2022

• Dr. Luisa Superbia-Guimaraes - Attention-based maintenance in the working memory of children and adolescents with attention-deficit/hyperactivity disorder (PhD)

  Supervisor: Prof. Dr. Valerie Camos

  Working memory is the cognitive system dedicated to the temporary storage and processing of information to accomplish goal-directed behaviour. Its functioning is closely intertwined with the functioning of attention, a cognitive resource used by typically developing individuals to boost memory representations held in working memory and maintain information therein. Rare studies in the literature investigated the use of attention-based maintenance in working memory by clinical populations suffering from working memory alterations, such as children and adolescents with attention-deficit/hyperactivity disorder (ADHD). The clinical literature has for long reported that ADHD is characterized by impairments in working memory functioning, yet mechanistic accounts of these deficits lack in the literature. In this thesis, we propose an experimental approach to identify the locus of the working memory deficits in ADHD. Through a series of three experiments, we investigated if children and adolescents (10 to 16 years) diagnosed with this disorder can orient attention and use it to refresh items during classical working memory tasks. Our results showed evidence suggesting that these two mechanisms of working memory functioning are intact in this population. We discuss our results according to the theoretical frameworks of the time-based resource-sharing model of working memory (TBRS) (Barrouillet et al., 2004; Barrouillet & Camos, 2015, 2021), and the working memory model of ADHD (Rapport, Chung, et al., 2001; Rapport, Kofler et al., 2008; Alderson et al., 2010).

• Dr. Fiona Rosselet-Jordan - An attentional mediation between working memory and long-term memory? The impact of the attentional refreshing availability on the long-term knowledge effects in working memory tasks (PhD)

  Supervisor: Prof. Dr. Valerie Camos

  For years, the dissociation between working memory (WM) and long-term memory (LTM) has been the subject of many questions. Indeed, attention plays a central role in all theoretical models of WM (see Logie et al., 2021 for a complete review). However, each models exhibits different conceptions of how attention moderates the role of LTM on WM. The objective of this project was therefore to test this mediating role of attention between WM and LTM. To achieve this, we choose to involve LTM effects in WM paradigms to test their quantitative and qualitative modulation depending on our manipulations of attentional availability in WM. Our first action was therefore to compare the predictions of important models of the WM field on several studies to clarify the nature of this information channel. Multinomial models were then applied to refine our results by observing the processes involved during recall and encoding in WM. Our results indicate that the contribution of LTM in WM is not moderated by attentional refreshment. These results agree with previous studies (Camos et al., 2019; Campoy et al., 2015; Loaiza & Camos, 2018), as well as with the observations made of the impact of the same factors on long-term performance. (Jacoby et al., 1993). Then, our results indicate that active maintenance in WM largely favors a process of direct access to verbatim-type representations rather than an engagement in a reconstruction process. The implication of knowledge in LTM can improve the encoding of these representations, as well as their reactivation in WM, but their beneficial effects are not attributable to the availability of the attentional refreshment mechanism as currently described in theoretical models of WM.

• Dr. Philippe Schneider - Investigating the impact of semantic long-term memory on attention-based processes during working memory maintenance (PhD)

  Supervisor: Prof. Dr. Valerie Camos

  Working memory is the system dedicated to the maintenance and processing of information at short time scale. Although this system has attracted a lot of research during the last 50 years, its inner functioning is still a matter of debate. One of the most acknowledged aspect of working memory is that attentional processes play an important role in its functioning, especially during maintenance. Indeed, two attention-based processes have been described during working memory maintenance: attentional refreshing and consolidation in working memory. Attentional refreshing is a domain-general maintenance process that helps maintaining information in working memory against temporal decay and interference. It works by focusing central attention on representation held in working memory, which counteract their forgetting. Consolidation in working memory is also an attention-based process, but it is used to transform fleeting iconic memory traces into more stable working memory traces and also relies on central attention. In this thesis, we investigated whether attentional refreshing and consolidation are influenced by semantic long-term memory factors. In four series of experiments, we gathered evidence against the hypothesis that attentional refreshing functioning relies on semantic long-term memory. In contrast, we gathered evidence that information that already have a better encoding in long-term memory is consolidated more quickly. Implication of these finding in regard of how we conceive these two processes are discussed.

• Dr. Juliane Britz - The intrinsic dynamics of EEG microstates and their functional role for conscious awareness (Habilitation)

  Supervisor: Prof. Dr. Björn Rasch

  Trial-by-trial fluctuations in spontaneous brain activity are no longer dismissed as noise but considered as functionally relevant activity that can largely determine the response of the brain to external stimulation. This phenomenon is pervasive throughout the nervous system and pertains to scales ranging from single neurons whose response variability depends on the state of the local population they are embedded in to evoked potentials in humans whose morphology and topography vary with the global pre-stimulus brain state. Moreover, there is striking similarity between patterns of activity that emerge spontaneously and those evoked by external stimulation – ranging from neuronal populations in cat visual cortex to large-scale networks in humans. The striking similarity of spontaneous and evoked patterns of brain activity has been interpreted as reflecting spontaneously emerging internal representations of sensory attributes which can determine the processing of external stimuli. The notion of functionally relevant spontaneous fluctuations in brain activity has led to a paradigm shift in Cognitive Neuroscience from functionally specialized modules to networks, which considers brain activity to be modulated rather than driven by external stimuli and tasks. Along with this paradigm shift came a quest to better understand the intrinsic organization of brain activity both in terms of anatomy and dynamics.

  Moreover, spontaneous fluctuations of brain activity have become a powerful tool to shed a new light onto the neural correlates of conscious awareness which can be assessed by experimentally dissociating sensation from perception such that identical physical stimuli (e.g., multi-stable and threshold stimuli) give rise to stochastic variations in perceptual awareness. In addition to comparing brain response evoked by different perceptual outcomes of the same stimulus, one can also relate stochastic fluctuation in perceptual awareness to spontaneous fluctuation in pre-stimulus brain activity, which yields information about the causes underlying apparently random fluctuation of perceptual awareness for identical stimuli.

  The studies comprised in my habilitation use EEG microstates – a global measure of brain activity with high temporal resolution – to investigate the temporal dynamics of spontaneous fluctuations in brain activity and their role for generating fluctuations in conscious visual awareness.

2021

• Dr. Michael Papinutto - Using eye movements to isolate information use for faces and ecologically valid information sampling in the wild (PhD)

  Supervisor: Prof. Dr. Roberto Caldara

  The eyes sample the visual world at a high speed. The purpose of such fast sampling is to counteract the low-resolution information extracted by the extremities of the retina. As such, eye movements constantly position the targets at the retina centre with high resolution. Determining where the eyes land gives access to the information sampled and perhaps to the information processed by the brain, opening doors to cognition. However, it has been shown that the position of the fixation does not necessarily reflect information use, as the eyes may extract information from the periphery. To overcome this problem, gaze-contingent paradigms allow one to precisely control the extent of information available around the fixation. In addition to this limitation of eye movement research, most eye-tracking studies are performed in confined laboratory settings that do not guarantee the generalisability of their findings to the real world.

  This thesis aims first to evaluate information use in facial recognition utilising gaze-contingent paradigms. Second, it aims to ensure the ecological validity of eye movement studies in the laboratory. Despite the assessment, almost 50 years ago, of the amount of information that can be read in a single fixation and the growing number of studies evaluating facial information sampling, the perceptual span for faces—the facespan—has not been determined yet. The first contribution of this thesis is therefore an evaluation of the facespan with a gaze-contingent moving window paradigm. Several window sizes showing the target facial information were used in a face recognition task. Our results indicate that an aperture of at least 17° of visual angle allows for normal performance and oculomotor behaviour. Within this aperture, 7° were preserved from the Gaussian aperture, hence, evaluating the facespan at 7°. However, as in reading, this quantity might be modulated by different parameters such as expertise, disorders, or age. For this reason, the second contribution is an evaluation of the modulation of the quantity of facial information extracted in the case of non-hearing individuals. We presented faces upside down or upright to a group of hearing-impaired persons and a control group in a face identification task. This time, a window extending according to the duration of the fixation was used.

  Based on our results, the hearing-impaired people were less affected by the inversion effect than the control group. In addition, the hearing impaired extracted more information from a face at each fixation than the control group. Those studies performed in a confined laboratory raise the more general question of ecological validity for which previous studies did not find a consensus. Thus, the last contribution is an answer to this question. To this end, we compared the eye movements of participants in the real world and in the laboratory. Conditions were kept as similar as possible between the two environments. Our results revealed that, unlike in the laboratory, participants in the real world were regularly watching their next steps. Regarding similarities, participants in both groups looked at actionable objects, signs and faces in the same way. In conclusion, these contributions clarify the minimal quantity of facial information needed at each fixation and its modulation by deafness. In addition, the results of studies on eye movements obtained in the laboratory seem to be valid, but only under specific conditions.

• Dr. Jonas Beck - How Cognitions Affect Sleep (PhD)

  Supervisor: Prof. Dr. Björn Rasch

  Our thoughts and cognitions can affect sleep. The present dissertation aims to provide a better understanding of the mechanisms underlying how cognitions affect sleep. The empirical part of the dissertation includes three studies that examine the effect of positive and negative cognitions before and during sleep on sleep physiology. The theoretical part of the dissertation reviews mechanisms suggested by insomnia models and by the “Memories-of-Sleep” hypothesis, which assumes that mental concepts that are active during sleep affect sleep regulatory systems. The first study suggests that inducing positive cognitions during sleep by activating the mental concept of relaxation improves sleep depth. The second study showed that negative cognitions before sleep deteriorate sleep quality during early and during late sleep. The third study showed that positive cognitions before sleep enhance slow-waves but not memory consolidation processes. Thus, the empirical evidence of this dissertation suggests that positive and negative cognitions before as well as during sleep can affect sleep physiology. The findings are explained best by the theoretical framework of the “Memories-of-Sleep” hypothesis and provide a basis for future research and theory-driven interventions to improve sleep.

• Dr. Barbara Bechtler Perler - Entwicklung und Anwendung eines Kodiersystems zur Erfassung von behavioralen und emotionalen Emotionsregulationsstrategien für Kinder im Vorschulalter beim altersadaptierten Stresstest und Prüfung von Alter und Verhaltensauffälligkeiten als Einflussfaktoren (PhD)

  Supervisor: Prof. Dr. Simone Munsch

  Das primäre Ziel der vorliegenden Arbeit war die Kodierung von Emotionsregulationsstrategien beim altersadaptierten Stresstest, einem standardisierten Paradigma zur Stressinduktion. Die Literaturrecherche zur Erfassung von Emotionsregulationsstrategien in standardisierten Situationen bei Vorschulkindern zeigte, dass diesbezüglich auf kein existierendes Kodiersystem zurückgegriffen werden konnte. Es wurde deshalb in einem ersten Teil der Arbeit auf der Basis der zugrundeliegenden Theorien und Kodiersystemen in anderen Forschungskontexten ein Kodiersystem zur Erfassung behavioraler und emotionaler Emotionsregulationsstrategien entwickelt. Für eine möglichst vollständige Erfassung von behavioralen Emotionsregulationsstrategien wurden acht Kategorien festgelegt. Emotionale Emotionsregulationsstrategien wurden durch den Emotionsausdruck erfasst mit zwei Methoden, welche in Abhängigkeit zu den Forschungsfragen stehen. Zum einen wurde die im Gesicht sichtbare Stressreaktion erfasst basierend auf einem dimensionalen Emotionsmodell mit den beiden Dimensionen Valenz und Intensität. Zum anderen wurden die Emotionskategorien Verlegenheit, Scham, Enttäuschung und Ärger kodiert als Emotionen, die nach Misserfolg gezeigt werden können.

  Das Kodiersystem wurde in einem zweiten Teil der Arbeit auf eine gesunde Stichprobe von N=295 Kindern im Alter von vier bis sechs Jahren angewandt, die an der Swiss Preschoolers’ Health Study (SPLASHY) teilgenommen hatten. Von dieser Anwendung wurde die Interraterreliabilität berechnet, deskriptivstatistische Basisanalysen und weitere Itemanalysen durchgeführt und die zugrundeliegende Struktur in einer Faktorenanalyse überprüft.

