Table 1.
(a) Questionnaires and (b) neuropsychological tests used in the LORA study
(a) Questionnaires | |||||
---|---|---|---|---|---|
Topic | Questionnaire | B | F | 3m | #I |
Mental health | General health questionnaire-28 (GHQ-28) [18, 19] | x | x | x | 28 |
Health questionnaire for patients (PHQ-D) [20, 21] | x | x | 16 | ||
Mini international neuropsychiatric interview (M.I.N.I.) [16, 17] | x | x | |||
Micro- and macrostressors | |||||
History of critical life events | Life events checklist from LHC (adapted from Canli et al. [22]) | x | x | x | 27 |
Daily hassles | Mainz Inventory of Microstressors (MIMS) [23, 24] | x | x | x | 58 |
Childhood Trauma | Childhood trauma questionnaire (CTQ) [26, 27] | x | x | 25 | |
Perceived stress | Perceived stress scale (PSS) [28]; unpublished translation by A. Büssing, University of Witten/Herdecke | x | x | x | 10 |
Maltreatment and abuse | Maltreatment and abuse chronology of exposure (MACE) [29] | x | 18 | ||
Trauma | Harvard trauma questionnaire (HTQ) [30] | x | 35 | ||
Psychological variables | |||||
Ability to bounce back | Brief resilience scale (BRS) [31, 32] | x | x | 6 | |
Cognitive emotion regulation | Cognitive emotion regulation questionnaire (CERQ) [33, 34] | x | x | 29 | |
Coping flexibility | Coflex [35]; German version translated by study site | x | x | 13 | |
Coping style | Brief Cope [36, 37] | x | x | 28 | |
Empathy | Multifaceted empathy test (MET) (subsection: accuracy) [38] | x | x | 40 | |
Hardiness | Hardiness Scale ([39]; translated by study site) | x | x | 12 | |
Impulsive behavior | Urgency Premeditation Perseverance and Sensation Seeking Impulsive Behavior Scale (UPPS) [40, 41] | x | x | 45 | |
Impulsivity | Eight item impulsive behavior scale (I-8) [42] | x | x | 8 | |
Interpersonal reactivity | Interpersonal reactivity index (IRI) [43] | x | x | 28 | |
Locus of control | Locus of control scale [44, 45] | x | x | 28 | |
Optimism | Life orientation test (LOT-R) [46, 47] | x | x | 10 | |
Perceived social support | Social support questionnaire (F-SozU) [48] | x | x | 14 | |
Personality | Big-five-inventory (BFI-10) [49] | x | x | 10 | |
Positive and negative affect | Positive and negative affect schedule (PANAS) [50, 51] | x | x | 20 | |
Positive appraisal style | gPASS (Kalisch et al. in prep.) | x | x | 29 | |
Resilience factors | Connor–Davidson resilience scale (CD-Risk) [52, 53] | x | x | 25 | |
Self-efficacy | General self-efficacy scale (GSE) [54] | x | x | 10 | |
Sense of coherence | Orientation to life questionnaire [55, 56] | x | x | 29 | |
Social desirability | Social desirability scale-gamma (KSE-G) [57] | x | x | 6 | |
State-Trait Anger | State-trait anger anxiety questionnaire (STAXI) [58] | x | x | 44 | |
Well-being | WHO questionnaire on well-being (WHO 5) [59, 60] | x | x | 5 | |
Identity | Adapted from Skalen zur Messung der ethnischen Identität (MEIM) (GESIS [61]) | x | 7 | ||
Humiliation | Humiliation scale (Lindert and Mollica, in prep.) | 26 | |||
Sociodemographic variables | |||||
General sociodemographic data | General questionnaire for sociodemographic data, family history, ethnical background, employment/salary | x | x | 56 | |
Migration | Migration status questionnaire (based on Nesterko and Glaesmer) [62]) | x | x | 5 | |
Lifestyle variables | |||||
Alcohol use disorder | Alcohol use disorder identification test (AUDIT) [63] | x | x | 10 | |
Nicotine dependence | Fagerstrom test for nicotine dependence [64] | x | x | 6 | |
Drug consumption | General questionnaire about illegal drug consumption (questionnaire created by study sites) | x | x | 6 | |
Physical activity | International physical activity questionnaire (IPAQ) [65, 66] | x | x | 27 | |
Physical fitness | International fitness scale (IFIS) [67] | x | x | 5 | |
General health variables | General questions concerning health and lifestyle (based on: GESIS [61]) | 12 |
Neuropsychological tests | |||||
---|---|---|---|---|---|
Resilience mechanism | Task description | ||||
Psychological flexibility | For the assessment of switch costs, stability (distractor inhibition cost), and dispositional flexibility (i.e., the spontaneous switching rate in the face of ambiguous cues); the stability/flexibility task is used. Participants continuously perform a task on digits presented above a fixation cross (ongoing task, e.g., odd/even judgment on digits between 1 and 9). Infrequently, a second digit is presented beneath fixation, and depending on three different brightness conditions, participants have to either switch to the lower digit and perform a different task when the lower digit is brighter (e.g., < / > 5 judgment; flexibility condition) or ignore the lower digit when it is darker than the upper digit (distractor inhibition; stability condition). In the third of three conditions, the brightness difference between the two digits is so subtle that it is not consciously detectable (ambiguous condition). Here, the spontaneous switching rate is examined as an indicator of dispositional cognitive flexibility; established by Armbruster et al. [68] | ||||
