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See detailAssessing binge-watching behaviors: Development and validation of the “Watching TV Series Motives” and “Binge-Watching Engagement and Symptoms” questionnaires
Flayelle, Maèva UL; Canale, Natale; Vögele, Claus UL et al

in Computers in Human Behavior (2019), 90

The widespread practice of binge-watching (i.e. watching multiple episodes of a TV series in one session) recently generated concerns about associated negative outcomes. Its psychological investigation ... [more ▼]

The widespread practice of binge-watching (i.e. watching multiple episodes of a TV series in one session) recently generated concerns about associated negative outcomes. Its psychological investigation, however, remains fragmentary. Based on the previous phenomenological investigation of TV series watching, we developed and validated two original assessment instruments, assessing TV series watching motives and binge-watching engagement and symptoms, respectively. Preliminary items were created for each questionnaire, and a focus group with TV series viewers was conducted and analyzed to generate the final instruments. The questionnaires were then administered via an online survey (N=6556), together with complementary measures of affect, problematic Internet use and substance use. Exploratory and confirmatory factor analyses, along with correlational analyses, were performed to examine both structural and external validity of the scales. The factorial analyses resulted in a 4-factor model (i.e. emotional enhancement, enrichment, coping-escapism and social) for the Watching TV Series Motives Questionnaire (WTSMQ), and in a 7-factor model (i.e. engagement, positive emotions, desire-savoring, pleasure preservation, binge-watching, dependency and loss of control) for the Binge-Watching Engagement and Symptoms Questionnaire (BWESQ). The results suggest good psychometric properties for both scales. The current study thus provides theoretically-driven and psychometrically sound instruments for further research on binge-watching behaviors [less ▲]

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See detailEffects of acute yohimbine administration on interoception in major depression and childhood adversity
Kuehl, L. K.; Deuter, C. E.; Breden, I.-H. et al

in Psychoneuroendocrinology (2019), 107(Supplement 1), 4

Acute stress, release of stress hormones and chronic stress can affect the processing of visceral-afferent neural signals at different brain levels, which are important for interoception. However, it ... [more ▼]

Acute stress, release of stress hormones and chronic stress can affect the processing of visceral-afferent neural signals at different brain levels, which are important for interoception. However, it remains unclear if these effects are due to activation of the sympatho-adreno-medullary (SAM) axis or hypothalamicpituitary adrenocortical (HPA) axis. With this study, we aimed to investigate the selective effect of SAM axis activation on interoceptive accuracy. Central alpha2-adrenergic receptors represent a negative feedback mechanism of the SAM axis. For major depressive disorder (MDD) and adverse childhood experiences (ACE), alterations in the biological stress systems, including density and sensitivity of central alpha2-adrenergic receptors, have been shown. Healthy individuals without ACE (n = 46), healthy individuals with ACE (n = 23), patients with MDD and without ACE (n = 26) and patients with MDD with ACE (n = 22, all without antidepressant medication) were tested after oral administration of 10mg of yohimbine (alpha2-adrenergic receptors antagonist) and placebo administration in a repeated measures design. Interoceptive accuracy and sensibility were assessed in a heartbeat tracking task. Increases in systolic and diastolic blood pressure after yohimbine administration in all groups confirmed successful activation of the SAM axis. Interoceptive accuracy decreased after yohimbine intake only in the healthy group with ACE, but remained unchanged in all other groups. This ‘group’בdrug’ interaction effect may be due to selective up-regulation of alpha2- adrenergic receptors after experience of childhood trauma, which reduces capacity for attention focus on heartbeats. Suppressed processing of physical sensations in stressful situations may represent an adaptive response in healthy individuals with childhood adversity. [less ▲]

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See detailParental divorce is associated with an increased risk to develop mental disorders in women
Schaan, Violetta UL; Schulz, André UL; Schächinger, Hartmut et al

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 ▲]

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See detailInteroception in Bulimia Nervosa: Evidence at cortical and self-report levels
Lutz, Annika UL; Van Dyck, Zoé UL; Schulz, André UL et al

