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See detailNeurophysiologische Evidenz für eine veränderte ZNS-Repräsentation afferenter Signale aus dem kardiovaskulären System bei Depersonalisations-/Derealisationsstörung
Schulz, André UL; Köster, S.; Reuchlein, B. et al

in Abstractband Tradition und Aufbruch - 32. Symposium der Fachgruppe Klinische Psychologie und Psychotherapie der DGPs (2014)

Patienten mit Depersonalisations-/Derealisationsstörung (DP/DR) berichten häufig von einer Distanzierung der Wahrnehmung des eigenen Körpers sowie Empfindun-gen, die möglicherweise eng mit Körperprozessen ... [more ▼]

Patienten mit Depersonalisations-/Derealisationsstörung (DP/DR) berichten häufig von einer Distanzierung der Wahrnehmung des eigenen Körpers sowie Empfindun-gen, die möglicherweise eng mit Körperprozessen zu-sammenhängen, wie Emotionen. Während es zahlreiche neurophysiologische Belege für ein verändertes Erleben bei DP/DR gibt, existieren bislang keine derartigen Be-funde für eine veränderte Wahrnehmung des eigenen Körpers. Bei 23 Patienten mit DP/DR und 24 gesunden Kontroll-probanden wurden Herzschlag-evozierte Hirnpotenziale (HEPs) mittels EEG und EKG während einer fünfminü-tigen Ruhephase und während einer Herzschlagzähl-aufgabe (Schandry) gemessen. HEPs gelten als elektro-physiologischer Indikator für die kortikale Verarbeitung kardial-interozeptiver Prozesse. Außerdem wurde die Genauigkeit in dieser Herzschlagzählaufgabe und einer Herzschlagdiskriminationsaufgabe (Whitehead). Die DP/DR-Patientengruppe unterschied sich erwartungsgemäß hinsichtlich ihrer DP/DR-Symptome (CDS; S-CDS), subjektiver Wahrnehmung von Körpersignalen (KEKS), Depressivität (BDI-II) und State-/Trait-Ängstlichkeit (STAI-S;-T) von der Kontrollgruppe. Es zeigten sich keine Unterschiede hinsichtlich der Genau-igkeit in beiden Herzschlagdetektionstests zwischen den Gruppen. Die Kontrollgruppe zeigte höhere HEP-Amplituden während der Herzschlagzählaufgabe als während der Ruhephase, wie bereits mehrfach gezeigt. Im Gegensatz dazu zeigte sich dieser Unterschied in der DP/DR-Patientengruppe nicht (Interaktion: p = .03). Obwohl DP/DR-Patienten vergleichbare Genauigkeit in der Herzschlagdetektion zeigten, konnte jedoch keine Erhöhung der HEPs bei DP/DR während dieser Aufgabe gemessen werden, was auf eine dysfunktionale Reprä-sentation interozeptiver Signale auf kortikaler Ebene hinweist. Dies könnte bedeuten, dass DP/DR-Patienten die gleichen interozeptiven Signale empfangen wie Gesunde, aber diese Signale nicht adäquat in ihr Selbst integrieren können. Die Gruppenunterschiede im HEP-Pattern könnten außerdem damit zusammenhängen, dass Patienten mit DP/DR die Fokussierung der Aufmerk-samkeit auf eigene Körpersignale als aversiv wahrneh-men. [less ▲]

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See detailImpulsive reactions to food-cues predict subsequent food craving
Meule, Adrian; Lutz, Annika UL; Vögele, Claus UL et al

in Eating Behaviors (2014), 15

Low inhibitory control has been associated with overeating and addictive behaviors. Inhibitory control can modulate cue-elicited craving in social or alcohol-dependent drinkers, and trait impulsivity may ... [more ▼]

