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BackgroundIn spring of 2020, the Sars-CoV-2 incidence rate increased rapidly in Germany and around the world. Throughout the next 2 years, schools were temporarily closed and social distancing measures were put in place to slow the spread of the Covid-19 virus. Did these social restrictions and temporary school lockdowns affect children's physical fitness? The EMOTIKON project annually tests the physical fitness of all third-graders in the Federal State of Brandenburg, Germany. The tests assess cardiorespiratory endurance (6-min-run test), coordination (star-run test), speed (20-m sprint test), lower (powerLOW, standing long jump test), and upper (powerUP, ball-push test) limbs muscle power, and static balance (one-legged stance test with eyes closed). A total of 125,893 children were tested in the falls from 2016 to 2022. Primary analyses focused on 98,510 keyage third-graders (i.e., school enrollment according to the legal key date, aged 8 to 9 years) from 515 schools. Secondary analyses included 27,383 older-than-keyage third-graders (i.e., OTK, delayed school enrollment or repetition of a grade, aged 9 to 10 years), who have been shown to exhibit lower physical fitness than expected for their age. Linear mixed models fitted pre-pandemic quadratic secular trends, and took into account differences between children and schools.ResultsThird-graders exhibited lower cardiorespiratory endurance, coordination, speed and powerUP in the Covid pandemic cohorts (2020-2022) compared to the pre-pandemic cohorts (2016-2019). Children's powerLOW and static balance were higher in the pandemic cohorts compared to the pre-pandemic cohorts. From 2020 to 2021, coordination, powerLOW and powerUP further declined. Evidence for some post-pandemic physical fitness catch-up was restricted to powerUP. Cohen's |ds| for comparisons of the pandemic cohorts 2020-2022 with pre-pandemic cohorts 2016-2019 ranged from 0.02 for powerLOW to 0.15 for coordination. Within the pandemic cohorts, keyage children exhibited developmental losses ranging from approximately 1 month for speed to 5 months for cardiorespiratory endurance. For powerLOW and static balance, the positive pandemic effects translate to developmental gains of 1 and 7 months, respectively. Pre-pandemic secular trends may account for some of the observed differences between pandemic and pre-pandemic cohorts, especially in powerLOW, powerUP and static balance. The pandemic further increased developmental delays of OTK children in cardiorespiratory endurance, powerUP and balance.ConclusionsThe Covid-19 pandemic was associated with declines in several physical fitness components in German third-graders. Pandemic effects are still visible in 2022. Health-related interventions should specifically target those physical fitness components that were negatively affected by the pandemic (cardiorespiratory endurance, coordination, speed).
Physical fitness of primary school children differs depending on their timing of school enrollment
(2023)
Previous research has shown that children who were enrolled to school according to the legal key date (i.e., keyage children, between eight and nine years in third grade) exhibited a linear physical fitness development in the ninth year of life. In contrast, children who were enrolled with a delay (i.e., older-than-keyage children [OTK], between nine and ten years in third grade) exhibited a lower physical fitness compared to what would be expected for their age. In these studies, cross-sectional age differences within third grade and timing of school enrollment were confounded. The present study investigated the longitudinal development of keyage and OTK children from third to fifth grade. This design also afforded a comparison of the two groups at the same average chronological age, that is a dissociation of the effects of timing of school enrollment and age. We tested six physical fitness components: cardiorespiratory endurance, coordination, speed, power of lower and upper limbs, and static balance. 1502 children (i.e., 1206 keyage and 296 OTK children) from 35 schools were tested in third, fourth, and fifth grade. Except for cardiorespiratory endurance, both groups developed from third to fourth and from fourth to fifth grade and keyage children outperformed OTK children at the average ages of 9.5 or 10.5 years. For cardiorespiratory endurance, there was no significant gain from fourth to fifth grade and keyage and OTK children did not differ significantly at 10.5 years of age. One reason for a delayed school enrollment could be that a child is (or is perceived as) biologically younger than their chronological age at the school entry examination, implying a negative correlation between chronological and biological age for OTK children. Indeed, a simple reflection of chronological age brought the developmental rate of the chronologically youngest OTK children in line with the developmental rate observed for keyage children, but did not eliminate all differences. The mapping of chronological and biological age of OTK children and other possible reasons for lower physical fitness of OTK children remain a task for future research.
