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IntroductionPerfectionism, as a transdiagnostic variable, can influence both the intrapersonal and interpersonal domains, one of the most significant of them is thought to be marital relationship. Given that perfectionism within a couple can negatively affect their intimate relationship and potentially lead to destructive outcomes, reviewing studies conducted in this area seems to be essential to gain a clearer understanding. Therefore, the present systematic review aims to examine the association between perfectionism and marital outcomes in married individuals.MethodsA comprehensive search was conducted across major scientific databases, including APA PsycArticles, PubMed, and Web of Science, using specific keywords and Boolean operators. Included were the English-Language studies published between 1980 and 2023 that investigated the relationship between perfectionism and marital outcomes in heterosexual couples. Out of the studies identified, 23 met the inclusion criteria for this review, of which 16 studies met the criteria for meta-analysis.ResultsThe meta-analysis indicated a small-to-moderate effect size for the association between perfectionism and marital outcomes (r = 0.26). Given the importance of marital relationship, such effect sizes for variables which may influence marital relationship bears significant value.DiscussionTherefore, the findings may encourage researchers to conduct various studies to examine specific details, moderators, and mediators in the relationship between perfectionism and marital outcomes and may also prompt couple therapists to address perfectionism as a destructive factor and integrate strategies into their protocols to reduce its impact in intimate relationships.

IntroductionThe current systematic review aimed to examine the relationship between acculturative stress (AS) and psychological outcomes in international students to determine the role AS may play in predicting the mental health of international students.MethodsThe studies included in the current systematic review and meta-analysis had considered AS and its impact on psychological outcomes among international students studying abroad. After checking the studies found in our primary search through the scientific databases in terms of our eligibility criteria, 29 studies were included, of which 26 were eligible for a meta-analysis (total N = 7,247).ResultsMeta-analysis indicated a moderate mean correlation of AS with psychological outcomes like depression, life satisfaction, quality of life, vocational outcome expectations, drinking behaviors, resilience, health promotion behavior, psychological adjustment, psychological distress, negative affect, and mental health symptoms (r = 0.39) and depression (r = 0.41), respectively.DiscussionThe review of studies revealed a robust relationship between AS and increased negative psychological outcomes such as depression, psychological distress, and general stress, as well as decreased positive psychological outcomes such as psychological adjustment, mental health, life satisfaction, and quality of life.

The current study aims to investigate the meaning of life, psychological well-being, self-care, and social capital, with depression and death anxiety in the elderly living in nursing homes through the mediating role of loneliness. The statistical population included all the elderly aged at least 60 years living in Tehran, Qazvin and Zanjan, Iran in 2020, among whom 489 (273 men and 216 women) were selected using convenience sampling method. Participants filled out Steger's Meaning of Life, Ryff and Singer's Psychological Well-Being Scale, Söderhamn et al.’s Self-Care Ability, Nahapiet and Ghoshal's Social capital, Beck's depression, Templer's Death Anxiety, Russell et al.’s Loneliness questionnaires. The results indicated that meaning of life, psychological well-being, self-care, and social capital are negatively associated with loneliness, which in turn, is positively associated to depression. Furthermore, meaning of life, psychological well-being, self-care, and social capital are negatively associated with loneliness, which in turn, is positively associated to death anxiety. Moreover, the results of path analysis revealed that the hypothesized model of the current study has an excellent fit in the study sample. That is, meaning of life, psychological well-being, self-care, and social capital are related to depression and death anxiety through mediating role of loneliness.

