Description of the project
The overall aim of the present study is to compare two different psychological methods, Cognitive Behavioural Therapy (CBT) and Graduated Exposure in vivo (EXP) in the treatment of chronic back pain with regard to effectiveness and improvement of pain related disability. Exploratory research will also be conducted to identify predictors of which patient groups benefit more from which method. This should optimise treatment options and create effective treatment offers for subgroups of pain patients. Exposure therapy is an effective and economical treatment modality and was shown in a previous pilot study to be superior to CBT in reducing perceived movement limitation. CBT, on the other hand, appeared to be more effective in establishing coping strategies. With the help of the current study it should be possible to compare the effectiveness of both treatment methods and, in perspective, to identify those patient groups that benefit from exposure therapy and thus create a tailor-made treatment programme for subgroups of pain patients. A total of 380 patients (age: ≥ 18) with chronic back pain and a sufficient degree of impairment will be included and analysed in the study.
Project Collaborators
WiPP-Psychotherapeutische Universitätsambulanz Universität Koblenz - Landau
Tel.: 06341-280 356 27
E-Mail: effectback@uni-landau.de
Essener Rückenschmerzzentrum, Universitätsklinikum Essen
Tel.: 0201-723 2364
E-Mail: effectback@uk-essen.de
Schmerzzentrum, Universitätsklinikum Heidelberg
Tel.: 06221-56 6254
E-Mail: effectback.anae@med.uni-heidelberg.de
Poliklinische Institutsambulanz für Psychotherapie Johannes Gutenberg-Universität Mainz
Tel.: 06131-39 29 071
E-Mail: effect.back@uni-mainz.de
Psychotherapie Ambulanz Marburg
Philipps-Universität Marburg
Tel.: 06421-2823860
E-Mail: effectback@uni-marburg.de
Main Contact
Prof. Dr. Julia Anna Glombiewski
Ostbahnstr. 10 (3. OG, 3.1.11), 76829 Landau
Description of the project
There is broad evidence in placebo and pain research on the role of expectancy effects and conditioning processes as determinants of pain relief in pain treatments, known as placebo hypoalgesia. Nevertheless, there are large interindividual differences in responding to placebo manipulations in experimental studies and standardized placebo-controlled RCTs, which remain unexplained. It has been proposed that the ability to accurately perceive pain might be an important determinant of the strength of placebo hypoalgesia.
In our project we want to evaluate placebo manipulations not only in the context of expectancies in a therapeutic outcome but also in the context of individual interoceptive ability. We want to contribute to the current understanding of placebo mechanisms by showing that the strength of placebo hypoalgesia can be predicted by an interplay of interoceptive ability and the confidence in a therapeutic outcome. Prospectively, we aim to examine not only interoception but also the ability to regulate (interoaction) bodily processes in accordance with expectations as predictors of the placebo response in the context of pain. We want to contribute improving therapeutic outcomes at the patient level, increasing sensitivity and specificity in placebo-controlled RCTs and deepen the understanding on the etiology of somatoform and pain-related disorders.
Main Contact
Dr. Christopher Milde
Ostbahnstraße 10 (3. OG, 3.1.13); 76829 Landau
Citations
Preregistration: OSF
Description of the project
Cognitive behavior therapy including exposures is the most effective treatment of obsessive-compulsive disorder. However, many of treated patients remain symptomatic. The metacognitive therapy could achieve substantial gains in first pilot studies. The purpose of this study is to investigate this approach with a randomized controlled trial by comparing metacognitive therapy with exposure and response prevention for obsessive-compulsive disorder. Following a pilot study with 40 individuals we currently conduct a bi-central study at the universities Leipzig and Marburg with the aim of including 70 participants.
Our main hypothesis is that the metacognitive treatment will be not inferior to exposure treatment.