  Die Durchschnittswerte der Intraklassen-Korrelationskoeffizienten lagen für die verwendeten Kategorien behaviorale Emotionsregulationsstrategien in den Bereichen gut bis exzellent, für emotionale Emotionsregulationsstrategien waren sie bei beiden Methoden zur Erfassung des Emotionsausdrucks moderat. Die Kategorien behavioraler Emotionsregulation wurden nach deskriptivstatistischen Basisanalysen und weiteren Itemanalysen auf neun Items der drei Kategorien verbale Selbstberuhigung, motorische Selbstberuhigung und nach sozialer Unterstützung suchen gekürzt. Eine exploratorische Faktorenanalyse mit Varimaxrotation bestätigte die postulierte Drei-Faktorenlösung für diese neun Items. In Bezug auf die emotionalen Emotionsregulationsstrategien zeigte sich gemäss dimensionalem Emotionsmodell nach Stressinduktion ein stärker ausgeprägter negativer Emotionsausdruck als bei der Baseline. Der Unterschied war in einem t-Test statistisch signifikant. Die Emotion, die nach dem erlebten Misserfolg am häufigsten gezeigt wurde, war Verlegenheit (43.96%), gefolgt von Scham (29.38%) und Enttäuschung (23.84%). Die Emotion Ärger wurde kaum gezeigt (4.18%).

  In einem weiteren Teil der Arbeit wurden Hypothesen zu Alter und Verhaltensauffälligkeiten als Einflussfaktoren auf behaviorale und emotionale Emotionsregulationsstrategien anhand von multiplen hierarchischen Regressionsanalysen überprüft. Dadurch wurden dem Kodiersystem zugrundeliegende Annahmen geprüft.

  Für verbale Selbstberuhigung und motorische Selbstberuhigung erwies sich das Alter nicht als signifikanter Einflussfaktor. Hingegen leistete das Alter einen hoch signifikanten Erklärungsbeitrag für die interpersonale Beruhigungsstrategie nach sozialer Unterstützung suchen. Verhaltensauffälligkeiten war ein signifikanter Einflussfaktor auf verbale Selbstberuhigung, motorische Selbstberuhigung und nach sozialer Unterstützung suchen. Bei einer Spezifizierung der Problembereiche erwies sich Hyperaktivitäts-/Aufmerksamkeitsprobleme als relevanter Prädiktor für verbale Selbstberuhigung und motorische Selbstberuhigung. Externalisierende Verhaltensprobleme und Probleme mit Gleichaltrigen waren relevante Prädiktoren für nach sozialer Unterstützung suchen. Weder Alter noch Verhaltensauffälligkeiten hatten einen signifikanten Einfluss auf emotionale Emotionsregulationsstrategien, respektive den Emotionsausdruck gemäss dimensionaler Emotionstheorie.

  Die Erkenntnis, dass für die drei Beruhigungsstrategien unterschiedliche Prädiktoren relevant sind, zeigt, dass es im Vorschulalter sinnvoll und notwendig ist, zwischen verschiedenen Beruhigungsstrategien zu differenzieren.

  Auf der Basis der ersten Anwendung und statistischen Analysen werden für künftige Anwendungen des Kodiersystems zur Erfassung von behavioralen Emotionsregulationsstrategien folgende Empfehlungen gemacht: Bei Stichproben mit gesunden Kindern kann mit der gekürzten Version des Kodiersystems und der Kodierung von nur einer Spielrunde und somit vier Intervallen gearbeitet werden. Bei einer Anwendung des Kodiersystems auf klinische Stichproben soll das umfassende, ursprüngliche Kodiersystems angewandt werden.

  Diese Arbeit trägt als Ganzes zu einem besseren Verständnis der Stressreaktion von Kindern bei, was insbesondere relevant ist, weil der altersadaptierte als Goldstandard in der Stressinduktion im Vorschulalter gilt.

• Dr. Felicitas Forrer - Relevance of Emotion Regulation Difficulties in the Etiology and Treatment of Binge-Eating Disorder and Loss of Control Eating: An Empirical Investigation in Adults and Youth (PhD)

  Supervisor: Prof. Dr. Simone Munsch

  Binge-Eating Disorder (BED) and Loss of Control Eating (LOC) represent the most prevalent eating disorders (EDs) in adults respectively youth with detrimental consequences for mental and physical health. Recent studies indicated that emotion regulation difficulties are an important factor in the development and maintenance of BED/ LOC, but little is known about the mechanisms and potential gender differences of how they relate to BED/ LOC. Interplays with etiological factors such as body dissatisfaction, body-related cognitive distortions and appearance-based rejection sensitivity (referred to as interpersonal emotion regulation difficulties) can be assumed. Findings of publication 1 indicate that emotion regulation difficulties as opposed to body-related cognitive distortions might not mediate the relationship between body dissatisfaction and ED pathology in a community sample of women and men. Mechanisms of emotion regulation difficulties therefore need further clarification in clinical samples, whereas their relevance for the development and maintenance of BED/LOC remains undisputed. In line with this and given that more efficacious and accessible treatments are needed especially for youth with LOC, publication 2 investigated for the first time the efficacy of a blended treatment program for youth with LOC, including interventions addressing interpersonal emotion regulation difficulties. Results indicate that blended treatments might be efficacious in reducing core LOC and depressive symptoms, whereas the treatment of interpersonal emotion regulation difficulties may need more profound and enduring interventions. Publication 3 complemented that increased emotion regulation difficulties at treatment begin might be a relevant predictor of particularly immediate treatment outcome in online guided self-help for individuals with BED. While findings of publication 2 and 3 support the relevance of (interpersonal) emotion regulation difficulties in the maintenance and treatment of BED/ LOC in adults and youth, results from publication 1 also indicate that emotion regulation difficulties do not represent a sufficient condition to elicit BED/ LOC. Mechanisms of difficulties in emotion regulation in the etiology of BED/ LOC need to be investigated more differentiated in terms of specific aspects of emotion regulation difficulties in clinical samples suffering from increased emotional distress. It is proposed to enhance clinical and scientific efforts to include emotion regulation difficulties in the diagnostic assessment, prevention and treatment of BED and LOC.

• Dr. Selina Combertaldi - How cognitive factors affect sleep: The impact of manipulated intention, instruction, and pre-sleep arousal on sleep quality in healthy sleepers. (PhD)

  Supervisor: Prof. Dr. Björn Rasch

  Sleep is important for health and well-being. Nevertheless, sleep is disturbed in about 20% of the population (e.g., by insomnia) with cognition (e.g., recurrent thoughts, rumination, or worry) making sleep harder. This dissertation therefore describes three cognitive models that illustrate the influence of cognition on sleep. The first model describes how negative cognitive activity leads to physical activation and to (emotional) stress. The second model adds a neurobiological component to the first in order to further substantiate this process. The last model tries to show this connection in healthy individuals and not only in patients. This is why the activation of "sleep/wake memories" and their embodiment is in the foreground. Additionally, a reactivation component during the night is included. The three studies attempt to substantiate these models and to show how changes in cognition before falling asleep influence nighttime sleep. This should lead to a better understanding of the relationship between cognition and sleep in healthy sleepers instead of patients.

  The first study investigated the relationship between intention and sleep. Participants were instructed to improve or to worsen sleep intentionally. As expected, results confirmed that it is possible to sleep worse just by thinking about sleeping worse. Participants managed to increase their sleep onset latency, woke up more often, and decreased total sleep time. Furthermore, there was a misperception between objective and subjective measurements. This misperception is typical for patients with insomnia as well.

  The second study aimed at looking at the relationship between pre-sleep (cognitive) arousal and its effects on sleep. Participants used social media intensively for 30 minutes before sleep, as previous studies have shown its arousing effects. Social media consumption was compared with a neutral control condition and a relaxing control condition, in which participants performed a progressive muscle relaxation session for 30 minutes. Results showed that social media consumption did not increase arousal and expected effects on sleep parameters were missing. Additionally, relaxation improved sleep despite the absence of a decreased arousal.

  The aim of the third study was to explain the role of on-call instructions on sleep. Participants were instructed to respond to alarm sounds, which was compared to a neutral night. Furthermore, the study design introduced a sound-group with alarm sounds on both nights while the no-sound-group never got sounds. Results showed that the on-call instruction altered sleep quality, independently from the actual presentation of alarm sounds. Additionally, results showed a protective role of instruction on sleep on a neurophysiological level.

  Taken together, these results confirm the relationship between cognition and sleep not only in patients with insomnia but in healthy sleepers as well. The three studies showed that the pre-sleep manipulation remained active during sleep and affected sleep quality. Out of the three models, the last model explained these results the best: the MemoSleep hypothesis states that pre-sleep cognitive activity is embodied through “sleep/wake memories” and (spontaneously) reactivated during the night. Thus, these “sleep/wake memories” affect sleep quality and recovery in the next morning. The results provided by this thesis provided initial evidence for the MemoSleep hypothesis. Future research should investigate this model and implement the targeted reactivation during the night not only with sounds but with the “sleep/wake memories” to confirm these preliminary data.

• Dr. Regula Windlinger - Leadership in Schools and Teacher Well-Being: An Investigation of Influence Processes (PhD)

  Supervisor: Prof. Dr. Petra Klumb

  Teaching is a meaningful and rewarding occupation but can also be challenging and stressful. Being well is an essential basis for teachers to do their work well. Moreover, teacher well-being is also linked to the quality of the education system as a whole and to the well-being and learning of students. Teacher well-being is influenced by different factors, such as personal resources and the job demands and job resources at their workplace. School leadership can function as such a job resource and directly influence teacher well-being. Apart from that, influence on teacher wellbeing can also be indirect, via effects of leadership on features of the working environment in the schools. As several issues regarding school leadership and teacher well-being require more and closer attention, this dissertation aims to investigate the processes that connect constructive leadership in schools and teacher well-being. To this end, three studies investigated types of constructive leadership in schools and the processes through which they relate to a range of indicators of teacher well-being. The first study, with a cross-sectional design, examined effects of individual-focused and group-focused transformational leadership on individual and collective teacher efficacy simultaneously and further studied the moderating role of principals’ span of control. The second study, with a daily diary design, focused on effects of constructive vertical leadership by the formal leader as well as constructive shared leadership by the colleagues in teachers’ daily work life. The third study had a longitudinal design to compare three process models of the effects of leader support on team social resources and work engagement. The results of the three dissertation studies show that constructive vertical leadership in schools is related to different dimensions of teacher well-being, such as fluctuating affective states like pleasant affect and state work engagement in teacher daily work life as well as to more stable experiences like teacher efficacy and work engagement. These effects occur through different processes, such as through dyadic interactions of the principal with each follower, through leadergroup interactions as well as indirectly, via interaction quality and team social resources. While teachers reported to experience shared constructive leadership by their colleagues, this type of leadership did not have any effects on teacher well-being in our sample. The results highlight not only the importance of vertical leadership in school for teacher well-being but also the value of having positive social interactions at work.

• Dr. Michael Ackert - Centrality of Religiosity Scale - Test of Model Configuration, Reliability, and Consistency in Romania, Georgia and Russia (PhD)

  Supervisor: Prof. Dr. Dominik Schoebi

  Measurement is fundamental in science. Social sciences generally and psychology, in particular, depend on objective, valid, and reliable psychometric scales. In the 20th century, the psychology of religion and spirituality spent a long time searching for comprehensive and trustworthy instruments to assess psychological constructs in the field of empirical studies of religion and spirituality. This search has manifold causes and goals, one of them was to find an extensive measurement of the general religiosity. In 2003 a new instrument was introduced to the measurement of religiosity by Stefan Huber. The Centrality of Religiosity Scale (CRS) is based upon a new approach – centrality and content-model of measurement of religiosity. The model designs a comprehensive, integrative way to collect empirical evidence by a self- report scale – the CRS. Driven by the research question of whether the Centrality of Religiosity Scale is a reliable and constant instrument to assess religiosity, a systematic empirical test of the scale was done in three Eastern European countries i.e., Romania, Georgia, and Russia. The focus lied on the examination of internal consistency and external reliability as well as the configural, metric, and scalar invariance testing via multigroup confirmatory factor analysis of the short versions of the CRS, the Abrahamitic CRS-5 and the interreligious CRSi-7. Special attention was given to the time-invariance of the short versions of the CRS. Apart from methodological interest in psychometric scale performance, attention was given to the ability of the CRS to detect particularities of the local religious traditions in the three predominant Christian Orthodox countries. Findings suggest acceptable to good internal consistency coefficients with the lowest values of Cronbach’s and McDonald’s being in Georgia and the highest in Russia and Romania. Configural invariance could be observed in all analyzed samples, additionally, metric invariance is found in the Russian and Georgian dataset with the CRS-5 and in the Russian sample with the CRSi- 7, as well as scalar invariance with the CRS-5 in Georgia. Correlated indicator residuals that are stable over time imply that the measurement model of the CRS does not include all systematic variance of the core dimensions of religiosity. These findings show that the centrality of religiosity cannot capture the entire dynamic of religiosity, with some variance being left over which is indicative of particularities in the underlying religious tradition. The empirical results support the multidimensional model configuration, the reliability, and the consistency of the Centrality of Religiosity Scale. The scale seems suitable to assess religiosity as proposed by the theory behind it. However, attention is advised with the association of the residuals of the indicators. Applications in the context of Christian Orthodox tradition e.g., disclose the tendency of believers to partly bypass practical core dimensions of religiosity by carrying out some outward religious behavior. In Romania, the investigation show that highly religious believers tend to focus more on the experiential and intellectual aspects of faith life. Further, research on religion and spirituality with the CRS should consider more invariance testing while also taking into account the constraints on the indicator residuals to detect particularities of the analyzed samples. The configural invariance should be tested to ensure multidimensionality, while metric invariance is advisable if group comparison is of interest, and scalar invariance should be applied if the changes of latent means should be tracked. The results encourage further empirical investigations with the CRS e.g., cross-cultural comparisons, longitudinal studies, the examination of new hypotheses regarding the qualitative changes of faith which occur with higher or lower levels of centrality of religiosity, and further hypotheses regarding the inner dynamics of the postulated core dimensions of religiosity.

