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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 detailHow does food taste in anorexia and bulimia nervosa? A protocol for a quasiexperimental, cross-sectional design to investigate taste aversion or increased hedonic valence of food in eating disorders
Garcia-Burgos, David; Maglieri, Sabine; Vögele, Claus UL et al

in Frontiers in Psychology (2018), 9

Background. Despite on-going efforts to better understand dysregulated eating, the olfactory-gustatory deficits and food preferences in eating disorders (ED), and the mechanisms underlying the perception ... [more ▼]

Background. Despite on-going efforts to better understand dysregulated eating, the olfactory-gustatory deficits and food preferences in eating disorders (ED), and the mechanisms underlying the perception of and responses to food properties in anorexia nervosa (AN) and bulimia nervosa (BN) remain largely unknown; both during the course of the illness and compared to healthy populations. It is, therefore, necessary to systematically investigate the gustatory perception and hedonics of taste in patients with AN and BN. To this end, we will examine whether aversions to the taste of high-calorie food is related to the suppression of energy intake in restricting-type AN, and whether an increased hedonic valence of sweet, caloric-dense foods may be part of the mechanisms triggering binge-eating episodes in BN. In addition, the role of cognitions influencing these mechanisms will be examined. Method. In study 1, four mixtures of sweet-fat stimuli will be presented in a sensory two-alternative forced-choice test involving signal detection analysis. In study 2, a full-scale taste reactivity test will be carried out, including psychophysiological and behavioural measures to assess subtle and covert hedonic changes. We will compare the responses of currently-ill AN and BN patients to those who have recovered from AN and BN, and also to those of healthy normal-weight and underweight individuals without any eating disorder pathology. Discussion. If taste response profiles are differentially linked to ED types, then future studies should investigate whether taste responsiveness represents a useful diagnostic measure in the prevention, assessment and treatment of EDs. The expected results on cognitive mechanisms in the top-down processes of food hedonics will complement current models and contribute to the refinement of interventions to change cognitive aspects of food aversions, to establish functional food preferences and to better manage food cravings associated with binge-eating episodes. No trial registration was required for this protocol, which was approved by the Swiss ethics committee (CER-VD, nº2016-02150) and the Ethics Review Panel of the University of Luxembourg. [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 detailEffects of cold stimulation on cardiac-vagal activation: Randomized controlled trial with healthy participants
Jungmann, Manuela; Vencatachellum, Shervin UL; Van Ryckeghem, Dimitri UL et al

in Journal of Medical Internet Research (2018), 2(2), 10257

Background: The experience of psychological stress has not yet been adequately tackled with digital technology by catering to healthy individuals who wish to reduce their acute stress levels. For the ... [more ▼]

Background: The experience of psychological stress has not yet been adequately tackled with digital technology by catering to healthy individuals who wish to reduce their acute stress levels. For the design of digitally mediated solutions, physiological mechanisms need to be investigated that have the potential to induce relaxation with the help of technology. Research has shown that physiological mechanisms embodied in the face and neck regions are effective for diminishing stress related symptoms. The study described in this paper expands on these areas with the design for a wearable in mind. As this study charts new territory in research, it also represents a first evaluation of the viability for a wearables concept to reduce stress. We inquire into the effects of cold stimulation on heart rate (HR) and heart rate variability (HRV) in the neck region using a Thermode device. Objective: The objectives of this study were to assess whether (a) HRV is increased and (b) HR is decreased during a cold stimulation compared to a (non-stimulated) control condition. Effects were in particular expected in the neck and cheek regions and less in the forearm area (c). Methods: Participants were seated in a lab chair and tested with cold stimulation on the right side of the body. A Thermode was placed on the neck, cheek and forearm. Participants’ electrocardiogram was recorded and subsequently analyzed. The study was a fully randomized, within subject design. The cold stimulation was applied in 16 s intervals over 4 trials per testing location. The control condition proceeded exactly like the cold condition, except the thermal variable was manipulated to remain on the baseline temperature. HR was measured in msec IBI. rMSSD analyses were used to index HRV. Data were analyzed using a repeated measurements analysis of variance approach with two repeated measurements factors, i.e. Body Location (neck, cheek, forearm) and Condition (cold, control) Results: The data analysis of 61 participants (on exclusion of outliers) showed a main effect for body location for HR and HRV, a main effect for condition for HR and HRV and an interaction effect for condition and body location for HR and HRV. The results obtained demonstrate a pattern of cardiovascular reactivity to cold stimulation, suggesting an increase in cardiac-vagal activation. The effect was found to be significant for cold stimulation in the lateral neck area. Conclusion: The results confirmed our main hypothesis. This sets the stage for further investigations of the stress reduction potential in the neck region by developing a wearable prototype that can be used for cold application. Future studies should include a stress condition, test for a range of temperatures and durations, and collect self-report data on perceived stress levels to advance current findings. [less ▲]

