How Terminology Affects Users' Responses to System Failures.

OBJECTIVE: The objective of our research is to advance the understanding of behavioral responses to a system's error. By examining trust as a dynamic variable and drawing from attribution theory, we explain the underlying mechanism and suggest how terminology can be used to mitigate the so-called algorithm aversion. In this way, we show that the use of different terms may shape consumers' perceptions and provide guidance on how these differences can be mitigated. BACKGROUND: Previous research has interchangeably used various terms to refer to a system and results regarding trust in systems have been ambiguous. METHODS: Across three studies, we examine the effect of different system terminology on consumer behavior following a system failure. RESULTS: Our results show that terminology crucially affects user behavior. Describing a system as "AI" (i.e., self-learning and perceived as more complex) instead of as "algorithmic" (i.e., a less complex rule-based system) leads to more favorable behavioral responses by users when a system error occurs. CONCLUSION: We suggest that in cases when a system's characteristics do not allow for it to be called "AI," users should be provided with an explanation of why the system's error occurred, and task complexity should be pointed out. We highlight the importance of terminology, as this can unintentionally impact the robustness and replicability of research findings. APPLICATION: This research offers insights for industries utilizing AI and algorithmic systems, highlighting how strategic terminology use can shape user trust and response to errors, thereby enhancing system acceptance.

Psychological distress and decision-making factors for prophylactic bilateral mastectomy in cancer-unaffected BRCA1/2 pathogenic variant carriers.

OBJECTIVE: Women carrying a BRCA1/2 pathogenic variant have an increased risk for breast cancer and may opt for risk-reducing bilateral mastectomy. In this study, we examine which demographic, psychosocial, and personality factors are associated with their decision to undergo risk-reducing bilateral mastectomy. METHODS: Cancer-unaffected women with a pathogenic variant in BRCA1 or BRCA2 were recruited before receiving their genetic test result and completed follow-up including decision to undergo mastectomy over 6-8 months after genetic test result disclosure. Anxiety, depression, breast cancer worry, personality and sociodemographic data were assessed. RESULTS: A total of 125 cancer-unaffected women were included in the analysis. Participants were found to have higher anxiety levels than the general female population regardless of mastectomy decision. Breast cancer worry was higher among women who opted for risk-reducing mastectomy and did not decrease over time. By contrast, women who did not opt for surgery experienced decreasing levels of breast cancer worry. Regression analysis found that women with a pathogenic variant in BRCA1, younger women and women with higher breast cancer worry were more likely to opt for surgery. CONCLUSIONS: Our study provides valuable insights into the factors that influence women with a BRCA1/2 pathogenic variant to undergo risk-reducing mastectomy. These findings may be helpful in understanding individual differences in decision-making concerning preventive options and show the need to address negative anticipatory feelings associated with carrying a pathogenic variant in a high breast cancer risk gene in clinical care.

Bispecific antibody-mediated redirection of NKG2D-CAR natural killer cells facilitates dual targeting and enhances antitumor activity.

BACKGROUND: Natural killer group 2D (NKG2D) is an activating receptor of natural killer (NK) cells and other lymphocytes that mediates lysis of malignant cells through recognition of stress-induced ligands such as MICA and MICB. Such ligands are broadly expressed by cancer cells of various origins and serve as targets for adoptive immunotherapy with effector cells endogenously expressing NKG2D or carrying an NKG2D-based chimeric antigen receptor (CAR). However, shedding or downregulation of NKG2D ligands (NKG2DL) can prevent NKG2D activation, resulting in escape of cancer cells from NKG2D-dependent immune surveillance. METHODS: To enable tumor-specific targeting of NKG2D-expressing effector cells independent of membrane-anchored NKG2DLs, we generated a homodimeric recombinant antibody which harbors an N-terminal single-chain fragment variable (scFv) antibody domain for binding to NKG2D, linked via a human IgG4 Fc region to a second C-terminal scFv antibody domain for recognition of the tumor-associated antigen ErbB2 (HER2). The ability of this molecule, termed NKAB-ErbB2, to redirect NKG2D-expressing effector cells to ErbB2-positive tumor cells of different origins was investigated using peripheral blood mononuclear cells, ex vivo expanded NK cells, and NK and T cells engineered with an NKG2D-based chimeric receptor. RESULTS: On its own, bispecific NKAB-ErbB2 increased lysis of ErbB2-positive breast carcinoma cells by peripheral blood-derived NK cells endogenously expressing NKG2D more effectively than an ErbB2-specific IgG1 mini-antibody able to induce antibody-dependent cell-mediated cytotoxicity via activation of CD16. Furthermore, NKAB-ErbB2 synergized with NK-92 cells or primary T cells engineered to express an NKG2D-CD3ζ chimeric antigen receptor (NKAR), leading to targeted cell killing and greatly enhanced antitumor activity, which remained unaffected by soluble MICA known as an inhibitor of NKG2D-mediated natural cytotoxicity. In an immunocompetent mouse glioblastoma model mimicking low or absent NKG2DL expression, the combination of NKAR-NK-92 cells and NKAB-ErbB2 effectively suppressed outgrowth of ErbB2-positive tumors, resulting in treatment-induced endogenous antitumor immunity and cures in the majority of animals. CONCLUSIONS: Our results demonstrate that combining an NKAB antibody with effector cells expressing an activating NKAR receptor represents a powerful and versatile approach to simultaneously enhance tumor antigen-specific as well as NKG2D-CAR and natural NKG2D-mediated cytotoxicity, which may be particularly useful to target tumors with heterogeneous target antigen expression.

