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The genesis of chronic pain is explained by a biopsychosocial model. It hypothesizes an interdependency between environmental and genetic factors provoking aberrant long-term changes in biological and psychological regulatory systems. Physiological effects of psychological and physical stressors may play a crucial role in these maladaptive processes. Specifically, long-term demands on the stress response system may moderate central pain processing and influence descending serotonergic and noradrenergic signals from the brainstem, regulating nociceptive processing at the spinal level. However, the underlying mechanisms of this pathophysiological interplay still remain unclear. This paper aims to shed light on possible pathways between physical (exercise) and psychological stress and the potential neurobiological consequences in the genesis and treatment of chronic pain, highlighting evolving concepts and promising research directions in the treatment of chronic pain. Two treatment forms (exercise and mindfulness-based stress reduction as exemplary therapies), their interaction, and the dose-response will be discussed in more detail, which might pave the way to a better understanding of alterations in the pain matrix and help to develop future prevention and therapeutic concepts
Objective: To investigate associations between socioeconomic status (SES) indicators (education, job position, income, multidimensional index) and the genesis of chronic low back pain (CLBP).
Design: Longitudinal field study (baseline and 6-month follow-up).
Setting: Four medical clinics across Germany.
Participants: 352 people were included according to the following criteria: (1) between 18 and 65 years of age, (2) intermittent pain and (3) an understanding of the study and the ability to answer a questionnaire without help. Exclusion criteria were: (1) pregnancy, (2) inability to stand upright, (3) inability to give sick leave information, (4) signs of serious spinal pathology, (5) acute pain in the past 7 days or (6) an incomplete SES indicators questionnaire.
Outcome measures: Subjective intensity and disability of CLBP.
Results Analysis: showed that job position was the best single predictor of CLBP intensity, followed by a multidimensional index. Education and income had no significant association with intensity. Subjective disability was best predicted by job position, succeeded by the multidimensional index and education, while income again had no significant association.
Conclusion: The results showed that SES indicators have different strong associations with the genesis of CLBP and should therefore not be used interchangeably. Job position was found to be the single most important indicator. These results could be helpful in the planning of back pain care programmes, but in general, more research on the relationship between SES and health outcomes is needed.
Objective: To investigate associations between socioeconomic status (SES) indicators (education, job position, income, multidimensional index) and the genesis of chronic low back pain (CLBP).
Design: Longitudinal field study (baseline and 6-month follow-up).
Setting: Four medical clinics across Germany.
Participants: 352 people were included according to the following criteria: (1) between 18 and 65 years of age, (2) intermittent pain and (3) an understanding of the study and the ability to answer a questionnaire without help. Exclusion criteria were: (1) pregnancy, (2) inability to stand upright, (3) inability to give sick leave information, (4) signs of serious spinal pathology, (5) acute pain in the past 7 days or (6) an incomplete SES indicators questionnaire.
Outcome measures: Subjective intensity and disability of CLBP.
Results: Analysis showed that job position was the best single predictor of CLBP intensity, followed by a multidimensional index. Education and income had no significant association with intensity. Subjective disability was best predicted by job position, succeeded by the multidimensional index and education, while income again had no significant association.
Conclusion: The results showed that SES indicators have different strong associations with the genesis of CLBP and should therefore not be used interchangeably. Job position was found to be the single most important indicator. These results could be helpful in the planning of back pain care programmes, but in general, more research on the relationship between SES and health outcomes is needed.
