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Objectives While self-compassion (SC) has mostly been understood as a stable trait-like property, growing evidence suggests that it may fluctuate over time within a given individual. However, little is known on how these fluctuations relate to affective well-being and affective dynamics, such as emotional inertia and stress reactivity in daily life. Methods A sample of 119 non-clinical individuals (mean age: 31.3 years, 53.8% female) completed a 7-day smartphone-based ecological momentary assessment study with six semi-random signals per day. With each signal, individuals reported their momentary positive affect (PA) and negative affect (NA), recent SC, and occurrence and perceived strain of daily hassles since the last signal. Results Whenever individuals reported higher recent SC than usual, they experienced higher momentary PA and lower momentary NA. Moreover, higher recent SC related to lower stress reactivity in terms of lower decrease of PA and lower increase of NA following the experience of daily hassles. No associations between SC and emotional inertia were found. When distinguishing between the positive components (SC-Pos) and negative components (SC-Neg) of SC, SC-Neg (compared to SC-Pos) was more strongly connected to NA, while SC-Pos and SC-Neg were similarly connected to PA. SC-Pos was associated with an attenuated NA stress reactivity, and SC-Neg with an increased NA stress reactivity. SC-Pos and SC-Neg did not significantly moderate PA stress reactivity nor emotional inertia. Conclusions Results show that the benefits of SC for well-being and stress reactivity may unfold whenever we treat ourselves with compassion, irrespective of how self-compassionate we are in general.

Recent research has demonstrated the adaptiveness of variability in emotion regulation (ER) by showing that variability between and, when controlled for depression, within ER strategies as assessed via the standard deviation was associated with less negative affect. We first replicated associations with negative affect by using the relative standard deviation, which is less confounded with the mean. Second, following research on affect dynamics, we extended this line of research by examining five additional ER dynamic measures covering ER instability, inertia, predictability, differentiation, and diversity. Reanalyzing data from five ambulatory assessment data sets (N = 717), we found that (a) the eight ER dynamic measures loaded on five factors that explained unique variance, (b) most ER dynamic measures had good reliabilities, and (c) between-strategy mean endorsement was positively, whereas between-strategy variability and ER predictability were negatively associated with negative affect. These results suggest that the variable but predictable use of emotion regulation strategies in daily life is beneficial for individuals' affective well-being in daily life. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

ZusammenfassungDas Stresserleben durch die Erkrankung Diabetes mellitus stellt für einen Großteil der betroffenen Personen oft eine deutliche Belastung dar, die sich negativ auf das Diabetes-Selbstmanagement und damit auf die Gesundheit der Betroffenen auswirken kann. Das Ziel der vorliegenden Studie war die Evaluation einer diabetesspezifischen kognitiv-verhaltenstherapeutischen Gruppentherapie zur Reduktion des Stresserlebens, bestehend aus sechs Sitzungen für Personen mit Typ-1- oder Typ-2-Diabetes. Vermittelt wurden Techniken zur Stressbewältigung, wie Achtsamkeit und Entspannungsübungen, sowie kognitive Techniken, die auf den Alltag mit der Diabeteserkrankung und damit verbundene Gedanken und Emotionen der Teilnehmenden bezogen waren. Von 52 Personen (51,9% mit Typ-1-Diabetes, 61,5% weiblich, Alter MW= 50,4 Jahre) lagen nach Studienteilnahme Fragebögen vor. Eine signifikante Verbesserung konnte im Problem Areas In Diabetes Questionnaire (Δ6.24 [95%-KI: 1.85–10.62], p=.006), dem Perceived Stress Survey (Δ2.93 [95%-KI: 1.59–4.26], p=.000) und der Diabetes Acceptance Scale (Δ5.5 [95%-KI: 9.07–1.93], p=.003) erreicht werden. Diese erwies sich auch im Follow-Up nach sechs Monaten als stabil. Der selbstberichtete HbA1c-Wert reduzierte sich im Befragungszeitraum bei der Teilstichprobe von N= 40, von der die Daten verfügbar waren, ebenfalls signifikant (Δ0.73 [95%-KI: 0.015–1.452], p=.046). Das Gruppentherapieprogramm zur Stressreduktion kann als eine niedrigschwellige, psychotherapeutische Interventionen zur Reduktion diabetesbezogener Belastungen angesehen werden. Es könnte ein hilfreiches primär- und sekundärpräventives Angebot für stressbelastete Menschen mit Diabetes in der Standardversorgung darstellen.

Unter Diabetes mellitus wird eine Reihe endokriner Störungen zusammengefasst, die den Kohlenhydratstoffwechsel beeinträchtigen. Leitsymptom sind erhöhte Blutglukosewerte (Hyperglykämie), die sich bei einem unbehandelten Diabetes mellitus einstellen. Diabetes mellitus gilt berechtigterweise als verhaltensmedizinische Modellerkrankung: Das Zusammenspiel von psychosozialen und Verhaltensfaktoren, der Diabetes-Selbstbehandlung und medizinischen Faktoren ist entscheidend für die Prognose der Erkrankung. Nicht zuletzt aufgrund stetig steigender Fallzahlen werden Psychotherapeutinnen und Psychotherapeuten in der Praxis immer häufiger Menschen mit Diabetes behandeln, und sich daher mit diabetesspezifischen Problemfeldern ebenso wie mit diabetesspezifischen Besonderheiten in der Therapie psychischer Störungen bei komorbidem Diabetes konfrontiert sehen. Der Band gibt einen aktuellen und praxisorientierten Überblick über zentrale psychosoziale Themen, wie diabetesbezogenen Belastungen (Diabetes-Distress) und die Krankheitsakzeptanz, sowie über Besonderheiten bei der Diagnostik und Behandlung psychischer Störungen bei Diabetes mellitus. Notwendiges Basiswissen zu medizinischen Grundlagen und zur Behandlung des Diabetes mellitus wird anschaulich vermittelt. Neben diabetesspezifischen Problemfeldern, wie z.B. der Hypoglykämieangst oder der beeinträchtigten Hypoglykämiewahrnehmung, werden insbesondere Essstörungen und Depression bei Diabetes thematisiert und Spezifika in deren Diagnostik und Behandlung herausgestellt.

