An English list of trait words including valence, social desirability, and observability ratings.

To enable flexible and controlled research on personality, information processing, and interactions in socio-emotional contexts, the availability of highly controlled stimulus material, especially trait words and related attributes, is indispensable. Existing word databases contain mainly nouns and rating dimensions, and their role in studies within socio-emotional contexts are limited. This study aimed to create an English list of traits (ELoT), a database containing 500 trait adjectives rated by a large sample (n = 822, 57.42% female). The rating categories refer to the perceived valence associated with the traits and their social desirability and observability. Participants of different ages (18 to 65 years of age) and educational levels rated the words in an online survey. Both valence and social desirability ratings showed a bimodal distribution, indicating that most traits were rated either positive (respectively socially desirable) or negative (respectively socially undesirable), with fewer words rated as neutral. For observability, a bell-shaped distribution was found. Results indicated a strong association between valence and social desirability, whereas observability ratings were only moderately associated with the other ratings. Valence and social desirability ratings were not related to participants' age or gender, but observability ratings were different for females and males, and for younger, middle-aged, and older participants. The ELoT is an extensive, freely available database of trait norms. The large sample and the balanced age and gender distributions allow to account for age- and gender-specific effects during stimulus selection.

Development of the German social attitude barriers and facilitators to participation-scales: an analysis according to the Rasch model.

BACKGROUND: Social attitudes experienced by people with disabilities can strongly impact upon their health and quality of life. The extent to which social attitude measurement transcends specific cultures is unknown. Thus, the aim of the study was to develop German item banks to assess social attitude barriers and facilitators to participation and compare the construct definition with that developed in the United States. METHODS: The American version of the two item banks assessing social attitudes that act as barriers and facilitators in persons with disabilities was translated into German and culturally adapted. The sample consisted of 410 in- and outpatients treated for spinal diseases at a German University Hospital. The psychometric properties of the resulting 53 items-item pool were evaluated using Rasch analysis. A special focus was placed on the investigation of unidimensionality, local independence, differential item functioning (DIF) and targeting. To evaluate convergent and divergent validity correlations with perceived social support, depression and pain interference were calculated. RESULTS: Unlike the American version, both the barriers and facilitators item banks had to be divided into two subscales assessing attitudes that individuals with disabilities experience as being directed towards them (individual perception) or attitudes that respondents experience as being directed towards people with disabilities as a social group (societal perception). Four unidimensional scales were constructed. Fit to the Rasch model required item deletion and forming testlets to account for extensive local dependence. There was no evidence of DIF with regard to gender or age. Targeting of the subscales was moderate to good. CONCLUSIONS: Results support a distinction between social attitudes at the individual and societal level, allowing a more specific assessment than is possible when this distinction is ignored.

Borderline personality disorder and childhood trauma: Exploring the buffering role of self-compassion and self-esteem.

OBJECTIVES: The aim of the present study was to investigate whether patients with borderline personality disorder (BPD) show lower self-compassion and self-esteem than healthy controls and whether patients' self-compassion and self-esteem moderate the association between childhood trauma and the severity of their BPD symptoms. METHOD: Self-reported self-compassion, self-esteem, and the current severity of BPD symptoms were assessed in 35 female patients with BPD and 35 age-matched control participants. Further, traumatic childhood experiences were recorded in the patient group. RESULTS: Patients with BPD reported significantly lower self-compassion and self-esteem compared to healthy controls. In addition, self-compassion but not self-esteem moderated the positive correlation between childhood trauma and the severity of BPD symptoms. DISCUSSION: Self-compassion appears to buffer the negative consequences of childhood traumatization. Therefore, cultivating self-compassion may be an important therapeutic aim for patients with BPD.

Asymmetric tumor-related alterations of network-specific intrinsic functional connectivity in glioma patients.

