Guiding principle:
The lab focuses on interpersonal experiences in the context of development, mental health and illness, and recovery (through psychotherapy).
We examine these associations at different levels and relating to various life circumstances. For instance, we investigate societal challenges such as loneliness as well as relationship experiences in psychotherapy – within the therapy room and beyond.
As such, we are consolidating our focus on intersession processes (comprising thoughts and feelings relating to the therapy/the therapist that spontaneously arise or are intentionally activated between appointments).
We dedicate ourselves to these topics using new developments such as Ecological Momentary Assessment (EMA) and daily-diary studies; applying them in a transdiagnostic and theoretically integrative way in both community and high-risk patient samples. We are driven to incorporate these perspectives into psychotherapy process and outcome research. It is important to us to contribute to strengthening psychotherapy as an evidence-based method that seeks to understand the person in their entirety, individuality and within the context of their biography.
Principal Investigator:
Ongoing projects:
Intersession dynamics
Psychotherapy outcomes extend beyond sessions, yet the underlying mechanisms remain elusive.
Intersession Processes (ISP) have been proposed as instrumental to therapeutic change. Despite their
conceptual alignment with Reflective Functioning (RF) and the wealth of evidence for within-person
changes in RF, empirical investigations into their dynamic interplay are lacking.
This pilot study addresses this research gap through a mixed-methods daily-diary study. Utilizing short, validated questionnaires, daily assessments will capture RF, ISP, and symptoms. The study design, poised at our outpatient center, harnesses synergies between established clinical practice and research, seeking to unveil the temporal variability and mutual dependencies of ISP, RF, and symptoms. Through qualitative inquiry, we aim to capture subjective experiences adding important information; also to adapt the procedure for future endeavours. A deepened understanding of ISP as a mechanism of change holds the potential to advance psychotherapy research and practice in a way that matters to patients, enhancing treatment personalization and effectiveness.
This project is currently in preparation. It is being funded through the Society for Psychotherapy Research’s Small Grant Programme.
TempRes (Temporal Variability of Risk and Resilience Factors for Suicidal Ideation)
The project uses Ecological Momentary Assessment (EMA) to investigate temporal dynamics of mood and psychological distress with a special focus on loneliness and suicidal ideation; and on theoretically derived vulnerability and protective factors in a clinical and a community sample. It combines new developments in suicide research with a psychodynamic perspective and transdiagnostic constructs such as personality functioning. The results will provide an empirical basis for the development of specific interventions to promote resilience in the population and at-risk groups.
TempRes is conducted in cooperation with the University Medical Center Mainz and the University of Glasgow. Funded through a grant from the MZPG CONNECT Early Career Program of the Mainz Center for Mental Health 2021-2022.
Selected publications:
Ernst, M., Gemke, T. J., Olivi, L. J., & O’Connor, R. C. (2024). Ambulatory assessment of suicidal ambivalence: The temporal variability of the wish to live and the wish to die and their relevance in the concurrent and prospective prediction of suicidal desire. Suicide and Life‐Threatening Behavior, 54(5), 831-843. https://doi.org/10.1111/sltb.13120
TASC (Together against suicidal ideation and behavior in cancer patients and survivors)
Cancer patients and survivors are at increased risk for suicidal thoughts and behaviors, which is why this project aims to strengthen suicide prevention in the oncological context. It combines analyses of existing data (e.g., a prospective community cohort and psychotherapeutic intervention studies) and a new data collection of patients treated at the Comprehensive Cancer Center Mainz.
It has three objectives:
In total, data from more than >2,500 cancer patients/survivors will be analyzed and compared to appropriate, population-representative samples. The question of whether suicidal ideation in cancer patients is adequately explored will be investigated using both qualitative and quantitative methods: a detailed analysis of care at the UCT Mainz through interviews with different professional groups and a nationwide expert survey which includes questions/categories derived from the interviews
TASC is conducted in cooperation with the University Medical Center Mainz and the MedUni Vienna. Funded by the German Cancer Aid.
