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The human language processing mechanism assigns a structure to the incoming materials as they unfold. There is evidence that the parser prefers some attachment types over others; however, theories of sentence processing are still in dispute over the stage at which each source of information contributes to the parsing system. The present study aims to identify the nature of initial parsing decisions during sentence processing through manipulating attachment type and verbs' argument structure. To this end, we designed a self-paced reading task using globally ambiguous constructions in Dutch. The structures included double locative prepositional phrases (PPs) where the first PP could attach both to the verb (high attachment) and the noun preceding it (low attachment). To disambiguate the structures, we presented a visual context in the form of short animation clips prior to each reading task. Furthermore, we manipulated the argument structure of the sentences using 2- and 3-argument verbs. The results showed that parsing decisions were influenced by contextual cues depending on the argument structure of the verb. That is, the visual context overcame the preference for high attachment only in the case of 2-argument verbs, while this preference persisted in structures including 3-argument verbs as represented by longer reading times for the low attachment interpretations. These findings can be taken as evidence that our language processing system actively integrates information from linguistic and non-linguistic sources from the initial stages of analysis to build up meaning. We discuss our findings in light of serial and parallel models of sentence processing.
Background & aims:
This study aimed to describe the association of healthy eating literacy (HEL) with energy, nutrients, and food consumption in young women who had normal and lean weight at a Japanese university, considering their resident status.
Methods:
Cross-sectional data from the Ochanomizu Health Study were used in this study. Participants answered a self-administered, two-part, anonymous survey in 2018 and 2019.
A total of 203 female undergraduate students with lean and normal body mass index (BMI) were included in the analysis. Single and stepwise multiple linear regression analysis was used to examine the association of HEL and resident status with healthy food consumption, such as vegetables, fish, and shellfish.
The dependent variables were HEL and resident status, and the covariates were age, BMI, and the total metabolic equivalents.
Results:
The median (25th and 75th percentiles) age, BMI, and total HEL score were 20 (19, 21) years, 20.2 (18.9, 21.3) kg/m 2, and 18 (16, 20), respectively.
Resident status and HEL were independently associated with vegetables, fish, and shellfish intake.
Participants who had higher total HEL scores and lived in their family home consumed significantly more vegetables (b = 0.17 and-0.34, p < 0.05) and fish and shellfish (b = 0.24,-0.28, p < 0.001).
Conclusion:
This study provides an insight into the association between HEL and dietary consumption in young women with normal and lean BMI.
Alcohol use disorder (AUD) is the most common substance use disorder worldwide. Although dopamine-related findings were often observed in AUD, associated neurobiological mechanisms are still poorly understood. Therefore, in the present study, we investigate D2/3 receptor availability in healthy participants, participants at high risk (HR) to develop addiction (not diagnosed with AUD), and AUD patients in a detoxified stage, applying F-18-fallypride positron emission tomography (F-18-PET). Specifically, D2/3 receptor availability was investigated in (1) 19 low-risk (LR) controls, (2) 19 HR participants, and (3) 20 AUD patients after alcohol detoxification. Quality and severity of addiction were assessed with clinical questionnaires and (neuro)psychological tests. PET data were corrected for age of participants and smoking status. In the dorsal striatum, we observed significant reductions of D2/3 receptor availability in AUD patients compared with LR participants. Further, receptor availability in HR participants was observed to be intermediate between LR and AUD groups (linearly decreasing). Still, in direct comparison, no group difference was observed between LR and HR groups or between HR and AUD groups. Further, the score of the Alcohol Dependence Scale (ADS) was inversely correlated with D2/3 receptor availability in the combined sample. Thus, in line with a dimensional approach, striatal D2/3 receptor availability showed a linear decrease from LR participants to HR participants to AUD patients, which was paralleled by clinical measures. Our study shows that a core neurobiological feature in AUD seems to be detectable in an early, subclinical state, allowing more individualized alcohol prevention programs in the future.
Anger, indignation, guilt, rumination, victim compensation, and perpetrator punishment are considered primary responses associated with justice sensitivity (JS).
However, injustice and high JS may predispose to further responses.
We had N = 293 adults rate their JS, 17 potential responses toward 12 unjust scenarios from the victim's, observer's, beneficiary's, and perpetrator's perspectives, and several control variables.
Unjust situations generally elicited many affective, cognitive, and behavioral responses. JS generally predisposed to strong affective responses toward injustice, including sadness, pity, disappointment, and helplessness. It impaired trivialization, victim-blaming, or justification, which may otherwise help cope with injustice.
