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See detailCardiac cycle phases affect auditory-evoked potentials, startle eye blink and pre-motor reaction times in response to acoustic startle stimuli
Schulz, André UL; Vögele, Claus UL; Bertsch, Katja et al

in International Journal of Psychophysiology (in press)

Startle stimuli evoke lower responses when presented during the early as compared to the late cardiac cycle phase, an effect that has been called ‘cardiac modulation of startle’ (CMS). The CMS effect may ... [more ▼]

Startle stimuli evoke lower responses when presented during the early as compared to the late cardiac cycle phase, an effect that has been called ‘cardiac modulation of startle’ (CMS). The CMS effect may be associated with visceral-afferent neural traffic, as it is reduced in individuals with degeneration of afferent autonomic nerves. The aim of this study was to investigate whether the CMS effect is due a modulation of only early, automatic stages of stimulus processing by baro-afferent neural traffic, or if late stages are also affected. We, therefore, investigated early and late components of auditory-evoked potentials (AEPs) to acoustic startle stimuli (105, 100, 95 dB), which were presented during the early (R-wave +230 ms) or the late cardiac cycle phase (R +530 ms) in two studies. In Study 1, participants were requested to ignore (n=25) or to respond to the stimuli with button-presses (n=24). In Study 2 (n=23), participants were asked to rate the intensity of the stimuli. We found lower EMG startle response magnitudes (both studies) and slower pre-motor reaction times in the early as compared to the late cardiac cycle phase (Study 1). We also observed lower N1 negativity (both studies), but higher P2 (Study 1) and P3 positivity (both studies) in response to stimuli presented in the early cardiac cycle phase. This AEP modulation pattern appears to be specific to the CMS effect, suggesting that early stages of startle stimulus processing are attenuated, whereas late stages are enhanced by baro-afferent neural traffic [less ▲]

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See detailNoradrenergic activation induced by yohimbine decreases interoceptive accuracy in healthy individuals with childhood adversity
Schulz, André UL; Deuter, Christian E.; Breden, Ion-Hideo et al

in Development and Psychopathology (in press)

Acute stress affects interoception, but it remains unclear if this is due to activation of the sympatho-adreno-medullary (SAM) or hypothalamicpituitary-adrenocortical axis. This study aimed to investigate ... [more ▼]

Acute stress affects interoception, but it remains unclear if this is due to activation of the sympatho-adreno-medullary (SAM) or hypothalamicpituitary-adrenocortical axis. This study aimed to investigate the effect of SAM axis activation on interoceptive accuracy (IAcc). Central alpha2-adrenergic receptors represent a negative feedback mechanism of the SAM axis. Major depressive disorder and adverse childhood experiences (ACE) are associated with alterations in the biological stress systems, including central alpha2-adrenergic receptors. Here, healthy individuals with and without ACE as well as depressive patients with and without ACE (n=114; all without antidepressant medication) were tested after yohimbine (alpha2-adrenergic antagonist) and placebo. We assessed IAcc and sensibility in a heartbeat counting task. Increases in systolic and diastolic blood pressure after yohimbine confirmed successful SAM axis activation. IAcc decreased after yohimbine only in the healthy group with ACE, but remained unchanged in all other groups (‘group’ × ‘drug’ interaction). This effect may be due to selective up-regulation of alpha2-adrenergic receptors after childhood trauma, which reduces capacity for attention focus on heartbeats. The sympathetic neural pathway including alpha2-adrenergic circuitries may be essential for mediating interoceptive signal transmission. Suppressed processing of physical sensations in stressful situations may represent an adaptive response in healthy individuals who experienced ACE. [less ▲]

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See detailDisorganized attachment in adolescence: Emotional and physiological dysregulation during the Friends and Family Interview and a conflict interaction
Decarli, Alessandro; Pierrehumbert, Blaise; Schulz, André UL et al

in Development and Psychopathology (in press)

The current study examined the effects of attachment on autonomy, relatedness and emotion regulation during an attachment interview (Friends and Family Interview; FFI) and a parent-child conflict ... [more ▼]