Selected publications:
Ernst, M., Schwinn, T., Hirschmiller, J., Cleare, S., Robb, K. A., Brähler, E., Zwerenz, R., Wiltink, J., O’Connor, R. C., & Beutel, M. E. (2024). To what extent are psychological variables considered in the study of risk and protective factors for suicidal thoughts and behaviours in individuals with cancer? A systematic review of 70 years of research. Clinical psychology review, 102413. https://doi.org/10.1016/j.cpr.2024.102413
Schwinn, T., Paul, R. H., Hirschmiller, J., Brähler, E., Wiltink, J., Zwerenz, R., O’Connor, R. C., Wild, P. S., Münzel, T., König, J., Geschke, K., Moehler, M., Konstantinides, S., Justenhoven, C., Lackner, K. J., Pfeiffer, N., Beutel, M. E., & Ernst, M. (2024). Prevalence of current suicidal thoughts and lifetime suicide attempts in individuals with cancer and other chronic diseases in Germany: Evidence for differential associations from a representative community cohort. Journal of Affective Disorders, 367, 193-201. https://doi.org/10.1016/j.jad.2024.08.093
Hirschmiller, J., Schmeckenbecher, J., Schwinn, T., Wiltink, J., Brähler, E., Kapusta, N., Zwerenz, R., Beutel, M. E., & Ernst, M. (2024). Perceived Control as a Potential Protective Factor for Suicidal Thoughts and Behaviors in Cancer Patients and Survivors: A Systematic Review With Meta‐Analysis. Psycho‐Oncology, 33(11), e70030. https://doi.org/10.1002/pon.70030
Further investigations, including in the context of ongoing international cooperations, comprise:
- Clinical trials such as the LAC Psychotherapy study
Selected publications:
Krakau, L., Ernst, M., Hautzinger, M., Beutel, M. E., & Leuzinger-Bohleber, M. (2024). Childhood trauma and differential response to long-term psychoanalytic versus cognitive–behavioural therapy for chronic depression in adults. The British Journal of Psychiatry, 225(4), 446-453. https://doi.org/10.1192/bjp.2024.112Beutel, M., Krakau, L., Kaufhold, J., Bahrke, U., Grabhorn, A., Hautzinger, M., Fiedler, G., Kallenbach-Kaminski, L., Ernst, M., Rüger, B., & Leuzinger‐Bohleber, M. (2023). Recovery from chronic depression and structural change: 5‐year outcomes after psychoanalytic and cognitive‐behavioural long‐term treatments (LAC depression study). Clinical psychology & psychotherapy, 30(1), 188-201. https://doi.org/10.1002/cpp.2793
- Examinations of routine clinical data from multimodal inpatient psychotherapy
Selected publications:
Ernst, M., Zwerenz, R., Michal, M., Wiltink, J., Tuin, I., & Beutel, M. E. (2023). Ambivalent toward life, ambivalent toward psychotherapy? An investigation of the helping alliance, motivation for treatment, and control expectancies in patients with suicidal ideation in inpatient psychotherapy. Suicide and Life‐Threatening Behavior, 53(4), 557-571. https://doi.org/10.1111/sltb.12964
Ernst, M., Beutel, M. E., Zwerenz, R., & Krakau, L. (2023). Seeing the past in a new light: change in reports of childhood abuse and neglect before and after inpatient psychotherapy and its relevance for change in depression symptoms. Psychotherapy Research, 33(2), 222-234. https://doi.org/10.1080/10503307.2022.2088313
- Representative population surveys
Selected publications:
Ernst, M., Brähler, E., Beutel, M. E., Kruse, J., & Andreas, S. (2024). Socially isolated, but not lonely in lockdown: Exploring the role of reflective functioning as a protective factor in the early days of the COVID-19 pandemic in Germany. Journal of Affective Disorders, 362, 201-208. https://doi.org/10.1016/j.jad.2024.06.109Ernst, M., Brähler, E., Kampling, H., Kruse, J., Fegert, J. M., Plener, P. L., & Beutel, M. E. (2022). Is the end in the beginning? Child maltreatment increases the risk of non-suicidal self-injury and suicide attempts through impaired personality functioning. Child Abuse & Neglect, 133, 105870. https://doi.org/10.1016/j.chiabu.2022.105870
Ernst, M., Klein, E. M., Beutel, M. E., & Brähler, E. (2021). Gender-specific associations of loneliness and suicidal ideation in a representative population sample: Young, lonely men are particularly at risk. Journal of Affective Disorders, 294, 63-70. https://doi.org/10.1016/j.jad.2021.06.085
Meta-research including systematic reviews and meta-analyses
Selected publications:
Ernst, M., Niederer, D., Werner, A. M., Czaja, S. J., Mikton, C., Ong, A. D., Rosen, T., Brähler, E., & Beutel, M. E. (2022). Loneliness before and during the COVID-19 pandemic: A systematic review with meta-analysis. American Psychologist, 77(5), 660.
Krakau, L., Leuzinger-Bohleber, M., Brähler, E., Schmidt, P., Rost, F., Huber, D., Klug, G., Löffler-Stastka, H., Rössler-Schülein, H. Leichsenring, F., Salzer, S., Brockmann, J., Jakobsen, T., Ernst, M., & Beutel, M. E. (2023). Efficacy of high-intensity versus low-intensity psychoanalytically oriented long-term treatments and determinants of outcome: individual participant data Meta-analysis of Long-term Analytic treatment Studies (MeLAS). BMJ open, 13(7), e069332. https://doi.org/10.1136/bmjopen-2022-069332
