Search

Abstract BackgroundDigital interventions are promising additions for both usual care and rehabilitation. Evidence and studies for the latter, however, are still rare. ObjectiveThe aim of the study was to examine the app/web-based patient education program called “mebix” (previously called “Vision 2 – Gesundes Herz”) regarding its effectiveness in relation to the parameters of disease-specific quality of life (HeartQoL), cardiovascular risk profile (Cardiovascular Risk Management [CARRISMA]), and prognostic estimation of early retirement (Screening instrument work and occupation [SIBAR]) in 190 participants from a cardiological rehabilitation clinic. MethodsTo evaluate mebix, 354 patients from the Roderbirken Clinic of the German Pension Insurance Rhineland (Germany) with a coronary heart diesase were recruited and randomized either to the intervention group (using mebix postrehabiliation for up to 12 months) or the control group (receiving standard care). The data collection took place at the end of inpatient rehabilitation (t0), as well as 6 months (t1) and 12 months (t2) after the end of rehabilitation. Analyses of variance are used to assess the overall significance of difference in outcome parameters between groups and over time. ResultsThe primary endpoint of disease-related quality of life shows a significant improvement of 7.35 points over the course of the intervention that is also more pronounced in the intervention group. Similarly, the 10-year risk of cardiovascular death and myocardial infarction showed significant improvements in the cardiovascular risk profile over time and between groups, indicating better results in the intervention group (ie, a reduction of −1.59 and −5.03, respectively). Positive effects on secondary outcomes like body weight, blood pressure, and number of smokers only showed time effects, indicating no difference between the groups. In addition, the SIBAR was significantly lower/better at the end of the observation period than at the beginning of the observation for both groups. ConclusionsOverall, the digital training program represents an effective follow-up offer after rehabilitation that could be incorporated into standard care to further improve disease-related quality of life and cardiovascular risk profiles.

Abstract Background Young Middle Eastern male refugees are currently among the most vulnerable groups in Europe. Most of them have experienced potentially traumatic events (PTEs) such as rape, torture, or violent assaults. Compared to their peers, young refugees suffer more from internalizing and externalizing symptoms, especially when unaccompanied. Little is known about the cumulative impact of experiencing different types of PTEs on mental health outcomes (polytraumatization) of young male refugees from the Middle East. We investigated (1) whether there is a dose–response relationship between multiple PTE types experienced and mental health outcomes, (2) whether individual types of PTEs are particularly important, and (3) to what extent these are differentially associated with mental health outcomes among unaccompanied or accompanied peers. Methods In total, 151 young Middle Eastern male refugees in Germany (M age = 16.81 years, SD age = 2.01) answered questionnaires on PTEs, mental health, and post-migration stress. Results Hierarchical regression analyses revealed, while controlling for age, duration of stay, unaccompanied status, and post-migration stress, (1) a dose–effect between PTE types on both internalizing and externalizing symptoms. Moreover, (2) regarding internalizing symptoms, violent family separation and experiencing life-threatening medical problems were particularly crucial. The latter was driven by unaccompanied refugees, who also reported higher levels of substance use. Conclusions The results extend findings from the literature and suggest that not only may greater polytraumatization be related to greater depression among refugees, but also to a range of other mental health outcomes from the internalizing and externalizing symptom domains. Furthermore, the results highlight the mental health risks that unaccompanied and accompanied refugee adolescents face after exposure to PTEs, and provide information for practitioners as well as researchers about event types that may be particularly relevant.

Summary Objective Weight loss during an inpatient obesity treatment is an important predictor of subsequent weight maintenance. However, psychological factors influencing weight loss are not well established. Psychological models suggest some importance of executive functioning and emotion regulation strategies. Therefore, this study investigated whether these factors predict weight loss during an inpatient obesity treatment and whether this effect holds after controlling for general personal and treatment characteristics. Method A total of 158 adolescents with diagnosed obesity underwent inpatient obesity treatment at a German rehabilitation clinic. Psychological factors (executive functioning and emotion regulation) were measured at admission and used to predict BMI reduction after treatment completion. Results More frequent use of reappraisal as an emotion regulation strategy, but not suppression or executive functioning, predicted weight loss at the end of the obesity treatment, even after controlling for age, gender, treatment duration, and BMI at admission. Conclusion Functional emotion regulation strategies, like reappraisal, might offer an additional target for obesity treatment programmes, complementary to the more traditional components of psychoeducation, physical activity, and caloric restriction.