The current study examined the effects of attachment on autonomy, relatedness and emotion regulation during an attachment interview (Friends and Family Interview; FFI) and a parent-child conflict interaction (Family Interaction Task; FIT) in 49 adolescents (11 to 17 years old). Disorganized adolescents showed a steeper decrease in heart rate variability (HRV) than organized ones, during both the FFI and the FITs. Dismissing adolescents showed a more pronounced decrease in HRV during the FFI than secure and preoccupied individuals; no differences were found between these groups in HRV during the FITs. The results suggest that disorganized adolescents had more difficulties in regulating their emotions during both the FFI and the FITs, whereas dismissing individuals seemed effectively challenged only during the interview. [less ▲]

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See detailGastric interoception and gastric myoelectrical activity in bulimia nervosa and binge eating disorder
van Dyck, Zoé UL; Schulz, André UL; Blechert, Jens et al

in International Journal of Eating Disorders (2020)

Objective: Identifying factors that control food intake is crucial to the understanding and treatment of eating disorders characterized by binge eating. In healthy individuals, stomach distension plays an ... [more ▼]

Objective: Identifying factors that control food intake is crucial to the understanding and treatment of eating disorders characterized by binge eating. In healthy individuals, stomach distension plays an important role in the development of satiation, but gastric sensations might be overridden in binge eating. The present study investigated the perception of gastric signals (i.e., gastric interoception) and gastric motility in patients experiencing binge eating episodes, i.e. bulimia nervosa (BN) and binge-eating disorder (BED). Method: Twenty-nine patients with BN or BED (ED group) and 32 age-, sex-, and BMI-matched healthy controls (HC group) participated in the study. The onset of satiation and stomach fullness were assessed using a novel 2-step water load test (WLT-II). Gastric myoelectrical activity (GMA) was measured by electrogastrography (EGG) before and after ingestion of non-caloric water. Results: Individuals in the ED group drank significantly more water until reporting satiation during the WLT-II. The percentage of normal gastric myoelectrical power was significantly smaller in the ED group compared to HC, and negatively related to the number of objective binge-eating episodes per week in bulimic patients. Power in the bradygastria range was greater in ED than in HC subjects. Discussion: Patients with EDs have a delayed response to satiation compared to HC participants, together with abnormal GMA. Repeated binge eating episodes may induce disturbances to gastric motor function. [less ▲]

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See detailEffects of rejection intensity and rejection sensitivity on social approach behavior in women
Schaan, Violetta; Schulz, André UL; Bernstein, Michael et al

in PLoS ONE (2020), 15(1), 0227799

Objective: Perceived rejection plays an important role for mental health and social integration. This study investigated the impact of rejection intensity and rejection sensitivity on social approach ... [more ▼]

Objective: Perceived rejection plays an important role for mental health and social integration. This study investigated the impact of rejection intensity and rejection sensitivity on social approach behavior. Method: 121 female participants were randomly assigned to one of three conditions differing in the degree of induced rejection (inclusion, medium rejection, severe rejection). Thereafter they were asked to interact with an unknown person during a touch-based cooperative task. Results: Participants high in rejection sensitivity sought significantly less physical contact than participants low in rejection sensitivity. Individuals in the medium rejection condition touched their partners more often than those in the included condition, while no difference between included and severely rejected participants could be observed. Conclusions: The results suggest that the intensity of rejection matters with regard to coping. While participants in the medium intensity rejection condition aimed to ‘repair’ their social self by seeking increased contact with others, severely rejected participants did not adapt their behavior compared to included participants. Implications for therapy are discussed. [less ▲]

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See detailBiased perception of physiological arousal in child social anxiety disorder before and after cognitive behavioral treatment
Asbrand, Julia; Schulz, André UL; Heinrichs, Nina et al

in Clinical Psychology in Europe (2020), 2(2), 2691

Background: A biased perception of physiological hyperreactivity to social-evaluative situations is crucial for the maintenance of social anxiety disorder (SAD). Alterations in interoceptive accuracy (IAc ... [more ▼]