Resting-state functional MRI (rs-fMRI) allows mapping temporally coherent brain networks, and intra- and inter-network alterations have been described in different diseases. This prospective study investigated hemispheric resting-state functional connectivity (RSFC) differences in the default-mode network (DMN) and fronto-parietal network (FPN) between patients with left- and right-hemispheric gliomas (LH PAT, RH PAT), addressing asymmetry effects the tumor might have on network-specific intrinsic functional connectivity under consideration of the prognostically relevant isocitrate-dehydrogenase (IDH) mutation status. Twenty-seven patients (16 LH PAT, 12 IDH-wildtype) and 27 healthy controls underwent anatomical and rs-fMRI as well as neuropsychological assessment. Independent component analyses were performed to identify the DMN and FPN. Hemispheric DMN- and FPN-RSFC were computed, compared across groups, and correlated with cognitive performance. Patient groups did not differ in tumor volume, grade or location. RH PAT showed higher contra-tumoral DMN-RSFC than controls and LH PAT. With regard to the FPN, contra-tumoral RSFC was increased in both patient groups as compared to controls. Higher contra-tumoral RSFC was associated with worse cognitive performance in patients, which, however, seemed to apply mainly to IDH-wildtype patients. The benefit of RSFC alterations for cognitive performance varied depending on the affected hemisphere, cognitive demand, and seemed to be altered by IDH-mutation status. At the time of study initiation, a clinical trial registration was not mandatory at our faculty, but it can be applied for if requested.

Patients with degenerative cervical myelopathy have signs of blood spinal cord barrier disruption, and its magnitude correlates with myelopathy severity: a prospective comparative cohort study.

PURPOSE: The aim of this study is to detect the presence of blood spinal cord barrier (BSCB) disruption in patients with degenerative cervical myelopathy (DCM). METHODS: In this prospective non-randomized controlled cohort study, 28 patients with DCM were prospectively included. All patients had indication for neurosurgical decompression. Furthermore, 38 controls with thoracic abdominal aortic aneurysm (TAAA) and indication for surgery were included. All patients underwent neurological examination. Regarding BSCB disruption and intrathecal immunoglobulin (Ig) concentrations, cerebrospinal fluid (CSF) and blood serum were examined for albumin, IgG, IgA and IgM. Quotients (Q) (CSF/serum) were standardized and calculated according to Reibers' diagnostic criteria. RESULTS: Patients and controls distinguished significantly in their clinical status. AlbuminQ, as expression of BSCB disruption, was significantly increased in the DCM patients compared to the controls. Quotients of IgG and IgA differed significantly between the groups as an expression of intrathecal diffusion. In the subgroup analysis of patients with mild/moderate clinical status of myelopathy and patients with severe clinical status, the disruption of the BSCB was significantly increased with clinical severity. Likewise, IgAQ and IgGQ presented increased quotients related to the clinical severity of myelopathy. CONCLUSION: In this study, we detected an increased permeability and disruption of the BSCB in DCM patients. The severity of BSCB disruption and the diffusion of Ig are related to the clinical status in our patient cohort. Having documented this particular pathomechanism in patients with DCM, we suggest that this diagnostic tool cloud be an important addition to surgical decision making in the future. These slides can be retrieved under Electronic Supplementary Material.

Elated or sad mood induction affects the attention of patients with a bipolar disorder less than that of patients with a depressive disorder.

Introduction: The role of acute mood states as mediating factors in cognitive impairment in patients with mania or depression is not sufficiently clear. Similarly, the extent to which cognitive impairment is trait or state-specific remains an open question. Therefore, the aim of this study was to investigate the effect of a mood-induction on attention in patients with an affective disorder.Methods: Twenty-two depressed bipolar patients, 10 manic bipolar patients, 17 with a depressive episode (MDE), and 24 healthy controls performed the Attention-Network-Test (ANT). In a within-participants design, elated and sad moods were induced by an autobiographic recall and measured on a self-report scale. Subsequently, participants performed the ANT again.Results: The modulating effect of the elated mood induction on attention was small. Only the MDE group displayed moderate improvements in selective attention and tonic alertness. Surprisingly, after the sad mood induction, patients with MDE improved moderately on phasic and tonic alertness. Phasic alertness was also enhanced in patients with mania. Finally, after the mood induction, patients with MDE showed the largest variability in attentional performance.Conclusions: Results showed only small effects of mood induction on attention. This supports the view that attention deficits reflect trait variables.

Sense it and use it: interoceptive accuracy and sensibility in suicide ideators.

