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See detailSelbstberichteter psychosozialer Stress und chronische Besorgnis, sowie Low-Frequency-Herzratenvariabilität, aber nicht Morgen- oder Tagescortisolspiegel, sagen somatoforme Symptome vorher
Schulz, André UL; Larra, M.; Rost, Silke UL et al

in Kubiak, T.; Wessa, M.; Witthöft, M. (Eds.) et al 15. Kongress der Deutschen Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation - Abstractband (2016)

Im positiven Feedback-Modell zu Interozeption und Stress (Schulz & Vögele, 2015) wird postuliert, dass chronischer Stress zu einer Dysregulation der beiden physiologischen Stressachsen (HPA-Achse, ANS ... [more ▼]

Im positiven Feedback-Modell zu Interozeption und Stress (Schulz & Vögele, 2015) wird postuliert, dass chronischer Stress zu einer Dysregulation der beiden physiologischen Stressachsen (HPA-Achse, ANS) führt, was wiederum durch veränderte Interozeption zur Entstehung körperlicherSymptome beitragen kann. Dieser postulierte Zusammenhang basiert jedoch bislang auf einer Integration von Einzelbefunden und wurde bisher noch nicht an einer gemeinsamen Stichprobe überprüft. Bei einer studentischen Stichprobe (N=217; 113 w; Alter: 18-33 [M=23.0; SD=2.9] Jahre; BMI=22.2 [SD=2.8]) wurden selbstberichteter chronischer Stress (Trierer Inventar für Chronischen Stress/TICS) und somatoforme Symptome (Screening für Somatoforme Störungen/SOMS-2) erhoben. Alle Probanden lieferten Cortisol-Aufwachreaktionen (Erwachen,+15,+30,+45,+60 Min.) an zwei aufeinanderfolgenden Tagen, sowie ein Cortisol-Tagesprofil. Zusätzlich wurde im Labor in einer 10-minütigen Ruhemessung EKG zur Bestimmung der Ruhe-Herzratenvariabilität (RMSSD, pNN50, SDNN; Low- [0.06-0.14 Hz] und High-Frequency [0.15-0.4 Hz]) als Indikatoren des zentralen sympathischen und parasympathischen Tonus erfasst. Diejenigen TICS-Skalen, die psychosozialen Stress reflektieren, sowie „Chronische Besorgnis“ waren zwischen r=.16 und .26 mit somatoformen Symptomen korreliert. Die Skala „Chronische Besorgnis“ korrelierte außerdem positiv mit dem Tagescortisolspiegel (r=.19), sowie negativ mit SDNN (r=-.20), RMSSD (r=-.17), pNN50 (r=-.17), LF-Power (r=-.19) und HF-Power (r=-.16; alle ps < .05). Somatoforme Symptome korrelierten hingegen nicht mit Indikatoren der physiologischen Stressachsen. In einem Regressionsmodell mit Somatisierungsindex als Kriterium zeigte sich nur für die TICS-Skalen „Mangel an sozialer Anerkennung“ (b=.19) und „chronische Besorgnis“ (b=.25), sowie LF-HRV (b=.20) signifikante Vorhersagekraft. Die Annahmen des Modells zu Interozeption und Stress konnten nur teilweise bestätigt werden. Selbstberichteter Stress, vor allem „Besorgnis“, ist bei gesunden Probanden der beste Prädiktor für somatoforme Symptome. Auch höherer sympathischer Tonus könnte für somatoforme Symptome eine Rolle spielen. [less ▲]

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See detailGastrische Modulation der Schreckreaktion und gastrisch-evozierte Potenziale: zwei neue psychophysiologische Indikatoren für Interozeption des gastrointestinalen Systems
Schulz, André UL; Schaan, L.; Van Dyck, Zoé UL et al

in Kathmann, N. (Ed.) 42. Tagung Psychologie und Gehirn Abstractband (2016)

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See detailReduced early visual processing of own body images in anorexia nervosa: An event-related potentials study
Lutz, Annika UL; Herbert, Cornelia; Schulz, André UL et al

Poster (2016)

Introduction. Although body image distortion in anorexia nervosa (AN) has been extensively studied over the past decades, its underlying mechanisms are not yet fully understood. Neuro-imaging studies have ... [more ▼]

