ABSTRACT
Attachment insecurity is important for psychotherapy both as an aspect influencing the therapeutic process as well as potential outcome variable of a treatment. Two German short forms of the Experiences in Close Relationships - Revised (ECR-R) have been proposed to assess individual differences in attachment anxiety and avoidance. In this research, we examined whether these questionnaires are suitable for measuring change in attachment anxiety and avoidance by testing longitudinal measurement invariance in two independent clinical samples (N1 = 493, N2 = 273) using a pre-post design. Results indicated that strict longitudinal measurement invariance can be assumed for both measures. Thus, changes in scale scores before and after treatment can be interpreted as changes in the latent dimensions of attachment anxiety and avoidance. Both questionnaires were also sensitive to treatment in that attachment insecurity was overall reduced after therapy. Although both measures appear to be generally suitable for investigating treatment effects, they exhibited consistent problems with structural validity across samples that should be reexamined in future research.
Subject(s)
Interpersonal Relations , Object Attachment , Humans , Anxiety , Anxiety Disorders , Surveys and QuestionnairesABSTRACT
The quality of an individual's relationship plays a central role in their personal well-being as well as their mental and physical health. Despite its great importance, there are only a few ultra-short self-report measures for the assessment of relationship quality. An exception is the four-item version of the Dyadic Adjustment Scale (DAS-4), which is gaining increasing popularity internationally. In this study, the German version of the DAS-4 was evaluated for the first time with regard to its psychometric properties in a general population sample of individuals in a romantic relationship (N=1296). In addition to satisfactory item characteristics, the unidimensional measurement model showed sufficient goodness of fit and the internal consistency was satisfactory (ω=0.80). Measurement invariance was shown for men and women based on the latent construct of the DAS-4. In line with the hypothesis, associations of the DAS-4 with gender, general life satisfaction, psychopathology and attachment styles were found, which suggests construct validity. Despite the lack of application experiences and pending psychometric analyses of the DAS-4 in relevant target groups, such as individuals in couples counselling or therapy, the four-item version can be recommended for assessing relationship satisfaction.
Subject(s)
Interpersonal Relations , Personal Satisfaction , Psychometrics , Humans , Female , Male , Adult , Middle Aged , Germany , Young Adult , Reproducibility of Results , Surveys and Questionnaires , Aged , AdolescentABSTRACT
OBJECTIVE: Disorganized attachment represents the greatest risk factor for psychopathology compared to the "organized" insecure attachment dimensions in various meta-analyses. Recently, the Adult Disorganized Attachment Scale (ADA) was developed as a self-rating scale for measuring disorganized attachment in romantic partnerships. However, a translation and evaluation in German-speaking samples is not yet available. METHODS: A German Translation of the scale (ADA-D) comprising nine items was assessed in a general population sample (N=1101) and in a student sample (N=328). The factor structure, psychometric properties, and validity of the scale with respect to psychopathology and the Experiences in Close Relationships questionnaire (ECR-RD) were examined. The differential associations of ADA-D and ECR-RD with psychopathology were determined using linear regression models. RESULTS: The unidimensional factor structure of the original version could be confirmed for the ADA-D and the instrument exhibited high internal consistency (McDonalds ω=0.91 / 0.89). Compared to attachment anxiety and avoidance, ADA-D was the strongest predictor of dissociative symptoms (Sample 1: ß=0.48; p<0.001; Sample 2: ß=0.23; p<0.01) and, in Sample 1, additionally for physical aggression (ß=0.37; p<0.001). DISCUSSION: The ADA-D exhibits good psychometric properties that are comparable to the original version of the scale. The associations with aggressiveness and dissociation are in line with previous findings regarding the unresolved attachment status in the Adult Attachment Interview. CONCLUSION: The ADA-D can be recommended for further use in research as a screening instrument for disorganized attachment in adulthood. An application in psychotherapeutic diagnostics seems promising, however, evaluations in clinical samples are necessary beforehand.