Period: Aug 05, 2022 - Aug 05, 2022
Project Collaborators
Prof. Dr. Cornelia Exner, University of Leipzig; Dr. Jana Hansmeier, University of Leipzig; Dr. Anke Haberkamp, University of Marburg
Main Contact
Prof. Dr. Julia Anna Glombiewski
Ostbahnstr. 10 (3. OG, 3.1.11), 76829 Landau
Description of the project
Video feedback allows to look back at a session repeatedly without bias. It is a best-practice recommendation in current competency-based supervision guidelines (Milne, 2018). Despite the benefits, videos are rarely used in practice (Weck et al., 2017). The current project aims to (1) investigate factors that may influence the acceptance and usefulness of video feedback and (2) evaluate structured vs. unstructured video feedback (Gonsalvez et al., 2016).
Main Contact
Description of the project
The post-COVID syndrome is increasingly recognized as a clinical condition characterized by the persistence of symptoms in the context of a SARS-CoV-2 infection. The first part of the project aims to explore whether psychological factors contribute to the development of post-COVID. Our intention is to complement the primarily medically dominated understanding of post-COVID by taking a biopsychosocial perspective. Indeed, we found preliminary evidence that psychological risk factors predicted the odds and impairment of post-COVID symptoms beyond established demographic and medical factors. These findings offer new possibilities to detect patients at risk and highlight the potential of psychological interventions within a multidisciplinary treatment approach. The second part of the project aims to develop a psychological intervention that can easily be integrated into various treatment settings. Together with patient partners, our objective is to develop and evaluate a single-session intervention within a single-case experimental paradigm.
Partner
Dr. Marcel Wilhelm
Staff
Prof. Dr. Julia Glombiewski
Dr. Lea Schemer
Dr. Christopher Milde
Funding
This project is supported by the Research Initiative of Rhineland-Palatinate, Germany (“Nachwuchsfonds der Forschungsinitiative Rheinland-Pfalz”).
Reference
Milde, C., Glombiewski, J.A., Wilhelm, M., & Schemer, L. (in preparation). Psychological factors predict higher odds and impairment
Description of the project
Clinical decision-making is a complex task. The clinician must understand the problem of the patient, set goals for psychotherapy, select a suitable intervention, apply that intervention, and monitor the progress of the patient (Bartling et al., 2016). Due to heuristics and biases, decisions that must be made throughout this process are error-prone. Using data to inform clinical decision-making could enhance the decision-making process and thus the clinical outcome (Lutz et al., 2022). In current projects, network analysis is explored as a data-based supplement to collaborative case conceptualization and treatment selection.
Staff
Dr. Saskia Scholten
scholten(at)uni-landau.de
References
Scholten, S., Lischetzke, T., & Glombiewski, J. A. (2021). Integrating theory-based and data-driven methods to case conceptualization: A functional analysis approach with ecological momentary assessment. Psychotherapy Research, 1–13. https://doi.org/10.1080/10503307.2021.1916639
Description of the project
For over a decade, our group has performed research on different aspects of effectiveness of CBT and other psychological treatments for chronic pain (e.g. biofeedback) incorporating different methods such as RCTs, metaanalyses, singe case designs and secondary analyses of RCT data as well as experiments in order to disentangle potential treatment mechanisms.
Funding
University of Marburg Research Funds
Project partner
Prof. Dr. Winfried Rief, University of Marburg
Staff
Prof. Dr. Julia Anna Glombiewski
Ostbahnstr. 10 (3. OG, 3.1.11), 76829 Landau
+49 6341 280-35645
glombiewski at uni-landau.de
Dr. Lea Schemer
Ostbahnstraße 10 (3. OG, 3.1.13), 76829 Landau
+49 6341 280-35614
schemer at uni-landau.de
Description of the project
Traditional Cognitive Behavioural Therapy for chronic pain, including activity pacing, cognitive restructuring and relaxation or biofeedback is effective, but there is room for improvement especially concerning the reduction of pain related disability. There has been a call for more focused, tailored chronic pain treatments specifically addressing subgroups of pain patients in hope of achieving better results. To date, however, there is no empirical evidence as to whether pain interventions specifically tailored for particular subgroups or specific problems are in fact more effective than traditional, broad-spectrum cognitive behavioral treatments.