The genesis of chronic pain is explained by a biopsychosocial model. It hypothesizes an interdependency between environmental and genetic factors provoking aberrant long-term changes in biological and psychological regulatory systems. Physiological effects of psychological and physical stressors may play a crucial role in these maladaptive processes. Specifically, long-term demands on the stress response system may moderate central pain processing and influence descending serotonergic and noradrenergic signals from the brainstem, regulating nociceptive processing at the spinal level. However, the underlying mechanisms of this pathophysiological interplay still remain unclear. This paper aims to shed light on possible pathways between physical (exercise) and psychological stress and the potential neurobiological consequences in the genesis and treatment of chronic pain, highlighting evolving concepts and promising research directions in the treatment of chronic pain. Two treatment forms (exercise and mindfulness-based stress reduction as exemplary therapies), their interaction, and the dose-response will be discussed in more detail, which might pave the way to a better understanding of alterations in the pain matrix and help to develop future prevention and therapeutic concepts
During the first year of life, infants undergo perceptual narrowing in the domains of speech and face perception. This is typically characterized by improvements in infants' abilities in discriminating among stimuli of familiar types, such as native speech tones and same-race faces. Simultaneously, infants begin to decline in their ability to discriminate among stimuli of types with which they have little experience, such as nonnative tones and other-race faces. The similarity in time-frames during which perceptual narrowing seems to occur in the domains of speech and face perception has led some researchers to hypothesize that the perceptual narrowing in these domains could be driven by shared domain-general processes. To explore this hypothesis, we tested 53 Caucasian 9-month-old infants from monolingual German households on their ability to discriminate among non-native Cantonese speech tones, as well among same-race German faces and other-race Chinese faces. We tested the infants using an infant-controlled habituation-dishabituation paradigm, with infants' preferences for looking at novel stimuli versus the habituated stimuli (dishabituation scores) acting as indicators of discrimination ability. As expected for their age, infants were able to discriminate between same-race faces, but not between other-race faces or non-native speech tones. Most interestingly, we found that infants' dishabituation scores for the non-native speech tones and other-race faces showed significant positive correlations, while the dishabituation scores for non-native speech tones and same-race faces did not. These results therefore support the hypothesis that shared domain-general mechanisms may drive perceptual narrowing in the domains of speech and face perception.
Background: Life events (LEs) are associated with future physical and mental health. They are crucial for understanding the pathways to mental disorders as well as the interactions with biological parameters. However, deeper insight is needed into the complex interplay between the type of LE, its subjective evaluation and accompanying factors such as social support. The "Stralsund Life Event List" (SEL) was developed to facilitate this research.
Methods: The SEL is a standardized interview that assesses the time of occurrence and frequency of 81 LEs, their subjective emotional valence, the perceived social support during the LE experience and the impact of past LEs on present life. Data from 2265 subjects from the general population-based cohort study "Study of Health in Pomerania" (SHIP) were analysed. Based on the mean emotional valence ratings of the whole sample, LEs were categorized as "positive" or "negative". For verification, the SEL was related to lifetime major depressive disorder (MDD; Munich Composite International Diagnostic Interview), childhood trauma (Childhood Trauma Questionnaire), resilience (Resilience Scale) and subjective health (SF-12 Health Survey).
Results: The report of lifetime MDD was associated with more negative emotional valence ratings of negative LEs (OR = 2.96, p < 0.0001). Negative LEs (b = 0.071, p < 0.0001, beta = 0.25) and more negative emotional valence ratings of positive LEs (b = 3.74, p < 0.0001, beta = 0.11) were positively associated with childhood trauma. In contrast, more positive emotional valence ratings of positive LEs were associated with higher resilience (b = -7.05, p < 0.0001, beta = 0.13), and a lower present impact of past negative LEs was associated with better subjective health (b = 2.79, p = 0.001, beta = 0.05). The internal consistency of the generated scores varied considerably, but the mean value was acceptable (averaged Cronbach's alpha > 0.75).
Conclusions: The SEL is a valid instrument that enables the analysis of the number and frequency of LEs, their emotional valence, perceived social support and current impact on life on a global score and on an individual item level. Thus, we can recommend its use in research settings that require the assessment and analysis of the relationship between the occurrence and subjective evaluation of LEs as well as the complex balance between distressing and stabilizing life experiences.