It predisposed to conflict solutions and victim compensation. Particularly victim and beneficiary JS had stronger effects in unjust situations from the corresponding perspective.
These findings add to a better understanding of the main and interaction effects of unjust situations from different perspectives and the JS facets, differences between the JS facets, as well as the links between JS and behavior and well-being.
The ‘social brain’, consisting of areas sensitive to social information, supposedly gates the mechanisms involved in human language learning. Early preverbal interactions are guided by ostensive signals, such as gaze patterns, which are coordinated across body, brain, and environment. However, little is known about how the infant brain processes social gaze in naturalistic interactions and how this relates to infant language development. During free-play of 9-month-olds with their mothers, we recorded hemodynamic cortical activity of ´social brain` areas (prefrontal cortex, temporo-parietal junctions) via fNIRS, and micro-coded mother’s and infant’s social gaze. Infants’ speech processing was assessed with a word segmentation task. Using joint recurrence quantification analysis, we examined the connection between infants’ ´social brain` activity and the temporal dynamics of social gaze at intrapersonal (i.e., infant’s coordination, maternal coordination) and interpersonal (i.e., dyadic coupling) levels. Regression modeling revealed that intrapersonal dynamics in maternal social gaze (but not infant’s coordination or dyadic coupling) coordinated significantly with infant’s cortical activity. Moreover, recurrence quantification analysis revealed that intrapersonal maternal social gaze dynamics (in terms of entropy) were the best predictor of infants’ word segmentation. The findings support the importance of social interaction in language development, particularly highlighting maternal social gaze dynamics.
Previous studies suggest that associations between numbers and space are mediated by shifts of visuospatial attention along the horizontal axis. In this study, we investigated the effect of vertical shifts of overt attention, induced by optokinetic stimulation (OKS) and monitored through eye-tracking, in two tasks requiring explicit (number comparison) or implicit (parity judgment) processing of number magnitude. Participants were exposed to black-and-white stripes (OKS) that moved vertically (upward or downward) or remained static (control condition). During the OKS, participants were asked to verbally classify auditory one-digit numbers as larger/smaller than 5 (comparison task; Exp. 1) or as odd/even (parity task; Exp. 2). OKS modulated response times in both experiments. In Exp.1, upward attentional displacement decreased the Magnitude effect (slower responses for large numbers) and increased the Distance effect (slower responses for numbers close to the reference). In Exp.2, we observed a complex interaction between parity, magnitude, and OKS, indicating that downward attentional displacement slowed down responses for large odd numbers. Moreover, eye tracking analyses revealed an influence of number processing on eye movements both in Exp. 1, with eye gaze shifting downwards during the processing of small numbers as compared to large ones; and in Exp. 2, with leftward shifts after large even numbers (6,8) and rightward shifts after large odd numbers (7,9). These results provide evidence of bidirectional links between number and space and extend them to the vertical dimension. Moreover, they document the influence of visuo-spatial attention on processing of numerical magnitude, numerical distance, and parity. Together, our findings are in line with grounded and embodied accounts of numerical cognition.
Rhythmicity characterizes both interpersonal synchrony and spoken language. Emotions and language are forms of interpersonal communication, which interact with each other throughout development. We investigated whether and how emotional synchrony between mothers and their 9-month-old infants relates to infants' word segmentation as an early marker of language development. Twenty-six 9-month-old infants and their German-speaking mothers took part in the study. To measure emotional synchrony, we coded positive, neutral and negative emotional expressions of the mothers and their infants during a free play session. We then calculated the degree to which the mothers' and their infants' matching emotional expressions followed a predictable pattern. To measure word segmentation, we familiarized infants with auditory text passages and tested how long they looked at the screen while listening to familiar versus novel words. We found that higher levels of predictability (i.e. low entropy) during mother-infant interaction is associated with infants' word segmentation performance. These findings suggest that individual differences in word segmentation relate to the complexity and predictability of emotional expressions during mother-infant interactions.
