Psychopathology research – quo vadis? : Investigating potential improvements, expansions, and innovations of assessment methods

Abstract

Understanding factors which are associated with or can predict psychopathological developments is key to a constant improvement of health care services. However, this line of research depends on sound and reliable methodological approaches. In this thesis, I investigated three biopsychosocial components of the adaptive calibration model that proposes a psychoneuroendocrinological adaptation process during sensitive periods in life, especially early childhood or puberty, in response to stressors such as endocrine or autonomic modulations in reaction to adversity (e.g. parental neglect or maltreatment). First, I translated into German the Parental Bonding Instrument (PBI), a self-report questionnaire to retrospectively assess parental care and overprotection for mothers and fathers separately. An openly accessible and validated German translation of the well-established English original was missing so far. Upon evaluation, I could show that the data of a large online sample confirmed the psychometric qualities of this new German PBI version and supported both, a two and a three-factor model, with the latter dividing parental overprotection into discouragement of behavioral freedom and denial of psychological autonomy. Consequently, my first study offers a reliable instrument to measure parental care and overprotection in a German-speaking sample in future research e.g. on the association between parental bonding and psychopathology. Second, I investigated potential benefits of an extended assessment of salivary cortisol concentrations up to 270 minutes after awakening in a healthy sample. Typically, cortisol after awakening is measured for 60 minutes. Results showed that circadian cortisol release follows a pulsatile rhythm with high inter-individual variability that might be related to sex and menstrual cycle phase. Furthermore, the data suggested that the traditional assessment of the cortisol awakening response of 60 minutes might not capture the complete first pulse in all participants. Third, I developed a nature-based relaxation video paradigm to measure autonomic responsivity indicated by heart rate variability (HRV) during relaxation. I observed an increase in HRV and a decrease in heart rate during different video conditions suggesting a generic autonomic relaxation response to the paradigm. While associations across parenting behavior, cortisol and HRV (dys-) regulation, and subsequent psychopathology, are well supported by the literature, both the quantitative (positive vs. negative associations) and qualitative (cause vs. effect) direction of these relations are still unclear. With the results of my thesis, I aimed to contribute to new developments in the assessment of these three concepts: first the improvement of an existing measure (an updated translation and psychometric examination of the PBI to assess parental bonding in German-speaking samples), and the development of two new assessment approaches (an extended measurement of cortisol after awakening and a suggestion for a new approach to measuring HRV reactivity to a relaxation induction). Even though these methods are still in their infancy, they can provide a foundation for future studies to show if basic and clinical research on either one of the concepts or all three combined will benefit from these new developments.