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Metakognition oder das Denken über das Denken - Wie denken wir? Wie gehen wir mit Emotionen und ungewollten Gedanken um? Und was, wenn ungewollte Gedanken sich nicht mehr regulieren lassen und wir in eine "Denkfalle" tappen, aus der wir nicht mehr herausfinden? Es gibt charakteristische Denkverzerrungen, die zur Entstehung und Aufrechterhaltung von Zwangsstörungen beitragen können. Die Kunst ist es, diese immer wiederkehrenden Denkfallen zu erkennen und zu "entschärfen". Das Selbsthilfemanual "Erfolgreich gegen Zwangsstörungen" vermittelt anschaulich die aktuellen Theorien zu Zwangsstörungen und zeigt den Betroffenen anhand zahlreicher unterhaltsamer Beispiele und Übungen, wie sie mit diesen Denkfallen umgehen können. 14 häufige Denkverzerrungen bei Zwang werden mit bewährten Behandlungsstrategien (z. B. der Konfrontationsübung) und neuen Techniken (z. B. der Aufmerksamkeitsspaltung) beschrieben. Die umfangreiche Materialsammlung richtet sich vor allem an Betroffene, stellt aber auch eine wertvolle Ergänzung für Therapeuten dar. Zahlreiche Bilder veranschaulichen den Text und regen die Auseinandersetzung mit dem Denken an. Eine Begleit-CD enthält alle im Buch beschriebenen Übungen zum praktischen Gebrauch. - Den Denkfallen entkommen - effektiv und erfolgreich.

Narcissism scores are higher in individualistic cultures compared with more collectivistic cultures. However, the impact of sociocultural factors on narcissism and self-esteem has not been well described. Germany was formerly divided into two different social systems, each with distinct economic, political and national cultures, and was reunified in 1989/90. Between 1949 and 1989/90, West Germany had an individualistic culture, whereas East Germany had a more collectivistic culture. The German reunification provides an exceptional opportunity to investigate the impact of sociocultural and generational differences on narcissism and self-esteem. In this study, we used an anonymous online survey to assess grandiose narcissism with the Narcissistic Personality Inventory (NPI) and the Pathological Narcissism Inventory (PNI) to assess grandiose and vulnerable aspects of narcissism, and self-esteem with the Rosenberg Self-Esteem Scale (RSE) in 1,025 German individuals. Data were analyzed according to age and place of birth. Our results showed that grandiose narcissism was higher and self-esteem was lower in individuals who grew up in former West Germany compared with former East Germany. Further analyses indicated no significant differences in grandiose narcissism, vulnerable narcissism or self-esteem in individuals that entered school after the German reunification ( 19 years of age in 1989), significant differences were only found in one of the two scales assessing grandiose narcissism (NPI). Our data provides empirical evidence that sociocultural factors are associated with differences in narcissism and self-esteem.

Introduction: Craving alcohol is a core symptom of alcohol use disorder (AUD) and an important target for treatment. A new line of treatment for AUD aims at overriding the urge to consume alcohol by changing implicit cognitions via approach bias modification (ApBM). In a prior study, we tested a variant of ApBM called imaginal retraining, which reduced craving. As addiction and body-focused repetitive behaviors (BFRBs) share important symptoms (e.g., inability to resist urges), for the present study we merged imaginal retraining with a technique aimed at BFRB, called decoupling, to augment treatment effects. We hypothesized that the new technique, which is called 3P, would lead to a greater reduction in craving relative to (active) control conditions. Methods: The study was conducted online. Data from 227 participants were considered. Participants were randomized to 1 out of 5 conditions. Craving for alcohol before and after the brief intervention was the primary outcome. Results: Only the 3P condition lessened craving by approximately one third at an almost medium effect size (improvement: 34.5%, p = 0.003, d = 0.458). Effects were significantly larger relative to the wait-list control and two active control conditions (p's < 0.02; greater reduction than imaginal retraining at a small but nonsignificant effect size). Discussion/Conclusion: If replicated, the combination of imaginal retraining and decoupling (3P) represents a promising, easy-to-implement self-help technique to reduce immediate craving. Long-term effects in participants with formally diagnosed AUD have not yet been investigated.