2020

• Dr. Daniel Müller - Psychotherapy in Schizophrenia Patients. The Impact of Integrated Therapy Approaches on Treatment Outcome in Schizophrenia (Habilitation)

  Supervisor: Prof. Dr. Simone Munsch

  Schizophrenia is ranked among the top 25 leading causes of disability. According to the diagnosis of schizophrenia in DSM 5, a patient has to exhibit two or more symptoms addressing delusions, hallucinations, disorganized speech, grossly disorganized/catatonic behavior or negative symptoms over at least the period of one month, in addition to an impairment in at least one of the major areas of functioning. The majority of patients experience multiple relapses throughout the course of illness and are heavy-users of health care systems. The costs of schizophrenia are enormous. Regarding Switzerland, schizophrenia disorder seems to be the most expensive mental disease per patient.

  While pharmacotherapy represents standard practice for managing the disorder, it has clear limitations regarding the effectiveness of the treatment against negative symptoms, neurocognitive, social cognitive and social impairments. Some experts defined these deficits as core features of the illness and therefore as main treatment goals during rehabilitation. For example, some experts defined schizophrenia as a cognitive disorder pronouncing that 75-98% of the schizophrenia patients show poor cognitive performance. On the background of vulnerability-stress models, these approaches are based on the therapy rationale integrating systematically these core features into one therapy model of schizophrenia where the relationship between basic neurocognition and functional outcome (functional recovery) is mediated by social cognition, negative functions and patient’s subjective recovery addressing intrinsic motivation, self-efficacy, resource activation, resilience and the improvement of self-perception.

  Recently, some national empirically-based recommendation also for psychological therapy approaches has been newly defined: Psychoeducation/family therapy (PE) has been deemed to be effective in relapse prevention, Cognitive Behavior Therapy for psychosis (CBTp) to treat persistent positive and negative symptoms, Cognitive Remediation (CR) to decrease cognitive deficits, and Social Skills Therapy (SST) to reduce social deficits all got a recommendation of the highest order. Following the integrated mediator models described above, it seems to become evident that combining interventions which focus on rate-limiting basic neurocognitive functions (CR) together with other intervention targets referring to symptoms and other functions could support treatment outcome. Meta-analyses on CR support this assumption. Results show higher effects for integrated psychotherapy approaches in the distal outcome of social functioning (not focused in CR) compared to CR alone.

  Recently, some national empirically-based recommendation also for psychological therapy approaches has been newly defined: Psychoeducation/family therapy (PE) has been deemed to be effective in relapse prevention, Cognitive Behavior Therapy for psychosis (CBTp) to treat persistent positive and negative symptoms, Cognitive Remediation (CR) to decrease cognitive deficits, and Social Skills Therapy (SST) to reduce social deficits all got a recommendation of the highest order. Following the integrated mediator models described above, it seems to become evident that combining interventions which focus on rate-limiting basic neurocognitive functions (CR) together with other intervention targets referring to symptoms and other functions could support treatment outcome. Meta-analyses on CR support this assumption. Results show higher effects for integrated psychotherapy approaches in the distal outcome of social functioning (not focused in CR) compared to CR alone.

  My own research: first of all, it was of some importance to investigate whether the therapy rationale of the postulated integrated mediator models could be confirmed by our own data. In a sample comprised of 148 schizophrenia outpatients (DSM IV) we employed SEM with maximum likelihood estimation. In a cross-sectional design we measured neurocognition, social cognition and social functioning. As expected, the significant results strongly support the mediation hypothesis. The mediation model explained 21% of the variance in functional outcome. All of the model fit indices were very good suggesting high validity of the results. In a second step we included this result into a systematical review of studies that have investigated social cognition as a mediator variable between neurocognitive performance and functional recovery in schizophrenia (k=15 studies). The mean effect size of the indirect effect was 0.20. On average, 25% of the variance in functional outcome could be explained in the mediation models (Schmidt, Müller, Roder, 2011).

  In a second step, the interest of our research group addressed generalization and transfer effects of integrated therapy approaches using data from independent studies focusing IPT technology. From 1980 up to 2010, research groups in 12 countries all over the world have conducted 36 independent studies on IPT, including 1601 patients with schizophrenia diagnosed according to the DSM. We quantitatively reviewed the results of these studies by means of a meta-analytic procedure using a fixed effects model (Roder, Müller, Schmidt, 2011). IPT groups obtained highly significant medium to large effect sizes (ES) in the global therapy effect (composite score of all assessed variables) after therapy and at follow-up 8 months after end of treatment. In contrast, placebo-attention control conditions showed small but significant ES after therapy but not at follow-up. Standard care treatment without any group activities showed no effects. Regarding proximal outcome of IPT (neurocognition, social cognition, functional recovery) again all calculated ES were highly significant for IPT groups in the medium to large range. The strongest effect could be found in social cognition, but this effect was largely heterogeneous across studies. In the more distal outcome of symptoms, IPT groups reached again highly significant ES in positive and negative symptoms. The Effects were robust against setting and site condition as well as IPT variations, therefore no moderator variables could be found in these fields. The one important exception addresses the follow-up effects (vertical generalization): only studies including the complete IPT procedure showed long lasting follow-up effects of 8 months after end of therapy. It seems that the hypothesized therapy concept of IPT procedure is supported also by therapy process and therapy outcome.

  In a further study, we focused on patients’ age (Müller, Schmidt, Roder, 2013). Cognition remains a strong predictor of functional competence across the lifespan in schizophrenia patients, and the treatment of cognitive impairment associated with schizophrenia could improve individuals’ function independent of their age. On this background, we selected 15 independent controlled studies (n=632 inpatients) out of the pool of IPT studies to evaluate the impact of patients’ age on outcome. Using a median split method (median of the study mean age was 40 years), we categorized studies into studies including younger patients (age<40 years; 9 studies) and studies including middle-aged patients (age>40 years; 6 studies). In the global therapy effect younger and middle-aged IPT patients showed significant medium effects compared to controls. The age had no impact on IPT effects, but in controls only the younger patients showed a small but significant effect. Exactly the same effects were evident regarding cognitive, neurocognitive and social cognitive mean effects, with one but very important exception: the ESs for middle-aged IPT patients were significant and ES were of a large level, and they were twice as large as in studies with younger patients! The results support evidence of IPT independent of age, especially in cognition and may work as a fact promoting integrated treatment.

  Almost two decades ago, the U.S. National Institute of Mental Health (NIMH) supported the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative to find consensus in defining cognitive functions that are central to the understanding and treatment of schizophrenia. INT out of our lab represents the very first integrated therapy approach that includes interventions on all 11 MATRIC defined cognitive domains in schizophrenia. INT has been designed exclusively for outpatients as a further development of the cognitive part of IPT. It includes all successful intervention group techniques from IPT in addition psychoeducation, stress/emotion regulation and CBTp. INT focuses strongly on intrinsic motivation and includes some PC-based exercises. The efficacy of INT has been evaluated in RCTs comparing INT with TAU. In a large international multi-site RCT in Switzerland, Germany, and Austria a total of 156 schizophrenia outpatients (DSM) from 8 centers could be included (Müller, Schmidt, Roder, 2015). INT consisted 30 bi-weekly sessions that were in groups of 6–8 patients. Regarding proximal outcome most neurocognitive and social cognitive assessments obtained significant improvements for INT compared to TAU condition during treatment and at follow-up. Regarding more distal outcome, INT demonstrated significant reductions in positive and negative symptoms as well as significant improvements in functional recovery after therapy, but only the effects in negative symptoms and functional recovery could be maintained at follow-up. INT has the potential to produce generalization effects beyond cognitive functioning that may be maintained during follow-up period.

  In a further study, we addressed primary negative symptoms, which are intrinsic to schizophrenia, represent an unmet need in the care of schizophrenia patients. They have an unfavorable impact on real-life functioning and are generally thought not to respond to treatment. On this background we designed a new RCT on INT (Müller, Khalesi, Benzing, Castiglione, Roder, 2017). For that purpose, we selected only schizophrenia out-patients (DSM) with severe negative symptoms assessed by the Positive and Negative Syndrome Scale (PANSS). Participants had to be stabilized for at least 2 months, and they had to show a negative symptom score of 4 (moderate symptom severity; range 1–7) in at least one of the three items on PANSS (blunted affect, social withdrawal, lack of spontaneity) as defined by the Remission in Schizophrenia Working Group (RSWG). A total of 63 schizophrenia outpatients with severe negative symptoms could be included in the study. 42% INT patients showed symptom remission after therapy of 3 months and 77.8% at follow-up 1 year after baseline. However, there was also a diminution of severe negative symptoms in TAU patients at post-therapy (26.8%) and at follow-up (50.0%). Nevertheless, the difference favoring INT compared to TAU was significant. Our differential analysis of single PANSS items showed significant effects favoring INT in a motivational factor (avolition) assessed by lack of spontaneity and a tendency in the item social withdrawal, but not in an expressive factor assessed by blunted affect; these results are in line with those found in the only study of our knowledge that targets severe primary negative symptoms (MOVE home-treatment trail). INT seems to reduce severe negative symptoms to a clinical meaningful level.

  In addition to negative symptoms, we were always interested whether integrated therapy approaches, such as INT, have an impact on positive symptoms and relapse prevention. For that purpose, we conducted a study with stable schizophrenia outpatients (DSM) in remission (Müller, Khalesi, Roder 2020) according to RSWG criteria. 58 stabilized outpatients could be included into a RCT. All participants had to be in symptom remission for at least 2 months before study inclusion, as assessed by their referring physician. All participants had antipsychotic medication. The daily dose of the medication did not change noticeable during the assessment period of one year. The results supported strong evidence for relapse prevention through INT: only 13.3% in INT group relapsed during 3-month therapy compared to 50% in the TAU group, and only 24.1% in INT during 1-year therapy and follow-up period compared to 53.8% in TAU. Both comparisons were significant. Using a logistic regression model, we identified treatment condition (INT or TAU), negative symptoms, and to a lower extent, cognition to have the largest impact on relapse. Positive symptoms and medication did not have any impact. The significant model declared R2=69% of the variance and identified 87% of the relapse.

  To sum up, as creators of some well-distributed integrated therapy approaches for schizophrenia patients, it seemed important to generate empirical data in order to evaluate our therapy concepts. In line with these findings, IPT and INT seem to be an important adjunct to pharmacological treatment. Moreover, these psychological interventions pioneered by the development of IPT 40 years ago as well as its successor INT in outpatient settings may have more beneficial effects on recovery than pharmacotherapy itself. Nonetheless treatment of an illness, as severe as schizophrenia needs more optimization and research. As a result, I’m currently involved in a study combining INT with TMS in schizophrenia outpatients.

