Researchers, practitioners and legislators agree that it is important to understand which kinds of psychotherapeutic treatments lead to lasting positive changes in patients’ well-being, how those treatments can be administered in efficient ways and how it can be determined which patients would benefit from which treatment. In recent years, there has also been growing interest in those who practice psychotherapy; specifically, in the socio-emotional and interpersonal characteristics and competencies that psychotherapists should possess to provide high quality treatments for a variety of patients, irrespective of psychotherapy approach. This thesis studies one such important psychotherapist competency, namely the ability to recognize non-verbal emotional expressions in others. Psychotherapists need to be able to help patients experience, understand and express their emotions, and, in this context, it is crucial that they themselves have good socio-emotional competencies, like emotion recognition accuracy. Still, there is surprisingly little research about psychotherapists’ emotion recognition accuracy and about how they could be supported in improving this ability in the course of their education. 

Study I explores trainee psychotherapists’ emotion recognition accuracy in the beginning and in the end of theoretical and practical psychotherapy education, and compares it to a control group of undergraduate students. The results reveal that trainee psychotherapists in the beginning of their education show superior emotion recognition accuracy for multimodal (audio, video, audio-video) emotional expressions and micro expressions (<200ms) compared to the control group. This suggests that those who choose to become psychotherapists might already possess elevated emotion recognition accuracy or might have developed it early on during their studies. However, after one and a half years of education, their multimodal and micro expression emotion recognition accuracy does not improve significantly more than the control groups’ accuracy. This suggests that standard (psychodynamic and cognitive behavioral) psychotherapy education does not automatically lead to improved emotion recognition accuracy, even though the trainees learn how to conduct psychotherapy and also treat their first patients at the university clinic. Or, alternatively, that the socio-emotional competencies that develop during the education might not be captured by the standardized computerized emotion recognition accuracy tasks used in this study. Nonetheless, this finding might also suggest that more explicit training of emotion recognition accuracy is needed. Study II then investigates two newly developed standardized computerized emotion recognition accuracy trainings, one for multimodal emotion recognition accuracy and one for micro expression recognition accuracy. The trainings are evaluated in a sample of undergraduate students using a mixed design. The trainings are compared to one another and to an active control training. Both trainings are found to significantly improve the participants’ emotion recognition accuracy in a one-week posttest. Study III extends those findings using a sample of trainee psychotherapists. Also in the target population, both trainings are found to be effective in the one-week posttest. In addition to that, the multimodal training shows effects for unimodal emotion recognition accuracy for audio-only and video-only stimuli in the one-year follow-up towards the end of psychotherapy education. This indicates that standardized computerized emotion recognition accuracy training can be used as a tool for improving trainee psychotherapists’ emotion recognition accuracy, even though additional interventions might be needed for securing long-term success for all facets of emotion recognition. Future research should explore the practical impact of trainee psychotherapists’ emotion recognition accuracy and the training of this ability. 

The findings of this thesis are, on the one hand, surprising, in so far as psychotherapy education likely does not lead to improvements in trainee psychotherapists’ emotion recognition accuracy. On the other hand, they are encouraging, because they suggest that this ability can be trained with relatively simple and resource-efficient methods. Emotion recognition accuracy training could become part of standard or individualized psychotherapy training, alongside the training of other relevant verbal and non-verbal socio-emotional and interpersonal psychotherapist competencies.

The ability to recognize and work with patients’ emotions is considered an important part of most psychotherapy approaches. Surprisingly, there is little systematic research on psychotherapists' ability to recognize other people’s emotional expressions. In this study, we compared trainee psychotherapists’ non-verbal emotion recognition accuracy to a control group of undergraduate students at two time points: at the beginning and at the end of one and a half years of theoretical and practical psychotherapy training. Emotion recognition accuracy (ERA) was assessed using two standardized computer tasks, one for recognition of dynamic multimodal (facial, bodily, vocal) expressions and one for recognition of facial micro expressions. Initially, 154 participants enrolled in the study, 72 also took part in the follow-up. The trainee psychotherapists were moderately better at recognizing multimodal expressions, and slightly better at recognizing facial micro expressions, than the control group at the first test occasion. However, mixed multilevel modeling indicated that the ERA change trajectories for the two groups differed significantly. While the control group improved in their ability to recognize multimodal emotional expressions from pretest to follow-up, the trainee psychotherapists did not. Both groups improved their micro expression recognition accuracy, but the slope for the control group was significantly steeper than the trainee psychotherapists’. These results suggest that psychotherapy education and clinical training do not always contribute to improved emotion recognition accuracy beyond what could be expected due to time or other factors. Possible reasons for that finding as well as implications for the psychotherapy education are discussed.  

