Parental divorce is associated with an increased risk to develop mental disorders in women

in Journal of Affective Disorders (2019), 257(1), 91-99

Background: Parental divorce has been associated with reduced well-being in young adults. It is, however, unclear whether this finding is clinically relevant as studies using structural clinical ... [more ▼]

Background: Parental divorce has been associated with reduced well-being in young adults. It is, however, unclear whether this finding is clinically relevant as studies using structural clinical interviews are missing. This study, therefore, investigated if young adults with divorced parents are at risk to develop mental disorders. Furthermore, differences in parental care, social connectedness, chronic stress and traumatic experiences between children of divorced and non-divorced parents were investigated. Methods: 121 women (mean age: 23 years) were interviewed using the Structured Clinical Interview for DSMIV Axis I (i.e., major mental disorders) and II (i.e., personality disorders) Disorders and asked to complete questionnaires assessing parental care, social connectedness (loneliness, attachment anxiety and avoidance), chronic stress, childhood trauma and depression. Results: Young adults of divorced parents had a higher risk for Axis I but not Axis II disorders as compared to young adults of non-divorced parents. Participants from divorced families as compared to non-divorced families reported more depression, loneliness, childhood trauma, attachment avoidance, attachment anxiety, chronic stress and less parental care. Limitations: Due to the cross-sectional design of this study, conclusions about causality remain speculative. Conclusion: The increased vulnerability of children of divorced parents to develop mental disorders, and to experience more chronic stress, loneliness, attachment avoidance, attachment anxiety, and traumatic experiences during childhood is alarming and highlights the importance of prevention programs and psycho-education during the process of parental divorce. Parental support with regard to adequate caregiving is needed to help parents to better support their children during and after their divorce. [less ▲]

Interoception in Bulimia Nervosa: Evidence at cortical and self-report levels

in Psychophysiology (2019), 56(S1), 117

Bulimia nervosa (BN) is characterized by recurrent episodes of binge eating and compensatory behaviors, such as self- induced vomiting. Body image disturbance is also prominent in BN. Current research is ... [more ▼]

Bulimia nervosa (BN) is characterized by recurrent episodes of binge eating and compensatory behaviors, such as self- induced vomiting. Body image disturbance is also prominent in BN. Current research is trying to determine which dimensions and sensory domains of body perception are affected in BN. Regarding heartbeat perception, findings are inconclusive, with some studies reporting reduced and others reporting unaltered interoceptive accuracy in BN. The current study contributes further data on heartbeat perception by using an indicator of the cortical processing of cardio- afferent signals (heartbeat evoked potentials, HEPs). We investigated 22 women with current or partially remitted BN (BMI 23.94[3.61]; age 31.86[11.20]) and 22 healthy women (HC; BMI 24.24[3.37]; age 31.00[10.15]). Participants performed a heartbeat perception task (according to Schandry) with concurrent 64- channel- EEG and ECG recording. HEPs were calculated as mean EEG amplitudes in the interval 455- 595ms after the R- peak of the ECG. Results show no significant differences between the BN and HC groups, neither for heartbeat perception, HEPs, or mean heartrate. These results confirm previous findings of intact heartbeat perception in BN. In addition, cortical processing of cardio- afferent signals is unaltered. Heartbeat perception is particularly relevant for emotion processing and regulation. The previously reported emotion- regulation deficits in BN appear not to be based on altered CNS processing of cardiac signals [less ▲]

Langzeitkonsequenzen elterlicher Scheidung für die Gesundheit im jungen Erwachsenenalter

Presentation (2018, November 23)

Late heartbeat-evoked potentials are associated with survival after cardiac arrest

in Resuscitation (2018), 126(1), 7-13

RATIONALE: Cardiac arrest (CA) is a serious condition characterized by high mortality rates, even after initial successful resuscitation, mainly due to neurological damage. Whether brain-heart ... [more ▼]

RATIONALE: Cardiac arrest (CA) is a serious condition characterized by high mortality rates, even after initial successful resuscitation, mainly due to neurological damage. Whether brain-heart communication is associated with outcome after CA is unknown. Heartbeat-evoked brain potentials (HEPs) represent neurophysiological indicators of brain-heart communication. The aim of this study was to address the association between HEPs and survival after CA. METHODS: HEPs were calculated from resting EEG/ECG in 55 CA patients 24 hours after resuscitation. All patients were treated with targeted temperature management and a standardized sedation protocol during assessment. We investigated the association between HEP amplitude (180- 320 ms, 455-595 ms, 860-1000 ms) and 6-month survival. RESULTS: Twenty-five of 55 patients (45%) were still alive at 6-month follow-up. Survivors showed a higher HEP amplitude at frontopolar and frontal electrodes in the late HEP interval than non-survivors. This effect remained significant after controlling for between-group differences in terms of age, Fentanyl dose, and time lag between resuscitation and EEG assessment. There were no group differences in heart rate or heart rate variability. CONCLUSION: Brain-heart communication, as reflected by HEPs, is associated with survival after CA. Future studies should address the brain-heart axis in CA. [less ▲]