Low inhibitory control has been associated with overeating and addictive behaviors. Inhibitory control can modulate cue-elicited craving in social or alcohol-dependent drinkers, and trait impulsivity may also play a role in food-cue reactivity. The current study investigated food-cue affected response inhibition and its relationship to food craving using a stop-signal task with pictures of food and neutral stimuli. Participants responded slower to food pictures as compared to neutral pictures. Reaction times in response to food pictures positively predicted scores on the Food Cravings Questionnaire – State (FCQ-S) after the task and particularly scores on its hunger subscale. Lower inhibitory performance in response to food pictures predicted higher FCQ-S scores and particularly those related to a desire for food and lack of control over consumption. Task performance was unrelated to current dieting or other measures of habitual eating behaviors. Results support models on interactive effects of top-down inhibitory control processes and bottom-up hedonic signals in the self-regulation of eating behavior, such that low inhibitory control specifically in response to appetitive stimuli is associated with increased craving, which may ultimately result in overeating. [less ▲]

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See detailÄrgerbezogene Störungen (Band 55, Fortschritte der Psychotherapie)
Steffgen, Georges UL; de Boer, Claudia; Vögele, Claus UL

Book published by Hogrefe (2014)

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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 detailState of the Art in der Verhaltensmedizin: Keynote-Beiträge der DGVM-Jahrestagung 2013 - Editorial
Vögele, Claus UL; Leplow, Bernd; Hillert, Andreas

in Verhaltenstherapie (2014)

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See detailWas ist Gesundheit?
Vögele, Claus UL

in Verhaltenstherapie (2013), 23

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See detailResisting high calorie foods: Heart rate variability as an indicator of self-regulatory processes in restrained eating behaviour
Lutz, Annika UL; Van Dyck, Zoé UL; Vögele, Claus UL

in André, C; Bohn, T; Evers, D (Eds.) et al Nutrition, chronic health complications, and healthy ageing (2013, October 25)

INTRODUCTION. In our affluent western society many people, especially young women, try to restrict their food intake in order to conform to the society’s thin ideal in spite of the omnipresence of high ... [more ▼]

INTRODUCTION. In our affluent western society many people, especially young women, try to restrict their food intake in order to conform to the society’s thin ideal in spite of the omnipresence of high-calorie foods. However, this dieting behaviour is often linked to eating binges, leads to weight gain in the long run, and is the best established risk factor for eating disorders. Therefore, it is of great importance to study the factors associated with successful vs. unsuccessful control of eating behaviour. Restrained eaters are people who habitually try to resist high calorie foods in order to restrict their food intake and have been shown to be prone to a breakdown of self-regulation. Heart rate variability (HRV) is a psychophysiological measure calculated from heart rate. It serves as an indicator of self-regulatory capacity and effort because of neural linkages between heart and brain. Resisting high calorie foods is associated with an increase of state-HRV and temporarily depletes self-regulatory resources, a mechanism which could explain breakdowns in self-regulation of food intake. Therefore, the current study investigated the changes in HRV during confrontation with high vs. low calorie foods in restrained and unrestrained eaters. METHOD. After a three hour-fast, 60 female university students were exposed to either high (brownie) or low calorie food (carrot). They were asked to look at the food and smell it, but to refrain from eating it. Heart rate was continuously recorded during exposure, as well as during rest before and after exposure. Restrained eating was assessed with the Dutch Eating Behavior Questionnaire. RESULTS. HRV increased during exposure. This increase was characterised by an interaction of exposure condition and restrained eating. In the high-calorie condition, HRV increase was related to restrained eating. The higher the restrained eating scores, the stronger was the increase in HRV. In the low-calorie condition there was no significant association between HRV and restrained eating. DISCUSSION. The results suggest increased self-regulatory effort in highly restrained eaters when exposed to high calorie foods. In addition, restrained eaters seem to have spared their self-regulatory resources when exposed to diet-congruent low calorie food. These findings provide first insights into dietary strategies at a basic self-regulation level, using psychophysiological methods. In the long run, a detailed understanding of basic self-regulatory mechanisms in dietary restriction will help to develop strategies for healthy eating behaviour in normal-weight and over-weight populations. [less ▲]

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See detailInteroceptive sensitivity in disordered eating behaviours
Van Dyck, Zoé UL; Vögele, Claus UL

Scientific Conference (2013, October 25)

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See detailIntegrating mixed method data in psychological research: Combining Q methodology and questionnaires in a study investigating cultural and psychological influences on adolescent sexual behavior.
Franz, Anke; Worrell, Marcia; Vögele, Claus UL

in Journal of Mixed Methods Research (2013), 7(4), 370-389

In recent years, combining quantitative and qualitative research methods in the same study has become more and more acceptable in both applied and academic psychological research. However, a difficulty ... [more ▼]

