between 0.19 and 0.26, ps ≤ .022) and toward other outgroups (ds between 0.16 [p = .054] and 0.21 [p = .009]) and showed more democratic behavior–intentions (ds between 0.19 and 0.32, ps ≤ .024) compared to both control conditions. Through our intervention, research participants were encouraged to form compromises and coalitions with opponents, which is a crucial aspect of democracy.

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Planetary health and mental health

Der Nervenarzt

Zusammenfassung Der Klimawandel stellt die größte globale Gesundheitsbedrohung des 21. Jahrhunderts dar. Treibhausgasemissionen und die hierdurch steigenden Durchschnittstemperaturen führen zu Hitzewellen, Dürre, Wasser- und Nahrungsmangel, Extremwetterereignissen, dem Anstieg des Meeresspiegels, Migrationsbewegungen sowie dem Verlust von Biodiversität und dem Untergang von Ökosystemen, wie wir sie kennen. Bereits dafür, dass die globale Durchschnittstemperatur bis 2029 maximal um 1,5 °C steigt, sind nach aktuellen Schätzungen viel umfangreichere gesellschaftliche Maßnahmen als bisher erforderlich. Doch nicht nur der Klimawandel, sondern auch andere menschengemachte Faktoren wie Lärm, Licht, Feinstaub und Plastik bedrohen die Gesundheit unseres Planeten und damit unweigerlich auch die Gesundheit des Menschen – sowohl die körperliche als auch die psychische. Dieser Artikel erweitert das DGPPN-Positionspapier „Klimawandel und psychische Gesundheit“ um den Begriff Planetare Gesundheit. Insbesondere die normative Dimension der Canmore-Erklärung zur Planetaren Gesundheit, Transdisziplinarität als Wissenschaftsprinzip sowie mögliche konkrete Handlungsanweisungen sollen hier in ihrer besonderen Relevanz für die Psychiatrie, Psychotherapie und die sprechende Medizin dargestellt und die Zusammenhänge grafisch illustriert werden.


Questions, responses, and endorsement in the metacognitive training condition
A Pilot Study of Metacognitive Training in U.S. Republican Leaners: Reducing Polarization Toward LGBTIQ+ Persons

April 2024

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179 Reads

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1 Citation

Negative attitudes and stigmatization toward sexual minorities is a cause of minority stress of non-heterosexual persons on an individual level and has a negative impact on democratic coexistence in postmodern, plural society on a societal level. Derived from clinical research, we developed a short metacognitive training (MCT) intended to induce doubt toward inaccurate beliefs about LGBTIQ+ persons. We expected this MCT to reduce homonegativity, threat perceptions of LGBTIQ+ persons, and to foster extended outgroup tolerance compared to an education and a no-treatment control condition. We tested this hypothesis in U.S. Republican leaners who represent a social group that is likely to hold homonegative attitudes. We randomly assigned 490 U.S. Republican leaners to an MCT condition comprising 16 questions and respective answers ( n = 166) vs. an education control condition ( n = 164) vs. a no-treatment control condition ( n = 160). We found that Republican leaners after receiving MCT (1) had a significant reduction of homonegativity ( d s ≥ 0.28), (2) significantly perceived LGBTIQ+ persons as less threatening ( d s ≥ 0.30), and (3) were significantly more tolerant of various outgroups such as LGBTIQ+ persons, feminists, liberals, and climate activists ( d s ≥ 0.23) relative to both control conditions. The small effects of this short intervention and the possibility of systematically applying MCT in social discourse to reduce homonegativity with its potential significance for LGBTIQ+ individuals’ mental health are discussed. Furthermore, we highlight this pilot study’s significance toward intervention possibilities regarding political division and polarization in postmodern, democratic societies.


Originalbeiträge (Originals). Der Zusammenhang zwischen der Strukturachse nach OPD-2 und dem statischen/dynamischen Risiko für das Begehen von sexuellem Kindesmissbrauch bei 30 Männern mit sexuellem Interesse an Minderjährigen aus dem Dunkelfeld – eine Pilotstudie: The Relation between the OPD-2 Axis Structure and the Static/Dynamic Risk for Committing Child Sexual Abuse in a Sample of 30 Men with Sexual Interest in Minors from the Dark Field – A Pilot Study