Introduction. Although body image distortion in anorexia nervosa (AN) has been extensively studied over the past decades, its underlying mechanisms are not yet fully understood. Neuro-imaging studies have identified functional and structural alterations in brain areas involved in visual body perception, but the time course of visual body processing in AN remains mostly unexplored. The current study used event-related brain potentials (ERPs) to investigate single processing steps along the time course, particularly the visual processing of physical body image characteristics (featural processing, P1) and the recognition of a body as such (configural processing, N1). Methods. Twenty in-patients with AN, and 20 healthy women viewed photographs of themselves, of another woman’s body and of their own and another woman’s standardized object (cup) with concurrent EEG recording. Results. Body images elicited an accentuation of the P1 component (105-160 ms), which was absent for the comparison between own-body and own-cup images in the AN group. Results regarding the N1 component suggest alterations in object processing in AN. Conclusions. Our results demonstrate that individuals with AN show reduced featural processing of their own body image, a process which, due to its position early in the visual processing stream, is unlikely to involve higher cognitive stimulus processing. This suggests a possible role of previously undetected pre-conscious mechanisms in body image disturbance. [less ▲]

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See detailRespiratory modulation of startle eye blink: a new approach to assess afferent signals from the respiratory system
Schulz, André UL; Schilling, T. M.; Vögele, Claus UL et al

in Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences (2016), 371(1708),

Current approaches to assess interoception of respiratory functions cannot differentiate between the physiological basis of interoception, i.e. visceral-afferent signal processing, and the psychological ... [more ▼]

Current approaches to assess interoception of respiratory functions cannot differentiate between the physiological basis of interoception, i.e. visceral-afferent signal processing, and the psychological process of attention focusing. Furthermore, they typically involve invasive procedures, e.g. induction of respiratory occlusions or the inhalation of CO2 enriched air. The aim of the current study was to test the capacity of startle methodology to reflect respiratory-related afferent signal processing, independent of invasive procedures. Forty-two healthy participants were tested in a spontaneous breathing and in a 0.25 Hz paced breathing condition. Acoustic startle noises of 105 dB(A) intensity (50 ms white noise) were presented with identical trial frequency at peak and on-going inspiration and expiration, based on a new pattern detection method, involving the online processing of the respiratory belt signal. The results show the highest startle magnitudes during on-going expiration compared to any other measurement points during the respiratory cycle, independent of whether breathing was spontaneous or paced. Afferent signals from slow adapting phasic pulmonary stretch receptors may be responsible for this effect. The current study is the first to demonstrate startle modulation by respiration. These results offer the potential to apply startle methodology in the non-invasive testing of interoception-related aspects in respiratory psychophysiology. [less ▲]

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See detailThe relationship between emotion regulation capacity, heart rate variability, and quality of life in individuals with alcohol-related brain damage
Steinmetz, Jean-Paul; Vögele, Claus UL; Theisen-Flies, Christiane et al

in Psychology Research and Behavior Management (2016), 9

The reliable measurement of quality of life (QoL) presents a challenge in individuals with alcohol-related brain damage. This study investigated vagally mediated heart rate variability (vmHRV) as a ... [more ▼]

The reliable measurement of quality of life (QoL) presents a challenge in individuals with alcohol-related brain damage. This study investigated vagally mediated heart rate variability (vmHRV) as a physiological predictor of QoL. Self- and proxy ratings of QoL and dysexecutive symptoms were collected once, while vmHRV was repeatedly assessed over a 3-week period at weekly intervals in a sample of nine alcohol-related brain damaged patients. We provide robustness checks, bootstrapped correlations with confidence intervals, and standard errors for mean scores. We observed low to very low heart rate variability scores in our patients in comparison to norm values found in healthy populations. Proxy ratings of the QoL scale “subjective physical and mental performance” and everyday executive dysfunctions were strongly related to vmHRV. Better proxy-rated QoL and fewer dysexecutive symptoms were observed in those patients with higher vmHRV. Overall, patients showed low parasympathetic activation favoring the occurrence of dysfunctional emotion regulation strategies. [less ▲]

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See detailMaking sense of what you sense: Disentangling interoceptive awareness, sensibility and accuracy
Forkmann, Thomas; Scherer, Anne; Meessen, Judith et al

in International Journal of Psychophysiology (2016), 109(1), 71-80

Garfinkel and Critchley (2013) recently proposed a three level model of interoception. Only few studies, however, have empirically tested this theoretical model thus far. The present study aimed at ... [more ▼]

Garfinkel and Critchley (2013) recently proposed a three level model of interoception. Only few studies, however, have empirically tested this theoretical model thus far. The present study aimed at investigating (1) the central assumptions of this model, i.e. that Accuracy, Sensibility and Awareness are distinguishable facets of interoception and that Interoceptive Accuracy is the basic level of interoception, and (2) whether cardiovascular activation (as indexed by heart rate) is differentially related to the three facets of interoception. Analyses were conducted on a total sample of N=159 healthy participants (118 female [74.2%]; mean age = 23.9 years, SD = 3.3, range = 19-45) who performed either the heartbeat tracking task, the heartbeat discrimination task or both. The results suggest that Accuracy, Sensibility and Awareness are empirically distinct facets of interoception, showing no correlation when based on heartbeat tracking, but moderate correlations when based on heartbeat discrimination. The assumption that Interoceptive Accuracy is the basic level of interoception could only be partially confirmed. Instead, we conclude that the level of objective physiological states should be considered as the most basic level of interoceptive signal processing. [less ▲]

