Risk factors for internalizing symptoms: The influence of empathy, theory of mind, and negative thinking processes.

Internalizing symptoms such as elevated stress and sustained negative affect can be important warning signs for developing mental disorders. A recent theoretical framework suggests a complex interplay of empathy, theory of mind (ToM), and negative thinking processes as a crucial risk combination for internalizing symptoms. To disentangle these relationships, this study utilizes neural, behavioral, and self-report data to examine how the interplay between empathy, ToM, and negative thinking processes relates to stress and negative affect. We reanalyzed the baseline data of N = 302 healthy participants (57% female, Mage = 40.52, SDage = 9.30) who participated in a large-scale mental training study, the ReSource project. Empathy and ToM were assessed using a validated fMRI paradigm featuring naturalistic video stimuli and via self-report. Additional self-report scales were employed to measure internalizing symptoms (perceived stress, negative affect) and negative thinking processes (rumination and self-blame). Our results revealed linear associations of self-reported ToM and empathic distress with stress and negative affect. Also, both lower and higher, compared to average, activation in the anterior insula during empathic processing and in the middle temporal gyrus during ToM performance was significantly associated with internalizing symptoms. These associations were dependent on rumination and self-blame. Our findings indicate specific risk constellations for internalizing symptoms. Especially people with lower self-reported ToM and higher empathic distress may be at risk for more internalizing symptoms. Quadratic associations of empathy- and ToM-related brain activation with internalizing symptoms depended on negative thinking processes, suggesting differential effects of cognitive and affective functioning on internalizing symptoms. Using a multi-method approach, these findings advance current research by shedding light on which complex risk combinations of cognitive and affective functioning are relevant for internalizing symptoms.

Differential reduction of psychological distress by three different types of meditation-based mental training programs: A randomized clinical trial

Objective: There is little knowledge about which types of meditation-based training are effective for alleviating which facets of psychological distress. We investigated shared and specific effects of three meditation-based training programs on distress. Method: 332 healthy adults were assigned to a retest control cohort or to one of three 3-month mental training cohorts including: the cultivation of mindfulness-based attention (Presence), socio-affective skills such as compassion (Affect), or metacognitive skills such as perspective taking (Perspective). A battery of 68 self-reported distress measures was collected. Data were analyzed using machine learning methods, identifying the cohort allocation based on distress change scores. Results: Supporting only specific and not shared alleviation effects, the classifiers identified significantly above chance Presence from Affect and Affect from Perspective, but they did not identify the training cohorts from the retest cohorts. Conclusions: The classifiers revealed stable module-associated distress change profiles, which could help to precisely choose meditation-based interventions to target individuals’ specific distress patterns. (AU)

Differential reduction of psychological distress by three different types of meditation-based mental training programs: A randomized clinical trial.

Objective: There is little knowledge about which types of meditation-based training are effective for alleviating which facets of psychological distress. We investigated shared and specific effects of three meditation-based training programs on distress. Method: 332 healthy adults were assigned to a retest control cohort or to one of three 3-month mental training cohorts including: the cultivation of mindfulness-based attention (Presence), socio-affective skills such as compassion (Affect), or metacognitive skills such as perspective taking (Perspective). A battery of 68 self-reported distress measures was collected. Data were analyzed using machine learning methods, identifying the cohort allocation based on distress change scores. Results: Supporting only specific and not shared alleviation effects, the classifiers identified significantly above chance Presence from Affect and Affect from Perspective, but they did not identify the training cohorts from the retest cohorts. Conclusions: The classifiers revealed stable module-associated distress change profiles, which could help to precisely choose meditation-based interventions to target individuals' specific distress patterns.

A multicenter feasibility study on implementing a brief mindful breathing exercise into regular university courses.

Practicing mindfulness is associated with stress reduction and with positive effects in the context of learning and teaching. Although effects on student populations have been studied extensively, there are few studies implementing mindfulness exercises in university courses directly. For this reason, we aimed to investigate whether the use of a brief mindfulness exercise in regular university courses, guided by the lecturers, is feasible and has immediate effects on the students' mental states. We conducted a preregistered multicenter study with one observational arm, following an ABAB design. In total, N = 325 students from 19 different university courses were included at baseline and n = 101 students at post measurement. Students were recruited by N = 14 lecturers located in six different universities in Germany. Lecturers started their courses either by guiding a brief mindfulness exercise (intervention condition) or as they regularly would, with no such exercise (control condition). In both conditions, the mental states of students and lecturers were assessed. Over the semester, n = 1193 weekly observations from students and n = 160 observations from lecturers were collected. Intervention effects were analyzed with linear mixed-effects models. The brief mindfulness exercise, compared to no such exercise, was associated with lower stress composite scores, higher presence composite scores, higher motivation for the courses, as well as better mood in students. Effects persisted throughout a respective course session. Lecturers also reported positive effects of instructing mindfulness. Implementing a brief mindfulness exercise in regular university teaching sessions is feasible and has positive effects on both students and lecturers.

Social Factors Predict Distress Development in Adults With Pre-existing Mental Disorders During the Coronavirus Disease 2019 Pandemic.

Physical distancing measures during the coronavirus pandemic are associated with increased psychological distress, especially in people with mental disorders. We investigated which social risk and resilience factors influence distress over time in people with pre-existing mental disorders. We conducted a longitudinal online survey with weekly follow-ups between April and July 2020 (n = 196 individuals with, and n = 545 individuals without pre-existing mental disorders at baseline). Our results show that individuals with, but not those without pre-existing mental disorders displayed higher distress levels when social resources and empathic disconnection are low and perceived social isolation is high. The distress development differed between participants with and without pre-existing mental disorders depending on their level of social resources, empathic disconnection, and perceived social isolation. These findings offer specific information for targeted social interventions to prevent an increase in incidence of mental disorders during physical distancing measures.

Evaluation of a brief cognitive behavioral group intervention to reduce depersonalization in students with high levels of trait test anxiety: a randomized controlled trial.

Background and objectives: Students with high levels of test anxiety frequently experience depersonalization during examinations. We investigated whether a brief cognitive behavioral group intervention reduces these symptoms.Design: Randomized controlled trial.Methods: Students with high levels of trait test anxiety and impairing depersonalization symptoms during their last oral examination were randomized. While the intervention group (n = 22) received a group training, a control group (n = 16) underwent an active waiting time protocol. Effects of the intervention on depersonalization severity and its appraisal, attention focus, emotion regulation, anxiety, heart rate, and heart rate variability within the Trier Social Stress Test for groups were examined. A follow-up assessment was conducted after a university oral examination. Registration number: DRKS00010190.Results: Depersonalization and its appraisal significantly changed within the intervention group, but not within the control group. The intervention group reported significantly less self-focused attention and fear and used the coping strategy reappraisal significantly more often. No significant Group × Time interaction was detected regarding heart rate and heart rate variability. Follow-up results give a first indication of the reduction of depersonalization through the intervention in a naturalistic setting.Conclusion: The intervention seems promising for treating depersonalization in students with high levels of trait test anxiety.