Abstract Background The UN Convention on the Rights of Persons with Disabilities, and the reformed guardianship law in Germany, require that persons with a disability, including people with dementia in Alzheimer’s disease (PwAD), are supported in making self-determined decisions. This support is achieved through communication. While content-related communication is a deficit of PwAD, relational aspects of communication are a resource. Research in supported decision-making (SDM) has investigated the effectiveness of different content-related support strategies for PwAD but has only succeeded in improving understanding, which, although one criterion of capacity to consent, is not sufficient to ensure overall capacity to consent. The aim of the ‘spatial intervention study’ of the DECIDE project is to examine an innovative resource-oriented SDM approach that focuses on relational aspects. We hypothesise that talking to PwAD in their familiar home setting (as opposed to a clinical setting) will reduce the complexity of the decision-making process and enhance overall capacity to consent. Methods People with a suspected or confirmed diagnosis of dementia in Alzheimer’s disease will be recruited from two memory clinics (N = 80). We will use a randomised crossover design to investigate the intervention effect of the decision-making place on capacity to consent. Besides reasoning capacity, which is part of overall capacity to consent and will be the primary outcome, various secondary outcomes (e.g., other aspects of capacity to consent, subjective task complexity, decisional conflict) and suspected moderating or mediating variables (e.g., meaning of home, demographic characteristics) will be assessed. Discussion The results of the study will be used to develop a new SDM strategy that is based on relational resources for PwAD. If a change in location achieves the anticipated improvement in capacity to consent, future research should focus on implementing this SDM strategy in a cost-effective manner in clinical practice. Trial registration: DRKS00030799 .

Abstract Background Prior research mainly focussed on the impact of the teacher-student relationship on teachers emotions and wellbeing. Current data shows a relationship between the quality of the teacher-student relationship and children's mental health. Unfortunately, it has not yet been investigated whether meaningful experiences with teachers also have an impact on students' well-being and whether an effect can still be found in adulthood. This work examines the impact of meaningful experiences with teachers during childhood and adolescence on the well-being of adults. Methods The data in this study was collected by using a questionnaire. The current well-being of the participants was assessed with measures of life satisfaction, resilience, anxiety, stress, depressiveness, and self-esteem. Also, participants were asked to briefly write about their most meaningful experiences with teachers and rate them regarding their valence. These experiences were categorized into seven categories using a summarizing content analysis. We then conducted a statistical analysis with the data obtained. Results The results showed a highly significant correlation between the participants’ self-esteem and the valence ratings of their experiences. Furthermore, the experience category had a substantial effect on individual self-esteem. Overall, this study demonstrated that a relationship exists between the well-being of adults and their experiences with teachers during childhood and adolescence. Conclusion The results of this study call for a reflective, fair, authentic, and empathetic approach to students. Accordingly, teachers should be intensively trained to establish a relationship with their students that is characterized by appreciation and empathy.

Abstract Background The current study aims to investigate the relationship between attachment styles and happiness through the mediating role of reminiscence styles in the elderly. Methods This was a correlational study of structural equations modelling (SEM) type. The statistical population included all the elderly aged at least 60 years living in Kermanshah province, Iran in 2021, among whom 380 (182 men and 198 women) were selected using convenience sampling method. Participants filled out the questionnaires of Adult Attachment Styles, Oxford Happiness, and Amani et al.’s Reminiscence Styles. Results The results indicated that secure attachment style has a positive and negative relationship with positive reminiscence (PR) and negative reminiscence (NR), respectively. However, the opposite held true for both avoidant and ambivalent attachment styles. It was also found that secure attachment style has a positive relationship, and avoidant and ambivalent attachment styles have a negative relationship with happiness. Moreover, participants’ gender and age had no moderating effect on the mentioned relationships. The results of SEM indicated that secure and ambivalent attachment styles were associated with happiness through both PR and NR, and avoidant attachment style was associated with happiness only through NR. Conclusions The findings emphasize the significance of the development of internal working models based on the kind of parent-child’s reminiscences and narratives, and the lifelong effects of these models.

Abstract The goal of this study was to examine whether a subject’s emotional competence correlates to attachment styles and parenting styles in children and their parents. The study was conducted with fifty children (9–11 years old) and their parents, both of whose emotional competence (EKF) and parenting style (PAQ) were measured. The attachment styles of parents and children were measured with the Adult Attachment Scale (AAS) and the Bochumer Bindungstest (BoBiTe), respectively. The findings provide initial support to the assumption that attachment is related to emotional competence in parents. This relationship, however, was not significantly correlated in children. In addition, authoritative parenting and permissive parenting were significantly associated with emotional competence in parents. Emotional competence in children showed to be associated with an authoritative parenting style.