BACKGROUND: Interoceptive deficits have been found to be associated with suicidal ideation and behavior. However, an objective measure of interoceptive accuracy has not been investigated in participants with suicide ideation, by now. This study aimed at investigating interoceptive accuracy and sensibility in persons with and without suicide ideation (SI) while controlling for severity of depressive symptoms. METHOD: Ninety-five participants (age: M = 34.8, SD = 11.6, n = 56 female [58.9%]; n = 51 patients with a Major Depressive Disorder and n = 44 healthy participants) were assessed for interoceptive accuracy and sensibility, depression and SI. RESULTS: Twenty-five participants (26%) reported SI. They showed interoceptive accuracy comparable to persons without SI (t = -.81, p = .422), but significantly lower interoceptive sensibility. After controlling for severity of depressive symptoms in a hierarchical linear regression analysis, most associations between interoceptive sensibility and SI disappeared. CONCLUSION: Results suggest that suicide ideators do not lack the ability to perceive their own bodily signals but they feel less able to use them in a way that is advantageous for them. Differences between suicide ideators and non-ideators appear to be largely driven by depressive symptoms (depression bias).

The Aachen List of Trait Words.

In this study, we present the Aachen List of Trait Words (ALoT), including a total of 606 German adjectives with English translations, describing personality traits. The lack of ratings regarding the social desirability of traits led us to create a German trait database. Ratings of valence and social desirability were obtained from 100 participants. Statistical analyses of 99 participants indicated that valence and social desirability ratings were strongly correlated. However, there are several words showing a weak or no relationship. Furthermore, uncommon words were rated less positively (or desirable) than more common traits. Word frequency and word length were positively correlated, showing that short terms were more common than long ones. Social desirability and valence ratings are presented together with several psycholinguistic variables known to influence word processing (e.g. word length) in the ALoT. Scores for each word are provided as supplemental materials. The ALoT is intended to provide stimulus material for experiments dealing with the affective processing of German trait adjectives.

Development of a short scale for assessing economic environmental aspects in patients with spinal diseases using Rasch analysis.

BACKGROUND: Economic environmental factors represent important barriers to participation and have deleterious effects on quality of life (QOL) in persons with spinal diseases (SpD). While economic factors are anchored in the International Classification of Functioning, Disability and Health, their influence on QOL and participation from patients' perspectives is an infrequent focus of research. The aim of the present research is to calibrate a culturally adapted Rasch-based questionnaire assessing economic QOL in patients with SpD. METHODS: The 11-items of the German economic-QOL-scale were answered by 325 patients with SpD on a four-point Likert-scale. Fit to the Rasch measurement model was investigated by testing for stochastic ordering of the items, unidimensionality, local independence, and differential item functioning (DIF). RESULTS: After adjusting for local dependency, fit to the Rasch model was achieved with a non-significant item-trait interaction (chi-squaredf = 20 = 34.8, p = 0.021). The person separation reliability equaled 0.88, the scale was free from age- or gender-related DIF, and unidimensionality could be verified. CONCLUSIONS: The Rasch-based German version of the economic-QOL-scale represents a suitable instrument to investigate the influences of economic factors on patients' QOL at a group and individual level. It can be easily applied in research and practice and may be administered quickly in combination with other instruments. The short test duration implies a low test burden for patients and a minimum of time expenditure by clinicians when evaluating the results.

Neural correlates of positive and negative performance feedback in younger and older adults.

BACKGROUND: Recent studies with younger adults have shown that performance feedback can serve as a reward, and it elicits reward-related brain activations. This study investigated whether performance feedback is processed similarly in younger and older adults and whether there are differential aging effects for positive and negative performance feedback. METHODS: We used event-related fMRI in a choice reaction-time task and provided performance feedback after each trial. RESULTS: Although younger and older adults differed in task-related activation, they showed comparable reward-related activation. Positive performance feedback elicited the strongest striatal and amygdala activation, which was reflected behaviorally in slightly faster reaction times. CONCLUSIONS: These results suggest that performance feedback serves as a reward in both younger and older adults.

Implicit sequence learning in juvenile anorexia nervosa: neural mechanisms and the impact of starvation.

