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Background: Adolescents and young adults (AYA) with a chronic medical condition show an increased risk for developing mental comorbidities compared to their healthy peers. Internet- and mobile-based cognitive behavioral therapy (iCBT) might be a low-threshold treatment to support affected AYA. In this randomized controlled pilot trial, the feasibility and potential efficacy of youthCOACH(CD), an iCBT targeting symptoms of anxiety and depression in AYA with chronic medical conditions, was evaluated. Methods: A total of 30 AYA (M-age 16.13; SD= 2.34; 73% female), aged 12-21 years either suffering from cystic fibrosis, juvenile idiopathic arthritis or type 1 diabetes, were randomly assigned to either a guided version of the iCBT youthCOACH(CD) (IC, n=15) or to a waitlist control group (CG, n=15), receiving an unguided version of the iCBT six months post-randomization. Participants of the IG and the CG were assessed before (t0), twelve weeks after (t1) and six months after (t2) randomization. Primary outcome was the feasibility of the iCBT. Different parameters of feasibility e.g. acceptance, client satisfaction or potential side effects were evaluated. First indications of the possible efficacy with regard to the primary efficacy outcome, the Patient Health Questionnaire Anxiety and Depression Scale, and further outcome variables were evaluated using linear regression models, adjusting for baseline values. Results: Regarding feasibility, intervention completion was 60%; intervention satisfaction (M = 25.42, SD = 5.85) and perceived therapeutic alliance (M = 2.83, SD = 1.25) were moderate and comparable to other iCBTs. No patterns emerged regarding subjective and objective negative side effects due to participation in youthCOACH(CD). Estimates of potential efficacy showed between group differences, with a potential medium-term benefit of youthCOACH(CD) (beta = -0.55, 95%Cl: -1.17; 0.07), but probably not short-term (beta = 0.20, 95%Cl: -0.47; 0.88). Conclusions: Our results point to the feasibility of youthCOACH(CD) and the implementation of a future definitive randomized controlled trial addressing its effectiveness and cost-effectiveness. Due to the small sample size, conclusions are premature, however, further strategies to foster treatment adherence should be considered.
Objective:
The open expression of hatred, hostility, and violence against minorities has become a common online phenomenon. Adolescents are at particular risk of being involved in different hate speech roles (e.g., witness, perpetrator).
However, the correlates of their involvement as perpetrators and the mechanisms that might explain their involvement in hate speech across different roles have not yet been thoroughly investigated.
To this end, this study investigates moral disengagement and empathy as correlates of online hate speech perpetration and the moderation effects of empathy and moral disengagement in the relationship between witnessing and perpetrating online hate speech.
Method:
The sample consists of 3,560 7th to 9th graders from 40 schools in Germany and Switzerland. Self-report questionnaires were utilized to assess online hate speech involvement, moral disengagement, and empathy.
Results:
Multilevel regression analyses revealed that moral disengagement and witnessing online hate speech were positively associated with online hate speech perpetration, while empathy was negatively associated with it.
The findings also showed that the positive relationship between witnessing and perpetrating online hate speech was stronger at higher levels of moral disengagement and weaker when moral disengagement was low.
The association between witnessing and perpetrating online hate speech was weaker when adolescents had higher rather than lower levels of empathy.
Conclusions:
The findings underscore the need for prevention efforts to accelerate moral engagement and empathy as critical future directions in hate speech prevention. This study also contributes to our understanding of underlying mechanisms that explain adolescents' involvement across different roles in hate speech.
Adolescents around the globe are increasingly exposed to online hate speech (OHS). And yet little is known about the varying roles of involvement and the determinants of adolescents' hate speech perpetration.
Building on previous research, this study aims to test the cycle of violence hypothesis for OHS and to analyze whether moral disengagement (MD) and empathy moderate the victim-to-perpetrator relationship.
The sample consists of 3,560 seventh to ninth graders (52.1 percent girls), recruited from 40 schools across Germany and Switzerland. Self-report questionnaires were administered to assess OHS involvement, MD, and empathy.