Background Policy frameworks focusing on policy implementation may vary in terms of their scope, included constructs, relationships between the constructs, and context factors. Although multiple policy implementation frameworks exist, the overarching synthesis characterizing differences between the frameworks is missing. This study investigated frameworks guiding implementation of policies aiming at healthy nutrition, physical activity promotion, and a reduction of sedentary behavior. In particular, we aimed at examining the scope of the frameworks and the content of included constructs (e.g., referring to implementation processes, determinants, or implementation evaluation), the level at which these constructs operate (e.g., the individual level, the organizational/community level), relationships between the constructs, and the inclusion of equity factors. Methods A systematic review (the PROSPERO registration no. CRD42019133251) was conducted using 9 databases and 8 stakeholder websites. The content of 38 policy implementation frameworks was coded and analyzed. Results Across the frameworks, 47.4% (18 in 38) addressed three aims: description of the process, determinants, and the evaluation of implementation. The majority of frameworks (65.8%; 25 in 38) accounted for constructs from three levels: individual, organizational/community, and the system level. System-level constructs were included less often (76.3%; 29 in 38) than individual-level or organizational/community-level constructs (86.8% [33 in 38 frameworks] and 94.7% [36 in 38 frameworks] respectively). The majority of frameworks (84.2%, 32 in 38) included at least some sections that were solely of descriptive character (a list of unassociated constructs); 50.0% (19 in 38) included sections of prescriptive character (general steps of implementation); 60.5% (23 in 38) accounted for explanatory sections (assuming bi- or uni-directorial associations). The complex system approach was accounted for only in 21.1% (8 in 38) of frameworks. More than half (55.3%; 21 in 38) of frameworks did not account for any equity constructs (e.g., socioeconomic status, culture). Conclusions The majority of policy implementation frameworks have two or three aims (combining processes, determinants and/or the evaluation of implementation), include multi-level constructs (although the system-level determinants are less frequently included than those from the individual- or organizational/community-level), combine sections of purely descriptive character with sections accounting for prescriptive and/or explanatory associations, and are likely to include a little or no equity constructs. Registration PROSPERO, #CRD42019133251.

Depression und Demenz sind angesichts ihrer hohen Pravalenz im hoheren Lebensalter und aufgrund ihrer gravierenden Auswirkungen auf das Diabetesselbstmanagement und die Lebensqualitat bedeutsame Komorbiditaten des Diabetes im Alter, die sowohl bei der Diagnostik als auch in der Behandlung alterer Menschen berucksichtigt werden mussen. Der vorliegende Beitrag gibt einen Uberblick uber die Epidemiologie, die physiologischen Grundlagen, die Diagnostik und die Besonderheiten der Therapie von Depression und Demenz bei alteren Menschen mit Diabetes sowie uber die Komorbiditat dieser Erkrankungen.

Research on ego depletion has often relied on the dual-task setting employing short tasks with low ecological validity. The comparatively few studies on ego depletion in daily life so far used diverging operationalization and yielded ambiguous results. We argue that fundamental research on short-term self-control limitations can benefit from research on the limit violation effect, which highlights the danger to self-control when setbacks are attributed to internal causes. To test the role of setbacks and compare different ego depletion operationalizations in daily life, we used data from two ambulatory assessment studies ( N = 125 and 205). No consistent ego depletion effects were observed in Study 1; instead, momentary self-control success was only impaired after setbacks (prior self-control efforts failed). The role of prior setbacks was replicated in Study 2, highlighting the importance of setbacks in subsequent self-control efforts beyond mere resisting, which should be incorporated in interventions targeting self-control improvements.

Although the importance of contextual factors is often recognised, research on emotion regulation strategies (ERS) has mainly focused so far on the effectiveness of ERS across situations. In the present research, we tested the strategy-situation fit hypothesis, which does not assume general effectiveness of ERS but instead stresses the importance of the congruency between ERS and the contexts in which they are used. Using a longitudinal Ambulatory Assessment dataset (

Background. COVID-19 research has relied heavily on convenience-based samples, which—though often necessary—are susceptible to important sampling biases. We begin with a theoretical overview and introduction to the dynamics that underlie sampling bias. We then empirically examine sampling bias in online COVID-19 surveys and evaluate the degree to which common statistical adjustments for demographic covariates successfully attenuate such bias. Methods. We analysed responses to identical questions from three convenience and three largely representative samples (total N = 13,731) collected online in Canada within the International COVID-19 Awareness and Responses Evaluation Study (www.icarestudy.com). We compared samples on 11 behavioural and psychological outcomes (e.g., adherence to COVID-19 prevention measures, vaccine intentions) across three time points and employed multiverse-style analyses to examine how 512 combinations of demographic covariates (e.g., sex, age, education, income, ethnicity) impacted sampling discrepancies on these outcomes.Results. Significant discrepancies emerged between samples on 73% of outcomes. Participants in the convenience samples held more positive thoughts towards and engaged in more COVID-19 prevention behaviours. Covariates attenuated sampling differences in only 55% of cases and increased differences in 45%. No covariate performed reliably well. Conclusion. Our results suggest that online convenience samples may display more positive dispositions towards COVID-19 prevention behaviours being studied than would samples drawn using more representative means. Adjusting results for demographic covariates frequently increased rather than decreased bias, suggesting that researchers should be cautious when interpreting adjusted findings. Using multiverse-style analyses as extended sensitivity analyses is recommended.

