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Petri-Romão P, Engen H, Rupanova A, Puhlmann L, Zerban M, Neumann RJ, Malyshau A, Ahrens KF, Schick A, Kollmann B, Wessa M, Walker H, Plichta MM, Reif A, Chmitorz A, Tuescher O, Basten U, Kalisch R. Self-report assessment of Positive Appraisal Style (PAS): Development of a process-focused and a content-focused questionnaire for use in mental health and resilience research. PLoS One 2024; 19:e0295562. [PMID: 38306328 PMCID: PMC10836662 DOI: 10.1371/journal.pone.0295562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 11/23/2023] [Indexed: 02/04/2024] Open
Abstract
Positive Appraisal Style Theory of Resilience posits that a person's general style of evaluating stressors plays a central role in mental health and resilience. Specifically, a tendency to appraise stressors positively (positive appraisal style; PAS) is theorized to be protective of mental health and thus a key resilience factor. To this date no measures of PAS exist. Here, we present two scales that measure perceived positive appraisal style, one focusing on cognitive processes that lead to positive appraisals in stressful situations (PASS-process), and the other focusing on the appraisal contents (PASS-content). For PASS-process, the items of the existing questionnaires Brief COPE and CERQ-short were analyzed in exploratory and confirmatory factor analyses (EFA, CFA) in independent samples (N = 1157 and N = 1704). The resulting 10-item questionnaire was internally consistent (α = .78, 95% CI [.86, .87]) and showed good convergent and discriminant validity in comparisons with self-report measures of trait optimism, neuroticism, urgency, and spontaneity. For PASS-content, a newly generated item pool of 29 items across stressor appraisal content dimensions (probability, magnitude, and coping potential) were subjected to EFA and CFA in two independent samples (N = 1174 and N = 1611). The resulting 14-item scale showed good internal consistency (α = .87, 95% CI [.86, .87]), as well as good convergent and discriminant validity within the nomological network. The two scales are a new and reliable way to assess self-perceived positive appraisal style in large-scale studies, which could offer key insights into mechanisms of resilience.
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Affiliation(s)
| | - Haakon Engen
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Anna Rupanova
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Lara Puhlmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Matthias Zerban
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Rebecca J Neumann
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Aliaksandr Malyshau
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Kira F Ahrens
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Anita Schick
- Medical Faculty Mannheim, Department of Public Mental Health, Central Institute of Mental Health (CIMH), Heidelberg University, Mannheim, Germany
| | - Bianca Kollmann
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg University, Mainz, Germany
| | - Henrik Walker
- Department of Psychiatry & Psychotherapy, Division of Mind and Brain Research, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michael M Plichta
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry, University Hospital, Psychosomatic Medicine and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Andrea Chmitorz
- Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
| | - Oliver Tuescher
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Ulrike Basten
- Department of Psychology, University of Kaiserslautern-Landau, Landau, Germany
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
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Ahrens KF, Neumann RJ, Kollmann B, Brokelmann J, von Werthern NM, Malyshau A, Weichert D, Lutz B, Fiebach CJ, Wessa M, Kalisch R, Plichta MM, Lieb K, Tüscher O, Reif A. Impact of COVID-19 lockdown on mental health in Germany: longitudinal observation of different mental health trajectories and protective factors. Transl Psychiatry 2021; 11:392. [PMID: 34282129 PMCID: PMC8287278 DOI: 10.1038/s41398-021-01508-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/02/2021] [Accepted: 06/21/2021] [Indexed: 12/29/2022] Open
Abstract
The COVID-19 pandemic and resulting measures can be regarded as a global stressor. Cross-sectional studies showed rather negative impacts on people's mental health, while longitudinal studies considering pre-lockdown data are still scarce. The present study investigated the impact of COVID-19 related lockdown measures in a longitudinal German sample, assessed since 2017. During lockdown, 523 participants completed additional weekly online questionnaires on e.g., mental health, COVID-19-related and general stressor exposure. Predictors for and distinct trajectories of mental health outcomes were determined, using multilevel models and latent growth mixture models, respectively. Positive pandemic appraisal, social support, and adaptive cognitive emotion regulation were positively, whereas perceived stress, daily hassles, and feeling lonely negatively related to mental health outcomes in the entire sample. Three subgroups ("recovered," 9.0%; "resilient," 82.6%; "delayed dysfunction," 8.4%) with different mental health responses to initial lockdown measures were identified. Subgroups differed in perceived stress and COVID-19-specific positive appraisal. Although most participants remained mentally healthy, as observed in the resilient group, we also observed inter-individual differences. Participants' psychological state deteriorated over time in the delayed dysfunction group, putting them at risk for mental disorder development. Consequently, health services should especially identify and allocate resources to vulnerable individuals.