IntroductionSeveral lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have been described for occupational cognitive requirements (OCR) in midlife, it is currently unknown whether they are conveyed by brain maintenance (BM), brain reserve (BR), or cognitive reserve (CR) or a combination of them.MethodsWe systematically derived hypotheses for these resilience concepts and tested them in the population-based AgeCoDe cohort and memory clinic-based AD high-risk DELCODE study. The OCR score (OCRS) was measured using job activities based on the O*NET occupational classification system. Four sets of analyses were conducted: (1) the interaction of OCR and APOE-ε4 with regard to cognitive decline (N = 2,369, AgeCoDe), (2) association with differentially shaped retrospective trajectories before the onset of dementia of the Alzheimer's type (DAT; N = 474, AgeCoDe), (3) cross-sectional interaction of the OCR and cerebrospinal fluid (CSF) AD biomarkers and brain structural measures regarding memory function (N = 873, DELCODE), and (4) cross-sectional and longitudinal association of OCR with CSF AD biomarkers and brain structural measures (N = 873, DELCODE).ResultsRegarding (1), higher OCRS was associated with a reduced association of APOE-ε4 with cognitive decline (mean follow-up = 6.03 years), consistent with CR and BR. Regarding (2), high OCRS was associated with a later onset but subsequently stronger cognitive decline in individuals converting to DAT, consistent with CR. Regarding (3), higher OCRS was associated with a weaker association of the CSF Aβ42/40 ratio and hippocampal volume with memory function, consistent with CR. Regarding (4), OCR was not associated with the levels or changes in CSF AD biomarkers (mean follow-up = 2.61 years). We found a cross-sectional, age-independent association of OCRS with some MRI markers, but no association with 1-year-change. OCR was not associated with the intracranial volume. These results are not completely consistent with those of BR or BM.DiscussionOur results support the link between OCR and CR. Promoting and seeking complex and stimulating work conditions in midlife could therefore contribute to increased resistance to pathologies in old age and might complement prevention measures aimed at reducing pathology.

Abstract Background Equine-assisted therapy is more often practiced with children and adolescents than with the elderly, although individuals in the second half of life could also profit from it. This group, from the age of 50, is characterised by increasing emotional, social, health-related and cognitive changes; a critical life event, such as a neurological illness or loss of a family member, can increase the likelihood of subclinical depression. Individuals who exhibit depressive symptoms not necessarily diagnosed with a major depression may suffer from relevant losses of quality of life (e.g. sleep disorders, memory disorders, feelings of guilt, hopelessness). Despite the fact that the various healthcare systems are in general more frequently used, such individuals often do not receive adequate therapy. The processing of one’s biography (reminiscence) is an elementary component of most psychotherapy approaches and has been demonstrated to treat and prevent the development of major depression. In this study, equine-assisted biographical work (EABW), a combination of equine-assisted therapy and biographical work, will be applied with individuals with subclinical depression in the second half of their life. Methods This is a multicentre, prospective, randomised, controlled and open phase III study in enrolling participants with subclinical depression. The aim of the study is to evaluate whether a preventive, equine-assisted, age-specific treatment combining elements of equine-assisted intervention with those of biographical work offers better treatment potentials in comparison to a control group with no intervention. Study participants in the intervention group will receive weekly equine-assisted biographical work over a period of 8 weeks. The primary endpoint is the change in Beck Depression Inventory-II (BDI-II) in a pre-post comparison. Secondary endpoints include other health-related questionnaires including quality of life, reminiscence functions and anxiety. Discussion The present study is the first randomised study examining the efficacy of biographical work with a horse and has the potential to establish an empirically based treatment for individuals in the second half of life and improving the symptoms of subclinical depression. Trial registration German Clinical Trials Register DRKS00017010 . Registered on 01 April 2019