Background: A biased perception of physiological hyperreactivity to social-evaluative situations is crucial for the maintenance of social anxiety disorder (SAD). Alterations in interoceptive accuracy (IAc) when confronted with social stressors may play a role for SAD in children. We expected a biased perception of hyperarousal in children with SAD before treatment and, consequently, a reduced bias after successful cognitive behavioral therapy (CBT). Method: In two centers, 64 children with the diagnosis of SAD and 55 healthy control (HC) children (both 9 to 13 years) participated in the Trier Social Stress Test for Children (TSST-C), which was repeated after children with SAD were assigned to either a 12-week group CBT (n = 31) or a waitlist condition (n = 33). Perception of and worry about physiological arousal and autonomic variables (heart rate, skin conductance) were assessed. After each TSST-C, all children further completed a heartbeat perception task to assess IAc. Results: Before treatment, children with SAD reported both a stronger perception of and more worry about their heart rate and skin conductance than HC children, while the objective reactivity of heart rate did not differ. Additionally, children with SAD reported heightened perception of and increased worry about trembling throughout the TSST-C compared to HC children, but reported increased worry about blushing only after the stress phase of the TSST-C compared to HC children. Children with and without SAD did not differ in IAc. Contrary to our hypothesis, after treatment, children in the CBT group reported heightened perception of physiological arousal and increased worry on some parameters after the baseline phase of the TSST-C, whereas actual IAc remained unaffected. IAc before and after treatment were significantly related. Conclusions: Increased self-reported perception of physiological arousal may play a role in childhood SAD and could be an important target in CBT. However, further studies should examine if this is an epiphenomenon, a temporarily occurring and necessary condition for change, or indeed an unwanted adverse intervention effect. [less ▲]

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See detailDistinctive body perception mechanisms in high versus low symptom reporters: a neurophysiological model for medically-unexplained symptoms
Schulz, André UL; Rost, Silke; Flasinski, Tabea et al

in Journal of Psychosomatic Research (2020), 137(1), 110223

OBJECTIVE: The neurophysiological processes involved in the generation of medicallyunexplained symptoms (MUS) remain unclear. This study tested three assumptions of the perception-filter model ... [more ▼]

OBJECTIVE: The neurophysiological processes involved in the generation of medicallyunexplained symptoms (MUS) remain unclear. This study tested three assumptions of the perception-filter model contributing to MUS: (I.) increased bodily signal strength (II.) decreased filter function, (III.) increased perception. METHODS: In this cross-sectional, observational study, trait MUS was assessed by a webbased survey (N=486). The upper and lower decile were identified as extreme groups of high (HSR; n=29; 26 women; Mage=26.0 years) and low symptom reporters (LSR; n=29; 21 women; Mage=28.4 years). Mean heart rate (HR) and heart rate variability (HRV), and cortisol awakening response (CAR) were assessed as indicators of bodily signal strength (I.). Heartbeat-evoked potentials (HEPs) were assessed during rest and a heartbeat perception task. HEPs reflect attentional resources allocated towards heartbeats and served as index of filter function (II.). Interoceptive accuracy (IAc) in heartbeat perception was assessed as an indicator of perception (III.). RESULTS: HSR showed higher HR and lower HRV (RMSSD) than LSR (I.), but no differences in CAR. HSR exhibited a stronger increase of HEPs when attention was focused on heartbeats than LSR (II.); there were no group differences in IAc (III.). CONCLUSIONS: The perception-filter model was partially confirmed in that HSR showed altered bodily signals suggesting higher sympathetic activity (I.); higher HEP increases indicated increased filter function for bodily signals (II.). As more attentional resources are mobilized to process heartbeats, but perception accuracy remains unchanged (III.), this overflow could be responsible for detecting minor bodily changes associated with MUS. [less ▲]

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See detailAltered interoceptive awareness in high habitual symptom reporters and patients with somatoform disorders
Flasinski, Tabea; Dierolf, Angelika UL; Rost, Silke et al

in Frontiers in Psychology (2020), 11(1), 1859

Objective. Altered interoception may play a major role in the etiology of medically unexplained symptoms (MUS). It remains unclear, however, if these alterations concerns noticing of signals or if they ... [more ▼]