• Dr. Maximiliane Uhlich - Relationship Processes in Understudied Samples : Implications for Relationship Functioning and Sexuality in Romantic Relationships (PhD)

  Supervisor: Prof. Dr. Dominik Schoebi

  Relationship functioning can be investigated from different angles; next to investigating dyadic outcomes between couples we can also zoom into processes within subjects. Adopting a cultural lens adds another layer, as the cultural context influences norms around intimate relationships, and can be inspected using the framework of Bronfenbrenner´s (1977) ecological systems theory. In more collectivistic societies, for instance, the extended family is much more involved in decisions regarding the couple relationship, accompanied by more obligations and duties towards family members, and maintaining harmony within the community is much more important than the relationship satisfaction between spouses. It is therefore highly relevant to replicate existing evidence and extend these results beyond Western, Educated, Industrialized, Rich and Democratic (WEIRD) samples. This thesis aims at investigating predictors, correlates and processes in a non- Western sample and in intercultural couples, drawing on several relevant theories, in two empirical studies and a quantitative review. The empirical studies are based on a sample of 180 Iranian couples of which both partners provided weekly reports on their relational experiences during the past seven days, over the course of six consecutive weeks. In study 1, we tested a concurrent mediation model and demonstrated that drops in sexual satisfaction can explain variance of within-subject associations of conflict frequency with relationship satisfaction. In study 2, we found that both the absence or occurrence of sex, as well as cumulative sex frequency, predicted intimacy and relationship satisfaction in later weeks. The lagged model showed that sexual intercourse predicted prospective residualized change in womens´ perception of emotional intimacy one week later, which in turn predicted prospective residualized change in the partners´ relationship satisfaction two weeks later. These two studies provide further evidence for the tight interconnection of distressed interactions and sexual life in non-Western intimate relationships. The data also suggest these associations found in Western couples extend to non- Western couples in predominantly Muslim societies. Moving away from a single culture, in study 3 we considered couples with different socio-cultural backgrounds. Previous research found that couples with different socio- cultural backgrounds are less stable and less satisfied in their relationships than culturally homogeneous couples, due to additional stressors these couples face. We computed effect sizes comparing couples with different socio-cultural backgrounds and culturally homogeneous couples based on the studies included in this review. Our results suggest that controlling for socio-demographic variables that are specific to socio-culturally different couples decreases the gap in relationship functioning between the two groups. Besides the confirmation of several exchange theory components, we complement the underlying theory with our results in non-Western samples. Additionally, within-subject analysis showed considerable within- person variation implying complex relationship processes. All three studies underline that associations between indicators of relationship functioning in non-Western couples are similar to Western relationships. This supports the assumption that many intimacy-related aspects represent basic human needs. This dissertation further provides a comprehensive view on several indicators of relationship functioning by shedding light on predictors, processes and relationship outcomes within- and between-subjects.

• Dr. Jacqueline Fay Esslinger - Family Interactions and Cortisol Expressions in Children With Attention-Deficit/Hyperactivity Disorder (PhD)

  Supervisor: Prof. Dr. Dominik Schoebi

  Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent in children and adolescents worldwide. Typical symptoms include inattention, impulsivity and hyperactivity. Comorbidity with other disorders, such as Oppositional-Defiant Disorder (ODD) or Conduct Disorder (CD) are very common. Due to child symptoms, families of children with ADHD are prone to impaired family functioning. This includes strained parent-child relationships, higher conflict, more negative emotional experiences and less positive family interactions (Johnston & Mash, 2001; Whalen et al., 2011). Based on the conjecture of physiological under-arousal in children with ADHD (Barkley, 1997), the physiology of individuals with ADHD became a biopsychological research interest. The most frequently investigated biomarker is cortisol, an end product of the Hypothalamus- Pituitary-Adrenal (HPA)-axis, and a principal actor in the bodily stress response. Results regarding diurnal HPA-axis functioning in children with ADHD are largely inconsistent. While some found an effect of ADHD on diurnal cortisol, an equally large body of research did not replicate the claimed difference to non-affected individuals. Again others suggest that differences in HPA-axis functioning are solely related to disruptive comorbid symptoms. HPA-axis functioning is health-relevant and calibrated throughout childhood and adolescence (Boyce & Ellis, 2005; Del Giudice et al., 2011). The axis reacts to everyday experiences (Belsky & Pluess, 2009) and the present thesis aims to inquire, how child symptoms as well as family interactions are connected to cortisol expression. This thesis contributes to understanding two - potentially interacting - determinants of child development and later physical and mental health: The parent-child relationship and the physiological stress regulation in children with ADHD. This was realized through three empirical contributions, based on an intensive saliva and diary sampling design with N= 145 children (n= 65 with ADHD) between 7 and 16 years of age and their parents. Five diurnal saliva samples were collected over seven days. Using a smartphone application, children and one of their parents answered momentary assessment questions three times a day. This allowed capturing family interactions, displayed behavior and positive and negative affect as well as child symptoms. Study 1 set out to determine whether children with symptoms of ADHD or rather, disruptive behavior such as ODD/CD showed a distinct output of diurnal salivary cortisol compared to non-affected peers. Therefore, the cortisol awakening response (CAR) as well as total output across the day via area under the curve (AUC) were derived for children with ADHD, children with symptoms of ODD/CD and a comparison group. Neither ADHD nor ODD/CD symptoms were associated with diurnal cortisol expression. Cortisol was significantly related to child age and stage of puberty, corroborating the importance of developmental-specific covariates in salivary bioscience with children and adolescents. Study 2 focused on everyday interactions between children and their parents to examine the relationship between child symptoms, positive and negative parent behavior and positive and negative affect of children and parents. Child symptoms significantly predicted more negative as well as less positive parent behavior towards the child in all models. Negative parent behavior also predicted higher parent negative affect, emphasizing the impact of children’s behavioral symptoms on healthy family relationships. Study 3 was designed to test whether everyday experiences in the parent-child relationship would be associated with HPA-axis responses. This assessment of natural interactions in everyday family environments as well as child symptoms and diurnal cortisol found some of children’s ADHD and comorbidity symptoms to predict cortisol. In summary, the results suggest that children and adolescents with ADHD or comorbid disruptive symptoms do not differ from comparison children in regards to diurnal cortisol. However, the investigation of cortisol sampled concurrently to the assessment of psychosocial events, showed that children’s symptoms were related to their HPA-axis output. Child symptoms’ impact on family dynamics became especially apparent in the association with more negative and less positive parent behavior towards the child. Family interactions and parent behavior are an important target for prevention, intervention and therapy. Enabling positive and affectionate family relationships is crucial to healthy child development, particularly in the presence of ADHD and comorbid impairments. As parents of children with ADHD and comorbidities face more challenges, families should be provided with the necessary skills to evade vicious cycles where children and parents reinforce one another’s dysfunctional behavior. Interactions of everyday family life are key to our understanding of HPA-axis adaptation to the environment and stress-health links in children and later adults.

• Dr. Mayron Picolo - Reward-related behavioral and biological responses associated with eating – Insights from anorexia (nervosa and obesity research) (PhD)

  Supervisor: Prof. Dr. Chantal Martin-Sölch

  Research on clinical populations with eating disturbances has shown the involvement of reward processing in the maintenance of disease-associated symptoms. Investigation on food as a reward indicates the metabolic or feeding state (i.e. fasted or fed state) as a modulator of food as a reward, but little is known about how these states influence other types of reward. This is important because responses to rewards other than food are also altered in several disorders, including those involving eating disturbances. Therefore, the aim of this dissertation was to investigate behavioral and biological responses to monetary reward during fasting and fed states in healthy women, women with anorexia nervosa and women with obesity. For the behavioral responses, we used an experimental gambling task, the wheel of fortune, to evaluate responses to winning or losing a monetary reward involving different probabilities. The patients with anorexia nervosa (AN) repeated the same procedures after weight-restoration treatment. This procedure resulted in empirical studies 1 and 2. The biological responses consisted of circulating levels of endoncannabinoids (eCB) in the participants, and investigation of the correlation between eCB and the responses to reward were reported in empirical study 3. In summary, our results show higher positive mood to winning monetary rewards during fasting for normal-weight women, but not women with anorexia nervosa and more negative mood to not winning during the fed state in normal-weight women and women with AN. No difference regarding mood between feeding states was observed for women with obesity. Regarding affect before and after the task, independently of the feeding state, women with AN and women with obesity reported more negative affect than normal-weight women, with positive affect improving in normal-weight women and women with AN after the task, but not in women with obesity. Patients with AN’s mood reactivity to losing monetary rewards was blunted in comparison to normal-weight controls. Patients with obesity also showed blunted activity to losing low-risk monetary rewards, but also showed less mood reactivity to winning high-risk rewards than controls. Reaction times to categories that involved equal chance (50% of chance of either option) in AN were longer than controls and other categories. With regards to the biological responses, no significant correlations were found between eCB and behavioral responses to monetary rewards. Anandamide, and eCB, was found to be significantly lower during fasting in comparison to the fed state. In patients with AN, levels of anandamide were significantly lower than in healthy controls and remained unchanged following weight-restoration treatment. These results indicate that some types of responses to monetary rewards can be modulated by the feeding state. The applicability of the results is discussed.

• Père Dr. Elie Rahme - Influence de l’accompagnement psycho-spirituel sur la capacité de résilience face à l’abus sexuel chez de jeunes adultes (PhD)

  Superviseure: Prof. Dr. Chantal Martin-Sölch

  Étude de cas multiples menée auprès de jeunes adultes libanais croyants âgés de 20 à 30 ans survivants d’abus sexuel

  Le traumatisme de l’abus sexuel est un événement adverse qui cause des répercussions négatives sur la vie physique, psychologique et spirituelle de la victime. Nous remarquons que les recherches, dans les pays développés, sont plus avancées sur ce sujet que dans les pays du Moyen-Orient. En effet, au Liban, nous n’avons pas assez de recherches sur le thème de l’abus sexuel parce que ce sujet reste encore tabou surtout chez les jeunes hommes. Pour cela, dans cette recherche, nous traitons le thème de l’abus sexuel et nous travaillons sur des capacités de résilience tels les mécanismes de défense matures, le bon investissement narcissique, les affects positifs et la capacité de contrôle et de tolérance au stress.

  Puisque le domaine de la Religion nous concerne, nous accompagnons de jeunes adultes libanais croyants âgés entre 20 et 30 ans, abusés durant la période de latence (7-10 ans), et nous nous intéressons au rôle de la spiritualité qui pourrait être un facteur de résilience. La combinaison d’une approche psychologique et d’une approche spirituelle donne naissance à l’accompagnement psycho-spirituel qui est un ministère offert aux fidèles par l’Église Catholique. Nous développons, en effet, cette approche parce qu’il existe encore peu de programmes validés et/ou de connaissances sur ses effets.

  Nous avons rencontré 20 participants qui ont eu le choix entre quatre modes d’accompagnement : psycho-spirituel, psychologique, spirituel et un groupe témoin. Nous leur avons administré des tests projectifs en début et à la fin de l’accompagnement qui a duré 18 mois. De plus, nous leur avons passé des questionnaires et des échelles cliniques en cours de l’accompagnement, au 12 e mois, et après l’accompagnement, au 21 e mois. Ces diverses mesures avaient l’objectif de tester, dans chaque mode d’accompagnement, la significativité des changements des capacités de résilience.

  Nos résultats ont indiqué que l’accompagnement psycho-spirituel et l’accompagnement psychologique sont efficaces, au niveau des quatre composantes de la capacité de résilience, par rapport à l’accompagnement spirituel et au groupe témoin (contrôle). Pourtant, l’accompagnement spirituel a montré une évolution significative au niveau de l’utilisation des mécanismes de défense matures et du bon investissement narcissique et le groupe qui ne suit aucun accompagnement a montré des différences évolutives significatives, seulement, au niveau de l’utilisation des mécanismes de défense matures.

  En guise de conclusion, nous suggérons que l’accompagnement psycho-spirituel pourrait être un traitement efficace, d’après notre recherche, pour les accompagnés croyants, dans un contexte culturel encore religieux.

  MOTS CLÉS
  Traumatisme, abus sexuel, résilience, accompagnement, psycho-spirituel, mécanismes de défense matures, bon investissement narcissique, affects positifs, capacité de contrôle et de tolérance au stress, Liban.