This pre-registered study examined the prevalence and correlates of sexual aggression in a sample of 530 Iranians (322 women, 208 men) with a behaviorally specific questionnaire distinguishing between different coercive strategies, victim-perpetrator relationships, and sexual acts. Significantly more women (63.0%) than men (51.0%) experienced at least one incident of sexual aggression victimization since the age of 15 years, and significantly more men (37.0%) than women (13.4%) reported at least one incident of sexual aggression perpetration. In women and men, the experience of child sexual abuse predicted sexual victimization and sexual aggression perpetration after the age of 15 years, both directly and indirectly through higher engagement in risky sexual behavior. Greater endorsement of hostile masculinity among men explained additional variance in the prediction of sexual aggression perpetration. This research is a first step towards documenting and explaining high rates of sexual aggression victimization and perpetration among Iranian women and men, providing important information for sex education as well for the prevention of sexual aggression. However, to achieve these goals, we highlight the need for systematic actions in all educational, social, and legal sectors of Iranian society.
The development of interface technologies is driven by the goal of making interaction more positive through natural action-control mappings.
In Virtual Reality (VR), the entire body is potentially involved for interaction, using such mappings with a maximum of degrees of freedom. The downside is the increase in interaction complexity, which can dramatically influence interface design.
A cognitive perspective on detailed aspects of interaction patterns is lacking in common interface design guidelines, although it can be helpful to make this complexity controllable and, thus, make interaction behavior predictable.
In the present study, the distinction between grounding, embodiment, and situatedness (the GES framework) is applied to organize aspects of interactions and to compare them with each other.
In two experiments, zooming into or out of emotional pictures through changes of arm span was examined in VR. There are qualitatively different aspects during such an interaction: i) perceptual aspects caused by zooming are fundamental for human behavior (Grounding: closer objects appear bigger) and ii) aspects of gestures correspond to the physical characteristics of the agents (Embodiment: little distance of hands signals little or, in contrast, "creating more detail").
The GES-framework sets aspects of Grounding against aspects of Embodiment, thus allowing to predict human behavior regarding these qualitatively different aspects.
For the zooming procedure, the study shows that Grounding can overrule Embodiment in interaction design.
Thus, we propose GES as a cognitive framework that can help to inform interaction guidelines for user interface design in VR.
Purpose
Rehabilitation professionals are faced with judging and describing the social-medicine status of their patients. Rehabilitation professionals must know the core concepts of acute unfitness for work, psychological capacities, and long-term work capacity.
Acquiring and applying this knowledge, requires training. The research question is if and to what extent medical professionals and students' knowledge changes after social medicine training.
Methods
This quasi-experimental study was carried out in the real-life context of social medicine training. Psychology students (n = 42), physicians/psychotherapists (i.e. state-licensed health professionals) (n = 44) and medical assistant professionals (n = 29) were trained. Their social medicine knowledge was measured before and after training by a 10-min expert-approved and content valid knowledge questionnaire.
Three free-text questions had to be answered on the essential aspects of present and prognostic work ability and psychological capacities.
Answers were rated for correctness by two experts. Paired t tests and variance analysis have been calculated for group comparisons.
Results
All groups improved their social medicine knowledge from the pre- to the post-test. The students started with the lowest level of knowledge in the pre-test.
After training, 69% of the physicians/psychotherapists and 56.8% of the medical assistant professionals, but only 7% of the students, obtained maximum scores for naming psychological capacities.
Conclusions
Social medicine knowledge increased after a training course consisting of eight lessons. The increase was greater for medical assistant professionals and physicians/psychotherapists than for students. Social medicine training must be adjusted to the trainee groups' knowledge levels.
The functional significance of the two prominent language-related ERP components N400 and P600 is still under debate.
It has recently been suggested that one important dimension along which the two vary is in terms of automaticity versus attentional control, with N400 amplitudes reflecting more automatic and P600 amplitudes reflecting more controlled aspects of sentence comprehension.
The availability of executive resources necessary for controlled processes depends on sustained attention, which fluctuates over time.
Here, we thus tested whether P600 and N400 amplitudes depend on the level of sustained attention.
We reanalyzed EEG and behavioral data from a sentence processing task by Sassenhagen and Bornkessel-Schlesewsky [The P600 as a correlate of ventral attention network reorientation. Cortex, 66, A3-A20, 2015], which included sentences with morphosyntactic and semantic violations.
Participants read sentences phrase by phrase and indicated whether a sentence contained any type of anomaly as soon as they had the relevant information.
To quantify the varying degrees of sustained attention, we extracted a moving reaction time coefficient of variation over the entire course of the task.
We found that the P600 amplitude was significantly larger during periods of low reaction time variability (high sustained attention) than in periods of high reaction time variability (low sustained attention). In contrast, the amplitude of the N400 was not affected by reaction time variability.