Late heartbeat-evoked potentials, indicators of cortical representation of interoceptive signal processing, are associated with survival after cardiac arrest

in Hennig, J.; Stark, R. (Eds.) Abstractband Psychologie und Gehirn 2018 (2018)

Rationale: Cardiac arrest (CA) is a serious condition characterized by high mortality rates, even after initial successful resuscitation, mainly due to neurological damage. Whether brain-heart ... [more ▼]

Rationale: Cardiac arrest (CA) is a serious condition characterized by high mortality rates, even after initial successful resuscitation, mainly due to neurological damage. Whether brain-heart communication is associated with outcome after CA is unknown. Heartbeat-evoked brain potentials (HEPs) represent neurophysiological indicators of brain-heart communication, as they reflect cortical representation of interoceptive signal processing. The aim of this study was to address the association between HEPs and survival after CA. Methods: HEPs were calculated from resting EEG/ECG in 55 CA patients 24 h after resuscitation. All patients were treated with targeted temperature management and a standardized sedation protocol during assessment. We investigated the association between HEP amplitude (180{320 ms, 455{595 ms, 860{1000 ms) and 6-month survival. Results: Twenty-five of 55 patients (45%) were still alive at 6-month follow-up. Survivors showed a higher HEP amplitude at frontopolar and frontal electrodes in the late HEP interval than non-survivors. This effect remained significant after controlling for between-group differences in terms of age, Fentanyl dose, and time lag between resuscitation and EEG assessment. There were no group differences in heart rate or heart rate variability. Conclusion: Brain-heart communication, as re ected by HEPs, is associated with survival after CA. Cardiovascular autonomic arousal may not be involved in mediating this effect. Adequate cortical representation of interoceptive signals may be essential to preserve cariovascular health and should be in the focus of prevention strategies. Future studies should address the brain-heart axis in CA. [less ▲]

Respiratory modulation of startle: effects on subjective intensity and psychomotor response times

in Hennig, J.; Stark, R. (Eds.) Abstractband Psychologie und Gehirn 2018 (2018)

Respiratory cycle time modulates reflexive startle eye blink responses to acoustic stimuli. Responsible for this effect seems to be the afferent input of slow adapting pulmonary stretch receptors. It ... [more ▼]

Respiratory cycle time modulates reflexive startle eye blink responses to acoustic stimuli. Responsible for this effect seems to be the afferent input of slow adapting pulmonary stretch receptors. It remains unclear, however, whether this respiratory modulation of startle (RMS) effect is also reflected in the modulation of higher cognitive, evaluative processing of the startle stimulus. Twenty-nine healthy volunteers received 80 acoustic startle stimuli (100 or 105 dB(A); 50 ms; binaural; instantaneous rise time), which were presented during peak and ongoing inspiration and expiration, while performing a paced breathing task at 0.25 Hz. Participants first responded to the startle probes by `as fast as possible' button pushes and then rated the perceived intensity of the acoustic stimuli. Psychomotor response time was divided into pre-motor (from stimulus onset to home button release; represents stimulus evaluation) and motor response time (from home button release to target button press). Intensity judgements were higher and evaluative response times accelerated during on-going expiration. No effect of respiratory cycle phase was found on eye blink responses and motor response time. We conclude, therefore, that respiratory cycle phase affects higher cognitive, attentional processing of acoustic startle stimuli. [less ▲]

Post-learning cold pressor stress, after a heartbeat perception training, enhances interoceptive accuracy in high blood pressure responders

in Abstractband Psychologie und Gehirn 2018 (2018)

Interoceptive accuracy (IAc) plays an important role for generation of medically unexplained symptoms (MUS) and trainings to enhance IAc reduces the perceived symptom severity of MUS. Post-learning stress ... [more ▼]