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See detailKardiale Modulation der Schreckreaktion bei hoher gegenüber niedriger Symptombelastung: afferente Signalübermittlung auf der Hirn-Körper-Achse beein usst frühe Stimulus-Verarbeitung bei hoher Symptombelastung
Dierolf, Angelika UL; Rost, Silke; Lutz, Annika UL et al

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

Somatische Belastungsstörungen (SBS) sind oftmals durch andauernde medizinisch- unerklärte Symptome gekennzeichnet, deren Entstehung größtenteils ungeklärt ist. Diese Studie hatte zum Ziel, die empirisch ... [more ▼]

Somatische Belastungsstörungen (SBS) sind oftmals durch andauernde medizinisch- unerklärte Symptome gekennzeichnet, deren Entstehung größtenteils ungeklärt ist. Diese Studie hatte zum Ziel, die empirisch bislang unbeantwortete Frage zu klären, ob Symptomentstehung auf veränderte Signalübermittlung auf der Hirn-Körper-Achse zurückzuführen ist. Zunächst wurden 486 Personen aus der Allgemeinbevölkerung anhand des SOMS-2 in Personen mit hoher Symptombelastung (HSB; unterstes Perzentil) und niedriger Symptombelastung (NSB; oberstes Perzentil) unterteilt. Personen mit HSB stellen eine besondere Risikogruppe für SBS dar. 28 HSB- und 31 NSB-Personen durchliefen ein Paradigma der kardialen Modulation der Schreckreaktion (CMS), ein Verfahren, das kardio-afferente Signalübermittlung prä-attentiv abbilden kann. Ihnen wurden je zehn akustische Schreckreize (105 dB) in sechs Zeitpunkten nach der kardialen R-Zacke (0, 100, 200, 300, 400, 500 ms) präsentiert. Als Indikator für die Schreckreaktion wurden die N1- und P2-Amplitude der auditorisch-evozierten Potenziale über Cz gemessen, da der Effekt der Hirn-Körper-Signalübermittlung im Kortex abgebildet werden sollte. Es zeigten sich geringere N1-Amplituden auf die Schreckreize, die während der systolischen Phase (200, 300 ms) im Vergleich zur diastolischen Phase (0 ms) präsentiert wurden (p=.0002), was für das Vorliegen eines CMS-Effekts spricht. Die HSB-Gruppe zeigte höhere P2-Amplituden als die NSB-Gruppe. Es zeigte sich außerdem, dass der CMS-Effekt bezüglich der N1-Komponente in der HSB-Gruppe geringer ist (p=.035), jedoch bezüglich der P2-Komponente stärker ist als in der NSB-Gruppe (p=.031). Afferente Signalübermittlung auf der Hirn-Körper-Achse könnte bei Personen mit HSB bereits frühe, automatischeWahrnehmungsprozesse verändern, die durch späte, aufmerksamkeits-gesteuerte Prozesse kompensiert werden. Diese prä-attentive Beeinflussung der Stimulus-Verarbeitung könnte ein Mechanismus der Symptomentstehung bei Personen mit HSB und SBS sein. [less ▲]

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See detailDie Erweiterung von Konzepten und Definitionen von Suchtverhalten
Billieux, Joël UL; Vögele, Claus UL

in Verhaltenstherapie (2018), 28(4), 209-211

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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 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 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 ▲]

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See detailProinflammatory T Cell Status Associated with Early Life Adversity
Elwenspoek, M.M.C.; Hemgesch, X.; Leenen, F.A.D et al

in Journal of Immunology (2017)

Early life adversity (ELA) has been associated with an increased risk for diseases in which the immune system plays a critical role. The ELA immune phenotype is characterized by inflammation, impaired ... [more ▼]