Throughout the years 2020 and 2021, schools were temporarily closed to slow the spread of SarsCoV-2. For some periods, children were locked out of sports in schools (physical education lessons, school sports working groups) and organized sports in sports clubs which often resulted in physical inactivity. Did these restrictions affect children’s physical fitness? The EMOTIKON project (www.uni-potsdam.de/emotikon) annually assesses the physical fitness (cardiorespiratory endurance [6-minute-run test], coordination [star-run test], speed [20-m sprint test], lower [standing long jump test] and upper [ball push test] limbs muscle power, and balance [one-legged stance test]) of all third graders in the Federal State of Brandenburg, Germany. Participation is mandatory for all public primary schools. In the falls from 2016 to 2021, 83,476 keyage children (i.e., school enrollment according to the legal key date, between eight and nine years in third grade) from 512 schools were assessed with the EMOTIKON test battery. We tested the Covid pandemic effect on a composite score of the four highly correlated physical fitness tests assessing cardiorespiratory endurance, coordination, speed and powerLOW and on another composite score of the three running tests (cardiorespiratory endurance, coordination, speed), as well as separately on all six physical fitness components. Secular trends for each of the physical fitness components and differences between schools and children were taken into account in linear mixed models. We found a negative Covid pandemic effect on the two composite physical fitness scores, as well as on cardiorespiratory endurance, coordination, and speed. We found a positive Covid pandemic effect on powerLOW. Coordination was associated with the largest negative Covid pandemic effect, also passing the threshold of smallest meaningful change (SMC, i.e., 0.2 Cohen’s d) when accumulated across two years. Given the educational context, Covid pandemic effects were also compared relative to the expected age-related development of the physical fitness components between eight and nine years. The Covid pandemic-related developmental costs/gains ranged from three to seven months relative to a longitudinal age effect, and from five to 17 months relative to a cross-sectional age effect. We propose that a longitudinal assessment yields a more reliable estimate of the developmental (age-related) gain than a cross-sectional one. Therefore, we consider the smaller Covid pandemic-related developmental costs/gains to be more credible. Interestingly, on the school level, „fitter” schools (relatively higher Grand Mean) exhibited larger negative Covid pandemic effects than schools with a lower physical fitness score. Negative Covid pandemic effects for the three run tasks were also found by Bähr et al. (2022), who tested the physical fitness of 16,496 Thuringian third-graders from 292 schools with the same six physical fitness tests used in EMOTIKON. Our results may be used to prioritize health-related interventions.
Background
The centrality of an event indicates the extent to which it becomes a core part of identity and life story. Event centrality (EC) has been shown to have a strong relationship with PTSD symptoms, which seems to be indirectly influenced by negative posttraumatic cognitions (PTC). However, research on this potential mediation and its causal links particularly with clinical samples is limited and essential to derive treatment implications.
Methods
Pre- and posttreatment data of 103 day-unit patients with PTSD was examined using mediation analyses and structural equation modeling.
Results
Negative PTC mediated the relationship between EC and PTSD symptoms, partially pre- and completely posttreatment. Within extended longitudinal analyses causal directions of the mediation pathways were not adequately interpretable due to unexpected suppression effects.
Conclusions
The results suggest that EC may only have an indirect effect on PTSD symptoms through negative PTC. Thus, decreasing negative PTC which are connected to centralized events might be a key element for PTSD treatment. Thereby, transforming the cognitions' valence to more positive and constructive forms could be crucial rather than mere decentralization. Although suppression effects limited causal inferences, they do not contradict the mediation and further indicate potential interactional terms and a transformation of EC.
