[Better Sleep and Less Pain? Sleep Training in Orthopedic Rehabilitation]. / Besserer Schlaf und weniger Schmerzen? Schlaftraining in der orthopädischen Rehabilitation.

PURPOSE: There is high comorbidity between chronic pain and insomnia. Not only does chronic pain impair sleep, poor sleep quality can also exacerbate the sensation of pain. However, usually, the respective symptoms are treated separately. We evaluate a new cognitive behavioral sleep-pain-training aiming at improving symptoms of both insomnia and chronic pain in the setting of ambulant orthopedic rehabilitation. METHODS: N=41 patients participated in the study (with 15 participants being enrolled in the control group). The training consists of 4 modules á 90min and was explicitly developed for patients suffering from chronic pain and comorbid insomnia. It includes several methods of cognitive behavioral therapy for the treatment of insomnia and pain (e. g., sleep hygiene, sleep restriction, sleep-pain-protocol, cognitive restructuring) and specifically addresses the relationship between the two. Sleep quality, sleep related thoughts (focusing, rumination), internal health locus of control, pain intensity (day and night) as well as pain related thoughts (pain related anxiety, pain related depression/helplessness) were assessed pre and post training by means of a questionnaire. RESULTS: Mixed ANOVAS revealed small (η²=: 0,010) to medium (η²=: 0,068) interaction effects for most dependent variables (sleep quality, sleep efficiency, focusing, rumination, internal health locus of control, average day and night pain, maximum night pain, pain related anxiety and pain related depression/helplessness) for the interaction of time and group. However, effects for rumination and average day pain were not significant. There was no interaction effect for maximum day pain. Effect sizes for single group analyses revealed medium (internal sleep locus of control: d=0,52) to large (sleep quality: d=1,73) significant effects for the training group and no (focusing: d=0,00) to small (maximum day pain: d=-0,43) and non-significant effects for the control group. CONCLUSION: The training analyzed in this study may constitute a complement to existing treatment possibilities for patients suffering from chronic pain and should be further evaluated in larger samples.

The Everyday Moral Judge - Autobiographical Recollections of Moral Emotions.

Moral emotions are typically elicited in everyday social interactions and regulate social behavior. Previous research in the field of attribution theory identified ought (the moral standard of a given situation or intended goal), goal-attainment (a goal can be attained vs. not attained) and effort (high vs. low effort expenditure) as cognitive antecedents of moral emotions. In contrast to earlier studies, mainly relying on thought experiments, we investigated autobiographical recollections of N = 312 participants by means of an online study. We analyzed a diverse range of moral emotions, i.e., admiration, anger, contempt, indignation, pride, respect, schadenfreude, and sympathy, by using a mixed-method approach. Qualitative and quantitative methods clearly corroborate the important role of ought, goal-attainment, and effort as eliciting conditions of moral emotions. Furthermore, we built categorical systems based on our participants' descriptions of real-life situations, allowing for more fine-grained distinctions between seemingly similar moral emotions. We thus identify additional prerequisites explaining more subtle differences between moral emotion clusters as they emerge from our analyses (i.e., cluster 1: admiration, pride, and respect; cluster 2: anger, contempt, and indignation; cluster 3: schadenfreude and sympathy). Results are discussed in the light of attributional theories of moral emotions, and implications for future research are derived.

Daniel has fallen into a muddy puddle--schadenfreude or sympathy?

The present study investigated the experience of schadenfreude among children. Participants were 4- to 8-year-old children (n = 100) who were told stories of another child experiencing a misfortune while pursuing a morally positive versus morally negative goal. Schadenfreude, sympathy, and helping behaviour towards the suffering child were assessed. Results showed that beginning at the age of 4, emotional and behavioural reactions towards a misfortune of another child were predicted by the moral valence of the other child's goal. Furthermore, morally negative goals decreased helping behaviour and morally positive goals increased helping behaviour. Multilevel mediation analysis revealed that the relation between goal valence and helping behaviour was mediated by both schadenfreude and sympathy. However, those effects were especially pronounced in older children.