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Affiliation(s)
- K F Ahrens
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - R J Neumann
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - B Kollmann
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany.
| | - J Brokelmann
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - N M von Werthern
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - A Malyshau
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - D Weichert
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - B Lutz
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
- Institute of Physiological Chemistry, University Medical Center Mainz, Mainz, Germany
| | - C J Fiebach
- Department of Psychology, Goethe University Frankfurt, Frankfurt, Germany
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - M Wessa
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - R Kalisch
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), University Medical Center Mainz, Mainz, Germany
| | - M M Plichta
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - K Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
| | - O Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR) gGmbH, Mainz, Germany
| | - A Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
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Biere S, Kranz TM, Matura S, Petrova K, Streit F, Chiocchetti AG, Grimm O, Brum M, Brunkhorst-Kanaan N, Oertel V, Malyshau A, Pfennig A, Bauer M, Schulze TG, Kittel-Schneider S, Reif A. Risk Stratification for Bipolar Disorder Using Polygenic Risk Scores Among Young High-Risk Adults. Front Psychiatry 2020; 11:552532. [PMID: 33192665 PMCID: PMC7653940 DOI: 10.3389/fpsyt.2020.552532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/10/2020] [Indexed: 11/30/2022] Open
Abstract
Objective: Identifying high-risk groups with an increased genetic liability for bipolar disorder (BD) will provide insights into the etiology of BD and contribute to early detection of BD. We used the BD polygenic risk score (PRS) derived from BD genome-wide association studies (GWAS) to explore how such genetic risk manifests in young, high-risk adults. We postulated that BD-PRS would be associated with risk factors for BD. Methods: A final sample of 185 young, high-risk German adults (aged 18-35 years) were grouped into three risk groups and compared to a healthy control group (n = 1,100). The risk groups comprised 117 cases with attention deficit hyperactivity disorder (ADHD), 45 with major depressive disorder (MDD), and 23 help-seeking adults with early recognition symptoms [ER: positive family history for BD, (sub)threshold affective symptomatology and/or mood swings, sleeping disorder]. BD-PRS was computed for each participant. Logistic regression models (controlling for sex, age, and the first five ancestry principal components) were used to assess associations of BD-PRS and the high-risk phenotypes. Results: We observed an association between BD-PRS and combined risk group status (OR = 1.48, p < 0.001), ADHD diagnosis (OR = 1.32, p = 0.009), MDD diagnosis (OR = 1.96, p < 0.001), and ER group status (OR = 1.7, p = 0.025; not significant after correction for multiple testing) compared to healthy controls. Conclusions: In the present study, increased genetic risk for BD was a significant predictor for MDD and ADHD status, but not for ER. These findings support an underlying shared risk for both MDD and BD as well as ADHD and BD. Improving our understanding of the underlying genetic architecture of these phenotypes may aid in early identification and risk stratification.
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Affiliation(s)
- Silvia Biere
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Thorsten M Kranz
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Kristiyana Petrova
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | - Andreas G Chiocchetti
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Center of Excellence Frankfurt, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Oliver Grimm
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Murielle Brum
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Natalie Brunkhorst-Kanaan
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Viola Oertel
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Aliaksandr Malyshau
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Dresden University of Technology, Dresden, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Dresden University of Technology, Dresden, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics, University Hospital Munich, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany.,Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital of Würzburg, University of Würzburg, Würzburg, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
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