Introduction: Psychotherapists’ emotional and empathic competencies have a positive influence on psychotherapy outcome and alliance. However, it is doubtful whether psychotherapy education in itself leads to improvements in trainee psychotherapists’ emotion recognition accuracy (ERA), which is an essential part of these competencies.

Methods: In a randomized, controlled, double-blind study (N = 68), we trained trainee psychotherapists (57% psychodynamic therapy and 43% cognitive behavioral therapy) to detect non-verbal emotional expressions in others using standardized computerized trainings – one for multimodal emotion recognition accuracy and one for micro expression recognition accuracy – and compared their results to an active control group one week after the training (n = 60) and at the one-year follow up (n = 55). The participants trained once weekly during a three-week period. As outcome measures, we used a multimodal emotion recognition accuracy task, a micro expression recognition accuracy task and an emotion recognition accuracy task for verbal and non-verbal (combined) emotional expressions in medical settings.

Results: The results of mixed multilevel analyses suggest that the multimodal emotion recognition accuracy training led to significantly steeper increases than the other two conditions from pretest to the posttest one week after the last training session. When comparing the pretest to follow-up differences in slopes, the superiority of the multimodal training group was still detectable in the unimodal audio modality and the unimodal video modality (in comparison to the control training group), but not when considering the multimodal audio-video modality or the total score of the multimodal emotion recognition accuracy measure. The micro expression training group showed a significantly steeper change trajectory from pretest to posttest compared to the control training group, but not compared to the multimodal training group. However, the effect vanished again until the one-year follow-up. There were no differences in change trajectories for the outcome measure about emotion recognition accuracy in medical settings.

Discussion: We conclude that trainee psychotherapists’ emotion recognition accuracy can be effectively trained, especially multimodal emotion recognition accuracy, and suggest that the changes in unimodal emotion recognition accuracy (audio-only and video-only) are long-lasting. Implications of these findings for the psychotherapy education are discussed.

Nonverbal emotion recognition accuracy (ERA) is a central feature of successful communication and interaction, and is of importance for many professions. We developed and evaluated two ERA training programs—one focusing on dynamic multimodal expressions (audio, video, audio-video) and one focusing on facial micro expressions. Sixty-seven subjects were randomized to one of two experimental groups (multimodal, micro expression) or an active control group (emotional working memory task). Participants trained once weekly with a brief computerized training program for three consecutive weeks. Pre-post outcome measures consisted of a multimodal ERA task, a micro expression recognition task, and a task about patients' emotional cues. Post measurement took place approximately a week after the last training session. Non-parametric mixed analyses of variance using the Aligned Rank Transform were used to evaluate the effectiveness of the training programs. Results showed that multimodal training was significantly more effective in improving multimodal ERA compared to micro expression training or the control training; and the micro expression training was significantly more effective in improving micro expression ERA compared to the other two training conditions. Both pre-post effects can be interpreted as large. No group differences were found for the outcome measure about recognizing patients' emotion cues. There were no transfer effects of the training programs, meaning that participants only improved significantly for the specific facet of ERA that they had trained on. Further, low baseline ERA was associated with larger ERA improvements. Results are discussed with regard to methodological and conceptual aspects, and practical implications and future directions are explored.

This study presents findings about the effectiveness of two computerized training-programs for emotion recognition accuracy that were evaluated in a double-blind randomized controlled study with repeated measures design. Both trainings are effective in training emotion recognition accuracy. The trainings and results are presented in detail and practical implications are discussed.

Background: Computerized trainings for emotion recognition accuracy (ERA) have shown to be successful, however, are often lacking external validity. The use of still pictures, the focus on the face, and limited response sets limit generalizability of findings. Further, trainings often use between-subjectsdesigns and short time intervals between, or same items for ERA training and outcome measure. In response, we developed and evaluated a multi-modal ERA training in a randomized controlled trial.

Method: Seventy-two undergraduate students (M=24.7, SD=7.69, 75% women) signed up for the study; 68 completed all measurements. They were randomly assigned to the multimodal ERA training or one of two control conditions. The ERA outcome measure (ERAM; Laukka et al., 2015) assesses 12 emotions separately in three modalities (audio, video, audio-video) using 72 dynamic stimuli. The multimodal training consisted and immediate and extensive feedback using different items. The last training session and the ERA outcome measurement lay approximately one week apart.

