Die Erweiterung von Konzepten und Definitionen von Suchtverhalten

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

Effects of cold stimulation on cardiac-vagal activation: Randomized controlled trial with healthy participants

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 ▲]

Respiratory modulation of startle: effects on subjective intensity and psychomotor response times

in Hennig, J.; Stark, R. (Eds.) 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 ▲]

Binge-watching engagement as determined by motivations, impulsivity and emotional reactivity: A cluster analytic approach.

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

Kardiale Modulation der Schreckreaktion bei hoher gegenüber niedriger Symptombelastung: afferente Signalübermittlung auf der Hirn-Körper-Achse beein usst frühe Stimulus-Verarbeitung bei hoher Symptombelastung

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 ▲]

Late heartbeat-evoked potentials, indicators of cortical representation of interoceptive signal processing, are associated with survival after cardiac arrest

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 ▲]

Sensing Your Body: Interoceptive Awareness and Medically Unexplained Symptoms

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 ▲]

Post-learning cold pressor stress, after a heartbeat perception training, enhances interoceptive accuracy in high blood pressure responders

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 ▲]

Proinflammatory T Cell Status Associated with Early Life Adversity

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 ▲]

T cell immunosenescence after early life adversity: association with cytomegalovirus infection.

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 ▲]