A fully automated three-step protein purification procedure for up to five samples using the NGC chromatography system.

The drug discovery process in the biopharmaceutical industry usually starts with the generation of plasmids coding for certain proteins. Due to advances in cloning techniques the generation of thousands of different plasmids is not a limiting factor anymore. The next step is the expression and evaluation of the proteins. In recent years significant progress has been made in the miniaturization of protein expression and purification. These processes have been adapted to robotic platforms and hundreds of proteins can be expressed and purified in parallel. As a consequence of miniaturization, the protein purification is restricted to a one-step process. In addition the amount of purified protein is usually in the µg-range. This might be suitable if a sensitive initial screening assay is available. However, when larger amounts of proteins are required robotic platforms are no longer appropriate. In addition, a one-step purification procedure is often not sufficient to obtain pure protein preparations. To address this topic we have used the NGC chromatography system for automated purification of up to five samples using a three-step purification procedure. The first chromatographic step is the capture step followed by a desalting step. The final purification was done using size exclusion chromatography. This set-up reduces the overall-time needed for protein production, needs minimal operator invention, is easy to handle and thus increases the throughput.

Emotion suppression, not reappraisal, predicts psychotherapy outcome.

OBJECTIVES: The aim of this study was to identify whether trait emotion regulation strategies predict successful or unsuccessful psychotherapy outcomes in cognitive behaviour therapy. METHODS: Three emotion regulation strategies (reappraisal, suppression, and externalizing behaviour) were assessed in 358 in- and outpatients. Patients were then grouped by therapy outcome. Emotion regulation strategies and confounding variables were entered as predictors in multinomial logistic regression analyses. RESULTS: Emotion suppression, but not reappraisal, was found to predict therapy outcomes for in- and outpatients, with patients high in suppression experiencing worse outcomes. Externalizing behaviour was only relevant in inpatient treatment. CONCLUSIONS: High suppression might be detrimental to psychotherapy outcome and should be assessed early on. Further research should investigate the influence of suppression on the mechanisms that facilitate change in psychotherapy.

Making sense of what you sense: Disentangling interoceptive awareness, sensibility and accuracy.

Garfinkel and Critchley (2013) recently proposed a three level model of interoception. Only few studies, however, have empirically tested this theoretical model thus far. The present study aimed at investigating (1) the central assumptions of this model, i.e. that Accuracy, Sensibility and Awareness are distinguishable facets of interoception and that Interoceptive Accuracy is the basic level of interoception, and (2) whether cardiovascular activation (as indexed by heart rate) is differentially related to the three facets of interoception. Analyses were conducted on a total sample of N=159 healthy participants (118 female [74.2%]; mean age=23.9years, SD=3.3, range=19-45) who performed either the heartbeat tracking task, the heartbeat discrimination task or both. The results suggest that Accuracy, Sensibility and Awareness are empirically distinct facets of interoception, showing no correlation when based on heartbeat tracking, but moderate correlations when based on heartbeat discrimination. The assumption that Interoceptive Accuracy is the basic level of interoception could only be partially confirmed. Instead, we conclude that the level of objective physiological states should be considered as the most basic level of interoceptive signal processing.

[Fearlessness about Death and Suicidal Behavior: Psychometric Properties of the German Version of the Revised Acquired Capability for Suicide Scale (ACSS-FAD)]. / Furchtlosigkeit vor dem Tod und Suizidalität: Psychometrische Eigenschaften der deutschen Version der revidierten Acquired Capability for Suicide Scale (ACSS-FAD).