Early life adversity (ELA) has been associated with an increased risk for diseases in which the immune system plays a critical role. The ELA immune phenotype is characterized by inflammation, impaired cellular immunity, and immunosenescence. However, data on cell-specific immune effects are largely absent. Additionally, stress systems and health behaviors are altered in ELA, which may contribute to the generation of the ELA immune phenotype. The present investigation tested cell-specific immune differences in relationship to the ELA immune phenotype, altered stress parameters, and health behaviors in individuals with ELA (n = 42) and those without a history of ELA (control, n = 73). Relative number and activation status (CD25, CD69, HLA-DR, CD11a, CD11b) of monocytes, NK cells, B cells, T cells, and their main subsets were assessed by flow cytometry. ELA was associated with significantly reduced numbers of CD69+CD8+ T cells (p = 0.022), increased numbers of HLA-DR+ CD4 and HLA-DR+ CD8 T cells (p < 0.001), as well as increased numbers of CD25+CD8+ T cells (p = 0.036). ELA also showed a trend toward higher numbers of CCR4+CXCR3−CCR6+ CD4 T cells. Taken together, our data suggest an elevated state of immune activation in ELA, in which particularly T cells are affected. Although several aspects of the ELA immune phenotype were related to increased activation markers, neither stress nor health-risk behaviors explained the observed group differences. Thus, the state of immune activation in ELA does not seem to be secondary to alterations in the stress system or health-risk behaviors, but rather a primary effect of early life programming on immune cells. [less ▲]

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See detailRejection sensitivity as a vulnerability marker for depressive symptom deterioration in men.
De Rubeis, Jannika; Lugo, Ricardo; Witthöft, Michael et al

in PLoS ONE (2017), 12(10), 0185802

Consistent across time and cultures, men and male adolescents older than 14 years of age appear underrepresented in mood disorders, and are far less likely than women to seek psychological help. The much ... [more ▼]

Consistent across time and cultures, men and male adolescents older than 14 years of age appear underrepresented in mood disorders, and are far less likely than women to seek psychological help. The much higher rate of suicide amongst males suggests that depression in men might be underreported. One of the core human motives is to seek acceptance by others and avoid rejection. Rejection Sensitivity (RS) has been conceptualized as the cognitive-affective processing disposition to anxiously expect, readily perceive, and intensely respond to cues of rejection in the behavior of others. RS has been previously linked with the onset and course of depression, but - as yet - has not been investigated longitudinally in a clinical population. We investigated the predictive role of RS to symptom deterioration 6 months after end-of- treatment in 72 male inpatients with depressive spectrum disorder. The BDI was administered at intake, end-of-treatment and 6 month follow-up. RS scores were obtained at intake. Rejection Sensitivity had additional predictive power on BDI scores at 6 months follow-up controlling for BDI scores at end-of-treatment (ΔR2 = .095). The results are discussed in terms of the importance of targeting RS during treatment, and highlight the fact that therapeutic follow-up care is paramount. Future research should investigate possible mediators of the RS- relapse-to-depression association, such as self-blame, rumination, neuroticism, pessimism, emotion dysregulation, and low self-esteem. [less ▲]

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See detailT cell immunosenescence after early life adversity: association with cytomegalovirus infection.
Elwenspoek, M.M.C.; Sias, K.; Hengesch, X. et al

in Frontiers in Immunology (2017), 8

Early life adversity (ELA) increases the risk for multiple age-related diseases, such as diabetes type 2 and cardiovascular disease. As prevalence is high, ELA poses a major and global public health ... [more ▼]

Early life adversity (ELA) increases the risk for multiple age-related diseases, such as diabetes type 2 and cardiovascular disease. As prevalence is high, ELA poses a major and global public health problem. Immunosenescence, or aging of the immune system, has been proposed to underlie the association between ELA and long-term health consequences. However, it is unclear what drives ELA-associated immunosenescence and which cells are primarily affected. We investigated different biomarkers of immunosenescence in a healthy subset of the EpiPath cohort. Participants were either parent-reared (Ctrl, n = 59) or had experienced separation from their parents in early childhood and were subsequently adopted (ELA, n = 18). No difference was observed in telomere length or in methylation levels of age-related CpGs in whole blood, containing a heterogeneous mixture of immune cells. However, when specifically investigating T cells, we found a higher expression of senescence markers (CD57) in ELA. In addition, senescent T cells (CD57+) in ELA had an increased cytolytic potential compared to senescent cells in controls. With a mediation analysis we demonstrated that cytomegalovirus (CMV) infection, which is an important driving force of immunosenescence, largely accounted for elevated CD57 expression observed in ELA. Leukocyte telomere length may obscure cell-specific immunosenescence; here, we demonstrated that the use of cell surface markers of senescence can be more informative. Our data suggest that ELA may increase the risk of CMV infection in early childhood, thereby mediating the effect of ELA on T cell-specific immunosenescence. Thus, future studies should include CMV as a confounder or selectively investigate CMV seronegative cohorts. [less ▲]