Sixteen years ago, a new treatment, graded in vivo exposure for chronic low back pain (“Exposure”) was developed, focusing on a subgroup of individuals with chronic back pain who avoid activity due to fear of harm. In a series of studies using different designs and methods (RCTs, multicenter trials, singe case designs, systematic reviews, metaanlyses) we investigate the effectiveness of Exposure Treatment for chronic low back pain. We are also interested in underlying treatment process, more and less effective treatment components, different setting and the optimal treatment dosage.
Funding
Deutsche Forschungsgemeinschaft
Project partners
Winfried Rief, University of Marburg
Johan Vlaeyen, Leuven & Maastricht Universities
Jeroen De Jong, Maastricht University Hospital
Steven Linton, Örebro University
Ulrike Bingel, Essen University Hospital
Staff
Prof. Dr. Julia Anna Glombiewski
Ostbahnstr. 10 (3. OG, 3.1.11), 76829 Landau
Dr. Jenny Riecke
riecke at staff.uni-marburg.de
Ostbahnstraße 10 (3. OG, 3.1.13); 76829 Landau
Publications
Preregistration: Study 1 / Study 2
Glombiewski, J.A. (2018). Exposure therapy for chronic back pain (2018). Der Schmerz. DOI:10.1007/s00482-018-0311-9
Schemer, L., Vlaeyen, J. W. S., Doerr, J. M., Skoluda, N., Nater, U. M., Rief, W., Glombiewski, J.A. (2018). Treatment processes during exposure and cognitive-behavioral therapy for chronic back pain: A single-case experimental design with multiple baselines. Behaviour Research and Therapy, 108, 58-67.
Glombiewski, J.A., Holzapfel, S., Riecke, J., Vlaeyen, J., De Jong, J., Lemmer, G. & Rief, W. (2018) Exposure and CBT for Chronic Back Pain: An RCT on Differential Efficacy and Optimal Length of Treatment. Journal of Consulting and Clinical Psychology, 86(6), 533-545.
Riecke, J., Holzapfel, S., Rief, W., & Glombiewski, J. A. (2013). Evaluation and implementation of graded in vivo exposure for chronic low back pain in a German outpatient setting: A study protocol of a randomized controlled trial. Trials, 14(1), 203.
Description of the project
Exposure-based interventions, the most effective treatment option for anxiety disorders, challenge patients´ expectations directly by creating situations where patients can test and modify their expectations. Around 30 per cent of exposure treatments for chronic pain or psychological disorders such as OCD are not effective in the long term. We assume that the persistence of expectations despite exposure experience is due to a process called “immunization”. Participants of an exposure-based pain treatment program may cognitively reappraise the experience which is contradictory to their expectations so that their expectations do not need to be changed. There are two mechanisms underlying immunization: (1) The experience gained in the expectation violation situation is considered as an exception, whereas the general expectation is maintained. (2) The credibility of the experience is questioned in general. We also assume that failure of exposure treatments might be due to disturbed acquisition and extinction during treatment.
We aim at identifying basic difficulties in learning that might lead to failed exposures; comparing different theories on exposure treatment; and investigating the role of immunization in failure of exposure treatment in chronic pain.
This project is a subproject of the Research Training Group (RTG, in German: Graduiertenkolleg GRK 2271 "Maintenance vs. change of expectations in the context of expectation violations" funded by the German Research Foundation (Deutsche Forschungsgemeinschaft DFG). The overall aim of the RTG is to explore why and when organisms (humans and animals) modify or maintain generalized expectations in the face of adverse evidence. Fourteen PhD projects include a series of questions related to persistence of or change in expectancies in a variety of research areas (including clinical psychology, educational psychology, social psychology, cognitive psychology and biological psychology). Sixteen Researchers ("Principal Investigators"), most of them from Marburg's Department of Psychology, participate in the RTG. More information about the researchers, the research program and the qualification program can be found on this website: www.uni-marburg.de/en/fb04/rtg-2271 .