Multilevel analyses revealed that victims of OHS were more likely to report OHS perpetration.
In addition, victims of OHS were more likely to report OHS perpetration when they reported higher levels of MD than those with lower levels of MD.
Finally, victims of OHS were less likely to report OHS perpetration when they reported higher levels of empathy than those with lower levels of empathy.
The findings extend the cycle of violence hypothesis to OHS and highlight the need to address MD and empathy in hate speech prevention. Implications for future research will be discussed.
Objective
Problem-drinking among university students is common and poses serious health-related risks. Therefore, identifying and addressing associated factors is important.
Participants and methods
A large cross-sectional online-survey with 12,914 university students from Berlin was conducted from November 2016 to August 2017. Relative-risk- and correlation-analysis was used to identify factors associated with problem-drinking and regular heavy-drinking. Independent t-tests compared impulsivity and personality traits, chi-square-tests compared drinking motives between risk- and non-risk-drinkers.
Results
Male gender, tobacco-smoking, illegal substance use, impulsivity and various sociodemographic and psychosocial variables were significantly related to problem/heavy-drinking. Extraversion was a risk, conscientiousness and agreeableness were protective factors. Drinking-motives did not differ significantly between risk- and non-risk-drinkers. Generally, the main drinking-motives were to feel elated, relax and social purposes.
Conclusion
The identified markers and related problem behaviors may serve as a tool to enhance the identification of student subgroups at risk for problem/heavy-drinking, and hence improve targeted health-intervention-programs.
There has been little research attention given to how Gay-Straight Alliances might mitigate mental health consequences associated with experiencing homophobic cyberbullying. To address this gap in knowledge, the purpose of this one-year longitudinal study was to investigate the moderating effect of perceived social support from Gay-Straight Alliances in the relationships among homophobic cyberbullying victimization and bystanding and depressive and anxiety symptoms among 466 LGBTQIA adolescents (M-age = 15.76; 52% female). The findings revealed that perceived social support was related negatively to homophobic cyberbullying involvement and depressive and anxiety symptoms. Homophobic cyberbullying involvement was related positively to depressive and anxiety symptoms. High perceived social support buffered against the depressive and anxiety symptoms resulting from homophobic victimization and bystanding among LGBTQIA adolescents but low levels and average levels did not moderate these associations. These findings highlight the importance of expanding Gay-Straight Alliances in schools.
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.
There is a longstanding and widely held misconception about the relative remoteness of abstract concepts from concrete experiences. This review examines the current evidence for external influences and internal constraints on the processing, representation, and use of abstract concepts, like truth, friendship, and number. We highlight the theoretical benefit of distinguishing between grounded and embodied cognition and then ask which roles do perception, action, language, and social interaction play in acquiring, representing and using abstract concepts. By reviewing several studies, we show that they are, against the accepted definition, not detached from perception and action. Focussing on magnitude-related concepts, we also discuss evidence for cultural influences on abstract knowledge and explore how internal processes such as inner speech, metacognition, and inner bodily signals (interoception) influence the acquisition and retrieval of abstract knowledge. Finally, we discuss some methodological developments. Specifically, we focus on the importance of studies that investigate the time course of conceptual processing and we argue that, because of the paramount role of sociality for abstract concepts, new methods are necessary to study concepts in interactive situations. We conclude that bodily, linguistic, and social constraints provide important theoretical limitations for our theories of conceptual knowledge.
This special issue, "Concrete constraints of abstract concepts", addresses the role of concrete determinants, both external and internal to the human body, in acquisition, processing and use of abstract concepts while at the same time presenting to the readers an overview of methods used to assess their representation.
Analysis of physicians' probability estimates of a medical outcome based on a sequence of events
(2022)
IMPORTANCE
The probability of a conjunction of 2 independent events is the product of the probabilities of the 2 components and therefore cannot exceed the probability of either component; violation of this basic law is called the conjunction fallacy. A common medical decision-making scenario involves estimating the probability of a final outcome resulting from a sequence of independent events; however, little is known about physicians' ability to accurately estimate the overall probability of success in these situations.