Results and Conclusions: A repeated-measures ANOVA with baseline as covariate showed a main effect of training on the ERAM, F(2/63) = 8.04, p < .001, ηp2 = .20. Bonferroni-corrected posthoc tests revealed the change for the multimodal training was significantly superior to the control conditions (p=.001; p=.003). Detailed results per modality and descriptive statistics will be presented. Due to its multimodal and dynamic nature, delay between training and outcome measure and use of different items, the multimodal training is a promising tool for training ERA in different contexts, like clinical settings, assessment procedures or law enforcement training.

When in a stressful situation, access to adult attachment figures (e.g., romantic partners) is an important means by which adults regulate stress responses. The practice of smelling a partner's worn garment is reported as a self-treatment against stress. Here, we experimentally determined whether exposure to a partner's body odor attenuates adults' subjective discomfort and psychophysiological responses, and whether such effects are qualified by adult attachment security. In a blocked design, participants (N = 34) were presented with their partner's body odor, their own body odor, the odor of a clean t-shirt and rose odor, while exposed to weak electric shocks to induce discomfort and stress responses. Results showed that partner body odor reduces subjective discomfort during a stressful event, as compared with the odor of oneself. Also, highly secure participants had attenuated skin conductance when exposed to partner odor. We conclude that partner odor is a scent of security, especially for attachment-secure adults.

How are psychotherapists affected by emotions presented by their patients? In an experimental study training psychotherapists were investigated in the fmri-scanner. Would it be possible to improve their capacity to recognize emotional expressions by a specific training programme and which brain changes could be observed? The presentation focuses on the training method, the stimulus material, brain changes and clinical implications.

Intranasal oxytocin (OT) has previously been found to increase spirituality, an effect moderated by OT-related genotypes. This pre-registered study sought to conceptually replicate and extend those findings. Using a single dose of intranasal OT vs placebo (PL), we investigated experimental treatment effects, and moderation by OT-related genotypes on spirituality, mystical experiences, and the sensed presence of a sentient being. A more exploratory aim was to test for interactions between treatment and the personality disposition absorption on these spirituality-related outcomes. A priming plus sensory deprivation procedure that has facilitated spiritual experiences in previous studies was used. The sample (N = 116) contained both sexes and was drawn from a relatively secular context. Results failed to conceptually replicate both the main effects of treatment and the treatment by genotype interactions on spirituality. Similarly, there were no such effects on mystical experiences or sensed presence. However, the data suggested an interaction between treatment and absorption. Relative to PL, OT seemed to enhance spiritual experiences in participants scoring low in absorption and dampen spirituality in participants scoring high in absorption.

In normal aging, people are confronted with impairment in both socioemotional and cognitive abilities. Specifically, there are age-related declines in inhibitory processes that regulate attention towards irrelevant material. In last years, the intranasal administration of the neuropeptide oxytocin has mainly been related to improvements in several domains such as emotion recognition and memory, but to date the effects of oxytocin in aging remain largely unknown. In a randomized, double blind, placebo controlled, within-subjects study design, we investigated whether oxytocin facilitates inhibitory processing in older adults compared to younger adults. In total, 41 older adults (51% women; age range 65-75 years) and 37 younger adults (49% women; age range 20-30 years) participated in this study two times, receiving a single intranasal dose of 40 IU of placebo and oxytocin in randomized order 45 minutes before engaging in the task. Participants were tested approximately a month apart and mostly at the same hour during both occasions. Inhibition was measured with a Go/NoGo task which included happy and neutral faces as targets (Go stimuli) and distractors (NoGo stimuli) shown on a computer screen. Participants were instructed to press a button any time they saw a target and remain passive when encountering a distractor. Preliminary results indicate effects for happy and neutral faces, but only in the distractor condition. For happy distractors, women rejected correctly happy faces more accurately than men did, both in the placebo and oxytocin conditions. A main effect of age was observed for the neutral distractors, where older adults were more successful in inhibiting responses than younger adults during oxytocin and placebo treatments. We did not observe effects of oxytocin in the different tasks. The role of oxytocin was not clear distinguished in the tasks. In sum, our findings showed that age and gender can influence inhibition but their effects depend on the displayed emotions. This suggests that the ability to inhibit interfering distractors may remain intact despite of age and that deficits in inhibition may be selective. The role of oxytocin in inhibition needs to be further investigated since it is possible that it is context dependent.