In recent years, combining quantitative and qualitative research methods in the same study has become more and more acceptable in both applied and academic psychological research. However, a difficulty for many mixed methods researchers is how to integrate findings consistently. The value of using a coherent framework throughout the research process is discussed. Arguments are illustrated by referring to a study on individual- and cultural-level influences on attitudes to sexual health behaviours conducted with adolescents in Germany and England between 2005 and 2009. The article concludes that using an appropriate framework throughout the research process can ensure integration of findings in a consistent and coherent way. This can improve mixed-methods research and produce greater “yield’ (O’Cathain et al., 2007, 147). [less ▲]

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See detailHeart rate variability as an indicator of self-regulatory processes in restrained eating behaviour
Lutz, Annika UL; Van Dyck, Zoé UL; Vögele, Claus UL

in Psychophysiology (2013, September), 50(S1), 81

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See detailEnhanced cardiac perception is associated with increased susceptibility to framing effects
Sütterlin, Stefan UL; Schulz, Stefan M.; Stumpf, Theresa et al

in Cognitive Science (2013), 37

Previous studies suggest in line with dual process models that interoceptive skills affect controlled decisions via automatic or implicit processing. The "framing effect" is considered to capture implicit ... [more ▼]

Previous studies suggest in line with dual process models that interoceptive skills affect controlled decisions via automatic or implicit processing. The "framing effect" is considered to capture implicit effects of task-irrelevant emotional stimuli on decisionmaking. We hypothesized that cardiac awareness, as a measure of interoceptive skills, is positively associated with susceptibility to the framing effect. Forty volunteers performed a risky-choice framing task in which the effect of loss vs. gain frames on decisions based on identical information was assessed. The results show a positive association between cardiac awareness and the framing effect, accounting for 24 % of the variance in the framing effect. These findings demonstrate that good interoceptive skills are linked to poorer performance in risky choices based on ambivalent information when implicit bias is induced by task irrelevant emotional information. These findings support a dual process perspective on decision-making and suggest that interoceptive skills mediate effects of implicit bias on decisions. [less ▲]

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See detailThe psychology of eating. Speciality Grand Challenge article.
Meule, Adrian; Vögele, Claus UL

in Frontiers in Psychology (2013), 4

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See detailQuality of life, emotion regulation, and heart rate variability in individuals with intellectual disabilities and concomitant impaired vision
Meule, Adrian; Fath, Katharina; Real, Ruben et al

in Psychology of Well-Being: Theory, Research and Practice (2013), 3

Background: Positive associations have been found between quality of life, emotion regulation strategies, and heart rate variability (HRV) in people without intellectual disabilities. However, emotion ... [more ▼]

Background: Positive associations have been found between quality of life, emotion regulation strategies, and heart rate variability (HRV) in people without intellectual disabilities. However, emotion regulation and HRV have rarely been investigated in people with intellectual disabilities. Assessment of subjectively reported quality of life and emotion regulation strategies in this population is even more difficult when participants are also visually impaired. Methods: Subjective and objective quality of life, emotion regulation strategies, and HRV at rest were measured in a sample of people with intellectual disabilities and concomitant impaired vision (N = 35). Heart rate was recorded during a 10 min resting period. For the assessment of quality of life and emotion regulation, custom made tactile versions of questionnaire-based instruments were used that enabled participants to grasp response categories. Results: The combined use of reappraisal and suppression as emotion regulation strategies was associated with higher HRV and quality of life. HRV was associated with objective quality of life only. Emotion regulation strategies partially mediated the relationship between HRV and quality of life. Conclusions: Results replicate findings about associations between quality of life, emotion regulation, and HRV and extend them to individuals with intellectual disabilities. Furthermore, this study demonstrated that quality of life and emotion regulation could be assessed in such populations even with concomitant impaired vision with modified tactile versions of established questionnaires. HRV may be used as a physiological index to evaluate physical and affective conditions in this population. [less ▲]