These results thus suggest that the P600 component is sensitive to sustained attention whereas the N400 component is not, which provides independent evidence for accounts suggesting that P600 amplitudes reflect more controlled and N400 amplitudes reflect more automatic aspects of sentence comprehension.
Digital media are being used more and more frequently by children and for a wide variety of functions.
However, there are no studies to date that examine the effect of such use on peer interactions and the occurrence of prosocial behavior in peers.
For parents, it has been found that when using digital media only few parents respond responsively to their children's attempts at interaction and also very rarely, they communicate with them verbally and nonverbally.
In the present study, we investigated how playing a game in a digital versus analog form influences in-teractions (especially prosocial behavior) of peers.
We used an experimental situation, where 24 dyads of 4-10-year-old children were examined. Each of the dyads was randomly assigned to a condition where they played either a digital or analog game together. Various interaction parameters and prosocial behavior during and after the game were analyzed.
Results show that children in the analog condition communicated verbally with each other more often, responded more often to interaction attempts of their partners and showed less often negative forms of inter-action and more often positive forms of interaction than children in the digital condition.
However, the type of medium had no influence on prosocial behavior after the game situation.
These results suggest that the format of a game (digital vs. analog) has a decisive influence on peer interactions concerning their communication during but not their prosocial behavior after the game situation.
Background: The loss of a sibling can have a long-term impact on the mental and physical health of the surviving sibling throughout adolescence and later adulthood. Even though bereaved siblings can be identified as a high-risk group, evidence-based interventions for this bereavement group are still missing.
Aim: To evaluate the treatment effects of an internet-based writing intervention for bereaved siblings aged 16-65 years.
Design: A two-armed randomized controlled trial (DRKS00011514) compared the intervention to a waiting list control group. The 6-week intervention consisted of six structured writing assignments that were based on cognitive behavioral therapy, focusing on the specific situation of bereaved siblings.
Setting/participants: Eighty-six bereaved siblings (loss >1 month ago, no severe psychiatric symptoms) were randomly allocated to the intervention group (n = 47) or the waiting list control group (n = 39). Primary outcomes were symptoms of prolonged grief disorder and depression; secondary outcomes were posttraumatic stress symptoms and survivor guilt.
Results: Symptoms of depression and prolonged grief disorder improved significantly in the intention-to-treat analyses from pre-to post-measurement compared with the control group (g(Depression) = -0.62, g(Grief) = 0.33). In the intervention group, all primary and secondary outcomes decreased significantly from baseline to 12-month follow-up (gs = -0.38 to -1.04). A significant clinical change could be found for depression (34%) compared to the waitlist control group (10%).
Conclusions: Bereaved siblings profited from this brief internet-based writing intervention in the short- and long-term. However, future research, such as dismantling studies, may help to further optimize the benefits of an intervention aimed at bereaved siblings.
Safe human-robot interactions require robots to be able to learn how to behave appropriately in spaces populated by people and thus to cope with the challenges posed by our dynamic and unstructured environment, rather than being provided a rigid set of rules for operations. In humans, these capabilities are thought to be related to our ability to perceive our body in space, sensing the location of our limbs during movement, being aware of other objects and agents, and controlling our body parts to interact with them intentionally. Toward the next generation of robots with bio-inspired capacities, in this paper, we first review the developmental processes of underlying mechanisms of these abilities: The sensory representations of body schema, peripersonal space, and the active self in humans. Second, we provide a survey of robotics models of these sensory representations and robotics models of the self; and we compare these models with the human counterparts. Finally, we analyze what is missing from these robotics models and propose a theoretical computational framework, which aims to allow the emergence of the sense of self in artificial agents by developing sensory representations through self-exploration.
The experience of premenstrual syndrome (PMS) affects up to 90% of individuals with an active menstrual cycle and involves a spectrum of aversive physiological and psychological symptoms in the days leading up to menstruation (Tschudin et al., 2010). Despite its high prevalence, the precise origins of PMS remain elusive, with influences ranging from hormonal fluctuations to cognitive, social, and cultural factors (Hunter, 2007; Matsumoto et al., 2013).