OBJECTIVE
To ascertain whether physicians are able to correctly estimate the overall probability of a medical outcome resulting from 2 independent events.
DESIGN, SETTING, AND PARTICIPANTS
This survey study consisted of 3 separate substudies, in which 215 physicians were asked via internet-based survey to estimate the probability of success of each of 2 components of a diagnostic or prognostic sequence as well as the overall probability of success of the 2-step sequence. Substudy 1 was performed from April 2 to 4, 2021, substudy 2 from November 2 toll, 2021, and substudy 3 from May 13 to 19, 2021. All physicians were board certified or board eligible in the primary specialty germane to the substudy (ie, obstetrics and gynecology for substudies land 3 and pulmonology for substudy 2), were recruited from a commercial survey service, and volunteered to participate in the study.
EXPOSURES
Case scenarios presented in an online survey.
MAIN OUTCOMES AND MEASURES
Respondents were asked to provide their demographic information in addition to 3 probability estimates. The first substudy included a scenario describing a brow presentation discovered during labor; the 2 conjuncts were the probabilities that the brow presentation would resolve and that the delivery would be vaginal. The second substudy involved a diagnostic evaluation of an incidentally discovered pulmonary nodule; the 2 conjuncts were the probabilities that the patient had a malignant condition and that a technically successful transthoracic needle biopsy would reveal a malignant condition. The third substudy included a modification of the first substudy in an attempt to debias the conjunction fallacy prevalent in the first substudy. Respondents' own probability estimates of the individual events were used to calculate the mathematically correct conjunctive probability.
RESULTS
Among 215 respondents, the mean (SD) age was 54.0 (9.5) years; 142 respondents (66.0%) were male. Data on race and ethnicity were not collected. A total of 168 physicians (78.1%) estimated the probability of the 2-step sequence to be greater than the probability of at least 1 of the 2 component events. Compared with the product of their 2 estimated components, respondents overestimated the combined probability by 12.8% (95% CI, 9.6%-16.1%; P < .001) in substudy 1, 19.8% (95% Cl, 16.6%-23.0%; P < .001) in substudy 2, and 18.0% (95% CI, 13.4%-22.5%; P < .001) in substudy 3, results that were mathematically incoherent (ie, formally illogical and mathematically incorrect).
CONCLUSIONS AND RELEVANCE
In this survey study of 215 physicians, respondents consistently overestimated the combined probability of 2 events compared with the probability calculated from their own estimates of the individual events. This biased estimation, consistent with the conjunction fallacy, may have substantial implications for diagnostic and prognostic decision-making.
The presence of task-irrelevant sound disrupts short-term memory for serial information. Recent studies found that enhanced perceptual task-encoding load (static visual noise added to target items) reduces the disruptive effect of an auditory deviant but does not affect the task-specific interference by changing-state sound, indicating that the deviation effect may be more susceptible to attentional control. This study aimed to further specify the role of attentional control in shielding against different types of auditory distraction, examining speech and nonspeech distractors presented in laboratory and Web based experiments. To further elucidate the role of controlled processes, we tested whether the detrimental effects of distractor sounds-and their modulation by attentional control-reach participants' awareness. We found that changing-state sound and auditory deviants in steady-state sound equally affected both objective recall performance and metacognitive confidence judgments but did not affect the accuracy of confidence judgments. Most importantly, across four experiments, an increase of task load (visual degradation of the to-be-remembered items) did not reduce either type of auditory distraction. A close replication of the original modulation of the deviation effect by perceptual task load (in an online environment) even revealed a stronger deviation effect at high task load, suggesting that the manipulation may have influenced cognitive load and the ability to control distractor interference in memory. In line with a unitary account of auditory distraction, the results suggest that although both types of distraction reach metacognitive awareness, they may be equally unrelated to perceptual load and the availability of attentional resources. <br /> Public Significance Statement Our ability to hold information in short-term memory suffers in the presence of background sound, but it is unclear to what extent auditory distraction depends on attentional control and metacognitive monitoring. This study reassessed a finding, whereby the diversion of attention by deviant sounds is reduced when the focal task becomes more difficult to process (via perceptual degradation). A series of experiments showed that both the effect of auditory deviants and the interference by changing-state sound is largely resistant to a manipulation of task load, indicating that distraction is not susceptible to attentional control. Nevertheless, participants appeared to be well aware of the detrimental sound effects on performance, as reflected in metacognitive confidence judgments. The findings have important implications for theoretical accounts of auditory distraction, indicating that disruption is attributable to automatic attentional capture, which cannot be controlled despite us being aware of it.