  ---

  The trauma resulting from sexual abuse is a difficult experience that causes negative physical, psychological and spiritual impact on the victim. Research on this topic is more advanced in developed countries than in the Middle East. Lebanon lacks sufficient research about sexual abuse since it is still a taboo subject especially among young men. Thus, in this research, we have decided to tackle the theme of sexual abuse and to develop resilience capacities such as mature defense mechanisms, good narcissistic investment, positive affects, and control capacity and stress tolerance.

  Since we are directly involved in the field of Religion, we will accompany youngster Lebanese believers, between 20 and 30 years old, abused during the latency period (7-10 years old), and we will examine the role of spirituality which could be a factor of resilience. The combination of psychological and spiritual approaches gives birth to the psycho-spiritual accompaniment which is a ministry offered to the faithful by the Catholic Church. We develop this approach because there are still few validated programs and / or knowledge about its effects.

  We met 20 participants who had the choice of four modes of accompaniment: psycho- spiritual, psychological, spiritual or a control group. We gave them projective tests at the beginning and at the end of the accompaniment that lasted 18 months. In addition, we gave them clinical questionnaires and scales during the accompaniment, in the 12 th month, and after the accompaniment, in the 21 st month. These various measures had the objective of testing, in each mode of accompaniment, the significance of the changes in their resilience capacities.

  Our results indicated that psycho-spiritual accompaniment and psychological counseling are effective at the four components of resilience capacity, in relation to spiritual accompaniment and the control group. However, the spiritual accompaniment showed a significant progress in the use of the mature defense mechanisms and the good narcissistic investment; and the group which does not follow any accompaniment showed significant evolutionary differences at one level only which is the use of the mature defense mechanisms.

  In conclusion, we suggest that psycho-spiritual accompaniment could be an effective treatment, according to our research, for the faithful believers bound to a cultural and religious context.

  KEYWORDS
  Trauma, sexual abuse, resilience, accompaniment, psycho-spiritual, mature defense mechanisms, good narcissistic investment, positive affects, control capacity and tolerance to stress, Lebanon.

2019

• Dr. Helen Rodger - Mapping the Development of Visual Information Use for Facial Expression Recognition (PhD)

  Supervisor: Prof. Dr. Roberto Caldara

  In this thesis, I aimed to map the development of facial expression recognition from early childhood up to adulthood by identifying for the first time in the literature the quantity and quality of visual information needed to recognise the six 'basic' emotions. Using behavioural and eye tracking measures, the original contributions of this thesis include:

  1. An unbiased fine-grained mapping of the continued development of facial expression recognition for the six basic emotions with the introduction of a psychophysical measure to the literature;
  2. The identification of two main phases in the development of facial expression recognition, ranging from 5 to 12 years old and 13 years old to adulthood;
  3. The quantity of signal and intensity information needed to recognise the six basic emotions across development;
  4. The processing of signal and intensity information becomes more discriminative during development as less information is needed with age to recognise anger, disgust, surprise and sadness;
  5. Novel analysis of response profiles (the sequence of responses across trials) revealed subtle but important changes in the sequence of responses along a continuum of age - profiles become more similar with age due to less random erroneous categorizations;
  6. The comparison of two recognition measures across the same cohort revealing that two types of stimuli commonly used in facial emotion processing studies (expressions at full intensity vs. expressions of varying intensities) cannot be straightforwardly compared during development;
  7. Novel eye movement analyses revealed the age at which perceptual strategies for the recognition of facial expressions of emotion become mature.

  An initial review of the literature revealed several less studied areas of the development of facial expression recognition, which I chose to focus on for my thesis. Firstly, at the outset of this thesis there were no studies of the continued development of facial expression recognition from early childhood up to adulthood. Similarly, there were no studies which examined all six of, what are termed, the 'basic emotions' and a neutral expression within the same paradigm. Therefore, the objective of the first study was to provide a fine-grained mapping of the continued development for all six basic expressions and neutral from the age of 5 up to adulthood by introducing a novel psychophysical method to the developmental literature. The psychophysical adaptive staircase procedure provided a precise measure of recognition performance across development. Using linear regression, we then charted the developmental trajectories for recognition of each of the 6 basic emotions and neutral. This mapping of recognition across development revealed expressions that showed a steep improvement with age – disgust, neutral, and anger; expressions that showed a more gradual improvement with age – sadness, surprise; and those that remained stable from early childhood – happiness and fear; indicating that the coding for these expressions is already mature by 5 years of age. Two main phases were identified in the development of facial expression recognition as recognition thresholds were most similar between the ages of 5 to 12 and 13 to adulthood.

  In the second study we aimed to take this fine-grained mapping of the development of facial expression recognition further by quantifying how much visual information is needed to recognise an expression across development by comparing two measures of visual information, signal and intensity. Again, using a psychophysical approach, this time with a repeated measures design, the quantity of signal and intensity needed to recognise sad, angry, disgust, and surprise expressions decreased with age. Therefore, the processing of both types of visual information becomes more discriminative during development as less information is needed with age to recognize these expressions. Mutual information analysis revealed that intensity and signal processing are similar only during adulthood and, therefore, expressions at full intensity (as in the signal condition) and expressions of varying intensities (as in the intensity condition) cannot be straightforwardly compared during development.

  While the first two studies of this thesis addressed how much visual information is needed to recognise an expression across development, the aim of the third study was to investigate which information is used across development to recognise an expression using eye-tracking. We recorded the eye movements of children from the age of 5 up to adulthood during recognition of the six basic emotions using natural viewing and gaze-contingent conditions. Multivariate statistical analysis of the eye movement data across development revealed the age at which perceptual strategies for the recognition of facial expressions of emotion become mature. The eye movement strategies of the oldest adolescent group, 17- to 18-year-olds, were most similar to adults for all expressions. A developmental dip in strategy similarity to adults was found for each emotional expression between 11- to 14-years, and slightly earlier, 7- to 8-years, for happiness. Finally, recognition accuracy for happy, angry, and sad expressions did not differ across age groups but eye movement strategies diverged, indicating that diverse approaches are possible for reaching optimal performance.

  In sum, the studies map the intricate and non-uniform trajectories of the development of facial expression recognition by comparing visual information use from early childhood up to adulthood. The studies chart not only how well recognition of facial expressions develops with age, but also how facial expression recognition is achieved throughout development by establishing whether perceptual strategies are similar across age and at what stage they can be considered mature. The studies aimed to provide the basis of an understanding of the continued development of facial expression recognition which was previously lacking from the literature. Future work aims to further this understanding by investigating how facial expression recognition develops in relation to other aspects of cognitive and emotional processing and to investigate the potential neurodevelopmental basis of the developmental dip found in fixation strategy similarity.

• Dr. Nadine Humbel - A Multidimensional Approach to the Relationship between Emotion Regulation Difficulties and Eating Disorder Psychopathology (PhD)

  Supervisor: Prof. Dr. Simone Munsch

  Emotion regulation difficulties (ERD), or the inability to flexibly adjust emotional responses to environmental or personal demands, have persistently been associated in research with puzzling eating disorder (ED) psychopathology. However, consistent findings on the specificity of association between specific dimensions of ERD and specific symptoms of EDs are lacking. This thesis proposes an exhaustive exploration of the complex relationship between ERD and ED symptoms by means of complementing study designs. This thesis adopts a transdiagnostic approach to both ERD and ED symptoms by examining a large heterogeneous female sample consisting of ED patients, patients with mixed mental disorders (MMD) and healthy controls (HC) aged 18 to 35. Analyses based on the multidimensional Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer, 2004) revealed a rather consistent picture of the implication of attending to and acknowledging ones emotions in ED symptomatology across the spectrum of mental health, in contrast to more action-oriented regulatory processes.

  This thesis corroborates the implication of some but not all dimensions of ERD in ED pathology in a heterogeneous sample and contributes to identify in which circumstances these associations are observable. The combined exploration of the underlying psychological and biological processes involved in emotion regulation (ER) and EDs is recommended, in order to determine most adequate interventions.

• Dr. Claudie Gaillard - Reward processing under influence: effects of stress and cognitive load on reward processing, and their clinical implications for the vulnerability to major depression (PhD)

  Supervisor: Prof. Dr. Chantal Martin-Sölch

  Humans have a propensity to pursue rewards and to avoid punishments. The motivation to seek rewards and the ability to experience and to learn from positive consequences are fundamental functions in the reward processing. They promote survival and well-being. However, these functions can be challenged or impaired by stressful events or contexts. To clarify the determinant factors that might impair the normal reward function in healthy humans, this thesis has four aims. First, to investigate the brain and psychological mechanisms that foster adaptive motivated behaviors and hedonic responsiveness, and how unpredictable acute stress exposure might challenge these mechanisms. Second, to explore how the availability of cognitive regulatory processes may modulate the effect of stress exposure on these reward functions. Third, since emotion regulation strategies might improve or alter the maintenance of an adaptive reward processing, this thesis examines how the propensity to use adaptive or maladaptive emotion regulation strategies influences the responsiveness to reward delivery in healthy individuals. Of clinical importance, the fourth aim is based on the fact that major depression disorder (MDD) is characterized by a disrupted reward processing, increased stress sensitivity, and altered cognitive and emotion regulation processes. Consequently, we used the vulnerability to MDD as a clinical model to test the neural and psychological effects of stress exposure on motivated behaviors and hedonic responsiveness in healthy individuals vulnerable to MDD (HV) compared to closely matched healthy controls (HC).

  Three empirical works address these aims. Empirical work I explores how, in healthy individuals, unpredictable acute stress exposure affects the neural and behavioral mechanisms engaged during cues predicting rewards and during reward delivery, and how cognitive effort modulates stress-related effects on reward processing. To measure brain activations during reward processing, we used an event-related functional magnetic resonance imaging (fMRI) reward task with unpredictable acute stress induced by threat-of-shock, and reward responsiveness modulated by variable reinforcement schedules (rewarded vs not-rewarded trials). The availability of cognitive regulatory processes was manipulated by two levels of cognitive effort to exert in the task (low, high working memory load). Our findings indicate that both stress exposure and increased cognitive effort influenced the striatal reactivity during the delivery phase, but these factors did not interact. In all conditions, stress exposure enhanced both dorsal striatal activation during the delivery phase and cognitive performance, while higher cognitive effort reduced both ventral striatal reactivity to reward receipt and cognitive performance.

  Moving on from there, Empirical work II provides insight into the relationship between the propensity of healthy adults to use adaptive or maladaptive emotion regulation strategies, and their neural responsiveness to reward delivery, a measure of hedonic responsivity. Our findings demonstrate that the ventral striatal responsiveness to reward delivery was negatively associated with both the subject’s tendency to use maladaptive emotion regulation strategies, and the severity and intensity of the subclinical depressive symptoms they reported.

  With the aim to test the clinical implications for the vulnerability to MDD, Empirical work III examines whether unpredictable acute stress exposure affects differently HC’s and HV’s neural responsiveness to cues predicting rewards and to reward delivery when performing the reward task used in our first empirical work. In an exploratory way, we also investigate whether cognitive effort modulates differently the effect of unpredictable acute stress exposure on reward responsiveness. Our findings evidence that stress exposure reduced the ventral striatal reactivity in HV during the anticipation phase, regardless of reinforcement schedule. This stress-related effect was potentiated when individuals were asked to exert a lower cognitive effort in the task. Also, HV showed diminished dorsal striatal activation in all conditions during the anticipation phase. During the delivery phase, the exertion of higher cognitive effort decreased the ventral striatal reactivity in HV, irrespective of stress exposure and reinforcement schedule.

  Overall, the findings of this thesis demonstrate that stress exposure might strengthen arousal resulting possibly in increased reward-seeking motivation and in the emergence of automatized actions at the expense of goal-directed behaviors. Our results bring new insights into the complex influence of cognitive demands and how they modulate the effect of unpredictable acute stress on the reward processing. Regarding the role played by emotion regulation, maladaptive emotion regulation strategies might have an adverse effect on the ability to experience hedonic feelings. Of clinical significance, our findings indicate finally that increased familial risk for MDD may be associated with impaired ability to encode incentive value and with dysfunctions in reward learning processes including the learning of action-outcome and stimulus-outcome associations. Altogether, the results of this thesis might open new avenues for developing efficient prevention programs promoting resilience in the face of stress exposure, and for reducing the risk for stress-related psychopathological symptoms.