Basic psychological needs theory postulates that a social environment that satisfies individuals’ three basic psychological needs of autonomy, competence, and relatedness leads to optimal growth and well-being. On the other hand, the frustration of these needs is associated with ill-being and depressive symptoms foremost investigated in non-clinical samples; yet, there is a paucity of research on need frustration in clinical samples. Survey data were compared between adult individuals with major depressive disorder (MDD; n = 115; 48.69% female; 38.46 years, SD = 10.46) with those of a non-depressed comparison sample (n = 201; 53.23% female; 30.16 years, SD = 12.81). Need profiles were examined with a linear mixed model (LMM). Individuals with depression reported higher levels of frustration and lower levels of satisfaction in relation to the three basic psychological needs when compared to non-depressed adults. The difference between depressed and non-depressed groups was significantly larger for frustration than satisfaction regarding the needs for relatedness and competence. LMM correlation parameters confirmed the expected positive correlation between the three needs. This is the first study showing substantial differences in need-based experiences between depressed and non-depressed adults. The results confirm basic assumptions of the self-determination theory and have preliminary implications in tailoring therapy for depression.
Basic psychological needs theory postulates that a social environment that satisfies individuals’ three basic psychological needs of autonomy, competence, and relatedness leads to optimal growth and well-being. On the other hand, the frustration of these needs is associated with ill-being and depressive symptoms foremost investigated in non-clinical samples; yet, there is a paucity of research on need frustration in clinical samples. Survey data were compared between adult individuals with major depressive disorder (MDD; n = 115; 48.69% female; 38.46 years, SD = 10.46) with those of a non-depressed comparison sample (n = 201; 53.23% female; 30.16 years, SD = 12.81). Need profiles were examined with a linear mixed model (LMM). Individuals with depression reported higher levels of frustration and lower levels of satisfaction in relation to the three basic psychological needs when compared to non-depressed adults. The difference between depressed and non-depressed groups was significantly larger for frustration than satisfaction regarding the needs for relatedness and competence. LMM correlation parameters confirmed the expected positive correlation between the three needs. This is the first study showing substantial differences in need-based experiences between depressed and non-depressed adults. The results confirm basic assumptions of the self-determination theory and have preliminary implications in tailoring therapy for depression.
Developmental Gains in Physical Fitness Components of Keyage and Older-than-Keyage Third-Graders
(2022)
Children who were enrolled according to legal enrollment dates (i.e., keyage third-graders aged eight to nine years) exhibit a positive linear physical fitness development (Fühner et al., 2021). However, children who were enrolled with a delay of one year or who repeated a grade (i.e., older-than-keyage children [OTK] aged nine to ten years in third grade) appear to exhibit a poorer physical fitness relative to what could be expected given their chronological age (Fühner et al., 2022). However, because Fühner et al. (2022) compared the performance of OTK children to predicted test scores that were extrapolated based on the data of keyage children, the observed physical fitness of these children could either indicate a delayed physical-fitness development or some physiological or psychological changes occurring during the tenth year of life. We investigate four hypotheses about this effect. (H1) OTK children are biologically younger than keyage children. A formula transforming OTK’s chronological age into a proxy for their biological age brings some of the observed cross-sectional age-related development in line with the predicted age-related development based on the data of keyage children, but large negative group differences remain. Hypotheses 2 to 4 were tested with a longitudinal assessment. (H2) Physiological changes due to biological maturation or psychological factors cause a stagnation of physical fitness development in the tenth year of life. H2 predicts a decline of performance from third to fourth grade also for keyage children. (H3) OTK children exhibit an age-related (temporary) developmental delay in the tenth year of life, but later catch up to the performance of age-matched keyage children. H3 predicts a larger developmental gain for OTK than for keyage children from third to fourth grade. (H4) OTK children exhibit a sustained physical fitness deficit and do not catch up over time. H4 predicts a positive development for keyage and OTK children, with no greater development for OTK compared to keyage children. The longitudinal study was based on a subset of children from the EMOTIKON project (www.uni-potsdam.de/emotikon). The physical fitness (cardiorespiratory endurance [6-minute-run test], coordination [star-run test], speed [20-m sprint test], lower [standing long jump test] and upper [ball push test] limbs muscle power, and balance [one-legged stance test]) of 1,274 children (1,030 keyage and 244 OTK children) from 32 different schools was tested in third grade and retested one year later in fourth grade. Results: (a) Both keyage and OTK children exhibit a positive longitudinal development from third to fourth grade in all six physical fitness components. (b) There is no evidence for a different longitudinal development of keyage and OTK children. (c) Keyage children (approximately 9.5 years in fourth grade) outperform age-matched OTK children (approximately 9.5 years in third grade) in all six physical fitness components. The results show that the physical fitness of OTK children is indeed impaired and are in support of a sustained difference in physical fitness between the groups of keyage and OTK children (H4).