Subject(s)
Anxiety Disorders , Anxiety , Humans , Adult , Anxiety/diagnosis , Surveys and Questionnaires , Psychopathology , Psychometrics , Reproducibility of ResultsABSTRACT
Objectives: The relationship between patients' attachment strategies and the effectiveness of psychotherapy is empirically well established. However, studies on outcome measures other than symptomatic change are mostly lacking. The present study investigates if attachment anxiety and avoidance predict changes in personality functioning at the end of inpatient psychotherapy. Method: In two independent samples (the first sample consisting of N = 967 diagnostically heterogeneous patients, Fachklinikum Tiefenbrunn, and the second sample comprising N = 344 patients with personality impairments, Rehaklinik Bad Grönenbach), personality functioning was assessed by means of the short version of the OPD structure questionnaire OPD-SQS (OPD-Strukturfragebogen 12-Item-Screeningversion, OPD-SFK) at admission and discharge in a naturalistic study design. Data on the Brief Symptom Inventory (BSI) and the Inventory of Interpersonal Problems (IIP-32) were evaluated as additional outcome measures in the first sample. Patients' attachment strategies were assessed at admission using the German short version of the Experiences in Close Relationships (ECR-RD 12). Results: Attachment avoidance at baseline was inversely associated with improvements in personality functioning, psychopathology, and interpersonal problems. In the sample of patients diagnosed with personality disorders (sample 2), we found a negative association between attachment anxiety and improvements in the ability to make contact with others. Conclusions: Considering the limitations, our results underline the relevance of attachment for the treatment outcome of inpatient psychotherapy. The assessment of patient's attachment strategy as part of standardized diagnostics can be helpful in clinical practice regarding prognosis, therapy planning as well as the adjustment of the therapeutic relationship while treating patients suffering from impairments in personality functioning.
Subject(s)
Inpatients , Personality Disorders , Anxiety Disorders/diagnosis , Anxiety Disorders/therapy , Hospitalization , Humans , Personality , Personality Disorders/diagnosis , Personality Disorders/therapyABSTRACT
The transdiagnostic concept of personality structure plays a key role in psychodynamic nosology, since many mental and psychosocial disorders are considered mainfestations of structural vulnerabilities and deficits. Therefore, structural diagnostics is of particular importance, especially with respect to the planning of tailor-made psychotherapeutic interventions. Because changes in personality structure are increasingly being considered as a relevant therapeutic goal, any measures employed towards achieving this goal should be sensitive enough to capture these changes appropriately. Although the short form of the OPD Structure Questionnaire (OPD-SQS) can easily be administered and is therefore frequently used in clinical and research settings, its sensitivity to change has not yet been analyzed. Two large, independent and diagnostically heterogeneous samples of inpatient psychotherapy patients (n=1183 and n=967, respectively) completed the OPD-SQS both at admission and before discharge. Standardized Effect Size (SES), Standardized Response Mean (SRM) and Smallest Real Difference (SRD) were computed as indicators of the measure's ability to capture change. For the OPD-SQS and its subscales, low effect sizes were found in both samples (SES between 0.23 and 0.48; SRM between 0.27 and 0.53). Additionally, it was demonstrated that greater changes among patients with structural deficits were detectable with the OPD-SQS compared to those without structural deficits, and that these group differences were significant. By means of the SRD, we determined a proportion of about 22% of patients with significantly structurally improved changes in both samples. Despite some methodological issues, our findings suggest that the OPD-SQS is suitable for measuring changes in personality structure in inpatients between the beginning and the end of treatment. Since studies on the sensitivity to change of similar assessment tools are still pending, it is not yet possible to formulate any empirically validated recommendations as to which of the measure best captures therapeutically induced changes in personality structure.
Subject(s)
Personality Disorders , Personality , Humans , Inpatients , Personality Disorders/diagnosis , Personality Disorders/therapy , Surveys and QuestionnairesABSTRACT
Psychometric evaluation of the Experiences in Close Relationships Revised German 12-item version (ECR-RD 12) in a sample of psychotherapeutic inpatients Objectives: The ECR-R assesses the self-description of adult attachment strategies in romantic relationships. The present study evaluates the psychometric properties of the German 12-item short version ECR-RD 12 in a large sample of patients in psychotherapeutic inpatient treatment. Method: Inpatients in psychotherapeutic treatment (N = 2231) were assessed using the ECR-RD 12 and other clinical questionnaires. Its psychometric properties and factor structure of were evaluated. Results: The psychometric properties of the short form measure were in line with the German full length version (ECR-RD). In contrast to theoretical assumptions, factor analysis suggested a three factor solution in the present sample. Discussion: The ECR-RD 12 can be recommended as a screening measure for assessing attachment styles in inpatient psychotherapeutic settings. Further studies are required to investigate the factor structure of the measure in clinical samples.