Interoceptive accuracy (IAc) plays an important role for generation of medically unexplained symptoms (MUS) and trainings to enhance IAc reduces the perceived symptom severity of MUS. Post-learning stress may facilitate recognition learning. It is yet unknown, however, if acute stress, when evoked during the memory consolidation phase, could enhance the visceral learning in a heartbeat perception training (HBPT). The present study is the first to investigate the effects of a socially evaluated cold pressor test (SECPT) induced after a HBPT aimed at increasing IAc. The sample consisted of 48 healthy students (28 women). IAc was assessed at three different time points: (1) once as a baseline measure, (2) 30 minutes after the SECPT, and (3) the day after. Assessment of IAc was performed using the heartbeat perception task developed by Schandry (1981). The HBPT followed the baseline IAc assessment and was a replication of the paradigm developed by Schaefer et al. (2014). The SECPT followed immediately after the HBPT. Results showed that post-encoding stress significantly increased IAc between T1 and T3 for participants showing a high blood pressure (BP) response in the SECPT compared to the control group, whereas low BP responders did not show such an effect. This indicates that post-encoding stress enhances visceral memory consolidation in high BP responders compared to low BP responder and non-stressed control participants. Post-learning stress facilitation of visceral learning and memory may represent a mechanism underlying symptom generation, which should be addressed in studies on somatic symptom disorders in the future. [less ▲]

Sensing Your Body: Interoceptive Awareness and Medically Unexplained Symptoms

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 ▲]

Impaired filter function in patients with somatoform disorders and major depression, as reflected by auditory evoked potentials in an oddball and an active distraction paradigm

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 ▲]

Interozeption und Stress: die Psychophysiologie der bi-direktionalen Kommunikation auf der Hirn-Körper-Achse

in Schächinger, H. (Ed.) Abstractband 43. Tagung Psychologie und Gehirn (2017)

Gehirn und Körper tauschen permanent Informationen aus. Interozeption, die Wahrnehmung von Körperprozessen, ist ein wichtiges Beispiel für aufsteigende Informationsübermittlung vom Körper zum Gehirn ... [more ▼]

Gehirn und Körper tauschen permanent Informationen aus. Interozeption, die Wahrnehmung von Körperprozessen, ist ein wichtiges Beispiel für aufsteigende Informationsübermittlung vom Körper zum Gehirn. Stress wiederum kann als prototypisch für absteigende Informationen vom Gehirn zum Körper gesehen werden. Eine Veränderung der Kommunikation auf der Hirn-Körper-Achse kann zur Entstehung körperlicher Symptome bei psychischen Störungen führen. Neueste Theorien zu Interozeption weisen darauf hin, dass es sich nicht um ein uniformes Konstrukt handelt, sondern in die Facetten ‚Bewusstheit‘ (Awareness), ‚Sensibilität‘ (Sensibility), ‚Genauigkeit‘ (Accuracy) und ZNS-Repräsentation afferenter Körpersignale separiert werden kann. Körperliche Symptome können aus der selektiven Veränderung weniger Facetten entstehen. Stress kann differenziert werden in psychologische (selbstberichteten Stress), sowie physiologische Komponenten, wie die Aktivität der beiden physiologischen Stressachsen, des autonomen Nervensystems und der HPA-Achse. In diesem Symposium werden erstmals Erkenntnisse zum Zusammenhang von Interozeption und Stress auf allen Beobachtungsebenen integriert. Zunächst werden Zusammenhänge von akuter Stressreaktivität und –Erholung mit ‚Interozeptiver Genauigkeit‘ bei gesunden Probanden diskutiert (van Dyck/Luxemburg). Anschließend werden Erkenntnisse zu chronischem Stress, ‚Interozeptiver Bewusstheit‘ und gesundheitlichen Beschwerden bei Angestellten präsentiert (Trojan/Landau). Danach wird die ZNS-Repräsentation von Körpersignalen und ‚Interozeptive Genauigkeit‘ bei Kindern und Jugendlichen besprochen (Mai/Ulm), da sich das Jugendalter als entwicklungsbedingte Phase besonderer Stressvulnerabilität erweist. Im der folgenden Studie wird ‚Interozeptive Genauigkeit‘, Stressbelastung und –reaktivität bei Erwachsenen mit einer Trennungserfahrung der Eltern im Kindesalter als Stressor untersucht (Schaan/Luxemburg). Abschließend werden Daten zu ZNS-Repräsentation von Körpersignalen und HPA-Achsenaktivität bei posttraumatischer Belastungsstörung präsentiert (Müller/Heidelberg). Letztlich wird eine Synthese der Einzelbefunde in eine erweiterte Theorie zu Interozeption und Stress diskutiert. [less ▲]