References of "Koch, Stefan"
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See detailSensing Your Body: Interoceptive Awareness and Medically Unexplained Symptoms
Flasinski, Tabea UL; Dierolf, Angelika UL; Voderholzer, Ulrich et al

in Abtracts of the 32nd Annual Conference of the European Health Psychology Society (2018)

According to contemporary theories of medically unexplained symptoms (MUS), alterations in interoception play a major role in symptom development and maintenance. Nevertheless, the mechanisms underlying ... [more ▼]

According to contemporary theories of medically unexplained symptoms (MUS), alterations in interoception play a major role in symptom development and maintenance. Nevertheless, the mechanisms underlying this relationship remains unclear. To address this unresolved issue, we investigated whether individuals with varying degrees of MUS differ in different facets of interoceptive awareness as assessed with the Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire. In study 1, 486 individuals were screened with an online version of the Screening for Somatoform Disorders (SOMS-2). Individuals with a SOMS index below 5 (low reporter, n=32) and above 20 (high reporter, n=32) were invited to fill in the MAIA. High symptom reporter had lower scores on the Not-Distracting, Not-Worrying, and Trusting subscales, and higher scores on the Emotional Awareness subscale (Cohen´s d=.70–1.16). In study 2, individuals with DSM-IV somatoform disorder (SFD; n=25) were compared to individuals with major depressive disorder (MDD; n=24) and healthy controls (HC; n=25). The SFD and MDD groups had lower scores on the Not-Distracting, Attention Regulation, Self-Regulation, and Trusting subscales than HC. The MDD group had lower scores than the SFD and HC groups on the Body Listening subscale (partial eta-squared=.18-.26). No differences with regard to Noticing of bodily sensations were found. Groups with subclinical SFD, SFD and MDD do not differ from healthy individuals in terms of actual body perception, whereas cognitive facets of interoception, such as distraction or self-regulation are differentially affected. This highlights the necessity of including specifically targeted mindfulness-based interventions [less ▲]

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See detailImpaired filter function in patients with somatoform disorders and major depression, as reflected by auditory evoked potentials in an oddball and an active distraction paradigm
Hutmacher, Djenna UL; Dierolf, Angelika UL; Lutz, Annika UL et al

in Abstractband Psychologie und Gehirn 2018 (2018)

Introduction: In the in influential perception-filter model of somatoform disorders (SD), three stages of symptom perception are postulated: (1) bodily signals, which may be amplified by stress, (2) a ... [more ▼]

Introduction: In the in influential perception-filter model of somatoform disorders (SD), three stages of symptom perception are postulated: (1) bodily signals, which may be amplified by stress, (2) a filter system, which distinguishes between relevant and irrelevant stimuli, and (3) cortical perception of physical symptoms. As there is dearth of evidence so far supporting the relationship between (1) bodily signals and (2) filter processes in SD, this study investigated if filter processes are altered in SD and if stress may affect filter mechanisms. Methods: Twenty-four patients with SD, 24 with depression and 24 healthy control individuals were assessed. Event-related potentials (ERPs) with two different auditory distraction procedures were recorded over four blocks, one before and three after either a socially evaluated cold pressor test (SECPT) or a control procedure. We manipulated both the frequency of and the attentional focus on stimuli to reflect filter processes. Results: We found smaller P3b amplitudes (reflecting memory storage) in patients with depression and SD, as compared to healthy controls. Furthermore, both patient groups showed a smaller P3a amplitude (reflecting attention), when counting the infrequent tone ("Oddball task") and a smaller N1 amplitude when counting the frequent tone ("active distraction"). In patients with SD, the SECPT had a decreasing effect on P3a amplitudes. Conclusions: Both late filter processes, reflecting attention (P3a) and memory storage (P3b), may be impaired in SD and depression. As acute stress affected attention in SD patients only, the impact of bodily signals (1) on filter processes (2) may be specific for SD. [less ▲]

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See detailAffective evaluation of body images in anorexia nervosa
Lutz, Annika UL; Herbert, Cornelia; Schulz, André UL et al

in Psychophysiology (2017), 54(S1),

Anorexia nervosa is characterized by fear of weight gain. This is reflected in amygdala activation during confrontation with distorted photographs of oneself simulating weight gain. In contrast ... [more ▼]

