Online psychotherapy as a first clinical experience during the Covid-19 pandemic: A new generation of psychotherapists in the digital age.

The temporary closure of the Outpatient Psychotherapy Clinic at the Sigmund Freud Private University in Vienna during the Covid-19 pandemic demanded an immediate and unexpected reaction to assure further psychotherapeutic services. Both psychotherapists and patients were forced into a rapid transition to online psychotherapy. While Covid-19 research has comprehensively described challenges of online psychotherapies, we were interested in learning specifically how early stage psychotherapists-in-training, who started their clinical work with patients exclusively in the online setting, experienced this unprecedented clinical situation. Sixteen in-depth interviews were conducted with psychotherapists in training. The data were analyzed using a thematic analysis. The analysis revealed how psychotherapists in training were able to cultivate a set of early-training resources and competencies in the online therapy setting without evidence-based guidelines from supervisors and the institution. This study highlighted the necessity of incorporating specific and novel educational input that is necessary for achieving specific online skills in the early training phase. Recognizing that the therapeutic landscape has undergone an irreversible transformation, the data suggest that distinct techniques are necessary to equip early-training psychotherapists for the now commonly practiced alternation between online setting and in-person setting in psychotherapeutic processes.

Psychotherapists' Reports regarding the Impact of the COVID-19 Pandemic on Their Patients: A Cross-National Descriptive Study Based on the Social-Ecological Model (SEM).

The COVID-19 outbreak has raised questions about how vulnerable groups experience the pandemic. Research that focuses on the view of individuals with pre-existing mental health conditions is still limited, and so are cross-country comparative surveys. We gathered our sample of qualitative data during the first lockdown after governmental measures against the spread of the SARS-CoV-2 virus came into force in Austria, Czechia, Germany, and Slovakia. A total of n = 1690 psychotherapists from four middle European countries answered the question of how the COVID-19 pandemic was addressed in sessions by their patients during the early stage of unprecedented public health conditions. We employed a descriptive qualitative methodology to determine themes following levels of the social-ecological model (SEM) regarding how the COVID-19 pandemic affected patients. At the public policy level, stressful environmental conditions concerned the governmental mitigation efforts. At the level of community/society, reported key themes were employment, restricted access to educational and health facilities, socioeconomic consequences, and the pandemic itself. Key themes at the interpersonal level regarded forced proximity, the possibility of infection of loved ones, childcare, and homeschooling. Key themes at the individual level were the possibility of contracting COVID-19, having to stay at home/isolation, and a changing environment. Within the SEM framework, adaptive and maladaptive responses to these stressors were reported, with more similarities than differences between the countries. A quantification of word stems showed that the maladaptive reactions predominated.

Dispositional resilience predicted the perceived stress experienced by psychotherapists during the COVID-19 outbreak.

The coronavirus disease (COVID-19) pandemic elicited huge stress responses in most world populations, and at this time psychotherapy is an important protective service against this stress. However, a somewhat neglected question is: How stressful was the COVID-19 outbreak for psychotherapists themselves? The main aim of the present study was to investigate whether dispositional resilience predicted the perceived stress reported by psychotherapists during the COVID-19 outbreak. A total of 338 psychotherapists organized within the national psychotherapy associations of three European countries (Czech Republic, Germany, and Slovakia) were included in this online study (mean age 46.7, 77.8% female, 22.2% male). The participants were administered the Perceived Stress Scale (PSS-10) and the Connor-Davidson Resilience Scale (CD-RISC). For the data analysis, nonparametric ANOVA and two-level (mixed-effect) linear regression models were used. Dispositional resilience significantly predicted the perceived stress reported by psychotherapists during the COVID-19 outbreak. Higher dispositional resilience significantly reduced the level of perceived stress among psychotherapists (adjusted ß = -0.47, p < .001). Those with moderate resilience (between mean ± SD values) had a lower perceived stress score than those with low resilience (mean + SD value) had a lower perceived stress score than the low resilience group by an average of 6.5. The results of this study imply that the involvement of psychotherapists in resilience supportive training may reduce their vulnerability to stress. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Decreased emotional creativity and its relationship with cognitive functions in Parkinson's disease: A preliminary study.

Patients with Parkinson's disease (PD) suffer from a wide range of non-motor symptoms, including cognitive deficits and impairment of emotional processing. The present study aimed to explore in PD patients compared to healthy adults the relationship between cognitive performance and emotional creativity (EC), defined as a set of cognitive abilities and personality traits related to originality and appropriateness of emotional experience. PD patients (n = 22) and healthy controls (n = 40) underwent a complex neuropsychological assessment and were administrated with the self-reported Emotional Creativity Inventory (ECI) questionnaire. To explore the relationship between cognitive tests and the ECI, a regression analysis was conducted. PD patients and healthy controls differed significantly in the EC component Preparedness as well as in the neuropsychological test battery scores. PD patients showed lower scores in cognitive tests and a lower score in Preparedness compared to healthy adults. The output of the regression analysis showed that the extent to which the neuropsychological tests relate to the ECI components is low.