OBJECTIVES: The Acquired Capability of Suicide Scale (ACSS-FAD) assesses fearlessness about death according to the Interpersonal Theory of Suicide. Psychometric properties of the German version of the ACSS-FAD are investigated. METHODS: Dimensionality and validity were analysed in a sample of N=268 undergraduate students. RESULTS: Confirmatory factor analysis replicated the unidimensionality of the measure. Correlations with suicidal ideation (r= .05) and self-reported capability for suicide (r= .14) supported the validity of the scale, while the association with depression (r= - .20) is not in line with the theory. Male participants and participants reporting past self-injurious behaviour/suicidal attempts did not show higher levels of fearlessness about death. CONCLUSION: The study demonstrates good psychometric properties of the German ACSS-FAD and largely supports the validity of the measure. However, future research needs to further investigate the validity of the ACSS-FAD (i.e. testing the utility of the instrument in predicting suicidal behaviour in patients at risk).

Does cognitive behavior therapy alter emotion regulation in inpatients with a depressive disorder?

INTRODUCTION: Emotion regulation plays an important role in the development and treatment of depression. The present study investigated whether the emotion regulation strategies, expressive suppression (ES) and cognitive reappraisal (CR) change in the course of cognitive behavior therapy (CBT) of depressive inpatients. Furthermore, it also examined whether changes in CR and ES correlated with positive treatment outcomes. METHODS: Forty-four inpatients from a psychotherapeutic hospital who suffered from a depressive disorder (mean age =36.4 years, standard deviation =13.4 years; 63.6% female) filled in the Emotion Regulation Questionnaire and the Beck Depression Inventory at admission and discharge. To detect changes in emotion regulation, and depression across treatment, data were analyzed using multivariate analyses of variance (MANOVA) for repeated measures, effect sizes, and Spearman correlations. A P-value of ≤0.05 was considered statistically significant. RESULTS: Depression severity (F[1]=10.42, P=0.003; η(2) =0.22) and CR (F[1]=4.71, P=0.04; η(2) =0.11) changed significantly across CBT treatment. ES remained virtually stable. Post-treatment scores of CR were also positively correlated with reduction in depressive symptoms across treatment (ρ=0.30, P=0.05). CONCLUSION: The results suggest that CBT affects emotion regulation in depressive inpatients only for CR and that higher post-treatment scores in CR were related to greater reduction in depressive symptoms across treatment.

The relation of cognitive reappraisal and expressive suppression to suicidal ideation and suicidal desire.

The differential relations between the emotion regulation strategies "cognitive reappraisal" and "expressive suppression" and suicidality in a mixed inpatient sample (N = 232, 69.4% female) of a German psychotherapeutic hospital were examined. Patients filled in the Emotion Regulation Questionnaire and items on suicidal ideation and desire. A structural equation model fitted the data (RMSEA = .044; CFI = .96) and revealed that "expressive suppression" significantly predicted increased suicidal ideation. Moderation analysis showed that results were independent from a current depressive episode. Potential implications for psychotherapeutic treatment of suicidality are discussed.

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.

[Assessing desire for suicide: first results on psychometric properties of the German version of the Interpersonal Needs Questionnaire (INQ)]. / Die Erfassung von Suizidwünschen: Erste psychometrische Befunde zur deutschen Version des Interpersonal Needs Questionnaire (INQ).

OBJECTIVES: The Interpersonal Needs Questionnaire (INQ) assesses desire for suicide according to the Interpersonal Theory of Suicide. Psychometric properties of the German version of the INQ are investigated. METHODS: The INQ was applied in a sample of 281 undergraduate students to investigate dimensionality, reliability and validity. RESULTS: The 2-factorial structure of the original version was confirmed for the German version of the INQ in this sample. The subscales "Perceived Burdensomeness" (α = 0.88) and "Thwarted Belongingness" (α = 0.83) show very good internal consistencies. Both subscales show medium range correlations with depressiveness. There are significantly higher levels of "Perceived Burdensomeness" and "Thwarted Belongingness" in participants with current suicidal ideation or prior suicidal or self-injuring behaviour. CONCLUSION: These findings show that the German version of the INQ has good psychometric properties. Further research is needed to replicate these findings in clinical samples, and to test the utility of the INQ in predicting and preventing suicidal behaviour in patients at risk.

A mediation model of mindfulness and decentering: sequential psychological constructs or one and the same?