Subject(s)
Inpatients/psychology , Interpersonal Relations , Psychometrics , Sexual Partners/psychology , Translating , Adult , Factor Analysis, Statistical , Female , Germany , Humans , Male , Object Attachment , Surveys and QuestionnairesABSTRACT
Adolescence is a critical maturation period for human cognitive control and executive function. In this study, a large sample of adolescents (n = 85) performed a reversal learning task during functional magnetic resonance imaging. We analyzed behavioral data using a reinforcement learning model to provide individually fitted parameters and imaging data with regard to reward prediction errors (PE). Following a model-based approach, we formed two groups depending on whether individuals tended to update expectations predominantly for the chosen stimulus or also for the unchosen one. These groups significantly differed in their problem behavior score obtained using the child behavior checklist (CBCL) and in a measure of their developmental stage. Imaging results showed that dorsolateral striatal areas covaried with PE. Participants who relied less on learning based on task structure showed less prefrontal activation compared with participants who relied more on task structure. An exploratory analysis revealed that PE-related activity was associated with pubertal development in prefrontal areas, insula and anterior cingulate. These findings support the hypothesis that the prefrontal cortex is implicated in mediating flexible goal-directed behavioral control.
Subject(s)
Brain Mapping , Executive Function/physiology , Prefrontal Cortex/physiology , Reversal Learning/physiology , Adolescent , Aging , Female , Gyrus Cinguli/physiology , Humans , Magnetic Resonance Imaging , Male , Reinforcement, Psychology , RewardABSTRACT
OBJECTIVE: The socioecological model emphasize the relevance of political, cultural and economic socialization effects for the prevalence of childhood maltreatment, which are analyzed by comparing child maltreatment between East and West German subjects who came of age before the fall of the Berlin Wall. METHODS: Using an online survey, a representative general population sample with respect to age, gender distribution and income was assessed regarding child maltreatment and current psychological distress using standardized self-report instruments. RESULTS: Of 507 study participants, 22,5% reported being born and socialized in East Germany. They reported significantly less emotional abuse than the 77,5% who grew up in the FRG. The East and West German subjects did not differ in any other form of abuse. CONCLUSION: Our findings underline the importance of socialization and enculturation effects on memory, which should be considered when interpreting the results.
Subject(s)
Child Abuse , Humans , Child , Self Report , Germany/epidemiology , Child Abuse/psychology , Germany, West/epidemiology , Surveys and Questionnaires , Germany, EastABSTRACT
Conduct disorder (CD) is a psychiatric disorder of childhood and adolescence which has been linked to deficient emotion processing and regulation. The behavioral and neuronal correlates targeting the interaction of emotion processing and response inhibition are still under investigation. Whole-brain event-related fMRI was applied during an affective Stroop task in 39 adolescents with CD and 39 typically developing adolescents (TD). Participants were presented with an emotional stimulus (negative/neutral) followed by a Stroop task with varying cognitive load (congruent/incongruent/blank trials). fMRI analysis included standard preprocessing, region of interest analyses (amygdala, insula, ventromedial prefrontal cortex) and whole-brain analyses based on a 2(group) × 2(emotion) × 3(task) full-factorial ANOVA. Adolescents with CD made significantly more errors, while reaction times did not significantly differ compared to TD. Additionally, we observed a lack of downregulation of left amygdala activity in response to incongruent trials and increased anterior insula activity for CD relative to TD during affective Stroop task processing [cluster-level family-wise error-corrected (p < 0.05)]. Even though no three-way interaction (group × emotion × task) interaction was detected, the findings presented still provide evidence for altered neuronal underpinnings of the interaction of emotion processing and response inhibition in CD. Moreover, our results may corroborate previous evidence of emotion dysregulation as a core dysfunction in CD. Future studies shall focus on investigating the interaction of emotion processing and response inhibition in CD subgroups (e.g., variations in callous-unemotional traits, impulsivity, or anxiety).
ABSTRACT
Parenting is an essential factor within a child's development, yet the impact of normative variations of parenting on neural emotion processing has not been studied to date. The present study investigated 83 healthy adolescents using functional magnetic resonance imaging and an emotional face-matching paradigm. The faces paradigm elicited an increased amygdala response towards negative facial expressions (fearful and angry each compared to neutral faces) and a significant activation of fusiform gyrus to all emotions separately (fearful, happy, angry faces) compared to neutral faces. Moreover, we investigated associations between neural responses towards emotional faces and mother's parenting behavior (maternal warmth and support, psychological pressure and control behavior). High maternal warmth and support correlated with lower activation to fearful faces in the amygdala. Maternal supportive rather than control behavior seems to have an impact on neural emotion processing, which could also be the key factor for brain functional abnormalities in maltreated children. These results expand existent findings in maltreated children to healthy populations.