Both social perception and temperament in young infants have been related to social functioning later in life. Previous functional Near-Infrared Spectroscopy (fNIRS) data (Lloyd-Fox et al., 2009) showed larger blood-oxygenation changes for social compared to non-social stimuli in the posterior temporal cortex of five-month-old infants. We sought to replicate and extend these findings by using fNIRS to study the neural basis of social perception in relation to infant temperament (Negative Affect) in 37 five-to-eight-month-old infants.
Infants watched short videos displaying either hand and facial movements of female actors (social dynamic condition) or moving toys and machinery (non-social dynamic condition), while fNIRS data were collected over temporal brain regions. Negative Affect was measured using the Infant Behavior Questionnaire.
Results showed significantly larger blood-oxygenation changes in the right posterior-temporal region in the social compared to the non-social condition. Furthermore, this differential activation was smaller in infants showing higher Negative Affect.
Our results replicate those of Lloyd-Fox et al. and confirmed that five-to-eight-month-old infants show cortical specialization for social perception. Furthermore, the decreased cortical sensitivity to social stimuli in infants showing high Negative Affect may be an early biomarker for later difficulties in social interaction.
Objective: The aim of the present study was to examine the effect of Cold Water Immersion (CWI) on the recovery of physical performance, hematological stress markers and perceived wellness (i.e., Hooper scores) following a simulated Mixed Martial Arts (MMA) competition.
Methods: Participants completed two experimental sessions in a counter-balanced order (CWI or passive recovery for control condition: CON), after a simulated MMAs competition (3 x 5-min MMA rounds separated by 1-min of passive rest). During CWI, athletes were required to submerge their bodies, except the trunk, neck and head, in the seated position in a temperature-controlled bath (similar to 10 degrees C) for 15-min. During CON, athletes were required to be in a seated position for 15-min in same room ambient temperature. Venous blood samples (creatine kinase, cortisol, and testosterone concentrations) were collected at rest (PRE-EX, i.e., before MMAs), immediately following MMAs (POST-EX), immediately following recovery (POST-R) and 24 h post MMAs (POST-24), whilst physical fitness (squat jump, countermovement-jump and 5- and 10-m sprints) and perceptual measures (well-being Hooper index: fatigue, stress, delayed onset muscle soreness (DOMS), and sleep) were collected at PRE-EX, POST-R and POST-24, and at PRE-EX and POST-24, respectively.
Results: The main results indicate that POST-R sprint (5- and 10-m) performances were 'likely to very likely' (d = 0.64 and 0.65) impaired by prior CWI. However, moderate improvements were in 10-m sprint performance were 'likely' evident at POST-24 after CWI compared with CON (d = 0.53). Additionally, the use of CWI 'almost certainly' resulted in a large overall improvement in Hooper scores (d = 1.93). Specifically, CWI 'almost certainly' resulted in improved sleep quality (d = 1.36), stress (d = 1.56) and perceived fatigue (d = 1.51), and 'likely' resulted in a moderate decrease in DOMS (d = 0.60).
Conclusion: The use of CWI resulted in an enhanced recovery of 10-m sprint performance, as well as improved perceived wellness 24-h following simulated MMA competition.
