Perceived empowerment and the impact of negative effects of the COVID-19 pandemic on the quality of life of persons with severe mental illness.

PURPOSE: Beyond its direct effects on physical health the COVID-19 pandemic has been shown to have negative effects on the living situation of people with severe mental illness (SMI). To date, there has been little research on resilience factors preventing people with SMI from experiencing negative effects of the COVID-19 pandemic. The objective of this study was to investigate the role of perceived empowerment (PE) as a resilience factor, preventing people with SMI from experiencing negative effects of the COVID-19 pandemic on daily living. METHODS: We investigated negative effects of the COVID-19 pandemic on daily living in 931 persons with SMI at two times within six month between June 2020 and Mai 2021. To take into account the longitudinal structure of the data we applied mixed effects regression analyses and longitudinal path models. RESULTS: A majority of participants experienced negative effects of the COVID-19 pandemic on several dimensions of daily living. Negative effects increased with rising levels of illness-related impairment but decreased as the level of PE rose. While negative effects of the COVID-19 pandemic at follow-up were negatively associated with overall subjective quality of life baseline, PE was negatively associated with the negative impact of the pandemic and positively with quality of life. CONCLUSION: Patients with SMI need support to reduce negative effects of the COVID-19 pandemic on their quality of life. The promotion of PE could help strengthen resilience in this target group. TRIAL REGISTRATION: German Clinical Trial Register, DRKS00019086, registered on 3 January 2020. (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00019086).

Does Attentional Focus Influence Psychophysiological Responses to an Acute Bout of Exercise? Evidence From an Experimental Study Using a Repeated-Measures Design.

Attentional focus during aerobic exercise has been studied in the context of sports performance, injury prevention and affective experience. Previous research suggests that an additional mental task parallel to the physical activity might influence exercise experience and performance. It has been tested if attentional focus influences cardiovascular activity, positive/negative affect, and subjective exertion during a cycling exercise. Data from N = 30 female participants has been collected using a repeated measures design, with the following experimental manipulations: (A) an internal attention focus (i.e., paying attention to force production of the quadriceps muscles), (B) an external attention focus (i.e., paying attention to changes in brightness in the cycling track simulation), and as control conditions, (C) exercise without attention focus (i.e., no specific instruction was given) and (D) no exercise, no attention focus. Subjective affect and subjective exertion were assessed, and changes in cardiovascular activity were recorded via mobile impedance cardiography (ICG) at rest, during and after the exercise, including HR, HRV (RMSSD, HF), PEP, CO, SV, LVET, and RSA. Exercise was associated with adaptations in cardiovascular activity, positive/negative affect, and subjective exertion. However, this did not interact with attentional focus. The original hypothesis could not be supported: instructed attentional focus does not influence affect, exertion, or cardiovascular activity during a cycling exercise. Therefore, attentional focusing during exercise does not appear to put notable additional mental demands on the physically active participant. Nonetheless, impedance cardiography delivered reliable measurements even during the cycling exercise.

Effectiveness and cost-effectiveness of a community-based mental health care programme (GBV) for people with severe mental illness in Germany: study protocol for a randomised controlled trial.

BACKGROUND: The community-based mental health care programme GBV is based on the British Community Mental Health Teams and the Dutch Flexible Assertive Community Treatment model. In addition, the programme offers crisis-intervention services. A special feature of this integrated care programme is the initial standardised assessment process regarding empowerment, unmet care needs, and psychosocial functioning, used to verify the need for such a comprehensive form of care. The project evaluates the assessment process and analyses the effectiveness and cost-effectiveness of GBV compared to treatment as usual. METHODS: This randomised, controlled study includes five assessments over 2 years. In twelve regions in Germany, 1000 patients with severely impaired psychosocial functioning and unmet care needs will be recruited. Study eligibility relies on an indication for GBV based on the results of the initial assessment. The primary outcome is improved self-reported empowerment. Further outcomes include improved treatment satisfaction and subjective quality of life, reductions in patients' unmet needs and illness-related clinical and social impairment, and an improved cost-effectiveness ratio of the resources used (from the perspectives of both statutory health insurance and the national economy). In addition, the GBV's effects on the burden and quality of life of informal caregivers of patients will be investigated. DISCUSSION: The study's results are expected to provide information on whether the community-based mental health care programme GBV contributes to improving mental health care provision in Germany. In addition, the study will show whether the GBV successfully overcomes the weaknesses that former research has identified regarding a German integrated care programme. Such improvement is particularly expected with respect to the semi-structured assessment within GBV. TRIAL REGISTRATION: German Clinical Trial Register, DRKS00019086 . Registered on 3 January 2020.

Regular Physical Activity, Short-Term Exercise, Mental Health, and Well-Being Among University Students: The Results of an Online and a Laboratory Study.