IntroductionDisordered eating behaviours (DEB) and eating disorders (ED) are among the most common mental health comorbidities of type 1 diabetes. However, research on diabetes-specific risk and protective factors is limited. To this end, comprehensive characterisations of DEB and ED in type 1 diabetes, as well as longitudinal research on the course of DEB and ED, are needed to gain more insight. The ‘Disordered eating behaviours and eating disorders in diabetes type I’ (DEBBI) study aims to describe DEB/ED and their correlates in people with type 1 diabetes, to identify key diabetes-specific, psychosocial risk and protective factors, and to describe the course of DEB over time.Methods and analysisThe DEBBI study is a longitudinal online survey with follow-up assessments after 6, 12 and 18 months, targeted at adults who have been diagnosed with type 1 diabetes for at least 12 months. The survey covers data on diabetes diagnosis and self-management (eg, diabetes treatment and complications), lifestyle (eg, eating habits, physical activity), psychosocial well-being (eg, anxiety, depressive symptoms) and demographic and medical information. It includes validated instruments and self-generated items. One key aspect of the data analysis will be latent profile analyses to determine latent subtypes of DEB manifestation in people with type 1 diabetes and their courses over time, including data on the clinical picture and symptoms, behaviours and diabetes-specific complications.Ethics and disseminationThe study protocol was approved by the Ethics Committee of the State Medical Chamber of Rhineland-Palatine, Germany (ID 2021-16040). Participants give informed written consent before starting the survey. The DEBBI study will provide more clarity in the so far inconsistent empirical evidence base and will help to inform research on prevention and intervention strategies that are tailored to diabetes-specific needs.Trial registration numberThe study is registered with DRKS German Clinical Trials Register (DRKS00028833).

Research based on the process model of emotion regulation has largely focused on affective outcomes of four prominent emotion regulation strategies: distraction, rumination, reappraisal, and suppression. We identified two areas that are relatively understudied regarding the prediction of affect in daily life: (a) comparing the importance of these four strategies to the subjective experience of event intensity and (b) including additional emotion regulation strategies that focus more on positive than negative affect. In two ecological momentary assessment data sets (Nindividuals = 299), we found that event intensity explained an average of 14.8% (4.9% to 25.9%) of the total variance in momentary affect above the variance explained by emotion regulation strategies. In turn, emotion regulation strategies explained an average of 8.3% (2.4% to 19.6%) in additional total variance in momentary affect. The added predictive power of emotion regulation strategies above event intensity was improved when strategies more specific to positive affect (ΔR² = 5.1%) were included. These results highlight avenues for future research that include strategies that focus on the selection and modification of an emotionally relevant situation and on positive affect. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Aims In this systematic review, we aimed (1) to identify and describe research investigating the use of advanced diabetes technologies (continuous subcutaneous insulin infusion, CSII; continuous glucose monitoring, CGM; automated insulin delivery, AID) in people with type 1 diabetes (T1DM) and disordered eating and (2) to discuss potential (dis)advantages of diabetes technology use in this population, derived from previous research. Methods We conducted a systematic literature search in two electronic databases for English language articles published between 2000 and 2020 addressing eating disorders and/or dysfunctional eating behaviours and diabetes technology use in children, adolescents and adults with T1DM (PROSPERO ID CRD42020160244). Results Of 70 publications initially identified, 17 were included. Overall, evidence on the use of diabetes technologies in people with T1DM and disordered eating is scarce. The majority of the studies reports findings on CSII in people with T1DM and dysfunctional eating behaviours or eating disorders. Findings predominantly stem from observational data and are, in most cases, secondary findings of the respective studies. Providing the greatest flexibility in diabetes management, CSII may have benefits in disordered eating. CGM data may complement the diagnostic process of disordered eating with a physiological indicator of insulin restriction (i.e., time spent in hyperglycaemia). Conclusions Results on possible (dis)advantages of diabetes technology use in people with T1DM and disordered eating are based on observational data, small pilot trials and anecdotical evidence from case reports. Prospective data from larger samples are needed to reliably determine potential effects of diabetes technology on disordered eating in T1DM.

Abstract. Background. The glucose hypothesis of self-control posits that acts of self-control may draw upon glucose as a source of energy, leading to a decrease in blood glucose levels after exerting self-control, mirroring the temporary depletion of self-control, but supporting evidence is mixed and inconclusive. This might partly be due to using methods that are not suitable to reliably quantify glucose utilization. Aims. We aimed at examining whether self-control exertion leads to an increase in glucose utilization. Method. In a sample of N = 30 healthy participants (50% women, age 26.5 ± 3.5 years) we combined a hyperinsulinemic euglycemic glucose clamp (a well-established and validated procedure in experimental endocrinology to reliably quantify systemic glucose utilization) with a standard self-control dual-task paradigm. In the first task, the experimental group completed a variation of a paper-and-pencil crossing out letter task (COLT) that demanded self-control; the control group completed a variation of the COLT that did not demand self-control. The second task for both groups was a computerized two-color word Stroop which demanded self-control. Results. We did not find a significant main effect for time, nor a time × group interaction with respect to glucose utilization, which indicates that glucose utilization did not differ significantly over time or between groups. Limitations. Due to the time-consuming and complicated clamp method, our sample was rather small. Conclusion. Our results revealed little evidence for the notion that self-control efforts are associated with a relevant increase in peripheral glucose utilization.