Objective. Altered interoception may play a major role in the etiology of medically unexplained symptoms (MUS). It remains unclear, however, if these alterations concerns noticing of signals or if they are limited to the interpretation of signals. We investigated whether individuals with MUS differ in interoceptive awareness as assessed with the Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire. Methods. Study 1: 486 individuals completed the Screening for Somatoform Disorders (SOMS-2). 32 individuals each of the upper and lower decile of the SOMS distribution (low symptom reporters/LSR, high symptom reporters/HSR) completed the MAIA. Study 2: MAIA scores of individuals diagnosed with somatoform disorder (SFD; n = 26) were compared to individuals with major depressive disorder (MDD; n = 25) and healthy controls (HC; n = 26). Results. HSR had lower scores than LSR on the MAIA scales Not-Distracting and Not-Worrying. The SFD and MDD groups showed lower scores than HC on the MAIA scales Not-Distracting, Self-Regulation, and Trusting. The MDD group scored lower than the other two groups on the scales Body Listening and Attention Regulation. There were no group differences on the scale Noticing. Conclusion. HSR, SFD and MDD patients do not differ from HC in the awareness of noticing of interoceptive signal processing, whereas cognitive facets of interoception, such as distraction or self-regulation are differentially affected. This highlights the necessity of including specifically targeted interventions, which improve interoceptive awareness, in the prevention and treatment of SFDs. [less ▲]

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See detailComment on "Zamariola et al., (2018), Interoceptive Accuracy Scores are Problematic: Evidence from Simple Bivariate Correlations"-The Empirical Data Base, the Conceptual Reasoning and the Analysis behind this Statement are Misconceived and do not Support the Authors' Conclusions.
Ainley, V.; Tsakiris, Emmanouil UL; Pollatos, O. et al

in Biological Psychology (2020), 152(1), 107870

A recent paper by Zamariola and colleagues is widely cited as an authority on the invalidity of the Heartbeat Counting Task as a measure of interoceptive accuracy. Given the widespread interest in this ... [more ▼]

A recent paper by Zamariola and colleagues is widely cited as an authority on the invalidity of the Heartbeat Counting Task as a measure of interoceptive accuracy. Given the widespread interest in this field, it is essential that papers about methods are conceptually sound. However, only one of the authors' four criticisms appears substantiated - that people count too few heartbeats. Their arguments about "simple bivariate correlations" and their finding that interoceptive accuracy and heart rate correlate, depend on 'spurious correlations' arising from the overlooked point that interoceptive accuracy is a ratio. Moreover, scrutiny of the authors' data shows that their fourth criticism (that interoceptive accuracy is lower on longer trials) is confounded by differences in mean heart rate between trials. We present data from our own labs to refute it. We draw the authors' and editors' attention to these issues and trust that they will reconsider these erroneous conclusions. [less ▲]

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See detailHealth benefits of walking in nature: a randomized controlled study under conditions of real-life stress.
Olafsdottir, Gunnthora; Cloke, Paul; Schulz, André UL et al

in Environment & Behavior (2020), 52(3), 248-274

We investigated the effects of recreational exposure to the natural environment on mood and psychophysiological responses to stress. We hypothesized that walking in nature has restorative effects over and ... [more ▼]

We investigated the effects of recreational exposure to the natural environment on mood and psychophysiological responses to stress. We hypothesized that walking in nature has restorative effects over and above the effects of exposure to nature scenes (viewing-nature-on-TV) or physical exercise alone (walking-on-a-treadmill-in-a-gym) and that these effects are greater when participants were expected to be more stressed. Healthy university students (N=90) were randomly allocated to 1 of 3 conditions and tested during an exam-free period and again during their exam time. Mood and psychophysiological responses were assessed before and after the interventions, and again after a laboratory stressor. All interventions had restorative effects on cortisol levels (p < .001), yet walking in nature resulted in lower cortisol levels than did nature viewing (p < .05) during the exam period. Walking in nature improved mood more than watching nature scenes (p < .001) or physical exercise alone (p < .05). [less ▲]

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See detailModulation of startle and heart rate responses by fear of physical activity in patients with heart failure and in healthy adults
Hoffmann, Jeremia Mark; Finke, Johannes B.; Schächinger, Hartmut et al

in Physiology and Behavior (2020), 225(1), 113044

Fear of physical activity (FoPA) is prevalent in patients with heart failure and associated with lower physical activity despite medical exercise prescriptions. The present study examined physiological ... [more ▼]