February 2024

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63 Reads

Zeitschrift fur Psychosomatische Medizin und Psychotherapie

Unlabelled: The Relation between the OPD-2 Axis Structure and the Static/Dynamic Risk for Committing Child Sexual Abuse in a Sample of 30 Men with Sexual Interest in Minors from the Dark Field - A Pilot Study Objectives: The present pilot study examined the relation between the OPD-2 axis structure of 30 men with a sexual interest in minors from the dark field and their static and dynamic risk factors for committing child sexual abuse. Methods: Two independent raters estimated the structural dimensions based on notes from outpatient psychotherapy sessions using the OPD-2 structure checklist.The interrater reliability of the structural data was moderate. Pearson/Spearman correlations between these structural data and the previously assessed static and dynamic risk were calculated. Results: Attachment was the only structural dimension to correlate significantly positively moderately with the dynamic risk.The less integrated the structural dimension of attachment was, the more pronounced the dynamic risk was. Conclusions: The correlation between the structural dimension of attachment and the dynamic riskmay provide first indications of the potential of structure-oriented psychotherapeutic interventions formodifying dynamic risk in individuals with a sexual interest in minors from the dark field. The limitations of the methodological approach constrain the significance of the findings, prompting further research on the relation between structure and risk.



Validation of the German Version of the Comparative Psychotherapy Process Scale

November 2023

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69 Reads

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2 Citations

Psychotherapy Theory Research Practice Training

The Comparative Psychotherapy Process Scale (CPPS) is a 20-item scale which aims to capture technical features distinguishing cognitive behavioral (CBT) from psychodynamic (PD) psychotherapy (and vice versa) in two corresponding subscales (CBT and PD Subscale). Our objective was to validate a German self-report version of the CPPS regarding a previous psychotherapy session in a psychotherapist- and in a patient-version. Fifty-three psychotherapists and their 53 patients answered to the according German CPPS Scale as well as to specific subscales of the Multitheoretical List of Therapeutic Interventions self-report-instrument (MULTI-30 subscales) assessing CBT- and PD-specific intervention characteristics. We analyzed (a) the correlation of the CPPS with the MULTI-30 subscales, (b) the ability of the CPPS to distinguish whether therapy sessions were either CBT or PD using logistic regression, and (c) the correlation between psychotherapists’ and patients’ self-report regarding the preceding session (correlation). Both the psychotherapist- and the patient-version showed acceptable to good values of internal consistencies (α = .78–.84). The CBT and PD Subscales of the MULTI-30 correlated with the CPPS subscales in both versions (CBT: rs = .85 [psychotherapist-version] and .80 [patient-version], PD: rs = .79 [both versions]). Subscales correctly discriminated whether the previous session was a CBT or a PD session (correct predictions in 88.7% in the psychotherapist-version, 73.6% in the patient-version; χ² ≥ 14.03, p < .001). The German version of the CPPS is a promising instrument to facilitate research on CBT- and PD-specific psychotherapy processes.


Structure of the optimized informed consent consultation. Gerke et al., 2023 JCCP
Flow of participants (CONSORT): Gerke et al., 2023 JCCP
Results for a Priori Defined Potential AE of Study Participation at Postassessment via Video Interview and at Follow-Ups via Online Questionnaire
Optimizing Treatment Expectations and Decision Making Through Informed Consent for Psychotherapy: A Randomized Controlled Trial

November 2023

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288 Reads

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5 Citations

Journal of Consulting and Clinical Psychology

Objective: The objective of this research was to determine the efficacy and safety of an optimized informed consent (OIC) consultation for psychotherapy. Method: We performed a randomized controlled superiority online trial involving 2 weeks of treatment and 3 months of follow-up. One hundred twenty-two adults with mental disorders confirmed by structured interview currently neither in out- nor inpatient psychotherapy (mean age: 32, gender identity: 51.6% female, 1.6% diverse), were randomized. Participants received an information brochure about psychotherapy for self-study (treatment as usual [TAU]; n = 61) or TAU plus a one-session OIC utilizing expectation management, contextualization, framing, and shared decision making (n = 61). The primary outcome was treatment expectations at 2-week follow-up. Results: At 2-week follow-up, participants receiving OIC showed more positive treatment expectations compared to those receiving TAU only (mean difference: 0.70, 95% CI [0.36, 1.04]) with a medium effect size (d = 0.73). Likewise, OIC positively influenced motivation (d = 0.74) and adherence intention (d = 0.46). OIC entailed large effects on reduction of decisional conflict (d = 0.91) and increase of knowledge (d = 0.93). Participants receiving OIC showed higher capacity to consent to treatment (d = 0.63) and higher satisfaction with received information (d = 1.34) compared to TAU. No statistically significant group differences resulted for expected adverse effects of psychotherapy. Results were maintained at 3-month follow-up. Data sets for n = 10 cases (8.2%) were missing (postassessment n = 4, 2-week n = 6, 3-month follow-up n = 8). Conclusions: Explaining to patients how psychotherapy works via a short consultation was effective in strengthening treatment expectations and decision making in a nonharmful way. Further trials clarifying whether this effectively translates to better treatment outcomes are required.