Abstract. Evidence on the existence of the ego depletion phenomena as well as the size of the effects and potential moderators and mediators are ambiguous. Building on a crossover design that enables superior statistical power within a single study, we investigated the robustness of the ego depletion effect between and within subjects and moderating and mediating influences of the ego depletion manipulation checks. Our results, based on a sample of 187 participants, demonstrated that (a) the between- and within-subject ego depletion effects only had negligible effect sizes and that there was (b) large interindividual variability that (c) could not be explained by differences in ego depletion manipulation checks. We discuss the implications of these results and outline a future research agenda.

This study examined whether an ultra-brief mindfulness (UBM) training can change state mindfulness and perceived state self-control in daily life (primary outcomes), ultimately improving habitual mindfulness and perceived self-control (secondary outcomes). To gain a better understanding of the beneficial effects of practising mindfulness, the study additionally examined how mindfulness and self-control were related to each other during the training. The randomised controlled trial combined a 40-day ecological momentary assessment with seven weekly surveys. Undergraduate students (Nenrolled = 137, 104 females, Mage = 23.08, SD = 5.04 years), were either assigned to the UBM training (n = 68) or wait-list control condition (n = 69). Primary outcomes were assessed six times a day using ecological momentary assessments (7-point scales). Secondary outcomes were measured weekly (6-point scales). A breath counting task at pre- and post-training was an additional behavioural measure of mindfulness. An intention-to-treat multivariate mixed model identified day-to-day training effects (group × days-interaction) on state mindfulness (b = .005, p = .001) and perceived state self-control (b = .007, p < .001). A mediation analysis revealed that state mindfulness mediated the training effect on perceived state self-control (b = .001, p < .001). Habitual mindfulness (b = .049, p < .001) and breath counting task performance (b = 2.446, p = .043) also improved with training whereas habitual perceived self-control did not. These findings suggest that state mindfulness and perceived state self-control may be interconnected in daily life and may be similarly improved through an UBM training. NCT02647801

The large body of research used to support ego–depletion effects is currently faced with conceptual and replication issues, leading to doubt over the extent or even existence of the ego–depletion effect. By using within–person designs in a laboratory (Study 1; 187 participants) and an ambulatory assessment study (Study 2; 125 participants), we sought to clarify this ambiguity by investigating whether prominent situational variables (such as motivation and affect) or personality traits can help elucidate when ego depletion can be observed and when not. Although only marginal ego–depletion effects were found in both studies, these effects varied considerably between individuals, indicating that some individuals experience self–control decrements after initial self–control exertion and others not. However, neither motivation nor affect nor personality traits such as trait self–control could consistently explain this variability when models were applied that controlled for variance due to targets and the depletion manipulation (Study 1) or days (Study 2) as well as for multiple testing. We discuss how the operationalization and reliability of our key measures may explain these null effects and demonstrate that alternative metrics may be required to study the consequences of the consecutive exertion of self–control. © 2019 European Association of Personality Psychology

ZusammenfassungResilienz bezeichnet die Aufrechterhaltung bzw. rasche Wiederherstellung der psychischen Gesundheit während oder nach stressvollen Lebensumständen. Aktuelle Forschungsergebnisse legen nahe, dass Resilienz dynamisch ist und trainiert werden kann. Obwohl Interventionen zur Stärkung der Resilienz häufig zur Gesundheitsförderung bei verschiedenen Zielgruppen eingesetzt werden, ist deren Effektivität jedoch kaum systematisch untersucht. Diese Übersichtsarbeit beurteilt narrativ die Ergebnisse 4 systematischer Reviews und Metaanalysen zu Resilienzinterventionen bei Erwachsenen und fasst die Evidenz aus den randomisiert-kontrollierten Primärstudien (N=44) zusammen. Insgesamt erzielten die Resilienzinterventionen kleine bis moderate Effekte bzgl. der Steigerung von Resilienz und der Verbesserung der psychischen Gesundheit. Trotz methodischer Schwächen scheinen Resilienzinterventionen wirksam zu sein und könnten somit eine gute Ergänzung zu aktuellen Präventionsmaßnahmen darstellen.

Background: Diabetes management apps may have positive effects on diabetes self-management. It remains unclear, however, which app features are particularly effective and encourage sustained app usage. Behavior change techniques (BCTs) and gamification are promising approaches to improve user engagement. However, little is known about the frequency BCTs and gamification techniques (GTs) are actually used. This app review aims to provide an overview of BCTs and GTs in current diabetes management apps. Methods: Google’s Play Store was searched for applications using a broad search strategy (keyword: “diabetes”). We limited our research to freely available apps. A total of 56 apps matched the inclusion criteria and were reviewed in terms of the features they offer to support self-management. We used a taxonomy comprising 29 BCTs and 17 GTs to evaluate the applications. Two independent raters tested and evaluated each app. Results: Interrater agreement was high (ICC = .75 for BCTs; ICC = .90 for GTs). An average of 7.4 BCTs (SD = 3.1) and an average of 1.4 out of 17 GTs (SD = 1.6) were implemented in each app. Five out of 29 BCTs accounted for 55.8% of the BCTs identified in total. The GT most often identified was “feedback” and accounted for 50% of the GTs. Conclusions: The potential of BCTs and GTs in diabetes management apps has not been fully exploited yet. Only very restricted sets of BCTs and gamification features were implemented. Systematic research on the efficacy of specific BCTs and GTs is needed to provide further guidance for app design.