<b><i>Introduction:</i></b> Imaginal retraining is a self-help technique that adapts the principles of approach bias modification to the imagination. Imaginal retraining has been shown to reduce craving and addictive behaviours in 3 randomized controlled trials (RCTs) on problematic alcohol consumption, overweight, and tobacco use. To date, there have been no studies evaluating the long-term efficacy of the intervention. The aim of the present study was to generate first hypotheses on the long-term efficacy of imaginal retraining in smokers in a controlled 1-year follow-up study. <b><i>Materials and Methods:</i></b> We recontacted the 345 participants who had taken part in an RCT on imaginal retraining for smokers 1 year later. The survey was carried out online and assessed craving for tobacco (primary outcome), smoking behaviour, well-being, and subjective appraisal. Individuals who applied the technique at least once during the previous year were categorized as the training group, whereas participants who never performed the training were categorized as the no-training group. Data were analysed using linear mixed models (LMMs). The study was preregistered as DRKS00021044. <b><i>Results:</i></b> The completion rate was 45.5%. Less than 40% used the intervention at least once in the previous 12 months. LMM analyses showed a significant reduction in craving for tobacco for the training compared to the no-training group after 1 year. No significant group differences emerged in smoking behaviour, depressive symptoms, or quality of life. Subjective appraisal of the intervention was favorable, similar to the initial study. <b><i>Conclusion:</i></b> The present study provides preliminary support for the long-term efficacy of imaginal retraining on craving for tobacco but not on smoking behaviour, highlighting the importance of multimodal treatment concepts in smoking cessation that target a variety of maintaining factors. Future studies need to investigate the long-term efficacy of the intervention in prospective RCTs that test alternative ways of conveying the technique to improve adherence.

Political polarization between conservatives and liberals threatens democratic societies. Ameliorating liberal research participants' negative feelings, evaluations, and stereotypes towards conservatives might be one step into the direction of a political depolarization. In a sample of U.S.-American liberal research participants recruited via Amazon's Mechanical Turk (N = 271), we randomly assigned participants in a pre-post-design either to a clinical-psychological, metacognitive-intervention (MCT), an educational, or a no-treatment-no-pre-measurement-control-condition. In the MCT-condition, participants were first asked seemingly simple questions that frequently elicited incorrect responses, followed by corrective information. In the educational condition, information was conveyed in a simple narrative form. MCT was significantly more effective in ameliorating liberal participants' negative feelings, evaluations, and stereotypes towards conservatives compared to the other two control-conditions. Further, MCT-participants significantly reduced their negative feelings, negative evaluations, and perceptions of threat from pre- to post-measurement, significantly more than participants in the educational condition. The results of our preliminary study and its implications are discussed, and recommendations for further research are made. ; peerReviewed ; publishedVersion

Political polarization between conservatives and liberals threatens democratic societies. Ameliorating liberal research participants' negative feelings, evaluations, and stereotypes towards conservatives might be one step into the direction of a political depolarization. In a sample of U.S.-American liberal research participants recruited via Amazon's Mechanical Turk (N = 271), we randomly assigned participants in a pre-post-design either to a clinical-psychological, metacognitive-intervention (MCT), an educational, or a no-treatment-no-pre-measurement-control-condition. In the MCT-condition, participants were first asked seemingly simple questions that frequently elicited incorrect responses, followed by corrective information. In the educational condition, information was conveyed in a simple narrative form. MCT was significantly more effective in ameliorating liberal participants' negative feelings, evaluations, and stereotypes towards conservatives compared to the other two control-conditions. Further, MCT-participants significantly reduced their negative feelings, negative evaluations, and perceptions of threat from pre- to post-measurement, significantly more than participants in the educational condition. The results of our preliminary study and its implications are discussed, and recommendations for further research are made.

<b><i>Objectives:</i></b> It is textbook knowledge that individuals with alcohol use disorder (AUD) show large neurocognitive deficits. However, these patients display a number of additional impairments (e.g., lack of drive and motivation) that may contribute to poor test results. The impact of these secondary mediators has not been explored systematically. Based on prior findings that low performance motivation, a negative attitude toward cognitive assessment, and momentary symptoms compromise neuropsychological test results in depression, schizophrenia, and obsessive-compulsive disorder, we examined the possibility that impaired test results in AUD partially represent an epiphenomenon. <b><i>Methods:</i></b> Fifteen patients with AUD and 20 matched nonclinical individuals underwent a comprehensive neuropsychological test battery. The neurocognitive assessment was flanked by the Momentary Influences, Attitudes and Motivation Impact on Cognitive Performance Scale (MIAMI), which captures momentary influences affecting performance. <b><i>Results:</i></b> Patients with AUD performed worse than nonclinical controls on most test parameters. Group differences achieved a very large effect size for parameters tapping speed and accuracy. Patients with AUD showed deviant scores, particularly on the post version of the MIAMI (retrospective assessment of symptoms and influences during testing) and the total scores. For accuracy, the MIAMI scores represented a partial mediator. For speed, significant group effect sizes were rendered nonsignificant when the MIAMI was taken into account. <b><i>Conclusion:</i></b> Like other psychiatric patients, patients with AUD show marked neurocognitive impairments that seem to be aggravated by, for example, distraction and lack of effort. This tentatively suggests that performance only partly reflects cortical impairments in areas hosting neurocognitive faculties. Contextual factors deserve greater attention in patients with addiction. The cross-sectional design of our study limits conclusions relating to causality.