Reasons for Discontinuing Active Participation on the Internet Forum Tinnitus Talk: Mixed Methods Citizen Science Study.

BACKGROUND: Tinnitus Talk is a nonprofit online self-help forum. Asking inactive users about their reasons for discontinued usage of health-related online platforms such as Tinnitus Talk is important for quality assurance. OBJECTIVE: The aim of this study was to explore reasons for discontinued use of Tinnitus Talk, and their associations to the perceptions of Tinnitus Talk and the age of users who ceased logging on to the platform. METHODS: Initially, 13,745 users that did not use Tinnitus Talk within the previous 2 months were contacted and the response rate was 20.47% (n=2814). After dataset filtering, a total of 2172 past members of Tinnitus Talk were included in the analyses. Nine predefined reasons for discontinued usage of Tinnitus Talk were included in the survey as well as one open question. Moreover, there were 14 predefined questions focusing on perception of Tinnitus Talk (usefulness, content, community, and quality of members' posts). Mixed methods analyses were performed. Frequencies and correlation coefficients were calculated for quantitative data, and grounded theory methodology was utilized for exploration of the qualitative data. RESULTS: Quantitative analysis revealed reasons for discontinued use of Tinnitus Talk as well as associations of these reasons with perceptions of Tinnitus Talk and age. Among the eight predefined reasons for discontinued use of Tinnitus Talk, the most frequently reported was not finding the information they were looking for (451/2695, 16.7%). Overall, the highest rated perception of Tinnitus Talk was content-related ease of understanding (mean 3.9, SD 0.64). A high number (nearly 40%) of participants provided additional free text explaining why they discontinued use. Qualitative analyses identified a total of 1654 specific reasons, more than 93% of which (n=1544) could be inductively coded. The coding system consisted of 33 thematically labeled codes clustered into 10 categories. The most frequent additional reason for discontinuing use was thinking that there is no cure or help for tinnitus symptoms (375/1544, 24.3%). Significant correlations (P<.001) were observed between reasons for discontinued usage and perception of Tinnitus Talk. Several reasons for discontinued usage were associated with the examined dimensions of perception of Tinnitus Talk (usefulness, content, community, as well as quality of members' posts). Moreover, significant correlations (P<.001) between age and reasons for discontinued use were found. Older age was associated with no longer using Tinnitus Talk because of not finding what they were looking for. In addition, older participants had a generally less positive perception of Tinnitus Talk than younger participants (P<.001). CONCLUSIONS: This study contributes to understanding the reasons for discontinued usage of online self-help platforms, which are typically only reported according to the dropout rates. Furthermore, specific groups of users who did not benefit from Tinnitus Talk were identified, and several practical implications for improvement of the structure, content, and goals of Tinnitus Talk were suggested.

Provision of Psychotherapy during the COVID-19 Pandemic among Czech, German and Slovak Psychotherapists.

Psychotherapists around the world are facing an unprecedented situation with the outbreak of the novel coronavirus disease (COVID-19). To combat the rapid spread of the virus, direct contact with others has to be avoided when possible. Therefore, remote psychotherapy provides a valuable option to continue mental health care during the COVID-19 pandemic. The present study investigated the fear of psychotherapists to become infected with COVID-19 during psychotherapy in personal contact and assessed how the provision of psychotherapy changed due to the COVID-19 situation and whether there were differences with regard to country and gender. Psychotherapists from three European countries: Czech Republic (CZ, n = 112), Germany (DE, n = 130) and Slovakia (SK, n = 96), with on average 77.8% female participants, completed an online survey. Participants rated the fear of COVID-19 infection during face-to-face psychotherapy and reported the number of patients treated on average per week (in personal contact, via telephone, via internet) during the COVID-19 situation as well as (retrospectively) in the months before. Fear of COVID-19 infection was highest in SK and lowest in DE (p < 0.001) and was higher in female compared to male psychotherapists (p = 0.021). In all countries, the number of patients treated on average per week in personal contact decreased (p < 0.001) and remote psychotherapies increased (p < 0.001), with more patients being treated via internet than via telephone during the COVID-19 situation (p < 0.001). Furthermore, female psychotherapists treated less patients in personal contact (p = 0.036), while they treated more patients via telephone than their male colleagues (p = 0.015). Overall, the total number of patients treated did not differ during COVID-19 from the months before (p = 0.133) and psychotherapy in personal contact remained the most common treatment modality. Results imply that the supply of mental health care could be maintained during COVID-19 and that changes in the provision of psychotherapy vary among countries and gender.

Effects of continuous positive airway pressure on neurocognitive and neuropsychiatric function in obstructive sleep apnea.