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See detailPlace, green exercise and stress: an exploration of lived experience and restorative effects
Olafsdottir, Gunnthora; Cloke, Paul; Vögele, Claus UL

in Health and Place (2017), 46

This paper reports on inter-disciplinary research designed to investigate the stress-buffering effects of green exercise, and the importance of the context in which exercise takes place. This ... [more ▼]

This paper reports on inter-disciplinary research designed to investigate the stress-buffering effects of green exercise, and the importance of the context in which exercise takes place. This investigation of context effects examines both individual physiological responses (salivary cortisol) and the phenomenological interpretation of lived experiences of the intervention, reported by a subsample of participants in a randomized, controlled trial, in which healthy, physically inactive university students were randomly allocated to three activities: walking on a treadmill in a gym, walking in semi-natural recreational area, and sitting and watching nature-based videos on TV. The study found clear indications of context effects, notably in the connections between positive appraisals of perceived circumstances, enjoyment in the enacted context, and physiological stress-reduction. [less ▲]

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See detailCommunity- and mHealth-based integrated management of diabetes in primary healthcare in Rwanda (D²Rwanda): The study protocol
Uwizihiwe, Jean Paul; Lygidakis, Charilaos UL; Vögele, Claus UL et al

Scientific Conference (2017, June 29)

Introduction: The diabetes mellitus (DM) prevalence in Rwanda is estimated at 3.5%. In 2013, there were only one medical doctor and one nurse per 15,000 and 1,200 people respectively in Rwanda. A new ... [more ▼]

Introduction: The diabetes mellitus (DM) prevalence in Rwanda is estimated at 3.5%. In 2013, there were only one medical doctor and one nurse per 15,000 and 1,200 people respectively in Rwanda. A new programme employing frontline workers (Home-Based Community Practitioners (HBCPs)) is currently piloted, aiming at following-up patients with non-communicable diseases in their communities. We hypothesise that the management of DM at community level will improve following the introduction of a HBCP programme with regular monthly assessments and disease management, coupled with integration of a mobile health (mHealth) application with patient diaries, notifications and educational material. Objective: The aim of the study is to determine the efficacy of such an integrated programme in Rwanda. Methods: The study is designed as a one-year, open-label cluster trial of two interventions (arm1: HBCP programme, arm2: HBCP programme + mHealth application) and usual care (control). The primary outcomes will be changes in glycated haemoglobin levels and health-related quality of life. Mortality, complications, health literacy, mental well-being and treatment adherence will be assessed as secondary outcomes. Measurements will be conducted at baseline, 6 and 12 months. An intention-to-treat approach will be used to evaluate outcomes. Before trial onset, ethical approval will be sought in Rwanda, Luxembourg and Denmark, and a cross-cultural adaptation of questionnaires and a pilot will be carried out. Relevance: The project will provide evidence on the efficacy of innovative approaches for integrated management of DM and may spur the development of similar solutions for other chronic diseases in low-resource settings. [less ▲]

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See detailDepression Burden in Luxembourg: Individual Risk Factors, Geographic Variations and the Role of Migration, 2013-2015 European Health Examination Survey
Ruiz-Castell, Maria; Kandala, Ngianga-Bakwin; Perquin, Magali et al

in Journal of Affective Disorders (2017), 222

Background: Depression is a complex mental disorder that affects an increasing proportion of the worldwide population. This study aims to estimate the prevalence of depressive symptoms in Luxembourg ... [more ▼]

Background: Depression is a complex mental disorder that affects an increasing proportion of the worldwide population. This study aims to estimate the prevalence of depressive symptoms in Luxembourg, associated risk factors and geographic variations. Additionally, it aims to assess whether first and second generation immigrants are at higher risk for depressive symptoms compared to non-immigrants. Methods: Representative cross-sectional data from 1499 residents of Luxembourg, aged 25 to 64 years, were collected from the Luxembourg European Health Survey (EHES-LUX). Depressive symptoms were defined as a score of ≥5 on the Patient Health Questionnaire for depression (PHQ-9) (i.e. mild, moderate or severe). Standard and Bayesian regression models were used to examine associations between depressive symptoms, immigration status and geographic distribution across Luxembourg. Results: The prevalence of depressive symptoms was 21.55% (15.54% mild, 3.54% moderate, and 2.49% moderately severe to severe). The odds of having depressive symptoms was higher among second generation immigrants compared to non-immigrants (OR: 1.58, 95% CI: 1.04, 2.41), independent of socioeconomic and behavioral characteristics. Healthier diet, higher social support and good health perception were protective towards experiencing depressive symptoms. One of the highest likelihoods of reporting depressive symptoms was observed in the South-West of the country with a positive effect at 80% credible region [CR] (1.42 [0.92, 2.73]). Limitations: The participation rate was low (26.7%). The cross-sectional nature of the study does not allow us to establish causality. Conclusions: Depression constitutes an important public health challenge in Luxembourg due to the impact on the overall health of the population. Social programs of health promotion should be developed to improve mental wellbeing in immigrants, especially those of second generation. [less ▲]