• Dr. Christophe Fitamen - Développement de la mémoire de travail et aide au maintien du but : Investigation du rôle joué par l’indiçage du but dans le fonctionnement de la mémoire de travail verbale chez les enfants de 4 à 9 ans (PhD)

  Supervisor: Prof. Dr. Valérie Camos

  Cruciale dans les apprentissages, notamment scolaires, la mémoire de travail se développe avec l’avancée en âge durant l’enfance. Ce travail de thèse vise à élargir nos connaissances sur le développement de son fonctionnement entre la période préscolaire et la période scolaire. De précédente études ont démontré que la négligence du but contribuait au faible contrôle exécutif des enfants d’âge préscolaire. Toutefois, présenter des indices de but durant une tâche améliore les performances des enfants dans des tâches d’inhibition et de flexibilité. L’objectif de cette thèse était d’étendre ces résultats à la mémoire de travail en examinant dans quelle mesure les faibles performances en mémoire de travail des enfants d’âge préscolaire peuvent résulter de la négligence du but de rappeler les items mémorisés à la fin de l’intervalle de rétention. Cette question a été traitée en introduisant, durant l’intervalle de rétention de paradigmes de type Brown-Peterson et des tâches d’empan simple ou complexe, des indices de but pouvant être exogènes (visuels ou auditivo-verbaux), exogènes et associés à un indiçage endogène (effectuer une gestuelle porteuse de sens), ou prendre la forme d’un jeu de rôle. Les résultats ont indiqué 1) que les enfants d’âge préscolaire répétaient plus fréquemment en présence d’un indiçage visuel sans toutefois que cela n’impacte leurs scores de rappel ; 2) qu’une association d’un indiçage exogène à un indiçage endogène améliore les performances en mémoire de travail des enfants ; 3) qu’effectuer en premier une condition de jeu de rôle permettait aux enfants de conserver le même niveau de performances en mémoire de travail dans une condition subséquente sans jeu de rôle. Toutefois, A) un indiçage auditivo-verbal a détérioré les performances de rappel des enfants ; B) l’effet bénéfique de l’association des indiçages exogène et endogène n’a pas été reproduit ; et C) l’effet bénéfique du jeu de rôle observé dans les études d’Istomina (1948) et de Bertrand et Camos (2015) ne fut pas répliqué. Ces évidences contrastent ainsi fortement avec les résultats d’autres tâches de contrôle exécutif et avec les résultats d’Istomina (1948) et de Bertrand et Camos (2015). Les limites du transfert de méthode d’un champ à un autre de la psychologie du développement sont discutées, ainsi que la capacité des enfants d’âge préscolaire à maintenir le but durant une tâche de mémoire de travail. Enfin, ce travail de thèse propose une ouverture vers l’étude du maintien du but dans des tâches d’empan complexe en modalité visio-spatiale et non plus verbale lors de paradigmes de type Brown-Peterson.

2018

• Dr. Kerstin Stülb - Stress und seine Bedeutung in der Kindheit: die Messung von frühen Stressoren und möglichen Folgen auf die psychische Gesundheit von Vorschulkindern (PhD)

  Supervisor: Prof. Dr. Simone Munsch

  Early adversities such as critical live events or cumulative everyday challenges might exceed individual coping strategies or resources and thus lead to pathological changes in the long term. Mal- adaptive physiological and psychological processes as a consequence of dysfunctional stress response are the basis of these changes. Preschool age plays an important role in this context, since the devel- oping brain still underlies a certain plasticity and thus behavior patterns and physiological processes are consolidating. Understanding the child`s normative stress response, it’s triggers and consequences, form the basis for counteracting maladaptive or pathological changes through prevention or interven- tion.

  Publication 1 presents the physiological stress reaction to an age-adapted stress task in two to six-year-olds. In addition, assessment of socio-economic, child- and task-related characteristics should provide information about the possible influences on preschooler’s stress response. Results revealed no overall response of the hypothalamic-pituitary-adrenal axis but a short-term response of the auto- nomic nervous system. The daily release of salivary-alpha-amylase, test lengths and movement further influenced the stress response. An anticipatory effect might have prevented further cortisol release during the stress test. However, the lack of additional cortisol release in combination with the activa- tion of the autonomic nervous system might as well reflect the response of a predominantly healthy sample.

  The results of publication 2 support this assumption by changes in the self-reported affect and children’s facial expressions. Children were less likely to choose the positive image and also displayed less positive connotated facial expressions under stress. This coherence in the two measurements has been rarely detected in previous studies.

  Publication 3 supplemented the results of the first two publications with current prevalences of behavioral problems in Swiss preschool children and the influence of parenting style on their occur- rence. Even in a predominantly healthy sample with only about seven percent of the children above the critical value for behavioral problems, parenting style plays an important role. Dysfunctional par- enting had an influence on the occurrence of behavioral problems in both testing years. Finally, the results are placed in the existing literature and the clinical implications and treatment options that result out of the presented findings are discussed.

• Dr. Regina Jensen - Combinig Work and Home Life Successfully: An Investigation of Antecedents, Processes, and Outcomes (PhD)

  Supervisor: Prof. Dr. Petra Klumb

  The challenge of completing an urgent task at work but being at home for dinner is a daily situation for many working adults. They search for an answer to the question how to combine work and home life successfully. This question is highly relevant as a successful integration of several life domains positively affects the well-being and behavior and has important consequences for family members as well as employers. This dissertation aimed to refine the theoretical understanding of the work-home interface and to provide extensive and detailed insights that can help to facilitate a healthy combination of work and home life. For this purpose, several assumptions derived from ten Brummelhuis and Bakker’s work-home resources model were tested. A number of these assumptions could be confirmed drawing upon data from a meta-analysis and two ecological momentary assessment studies. The meta-analysis (Study I) showed that demands are related to mutual negative influences of the two domains (i.e., work-home conflict), whereas resources are associated with mutual positive influences (i.e., work-home enrichment). Consistently, positive interactions at work were correlated with more positive and less negative parenting behavior in Study III. This relationship was mediated by positive mood. Besides the confirmation of several assumptions, the analyses revealed result patterns that complement the underlying model. Contextual resources such as autonomy at work or social support at home were found to be related to less work-home conflict in Study I. The combination of Study II and Study III proposes that parents might be able to selectively prevent negative and enable positive effects of the work domain on the home domain. The integration of these results leads to the proposition of an extended work-home resources model that refines the existing theoretical knowledge. The dissertation furthermore provides a comprehensive view on the work-home interface by shedding light on antecedents, processes and outcomes and offers a basis for practical measures. The integrated findings suggest for instance that strengthening contextual as well as personal resources is promising for a successful combination of work and home life.

• Dr. Sven Schmutz - Disability-Friendly Website Design Consequences for Nonimpaired Users and Users with Impairments (PhD)

  Supervisor: Prof. Dr. Jürgen Sauer

  The world wide web (web) is indispensable for the modern society. Many people have to use websites on a daily basis to get the information they need, be it at work, at school or at home. Being able to use websites is thus a prerequisite for members of such a society. Even though having access to information on the web is essential these days, people with physical or cognitive impairments often face barriers when using websites (e.g., Al-Wabil, Zaphiris, & Wilson, 2007; Chiang, Cole, Gupta, Kaiser, & Starren, 2005; Disability Rights Commission, 2004; Ruth-Janneck, 2011). Barriers occur because a large number of websites do not sufficiently consider needs of users with impairments (e.g., Gonçalves, Martins, Pereira, Oliveira, & Ferreira, 2013; Nurmela, Pirhonen, & Salminen, 2013). Such needs are, for instance, a high contrast between text and background for users with visual impairments, text alternatives describing audio content for users with hearing impairments and easy-to-read texts for people with cognitive impairments (e.g., Thatcher et al., 2006). There are different reasons why practitioners do not consider needs of people with impairments, including a lack of awareness (e.g., they do not know about specific needs of people with impairments) and economic considerations (e.g., they assume considering such needs increases work effort). A further prevalent and important reason for not considering needs of people with impairments are negative preconceptions about disability-friendly website design (e.g., practitioners assume considering needs of people with impairments results in ugly, boring and dull websites, which is disadvantageous for nonimpaired users; Ellcessor, 2014; Farrelly, 2011; Lazar, Dudley- Sponaugle, & Greenidge, 2004; Thatcher et al., 2006). The present work concerns such negative preconceptions by investigating possible side effects for nonimpaired users when applying disability-friendly website design.

• Dr. Benjamin Spicher - Leadership in Schools and Teacher Well-Being: An Investigation of Influence Processes (PhD)

  Supervisor: Prof. Dr. Petra Klumb

  No abstract available.

• Dr. Anne-Raphaëlle Richoz - Moving towards the understanding of dynamic human face processing (PhD)

  Supervisor: Prof. Dr. Roberto Caldara

  The human visual system is steadily stimulated by dynamic cues. Faces provide crucial information about identity, gender, ethnicity, speech, attention, eye-gaze direction, or emotions, all important for adapted social interactions. From an evolutionary perspective, humans have been more extensively exposed to dynamic faces, as static face images have only appeared recently with the advent of photography and the expansion of digital tools and social networks. Yet, most studies investigating face perception have relied on static faces and only a little is known about the mechanisms involved in dynamic face processing.

  To clarify this issue, this thesis aimed to use dynamic faces to investigate different aspects of face processing in different populations and age groups. In Study 1, we used dynamic faces to investigate whether the ability of infants aged 6, 9, and 12 months in matching audible and visible attributes of gender is influenced by the use of adult-directed (ADS) vs. infant-directed (IDS) speech. Our results revealed that from 6 months of age, infants matched female but not male faces and voices when presented with adult-directed speech. This ability emerged at 9 months of age when presented with infant-directed speech. Altogether, these findings support the idea that the perception of multisensory gender coherence is influenced by the very nature of social interactions.

  In Study 2, we used a novel 4D technique to reconstruct the dynamic internal representations of the six basic expressions in a pure case of acquired prosopagnosia (i.e., a brain-damaged patient severely impaired in recognizing familiar faces). This was done in order to re-examine the debated issue of whether identity and expression are processed independently. Our results revealed that patient PS used all facial features to represent basic expressions, contrasting sharply with her suboptimal use of facial information for identity recognition. These findings support the idea that different sets of representations underlie the processing of identity and expression. We then examined patient PS’s ability to recognize static and dynamic expressions using her internal representations as stimuli. Our results revealed that she was selectively impaired in recognizing many of the static expressions; an impairment that could be explained by her specific set of lesions in the right inferior occipital gyrus. In contrast, she displayed maximum accuracy in recognizing all the dynamic emotions with the exception of fear. The latter findings support recent evidence suggesting that separate cortical pathways, originating in early visual areas and not in the inferior occipital gyrus, are responsible for the processing of static and dynamic face information. Altogether, our findings suggest that the temporal properties of human facial expressions influence their processing, particularly in fragile face processing systems, questioning the evidence obtained by neuropsychological studies investigating expression recognition with static images only.

  Moving on from our second study, in Study 3, we investigated whether dynamic cues offer processing benefits for the recognition of facial expressions in other populations with fragile face processing systems; for instance, young children whose systems are yet to fully mature or elderly people whose systems are declining. To this aim, we conducted a large sample cross-sectional study with more than 400 participants aged between 5 to 96 years, investigating their ability to recognize the six basic expressions presented under different temporal conditions. Consistent with previous studies, our findings revealed the highest recognition performance for happiness, regardless of age and experimental condition, as well as marked confusions among expressions with perceptually similar facial signals (e.g., fear and surprise). By using Bayesian modelling, our results further enabled us to quantify, for each expression and condition individually, the steepness of increase and decrease in recognition performance, as well as the peak efficiency, the point at which observers’ performance reaches its maximum before declining. Finally, our results offered new evidence for a dynamic advantage for facial expression recognition, stronger for some expressions than others and more important at specific points in development.

   Overall, the results highlighted in this thesis underlie the critical importance of research featuring dynamic stimuli in face perception and expression recognition studies; not only in the field of prosopagnosia, but also in other domains of developmental and clinical neuroscience.