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 ▲]

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See detailTask interference and distraction efficacy in patients with fibromyalgia: an experimental investigation
Van Ryckeghem, Dimitri UL; Rost, Silke; Kissi, Ama et al

in Pain (2018), 159(6), 1119-1126

Pain has the capacity to interfere with daily tasks. Although task interference by pain is largely unintentional, it can be controlled to a certain extent. Such top-down control over pain has been thought ... [more ▼]

Pain has the capacity to interfere with daily tasks. Although task interference by pain is largely unintentional, it can be controlled to a certain extent. Such top-down control over pain has been thought to be reduced in fibromyalgia patients. In this study, we investigated task interference and distraction efficacy in fibromyalgia patients (FM) and a matched healthy control group. Forty-nine fibromyalgia patients and 49 heathy volunteers performed as quickly as possible (a) a visual localization task in the presence of non-painful vibrating or painful electric somatic stimuli, and (b) a somatosensory localization task (using non-painful or painful stimuli). Participants reported on their experience of the somatic stimuli on some of the trials during both localisation tasks. Results indicated that pain interferes with performance of the visual task, in both FM patients and healthy individuals. Furthermore, participants experienced the pain stimulus as less intense when directing attention away from the pain than when focusing on the pain. Overall, task performance of FM patients was slower compared to the task performance in the healthy control group. In contrast to our hypotheses, FM patients and healthy volunteers did not differ in the magnitude of the interference effect and distraction-efficacy. In conclusion, current study provides support for contemporary theories claiming that attention modulates the experience of pain and vice versa. However, no evidence was however found for an altered attentional processing of pain in fibromyalgia patients. Furthermore, results indicate that task interference and distraction-efficacy are not just two sides of the same coin. [less ▲]

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See detailBlunted endocrine response to a combined physical-cognitive stressor in adults with early life adversity
Hengesch, X.; Elwenspoek, M.M.C.; Schaan, Violetta UL et al

in Child Abuse and Neglect (2018)

The negative health effects of early life adversity (ELA) continue long into adulthood. Changes in the physiological response to psychosocial stressors have been proposed to mediate this effect. However ... [more ▼]

The negative health effects of early life adversity (ELA) continue long into adulthood. Changes in the physiological response to psychosocial stressors have been proposed to mediate this effect. However, many previous studies have come to contradicting conclusions as to whether ELA induces a long-term increase or decrease in stress reactivity. Therefore, we tested the association of ELA exposure and adult stress reactivity in a sample of early life adoptees and controls.Two previously validated stressful elements (bilateral feet CPT and the Paced Auditory Serial Addition Task (PASAT)) were combined in an extended Cold Pressor Test (CPT). This test was performed on 22 participants who had experienced severe ELA (separation from biological parents, institutionalization, and adoption in early childhood), and in 22 age-matched control participants.A prior history of ELA was associated with blunted reactivity of the hypothalamic-pituitary-adrenal (HPA) axis (Cohen´s d = 0.680). Cardiovascular reactivity remained unchanged, and affective reactivity (self-report ratings) were increased in participants exposed to ELA compared to the control group (range Cohen´s d: 0.642–0.879).Our results suggest that the activity of the HPA axis reactivity was inhibited in ELA participants. Importantly, cardiovascular stress responsiveness was not affected by ELA. This separation of the HPA axis and cardiovascular stress responses may best be explained by ELA selectively enhancing central feedback-sensitivity to glucocorticoids, but preserving cardiovascular/ autonomic stress reactivity. [less ▲]

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See detailLate heartbeat-evoked potentials are associated with survival after cardiac arrest
Schulz, André UL; Stammet, P.; Dierolf, Angelika UL et al

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 ▲]

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See detailThe D²Rwanda Study: March 2018 Report
Kallestrup, Per; Vögele, Claus UL; Uwizihiwe, JeanPaul et al

Report (2018)