The aim of this study was to determine the neurocognitive and neuropsychiatric effects of continuous positive airway pressure treatment on patients with obstructive sleep apnea. This cross-sectional, prospective, observational study included 126 patients with sleep apnea. The following tests were performed: the Montreal Cognitive Assessment for the evaluation of cognitive impairment, the Beck Depression Inventory, and the State-Trait Anxiety Inventory, together with the Epworth Sleepiness Scale for the evaluation of neuropsychiatric symptoms and a person's general level of daytime sleepiness. The first measurement did not show neurocognitive impairment or a higher level of depressive and anxiety symptoms in 126 patients with obstructive sleep apnea in comparison to normative standards. After the 3-month treatment indicated for 43 patients with obstructive sleep apnea, we did not find any significant improvement in cognitive performance (p = .213). However, patients with sleep apnea with continuous positive airway pressure treatment did show significantly less daytime sleepiness, anxiety and depressive symptoms (all p < .001). In conclusion, short-term (3 months) treatment of patients with obstructive sleep apnea can substantially alleviate their daytime sleepiness, as well as depressive and anxiety symptoms.

Amygdala and emotionality in Parkinson's disease: An integrative review of the neuropsychological evidence.

Parkinson's disease (PD) is often accompanied by significant changes in emotionality, such as apathy, anhedonia, anxiety and depression. The present review summarizes the empirical evidence, including amygdala changes and psychological changes in emotionality in people suffering from PD. Seventeen empirical full-text articles including research on both amygdala and emotionality in PD were reviewed. The changes in amygdala volumes as well as changes in binding potentials, functional connectivity, regional homogeneity and regional cerebral blood flow were found to have various impacts on emotionality in people with PD. The integration of the results showed that some effects of amygdala changes on emotionality were lateralized. Some of the reviewed studies indicated that the volume loss in the left amygdala was found to be related to increased anxiety, whereas bilateral volume loss in amygdala was linked to increased depressivity. The reviewed results also support a hypothesis of bradylimbic affective disturbance in patients with PD. The disturbed activation of amygdala accompanying the evaluation of negative facial expressions implies that the evaluation of the content of affective stimuli in terms of their affective meanings is disturbed in PD patients. Impaired evaluation of affective attributes given by amygdala-based translational deficits is likely to be related to problems in translating the results of cognitive appraisal into somatomotor, arousal and other changes. This mechanism is suggested to be responsible for apathy as well as for other changes in emotionality accompanying PD.

Understanding death, suicide and self-injury among adherents of the emo youth subculture: A qualitative study.

Emo youth subculture bases its subcultural identification mostly on symbols of death, dying, suicide, and other kinds of morbid content. The main goal of the present study was to explore attitudes toward suicidal behavior and self-injury in emo adolescents. Semistructured in-depth qualitative interviews were conducted with 14 emo adherents, accompanied by the analysis of emo Web discussion forums. Participants reported attitudes including high acceptance for suicidal behavior and self-injury. The identification with the emo youth subculture is considered to be a factor strengthening vulnerability towards risky behaviors.

Free Associations Mirroring Self- and World-Related Concepts: Implications for Personal Construct Theory, Psycholinguistics and Philosophical Psychology.

People construe reality by using words as basic units of meaningful categorization. The present theory-driven study applied the method of a free association task to explore how people express the concepts of the world and the self in words. The respondents were asked to recall any five words relating with the word world. Afterward they were asked to recall any five words relating with the word self. The method of free association provided the respondents with absolute freedom to choose any words they wanted. Such free recall task is suggested as being a relatively direct approach to the respondents' self- and world-related conceptual categories, without enormous rational processing. The results provide us, first, with associative ranges for constructs of the world and the self, where some associative dimensions are defined by semantic polarities in the meanings of peripheral categories (e.g., Nature vs. Culture). Second, our analysis showed that some groups of verbal categories that were associated with the words world and self are central, while others are peripheral with respect to the central position. Third, the analysis of category networks revealed that some categories play the role of a transmitter, mediating the pathway between other categories in the network.

Modeling Semantic Emotion Space Using a 3D Hypercube-Projection: An Innovative Analytical Approach for the Psychology of Emotions.

The widely accepted two-dimensional circumplex model of emotions posits that most instances of human emotional experience can be understood within the two general dimensions of valence and activation. Currently, this model is facing some criticism, because complex emotions in particular are hard to define within only these two general dimensions. The present theory-driven study introduces an innovative analytical approach working in a way other than the conventional, two-dimensional paradigm. The main goal was to map and project semantic emotion space in terms of mutual positions of various emotion prototypical categories. Participants (N = 187; 54.5% females) judged 16 discrete emotions in terms of valence, intensity, controllability and utility. The results revealed that these four dimensional input measures were uncorrelated. This implies that valence, intensity, controllability and utility represented clearly different qualities of discrete emotions in the judgments of the participants. Based on this data, we constructed a 3D hypercube-projection and compared it with various two-dimensional projections. This contrasting enabled us to detect several sources of bias when working with the traditional, two-dimensional analytical approach. Contrasting two-dimensional and three-dimensional projections revealed that the 2D models provided biased insights about how emotions are conceptually related to one another along multiple dimensions. The results of the present study point out the reductionist nature of the two-dimensional paradigm in the psychological theory of emotions and challenge the widely accepted circumplex model.