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See detailGeneralized hypervigilance in fibromyalgia: normal interoceptive accuracy, but reduced self-regulatory capacity
Rost, Silke UL; Van Ryckeghem, Dimitri UL; Schulz, André UL et al

in Journal of Psychosomatic Research (2017), 93(2), 48-54

Objective: The factors underlying the aetiology of fibromyalgia (FM) are largely unknown. According to the generalized hypervigilance hypothesis (GHH), FM patients show excessive attention towards pain ... [more ▼]

Objective: The factors underlying the aetiology of fibromyalgia (FM) are largely unknown. According to the generalized hypervigilance hypothesis (GHH), FM patients show excessive attention towards pain stimuli and other sensory events, thereby increasing pain perception and dysfunctional behaviour. We tested this notion by assessing interoceptive accuracy (IA) in FM patients and matched healthy controls. We also tested the hypothesis that FM is characterized by reduced self-regulatory capacity as indexed by heart rate variability (HRV). Methods: 47 FM patients (Mage = 45.5, 39 females) and 45 healthy controls (Mage = 44.9, 37 females) completed several self-report scales (Body Vigilance Scale, Depression Anxiety Stress Scales, Pain Catastrophizing Scale). To derive HRV, heart rate was monitored under resting conditions; for the assessment of IA participants performed a heartbeat tracking task in which they were asked to silently count their heartbeats. Results: FM patients reported higher body vigilance than healthy controls, but there were no group differences in IA. FM patients had lower HRV compared with healthy controls. HRV did not predictor IA. Conclusion: In conclusion, our findings do not support the hypothesis of generalized hypervigilance in FM patients. Patients reported a heightened focus on bodily sensations, which was not reflected in IA. It may be that hypervigilance is not a general and stable characteristic but is rather context dependent and modality-specific. [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 detailLangzeitkonsequenzen von frühkindlichem Stress: quadratischer Zusammenhang zwischen Stress und Interozeptionsfähigkeit
Schaan, Violetta UL; Schulz, André UL; Vögele, Claus UL

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

Traumatische Belastungen während der Kindheit können das Risiko für die Entwicklung unsicherer Bindungsstile erhöhen, die bereits mit langfristigen psychischen und körperlichen Gesundheitsproblemen in ... [more ▼]

Traumatische Belastungen während der Kindheit können das Risiko für die Entwicklung unsicherer Bindungsstile erhöhen, die bereits mit langfristigen psychischen und körperlichen Gesundheitsproblemen in Beziehung gebracht wurden. Die zugrundeliegenden Prozesse sind allerdings noch weitestgehend unklar. Da interozeptive Signale die Regulation negativer Emotionen als Reaktion auf sozialer Zurückweisung begünstigen können, die infolge einer Stressbelastung verändert sein könnten, wurde insbesondere der Effekt von kindlichem Stress auf Interozeption untersucht. Wir präsentieren zwei Studien, die den Zusammenhang zwischen kindlichem Stress und Gesundheit im Erwachsenenalter sowie Körperwahrnehmung und Gedächtnisfähigkeit untersuchen. In der ersten Studie nahmen 199 Teilnehmer an einer Onlineumfrage teil, bei der Gesundheit, frühkindliches Trauma, Resilienz und Zurückweisungssensitivität gemessen wurden. Teilnehmer mit geschiedenen Eltern berichteten erhöhte psychische Belastungswerte, kindliches Trauma, Zurückweisungssensitivität und weniger Resilienz. Die Beziehung zwischen elterlicher Scheidung und psychischer Gesundheit konnte vollständig durch diese vier Faktoren erklärt werden (Varianzaufklärung 44%). In einer zweiten Studie wurden bei 60 Teilnehmern verschiedene Selbstberichts-Parameter erhoben und die Gedächtnis- und Interozeptionsfähigkeit (Schandry Herzschlagwahrnehmungstest/EKG) vor und nach einem sozial-evaluativen Kaltwasser-Stresstest untersucht. Die Reaktion des autonomen Nervensystems wurde mithilfe von Herzraten- und Blutdruckvariabilität bestimmt. Erwachsene mit einer Vorgeschichte von elterlicher Trennung berichteten mehr bindungsbezogene Angst und Vermeidung als Kontrollpersonen. Das Erlebnis einer elterlichen Scheidung war negativ mit der Gedächtnisleistung nach dem Stresstest korreliert. Weiterhin weisen die Ergebnisse auf einen quadratischen Zusammenhang zwischen kindlicher Stressbelastung und Interozeptionsfähigkeit hin. Basierend auf diesen Ergebnissen könnte ein ‚gesunder Normbereich‘ der Interozeptionsfähigkeit existieren. Kindlicher Stress könnte sowohl eine Verringerung, als auch eine Erhöhung der Interozeptionsfähigkeit bewirken, was beides mit gesundheitlichen Problemen assoziiert sein könnte. [less ▲]