Anorexia nervosa is characterized by fear of weight gain. This is reflected in amygdala activation during confrontation with distorted photographs of oneself simulating weight gain. In contrast, photographs of emaciated women induce startle attenuation, suggesting a positive valuation of extreme slimness. To combine these findings, we applied an affective startle modulation paradigm containing photos of the participants simulating weight gain and photos simulating weight loss. We assessed eye-blink startle responses via EMG in 20 women with anorexia nervosa (AN; mean age = 25 years; mean BMI = 23) and 20 healthy control women (HC; mean age = 25 years; mean BMI = 23). We were able to replicate affective startle modulation of standard positive, negative, and neutral pictures, except for an absence of startle attenuation for positive pictures in AN. Body images did not modulate the startle response in either group. This was in contrast to the subjective ratings, in which the AN group indicated negative valence and high arousal for distorted body images. The body photographs used in our study emphasized general body shape and it appears that this was not threatening to AN patients. Photos highlighting body details might produce different results. Considering that body image exposure, a frequently used intervention tool for AN, aims at fear reduction through habituation, it is essential to determine which aspects of the body actually elicit fear responses to maximize therapy outcome. [less ▲]

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See detailInterozeption bei Anorexia nervosa: Befunde auf subjektiver und elektrophysiologischer Ebene
Lutz, Annika UL; Schulz, André UL; Voderholzer, Ulrich et al

Scientific Conference (2016, September)

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See detailInterozeption bei Anorexia nervosa: Befunde auf subjektiver und elektrophysiologischer Ebene
Lutz, Annika UL; Schulz, André UL; Voderholzer, Ulrich et al

in 15. Kongress der Deutschen Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation. Verhaltensmedizin 2.0 - von eHealth zu mHealth. 25. bis 27. Februar 2016, Johannes Gutenberg-Universität Mainz. Abstractband (2016, February)

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See detailInteroception in anorexia nervosa: evidence at cortical and self-report levels
Lutz, Annika UL; Schulz, André UL; Voderholzer, Ulrich et al

in Appetite (2016), 107

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See detailReduced early visual processing of own body images in anorexia nervosa: An event-related potentials study
Lutz, Annika UL; Herbert, Cornelia; Schulz, André UL et al

Poster (2016)

Introduction. Although body image distortion in anorexia nervosa (AN) has been extensively studied over the past decades, its underlying mechanisms are not yet fully understood. Neuro-imaging studies have ... [more ▼]

Introduction. Although body image distortion in anorexia nervosa (AN) has been extensively studied over the past decades, its underlying mechanisms are not yet fully understood. Neuro-imaging studies have identified functional and structural alterations in brain areas involved in visual body perception, but the time course of visual body processing in AN remains mostly unexplored. The current study used event-related brain potentials (ERPs) to investigate single processing steps along the time course, particularly the visual processing of physical body image characteristics (featural processing, P1) and the recognition of a body as such (configural processing, N1). Methods. Twenty in-patients with AN, and 20 healthy women viewed photographs of themselves, of another woman’s body and of their own and another woman’s standardized object (cup) with concurrent EEG recording. Results. Body images elicited an accentuation of the P1 component (105-160 ms), which was absent for the comparison between own-body and own-cup images in the AN group. Results regarding the N1 component suggest alterations in object processing in AN. Conclusions. Our results demonstrate that individuals with AN show reduced featural processing of their own body image, a process which, due to its position early in the visual processing stream, is unlikely to involve higher cognitive stimulus processing. This suggests a possible role of previously undetected pre-conscious mechanisms in body image disturbance. [less ▲]

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See detailZentralnervöse Verarbeitung von Körpersignalen bei Anorexia nervosa
Lutz, Annika UL; Schulz, André UL; Voderholzer, Ulrich et al

Scientific Conference (2015, April)

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See detailInteroception in anorexia nervosa: evidence at cortical and self-report levels
Lutz, Annika UL; Schulz, André UL; Voderholzer, Ulrich et al

in 45th Annual Congress of the European Association for Behavioural and Cognitive Therapies (EABCT) (2015)

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See detailBody or cup? Alterations in featural and configural body image processing in anorexia nervosa
Lutz, Annika UL; Herbert, Cornelia; Schulz, André UL et al

in Psychophysiology (2015), 52(supplement 1), 123

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See detailEnhanced cardiac perception predicts impaired performance in the Iowa Gambling Task in patients with panic disorder
Wölk, Julian; Sütterlin, Stefan UL; Koch, Stefan et al

in Brain and Behavior (2014), 4(2), 238-246

Objective: Somatic marker theory predicts that somatic cues serve intuitive decision- making; however, cardiovascular symptoms are threat cues for patients with panic disorder (PD). Therefore, enhanced ... [more ▼]