BACKGROUND: Previous studies have reported that cognitive deficits occur in patients with anorexia nervosa (AN) and that these deficits may represent a predisposition towards developing AN or perpetuate the disorder. Specifically, dysfunctional implicit learning may contribute to the development of highly resistant dieting behaviours that are fundamental to the persistence of the disorder. Thus, the aims of this study were (a) to investigate implicit sequence learning in adolescent patients with AN before and after weight recovery and (b) to elucidate the associated neural mechanisms in acute AN relative to healthy controls. METHODS: In a behavioural study, implicit sequence learning was assessed using a serial reaction time task in 27 adolescents with AN before (T1) and after weight recovery (T2) compared with age-matched healthy controls (HC) who were assessed at similar time intervals. The neural correlates of implicit sequence learning were subsequently investigated in 19 AN patients shortly after they were admitted to the hospital and 20 HC using functional magnetic resonance imaging (fMRI). RESULTS: At T1, AN patients showed reduced sequence learning compared with HC. However, no behavioural differences between HC and AN patients were found at T2. At the neural level, acute AN patients showed reduced thalamic activation during sequence learning compared with HC subjects. CONCLUSIONS: Our data suggest that the impaired implicit learning observed in adolescent AN patients before weight gain is a state-related dysfunction that normalises with weight gain. Thus, implicit learning deficits do not appear to represent a predisposition towards developing AN; rather, these deficits should be considered when planning psychotherapeutic interventions for acute AN. Reduced thalamic activation during the acute stage of AN may indicate a starvation-induced dysfunction of the neural circuitry that is involved in behavioural flexibility.

Effects of mindfulness-based cognitive therapy on self-reported suicidal ideation: results from a randomised controlled trial in patients with residual depressive symptoms.

INTRODUCTION: The aim of the present study was to investigate the effects of mindfulness-based cognitive therapy (MBCT) on suicidal ideation in an open-label randomised controlled trial of patients with residual depressive symptoms. Furthermore, this study aimed at examining whether an effect of MBCT on suicidal ideation was dependent on a reduction in depression severity, worry and rumination, or an increase in mindfulness. METHODS: One hundred and thirty participants were randomised to a treatment arm (treatment as usual plus MBCT) or a wait list arm. Change in depression, change in worry, change in rumination and change in mindfulness were entered as covariates in a repeated measures ANOVA in order to assess to what degree MBCT-induced changes in suicidal ideation were independent from changes in these parameters. RESULTS: There was a significant group×time (pre vs. post) interaction on suicidal ideation indicating a significant reduction of suicidal ideation in the MBCT group, but not in the control group. The interaction remained significant after addition of the above covariates. Change in worry was the only covariate associated with change in suicidal ideation, causing a moderate reduction in the interaction effect size. CONCLUSIONS: The results suggest that MBCT may affect suicidal ideation in patients with residual depressive symptoms and that this effect may be mediated, in part, by participants' enhanced capacity to distance themselves from worrying thoughts.

Metacognitive monitoring of attention performance and its influencing factors.

Metacognitive monitoring is a central element of metacognitive processing exerting widespread influences on information processing. Albeit being subject to numerous empirical investigations referring to memory performance, there is little research investigating metacognitive monitoring in other cognitive domains. The present study investigated in 45 healthy students whether factors that are known to influence monitoring of memory performance, i.e., task difficulty, time of assessment, and practice, also exhibit a significant impact on monitoring of attention performance. A multivariate analysis of variance with three within-subject repeated measures factors on two dependent variables (monitoring of (a) time, and (b) errors in an attention task) was conducted. Results showed that monitoring ability significantly decreased with increasing task difficulty, was significantly better for post than for pre-assessment, and significantly increased with practice. Therefore, results suggest that the examined factors influenced monitoring of attention performance equivalent to the influence of these factors found in metamemory research.

Measuring decentering in self-reports: Psychometric properties of the experiences questionnaire in a German sample.

Decentering is described as referring to one's current mental experiences from an objective perspective. This study presents a psychometric evaluation of a German version of the Experiences Questionnaire (EQ-D), a self-report instrument designed to measure decentering. Confirmatory factor analysis on a sample of 506 university students indicates acceptable-to-good model fit (χ(2)=58.3; TLI=.92; CFI=.95; RMSEA=.067) for a second-order factor Overall Decentering comprising the two first-order factors Accepting Self-Perception and Distanced Perspective. Preliminary evidence for the validity of the EQ-D was demonstrated via negative correlations with measures of depression and depressive rumination. The present results stress the multidimensional nature of decentering and provide important suggestions for future research on how to investigate and operationalize the decentering construct.

Internal and external self-affirmation resources: validation and assessment of psychometric properties of the spontaneous self-affirmation measure using structural equation modeling.