The Community- and MHealth-Based Integrated Management of Diabetes in Primary Healthcare in Rwanda: the D²Rwanda Study (which stands for Digital Diabetes Study in Rwanda) is a twin PhD project, developed ... [more ▼]

The Community- and MHealth-Based Integrated Management of Diabetes in Primary Healthcare in Rwanda: the D²Rwanda Study (which stands for Digital Diabetes Study in Rwanda) is a twin PhD project, developed in collaboration with Aarhus University (AU) and the University of Luxembourg (UL), and under the auspices of the University of Rwanda and Rwanda Biomedical Centre. The project involves two PhD students, Jean Paul Uwizihiwe (enrolled at AU) and Charilaos Lygidakis (enrolled at UL), and is kindly sponsored by the Karen Elise Jensens Foundation, alongside AU and UL. In this report we wished to narrate what we had been working on for the past two years: from the first steps to understanding better the context and mapping the territory; from obtaining the necessary authorisations to developing the app and translating the questionnaires. [less ▲]

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See detailA Latent State-Trait Analysis of Interoceptive Accuracy
Wittkamp, M.; Bertsch, K.; Vögele, Claus UL et al

in Psychophysiology (2018), e0185802

Interoceptive accuracy (IAc), i.e. the ability to accurately perceive one’s own bodily signals, is widely assumed to be a trait, although experimental manipulations, such as stress, may affect IAc. We ... [more ▼]

Interoceptive accuracy (IAc), i.e. the ability to accurately perceive one’s own bodily signals, is widely assumed to be a trait, although experimental manipulations, such as stress, may affect IAc. We used structural equation modeling to estimate the reliability of IAc, and the proportions of individual differences in IAc, explained by a trait and occasion-specific effects of situation and person-situation interactions. We assessed IAc in 59 healthy participants (40 women, MAge = 23.4 years) on three consecutive measurement occasions, approx. one week apart, in a ‘rest’ and ‘poststress’ condition, using a heartbeat counting and a heartbeat discrimination task. The results show fair temporal stability (intraclass correlation coefficients ≥ 0.38) and good reliability (Mdn = .63; range .49-.83) for both methods. While around 40% of the variance of a single IAc measurement could be explained by a trait, approx. 27% were accounted for by occasion-specific effects of situation and person-situation interaction. These results suggest that IAc measures are relatively consistent and that situations and person-situation interactions impact IAc as measured at a certain point in time. An aggregation across at least two measurements is recommended when using IAc as a trait variable. [less ▲]

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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 detailRespiratory modulation of startle: effects on subjective intensity and psychomotor response times
Münch, Eva Elisabeth UL; Vögele, Claus UL; Van Diest, Ilse et al

in 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 ▲]

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See detailBinge-watching engagement as determined by motivations, impulsivity and emotional reactivity: A cluster analytic approach.
Flayelle, Maèva UL; Maurage, Pierre; Vögele, Claus UL et al

in Alcoholism, Clinical and Experimental Research (2018), 42 (Suppl. 2)

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See detailLate heartbeat-evoked potentials, indicators of cortical representation of interoceptive signal processing, are associated with survival after cardiac arrest
Schulz, André UL; Stammet, Pascal; Dierolf, Angelika UL et al

in 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 reflected by HEPs, is associated with survival after CA. Cardiovascular autonomic arousal may not be involved in mediating this e ect. 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 ▲]

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See detailPost-learning cold pressor stress, after a heartbeat perception training, enhances interoceptive accuracy in high blood pressure responders
Breden, Ion-Hideo UL; Fischbach, Jean; Schenk, Lara UL et al

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 ▲]

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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 detailTrends and transitions
Vögele, Claus UL

in European Journal of Health Psychology (2018), 25(1), 1

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See detailAssessing binge-watching behaviors: Development of the « Watching TV Series Motives » and the « Binge-Watching Engagement » questionnaires
Flayelle, Maèva UL; Canale, Natale; Maurage, Pierre et al

in Journal of Behavioral Addictions (2018), 7 (Suppl.1)

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