One of the ongoing debates about visual consciousness is whether it can be considered as an all-or-none or a graded phenomenon. While there is increasing evidence for the existence of graded states of conscious awareness based on paradigms such as visual masking, only little and mixed evidence is available for the attentional blink paradigm, specifically in regard to electrophysiological measures. Thereby, the all-or-none pattern reported in some attentional blink studies might have originated from specifics of the experimental design, suggesting the need to examine the generalizability of results. In the present event-related potential (ERP) study (N = 32), visual awareness of T2 face targets was assessed via subjective visibility ratings on a perceptual awareness scale in combination with ERPs time-locked to T2 onset (components P1, N1, N2, and P3). Furthermore, a classification task preceding visibility ratings allowed to track task performance. The behavioral results indicate a graded rather than an all-or-none pattern of visual awareness. Corresponding graded differences in the N1, N2, and P3 components were observed for the comparison of visibility levels. These findings suggest that conscious perception during the attentional blink can occur in a graded fashion.
Number to me, space to you
(2022)
Recent work has shown that number concepts activate both spatial and magnitude representations. According to the social co-representation literature which has shown that participants typically represent task components assigned to others together with their own, we asked whether explicit magnitude meaning and explicit spatial coding must be present in a single mind, or can be distributed across two minds, to generate a spatial-numerical congruency effect. In a shared go/no-go task that eliminated peripheral spatial codes, we assigned explicit magnitude processing to participants and spatial processing to either human or non-human co-agents. The spatial-numerical congruency effect emerged only with human co-agents. We demonstrate an inter-personal level of conceptual congruency between space and number that arises from a shared conceptual representation not contaminated by peripheral spatial codes. Theoretical implications of this finding for numerical cognition are discussed.
Background: Some (minority) groups (MGs) are more vulnerable to sexual violence (SV) exposure than others. Othering-based stress (OBS) may mediate the relationship between minority identification and SV. This study aims to assess the prevalence of SV in different MGs to explore the relationship between minority identification and SV, to investigate whether belonging to multiple MGs moderates this relationship, and to explore OBS SV moderation for different MGs. Method: Through an online survey administered to a nationally representative sample in Belgium, data was collected from 4632 persons, of whom 21.01% self-identified as belonging to a MG (SI-Minority). SV prevalence was measured using behaviorally specific questions based on the WHO definition of SV. SI-Minority participants received an additional scale on OBS. Results: SI-Minority participants reported more SV victimization compared to the non-minorities. However, this increased risk was not moderated by minority identification but linked to the socio-demographic SV risk markers common to minority individuals. Multiple-minority participants were found more at risk of SV compared to single-minority respondents. Lesbian, gay, bisexual, pan-/omnisexual, asexual, and other non-heterosexual (LGB+) participants were found more at risk than heterosexual participants. OBS was found to be significantly correlated to SV in sexual and gender minorities and in cultural minorities. Conclusions: This study contributes to our understanding of the relationship between minority identification, OBS, and SV. Studying both specific and common SV vulnerabilities and outcomes within specific societal subgroups and the general population may inform policy makers when allocating resources to those interventions with the largest societal impact.