Funding
Deutsche Forschungsgemeinschaft; Graduiertenkolleg 2271
Project Partners
Prof. Dr. Harald Lachnit, University of Marburg
Staff
Prof. Dr. Julia Anna Glombiewski
Ostbahnstr. 10 (3. OG, 3.1.11), 76829 Landau
Dr. Jenny Riecke
riecke at staff.uni-marburg.de
Publications
Preregistration: Clinical Trials
Rief, W., Glombiewski, J. A., Gollwitzer, M., Schubö, A., Schwarting, R., & Thorwart, A. (2015). Expectancies as core features of mental disorders. Current Opinion in Psychiatry, 28(5), 378–385.
Description of the project
Many patients with chronic pain experience impairments in valued life tasks. They suffer from experiencing a discrepancy between their valued goals (ideal/ought self) and their actual attainment (actual self). This discrepancy leads to negative mood and stress. To reduce this negative state patients might avoid confronting themselves with their actual self and instead hold on to their former self-concept. Thus, they will engage in avoiding painful experience and potential damage instead of approaching further valued goals and accepting pain. The main goal of this project is to investigate motivational aspects of the self.
In next step interventions focusing on the self in order to enhance the effectiveness of CBT-based chronic pain treatments should be designed.
This project is a subproject of the Research Training Group (RTG, in German: Graduiertenkolleg GRK 2271 "Maintenance vs. change of expectations in the context of expectation violations" funded by the German Research Foundation (Deutsche Forschungsgemeinschaft DFG). The overall aim of the RTG is to explore why and when organisms (humans and animals) modify or maintain generalized expectations in the face of adverse evidence. Fourteen PhD projects include a series of questions related to persistence of or change in expectancies in a variety of research areas (including clinical psychology, educational psychology, social psychology, cognitive psychology and biological psychology). Sixteen Researchers ("Principal Investigators"), most of them from Marburg's Department of Psychology, participate in the RTG. More information about the researchers, the research program and the qualification program can be found on this website: www.uni-marburg.de/en/fb04/rtg-2271 .
Funding
Deutsche Forschungsgemeinschaft; Graduiertenkolleg 2271
Staff
Dr. Jenny Riecke
riecke at staff.uni-marburg.de
Prof. Dr. Julia Anna Glombiewski
Ostbahnstr. 10 (3. OG, 3.1.11), 76829 Landau
+49 6341 280-35645
Description of the project
Research has demonstrated that people with depression have difficulty revising negative beliefs in response to novel positive information. In our research group, we examine the cognitive, affective, behavioural, psychophysiological, and computational mechanisms underlying these difficulties in positive information processing. Of particular interest is a process referred to as “cognitive immunisation”, through which people devalue information that disconfirms their initial beliefs and thus become immune to learning from new experiences. This line of research not only seeks to improve the understanding of the psychopathology of depression, but also to inform its cognitive-behavioural treatment by addressing the relevant psychopathological processes in tailored interventions.