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See detailHerzratenvariabilität als Indikator für Selbstregulationsprozesse bei gezügeltem Essverhalten
Lutz, Annika UL; Van Dyck, Zoé UL; Vögele, Claus UL

in 11. Kongress der Fachgruppe Gesundheitspsychologie: Selbstregulation und Gesundheit: Abstractband des Kongresses (2013)

EINFÜHRUNG. Gezügelte Esser unterwerfen ihr Essverhalten einer ausgeprägten kognitiven Kontrolle. Sie versuchen andauernd, hochkalorische Nahrungsmittel zu vermeiden und diesen zu widerstehen. Dabei sind ... [more ▼]

EINFÜHRUNG. Gezügelte Esser unterwerfen ihr Essverhalten einer ausgeprägten kognitiven Kontrolle. Sie versuchen andauernd, hochkalorische Nahrungsmittel zu vermeiden und diesen zu widerstehen. Dabei sind sie jedoch sehr anfällig für ein kurzfristiges Versagen der Selbstregulation. Herzratenvariabilität (HRV) ist ein Indikator für Selbstregulationskapazität und -anstrengung. Sie steigt während des Versuchs, einem hochkalorischen Nahrungsmittel zu widerstehen, kurzfristig an. Im Anschluss an eine solche Anstrengung sind die Selbstregulationsressourcen vorübergehend erschöpft. Auf Grundlage dieser Befunde wurden in der vorliegenden Studie Veränderungen der HRV während der Konfrontation mit hoch- vs. niedrigkalorischen Nahrungsmitteln bei gezügelten und ungezügelten Essern untersucht. METHODIK. Nach dreistündigem Fasten wurden 60 Studentinnen entweder mit einem hochkalorischen (Brownie) oder mit einem niedrigkalorischen (Karotte) Nahrungsmittel konfrontiert. Sie wurden gebeten, das Nahrungsmittel zu betrachten und seinen Geruch wahrzunehmen, es aber nicht zu essen. Währenddessen wurde kontinuierlich die Herzrate aufgezeichnet. Zusätzlich fanden Ruhemessungen vor und nach der Konfrontation statt. Gezügeltes Essverhalten wurde mit dem Dutch Eating Behavior Questionnaire erfasst. ERGEBNISSE. Gezügelte Esser zeigten während der Konfrontation mit hochkalorischen Nahrungsmitteln einen stärkeren Anstieg der HRV als während der Konfrontation mit niedrigkalorischen Nahrungsmitteln. Bei ungezügelten Essern stieg die HRV in beiden Bedingungen gleich stark an. SCHLUSSFOLGERUNGEN. Gezügelte Esser setzen bei der Konfrontation mit hochkalorischen Nahrungsmitteln vermehrt Selbstregulationsressourcen ein, um sich zu kontrollieren. Bei der Konfrontation mit niedrigkalorischen Nahrungsmitteln, die den Erfolg ihrer Diät nicht bedrohen, scheint dies nur in geringem Maß nötig zu sein. Möglicherweise handelt es sich hier um eine Strategie zur Schonung von Selbstregulationsressourcen, um diese effektiver für die Vermeidung hochkalorischer Nahrungsmittel einsetzen zu können. Die Verwendung psychophysiologischer Methoden erweist sich als vielversprechender Ansatz zur Untersuchung grundlegender Selbstregulationsprozesse im Bereich des gezügelten Essverhaltens. [less ▲]

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See detailAn Online Platform as a Tool for Surveys by Patient Associations
Lygidakis, Charilaos UL; Vögele, Claus UL; Cambiaso, Silvio et al

in Global Telemedicine and eHealth Updates: Knowledge Resources (2013), 6

Patients are increasingly interested in sharing their experiences and learning about their conditions, their prevention and treatments, and are more frequently turning into advocates. The connectivity and ... [more ▼]