Background Although multiple systematic reviews indicate that various determinants (barriers and facilitators) occur in the implementation processes of policies promoting healthy diet, physical activity (PA), and sedentary behavior (SB) reduction, the overarching synthesis of such reviews is missing. Applying the Consolidated Framework for Implementation Research (CFIR), this meta-review aims to (1) identify determinants that were systematically indicated as occurring during the implementation processes and (2) identify differences in the presence of determinants across reviews versus stakeholder documents on healthy diet/PA/SB policies, reviews/stakeholder documents addressing healthy diet policies versus PA/SB policies targeting any population/setting, and healthy diet/PA/SB policies focusing on school settings. Methods A meta-review of published systematic scoping or realist reviews (k = 25) and stakeholder documents (k = 17) was conducted. Data from nine bibliographic databases and documentation of nine major stakeholders were systematically searched. Included reviews (72%) and stakeholder documents (100%) provided qualitative synthesis of original research on implementation determinants of policies promoting healthy diet or PA or SB reduction, and 28% of reviews provided some quantitative synthesis. Determinants were considered strongly supported if they were indicated by ≥ 60.0% of included reviews/stakeholder documents. Results Across the 26 CFIR-based implementation determinants, seven were supported by 66.7–76.2% of reviews/stakeholder documents. These determinants were cost, networking with other organizations/communities, external policies, structural characteristics of the setting, implementation climate, readiness for implementation, and knowledge/beliefs of involved individuals. Most frequently, published reviews provided support for inner setting and individual determinants, whereas stakeholder documents supported outer and inner setting implementation determinants. Comparisons between policies promoting healthy diet with PA/SB policies revealed shared support for only three implementation determinants: cost, implementation climate, and knowledge/beliefs. In the case of healthy diet/PA/SB policies targeting school settings, 14 out of 26 implementation determinants were strongly supported. Conclusions The strongly supported (i.e., systematically indicated) determinants may guide policymakers and researchers who need to prioritize potential implementation determinants when planning and monitoring the implementation of respective policies. Future research should quantitatively assess the importance or role of determinants and test investigate associations between determinants and progress of implementation processes. Trial registration PROSPERO, #CRD42019133341

BACKGROUND A large variety of smartphone-based interventions (SBIs) have emerged recently that aim to contribute to mental healthcare. SBIs that integrate a training of cognitive reappraisal (CR) may be particularly effective. Little is known whether CR as an evidence-based mechanism for mental health promotion is included in SBIs. OBJECTIVE The aim of this study was to systematically evaluate the integration of CR training in recent SBIs for clinical and non-clinical adult populations and meta-analyze their effect on prevalent mental health outcomes (depression, anxiety, perceived stress, and well-being). METHODS A comprehensive literature search in four databases revealed 1,836 unique records, which were screened for eligibility by two independent reviewers. 15 randomized controlled or controlled trials (N = 1406) including an adult sample that received an SBI with CR training and a comparison condition were identified. We performed a random-effects meta-analysis to calculate the standardized mean difference (SMD) between SBIs and control conditions. Subgroup analyses were conducted for sample population (clinical vs. non-clinical) and degree of human support (SBIs with human support vs. SBIs without human support). RESULTS Most of the studies assessed a clinical population, had depression as primary outcome, and were performed without human face-to-face support for the participants. The CR training of all SBIs involved active engagement of the users that was realized with a wide range of multimedia material. We found evidence for a small effect (SMD = –0.21, 95% CI –0.40 to –0.02; P = .04) on mental health (i.e., the reduction of symptoms of mental disorders) in favor of the SBIs including CR, with moderate to substantial heterogeneity (I2 = 60%; Chi2(df) = 35.32 (14); P = .001). The overall quality of the studies was relatively low. Subgroup analyses revealed evidence for larger effect sizes of studies with clinical compared to non-clinical populations. There was no evidence for a subgroup difference between interventions with vs. without human support. CONCLUSIONS CR can successfully be implemented in SBIs and reduce mental health symptoms.

OBJECTIVE Self-control is positively connected to well-being, but less is known about what, on the mechanistic level, explains this association. We hypothesized five pathways how this connection could be explained by emotion regulation, that is, by facilitating (a) strategy effectiveness, (b), adaptive strategy selection, (c) situation selection, (d) strategy variability, or (e) social sharing. METHOD To explore these pathways, we integrated two ambulatory assessment data sets (N = 250 participants, N = 22,796 observations) that included assessments of participants' emotions and their emotion regulation efforts. RESULTS We found that self-control was positively associated with affective well-being. Moreover, momentary but not trait self-control was associated with favoring adaptive and interpersonal strategy selection and less emotion regulation in general as well as with increased variability across strategies. However, these emotion regulation facets could not sufficiently explain the association between self-control and affective well-being. CONCLUSIONS Our main conclusion is that emotion regulation is not a mediator of the strong relation between self-control and affective well-being. Instead, we found evidence for the affective benefits of employing ways of emotion regulation that are less taxing mentally, which we discuss in light of current knowledge about self-control and emotion regulation.