Fear of physical activity (FoPA) is prevalent in patients with heart failure and associated with lower physical activity despite medical exercise prescriptions. The present study examined physiological indicators of FoPA by assessing startle modulation and heart rate responses after affective priming with lexical stimuli of positive, neutral, and negative valence, as well as words related to physical activity as potentially phobic cues. After screening for FoPA in patients with heart failure and healthy adults, twenty participants each were assigned to one of three subsamples: a healthy control group and two cardiac patient groups scoring either low or high on FoPA. The high-FoPA group showed more pronounced startle potentiation and heart rate acceleration (i.e., mobilization of defensive behavior) in the phobic prime condition compared to controls. Differences in FoPA accounted for 30% of the startle potentiation by phobic priming, whereas general anxiety, depression, and disease severity were no significant predictors in patients with heart failure. These findings suggest that heart failure-associated FoPA elicits avoidance behavior at a largely automatic level, and might thereby contribute to low adherence to exercise regimen. Thus, FoPA should be addressed in the design of psychological interventions for cardiac patients to foster physical activity. [less ▲]

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See detailHeart and brain: cortical representation of cardiac signals is disturbed in borderline personality disorder, but unaffected by oxytocin administration
Schmitz, M.; Müller, L. E.; Schulz, André UL et al

in Journal of Affective Disorders (2020), 264(1), 24-28

Background: Emotional dysregulation, a core feature of borderline personality disorder (BPD) has recently been linked to deficits in the cortical representation of bodily signals. Oxytocin modulates the ... [more ▼]

Background: Emotional dysregulation, a core feature of borderline personality disorder (BPD) has recently been linked to deficits in the cortical representation of bodily signals. Oxytocin modulates the salience of external social cues. However, its role in interoception is still not fully understood. The aim of the current study was to replicate reduced heartbeatevoked potentials (HEPs) as a marker for the cortical representation of cardiac signals in BPD and to explore potential effects of oxytocin on HEP amplitude. Methods: Fifty-three medication-free women with a DSM-IV diagnosis of BPD and sixty healthy female controls (HCs) participated in the study. In a randomized, double-blind placebo-controlled trial, participants self-administered either 24 I.U. of oxytocin or placebo and took part in a 5-minute resting-state electrocardiogram (ECG) with parallel electroencephalogram (EEG) measurement. In addition, emotional dysregulation and BPD symptomatology were assessed with self-report questionnaires. Results: Patients with BPD had significantly lower mean HEP amplitudes than HCs. Furthermore, HEP amplitudes were negatively correlated with emotional dysregulation in the whole sample. However, oxytocin had no significant effect on HEP amplitude. Limitations: Only female participants were investigated and no clinicial controls were included. Conclusions: This is the first replication from an independent sample showing a reduced cortical representation of cardiac signals in BPD patients. This, together with other bodyrelated symptoms, suggests deficits in the processing of bodily signals, which seem to be associated with emotional dysregulation. Whether oxytocin influences HEP during emotion regulation tasks needs to be investigated in future studies. [less ▲]

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See detailHigh blood pressure responders show largest increase in heartbeat perception accuracy after post-learning stress following a cardiac interoceptive learning task
Schenk, Lara; Fischbach, Jean T. M.; Müller, Ruta UL et al

in Biological Psychology (2020), 154(1), 107919

Mental disorders with physical symptoms, e.g. somatic symptom disorder, are characterized by altered interoceptive accuracy (IAc), which can be explained by individual differences in interoceptive ... [more ▼]

Mental disorders with physical symptoms, e.g. somatic symptom disorder, are characterized by altered interoceptive accuracy (IAc), which can be explained by individual differences in interoceptive learning (IL). We investigated if stress facilitates IL. Seventy-three healthy participants performed a heartbeat counting task (HCT: T1) and a heartbeat perception training (HBPT). After exposure to a socially-evaluated cold pressor stress test (SECPT; n=48) or a control condition (n=25), two more HCTs were performed (T2: 30 minutes after SECPT; T3: 24 h later). After the HBPT, all participants showed an increase in IAc. We separated the stress group into high vs. low systolic blood pressures (SBP) responders (n=24 each), with high SBP responders showing the largest IAc increases. Only SBP, but not cortisol responsiveness significantly predicted IAc increase from T1 to T2. Our results indicate that post-learning autonomic stress response facilitates IL, whereas the HPA axis response may be less important for this effect. [less ▲]

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See detailCortisol rapidly increases baroreflex sensitivity of heart rate control, but does not affect cardiac modulation of startle
Schulz, André UL; Richter, Steffen; Ferreira de Sá, Diana S. et al

in Physiology and Behavior (2020), 215(1), 112792

Cortisol, the final product of human HPA axis activation, rapidly modulates the cortical processing of afferent signals originating from the cardiovascular system. While peripheral effects have been ... [more ▼]