Biologically, hormonal fluctuations, particularly in gonadal steroids, are commonly believed to be implicated in PMS, with the central factor being varying susceptibilities to the fluctuations between individuals and cycles (Rapkin & Akopians, 2012). Allopregnanolone (ALLO), a neuroactive steroid and progesterone metabolite, has emerged as a potential link to PMS symptoms (Hantsoo & Epperson, 2020). ALLO is a positive allosteric modulator of the GABAA receptor, influencing inhibitory communication (Rupprecht, 2003; Andréen et al., 2006). Different susceptibility to ALLO fluctuations throughout the cycle may lead to reduced GABAergic signal transmission during the luteal phase of the menstrual cycle.
The GABAergic system's broad influence leads to a number of affected physiological systems, including a consistent reduction in vagally mediated heart rate variability (vmHRV) during the luteal phase (Schmalenberger et al., 2019). This reduction in vmHRV is more pronounced in individuals with high PMS symptoms (Baker et al., 2008; Matsumoto et al., 2007). Fear conditioning studies have shown inconsistent associations with cycle phases, suggesting a complex interplay between physiological parameters and PMS-related symptoms (Carpenter et al., 2022; Epperson et al., 2007; Milad et al., 2006).
The neurovisceral integration model posits that vmHRV reflects the capacity of the central autonomous network (CAN), which is responsible for regulatory processes on behavioral, cognitive, and autonomous levels (Thayer & Lane, 2000, 2009). Fear learning, mediated within the CAN, is suggested to be indicative of vmHRV's capacity for successful
VI
regulation (Battaglia & Thayer, 2022). Given the GABAergic mediation of central inhibitory functional connectivity in the CAN, which may be affected by ALLO fluctuations, this thesis proposes that fluctuating CAN activity in the luteal phase contributes to diverse aversive symptoms in PMS.
A research program was designed to empirically test these propositions. Study 1 investigated fear discrimination during different menstrual cycle phases and its interaction with vmHRV, revealing nuanced effects on acoustic startle response and skin conductance response. While there was heightened fear discrimination in acoustic startle responses in participants in the luteal phase, there was an interaction between menstrual cycle phase and vmHRV in skin conductance responses. In this measure, heightened fear discrimination during the luteal phase was only visible in individuals with high resting vmHRV; those with low vmHRV showed reduced fear discrimination and higher overall responses.
Despite affecting the vast majority of menstruating people, there are very limited tools available to reliably assess these symptoms in the German speaking area. Study 2 aimed at closing this gap, by translating and validating a German version of the short version of the Premenstrual Assessment Form (Allen et al., 1991), providing a reliable tool for future investigations, which closes the gap in PMS questionnaires in the German-speaking research area.
Study 3 employed a diary study paradigm to explore daily associations between vmHRV and PMS symptoms. The results showed clear simultaneous fluctuations between the two constructs with a peak in PMS and a low point in vmHRV a few days before menstruation onset. The association between vmHRV and PMS was driven by psychological PMS symptoms.
Based on the theoretical considerations regarding the neurovisceral perspective on PMS, another interesting construct to consider is attentional control, as it is closely related to functions of the CAN. Study 4 delved into attentional control and vmHRV differences between menstrual cycle phases, demonstrating an interaction between cycle phase and PMS symptoms. In a pilot, we found reduced vmHRV and attentional control during the luteal phase only in participants who reported strong PMS.
While Studies 1-4 provided evidence for the mechanisms underlying PMS, Studies 5 and 6 investigated short- and long-term intervention protocols to ameliorate PMS symptomatology. Study 5 explored the potential of heart rate variability biofeedback (HRVB) in alleviating PMS symptoms and a number of other outcome measures. In a waitlist-control design, participants underwent a 4-week smartphone-based HRVB intervention. The results revealed positive effects on PMS, with larger effect sizes on psychological symptoms, as well as on depressive symptoms, anxiety/stress and attentional control.
Finally, Study 6 examined the acute effects of HRVB on attentional control. The study found positive impact but only in highly stressed individuals.
The thesis, based on this comprehensive research program, expands our understanding of PMS as an outcome of CAN fluctuations mediated by GABAA receptor reactivity. The results largely support the model. These findings not only deepen our understanding of PMS but also offer potential avenues for therapeutic interventions. The promising results of smartphone-based HRVB training suggest a non-pharmacological approach to managing PMS symptoms, although further research is needed to confirm its efficacy.