Mindfulness is associated with a wide range of beneficial outcomes such as well-being. However, less is known about the mechanisms underlying these benefits. Some researchers suggest that the benefits could be driven by emotion regulation, either by improving the effectiveness of emotion regulation or by lessening the need for effortful emotion regulation. By using two longitudinal Ambulatory Assessment data sets (

The occurrence of daily hassles is associated with increased subsequent levels of negative affect. Neuroticism has been found to exacerbate this effect. So far, most research used single-item measures for the assessment of daily hassles or relied on daily diary studies. This study aimed to examine the interrelations of daily hassles, negative affect reactivity, and neuroticism in daily life employing an extensive inventory of daily hassles. Seventy participants (18-30 years; M = 23.9 years, 59% female) completed a 4-week smartphone-based ecological momentary assessment study reporting the occurrence and perceived strain of daily hassles as well as negative affect at five semi-random signals between 9 a.m. and 8 p.m. Multilevel analyses revealed significant associations between elevated levels of negative affect and higher cumulative daily hassle strain ratings per signal in concurrent and time-lagged analyses. Contrary to our expectations, there was no moderation by neuroticism on these associations. The results suggest that daily hassles can accumulate in their impact on mood in daily life and exert a prolonged effect on negative affect. The absence of a significant moderation by neuroticism may be interpreted in the light of methodological specifics of this study.

Although prior research has shown a relationship between the Big Five personality factors and trait anger, evidence that links these personality traits to the experience of state anger is rare. The current study investigated the effect of the Big Five personality traits on the state anger experience after a provocation in a staged social interaction and how status differences moderate these personality effects in an academic sample. In the equal status condition (N = 131, 56% female, aged 18 to 37) participants were provoked by a confederate; in the low status condition (N = 125, 55% female, aged 18 to 51) anger was instead provoked by the experimenter. In both conditions, individuals higher in neuroticism experienced more state anger after being provoked. In contrast to our hypotheses, no status effects or interaction effects between personality traits and status condition influenced the anger experience. Our findings illustrate the importance of neuroticism in understanding how people react to provocations in social situations, while status had no impact on the anger experience.

Zusammenfassung Hintergrund Mehr als die Hälfte aller Menschen mit Diabetes in Deutschland ist älter als 65 Jahre. Für eine erfolgreiche Insulinpumpentherapie (Continuous Subcutaneous Insulin Infusion; CSII) im hohen Erwachsenenalter sind Wünsche, Sorgen und Erfahrungen älterer Menschen mit Typ-1-Diabetes, erlebte Barrieren und förderliche Bedingungen von zentraler Bedeutung. Methodik Ältere Menschen mit Typ-1-Diabetes, die sich mit einer CSII behandeln (n = 136), sowie Fachkräfte aus dem Diabetesbereich (Diabetes Health Care Professionals; HCP; n = 96) nahmen an einem Fragebogensurvey teil, in dem anhand zweier offener Fragen Wünsche, Sorgen und Erfahrungen älterer Menschen mit Typ-1-Diabetes erfasst wurden. Durch systematische, induktive Datenreduktion wurden aus den Antworten zentrale Kategorien und Subkategorien identifiziert. Ergebnisse Es konnten vier Inhaltskategorien abgeleitet werden: (1) Fremdhilfe, (2) Technische Innovation, (3) Gesundheitspolitik und (4) Umstellung auf ICT. Am häufigsten wurde das Vorhandensein von kompetenter Hilfe von außen durch den HCP aus dem Diabetesbereich sowie durch Angehörige und andere Betroffene gewünscht. Die Befragten formulierten klare Wünsche an ein altersgerechtes Design von Insulinpumpen (z. B. großes Display, Sprachsteuerung). Sorgen der Pumpenträger/-innen bezogen sich u. a. auf Hilflosigkeit, Akutkomplikationen und verschlechterte Stoffwechsellage. Schlussfolgerung Die Befragten äußerten große Sorgen und Unsicherheiten bezüglich CSII im Alter, auf die seitens der Diabetologie, Industrie und Gesundheitspolitik eingegangen werden sollte, um Insulinpumpentherapie altersgerecht zu gestalten.

ZusammenfassungDie Diabetesprävalenz liegt in der Altersgruppe ab 80 Jahren bei über 30 %. Bei der Diagnostik und Therapie älterer Menschen mit Typ-1- und Typ-2 Diabetes müssen altersspezifische Besonderheiten wie funktionelle und kognitive Einschränkungen sowie Komorbiditäten und Aspekte der Polypharmazie in besonderem Maße berücksichtigt werden. Die S2k-Leitlinie der Deutschen Diabetes Gesellschaft wurde mit 6 weiteren Fachgesellschaften (Deutsche Gesellschaft für Kardiologie, Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin, Deutsche Gesellschaft für Geriatrie, Deutsche Gesellschaft für Ernährungsmedizin, Deutsche Gesellschaft für Pflegewissenschaft, Deutsche Gesellschaft für Palliativmedizin) und der Patientenvertretung (DBW) erarbeitet. Therapieziele wie Erhalt der Lebensqualität und strikte Vermeidung von Akutkomplikationen wie schwere Hypoglykämien treten in den Vordergrund. HbA1c-Ziele sollten gemeinsam mit den Patienten in Abhängigkeit der individuellen Wünsche und Fähigkeiten festgelegt werden. Altersspezifische Besonderheiten einzelner Medikamente müssen insbesondere im Kontext der Multimorbidität beachtet werden. In der Leitlinie werden pflegerische Aspekte, Schnittstellenmanagement, Schmerztherapie sowie häufige Komorbiditäten bei Diabetes wie Hypertonie, Frailty, Sarkopenie, Demenz, Depression, End-of-Life Situationen ausführlich dargestellt.