Fragestellung: Ziel war die Untersuchung des Verlaufs von Kindern mit Rechenstörungen bzw. Rechenschwächen. Neben der Persistenz wurden Auswirkungen von Rechenproblemen auf künftige Rechenleistungen sowie den Schulerfolg geprüft. Methodik: Für 2909 Schüler der 2. bis 5. Klasse liegen die Resultate standardisierter Rechen- und Intelligenztests vor. Ein Teil dieser Kinder ist nach 37 und 68 Mona-ten erneut untersucht worden. Ergebnisse: Die Prävalenz von Rechenstörungen betrug 1.4 %, Rechenschwächen traten bei 11.2 % auf. Rechen-probleme zeigten eine mittlere bis hohe Persistenz. Schüler mit Rechenschwäche blieben im Rechnen gut eine Standardabweichung hinter durchschnittlich und ca. eine halbe Standardabweichung hinter unterdurchschnittlich intelligenten Kontrollkindern zurück. Der allgemeine Schulerfolg rechenschwacher Probanden (definiert über Mathematiknote, Deutschnote und Schultyp) ähnelte dem der unterdurchschnittlich intelligenten Kontrollgruppe und blieb hinter dem Schulerfolg durchschnittlich intelligenter Kontrollkinder zurück. Eingangs ältere Probanden mit Rechenproblemen (4. bis 5. Klasse) wiesen eine schlechtere Prognose auf als Kinder, die zu Beginn die 2. oder 3. Klasse besuchten. Schluss-folgerungen: Rechenprobleme stellen ein ernsthaftes Entwicklungsrisiko dar. Längsschnittuntersuchungen, die Kinder mit streng definierter Rechenstörung bis ins Erwachsenenalter begleiten und Prädiktoren für unterschiedlich erfolgreiche Verläufe ermitteln, sind dringend notwendig.
Henne oder Ei
(2018)
Fragestellung: Ziel war die Untersuchung der Entwicklung und wechselseitigen Beziehung von Zahlen- und Mengenvorwissen (ZMW), Arbeitsgedächtnis (AG) und Intelligenz sowie deren Vorhersagekraft für die Rechenleistung in der ersten Klasse. Methodik: 1897 Kindergartenkinder nahmen an dieser Studie teil. Ein Teil dieser Kinder wurde 9 Monate später und erneut in der ersten Klasse untersucht. Ergebnisse: Während des Kindergartenjahres verbesserten sich die Kinder in allen untersuchten Leistungen. Reziproke Zusammenhänge zwischen den drei erhobenen Vorläuferfähigkeiten konnten nachgewiesen werden. Das ZMW erwies sich als guter Prädiktor für die AG- und Intelligenzleistung. Bei der Überprüfung der Vorhersage des Rechnens erwies sich das ZMW als bester Prädiktor der späteren Rechenleistung. Erwartungsgemäß zeigten die zu t1 erfassten allgemein-kognitiven Leistungen indirekte Effekte über das ZMW auf die Rechenleistung. Die Intelligenz und das AG zu t2 konnten direkt zur Vorhersage des Rechnens in der ersten Klasse beitragen. Schlussfolgerungen: Die Ergebnisse verdeutlichen, dass das AG und die Intelligenz zwar an dem Aufbau des ZMW beteiligt sind, aber vor allem selbst durch dieses vorhergesagt werden. Die Daten sprechen dafür das Potenzial des ZMWs in Trainingsprogrammen zu nutzen, durch dessen Förderung auch intellektuelle und Gedächtnisleistungen zunehmen können, die allesamt die schulische Rechenleistung positiv beeinflussen.
Wie klingt Motivation?
(2018)
Hintergrund/Fragestellung: Während einer erfolgreichen Psychotherapie – so Miller und Rollnick (2013) – initiiert der Therapeut ein lautes Nachdenken über Veränderung (change talk), das eine Verhaltensänderung einleitet und verschiedene Facetten der Motivation eines Patienten spiegelt. Auf den preparatory change talk (desire, ability, reasons, need) folgt der mobilizing change talk (commitment, activation, taking steps) und schließlich die Verhaltensänderung. Die vorliegende Studie ist ein erster Versuch, deutsche Begriffe und Redewendungen zu analysieren, um Therapeuten die Einschätzung der Motivation eines Patienten zu erleichtern. Methodik: Das schrittweise Vorgehen entsprach weitgehend einem in der englischsprachigen Literatur beschriebenen Verfahren zur Einschätzung von Begriffen und Redewendungen hinsichtlich der Motivation eines Sprechers (vgl. Amrhein, 2009): (1) Generierung einer Sammlung relevanter Begriffe und Redewendungen, (2) Einschätzung der Stärke einer Formulierung durch 430 Probanden, (3) Bestimmung der Retestreliabilität anhand der Einschätzungen von 63 Probanden, (4) Kategorisierung von 140 Begriffen und Redewendungen durch drei Experten. Ergebnisse: Die ausgewählten Begriffe und Phrasen lassen sich zuverlässig den von Miller und Rollnick (2013) beschriebenen Kategorien Preparatory Change Talk oder Mobilizing Change Talk zuordnen, κ = .83 (95 % CI, .80 ≤ κ≤ .85), p < .001, und spiegeln darüber hinaus verschiedene Ausprägungen der Motivation eines Sprechers wider. Die Einschätzungen der Stärke einer Formulierung sind jedoch nicht stabil (Retestreliabilität: .21 ≤ rtt ≤.70). Schlussfolgerungen: Die Beachtung typischer Schlüsselwörter kann das richtige Timing einer Intervention erleichtern und darüber hinaus Auskunft über die „Entschlossenheit“ eines Patienten geben. Im Rahmen von Forschungsprojekten könnten auf der Basis erweiterter Sammlungen relevanter Begriffe und Redewendungen Algorithmen entwickelt werden, die eine Einschätzung der Motivation und damit prognostisch bedeutsame Aussagen erlauben.