In conclusion, this thesis illuminates the complex web of factors contributing to PMS, providing valuable insights into its etiological underpinnings and potential interventions. By elucidating the relationships between hormonal fluctuations, CAN activity, and psychological responses, this research contributes to more effective treatments for individuals grappling with the challenges of PMS. The findings hold promise for improving the quality of life for those affected by this prevalent and often debilitating condition.
In real-world scene perception, human observers generate sequences of fixations to move image patches into the high-acuity center of the visual field. Models of visual attention developed over the last 25 years aim to predict two-dimensional probabilities of gaze positions for a given image via saliency maps. Recently, progress has been made on models for the generation of scan paths under the constraints of saliency as well as attentional and oculomotor restrictions. Experimental research demonstrated that task constraints can have a strong impact on viewing behavior. Here, we propose a scan-path model for both fixation positions and fixation durations, which include influences of task instructions and interindividual differences. Based on an eye-movement experiment with four different task conditions, we estimated model parameters for each individual observer and task condition using a fully Bayesian dynamical modeling framework using a joint spatial-temporal likelihood approach with sequential estimation. Resulting parameter values demonstrate that model properties such as the attentional span are adjusted to task requirements. Posterior predictive checks indicate that our dynamical model can reproduce task differences in scan-path statistics across individual observers.
Finger-based representation of numbers is a high-level cognitive strategy to assist numerical and arithmetic processing in children and adults. It is unclear whether this paradigm builds on simple perceptual features or comprises several attributes through embodiment. Here we describe the development and initial testing of an experimental setup to study embodiment during a finger-based numerical task using Virtual Reality (VR) and a low-cost tactile stimulator that is easy to build. Using VR allows us to create new ways to study finger-based numerical representation using a virtual hand that can be manipulated in ways our hand cannot, such as decoupling tactile and visual stimuli. The goal is to present a new methodology that can allow researchers to study embodiment through this new approach, maybe shedding new light on the cognitive strategy behind the finger-based representation of numbers. In this case, a critical methodological requirement is delivering precisely targeted sensory stimuli to specific effectors while simultaneously recording their behavior and engaging the participant in a simulated experience. We tested the device's capability by stimulating users in different experimental configurations. Results indicate that our device delivers reliable tactile stimulation to all fingers of a participant's hand without losing motion tracking quality during an ongoing task. This is reflected by an accuracy of over 95% in participants detecting stimulation of a single finger or multiple fingers in sequential stimulation as indicated by experiments with sixteen participants. We discuss possible application scenarios, explain how to apply our methodology to study the embodiment of finger-based numerical representations and other high-level cognitive functions, and discuss potential further developments of the device based on the data obtained in our testing.
The color red has been implicated in a variety of social processes, including those involving mating. While previous research suggests that women sometimes wear red strategically to increase their attractiveness, the replicability of this literature has been questioned. The current research is a reasonably powered conceptual replication designed to strengthen this literature by testing whether women are more inclined to display the color red 1) during fertile (as compared with less fertile) days of the menstrual cycle, and 2) when expecting to interact with an attractive man (as compared with a less attractive man and with a control condition). Analyses controlled for a number of theoretically relevant covariates (relationship status, age, the current weather). Only the latter hypothesis received mixed support (mainly among women on hormonal birth control), whereas results concerning the former hypothesis did not reach significance. Women (N = 281) displayed more red when expecting to interact with an attractive man; findings did not support the prediction that women would increase their display of red on fertile days of the cycle. Findings thus suggested only mixed replicability for the link between the color red and psychological processes involving romantic attraction. They also illustrate the importance of further investigating the boundary conditions of color effects on everyday social processes.
Background
There is consistent evidence that the COVID-19 pandemic is associated with an increased psychosocial burden on children and adolescents and their parents. Relatively little is known about its particular impact on high-risk groups with chronic physical health conditions (CCs). Therefore, the primary aim of the study is to analyze the multiple impacts on health care and psychosocial well-being on these children and adolescents and their parents.
Methods
We will implement a two-stage approach. In the first step, parents and their underage children from three German patient registries for diabetes, obesity, and rheumatic diseases, are invited to fill out short questionnaires including questions about corona-specific stressors, the health care situation, and psychosocial well-being. In the next step, a more comprehensive, in-depth online survey is carried out in a smaller subsample.
Discussion
The study will provide insights into the multiple longer-term stressors during the COVID-19 pandemic in families with a child with a CC. The simultaneous consideration of medical and psycho-social endpoints will help to gain a deeper understanding of the complex interactions affecting family functioning, psychological well-being, and health care delivery.