• Dr. Tamara Luginbühl - Emotional Inertia and Interpersonal Adaptation in Intimate Relationships (PhD)

  Supervisor: Prof. Dr. Dominik Schoebi

  Emotions are not static but fluctuate over time as a function of contextual changes (Kuppens, Allen, & Sheeber, 2010). This temporal feature of emotions is considered in the concept of emotional inertia, which reflects the degree to which emotions are resistant to change over time (Kuppens et al., 2010). Several studies suggest an association between emotional inertia and psychological maladjustment (e.g., Koval & Kuppens, 2012; Kuppens et al., 2010). The current work aims to extend the literature by elucidating the maladaptive impact of emotional inertia on intimate relationships. Three empirical contributions are included in the present doctoral thesis. Study I has a methodological focus. The paper illustrates how processes that occur within individuals and dyads can be accessed using intensive repeated measures designs based on ambulatory assessment procedures, and discusses advantages and challenges of such designs. The example that is used as illustration examines associations between emotional inertia and accuracy in perceiving partners’ emotions in daily life. Parents from 172 families rated their own and their partner’s emotional states six times a day during one week. The results revealed that both parents were able to predict the emotions of their partners’ accurately, but women with high levels of emotional inertia were particularly accurate in tracking emotional changes in their partners’. Study II examined short-and long-term correlates of emotional inertia in two studies. Study 1 examined associations between emotional inertia and emotional reactivity to conflict and intimacy. Momentary assessments from 44 participants were collected with an ambulatory assessment four times per day over 4 weeks. Emotional inertia showed a curvilinear association with context-sensitive emotional responses to conflict, with individuals high or low in emotional inertia experiencing blunted emotional reactions to conflict as compared to individuals with intermediate levels of emotional inertia. Study 2 assessed emotional inertia based on four emotional reports per day over 10 days of both partners in a total of 103 couples, and examined associations with perceptions of partners’ responsiveness and relationship satisfaction over 12 months. Compared to partners of individuals with intermediate levels of emotional inertia, partners of individuals high or low in emotional inertia perceived them to be less responsive during their interactions together, which then predicted steeper declines in their relationship satisfaction over the subsequent 12 months. Study III combined an ambulatory assessment procedure with an observational approach to explore whether emotional inertia is associated with emotion response patterns in couple support interactions that are predictive of relationship dysfunction. Individual differences in emotional inertia of 134 individuals (n=67 couples) were captured using a smartphone-based ambulatory assessment with four daily emotional self-reports across two weeks. Emotions in couple interactions were operationalized through reciprocity of facial expressions of emotions during videotaped social support interactions in the laboratory. Facial expressions of emotions were analyzed with the facial expression recognition and analysis software FACET (iMotions, 2015), and defined as the helper (or support provider) responding with equivalent facial expressions of emotions as the helpee (or support receiver). The results suggest that emotional inertia is associated with greater reciprocity of non-affiliative facial expressions of emotions (hard negative affect), but less reciprocity of affiliative facial expressions of emotions (positive affect, soft negative affect). Taken together, the results suggest that emotional inertia may interfere with the social function of emotions, that is to guide an individual's behavior in adaptive ways within relational situations (Keltner & Gross, 1999; Keltner & Haidt, 2001), affecting individual and relational functioning.

2017

• Dr. Pei Hwa Goh - Perception of Sexual Interest: Examining the Roles of Situation, Dispositions, and Culture (PhD)

  Supervisor: Prof. Dr. Dominik Schoebi

  This thesis incorporates a set of empirical studies addressing different perceiver-based predictors of sexual interest perception. We first tackled the question: what is the psychological function of perceiving sexual interest? Daily diary data (N = 84) from the first study in Chapter 3 revealed that perceiving sexual interest was associated with increases in momentary self-esteem. However, this depended on the relationship status of the perceiver and the person from whom they perceived sexual interest. Perceiving sexual interest from any other person boosted the state self-esteem of perceivers who were single but not for those who were in a relationship. People in a relationship only reported self-esteem boosts after perceiving sexual interest from their current relationship partner. We suggested that, in line with the sociometer theory (Leary, Tambor, Terdal, & Downs, 1995), self-esteem may also function as a gauge of how well one’s reproductive needs are being met, with sexual perceptions as input. On the basis of these findings, it was posited that perception of sexual interest may represent one important, albeit tenuous, resource that contributes to the development of good mate value. The following investigations were, thus, grounded on the proposition that situations and dispositions that afforded reward pursuit (rather than threat aversion) would increase individuals’ perception of sexual interest, presumably as a means to satisfy reproductive goals or mating needs via the accumulation of mate value. The second aim in the studies presented in Chapter 3 was to examine how self-esteem, as a trait, would shape sexual perceptions. According to the risk regulation model (Murray, Holmes, & Collins, 2006), trait self-esteem guides people’s sensitivity to social risks and rewards; in that people with high self-esteem are more motivated to pursue rewards (e.g., to connect with others, to recharge or build up mate value) because they possess a psychological resource that acts as a protective shield against social risk. Those with low self-esteem, however, lack such resources and therefore prioritize the avoidance of the consequences associated with social risks. As predicted, we found that people’s general level of self-esteem predicted increased sexual perceptions. As a follow-up to the findings in Chapter 3, the studies presented in Chapter 4 examined whether holding power – a situation that promotes reward pursuit – would also heighten sexual perception. Results from 3 experiments (Ns = 529) with Swiss military samples revealed that male military members reported higher estimations of sexual interest from a female military member when they held a higher military rank relative to the female target, compared to those holding either an equal rank or a relatively lower rank. Additionally, the power effect was not present among individuals who were hypersensitive to rewards by disposition, as they already perceived high sexual interest in general. Power only increase sexual perceptions for those who were low-to-moderately sensitive to rewards. Results from the studies in Chapters 3 and 4 support our proposition that sexual interest perception would increase in situations and dispositions that afford goal pursuit and decrease in those that trigger threat aversion. What about situations that do not provide the perceiver a so-called psychological insurance against risks (which power and high self-esteem offer), but instead just seems to be perceived as safe, rather than dangerous? For instance, one’s mood has been proposed in prior research to function as a signal of the conditions of his or her current environment. A positive mood indicates safety while a negative mood indicates a presence of threat. Given this, the final study (Chapter 5) examined if people perceive more sexual interest when they are in a good mood and less when they are in a negative mood. Experiments involving mood induction procedures were conducted on university students in Switzerland and Malaysia (Ns = 234). The results of this experiment revealed that negative mood significantly reduced men and women’s estimations of sexual interest, but not for Malaysian participants. Further analyses showed that the difference in mood effects in perception between the two samples could be explained by differential endorsement in sociocentric values; people who highly valued social harmony and stability (such as the Malaysian sample) were not significantly affected by their mood when making sexual judgments. Taken together, the results from the current work imply that sexual perception may be better understood as a situation-varying, individual-varying, and culture-varying phenomenon rather than simply being examined as a gendered one.

• Dr. Lisa-Katharin Kaufmann - "Reshaping" the Brain – Longitudinal investigation of structural and functional brain alterations during weight gain in Anorexia nervosa (PhD)

  Supervisor: Prof. Dr. Chantal Martin-Sölch

  Anorexia nervosa (AN) is a life threatening and difficult-to-treat eating disorder with a high relapse rate and an often chronic course of illness. Despite various efforts, the etiopathogenesis of this disorder remains enigmatic. This work sets out to investigate structural and functional brain alterations in young women with AN and closely matched healthy control participants, to help clarify the role of neural changes in this challenging disorder. Its main aim is the temporal mapping of neural and behavioural changes in a longitudinal design with three measurement time points: from the acute phase of AN, with severe underweight, to a weight- restored phase.

  To examine brain alterations during acute underweight, as well as res- torative mechanisms induced by weight gain treatment, two longitudinal studies and a cross-sectional study were conducted. Study I provides insight into structural brain alterations of AN patients during acute underweight as well as longitudinal regenerative processes with weight restoration. The findings demonstrate strong global reductions of cor- tical and subcortical grey matter at the beginning of treatment and a partial reversibility over the course of treatment. Notably, these brain recovery processes were dependent on patients’ age, potentially indicating decreases of brain plasticity across the lifespan.

  Study II examines network changes of resting-state functional connectiv- ity in patients with AN during acute underweight, as well as over the course of weight restoration treatment. With the help of network-based analyses a network of reduced functional connectivity was identified at the beginning of treatment comprising fronto-basal ganglia/limbic regions related to reward, learning, and cognitive-emotional integration. This network of reduced connectivity recovered with weight normalisation. The regeneration of functional connectivity within the network significantly correlated with changes in patients’ psychopathology.

  Study III is a cross-sectional investigation of structural connectivity at the beginning of treatment with a focus on the fornix, a tract of the limbic system connecting the mammillary bodies with the hippocampi. Findingsof reduced structural connectivity in previous studies had suggested the fornix as a key structure in the pathomechanism of AN. By integrating knowledge from Study I to investigate potential pitfalls in the investigation of structural connectivity in AN, Study III shows that previous results had been biased by enlarged ventricles of AN patients. The findings reveal that differences of structural connectivity in the fornix disappear, compared to healthy controls, when adequately controlling for effects of the enlarged ventricles. This suggests that microstructural alterations unlikely occurred in the fornix of AN patients.

  Taken together, the findings of the present PhD thesis demonstrate a tremendous plasticity of young AN patients’ brains and suggest that drastic alterations in the structural and functional realm are largely reversible with specific treatment and careful weight restoration. Remain- ing residual alterations both on a structural and functional level by the end of the weight normalisation treatment highlight the importance of sufficiently long and well-structured treatment programmes, including outpatient after-care, to further normalise and stabilise weight and eating behaviour, as well as to improve psychopathology. The complex nature of AN underscores the necessity in neuroimaging research to combine and carefully evaluate different sources of information to avoid erratic or premature conclusions about brain alterations.

• Dr. Ilana Berlowitz - Traditional Amazonian Medicine Adapted To Treat Substance Use Disorder (PhD)

  Supervisor: Prof. Dr. Chantal Martin-Sölch

  Pathological substance use is amongst the most persistent and costly ills of global modern society. In spite of advances made in therapeutic possibilities over the past decades, long-term treatment responses remain relatively discouraging, with relapse rates higher than for most other psychiatric disorders. The chronic disease course of substance use disorder (SUD) has led to debate whether illness management strategies from somatic chronic care may also be suitable for SUD. In particular, traditional or alternative medicines, a common present-day adjunct to conventional somatic chronic care, may offer benefits for SUDs as well.

  The current work consists of three empirical studies exploring the therapeutic potential of traditional Amazonian medicine as applied in an integrative addiction treatment program, using a multimodal and cross-disciplinary research approach. The investigation was conducted at the Takiwasi Center for Addiction Treatment and Rehabilitation in the Peruvian Amazon, an integrative healthcare center that implements a combination of traditional Amazonian medicine and conventional psychotherapy. As a first step, Study 1 aimed to investigate how SUD is understood in traditional Amazonian medicine and which kinds of treatment methods are used in this context, also aiming to identify the main therapeutic technique used for SUD. For this purpose, we conducted interviews with 13 practicing experts of Amazonian medicine, asking them about their underlying conceptions of disease etiology and treatment of SUD. A qualitative content analytic approach was adopted for data analysis, which revealed an array of conceptual categories. Some of the concepts regarding disease etiology showed similarity to Western scientific views proposing a biopsychosocial model for SUD. Amazonian treatment concepts however differed markedly from Western ones. Instead of identifying a main treatment constituent, the experts emphasized the importance of an integral, combined application of Amazonian methods.

  Study 2 then aimed to investigate who the people are that seek out the Amazonian medicine based treatment for SUDs, assessing clinical and socio-demographic characteristics of 50 SUD-diagnosed patients enrolling in the Takiwasi treatment by means of structured clinical interviews and psychological self-report measures. We additionally were interested to know the participants' motivations for selecting this particular therapy program, which we assessed via qualitative analysis of patient motivation letters. Our results showed that most Takiwasi patients were young or middle- aged, unmarried males living with their relatives in urban areas in Peru or other Latin American countries. Polydrug use was the most common diagnosis, with cannabis, alcohol, cocaine and cocaine base paste as the most prevalent substances. Common comorbid psychopathologies included anxiety and mood disorders as well as antisocial personality disorder. Compared to norms from patients entering conventional psychiatric treatment, severity was elevated in the Takiwasi sample on several addiction and well-being indicators. The motives behind individuals' choices to initiate treatment at this center are described.

  Finally, Study 3 aimed to explore short-term treatment effects of the overall Takiwasi therapy program. About one-third of the initial sample abandoned treatment prematurely, which resulted in a final sample of n = 36 SUD-diagnosed patients that completed the treatment. We found significant improvements of addiction severity from baseline assessment to treatment completion on indicators of drug use, alcohol use, psychiatric status, and social and familial relationships. Overall substance craving decreased significantly after treatment, as did overall emotional distress. Quality of life scores increased significantly at treatment completion. Taken together, these findings point to a substantial improvement of key symptomatic features of SUD after completing this alternative SUDtreatment. At the same time it is important to note that these results are preliminary and need to be confirmed by further, randomized-controlled studies including follow up assessments.