Selected publications:
Kube, T., Rief, W., Gollwitzer, M., Gärtner, T., & Glombiewski, J. A. (2019). Why dysfunctional expectations in depression persist–Results from two experimental studies investigating cognitive immunization. Psychological Medicine, 49(9), 1532-1544. https://doi.org/10.1017/S0033291718002106
Kube, T., Schwarting, R., Rozenkrantz, L., Glombiewski, J. A., & Rief, W. (2020). Distorted Cognitive Processes in Major Depression: A Predictive Processing Perspective. Biological Psychiatry, 87(5), 388-398. https://doi.org/10.1016/j.biopsych.2019.07.017
Contact:
Email: kube(at)uni-landau.de
Twitter: @kube_tobias
Description of the project
Patients with "Somatic Symptom Disorder" have problems integrating appropriate medical reassurance, such as normal results of diagnostic. That is, despite physicians telling them that most likely nothing serious is wrong with the body, many patients remain concerned that they could have an undetected serious disease and therefore keep visiting doctors. In this project, we investigate the psychological mechanisms underlying the deficient integration of medical reassurance using experimental designs. Insights from this project will not only be informative for the theoretical understanding of persistent physical symptoms, but will also allow implications for effective patient-clinician communication.
Selected publications:
Kube, T., Rozenkrantz, L., Rief, W., & Barsky, A. J. (2020). Understanding persistent physical symptoms: Conceptual integration of psychological expectation models and predictive processing accounts. Clinical Psychology Review, 76, 101829. https://doi.org/10.1016/j.cpr.2020.101829
Contact:
Email: kube(at)uni-landau.de
Twitter: @kube_tobias
Description of the project
Intrusive memories are a hallmark symptom of posttraumatic stress disorder, yet it is insufficiently understood how intrusions are formed and how their formation can potentially be prevented. Drawing on a predictive processing framework, we understand a traumatic event in Bayesian terms as a perceptual hypothesis that is subsequently given a very high a-priori likelihood due to its (life-) threatening significance; thus, this hypothesis is re-selected although it does not fit the actual sensory input. Based on this account, we recast the occurrence of intrusive memories such as flashbacks in terms of perceptual and interoceptive inference. Building on this theoretical account, we perform experimental studies in which we investigate how expectations influence the occurrence of intrusive memories, and examine aimed at reducing the frequency and severity of intrusions.
Selected publications:
Kube, T., Berg, M., Kleim, B., & Herzog, P. (2020). Rethinking post-traumatic stress disorder: A predictive processing perspective. Neuroscience & Biobehavioral Reviews, 113C, 448-460. https://doi.org/10.1016/j.neubiorev.2020.04.014
Herzog, P., Barth, C., Rief, W., Brakemeier, E.-L., & Kube, T. (2022). How expectations shape the formation of intrusive memories - An experimental study using the trauma film paradigm. Cognitive Therapy and Research, 46, 809-826. https://doi.org/10.1007/s10608-022-10290-4
Contact:
Email: kube(at)uni-landau.de
Twitter: @kube_tobias
Twitter: @herzog_ph
Description of the project
Placebo effects contribute substantially to clinical outcomes in a variety of physical and mental health problems. In recent years, it has been questioned whether deception is necessary for placebos to work; in fact, research has shown that in a variety of conditions placebos remain effective when provided with full transparency and disclosure (so-called “open-label placebos”). In our research group, we investigate the efficacy and the mechanisms of action of open-label placebos. In doing so, we particularly focus on the effects of open-label placebo on depressive symptoms, pain, and allergy symptoms. We also examine the mechanisms of nocebo effects (i.e., adverse effects of a medical/pharmaceutical treatment due to psychological factors).
Selected publications:
Kube, T., Rief, W., Vivell, M. B., Schäfer, N. L., Vermillion, T., Körfer, K., & Glombiewski, J. A. (2020). Deceptive and Nondeceptive Placebos to Reduce Pain: An Experimental Study in Healthy Individuals. The Clinical Journal of Pain, 36(2), 68-79. https://doi.org/10.1097/AJP.0000000000000781
Kube, T., Hofmann, V. E., Glombiewski, J. A., & Kirsch, I. (2021). Providing open-label placebos remotely – A randomized controlled trial in allergic rhinitis. PLoS ONE, 16(3), e0248367. https://doi.org/10.1371/journal.pone.0248367
Contact:
Email: kube(at)uni-landau.de
Twitter: @kube_tobias
The biopsychosocial approach to chronic pain understands emotional distress as
a significant contributor and major consequence to pain. The overall aim of the
project is to better understand how different regulation styles relate to chronic
pain. In cooperation with colleagues from other areas of psychology, we more
specifically intend to investigate (1) how regulatory styles are characterized in
the case that chronic pain coincides with depression, (2) how differences in
regulatory variability and flexibility develop throughout the lifespan, (3) how
impairments in executive functioning can explain regulatory deficits as an
underlying mechanism. By looking at its connection from various perspectives,
we hope to contribute to a more nuanced understanding of the role of affect
regulation in chronic pain.