The clinical profile termed developmental dyscalculia (DD) is a fundamental disability affecting children already prior to arithmetic schooling, but the formal diagnosis is often only made during school years. The manifold associated deficits depend on age, education, developmental stage, and task requirements. Despite a large body of studies, the underlying mechanisms remain dubious. Conflicting findings have stimulated opposing theories, each presenting enough empirical support to remain a possible alternative. A so far unresolved question concerns the debate whether a putative innate number sense is required for successful arithmetic achievement as opposed to a pure reliance on domain-general cognitive factors. Here, we outline that the controversy arises due to ambiguous conceptualizations of the number sense. It is common practice to use early number competence as a proxy for innate magnitude processing, even though it requires knowledge of the number system. Therefore, such findings reflect the degree to which quantity is successfully transferred into symbols rather than informing about quantity representation per se. To solve this issue, we propose a three-factor account and incorporate it into the partly overlapping suggestions in the literature regarding the etiology of different DD profiles. The proposed view on DD is especially beneficial because it is applicable to more complex theories identifying a conglomerate of deficits as underlying cause of DD.

The current study was aimed at investigating across-tasks intraindividual variability, also termed dispersion, in EF performance. The German adaptation of the Neuropsychological Assessment Battery (NAB) was used as a measure of EFs. Data of 444 participants aged 18–99 from six NAB Executive Functions Module subtests (i.e., Planning, Mazes, Letter Fluency, Judgment, Categories, and Word Generation) along with the NAB Total Index score as a measure of overall cognitive ability were analyzed. Maximum discrepancy (MD) was applied as a measure of dispersion. MD values ranged from 0.47 to 5.20 indicating substantial across-tasks dispersion in EF performance. Furthermore, dispersion moderately decreased with advancing age. Taking overall cognitive ability into account revealed that dispersion might be lower at older ages; especially, when associated with low overall ability levels. The dedifferentiation hypothesis offers a plausible explanation for these findings. That is, the cognitive profiles of older people might be less heterogenous than that of younger people, which may be due to age-related central nervous system constraints.

The aim of this study was to investigate sex similarities and differences in visuospatial and fluid abilities and IQ scores based on those abilities in children aged two to eight. Standardization data from the Snijders-Oomen Nonverbal Intelligence Test for Children aged 2−8 (SON-R 2−8) were used. A representative sample composed of 965 children from the Netherlands and 762 children from Germany was examined. Small but significant mean sex differences favoring girls were observed until age four. At ages six and seven, boys achieved similar cognitive development levels to girls regarding all abilities assessed and outperformed girls on the Mosaics subtest measuring visuospatial cognition. Boys also displayed higher variability rates in performance. The distribution of IQ scores, with the overrepresentation of girls scoring above mean and the overrepresentation of boys scoring below mean in early childhood, altered with age towards parity between the sexes. The results suggest that girls tend to mature earlier with respect to cognitive abilities. During the course of development, however, the differences between girls and boys may become negligible.

During the last years, the number of refugees around the world increased to about 22.5 million. The mental health of refugees, especially of unaccompanied minors (70% between the ages of 16 and 18 years) who have been exposed to traumatic events (e.g., war), is generally impaired with symptoms of post-traumatic stress disorder, depression, and anxiety. Several studies revealed (1) a huge variation among the prevalence rates of these mental problems, and (2) that post-migration stressors (e.g., language barriers, cultural differences) might be at least as detrimental to mental health as the traumatic events in pre- and peri-flight. As psychotherapy is a limited resource that should be reserved for severe cases and as language trainings are often publicly offered for refugees, we recommend focusing on intercultural competence, emotion regulation, and goal setting and goal striving in primary support programs: Intercultural competence fosters adaptation by giving knowledge about cultural differences in values and norms. Emotion regulation regarding empathy, positive reappraisal, and cultural differences in emotion expression fosters both adaptation and mental health. Finally, supporting unaccompanied refugee minors in their goal setting and goal striving is necessary, as they carry many unrealistic wishes and unattainable goals, which can be threatening to their mental health. Building on these three psychological processes, we provide recommendations for primary support programs for unaccompanied refugee minors that are aged 16 to 18 years.

The Fibromyalgia Survey Questionnaire (FSQ) assesses the key symptoms of fibromyalgia syndrome. The FSQ can be administrated in survey research and settings where the use of interviews to evaluate the number of pain sites and extent of somatic symptom intensity and tender point examination would be difficult. We validated the FSQ in a cross-sectional survey with FMS patients. In a cross-sectional survey, participants with physician diagnosis of FMS were recruited by FMS-self help organisations and nine clinical institutions of different levels of care. Participants answered the FSQ (composed by the Widespread Pain Index [WPI] and the Somatic Severity Score [SSS]) assessing the Fibromyalgia Survey Diagnostic Criteria (FSDC) and the Patient Health Questionnaire PHQ 4. American College of Rheumatology 1990 classification criteria were assessed in a subgroup of participants. 1,651 persons diagnosed with FMS were included into analysis. The acceptance of the FSQ-items ranged between 78.9 to 98.1% completed items. The internal consistency of the items of the SSS ranged between 0.75-0.82. 85.5% of the study participants met the FSDC. The concordance rate of the FSDC and ACR 1990 criteria was 72.7% in a subsample of 128 patients. The Pearson correlation of the SSS with the PHQ 4 depression score was 0.52 (p