<b><i>Objectives:</i></b> Smoking is a highly prevalent addictive behavior with severe and life-shortening health consequences. This is the first study to evaluate the efficacy of a newly developed imaginal variant of approach bias modification (ABM) (i.e., imaginal retraining) for the reduction of craving for tobacco and actual smoking behavior. <b><i>Methods:</i></b> We randomized 345 smokers to imaginal retraining (self-help manual) or a control group (either active control or wait-list control). Assessments were carried out online. The treatment interval was 6 weeks. Craving for tobacco represented the primary outcome. The study was registered as DRKS00016860. <b><i>Results:</i></b> Retention was 79.7% with no difference between groups. The intention-to-treat (ITT) analyses were significant for the primary outcome (Visual Analogue Scale on craving for tobacco) as well as subjective reduction of smoking (45.5 vs. 26.4%) in favor of imaginal retraining. In the treatment group, 47.6% performed the exercises at least once. This subgroup (per-protocol [PP] sample) showed a significant reduction in tobacco dependency as measured with the Cigarette Dependence Scale (short and long forms) and the Fagerström Test for Nicotine Dependence relative to controls. Number of daily cigarettes declined to a greater extent in imaginal retraining in the PP but not ITT analysis. A small dose-effect relationship emerged between craving and frequency of performance of the technique. <b><i>Conclusion:</i></b> When used regularly, imaginal retraining may reduce craving for tobacco and actual smoking behavior in a subgroup of smokers. In view of the large subgroup that did not read the manual or did not perform the exercises, alternative ways of conveying the imaginal retraining technique should be sought (e.g., demonstration via video clips). To conclude, imaginal retraining may represent a simple low-threshold technique to reduce smoking and assist current evidence-based treatment programs targeted at abstinence. It needs to be tested whether its mechanism of action deviates from standard ABM.

Psicosis de primer episodio; Entrenamiento metacognitivo; Entendimiento ; First-episode psychosis; Metacognitive training; Cognitive insight ; Psicosi de primer episodi; Entrenament metacognitiu; Enteniment ; Metacognitive training (MCT) has demonstrated its efficacy in psychosis. However, the effect of each MCT session has not been studied. The aim of the study was to assess changes in cognitive insight after MCT: (a) between baseline, post-treatment, and follow-up; (b) after each session of the MCT controlled for intellectual quotient (IQ) and educational level. Method: A total of 65 patients with first-episode psychosis were included in the MCT group from nine centers of Spain. Patients were assessed at baseline, post-treatment, and 6 months follow-up, as well as after each session of MCT with the Beck Cognitive Insight Scale (BCIS). The BCIS contains two subscales: self-reflectiveness and self-certainty, and the Composite Index. Statistical analysis was performed using linear mixed models with repeated measures at different time points. Self-certainty decreased significantly (p = 0.03) over time and the effect of IQ was negative and significant (p = 0.02). From session 4 to session 8, all sessions improved cognitive insight by significantly reducing self-certainty and the Composite Index. MCT intervention appears to have beneficial effects on cognitive insight by reducing self-certainty, especially after four sessions. Moreover, a minimum IQ is required to ensure benefits from MCT group intervention ; The project has been funded by the Instituto de Salud Carlos III (Spanish Government), research grant number PI11/01347 and PI14/00044; by the Fondo Europeo de Desarrollo Regional (FEDER), Progress and Health Foundation of the Andalusian Regional Ministry of Health, grant PI-0634/2011; Obra Social La Caixa (RecerCaixa call 2013); and Obra Social Sant Joan de Déu (BML).