Partner(s):
ARPID Team (vllt kann man die Webseite hier verlinken?)
Staff:
M.Sc. Christina Biela
Prof. Dr. Julia Glombiewski
M.Sc. Amadeus Hildebrandt
Dr. Christopher Milde
Dr. Lea Schemer
Funding:
This project is supported by the Research Initiative of Rhineland-Palatinate,
Germany (Forschungsinitiative Rheinland-Pfalz).
Reference:
Schemer, L., Basten, U., In-Albon, T., Karbach, J., Könen, T., Lischetzke, T., Winter,
D. & Glombiewski, J.A. (in preparation). Affect regulation and pain: Moving
forward with insights from selected psychological disciplines.
As clinical psychotherapists, we know about the dilemma that traditional research
methods pose for everyday clinical practice. Most of the research findings are
based on group designs, with patients being classified according to diagnostic
systems. While results of these designs allow us to draw conclusions about
anticipated treatment effects for some sort of hypothetically existing patient,
they might not necessarily apply to the patient sitting in front of you.
The aim of this project is to implement contemporary research methods and
designs (e.g., ambulatory assessments, network analyses, single-case
experimental designs) in a routine outpatient setting evaluating their benefits
and barriers from various perspectives. Our goal is to support the therapy
process for patients and psychotherapists in the best possible way and facilitate
meaningful improvements for the individual patient.
Partner(s):
Prof. Dr. Johan Vlaeyen
Staff:
Prof. Dr. Julia Glombiewski
Dr. Julia Haas
Dr. Philipp Herzog
Dr. Lea Schemer
Dr. Saskia Scholten
Reference:
Schemer, L., Glombiewski, J.A., & Scholten, S. (2022). All good things come in
threes: A systematic review and delphi study on advances and challenges of
ambulatory assessments, network analyses, and single-case experimental
designs. Clinical Psychology Science and Practice.
doi.org/10.1037/cps0000083
The post-COVID syndrome is increasingly recognized as a clinical condition
characterized by the persistence of symptoms in the context of a SARS-CoV-2
infection. The first part of the project aims to explore whether psychological
factors contribute to the development of post-COVID. Our intention is to
complement the primarily medically dominated understanding of post-COVID by
taking a biopsychosocial perspective. Indeed, we found preliminary evidence that
psychological risk factors predicted the odds and impairment of post-COVID
symptoms beyond established demographic and medical factors. These findings
offer new possibilities to detect patients at risk and highlight the potential of
psychological interventions within a multidisciplinary treatment approach. The
second part of the project aims to develop a psychological intervention that can
easily be integrated into various treatment settings. Together with patient
partners, our objective is to develop and evaluate a single-session intervention
within a single-case experimental paradigm.
Partner(s):
Dr. Marcel Wilhelm
Staff:
Prof. Dr. Julia Glombiewski
Dr. Christopher Milde
Dr. Lea Schemer
Funding:
This project is supported by the Research Initiative of Rhineland-Palatinate,
Germany (“Nachwuchsfonds der Forschungsinitiative Rheinland-Pfalz”).
Reference:
Milde, C., Glombiewski, J.A., Wilhelm, M., & Schemer, L. (under review).
Psychological factors predict higher odds and impairment of post-COVID
symptoms: A prospective study. Psychosomatic Medicine.