Handbewegungsverhalten von Patient*innen mit Sozialer Phobie und ihren Therapeut*innen in der psychotherapeutischen Interaktion: Expressivität in Struktur und Koordination sowie Flexibilität in Simultanität der Bewegungen

Katharina Charlotte Hildegard Reinecke

Publication: Book/ReportDissertations

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Abstract

Introduction: Unintentional movement during interactions has become a component of expressive psychology studies in psychological research. In patients with depression and social anxiety, an irregular hand movement structure with on body focus has been identified. Also, synchronization within the patient-therapist interaction is associated with social phobia (SP) symptomatology. The type of hand coordination provides the opportunity for expressive movements, which are impaired in patients with impaired psychological functioning. The aim of this dissertation is to work out the movement profile of patients with SP for the psychologically relevant parameters of movement structure, simultaneous movements, and coordination. The results will be used to identify new approaches for symptom assessment as well as intervention-related therapeutic benefits.
Methods: The NEUROGES®-ELAN analysis system was used for systematic movement analysis. Activation and structure of hand movements and simultaneous hand movements as well as hand coordination were analyzed in patients and their therapists. The complete video material was composed of 49 patients with SP and their therapists at one (Study I) or two (Study II and Study III) observation time points. The data analysis additionally included questionnaires on the symptomatology of SP (LSAS) and comorbid depression (BDI-II) as well as other questionnaires from the SOPHO-NET project.
Results: Frequent movements with irregular structure ("fidgeting") at the beginning of therapy correlate with comorbidity of depressive symptoms. The difference in simultaneous hand activation between patient and therapist during therapy correlates with improvements in SP symptoms. The proportion of time of the movement activity of the dominant patient's hand is related to the successful establishment of the working relationship. Patients with non-improved SP symptomatology are characterized by short expressive hand coordination (act apart) as well as by pronounced stimulating hand coordination (act on each other).
Conclusion: Microanalytical movements differ between patients and therapists and correlate with the symptomatology of SP and co-morbid depression. During the fist six minutes after the introductory question at the beginning of the therapy session the observable trias of (i) little expressive irregular-repetitive movement structure, (ii) little flexibility in simultaneous movement and (iii) little expressivity and much somatosensory stimulation in the hand coordination marks symptom impairment. Movements associated with self-regulation processes (irregular, act on each other) as well as with simultaneous hand movement are sensitive to change and serve as ad hoc markers for change processes during therapy sessions besides the use of questionnaires. Psychotherapists should use structured movement analyses of therapy sessions to identify markers of change and for intervision purposes.
Original languageGerman
Place of PublicationKöln
PublisherDeutsche Sporthochschule Köln
Number of pages44
Publication statusPublished - 2022

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