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See detailAffective instability in patients with chronic pain: a diary approach
Rost, Silke UL; Van Ryckeghem, Dimitri; Koval, Peter et al

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 ▲]

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See detailInterozeption bei Depersonalisations-/Derealisationsstörung: veränderte Repräsentation afferenter Körpersignale auf Ebene des Kortex und des Hirnstamms
Schulz, André UL; Matthey, J. H.; Köster, S. et al

in Kubiak, T.; Wessa, M.; Witthöft, M. (Eds.) et al 15. Kongress der Deutschen Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation - Abstractband (2016)

Die Depersonalisations-/Derealisationsstörung (DPD) ist durch eine subjektiv erlebte Distanz von Emotionen, sowie von Empfindungen des eigenen Körpers charakterisiert. Während viele neurophysiologische ... [more ▼]

Die Depersonalisations-/Derealisationsstörung (DPD) ist durch eine subjektiv erlebte Distanz von Emotionen, sowie von Empfindungen des eigenen Körpers charakterisiert. Während viele neurophysiologische Befunde ein verändertes Emotionserleben stützen, gibt es bislang keine neurophysiologischen Korrelate für eine veränderte Interozeption bei DPD. 27 Patienten mit DPD, sowie 27 gesunde Kontrollprobanden absolvierten zwei Herzschlagwahrnehmungstests: eine Herzschlagzählaufgabe (Schandry) und einen Test, bei dem zwischen Herzschlägen und exterozeptiven Signalen diskriminiert werden musste (Whitehead). Außerdem absolvierten die Probanden zwei psychophysiologische Verfahren, die interozeptive Signalübermittlung reflektieren: (1.) Herzschlag- evozierte Potenziale (HEPs), Indikatoren für die kortikale Verarbeitung afferenter Signale vom kardiovaskulären System und (2.) die kardiale Modulation der Schreckreaktion (CMS), welche als Index für die Verarbeitung kardio-afferenter Signale auf Ebene des Hirnstamms gilt. In den Herzschlagwahrnehmungstests gab es keine Gruppenunterschiede zwischen Patienten mit DPD und gesunden Kontrollprobanden, jedoch eine gegenläufige Tendenz beider Gruppen hinsichtlich der Genauigkeit über den Zeitverlauf (negative Lernkurve bei DPD). Bei der Kontrollgruppe zeigte sich ein intakter CMS-Effekt (geringere Schreckreaktionen während der frühen kardialen Phase), während sich bei den DPD-Patienten überhaupt kein CMS-Effekt beobachten ließ (Interaktion: p=.041). Ebenso wurden Gruppenunterschiede im HEP-Pattern beobachtet: gesunde Kontrollprobanden zeigten höhere HEP-Amplituden während der Aufmerksamkeitslenkung auf Körpersignale als während Ruhe. Dieser Effekt konnte bei DPD-Patienten nicht gefunden werden (Interaktion: p=.027). Die gegenläufigen Trends über den Zeitverlauf in verhaltensbasierten Indikatoren für Interozeption (Herzschlagwahrnehmung) bei DPD-Patienten gegenüber Kontrollprobanden impliziert, dass es Patienten weniger gut gelingt, ihre Aufmerksamkeit über längere Zeit auf Körperempfindungen zu fokussieren. Dieser Unterschied lässt sich auf veränderte Repräsentation afferenter Signale des kardiovaskulären Systems auf Hirnstammebene und auf kortikaler Ebene zurückführen. [less ▲]

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See detailAttachment Status Affects Heart Rate Responses to Experimental Ostracism in Inpatients with Depression
De Rubeis, Jannika; Sütterlin, Stefan; Lange, Diane et al

in PLoS ONE (2016), 11(3), 0150375

Depression is assumed to be both a risk factor for rejection and a result of it, and as such constitutes an important factor in rejection research. Attachment theory has been applied to understand ... [more ▼]