Introduction: People use coping strategies such as self-affirmation to manage threats to their self-esteem. In empirical research, self-affirmation often involves recalling personal values, strengths, or relationships to restore moral integrity. Research shows it improves attitude adjustment, resolves cognitive dissonance, and enhances well-being. Some studies stress the importance of distinguishing between different aspects of self-affirmation, like strengths or social relations. These aspects align with concepts in psychotherapy that differentiate between internal and external resource activation, benefiting health, self-esteem, and resilience. The aim of the current study was twofold: first, to independently test the three-factor structure of the Spontaneous Self-affirmation Measure (SSAM), and second, to integrate self-affirmation strategies into a broader resource activation framework as resilience factors. It also examined associations with self-esteem and effects of age, gender, and education on spontaneous self-affirmation. Methods: 1,100 participants (72% female, age 18-65) were recruited online. The original three-factor structure of the SSAM (with the factors Strengths, Values and Social relations) was examined using structural equation modeling. Further, a theory driven two-factor structure applying an internal and external resources framework was examined, integrating the factors of the SSAM into the taxonomy of resource activation (Internal resources: Strengths and Values; External resources: Social relations). Results: The results of confirmatory factor analyses showed that both the original three-factor structure and the complementary two-factor structure with an Internal resources and External resources factor fit the data appropriately. All three factors of the original factor model showed a high reliability (Strengths: ωt = 0.91, Values: ωt = 0.91, Social relations: ωt = 0.92). We also found measurement invariance across age, gender, and education. Furthermore, group differences regarding gender, education and ethnicity in the utilization of spontaneous self-affirmation strategies were apparent. Finally, it was demonstrated that the Internal resources factor of the complementary two-factor model is significantly more strongly correlated with self-esteem than the External Resources factor [z = 12.80, p < 0.001, 95%CIdiff (0.24, 0.33)]. Discussion: The study confirms the validity of both the three-factor and two-factor structures of the SSAM. Integrating self-affirmation into the resource activation framework may facilitate applying findings from self-affirmation studies to clinical contexts.

Validation of the factor structure of the Experiences Questionnaire using Exploratory Graph Analysis.

Introduction: Decentering describes the ability to shift the focus away from one's subjective experience onto the experience itself. The Experiences Questionnaire (EQ) is a self-report measure that was developed to systematically assess changes in Decentering ability. Although several studies show the validity of the questionnaire, there are discrepancies between the factorial structure of the Decentering scale of the EQ (EQ-D) found in the initial study (one factor) and other studies (two factors). Therefore, the current study aimed to assess the dimensionality of the EQ-D using Exploratory Graph Analysis (EGA). Methods: In total, 1,100 participants were recruited online (790 female, 307 male, 3 non-binary; age 18 to 65 years). Participants completed the EQ and the Rosenberg Self-esteem scale (RSES). Results: The bootstrapped EGA results revealed a two-dimensional structure of the EQ-D (Factor 1: Distanced Perspective, DP; Factor 2: Accepting Self-perception, AS) with high structural and item stability (all items > 0.70). The two dimensions of the EQ-D showed a high internal consistency (DP: ω = 0.74; AS: ω = 0.86) and discriminant validity with the rumination items of the EQ. Furthermore, a high convergent validity of the EQ was established, as the AS factor exhibited a significantly stronger correlation with self-esteem than the DP factor (z = 7.98, p < 0.001), which aligns with theoretical considerations suggesting that the AS factor encompasses aspects of self-compassion alongside decentering. We also found measurement invariance of the DP and AS factor across age, gender and country but not for education. Discussion: These results support the EQ's validity, demonstrated in a larger sample with a new methodology, aligning with existing two-factor decentering models literature.

Structural brain abnormalities in adolescent anorexia nervosa before and after weight recovery and associated hormonal changes.

OBJECTIVE: The neurobiological mechanisms of structural brain abnormalities in patients with anorexia nervosa (AN) remain poorly understood. In particular, little is known about the changes in and the recovery of gray matter (GM) volumes after weight gain and the relation to hormonal normalization in adolescent patients with AN. METHODS: Nineteen female patients aged 12 to 17 years were assessed using magnetic resonance imaging at the time of admission to the hospital (T1) and after weight recovery (T2). Patients were compared with typically developing girls matched for age and intelligence quotient. Structural brain images were analyzed using a voxel-based morphometric approach. Circulating levels of cortisol and gonadotropins were assessed in blood samples. RESULTS: Compared with controls, patients with AN showed reduced GM in several brain regions along the cortical midline, reaching from the occipital cortex to the medial frontal areas. These GM reductions were mostly reversible at T1. Patients showed a GM increase from T1 to T2 along the cortical midline and in the occipital, temporal, parietal, and frontal lobes. GM increases at T2 correlated inversely with cortisol levels at T1 and positively with weight gain at T2. The strongest associations between regional GM increase and weight gain were found in the cerebellum. In addition, increases in GM volumes at T2 in the thalamus, hippocampus, and amygdala were associated with increases in follicle-stimulating hormone. CONCLUSIONS: Our data suggest that brain alterations in adolescents with acute AN are mostly reversible at T1 and that GM recovery in specific brain regions is associated with weight and hormonal normalization.