Frühe mathematische Bildung
(2018)
Im vorliegenden Beitrag werden aktuelle Forschungstrends im Bereich der frühen mathematischen Bildung im Kontext jüngst formulierter Zieldimensionen für die frühe mathematische Bildung (siehe Benz et al., 2017) dargestellt. Es wird auf spielbasierte Fördermaßnahmen, Kompetenzen im Bereich „Raum und Form“, den Einfluss sprachlicher Parameter auf die Entwicklung mathematischer Kompetenzen sowie auf mathematikbezogene Kompetenzen frühpädagogischer Fachkräfte eingegangen. Darüber hinaus werden die Ergebnisse einer aktuellen Feldstudie zur Förderung früher mathematischer Kompetenzen (siehe Dillon, Kannan, Dean, Spelke & Duflo, 2017) vorgestellt. Abschließend wird die Entwicklung und Implementierung anschlussfähiger Bildungskonzepte als eine der zentralen Herausforderungen zukünftiger Forschungs- und Bildungsbemühungen diskutiert
Findings on the perceptual reorganization of lexical tones are mixed. Some studies report good tone discrimination abilities for all tested age groups, others report decreased or enhanced discrimination with increasing age, and still others report U-shaped developmental curves. Since prior studies have used a wide range of contrasts and experimental procedures, it is unclear how specific task requirements interact with discrimination abilities at different ages. In the present work, we tested German and Cantonese adults on their discrimination of Cantonese lexical tones, as well as German-learning infants between 6 and 18 months of age on their discrimination of two specific Cantonese tones using two different types of experimental procedures. The adult experiment showed that German native speakers can discriminate between lexical tones, but native Cantonese speakers show significantly better performance. The results from German-learning infants suggest that 6- and 18-month-olds discriminate tones, while 9-month-olds do not, supporting a U-shaped developmental curve. Furthermore, our results revealed an effect of methodology, with good discrimination performance at 6 months after habituation but not after familiarization. These results support three main conclusions. First, habituation can be a more sensitive procedure for measuring infants' discrimination than familiarization. Second, the previous finding of a U-shaped curve in the discrimination of lexical tones is further supported. Third, discrimination abilities at 18 months appear to reflect mature perceptual sensitivity to lexical tones, since German adults also discriminated the lexical tones with high accuracy.
