Generalized hypervigilance in fibromyalgia: normal interoceptive accuracy, but reduced self-regulatory capacity

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 ▲]

Zusammenhang zwischen interozeptiver Genauigkeit und kardiovaskulärer Veränderung nach akutem Stress bei gesunden Frauen

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

Einleitung:Interozeption als afferente und Stressverarbeitung als efferente Informationsverarbeitung können als komplementär hinsichtlich der Kommunikation zwischen Körper und Gehirn verstanden werden. Es ... [more ▼]

Einleitung:Interozeption als afferente und Stressverarbeitung als efferente Informationsverarbeitung können als komplementär hinsichtlich der Kommunikation zwischen Körper und Gehirn verstanden werden. Es wurde gezeigt, dass stressbedingte veränderte kardiovaskuläre Prozesse mit veränderter Interozeption zusammenhängen und in körperlichen Beschwerden resultieren können. Wenig erforscht ist in diesem Kontext jedoch die psychologische sowie physiologische Erregung, welche mit einem akuten mentalen Stressor einhergeht. Ziel der vorliegenden Studie ist es, diese Lücke zu schließen und den Zusammenhang zwischen interozeptiver Genauigkeit und kardiovaskulärer Reaktivität und Erholung nach einem mentalen Stressor in einer gesunden Stichprobe zu untersuchen. Methode: Es wurde die Pulsfrequenz von 69 Frauen (MAlter = 24.20 Jahre, Range 18-50 Jahre; MBMI = 23.19, Range 17.19-34.48) zur späteren Bestimmung der Herzratenvariabilität (HRV) gemessen. Zur Bestimmung der interozeptiven Genauigkeiten führten die Teilnehmerinnen eine Herzschlagzählaufgabe durch und als mentalen Stressor setzten wir eine choice reaction time task (CRTT) ein. Die Pulsfrequenz wurde während der CRTT sowie während einer 10-minütigen Erholungsphase aufgezeichnet um Werte der kardiovaskulären Stressreaktivität und – erholung zu erfassen. Ergebnisse: DieErgebnisse zeigten keinen Zusammenhang zwischen interozeptiver Genauigkeit und HRV-Reaktivität auf akuten mentalen Stress (r = .042, p = .785). Der Zusammenhang zwischen interozeptiver Genauigkeit und kardiovaskulärer Stresserholung nach der CRTT war negativ (r = -.377; p = .012). Diskussion: Ergebnisse der vorliegenden Studie liefern erste Hinweise dafür, dass eine gute Interozeptionsfähigkeit mit einer besseren kardiovaskulären Erholung nach einem mentalen Stressor zusammenhängen, d.h. kardiovaskuläre Prozesse positiv beeinflussen kann. Interventionen zur Verbesserung der Interozeptionsfähigkeit könnten kardiovaskuläre Erholung erleichtern und das damit einhergehende Risiko zukünftiger Herz-Kreislauf- Probleme verringern. [less ▲]

Psychiatric disorders and personality styles in mothers of female adolescent patients with eating disorders

in Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie (2016)

Objective: To provide further insight into the presently poorly understood role of familial psychopathology in the development of eating disorders (ED). Method: The present study assesses psychiatric and ... [more ▼]

Objective: To provide further insight into the presently poorly understood role of familial psychopathology in the development of eating disorders (ED). Method: The present study assesses psychiatric and personality disorders listed on Axis I and II of the DSM-IV in 27 mothers of adolescent patients with anorexia (AN mothers) and 14 bulimia nervosa (BN mothers) as well as 22 mentally healthy girls (CG mothers) on a categorical level. Furthermore, we conducted a dimensional diagnostic regarding personality styles and personality traits. Results: AN and BN mothers showed increased rates of Axis I disorders, especially affective, substance use, and anxiety disorders. Differences on Axis II did not reach statistical significance. However, BN mothers showed higher occurrences of paranoid, negativistic, and schizotypal personality styles compared to the other groups. BN mothers further showed higher occurrences than CG mothers of the personality traits excitability, aggressiveness, physical complaints, openness, and emotionality. AN mothers differed significantly from CG mothers on the scale demands. Conclusions: Increased occurrence of psychopathology on both categorical and dimensional levels in mothers of patients with AN and BN supports the assumption of a familial accumulation of psychopathology in ED. Longitudinal studies and genetic analyses should clarify a possible cause-effect relationship and interactions between familial dynamics and adolescent ED Objective: To provide further insight into the presently poorly understood role of familial psychopathology in the development of eating disorders (ED). Method: The present study assesses psychiatric and personality disorders listed on Axis I and II of the DSM-IV in 27 mothers of adolescent patients with anorexia (AN mothers) and 14 bulimia nervosa (BN mothers) as well as 22 mentally healthy girls (CG mothers) on a categorical level. Furthermore, we conducted a dimensional diagnostic regarding personality styles and personality traits. Results: AN and BN mothers showed increased rates of Axis I disorders, especially affective, substance use, and anxiety disorders. Differences on Axis II did not reach statistical significance. However, BN mothers showed higher occurrences of paranoid, negativistic, and schizotypal personality styles compared to the other groups. BN mothers further showed higher occurrences than CG mothers of the personality traits excitability, aggressiveness, physical complaints, openness, and emotionality. AN mothers differed significantly from CG mothers on the scale demands. Conclusions: Increased occurrence of psychopathology on both categorical and dimensional levels in mothers of patients with AN and BN supports the assumption of a familial accumulation of psychopathology in ED. Longitudinal studies and genetic analyses should clarify a possible cause-effect relationship and interactions between familial dynamics and adolescent ED. [less ▲]