The health benefits of regular physical activity and aerobic exercise are undisputed in the literature. The present series of pilot studies had two major objectives: (a) examine mental health, well-being, and regular physical activity of university students and (b) explore the potential health benefits of short-term aerobic exercise on university students in an online and a laboratory study. Mental health and well-being were measured before (Time 1, T1) and after (Time 2, T2) a 6 week (online study) and 2 week (laboratory study) low- to moderate-intensity aerobic exercise intervention. Mental health and well-being were assessed using standardized self-report measures of depression, anxiety, positive and negative affect, perceived stress and coping strategies, body dissatisfaction, and quality of life. The effects of the aerobic exercise were compared to a cognitive non-exercise control condition (online study), motor coordination exercise (laboratory study), and a waiting list (online and laboratory). A total of 185 university students were recruited from German universities at T1. Further, 74 (women: n = 67) students completed the 6-week intervention. Similarly, 32 (women: n = 30) participants completed the 2 week intervention (laboratory study). At T1, 36.6% of the students (women and men) reported experiencing depressive symptoms. 41.83% of them (women and men) had high levels of state anxiety. All the students reported experiencing stress (e.g., due to uncertainty related to factors such as their finances, job, and social relationships). At T1, regular physical activity was negatively correlated with self-reported depression, anxiety, and perceived psychosomatic stress and positively correlated with quality of life and positive affect. Among women, cardiovascular fitness (operationalized as resting heart rate variability) was negatively correlated with self-reported anxiety (state) and depression at T1 (laboratory study). The 6 week aerobic exercise intervention resulted in significant improvements in self-reported depression, overall perceived stress, and perceived stress due to uncertainty. The present results confirm that there is a relationship between regular physical activity, cardiovascular fitness, mental health, and well-being among university students. They support the hypothesis that short-term aerobic exercise interventions can act as buffer against depression and perceived stress in university students after 6 weeks of aerobic exercise of low to moderate intensity.

Affective Language, Interpretation Bias and Its Molecular Genetic Variations: Exploring the Relationship Between Genetic Variations of the OXTR Gene (rs53576 and rs2268498) and the Emotional Evaluation of Words Related to the Self or the Other.

Several studies have demonstrated links between oxytocin and socio-emotional information processing. Regarding the frequently studied single nucleotide polymorphism (SNP) rs53576 and the less studied, functional polymorphism rs2268498 of the oxytocin receptor (OXTR) gene, previous research suggested that their variants might be associated with different proficiency in the processing of social information. Differences between the genotype variants are not restricted to non-verbal stimulus processing but have also been reported in the verbal domain. Moreover, there is evidence that oxytocin expression influences empathic communication and language development during childhood, indicating that language-based theory-of-mind abilities may be affected by interindividual differences in OXTR genotypes as well. The present study therefore investigates whether two prominent SNPs of the OXTR gene (rs53576 GG vs. A+; rs2268498 TT vs. C+) also play a role in the affective evaluation of verbal stimuli varying in emotional valence and in self-other reference. Participants (N = 149 Caucasian participants, 104 females; A+: n = 80, GG: n = 69; C+: n = 98, TT: n = 51) were presented a series of written, self-, other-, and unreferenced words of positive, negative, and neutral valence and asked to affectively evaluate each word pair as positive, negative, or neutral by button press. In line with previous research, reaction times and accuracy (number of valence-congruent responses) showed a self-positivity bias (i.e., preferential processing of self-related positive words), which, however, was unaffected by participants' genotype. Regarding affective evaluation of neutral words (interpretation bias), A+ carriers displayed a weaker positive interpretation bias compared to GG carriers in the other- and unreferenced stimulus categories. C+ carriers showed a weaker positive interpretation bias than TT carriers in the self-reference condition and in the other-reference condition. These effects were independent from participants' gender. The present results suggest that the OXTR genotype and hence participants' genetic oxytocin sensitivity may cause an interpretation bias in the spontaneous appraisal of neutral words.

Whose emotion is it? Measuring self-other discrimination in romantic relationships during an emotional evaluation paradigm.

In healthy subjects, emotional stimuli, positive stimuli in particular, are processed in a facilitated manner as are stimuli related to the self. These preferential processing biases also seem to hold true for self-related positive stimuli when compared to self-related negative or other-related positive stimuli suggesting a self-positivity bias in affective processing. The present study investigates the stability of this self-positivity bias and its possible extension to the emotional other in a sample of N = 147 participants including single participants (n = 61) and individuals currently in a romantic relationship (n = 86) reporting moderate to high levels of passionate love. Participants were presented a series of emotional and neutral words that could be related to the reader's self (e.g., "my pleasure", "my fear"), or to an insignificant third person, unknown to the reader (e.g., "his pleasure", "his fear") or devoid of any person reference (e.g., "the pleasure", "the fear"). The task was to read the words silently and to evaluate the word pairs in reference to one's own feelings elicited during reading. Results showed a self-positivity bias in emotional judgments in all participants, particularly in men. Moreover, participants in a romantic relationship (women and men) evaluated positive, other-related stimuli more often as valence-congruent with one's own feelings than single participants. Taken together, these findings support the idea of a self-positivity bias in healthy subjects and an expansion of this bias while being in a romantic relationship.