Individual differences in demographics, personality, and other related beliefs are associated with coronavirus disease 2019 (COVID-19) threat beliefs. However, the relative contributions of these different types of individual differences to COVID-19 threat beliefs are not known. In this study, a total of 1,700 participants in Croatia (68% female; age 18-86 years) completed a survey that included questions about COVID-19 risks, questions about related beliefs including vaccination beliefs, trust in the health system, trust in scientists, and trust in the political system, the HEXACO 60 personality inventory, as well as demographic questions about gender, age, chronic diseases, and region. We used hierarchical regression analyses to examine the proportion of variance explained by demographics, personality, and other related beliefs. All three types of individual differences explained a part of the variance of COVID-19 threat beliefs, with related beliefs explaining the largest part. Personality facets explained a slightly larger amount of variance than personality factors. These results have implications for communication about COVID-19.
Little is known about the current state of research on the involvement of young people in hate speech. Thus, this systematic review presents findings on a) the prevalence of hate speech among children and adolescents and on hate speech definitions that guide prevalence assessments for this population; and b) the theoretical and empirical overlap of hate speech with related concepts. This review was guided by the Cochrane approach. To be included, publications were required to deal with real-life experiences of hate speech, to provide empirical data on prevalence for samples aged 5 to 21 years and they had to be published in academic formats. Included publications were full-text coded using two raters (kappa = .80) and their quality was assessed. The string-guided electronic search (ERIC, SocInfo, Psycinfo, Psyndex) yielded 1,850 publications. Eighteen publications based on 10 studies met the inclusion criteria and their findings were systematized. Twelve publications were of medium quality due to minor deficiencies in their theoretical or methodological foundations. All studies used samples of adolescents and none of younger children. Nine out of 10 studies applied quantitative methodologies. Eighteen publications based on 10 studies were included. Results showed that frequencies for hate speech exposure were higher than those related to victimization and perpetration. Definitions of hate speech and assessment instruments were heterogeneous. Empirical evidence for an often theorized overlap between hate speech and bullying was found. The paper concludes by presenting a definition of hate speech, including implications for practice, policy, and research.
Background The Covid-19 pandemic led to increased work-related strain and psychosocial burden in nurses worldwide, resulting in high prevalences of mental health problems. Nurses in long-term care facilities seem to be especially affected by the pandemic. Nevertheless, there are few findings indicating possible positive changes for health care workers. Therefore, we investigated which psychosocial burdens and potential positive aspects nurses working in long-term care facilities experience during the Covid-19 pandemic. Methods We conducted a mixed-methods study among nurses and nursing assistants working in nursing homes in Germany. The survey contained the third German version of the Copenhagen Psychosocial Questionnaire (COPSOQ III). Using Welch's t-tests, we compared the COPSOQ results of our sample against a pre-pandemic reference group of geriatric nurses from Germany. Additionally, we conducted semi-structured interviews with geriatric nurses with a special focus on psychosocial stress, to reach a deeper understanding of their experiences on work-related changes and burdens during the pandemic. Data were analysed using thematic coding (Braun and Clarke). Results Our survey sample (n = 177) differed significantly from the pre-pandemic reference group in 14 out of 31 COPSOQ scales. Almost all of these differences indicated negative changes. Our sample scored significantly worse regarding the scales 'quantitative demands', 'hiding emotions', 'work-privacy conflicts', 'role conflicts', 'quality of leadership', 'support at work', 'recognition', 'physical demands', 'intention to leave profession', 'burnout', 'presenteeism' and 'inability to relax'. The interviews (n = 15) revealed six main themes related to nurses' psychosocial stress: 'overall working conditions', 'concern for residents', 'management of relatives', 'inability to provide terminal care', 'tensions between being infected and infecting others' and 'technicisation of care'. 'Enhanced community cohesion' (interviews), 'meaning of work' and 'quantity of social relations' (COPSOQ III) were identified as positive effects of the pandemic. Conclusions Results clearly illustrate an aggravation of geriatric nurses' situation and psychosocial burden and only few positive changes due to the Covid-19 pandemic. Pre-existing hardships seem to have further deteriorated and new stressors added to nurses' strain. The perceived erosion of care, due to an overemphasis of the technical in relation to the social and emotional dimensions of care, seems to be especially burdensome to geriatric nurses.