Affective instability in patients with chronic pain: a diary approach

in Pain (2016), 157(8), 1783-1790

Affective instability, conceptualized as fluctuations in mood over time, has been related to ill-health and psychopathology. In this study we examined the role of affective instability upon daily pain ... [more ▼]

Affective instability, conceptualized as fluctuations in mood over time, has been related to ill-health and psychopathology. In this study we examined the role of affective instability upon daily pain outcomes in 70 chronic pain patients (Mage = 49.7 years; 46 females) using an end-of-day diary. During a baseline phase, patients completed self-reported questionnaires of pain severity, pain duration, disability, depression and anxiety. During a subsequent diary phase, patients filled out an electronic end-of-day diary over 14 consecutive days assessing daily levels of pain severity, disability, cognitive complaints, negative affect (NA) and positive affect (PA). Affective instability was operationalized as the mean square of successive differences (MSSD) in daily mood (separately for NA and PA), which takes into account the size of affective changes over consecutive days. Results indicated that NA instability was positively associated with daily disability, beyond the effects of daily pain severity. Furthermore, NA instability moderated the relationship between daily pain severity and daily disability and the relationship between daily pain severity and daily cognitive complaints. PA instability, however showed to be unrelated to all outcomes. Current findings extend previous results and reveal the putative role of affective instability upon pain-related outcomes and may yield important clinical implications. Indeed, they suggest that targeting NA instability by improving emotion regulation skills may be a strategy to diminish disability and cognitive complaints in patients with chronic pain. [less ▲]

Altered patterns of heartbeat-evoked potentials in depersonalization/derealization disorder: neurophysiological evidence for impaired cortical representation of bodily signals

in Psychosomatic Medicine (2015), 77(5), 506-516

OBJECTIVE: Core features of depersonalization-/derealization disorder (DPD) are emotional numbing and feelings of disembodiment. While there are several neurophysiological findings supporting subjective ... [more ▼]

OBJECTIVE: Core features of depersonalization-/derealization disorder (DPD) are emotional numbing and feelings of disembodiment. While there are several neurophysiological findings supporting subjective emotional numbing, the psychobiology of disembodiment remains unclear. METHODS: Heartbeat-evoked potentials (HEPs), which are considered psychophysiological indicators for the cortical representation of afferent signals originating from the cardiovascular system, were assessed in 23 patients with DPD and 24 healthy control individuals during rest and while performing a heartbeat perception task. RESULTS: Absolute HEP amplitudes did not differ between groups. Nevertheless, healthy individuals showed higher HEPs during the heartbeat perception task than during rest, while no such effect was found in DPD patients (p = .031). DPD patients had higher total levels of salivary alpha-amylase than healthy individuals (9626.6±8200.0 vs. 5344.3±3745.8 kUmin/l; p = .029), but there were no group differences in cardiovascular measures (heart rate: 76.2±10.1 vs. 74.3 ±7.5 bpm, p = .60; nLF HRV: .63±.15 vs. .56 ±.15 n.u., p = .099; LF/HF ratio: 249.3±242.7 vs. 164.8 ±108.8, p = .10), salivary cortisol (57.5±46.7 vs. 55.1±43.6 nmolmin/l, p = .86) or cortisone levels (593.2±260.3 vs. 543.8±257.1 nmolmin/l, p = .52). CONCLUSION: These results suggest altered cortical representation of afferent signals originating from the cardiovascular system in DPD patients, which may be associated with higher sympathetic tone. These findings may reflect difficulties of DPD patients to attend to their actual bodily experiences. [less ▲]

Perseverative Cognition in Fibromyalgia

Scientific Conference (2014, September 04)

The influence of emotional instability on daily pain outcomes in chronic pain patients

Poster (2014, May)

The relationship between emotion dynamics and pain outcomes

Scientific Conference (2013, September 06)

Spezifität der Körperbildstörung für Anorexia nervosa

Poster (2013, May 10)

Psychische Auffälligkeiten bei Müttern von Patientinnen mit Essstörungen im Vergleich zu Müttern gesunder Mädchen

Scientific Conference (2013, March 09)