Patients are increasingly interested in sharing their experiences and learning about their conditions, their prevention and treatments, and are more frequently turning into advocates. The connectivity and the wide availability of data have been shown to support this development enabling patients to play an active role in healthcare. The “Lumos!” platform is a web-based solution that has been designed to facilitate teams of researchers conducting multicentre studies, especially in countries and contexts with low research capacity. Nevertheless, it can be modified and tailored as a tool for research studies carried out by patient organisations. The aim of this study is to assess the feasibility of an online platform as a tool for anonymous surveys conducted by a patient organisation. Methods: A questionnaire is currently being distributed in the Region of Emilia Romagna (Italy) by the Regional Federation of Diabetics with the aim to study the needs of patients that use self-check-up devices. This observational study has been designed online with the use of the “Lumos!” platform, which enables the creation of the questionnaire with adjustable fields and variables, using the expertise of the participants and the creation of reports. Furthermore, a URL and a QR code linking to the questionnaire are being published on Social Networks and websites inviting people to participate in the study. Several data will be retrieved from the logs of the platform, such as the time required to complete a questionnaire by a patient, the number and types of errors, and the percentage of completed items. These variables will be analysed taking into account the demographic characteristics of the patients. Conclusions: By studying the indicators of the implementation and the characteristics of the participants, it will be possible to optimise participation rates and achieve higher engagement from the participants in the future. We expect that with the help of the online platform, patient associations will be supported in their quest to conduct surveys and, as a secondary outcome; they will empower their members to play a more active role in healthcare. [less ▲]

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See detail11. Kongress der Fachgruppe Gesundheitspsychologie, Abstractband
Vögele, Claus UL

Book published by University of Luxembourg (2013)

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See detailCortisol rapidly affects amplitudes of heartbeat-evoked brain potentials - Implications for the contribution of stress to an altered perception of physical sensations?
Schulz, André UL; Strelzyk, F.; Ferreira de Sá, D. S. et al

in Psychoneuroendocrinology (2013), 38(11), 2691-2698

Little is known about the impact of stress and stress hormones on the processing of visceral-afferent signals. Clinical data suggest that cortisol may lower the threshold for interoceptive stimuli, while ... [more ▼]

Little is known about the impact of stress and stress hormones on the processing of visceral-afferent signals. Clinical data suggest that cortisol may lower the threshold for interoceptive stimuli, while a pharmacological administration of cortisol decreases the sensitivity for physical symptoms. To clarify the role of cortisol for the processing of interoceptive signals, we investigated 16 healthy men on two occasions, once during the infusion of 4mg of cortisol and once during the infusion of a placebo substance. Heartbeat-evoked potentials (HEP; derived from resting EEG and ECG, during open and closed eyes), which are psychophysiological indicators for the cortical processing of cardioceptive signals, were measured over 6-min periods once before, and four times after the infusion (1-7, 11-17, 21-27 and 31-37min). We found that HEP amplitudes were higher during open than during closed eyes between 1 and 17min after cortisol infusion. There was no effect of cortisol on heart rate. We conclude that cortisol may rapidly modulate the cortical processing of cardioceptive neural signals. These results may have relevance for the effects of stress on the development and maintenance of psychosomatic symptoms. [less ▲]

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See detailCold pressor stress induces opposite effects on cardioceptive accuracy dependent on assessment paradigm
Schulz, André UL; Lass-Hennemann, Johanna; Sütterlin, Stefan UL et al

in Biological Psychology (2013), 93(1), 167-174

Interoception depends on visceral afferent neurotraffic and central control processes. Physiological arousal and organ activation provide the biochemical and mechanical basis for visceral afferent ... [more ▼]

Interoception depends on visceral afferent neurotraffic and central control processes. Physiological arousal and organ activation provide the biochemical and mechanical basis for visceral afferent neurotraffic. Perception of visceral symptoms occurs when attention is directed toward body sensations. Clinical studies suggest that stress contributes to the generation of visceral symptoms. However, during stress exposure attention is normally shifted away from bodily signals. Therefore, the net effects of stress on interoception remain unclear. We, therefore, investigated the impact of the cold pressor test or a control intervention (each n = 21) on three established laboratory paradigms to assess cardioceptive accuracy (CA): for the Schandry-paradigm, participants were asked to count heartbeats, while during the Whitehead-tasks subjects were asked to rate whether a cardiac sensation appeared simultaneously with an auditory or visual stimulus. CA was increased by stress when attention was focused on visceral sensations (Schandry), while it decreased when attention was additionally directed toward external stimuli (visual Whitehead). Explanations for these results are offered in terms of internal versus external deployment of attention, as well as specific effects of the cold pressor on the cardiovascular system. [less ▲]

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