Emotional interference inhibition | A classical flanker task, assessing emotional response interference inhibition, during which participants need to respond to a target cue presented in the center of the screen, surrounded by distractor cues. Before each target cue presentation, participants see a picture from the International Affective Picture Set (IAPS) database for 500 ms, differing in emotional valence (i.e., aversive or neutral). Then, a row of seven arrows is presented, which either all point congruently to the left/right side or the target cue points to the opposite site compared to the other arrows (i.e., incongruent trial). Participants are instructed to indicate the pointing direction of the target cue as fast and accurately as possible via a button press on the keyboard with the respective index finger (right index finger for right-pointing target cue; left index finger for left-pointing target cue). Participants receive direct written feedback on the screen for an incorrect or too slow (> 1000 ms) response. After each of five task runs, participants receive feedback about the percentage of correct responses within that run and their average reaction time displayed on the screen. Important outcomes are the reaction time and accuracy differences between congruent and incongruent task trials, between aversive and neutral trial pictures, as well as the interaction of both (congruency x valence); adapted from Stahl et al. [69] | ||||
Positivity bias | Information processing biases favoring positive versus negative information in attention and interpretation will be assessed with a visual probe task (VPT; [70]) and an ambiguous cue task (ACT; a variant of the task paradigm described in Schick et al. 2013 [71], with visual instead of auditory stimulus material), respectively. In the VPT, participants respond to abstract probe stimuli following the presentation of emotional faces (happy, fearful, and neutral). Positivity biases in attention are inferred from accelerated responses to probes that replace happy as opposed to neutral or negative faces. In the ACT, participants learn to associate two visual cues (e.g., a long and a short bar) with positive vs. negative monetary consequences. In the test phase, participants are presented with ambiguous cues (bars of medium length). Responses indicate an individual tendency to interpret ambiguous information as positive or negative | ||||
Volitional emotion regulation | Participants are presented with pictures of differing emotional valence (i.e., aversive and neutral) from the International Affective Picture Set (IAPS). For each picture, participants receive one of three instructions on screen: regard the picture, reappraise (i.e., situation-focused reappraisal), or dissociate. In the regarding condition, participants are expected to carefully look at the picture, take in all its details. In the reappraise condition, participants are asked to change their appraisal of the presented picture scene to regulate their emotions, e.g., by telling themselves that the presented picture is just a scene performed by actors. The dissociation condition is another way of regulating emotions, in which participants are asked to distance themselves actively from the picture content, e.g., by making themselves aware that they do not know the displayed people in the picture. After each picture presentation, participants are asked to rate the intensity of their feeling at that moment as fast as possible on a visual analogue scale from very week to very strong. Participants undergo a short instruction phase with example pictures to get familiar with the different emotion regulation strategies. Main outcomes are differences in the emotion ratings and reaction times and electromyographic (EMG) activity between task conditions; established by Schönfelder et al. [72, 73]. Before the experiment starts, three electrodes are placed on the forehead of the subject for EMG recordings. Two electrodes are placed above the left eyebrow for corrugator muscular activity assessment, while the ground electrode is placed close to the hairline, above all facial muscles (gel-filled electrodes, Biopac® Systems, Inc.) | ||||
Differential fear conditioning (discrimination) and extinction | Classical fear conditioning task, using two different geometric figures as CS + and CS −, respectively, which are counterbalanced either a square or a diamond shape. The CS + is paired with an aversive UCS [i.e., electrodermal stimulation; Digitimer DS7A(CE)] in 50% of all presentations during the acquisition phase by a pain electrode attached to the back of the right hand. Before the acquisition phase, participant’s individual pain threshold is calibrated to reach a pain level that is higher than six on a scale from 0 (“I do not feel anything”) to 10 (“The strongest pain I can imagine being applied with such an electrode”). After each CS + or CS- presentation, participants are asked to rate their level of anxiety, fear or tension as fast as possible on a visual analogue scale from “not at all” to “very much”. During extinction, the CS + is never coupled with the US. After the experiment, participants are asked, which symbol was coupled with the pain stimulation, to make sure that they learned the CS + UCS pairing. During the experiment, participant’s skin conductance rate (SCR) is measured with two electrodes attached to the palm of the left hand (Biopac® Systems, Inc.) |
Notes: B baseline, F follow-up at main assessments every 18 months; 3m = interim analyses every 3 months; #I = number of total items