Beliefs about emotions predict psychological stress related to somatic symptoms

September 2023

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131 Reads

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5 Citations

British Journal of Clinical Psychology

Background Previous research has shown that the more people believe their emotions are controllable and useful (BECU), the less they generally report psychological distress. Psychological distress, in turn, impacts health outcomes, and is among the most frequently reported complaints in psychotherapeutic and psychosomatic practice. Objective We aimed to examine how BECU predicts psychological distress related to somatic symptoms in a prospective sample from the general population and to replicate this association in two cross‐sectional samples of psychosomatic patients. Methods We applied a panel design with an interval of 2 weeks between T1 and T2 in general‐population panel‐participants ( N = 310), assessing BECU and psychological distress related to somatic symptoms via validated self‐report measures. Moreover, we cross‐sectionally replicated the relationship between BECU and psychological distress in a clinical sample of psychosomatic outpatients diagnosed with somatoform disorders ( n = 101) or without somatoform disorders ( n = 628). Results BECU predicted over and above the lagged criterion panel‐participants' psychological distress related to somatic symptoms, β = −.18, p < .001. BECU was also cross‐sectionally related to psychological distress in our clinical replication‐sample of psychosomatic outpatients diagnosed with somatoform disorders, r S (87) = −.33, p = .002 and in those without, r S (557) = ‐.21, p < .001. Conclusions BECU as a malleable way of thinking about emotions predicted psychological distress related to somatic symptoms in general‐population panel‐participants and correlated with the same in two clinical replication samples. BECU thus becomes a promising treatment target in psychotherapeutic approaches.



Citations (26)


... Our study was only a very short online intervention with small-tomedium effects stemming from classical psychotherapeutic ideas (Moritz et al., 2023;Moritz & Woodward, 2007, or from psychodynamic perspective: Jordet & Kjølbye, 2023Gaertner et al., 2025;Lilliengren, 2023;Skaalum Bloch, 2024). We know little about the durability of these effects, Table 3 Comparison Note. ...

Reference:

Metacognitive Training in U.S. Republican Leaners Reduces Polarization and Fosters Democratic Behavior–Intentions With Liberals: Evidence From a Randomized-Controlled Trial
Sexual Mentalizing Scale (SexMent): Conceptual introduction, scale development and validation
  • Citing Article
  • December 2024

Personality and Individual Differences

... In the present study, we aimed at conceptually replicating prior metacognitive training (MCT) studies in which polarization of the following research-participant groups with the respective disapproved target outgroups could be observed: Muslims versus Christians and vice versa, U.S. Liberals with regard to U.S. Conservatives, U.S. Republicans with regard to individuals who identify as lesbian, gay, bisexual, transgender, and queer/questioning (LGBTIQ+ persons), and White Americans with regard to opposition to critical race theory (Moritz et al., 2018(Moritz et al., , 2021Reininger et al., 2020;Reininger, Koulen, et al., 2024;Richmond et al., 2024). We replicate the aforementioned studies conceptually by adhering to the same question-answer format of MCT asking seemingly easy questions. ...

A Pilot Study of Metacognitive Training in U.S. Republican Leaners: Reducing Polarization Toward LGBTIQ+ Persons

... In the literature, MCT has shown that raising awareness of the cognitive biases involved in the pathogenesis of psychosis and reducing overconfidence through "aha" experiences are central mechanisms of action in the reduction of symptoms. The present pilot study with our adaptation of MCT in the nonclinical, social, and societal area contributes to one realization in particular: MCT might be able to promote intellectual humility and reduce overconfidence, which has the potential for radicalized polarization in intergroup contexts (e.g., Reininger, 2018;Reininger et al., 2024). Social group members obviously become more cautious, more tamed, more humble, less prejudiced, and less polarized in their assessment of outgroup members through MCT. ...