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See detailThe role of parents in children’s emotional ability.
Pinto Costa, Andreia UL; Steffgen, Georges UL; Vögele, Claus UL

Scientific Conference (2017)

Understanding the processes that lead to different emotional responses in children is important for prevention and intervention programs aimed at improving developmental outcomes. Among the many factors ... [more ▼]

Understanding the processes that lead to different emotional responses in children is important for prevention and intervention programs aimed at improving developmental outcomes. Among the many factors that can influence children’s emotional reactivity and emotion regulation, parents and the way they interact with their children can impact children’s emotional responses. Even though the influence of parents in children’s emotional responses has been extensively studied during infancy and toddlerhood, the way parents interact with their preschool and school-aged children during upsetting moments has received little attention. The present study aimed at examining the effects of parental presence and parental interaction during a frustration-eliciting situation on preschoolers’ and school-aged children’s emotional reactivity and emotion regulation. More specifically, it aimed at examining whether parents’ presence during a frustration-eliciting situation (attractive toy removal) influences children’s emotional reactivity and emotion regulation. Moreover, whether children whose parents interact with them differ in emotional reactivity and emotion regulation from those whose parents do not interact with them. A convenience sample of 66 children (19 girls) together with one of their parents participated in the study. Children were aged between 3 and 13 years (Mage=8.65; SDage=2.32) and parents were aged between 26 to 53 years (Mage=40.38; SDage=5.22). For 41 children, parents were present during the frustration-eliciting situation. For the remaining 25 children, parents were absent. Children and parents who were present were videotaped during the situation. Parents’ interaction with their children, children’s emotional reactivity, and children’s emotion regulation during the situation were coded by 2 independent observers. Ethical approval as well as parents’ and children’s informed consent was obtained before conducting the study. It was found that children whose parents were present, compared to children whose parents were absent, expressed more positive emotions [t(63)=3.19, p<.01, r=.37] and less neutral emotions [t(64)=2.92, p<.01, r=.34], but did not differ in the amount of negative emotions [t(64)=0.28, p=.78, r=.03], or in the use of adaptive emotion regulation strategies [t(64)=0.99, p=.33, r=.12]. Regarding parents’ interaction, it was found that children of parents who interacted with them, compared to children of parents who did not interact with them, expressed less neutral emotions [t(39)=2.80, p<.01, r=.41], expressed more positive [t(39)=2.01, p=.05, r=.31] and more negative emotions [t(33)=2.30, p<.05, r=.37], and used more emotion regulation strategies [t(39)=2.55, p<.05, r=.38]. These results show that parents’ presence can have an influence in preschoolers’ and school-aged children’s positive reactivity but not in children’s negative reactivity or in the use of adaptive emotion regulation strategies. Furthermore, when present, parents’ interaction with their children is related to children’s lower neutrality, and to higher positive and negative reactivity. It is also related to children’s use of more adaptive emotion regulation strategies. These results suggest that, either because parents interact more with reactive children, or because children are more expressive with interactive parents, parents’ interaction is related to children’s reactivity and better regulation. Including parents in interventions and providing parents with training on emotional support for their children may be beneficial for improving developmental outcomes in children with emotional difficulties. [less ▲]

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See detailGrand challenges in eating behavior research: preventing weight gain, facilitating long-term weight maintenance
Meule, Adrian; Vögele, Claus UL

in Frontiers in Psychology (2017), 8

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