BACKGROUND: Mindfulness and decentering are closely related processes both assumed to promote well-being. While some researchers claim that mindfulness and decentering can be clearly differentiated others suggest to use these concepts interchangeably. The precise relation between mindfulness and decentering remains unclear and therefore the present study aims to determine the relation between mindfulness and decentering. METHODS: In a structural equation modeling framework, a mediation model was tested among a sample group of 495 university students (average age 20.8 years, 30.3% female). RESULTS: The identified model shows an acceptable fit to the data and illustrates the role of decentering as a mediator of the relationship between mindfulness and depressive symptoms by complementary mediation and indirect-only mediation. CONCLUSION: The present results cannot sustain previous research, which converted mindfulness and decentering into one single variable. Rather the data suggests to treat mindfulness and decentering as two separable concepts and to regard decentering as an important working mechanism of mindfulness.

The negative affect repair questionnaire: factor analysis and psychometric evaluation in three samples.

BACKGROUND: Negative affect and difficulties in its regulation have been connected to several adverse psychological consequences. While several questionnaires exist, it would be important to have a theory-based measure that includes clinically relevant items and shows good psychometric properties in healthy and patient samples. This study aims at developing such a questionnaire, combining the two Gross [1] scales Reappraisal and Suppression with an additional response-focused scale called Externalizing Behavioral Strategies covering clinically relevant items. METHODS: The samples consisted of 684 students (mean age = 23.3, SD = 3.5; 53.6% female) and 369 persons with mixed mental disorders (mean age = 36.0 SD = 14.6; 71.2% female). Items for the questionnaire were derived from existing questionnaires and additional items were formulated based on suggestions by clinical experts. All items start with "When I don't feel well, in order to feel better…". Participants rated how frequently they used each strategy on a 5-point Likert scale. Confirmatory Factor Analyses were conducted to verify the factor structure in two separate student samples and a clinical sample. Group comparisons and correlations with other questionnaires were calculated to ensure validity. RESULTS: After modification, the CFA showed good model fit in all three samples. Reliability scores (Cronbach's α) for the three NARQ scales ranged between .71 and .80. Comparisons between students and persons with mental disorders showed the postulated relationships, as did comparisons between male and female students and persons with or without Borderline Personality Disorder. Correlations with other questionnaires suggest the NARQ's construct validity. CONCLUSIONS: The results indicate that the NARQ is a psychometrically sound and reliable measure with practical use for therapy planning and tracking of treatment outcome across time. We advocate the integration of the new response-focused strategy in the Gross's model of emotion regulation.

The Clinical Global Impression Scale and the influence of patient or staff perspective on outcome.

BACKGROUND: Since its first publication, the Clinical Global Impression Scale (CGI) has become one of the most widely used assessment instruments in psychiatry. Although some conflicting data has been presented, studies investigating the CGI's validity have only rarely been conducted so far. It is unclear whether the improvement index CGI-I or a difference score of the severity index CGI-S (dif) is more valid in depicting clinical change. The current study examined the validity of these two measures and investigated whether therapists' CGI ratings correspond to the view the patients themselves have on their condition. METHODS: Thirty-one inpatients of a German psychotherapeutic hospital suffering from a major depressive disorder (age M = 45.3, SD = 17.2; 58.1% women) participated. Patients filled in the Beck Depression Inventory (BDI). CGI-S and CGI-I were rated from three perspectives: the treating therapist (THER), the team of therapists involved in the patient's treatment (TEAM), and the patient (PAT). BDI and CGI-S were filled in at admission and discharge, CGI-I at discharge only. Data was analysed using effect sizes, Spearman's ρ and intra-class correlations (ICC). RESULTS: Effect sizes between CGI-I and CGI-S (dif) ratings were large for all three perspectives with substantially higher change scores on CGI-I than on CGI-S (dif). BDI (dif) correlated moderately with PAT ratings, but did not correlate significantly with TEAM or THER ratings. Congruence between CGI-ratings from the three perspectives was low for CGI-S (dif) (ICC = .37; Confidence Interval [CI] .15 to .59; F(30,60) = 2.77, p < .001; mean ρ = 0.36) and moderate for CGI-I (ICC = .65 (CI .47 to .80; F(30,60) = 6.61, p < .001; mean ρ = 0.59). CONCLUSIONS: Results do not suggest a definite recommendation for whether CGI-I or CGI-S (dif) should be used since no strong evidence for the validity of neither of them could be found. As congruence between CGI ratings from patients' and staff's perspective was not convincing it cannot be assumed that CGI THER or TEAM ratings fully represent the view of the patient on the severity of his impairment. Thus, we advocate for the incorporation of multiple self- and clinician-reported scales into the design of clinical trials in addition to CGI in order to gain further insight into CGI's relation to the patients' perspective.