Testing Heinz Kohut’s thoughts on narcissism and narcissistic rage: narcissistic injury paves the way for radicalization and subclinical paranoid states – an experimental study
  • Citing Article
  • February 2024

Psychoanalytic Psychotherapy

... Yamin et al., 2023) but especially patients' BECU. A result of such interventions focussing on affect and the expression of patients' emotion (which is one distinctive feature of psychodynamic-interpersonal psychotherapy; Hilsenroth et al., 2005;Reininger et al., 2023) should be that patients realize that the way they think about their emotions is important, as it affects their level of psychological distress related to somatic symptoms. In psychosomatic care, it might be helpful to find reasons why and to effectively experience that feelings are controllable as one can perceive them, name them and reflect on them. ...

Validation of the German Version of the Comparative Psychotherapy Process Scale

Psychotherapy Theory Research Practice Training

... 19 There is growing evidence that a positive modification of expectations may improve clinical outcomes in different medical and psychological conditions. [20][21][22][23] Here, placebo and nocebo effects play an integral role. Such effects can be understood as being induced by scham interventions (inert or active) that can still cause significant effects in the sense of worsening (nocebo) or improving (placebo) symptoms or conditions by manipulating the information context (eg, framing). ...

Optimizing Treatment Expectations and Decision Making Through Informed Consent for Psychotherapy: A Randomized Controlled Trial

Journal of Consulting and Clinical Psychology

... Complementing the limitations stated by the authors, namely the small sample size and the unbalanced male-female ratio, both the missing fit indices and the limited range of measures to assess construct validity restricts interpretability and drawing conclusions for further studies. Applying their translation of the EBQ in a prospective study, beliefs about emotions (EBQ) predicted psychological stress related to somatic symptoms two weeks later over previous psychological stress in three samples [33], thus stressing the EBQ's predictive validity. ...

Beliefs about emotions predict psychological stress related to somatic symptoms
  • Citing Article
  • September 2023

British Journal of Clinical Psychology

... (Kohut, 1972, pp. 364-365) Simply put, narcissistically injured individuals seek affiliation with an accessible group (indicating an alloyance with an omnipotent archaic object), which easily fosters Manichean worldview biases, such as seeing the world in black and white, in favor of one's own group (see also Reininger, 2018;Reininger & Denneberg, 2023). ...

Narzisstische Kränkung und narzisstische Wut als Antezedens von Radikalisierung: Psychodynamische Konzeption eines gesellschaftlichen ­Phänomens
  • Citing Article
  • June 2023

PDP – Psychodynamische Psychotherapie

... If uncertainty is considered a danger, a harmful outcome expectation arises, activating coping strategies to reduce uncertainty [43]. One of these coping mechanisms may also be ruminative thinking, which is led by evaluating danger and uncertainty [44]. Additionally, a traumatic event such as being diagnosed with cancer may activate rumination, a cognitive avoidance strategy, in people to avoid involuntary memories of the trauma [16]. ...

Appraisal, Coping, Psychological Distress, and Personal Growth: The Role of Rumination
  • Citing Article
  • May 2023

Trends in Psychology

... One factor are beliefs about emotions [9][10][11][12][13]: Superordinate beliefs about emotions (good versus bad; controllable versus uncontrollable) influence subsequent emotion regulation [14] by having an impact on effort and performance at all stages of Gross' process model of emotion regulation [5]. While there has been a growing number of research on the impact of malleability beliefs of emotions on emotion regulation (whether emotions are controllable, [9,11,13,[15][16][17][18], only few studies examined additional beliefs about the utility of emotions [19][20][21][22], its links to psychopathology [12,[23][24][25], or even emotion-specific control beliefs [26]. In general, beliefs about the (un-)controllability of emotions were associated with social anxiety [11,17], schizophrenia-spectrum [23], psychological stress [24], depressive symptoms [27], and poorer mental health [28]. ...

Affektive Mentalisierung als wahrgenommene Kontrollierbarkeit und Nützlichkeit von EmotionenAffective mentalization as beliefs about the controllability and usefulness of emotions: Validierung einer deutschsprachigen Version des Emotion Beliefs QuestionnaireValidation of a German language version of the Emotion Beliefs Questionnaire

Die Psychotherapie

... To assess previous experience with ADHD, we used seven items that were developed for an earlier study Hennig et al. (2021). The items included three questions on knowledge about ADHD ('have you heard about ADHD earlier to this study?, . . . ...

Zusammenhänge von Annahmen über ADHS mit günstigen und ungünstigen Erwartungen: Eine explorative Studie mit angehenden sonderpädagogischen Lehrkräften.