Cortisol, the final product of human HPA axis activation, rapidly modulates the cortical processing of afferent signals originating from the cardiovascular system. While peripheral effects have been excluded, it remains unclear whether this effect is mediated by cortical or subcortical (e.g. brainstem) CNS mechanisms. Cardiac modulation of startle (CMS) has been proposed as a method to reflect cardio-afferent signals at subcortical (potentially brainstem-) level. Using a single blind, randomized controlled design, the cortisol group (n = 16 volunteers) received 1 mg cortisol intravenously, while the control group (n = 16) received a placebo substance. The CMS procedure involved the assessment of eye blink responses to acoustic startle stimuli elicited at six different latencies to ECG-recorded R-waves (R + 0, 100, 200, 300, 400 and 500 ms). CMS was assessed at four measurement points: baseline, -16 min, +0 min, and +16 min relative to substance application. Baroreflex sensitivity (BRS) of heart rate (HR) control was measured non-invasively based on spontaneous beat-to-beat HR and systolic blood pressure changes. In the cortisol group, salivary cortisol concentration increased after IV cortisol administration, indicating effective distribution of the substance throughout the body. Furthermore, BRS increased in the cortisol group after cortisol infusion. There was no effect of cortisol on the CMS effect, however. These results suggest that low doses of cortisol do not affect baro-afferent signals, but central or efferent components of the arterial baroreflex circuit presumably via rapid, non-genomic mechanisms. [less ▲]

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See detailChildhood trauma affects stress-related interoceptive accuracy
Schaan, Violetta UL; Schulz, André UL; Rubel, Julian A. et al

in Frontiers in Psychiatry (2019), 10(1), 750

Early life adversity (ELA) may cause permanent disturbances in brain-body signaling. These disturbances are thought to contribute to physical symptoms and emotional dysregulation in adulthood. The current ... [more ▼]

Early life adversity (ELA) may cause permanent disturbances in brain-body signaling. These disturbances are thought to contribute to physical symptoms and emotional dysregulation in adulthood. The current study investigated the effects of childhood trauma on young adults’ interoceptive accuracy as an indicator of brain-body communication that may be dysregulated by ELA. Sixty-six participants completed an online-questionnaire followed by a laboratory session including the socially-evaluated cold pressor stress test during which ECG, salivary cortisol and interoceptive accuracy were assessed. Childhood trauma was negatively related to interoceptive accuracy (IAc) after the stressor. This stress-effect could not be observed for heart rate and cortisol, which were unrelated to IAc. Participants reporting higher baseline unpleasantness exhibited lower IAc after the stressor, while increases in unpleasantness due to the stressor were associated with higher IAc. Unpleasantness at baseline mediated the effect of childhood trauma on IAc after the stressor. [less ▲]

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See detailInteroceptive accuracy in preschool - aged children: The Jumping Jack Paradigm (JJP)
Opdensteinen, K.; Schaan, L.; Pohl, A. et al

Poster (2019, September 11)

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See detailRespiratory modulation of intensity ratings and psychomotor response times to acoustic startle stimuli
Münch, Eva Elisabeth; Vögele, Claus UL; Van Diest, Ilse et al

in Neuroscience Letters (2019), 711(1), 134388

Respiratory interoception may play an important role in the perception of respiratory symptoms in pulmonary diseases. As the respiratory cycle affects startle eye blink responses, startle modulation may ... [more ▼]

Respiratory interoception may play an important role in the perception of respiratory symptoms in pulmonary diseases. As the respiratory cycle affects startle eye blink responses, startle modulation may be used to assess visceral-afferent signals from the respiratory system. To ascertain the potential impact of brainstem-relayed signals on cortical processes, we investigated whether this pre-attentive 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), which were presented at end and mid inspiration and expiration, while performing a paced breathing task (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 stimuli. Psychomotor response time was divided into 'reaction time' (RT; from stimulus onset to home button release; represents stimulus evaluation) and 'movement time' time (MT; from home button release to target button press). Intensity judgements were higher and RTs accelerated during mid expiration. No effect of respiratory cycle phase was found on eye blink responses and MTs. We conclude that respiratory cycle phase affects higher cognitive, attentional processing of startle stimuli. [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 detailEnhanced Cortical Processing of Cardio-Afferent Signals in Anorexia Nervosa
Lutz, Annika UL; Schulz, André UL; Voderholzer, U. et al

in Clinical Neurophysiology (2019), 130(9), 1620-1627

Objective: To assess cardiac interoception in anorexia nervosa (AN) using a multidimensional approach. Methods: We assessed the physiological dimensions of cardioception, i.e. the peripheral signal itself ... [more ▼]