  In summary, findings from this research point to a promising novel treatment approach for SUD, which invites further investigation. We propose two parallel lines of research to be followed: One is qualitative, involving a detailed and systematic inquiry into the conceptual underpinnings of Amazonian medicine, and a thorough analysis of its characteristics and specifics for safe and efficacious application. The second line of research should involve quantitative studies on treatment effects, using progressively more controlled research designs adapted to a traditional medicines paradigm, while also assessing the transferability of Amazonian therapeutic methods to other cultural contexts. Results from the current work serve as a basis for future research and may in the long term open new treatment possibilities for SUD on a large scale.

• Dr. Andrea Samson - Emotion Dysregulation in Individuals with Autism Spectrum Disorder (Habilitation)

  Supervisor: Prof. Dr. Valérie Camos

  No abstract

2016

• Dr. Epaphrodite Nsabimina - The process of institutionalization-deinstitutionalization and children's psychological adjustement in Rwanda: Parents matter (PhD)

  Supervisor: Prof. Dr. Chantal Martin-Sölch and Prof. Dr. Eugène Rutembesa

  Abstract Negative effects of institutionalization and positive effects of deinstitutionalization on children’s wellbeing have been well documented. However, the majority of reports on institutional care rely on adult interviews and there is a wide disparity of results and methodologies in few result- oriented studies of deinstitutionalization outcome. In addition, though all over the world, especially in developed countries, many children in orphanage have parents, little is known about on the effect of having or not living biological parents and be institutionalized.

  The present thesis aims generally to investigate whether institutionalization negatively impacts the psychological adjustment of children. Specifically, this thesis aims at (1) exploring children’s perceptions on institutionalization process; (2) investigating the influence of biological parental living status on institutionalized children’s psychological adjustment; and (3) evaluating the effectiveness of deinstitutionalization as well as conditions for better psychological adjustment once children are deinstitutionalized. With a prospective longitudinal comparative design, focus group discussions and self-report questionnaires were used by the present thesis to collect respectively qualitative and quantitative data from 177 children aged 9 to 16 and their parents/primary caregivers divided in 6 registered orphanages and 5 primary schools in Rwanda. Grounded theory was used to analyze qualitative data whilst analysis of variance and multiple regression were used to analyze quantitative data. Outcome variables included externalizing and internalizing behavior, attachment and self- esteem.

  Taken together, our results show that institutionalization has a negative impact on children’s psychological adjustment. The most remarkable and unexpected finding is that Rwandan children living in institution have more impairment in psychopathological symptoms when they have living parents. They considered institutionalization as an orphanization process. Another remarkable finding is that the present thesis failed to prove the improvement of psychological adjustment due to de-institutionalization in all domains as expected. The improvement was reported in attachment while no change was observed in externalizing behavior or self-esteem after deinstitutionalization and worse, internalizing behavior worsened among de-institutionalized children. Family relationships and parenting involvement were reported to be the strongest predictors of children’s psychological adjustment in most of measured outcome variables. Unexpectedly, socioeconomic status, didn’t gain as much importance in that prediction. Contrariwise, adult’s perceived quality of life was a significant mediated predictor in children’s externalizing behavior and had a moderating effect in children’s internalizing behavior.

  This should be considered to develop and improve supportive specific interventions for children and considered when making the decision of placing or not a child with parents in an institution. Results suggest the intensification of identifying and addressing the behavioral problems as part of deinstitutionalization process focusing also on family characteristics to improve children’s psychological adjustment. Moreover, understanding the development of psychopathological problems during the process of institutionalization and de-institutionalization may be key to preventing high costs associated with these disorders across the life course.

2015

• Dr. Anne-Laure Oftinger - Evolution développementale des mécanismes de maintien de l’information verbale en mémoire de travail entre 6 et 9 ans (PhD)

  Supervisor: Prof. Dr. Valérie Camos

  La mémoire de travail permet le stockage temporaire d'informations et leur traitement. Pour maintenir de l’information verbale en mémoire de travail nous utilisons, en tant qu’adulte, deux mécanismes, la répétition articulatoire et le rafraîchissement attentionnel. Nous sommes capables d’utiliser ces deux mécanismes indépendamment et de façon additive. Les enfants utiliseraient ces deux mécanismes dès l’âge de 7 ans. Ce travail de thèse avait pour objectif de compléter la seule étude portant sur le développement conjoint de ces deux mécanismes, celle de Tam et al. (2010). Dans le but d’évaluer le développement conjoint des deux mécanismes autour de l’âge charnière de 7 ans, ces expériences ont porté sur des enfants âgés entre 6 et 9 ans. Les résultats obtenus confirment que les mécanismes de répétition articulatoire et de rafraîchissement attentionnel peuvent être utilisés par les enfants dès l’âge de 7 ans. La répétition articulatoire serait même disponible avant l’âge de 7 ans, remettant en question l’hypothèse d’un changement qualitatif à 7 ans. En effet, dès 6 ans les enfants utilisent des stratégies de maintien et sont sensibles à l’effet de similarité phonologique. Les résultats des trois études menées ne dévoilent aucune interaction entre la manipulation de l’utilisation du rafraîchissement attentionnel et celle de la répétition articulatoire. En accord avec les résultats obtenus chez l’adulte, ces deux mécanismes sont donc indépendants chez l’enfant dès l’âge de 6 ans.

• Dr. Benoît Perriard - L’effet du bilinguisme sur la mémoire de travail : comparaisons avec des monolingues et étude du changement de langue dans des tâches d’empan complexe (PhD)

  Supervisor: Prof. Dr. Valérie Camos

  Le but de cette thèse était d’étudier l’effet du bilinguisme et du changement de langues dans des tâches de mémoire de travail. La recherche sur le bilinguisme et la cognition a mis en évidence que les deux langues d’un bilingue étaient toujours activées (e.g., Hoshino & Kroll, 2008). Selon le modèle de l’inhibition de Green (1998), un bilingue qui souhaite s’exprimer dans une langue doit désactiver l’autre langue en utilisant un mécanisme de contrôle appelé l’inhibition. Bialystok et ses collègues (e.g., Bialystok, Craik, Klein, & Viswanathan, 2004; Bialystok & Martin, 2004; Bialystok & Senman, 2004) ont émis l’hypothèse que ce mécanisme était le même que celui utilisé pour le contrôle de l’attention de manière générale. Le contrôle de l’attention est assuré par des fonctions exécutives, dont les principales sont l’inhibition, le shifting et l’updating (Miyake et al., 2000). Ainsi, Bialystok et al. (2004) ont mis en évidence de meilleurs résultats de bilingues comparés à des monolingues sur une tâche mesurant l’inhibition. Néanmoins, ces résultats n’ont pu être répliqués lorsque le statut socio-économique de participants issus d’une même culture a été mesuré (Morton & Harper, 2007). D’autres chercheurs ont trouvé une supériorité des bilingues dans des tâches mesurant d’autres fonctions exécutives (e.g., (Bonifacci, Giombini, Bellocchi, & Contento, 2010; S. M. Carlson & Meltzoff, 2008; Costa, Hernández, & Sebastián-Gallés, 2008; P. M. J. Engel de Abreu, Cruz-Santos, Tourinho, Martin, & Bialystok, 2012).

  Dans le premier chapitre de cette thèse, nous avons comparé des bilingues et des monolingues sur une tâche de mémoire de travail, dont le fonctionnement requiert l’utilisation de fonctions exécutives (e.g., Baddeley, Della Sala, Robbins, & Baddeley, 1996; Miyake & Shah, 1999). Nous avons mesuré et pris en compte le statut socio-économique des participants. En effet, le statut socio-économique corrèle avec les performances de contrôle exécutif (e.g., Farah et al., 2006; Mezzacappa, 2004) et la capacité de mémoire de travail (e.g., Lee, Kawachi, Berkman, & Grodstein, 2003). Nous avons fait passer une tâche de mémoire de travail à des étudiants universitaires et des apprentis. Concernant le statut socio-économique, nous avons mesuré chez les premiers un indice significativement plus élevé. Les résultats à la tâche de mémoire de travail n’étaient pas significativement différents chez les étudiants universitaires. En revanche, les apprentis bilingues ont obtenu un score significativement plus élevé que les apprentis monolingues. Nous en avons conclu que le bilinguisme avait un effet positif sur la capacité de mémoire de travail pour des participants au niveau socio-économique modeste. Les résultats similaires des étudiants universitaires monolingues et bilingues, ayant été sélectionnés pour leurs bonnes capacités cognitives, correspondent au lien positif entre statut socio-économique et capacité de mémoire de travail mis en évidence par Lee et al. (2003).

  Dans les Chapitres II et III, nous nous sommes intéressés au coût cognitif engendré par le changement de langues durant une tâche de mémoire de travail chez des bilingues. Dans le Chapitre II, les participants devaient effectuer une tâche d’empan complexe mesurant la capacité de mémoire de travail. Cette tâche consistait à mémoriser dans l’ordre de présentation des séries d’items, dont la nature pouvait varier selon l’expérience. Il pouvait s’agir de chiffres ou de mots. Entre la présentation de chaque item, les participants devaient effectuer oralement une tâche concurrente, qui consistait à nommer des items apparaissant à l’écran. Nous avons également fait varier la nature de ces items (formes, chiffres ou couleurs) dans les différentes expériences menées. Les participants devaient compléter plusieurs conditions linguistiques. Des conditions dans lesquelles la tâche de rappel et la tâche concurrente étaient dans une même langue (le langage dominant, L1 vs la deuxième langue, L2), ainsi que des conditions dans lesquelles ils effectuaient la tâche de rappel dans une langue et la tâche concurrente dans l’autre. La nature des items à mémoriser a influencé la performance de rappel. Ainsi, lorsque les items à mémoriser étaient des chiffres, le rappel était meilleur dans les conditions comportant une seule langue. La performance était néanmoins similaire lorsque le rappel était en L1 comparé à L2. Lorsqu’il s’agissait de mémoriser des mots, le rappel était meilleur lorsque la tâche était entièrement en L1 comparé à la tâche entièrement en L2. En revanche, il n’y avait pas de différence significative de rappel entre les conditions comportant une et deux langues. Nous avons expliqué ces différences par la stratégie d’encodage possible selon la nature des items à mémoriser. Dans le Chapitre III, les participants ont effectué un reading span (Daneman & Carpenter, 1980). Cette tâche consiste à lire une série de phrases et à mémoriser le dernier mot de chaque phrase à rappeler à la fin d’une série. Nous avons créé un reading span multilingue, dans lequel les participants pouvaient avoir à lire et mémoriser des contenus dans une ou deux langues selon les conditions, cela parmi trois langues possibles : l’allemand (L1) et le français (L2), appris avant l’âge de 10 ans et l’anglais (L3), appris après l’âge de 10 ans. Les résultats ont montré que le rappel des mots était plus élevé lorsque la série de phrases était entièrement en L1, comparé aux conditions qui comportaient deux langues. Il n’y avait pas de différence significative entre les conditions entièrement en L2 ou en L3 et les conditions à deux langues L1L2 ou L1L3. Nous proposons d’expliquer ces résultats différents de ceux du Chapitre II par la nature différente de la tâche concurrente, i.e. la lecture d’une phrase entière, les intrusions lexicales des mots de la phrase à lire étant plus importantes.

  Dans le quatrième et dernier chapitre, nous avons mené une étude descriptive des bilingues de l’Université de Fribourg, dont sont issus un bon nombre des participants de nos expériences. Nous nous sommes intéressés à l’acquisition et l’usage de leurs langues. Pour ce faire, nous avons utilisé le Language Experience and Proficiency Questionnaire (LEAP-Q ; Marian, Blumenfeld, & Kaushanskaya, 2007). Ce questionnaire a permis d’établir deux profils distincts de bilingues. En effet, une analyse statistique a mis en évidence que la nature de l’utilisation actuelle de leurs deux langues pouvait diviser les bilingues en deux groupes distincts. Premièrement, un groupe qui parle une langue dans son cadre privé et une autre à l’extérieur. Deuxièmement, un groupe qui parle les deux langues dans chaque environnement qu’il fréquente.