Abstract Background The Holocaust was one of the most traumatic catastrophes in recorded human history. Survivors seeking psychotherapeutic help today, now in their seventies and older, often show symptoms of a posttraumatic stress disorder (PTSD), depression, or prolonged grief disorder. Established psychological treatments for PTSD (e.g. cognitive behaviour therapy, psychodynamic therapies) have been tested and assessed mainly with young and middle-aged adults; only very few studies examined them in old age. There is no therapy outcome study known to us for any treatment mode for Holocaust survivors. Moreover, there is a need for an age group-specific treatment of PTSD and other stress-related mental disorders. A narrative approach including life-review and narrative exposure seems to meet very well the natural need of older people to review their lives and is highly effective. However, most studies on the efficacy of life review therapy (LRT) focus on late-life depression. There is a lack of efficacy studies evaluating the effect of LRT on PTSD symptoms in older individuals that have experienced traumatic events. Methods The main goal of this study is to evaluate the effect of LRT for Holocaust survivors (LRT-HS) on symptoms of PTSD and related mental health problems (depression, anxiety, prolonged grief), compared to a supportive control group. A secondary goal is to identify the characteristics of participants that seem to especially benefit from the treatment. The proposed study is a randomised, controlled follow-up trial including Holocaust survivors with one or more trauma-related disorders. The LRT treatment consists of 20–25 sessions. Before and after the treatment phase, participants in both conditions will be assessed. Follow-up will take place 6 months after the treatment. A sample size of 80 is required (drop-out rate included). Discussion Efficacious treatments for trauma-related disorders in older people are of high importance, also because the probability of traumatisation and loss increases with age. Because this study is conducted with this specific group of multiply traumatised people, we are convinced that the results can easily transfer to other samples. Trial registration ISRCTN, ISRCTN12823306 . Registered 31 March 2018 – Retrospectively registered (first participant 22 December 2017).

Abstract Background Increasing the quality of life with short interventions for vulnerable patients is one of the objectives of palliative care. Biographical approaches are used in a range of different interventions which may require considerable resources of staff time and energy. This study evaluated the feasibility of training hospice volunteers in biographical interviews of patients confronted with a life-limiting disease. For the purpose of this study, we evaluated resources such as time needed for training, coordination and supervision, outcome such as completion of the intervention in appropriate time and risks such as causing distress in patients or volunteers as major determinants of feasibility. Methods Nine volunteers from a hospice service attended an advanced training with an introduction to palliative care, biography work, interview techniques, transcribing and writing. Volunteers interviewed a patient and developed a written narrative from the interview. Volunteers completed a questionnaire before training and were interviewed at the end of the project. The interviews were audiotaped, transcribed, and evaluated using descriptive and qualitative content analysis. Results Patients provided positive feedback from the intervention. Volunteers felt that their involvement was personally rewarding and were moved by the courage and confidence of the patients. There were no systematic problems or negative experiences reported neither by volunteers nor by patients. Conclusions We found the use of volunteers for biography work with patients in palliative care feasible and effective in this study. Volunteers needed supervision and ongoing support in providing this intervention.

Abstract Background Motivational abilities (MA), that describe skills in relation to goal-oriented behavior, have recently been found to be associated with neuropathological aging. Here we examine the impact of MA on the long-term course of mild cognitive impairment (MCI). Methods We followed-up N = 64 individuals diagnosed with MCI (M age = 73 years, 44% female) for 3 years. MA were assessed by long-term informants of the participants using two scales: motivation and decision regulation [Volitional Components Questionnaires, VCQ, (Kuhl and Fuhrmann, Decomposing self-regulation and self-control: the volitional components inventory, 1998)]. Cognitive abilities were assessed with the Mini Mental State Examination (J Psychiatr Res 12:189-98, 1975). Survival analyses and multilevel modeling (MLM) were applied to determine the predicting effect of informant-rated MA at baseline on the likelihood of MCI stability and on the trajectory of cognitive abilities. Results Fifty percent (n = 32) of the MCI participants remained stable, while 32.8% (n = 21) and 17.2% (n = 11) converted to Alzheimer’s disease (AD) or dropped-out, respectively. Survival analyses revealed that MCI cases with higher-rated MA at baseline were more likely to exert a stable course in MCI over 3 years (p = 0.036) when controlling for demographic characteristics and executive function. MLM analyses indicated that higher informant-rated MA at baseline were significantly related to higher cognitive abilities, even when controlling for MCI subtype (p = 0.030). Conclusions This study provides preliminary longitudinal evidence for a lower risk of conversion to AD and higher cognitive abilities by higher rated MA at an early stage of MCI.