Findings on the perceptual reorganization of lexical tones are mixed. Some studies report good tone discrimination abilities for all tested age groups, others report decreased or enhanced discrimination with increasing age, and still others report U-shaped developmental curves. Since prior studies have used a wide range of contrasts and experimental procedures, it is unclear how specific task requirements interact with discrimination abilities at different ages. In the present work, we tested German and Cantonese adults on their discrimination of Cantonese lexical tones, as well as German-learning infants between 6 and 18 months of age on their discrimination of two specific Cantonese tones using two different types of experimental procedures. The adult experiment showed that German native speakers can discriminate between lexical tones, but native Cantonese speakers show significantly better performance. The results from German-learning infants suggest that 6- and 18-month-olds discriminate tones, while 9-month-olds do not, supporting a U-shaped developmental curve. Furthermore, our results revealed an effect of methodology, with good discrimination performance at 6 months after habituation but not after familiarization. These results support three main conclusions. First, habituation can be a more sensitive procedure for measuring infants' discrimination than familiarization. Second, the previous finding of a U-shaped curve in the discrimination of lexical tones is further supported. Third, discrimination abilities at 18 months appear to reflect mature perceptual sensitivity to lexical tones, since German adults also discriminated the lexical tones with high accuracy.
Purpose: The acquisition of skills is essential to the conceptualization of cognitive-behavioural therapy. Yet, what experiences are encountered and what skills actually learned during therapy, and whether patients and therapists have concurrent views hereof, remains poorly understood.
Method: An explorative pilot study with semi-structured, corresponding interview guides was conducted. Pilot data from our outpatient unit were transcribed and content-analyzed following current guidelines.
Results: The responses of 18 participants (patients and their psychotherapists) were assigned to six main categories. Educational and cognitive aspects were mentioned most frequently and consistently by both groups. Having learned Behavioural alternatives attained the second highest agreement between perspectives.
Conclusions: Patients and therapists valued CBT as an opportunity to learn new skills, which is an important prerequisite also for the maintenance of therapeutic change. We discuss limitations to generalizability but also theoretical and therapy implications.
Rechtschreibung von Konsonantenclustern und morphologische Bewusstheit bei Grundschüler_innen
(2018)
Die vorliegenden Studien untersuchen die Entwicklung der Rechtschreibfähigkeit für finale Konsonantencluster im Deutschen und die ihr zugrundeliegenden Strategien bei Erst- bis Drittklässler_innen (N = 209). Dazu wurde der Einfluss der morphologischen Komplexität (poly- vs. monomorphematische Cluster) auf die Rechtschreibung qualitativ und quantitativ analysiert, sowie mit einer Messung zur morphologischen Bewusstheit korreliert. Von der ersten Klasse an zeigt sich eine hohe Korrektheit in der Schreibung und somit eine sprachspezifisch schnelle Entwicklung der alphabetischen Rechtschreibstrategie für finale Konsonantencluster. Der Einfluss morphologischer Verarbeitungsprozesse wurde allerdings erst für die Drittklässler_innen gefunden. Obwohl bereits die Erstklässler_innen gut entwickelte morphologische Bewusstheit zeigten, scheinen sie noch nicht in der Lage zu sein, diese bei der Rechtschreibung anzuwenden. Die Ergebnisse werden im Kontrast zu den umfangreicher vorliegenden Befunden für die englische Sprache diskutiert.
Ziel ist die Überprüfung der kurz- und mittelfristigen Wirksamkeit einer vorschulischen Förderung des Mengen- und Zahlenverständnisses bei Kindern mit einem Risiko für die Entwicklung einer Rechenstörung. Es wurden 32 Risikokinder mit einer Kombination aus den Förderprogrammen Mathematik im Vorschulalter und Mengen, zählen, Zahlen im letzten Kindergartenjahr von den Erzieherinnen trainiert und mit 38 untrainierten Risikokindern verglichen. Hinsichtlich der kurzfristigen Wirksamkeit zeigten sich positive Trainingseffekte auf die numerischen Leistungen im letzten Kindergartenjahr. Es ließen sich keine signifikanten mittelfristigen Trainingseffekte auf die Rechenleistungen im zweiten Halbjahr der 1. Klasse finden. Das eingesetzte vorschulische Präventionsprogramm leistete danach einen wichtigen Beitrag zur kurzfristigen Verbesserung der mathematischen Basiskompetenzen.
TBS-TK Rezension
(2018)