Psychological resilience refers to the phenomenon that many people are able to adapt to the challenges of life and maintain mental health despite exposure to adversity. This has stimulated research on training programs to foster psychological resilience. We evaluated concepts, methods and designs of 43 randomized controlled trials published between 1979 and 2014 which assessed the efficacy of such training programs and propose standards for future intervention research based on recent developments in the field. We found that concepts, methods and designs in current resilience intervention studies are of limited use to properly assess efficacy of interventions to foster resilience. Major problems are the use of definitions of resilience as trait or a composite of resilience factors, the use of unsuited assessment instruments, and inappropriate study designs. To overcome these challenges, we propose 1) an outcome-oriented definition of resilience, 2) an outcome-oriented assessment of resilience as change in mental health in relation to stressor load, and 3) methodological standards for suitable study designs of future intervention studies. Our proposals may contribute to an improved quality of resilience intervention studies and may stimulate further progress in this growing research field.

The present study examined how social status and gender determine anger expression and behavioral reactions toward experienced anger. In two experiments, anger was induced in a staged social interaction. Behavioral anger reactions were judged by observers. In Experiment 1 ( equal status condition ; N = 110) participants were provoked by a confederate, in Experiment 2 ( low status condition ; N = 116) participants were provoked by the experimenter. We found that participants expressed their anger to a lesser extent, were less resistant, and engaged in submissive behaviors if they had a lower status than the anger-target. As expected, gender had a moderating effect: While women's anger reactions were affected by having a lower status than the anger-target, men's anger reactions were affected by low status only when interacting with a female anger-target. Our findings provide new evidence regarding behavioral reactions to anger.

BACKGROUND Many of the existing scales for microstressor assessment do not differentiate between objective (i. e., observable) stressor events as opposed to stressful cognitions or concerns and often mix these items with other aspects of stress, such as perceived stressor severity, the evoked stress reaction or further consequences on health. This may result in spurious associations with other questionnaires measuring such constructs. Since most scales were de-veloped several decades ago, modern life stressors may not be represented. OBJECTIVE To develop a questionnaire that a) focuses on the retrospective assessment of objective microstressors over a one-week period and b) separates stressor occurrence from perceived stressor severity. METHODS Cross-sectional (N=109) and longitudinal studies (N=10 and N=70) were conduct-ed. In the longitudinal studies, Ecological Momentary Assessment (EMA) was used to com-pare stressor data, collected five times per day for 30 days, with retrospective reports (end-of-day, -week). Pearson correlations and multilevel-modelling were used in the analyses. RESULTS High correlations were found between the end-of-week, end-of-day and EMA data for microstressor occurrence (counts) (r ≥ .69 for comparisons per week, r ≥ .83 for cumulated data) and for mean perceived microstressor severity (r ≥ .74 for comparisons per week, r ≥ .85 for cumulated data). The end-of-week questionnaire predicted the EMA assessments suf-ficiently (counts: b= .03, 95% CI= .02 to .03, P CONCLUSIONS Our results provide evidence for the ecological validity of the MIMIS questionnaire. CLINICALTRIAL none

There is an active debate regarding whether the ego depletion effect is real. A recent pre-registered experiment with the Stroop task as the depleting task and the antisaccade task as the outcome task found a medium level effect size. In the current research, we pre-registered a multi-lab collaborating project to replicate that experiment. Data from twelve labs across the globe (N = 1775) revealed a small but significant ego depletion effect, g = 0.12, CI95 = [0.02, 0.21]. The data also provided some evidence in support of a moderating effect of individual differences in lay theory about willpower, such that participants with an unlimited-resource theory evinced a weaker depletion effect. Finally, a series of auxiliary analyses provided important implications for future studies investigating the robustness of ego depletion, such that strictly controlled experimental settings and outcome tasks with medium difficulty might be better for observing a stronger depletion effect.

Ecological Momentary Assessment (EMA) is the state-of-the-art methodology to capture an individual’s experiences (e.g., feelings, thoughts, behaviors) in daily life in an ecologically valid way. In this chapter, we outline the prominent role of EMA within a broader mobile sensing framework connecting domains of data acquisition from a range of sensing sources. We particularly highlight the advantages of context-aware assessment strategies that link the assessment of experiences to specific sensing events or patterns. Finally, we discuss strategies that go beyond assessment to implement innovative Ecological Momentary Interventions in real-life.