Objective: Somatic marker theory predicts that somatic cues serve intuitive decision- making; however, cardiovascular symptoms are threat cues for patients with panic disorder (PD). Therefore, enhanced cardiac perception may aid intuitive decision-making only in healthy individuals, but impair intuitive decision-making in PD patients. Methods: PD patients and age- and sex-matched volunteers without a psychiatric diagnosis (n = 17, respectively) completed the Iowa Gambling Task (IGT) as a measure of intuitive decision-making. Inter-individual differences in cardiac perception were assessed with a common mental tracking task. Results: In line with our hypothesis, we found a pattern of opposing associations (Fisher’s Z=1.78, p=.04) of high cardiac perception with improved IGT-performance in matched control-participants (r = .36, n = 14) but impaired IGT-performance in PD patients (r = -.38, n = 13). Conclusion: Interoceptive skills, typically assumed to aid intuitive decision-making, can have the opposite effect in PD patients who experience interoceptive cues as threatening, and tend to avoid them. This may explain why PD patients frequently have problems with decision-making in everyday life. Screening of cardiac perception may help identifying patients who benefit from specifically tailored interventions. [less ▲]

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See detailInteroception and inhibitory capacity in panic disorder and somatoform disorders
Grosche, Christian; Sütterlin, Stefan UL; Koch, Stefan et al

in 13. Kongress der Deutschen Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation (2011)

Hintergrund: Nach Damasios Theorie der Somatischen Marker werden Entscheidungen in komplexen Situationen durch die Wahrnehmung physiologischer Vorgänge (Interozeption) sowie durch die individuelle ... [more ▼]

Hintergrund: Nach Damasios Theorie der Somatischen Marker werden Entscheidungen in komplexen Situationen durch die Wahrnehmung physiologischer Vorgänge (Interozeption) sowie durch die individuelle Fähigkeit zu dieser Wahrnehmung (Interozeptivität) beeinflusst. Im Sinne zielgerichteten Verhaltens müssen die auf diese Weise gewonnenen, emotional mediierten Informationen bei Bedarf reguliert werden, wofür präfrontal initiierte, inhibitorische Prozesse maßgeblich sind. Die hierfür notwendige Inhibitionskapazität kann durch die vagal mediierte und präfrontal modulierte Herzratenvariabilität (HRV) peripherphysiologisch quantifiziert werden. Die Interaktion interozeptiver und inhibitorischer Fähigkeiten bei Entscheidungen unter emotional ablenkenden Bedingungen ist im klinischen Kontext insbesondere bei Krankheitsbildern mit disinhibitorischen und körperwahrnehmungsbezogenen Symptomen relevant. Die vorliegende Studie untersuchte Entscheidungsprozesse unter emotionalen Einflüssen bei Patienten mit Panikstörung und Somatoformen Störungen. Methode: 17 Patienten mit Panikstörung und 20 Patienten mit Somatoformen Störungen wurden im stationären Setting einer psychosomatischen Klinik untersucht. Die Interozeptivität wurde mit einer Trackingaufgabe des Herzschlages bestimmt, zur HRV-Bestimmung ein EKG unter Ruhebedingung aufgezeichnet. Entscheidungsprozesse wurden mit Hilfe einer emotionalen Flanker Task und der Iowa Gambling Task untersucht. Ergebnisse: Bei Patienten mit Panikstörung zeigte sich eine negative Interaktion zwischen HRV und Interozeptivität, die darüber hinaus mit der Ablenkbarkeit durch emotionale Reize in der Flanker Task assoziiert war. Bei Patienten mit Somatoformen Störungen traten diese Zusammenhänge nicht auf. Patienten mit Panikstörung zeigten eine signifikant niedrigere HRV im Vergleich mit Patienten mit Somatoformen Störungen. Diskussion: Die Ergebnisse legen nahe, dass Interozeptivität und Inhibitionskapazität jeweils allein nicht ausreichend sind, um die untersuchten klinischen Störungen spezifisch zu charakterisieren. Eine negative Interaktion beider Maße allerdings scheint spezifisch mit der Panikstörung assoziiert zu sein und spricht für eine präzise, aber dysfunktionale interozeptive Wahrnehmung bei verminderter Regulationskapazität, was sich in der Beeinflussung der Aufmerksamkeitsausrichtung durch emotionale Prozesse manifestiert. [less ▲]

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