Background: Reminiscence is used in a range of different interventions in palliative care, for example, Dignity Therapy or Life Review. However, literature has focused mainly on the methodology, and little has been published on patients’ priorities and primary concerns. Objective: This study looks at themes emerging in a reminiscence intervention with patients confronted with a life-limiting disease. Interviews were audiotaped and transcribed verbatim. Transcripts were analysed using thematic analysis. Setting/subjects: Seventeen patients who were receiving palliative care at the University Hospital Bonn participated in interviews reviewing parts or phases of their lives. Results: Patients expressed satisfaction and a sense of well-being with the intervention. Major themes emerging in the interviews were the factors involved in the development and expression of personality, such as character-forming influences, self-image, self-awareness, and philosophy of life. Talking about personality was entangled with influences from growing up, qualification/job, partner/spouse, children, resources, twists of fate/crossroads, and coping. Conclusion: The topics emerging from the interviews differed from the scope of guiding questions in common reminiscence methods like Life Review or Dignity Therapy. The underlying motivation of patients seemed to be the search for identity and continuity in one’s life.

The delay of gratification (DoG) in children is widely investigated with an experimental procedure originally called the “marshmallow test,” whereas the studies on self-regulation (SR) in adolescents and adults usually use self-report questionnaires. Delay discounting (DD) measures simplify the DoG procedure and focus on monetary rewards. The aim of this study was to investigate age differences in DoG and DD from childhood to old age using a test that is suitable for both children and adults. Furthermore, investigations were conducted on the association between DoG/DD and two future orientation constructs [future time perspective (FTP) and episodic future thinking (EFT)] as well as age differences in these constructs. Participants from five age groups (9–14, 18–25, 35–55, 65–80, 80+) participated in the study (N = 96). While we found no age difference for DoG, DD was the lowest [i.e., self-control (SC) was the highest] in young/middle adults; however, it was the highest (i.e., SC was the lowest) in children and old/oldest adults. Furthermore, we found significant age differences for DD and FTP. As predicted, there were strong correlations between DoG and FTP and between DD and FTP, but not between DoG/DD and EFT. These results indicate that age differences in SR vary across the measures used. Individuals who generally think and act in a future-oriented manner have a stronger ability to delay gratification.

Byline: Hesse. Michaela, Forstmeier. Simon, Mochamat. Mochamat, Radbruch. Lukas Aim: We find several interventions in palliative care to cover psychosocial needs and to relieve distress of patients. There is a [...]

AbstractBackground: Although skills of will (volitional competences), such as self-motivation or emotion regulation, are particularly necessary for patients with psychiatric and psychosomatic disorders, it is unknown whether volitional deficits can be reduced and thereby the efficacy of psychotherapy increased. We investigated the effect of a group therapy for improving volitional competence in an inpatient rehabilitation program. Methods: In a controlled clinical trial, patients from a rehabilitation clinic participated either in the volition group therapy in addition to the standard cognitive behavioral therapy (volition group, VG) or in the standard cognitive behavioral therapy (standard group, SG). Patients were tested for volitional competence, depressive symptoms, total psychiatric symptomatology, and physical complaints prior to, at the end of inpatient therapy and after 6 months of follow-up (n = 242). Results: At the end of inpatient therapy, better improvement in volitional competence was observed in the VG than in the SG [e.g. self-motivation: effect size (ES) 0.96 vs. 0.39; ANCOVA: F(1, 209) = 16.58; p < 0.001]. Patients with greater volitional improvements had a better rehabilitation outcome. In the VG, depressive symptoms as well as total psychiatric symptomatology decreased significantly more than in the SG [ES: 1.18 vs. 0.87, F(1, 207) = 4.68, p < 0.05, and ES 1.12 vs. 0.73, F(1, 205) = 4.68, p < 0.05, respectively], but not physical complaints [ES: 0.62 vs. 0.48, F(1, 207) = 1.08, n.s.]. Conclusions: Effect size increased in patients with initially low volitional competence and high motivation to participate in a volitional training. These results might lead to a more systematic assessment and training of volitional competence.Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]