Objective: To assess cardiac interoception in anorexia nervosa (AN) using a multidimensional approach. Methods: We assessed the physiological dimensions of cardioception, i.e. the peripheral signal itself (heart rate, HR, and heart rate variability, HRV) and its cortical representation (heartbeat evoked potentials, HEPs), and the psychological dimensions of interoceptive accuracy (heartbeat perception) and interoceptive sensibility (confidence ratings). Electroencephalogram (EEG) and electrocardiogram (ECG) were recorded concurrently during rest and while performing a heartbeat perception task in a sample of 19 female in-patients with AN (DSM-5) and 19 healthy control women (HC). Results: HEPs, defined as mean EEG amplitude in a time window of 455-595 ms after the Rpeak of the ECG, were significantly larger in the AN than in the HC group across conditions (p = .002, d = 1.06). There was a trend toward better heartbeat perception in AN, but no group differences in HR, HRV, and confidence ratings. Conclusions: Individuals with AN showed an interoceptive profile of heightened cortical processing, a trend toward heightened interoceptive accuracy, and unaltered cardiac autonomic activation and interoceptive sensibility. Significance: In terms of neurobiological models of AN, enhanced cortical representations of interoceptive signals might reflect a mechanism, which promotes fasting by alleviating negative body states. [less ▲]

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See detailHerzschlag-evozierte Potenziale bei Bulimia nervosa
Lutz, Annika UL; Van Dyck, Zoé UL; Schulz, André UL et al

Poster (2019)

Die ursprüngliche Annahme, dass Essstörungspatient/innen unter einem umfassenden Defizit der interozeptiven Wahrnehmung leiden, wird inzwischen differenzierter betrachtet. Unterschiedliche Befunde ergeben ... [more ▼]

Die ursprüngliche Annahme, dass Essstörungspatient/innen unter einem umfassenden Defizit der interozeptiven Wahrnehmung leiden, wird inzwischen differenzierter betrachtet. Unterschiedliche Befunde ergeben sich je nach betrachtetem Organsystem (Herz, Magen), Verarbeitungsebene (neuronal, Selbstbericht) und Diagnose. Die bisherige Befundlage ist jedoch unübersichtlich und widersprüchlich. Für Bulimia nervosa (BN) wurde sowohl reduzierte, als auch unveränderte Herzschlagwahrnehmung berichtet. Mit dem vorliegenden Beitrag steuern wir weitere Ergebnisse zur Herzschlagwahrnehmung bei und ergänzen diese um einen physiologischen Indikator der kortikalen Verarbeitung kardio-afferenter Signale (Herzschlag-evozierte Potenziale, HEPs). Es wurden 22 Frauen mit akuter oder teilremittierter BN (BMI 23,94±3,61; Alter 31,86±11,20) und 22 gesunde Frauen untersucht (BMI 24,24±3,37; Alter 31,00±10,15). Die Stichproben wurden nach Alter und BMI parallelisiert. Die Teilnehmerinnen führten eine Herzschlagwahrnehmungsaufgabe nach Schandry durch, während ein 64-Kanal-EEG aufgezeichnet wurde. HEPs wurden als mittlere EEG-Amplitude von 455ms bis 595ms nach der R-Zacke berechnet. Die Ergebnisse zeigen keine signifikanten Gruppenunterschiede in Herzschlagwahrnehmung, HEPs und Herzrate. Dies bestätigt vorherige Befunde einer intakten Herzschlagwahrnehmung bei BN. Zusätzlich können wir von einer intakten kortikalen Verarbeitung kardio-afferenter Reize ausgehen. Die Wahrnehmung des Herzschlags ist insbesondere für die Verarbeitung und Regulation von Emotionen relevant. Auf Basis der vorliegenden und früheren Befunde ist davon auszugehen, dass defizitäre Emotionsregulation bei BN nicht auf veränderte Herzschlagwahrnehmung zurückzuführen ist. [less ▲]

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