Cognitive flexibility in juvenile anorexia nervosa patients before and after weight recovery.

Deficits in set-shifting abilities have been robustly described in adult patients with anorexia nervosa (AN). These deficits are associated with behavioral traits, such as rigidity and perfectionism, and are independent of starvation. However, little is known about neurocognitive deficits in juvenile patients with AN. The brain circuits that support set shifting are not fully mature in these patients. One possibility is that neuroendocrinological changes, such as elevated cortisol levels, contributing to alterations in cognitive performance in individuals with AN. Set-shifting abilities (Visual Set-Shifting Task), cortisol levels, self-reported perfectionism and obsessive personality traits were assessed in 28 female adolescent patients with AN before (T0) and after (T1) weight rehabilitation and compared with 27 age- and IQ-matched healthy controls (CG). Compared with the CG, AN patients showed increased reaction times (RT) in shift trials (p < 0.001) and reduced error rates in both shift and non-shift trials across time points (p < 0.05). Across all subjects, perfectionism was associated with increased RTs during shift trials at T1 (r = 0.35, p < 0.05). Subjects with lower cortisol levels showed increased RTs and more errors in non-shift trials (p < 0.05). In contrast to the findings in adult patients, adolescent patients with AN did not display a marked deficit in set-shifting abilities. Instead, they demonstrated a perfectionistic cognitive style that was characterized by increased RTs in shift trials but improved accuracy. One could speculate that the shorter duration of illness and the incomplete maturation of the prefrontal cortices contribute to these findings.

Self-Referential Processing and Resting-State Functional MRI Connectivity of Cortical Midline Structures in Glioma Patients.

Metacognition has only scarcely been investigated in brain tumor patients. It is unclear if and how the tumor-lesioned brain might be able to maintain an adequate sense-of-self. As cortical midline structures (CMS) are regarded as essential for self-referential mental activity, we investigated resting-state fMRI connectivity (FC) of CMS to the default-mode network (DMN) and to the whole brain, comparing glioma patients and matched controls. Subjects furthermore performed a trait judgement (TJ), a trait recall task (TR), and neuropsychological testing. In the TJ, adjectives had to be ascribed as self- or non-self-describing, assessing the self-serving effect (SSE), a normally observed bias for positive traits. In the TR, the mnemic neglect effect (MNE), a memory advantage for positive traits, was tested. The groups were compared and partial correlations between FC and test metrics were analyzed. Although patients were significantly impaired in terms of verbal memory, groups did not differ in the SSE or the MNE results, showing preserved metacognitive abilities in patients. FC of CMS to the DMN was maintained, but was significantly decreased to whole brain in the patients. FC of the dorsomedial prefrontal cortex (DMPFC) to whole brain was correlated with the MNE in patients. Preserving the DMPFC in therapeutic interventions might be relevant for maintaining self-related verbal information processing in the memory domain in glioma patients.

A Microanalysis of Mood and Self-Reported Functionality in Stroke Patients Using Ecological Momentary Assessment.

Post-stroke depression has been repeatedly associated with the degree of functional and cognitive impairment. The present study aimed to conduct a microanalysis on this association and examined the association between mood and self-reported functionality in 20 stroke patients (6 females, age: M = 59.9, SD = 5.2) using ecological momentary assessments (EMA), a structured diary method capturing moment-to-moment variations. Mood and self-reported functionality were recorded via a smartphone-app eight times a day for seven consecutive days during inpatient rehabilitation care. The patients answered on average to 73.2% of the received prompts. Variability in patients' responses was caused by differences both between and within patients. Multilevel regression analyses revealed that mood and self-reported functionality were significantly associated at the same point in time, but only patients' mood predicted their self-reported functionality at the next assessment point in time-lagged analyses. These results remained stable after controlling for between-person differences as patients' age, staff-ratings of their awareness of illness, and their degree of functional independence. Patients' mood appeared to affect their future ratings of their functionality but not the other way around.