Timing of initial school enrollment may vary considerably for various reasons such as early or delayed enrollment, skipped or repeated school classes. Accordingly, the age range within school grades includes older-(OTK) and younger-than-keyage (YTK) children. Hardly any information is available on the impact of timing of school enrollment on physical fitness. There is evidence from a related research topic showing large differences in academic performance between OTK and YTK children versus keyage children. Thus, the aim of this study was to compare physical fitness of OTK (N = 26,540) and YTK (N = 2586) children versus keyage children (N = 108,295) in a representative sample of German third graders. Physical fitness tests comprised cardiorespiratory endurance, coordination, speed, lower, and upper limbs muscle power. Predictions of physical fitness performance for YTK and OTK children were estimated using data from keyage children by taking age, sex, school, and assessment year into account. Data were annually recorded between 2011 and 2019. The difference between observed and predicted z-scores yielded a delta z-score that was used as a dependent variable in the linear mixed models. Findings indicate that OTK children showed poorer performance compared to keyage children, especially in coordination, and that YTK children outperformed keyage children, especially in coordination. Teachers should be aware that OTK children show poorer physical fitness performance compared to keyage children.
Timing of initial school enrollment may vary considerably for various reasons such as early or delayed enrollment, skipped or repeated school classes. Accordingly, the age range within school grades includes older-(OTK) and younger-than-keyage (YTK) children. Hardly any information is available on the impact of timing of school enrollment on physical fitness. There is evidence from a related research topic showing large differences in academic performance between OTK and YTK children versus keyage children. Thus, the aim of this study was to compare physical fitness of OTK (N = 26,540) and YTK (N = 2586) children versus keyage children (N = 108,295) in a representative sample of German third graders. Physical fitness tests comprised cardiorespiratory endurance, coordination, speed, lower, and upper limbs muscle power. Predictions of physical fitness performance for YTK and OTK children were estimated using data from keyage children by taking age, sex, school, and assessment year into account. Data were annually recorded between 2011 and 2019. The difference between observed and predicted z-scores yielded a delta z-score that was used as a dependent variable in the linear mixed models. Findings indicate that OTK children showed poorer performance compared to keyage children, especially in coordination, and that YTK children outperformed keyage children, especially in coordination. Teachers should be aware that OTK children show poorer physical fitness performance compared to keyage children.
Objective:
Therapist competence is considered essential for the success of psychotherapy. Feedback is an intervention which has the potential to improve therapist competence. The present study investigated whether competence feedback leads to an improvement of therapist competence and patient outcome.
Method:
Sixty-seven master-level clinical trainees were randomly assigned to either a competence feedback group (CFG) or a control group (CG). Patients with a diagnosis of major depression (N = 114) were randomly assigned to CFG or CG. Treatment included 20 individual sessions of cognitive behavioral therapy (CBT). In CFG, therapists received, parallel to the treatment, five competence feedbacks, based on videotaped therapy sessions. Independent raters assessed therapist competence with the Cognitive Therapy Scale (CTS) and provided the competence feedback. Patient outcome was evaluated with the Beck Depression Inventory-II (BDI-II) and therapeutic alliance (Helping Alliance Questionnaire [HAQ]) from both therapist's (HAQ-T) and patient's (HAQ-P) perspective were evaluated after each of the 20 sessions.
Results:
(a) Therapist competence (CTS) increased significantly more for CFG than CG. (b) Depression (BDI-II) decreased significantly across sessions for both groups, but without evidence for a group-differential benefit for the CFG. (c) Therapeutic alliance (HAQ-T/P) increased significantly across sessions for both groups from both perspectives, but without group differences. (d) There is a positive effect of BDI-II on CTS at the beginning and a negative effect of CTS on BDI-II at the end of therapy.
Conclusion:
Competence feedback improves therapists' independently rated competence, but there is no evidence that competence feedback in CBT leads to better outcome.
What is the public health significance of this article? This study suggests the substantial value of systematic competence feedback for improving therapist competence in the psychotherapy of depression. No significant effect of competence feedback on the reduction of reported depressive symptoms was found.