Not much is known about how bystanders' emotional reactions after not intervening in cyberbullying might impact their health issues. Narrowing this gap in the literature, the present study focused on examining the moderating effects of emotional reactions (i.e., guilt, sadness, anger) after not intervening in cyberbullying on the longitudinal relationship between cyberbullying bystanding and health issues (i.e., subjective health complaints, suicidal ideation, non-suicidal self-harm). Participants were 1,067 adolescents between 12 and 15 years old included in this study (M-age = 13.67; 51% girls). The findings showed a positive association between Time 1 cyberbullying bystanding and Time 2 health issues. Guilt moderated the positive relationships among Time 1 cyberbullying bystanding, Time 2 subjective health complaints, suicidal ideation, and non-suicidal self-harm. Time 1 sadness also moderated the relationship between Time 1 cyberbullying bystanding and Time 2 suicidal ideation and non-suicidal self-harm. However, anger did not moderate any of the associations.
From the beginning of systematic research on sexual victimization, it has been recognized that a substantial proportion of women report nonconsensual sexual experiences meeting the defining criteria of rape in response to behaviorally specific items, but do not acknowledge their experience as rape in response to broad questions about whether they have ever been raped. Recent studies suggest that rates of unacknowledged rape may be as high or even higher among men than among women. This study examined rates of unacknowledged female and male victims of rape and sexual assault by comparing responses to behaviorally specific items of the Sexual Aggression and Victimization Scale (SAV-S) with responses to broad questions using the labels of sexual assault and rape (SARA) in 593 participants (303 women) in Germany. As predicted, more women and men were classified as rape victims based on behaviorally specific items than on the basis of the broad rape item. The rates of unacknowledged rape were about 60% for women and 75% for men. The gender difference was not significant. Against our prediction, no significant differences in acknowledgement of sexual assault were found in relation to coercive strategy and victim-perpetrator relationship. Few cases of rape and sexual assault identified by the SARA items were missed by the behaviorally specific questions. The implications for establishing prevalence rates of rape and sexual assault and for comparing victims and nonvictims in terms of vulnerability factors and outcomes of sexual victimization are discussed.
Individuals who score high in self-reported Intolerance of Uncertainty (IU) tend to find uncertainty aversive. Prior research has demonstrated that under uncertainty individuals with high IU display difficulties in updating learned threat associations to safety associations. Importantly, recent research has shown that providing contingency instructions about threat and safety contingencies (i.e. reducing uncertainty) to individuals with high IU promotes the updating of learned threat associations to safety associations. Here we aimed to conceptually replicate IU and contingency instruction-based effects by conducting a secondary analysis of self-reported IU, ratings, skin conductance, and functional magnetic resonance imaging (fMRI) data recorded during uninstructed/instructed blocks of threat acquisition and threat extinction training (n = 48). Generally, no significant associations were observed between self-reported IU and differential responding to learned threat and safety cues for any measure during uninstructed/instructed blocks of threat acquisition and threat extinction training. There was some tentative evidence that higher IU was associated with greater ratings of unpleasantness and arousal to the safety cue after the experiment and greater skin conductance response to the safety cue during extinction generally. Potential explanations for these null effects and directions for future research are discussed.
The Covid-19 pandemic imposed new constraints on empirical research and forced researchers to transfer from traditional laboratory research to the online environment. This study tested the validity of a web-based episodic memory paradigm by comparing participants' memory performance for trustworthy and untrustworthy facial stimuli in a supervised laboratory setting and an unsupervised web setting. Consistent with previous results, we observed enhanced episodic memory for untrustworthy compared to trustworthy faces. Most importantly, this memory bias was comparable in the online and the laboratory experiment, suggesting that web-based procedures are a promising tool for memory research.