On 27 October 2021, three young researchers were awarded the Stiftung Schmieder Prize 2020/2021 for their work in the field of neurological rehabilitation. During the Dies academicus at the University of Konstanz, which was broadcast live on the internet for the first time, Lisa Sophia Friedrich, Managing Director of the Schmieder Foundation for Science and Research, presented the prize to Gesa Pust, Milena Gölz and Livia Gretz.
"With their work, all three scientists make a valuable contribution to a better understanding of the clinical picture of multiple sclerosis (MS) and thus enrich research and the further development of therapies in this field," said the jury.
Psychodynamic perspective on MS fatigue
Gesa Pust, a prospective psychological psychotherapist, examines fatigue in multiple sclerosis from a psychodynamic/psychosomatic perspective in her dissertation. Her work shows that in addition to the dominant physical explanatory models, psychological factors also seem to play an important role in the development of MS fatigue in the context of MS. For example, their research suggests that emotional abuse and emotional neglect in childhood and adolescence have an impact on fatigue symptoms and that specific coping mechanisms in the face of stress are particularly significant for MS fatigue.
Psychodynamic theories have always been of particular importance for neurorehabilitation and psychosomatics. With a large-scale online study, Gesa Pust has now been able to test long-standing clinical hypotheses. Gesa Pust's work is the first to attempt to test a psychodynamic perspective on MS fatigue using empirical methods, thereby laying the foundation for new research questions and the further development of evidence-based therapeutic interventions. The two award-winning scientific publications are part of her dissertation within the framework of a joint project between the University of Konstanz, the Kliniken Schmieder Konstanz and the MS Outpatient Clinic of the University Medical Center Hamburg-Eppendorf (UKE).
Differentiating between subjective and objective exhaustion
Milena Gölz's excellent Master's thesis was written as part of the CogLoad project in the Working Group for Motor Cognition and Neurorehabilitation in the Department of Psychology at the University of Konstanz, in collaboration with the Kliniken Schmieder Konstanz, and was published in the journal Neurology and Rehabilitation in 2021. In her study, she examined the self-assessed state of mind and the attention and concentration performance of MS patients at the Kliniken Schmieder, both after stress and after relaxation. In the stress condition, the patients were asked to solve cognitively stressful tasks for three hours.
The aim was to distinguish between different concepts such as fatigue, subjective exhaustion, and fatigability, objective exhaustion, and to determine possible overlaps or connections with personality traits, depression, and self-control. The results of the study indeed showed significantly worse well-being and longer reaction times after stress compared to relaxation in the MS patients studied. However, no correlation between fatigue and fatigability could be found.
With her work, Milena Gölz makes it clear that it is important to include both subjective fatigue and objective fatigue in the diagnosis in everyday clinical practice. The appropriate therapy options can then be selected on this basis. In parallel to her doctorate in the Working Group for Motor Cognition and Neurorehabilitation, Milena Gölz has been working as a psychotherapist in training in the Department of Psychotherapeutic Neurology at the Kliniken Schmieder Konstanz since July 2021.
Importance of resilience in MS patients
For the first time, Livia Gretz, a graduate of the part-time bachelor's degree programme in Motor Neurorehabilitation at the University of Konstanz, has received an award. In her bachelor's thesis, the occupational therapist investigated the question of the importance of resilience in the use of everyday aids by MS patients. Resilience can be understood as the ability to master difficulties and crises by drawing on personal and socially mediated resources and to use these as an occasion for one's own development.
Even though there is already a lot of literature and research on this area, one finds few example reports of how resilience develops in a person suffering from multiple sclerosis during the course of the disease. The case analysis carried out by Livia Gretz can clearly show the connection between resilience and the use of everyday aids and thus makes an important contribution to understanding why patients recover differently.
The award winners and their award-winning work:
Gesa Pust, M. Sc., Department of Psychology
Fatigue in Multiple Sclerosis is associated with childhood adversities (published 2020 in Front. Psychiatry 11:811).
Association of Fatigue Severity With Maladaptive Coping in Multiple Sclerosis: A Data-Driven Psychodynamic Perspective. (published 2021 in Front. Neurol. 12:652177)
Milena Gölz, M. Sc., Department of Psychology
The relationship between subjective fatigue and performance measures in multiple sclerosis
Livia Gretz, B. Sc. Motor Neurorehabilitation, Department of History and Sociology with Sport Science and Empirical Educational Research
Do it yourself - and as effectively as possible: the importance of resilience in people with multiple sclerosis and daily living aids by means of case analysis