Mindfulness plays an important role in moderating affect dynamics. To date, associations between mindfulness and affect dynamics have mostly been examined with mindfulness as a trait-like characteristic. However, examining associations between momentary mindfulness and affect dynamics could reveal important within-person processes underlying mindfulness and wellbeing. The present study first examined dispositional mindfulness as a 1-dimensional as well as a multifaceted construct in relation to affect dynamics (instability, inertia, and valence switch). We further investigated how momentary mindfulness predicts affect dynamics, and how training momentary mindfulness with a mindfulness training influences affect dynamics in daily life. A final sample of 125 undergraduate students took part in a 6-week randomized controlled trial, either engaging in a low-intensity mindfulness training (n = 61) or being part of a wait-list control condition (n = 64). We assessed participants' low and high arousal positive (PA) and negative affect (NA) and their momentary mindfulness 6 times a day for 40 consecutive days by implementing an ambulatory assessment (AA) protocol during either the mindfulness training or waiting period, respectively. We found that the dispositional mindfulness facet present-awareness was negatively associated with low arousal NA inertia and a lower switching propensity. However, we found momentary mindfulness to be positively associated with low arousal PA inertia, a lower switching propensity to NA and less instability. Furthermore, participants who practiced mindfulness experienced reduced low arousal NA inertia. These findings demonstrate that momentary mindfulness may be helpful in promoting adaptive affect experiences and maintaining PA, which could ultimately foster affective well-being. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Glucose metabolism has been suggested as an underlying biological factor of self-control stimulating a range of studies exploring the associations between glucose and self-control. Research on interindividual trait-like differences in glucose metabolism and self-control is sparse, as most previous research has focused on associations between state self-control performance and momentary glucose levels. In two experiments in healthy participants (n = 60, mean age 35.2 ± 13.9, 58% women; n = 103, mean age 25.8 ± 6.3, 67% women) consisting of a baseline assessment and a laboratory session, we examined whether trait markers of glucose metabolism (fasting glucose levels, oral glucose tolerance, and insulin resistance) correlated with trait measures of self-control and state self-control performance measured in a self-control dual-task paradigm. We found only small to moderate associations with insulin resistance, indicating that higher trait self-control went together with lower insulin resistance. These associations were limited to self-reported measures only. For the association with objectively assessed self-control performance no consistent pattern was observed. Taken together, the present research does not provide support for a meaningful relationship between self-control and glucose metabolism.

Continuous glucose monitoring (CGM) systems provide people with diabetes with valuable real-time information on glucose trajectories and trends, thus offering opportunities for improving diabetes self-management. Ample evidence from clinical trials underscores CGM effectiveness for biomedical outcomes including HbA1C and hypoglycemia. However, interindividual variability in CGM uptake seems to be substantial: Neither do all individuals with diabetes adopt CGM readily in their diabetes self-management, nor do all of them benefit from CGM. In this article, we focus on CGM effects on quality of life and the potential role of psychosocial patient characteristics for determining the uptake and outcomes of CGM. After providing a brief overview on existing evidence on psychosocial factors in CGM use, gaps in existing research are identified and directions for future research are proposed that could answer key research questions and offer guidance for clinical diabetes care.

Background: Continuous glucose monitoring (CGM) patient systems have been shown to improve diabetes self-treatment when used consistently. The meaningful integration of this technology into everyday life, however, can vary greatly among CGM users and not all people with diabetes use CGM to its full potential. To address this issue, the study pursued 2 aims: first, to identify patient characteristics that underlie the acceptance of CGM in people with type 1 diabetes and, second, to examine the effects of different levels of experience with CGM use. Methods: Guided by a model based on the technology acceptance model (TAM), structural equation modeling (SEM) was employed to model the patient characteristics as predictors of CGM acceptance. In all, 111 participants (60.4% female, mean = 37.6 years, SD = 11.2) participated in a web-based survey; 40 were current CGM users, 18 were former users and 53 had no experience with CGM systems. Results: In general, participants evaluated CGM positively; however, the feeling of information overload represented a major barrier to the sustained use of CGM, while perceptions of usefulness and ease of use constituted incentives for using this technology. Moreover, patients without CGM experience imagined more information overload than current users reported. Current users showed more intention to use CGM than former users. Conclusion: This study highlights the importance of CGM user experience for the effective use of this technology.

Heart rate variability (HRV) has been suggested as a biological correlate of self-control. Whereas many studies found a relationship between HRV at rest and self-control, effect sizes vary substantially across studies in magnitude and direction. This meta-analysis evaluated the association between HRV at rest and self-control in laboratory tasks, with a particular focus on the identification of moderating factors (task characteristics, methodological aspects of HRV assessment, demographics). Overall, 24 articles with 26 studies and 132 effects (n=2317, mean age=22.44, range 18.4-57.8) were integrated (random effects model with robust variance estimation). We found a positive average effect of r=0.15, 95% CI [0.088; 0.221], p

In this daily diary study, we investigated the flexibility-enhancing effects of positive affect on the self-reported success of self-control strategies followed in daily life; 297 participants completed a 13-day daily diary that included measures of positive affect, desire, and habit strength as well as three self-control strategies (i.e., monitoring, distraction, and stimulus control). We found specific effects of positive affect on self-control strategies: Individuals with higher positive affect were most successful when following a strategy of distraction (e.g., thinking about something else), particularly when faced with strong tempting desires. These results reinforce the idea that positive affect is associated with both cognitive flexibility and distractibility, which may help people distract them from tempting desires.

Ambulatory Assessment (AA) comprises the use of in-field methods to assess individuals’ behavior, physiology, and the experience as they unfold in naturalistic settings. We propose that AA is favorable for the investigation of gene–environment interactions and for the search for endophenotypes, being able to assess the experienced environment and to track basic regulatory processes, such as stress reactivity, affective instability, and reward experience, which are potential common factors that underlie psychiatric disorders. In this article, we (a) first describe briefly the rationale of AA and summarize the key advantages of the approach, (b) highlight within-subject regulatory processes, such as stress reactivity, affective instability, and reward experience, (c) describe studies that used AA to examine genetic influences in psychiatric disorders, and (d) briefly review longitudinal studies that have investigated phenotypes of psychiatric disorders. The reported studies yielded promising, although sometimes inconclusive evidence for genetic effects on endophenotypes of psychiatric disorders. Moreover, most studies were twin or family studies, especially in stress-sensitivity research; thus, it is unclear which specific single nucleotide polymorphisms contribute to the endophenotypes of psychiatric disorders. We do hope that within-subject regulatory processes will enable us to clarify the fundamental psychological dimensions that cut across traditional disorders and link them to their genetic underpinnings.