Depression is assumed to be both a risk factor for rejection and a result of it, and as such constitutes an important factor in rejection research. Attachment theory has been applied to understand psychological disorders, such as depression, and can explain individual differences in responses to rejection. Research on autonomic nervous system activity to rejection experiences has been contradictory, with opposing strings of argumentation (activating vs. numbing). We investigated autonomic nervous system-mediated peripheral physiological responses (heart rate) to experimentally manipulated ostracism (Cyberball) in 97 depressed patients with organized (n = 52) and disorganized attachment status (n= 45). Controlling for baseline mean heart rate levels, depressed patients with disorganized attachment status responded to ostracism with significantly higher increases in heart rate than depressed patients with organized attachment status (p=.029; ηp²=.051). These results suggest that attachment status may be a useful indicator of autonomic responses to perceived social threat, which in turn may affect the therapeutic process and the patient-therapist relationship. [less ▲]

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See detailA systematic review on heart rate variability in Bulimia Nervosa
Peschel, Stephanie K.V.; Feeling, Nicole R.; Vögele, Claus UL et al

in Neuroscience and Biobehavioral Reviews (2016), 63

Eating disorders are associated with alterations of the autonomic nervous system (ANS). Heart rate variability (HRV) provides a readily available index of ANS function. While ANS dysfunction indexed by ... [more ▼]

Eating disorders are associated with alterations of the autonomic nervous system (ANS). Heart rate variability (HRV) provides a readily available index of ANS function. While ANS dysfunction indexed by HRV in Anorexia Nervosa has been addressed in previous reviews, here we aimed to review the current evidence on HRV in Bulimia Nervosa (BN). A systematic literature search in Web of Science, PsycInfo, Scopus, and PubMed identified 17 studies reporting HRV in patients with BN. Studies described (i) differences in resting state HRV in patients with BN compared to controls, (ii) alterations in the stress response in BN indexed by HRV, and (iii) treatment effects on HRV in patients with BN. Despite a number of conflicting results, we conclude that BN is characterized by increased resting state vagally-mediated HRV and an impaired stress-response. Intervention-studies suggest that altered ANS-activity in BN is at least partially reversible. Future studies on the complex relation between BN and HRV should investigate the effect of comorbid disorders, subtypes of BN, and mechanisms affecting treatment outcome. [less ▲]

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See detailCognitive, emotional and psychosocial functioning of girls treated with pharmacological puberty blockage for idiopathic central precocious puberty
Wojniusz, S; Callens, N; Sütterlin, S et al

in Frontiers in Psychology (2016), 7

Central precocious puberty (CPP) develops due to premature activation of the hypothalamic-pituitary-gonadal (HPG) axis, resulting in early pubertal changes and rapid bone maturation. CPP is associated ... [more ▼]

Central precocious puberty (CPP) develops due to premature activation of the hypothalamic-pituitary-gonadal (HPG) axis, resulting in early pubertal changes and rapid bone maturation. CPP is associated with lower adult height and increased risk for development of psychological problems. Standard treatment of CPP is based on postponement of pubertal development by blockade of the HPG axis with gonadotropin releasing hormone analogs (GnRHa) leading to abolition of gonadal sex hormones synthesis. Whereas the hormonal and auxological effects of GnRHa are well researched, there is a lack of knowledge whether GnRHa treatment influences psychological functioning of treated children, despite the fact that prevention of psychological problems is used as one of the main reasons for treatment initiation. In the present study we seek to address this issue by exploring differences in cognitive function, behavior, emotional reactivity, and psychosocial problems between GnRHa treated CPP girls and age-matched controls. Fifteen girls with idiopathic CPP; median age 10.4 years, treated with slow-release GnRHa (triptorelin acetate – Decapeptyl SR ® 11.25) and 15 age-matched controls, were assessed with a comprehensive test battery consisting of paper and pencil tests, computerized tasks, behavioral paradigms, heart rate variability, and questionnaires filled in by the children’s parents. Both groups showed very similar scores with regard to cognitive performance, behavioral and psychosocial problems. Compared to controls, treated girls displayed significantly higher emotional reactivity (p = 0.016; Cohen’s d = 1.04) on one of the two emotional reactivity task conditions. Unexpectedly, the CPP group showed significantly lower resting heart rates than the controls (p = 0.004; Cohen’s d = 1.03); lower heart rate was associated with longer treatment duration (r = - 0.582, p = 0.037). The results suggest that GnRHa treated CPP girls do not differ in their cognitive or psychosocial functioning from age matched controls. However, they might process emotional stimuli differently. The unexpected finding of lower heart rate that was associated with longer duration of the treatment should be further explored by methods appropriate for assessment of cardiac health. [less ▲]

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See detailGoals in Nutrition Science 2015–2020
Allison, David B.; Bassaganya-Riera, Josep; Burlingname, Barbara et al

in Frontiers in Nutrition (2015), 2(26),

With the definition of goals in Nutrition Science, we are taking a brave step and a leap of faith with regard to predicting the scope and direction of nutrition science over the next 5 years. The content ... [more ▼]

With the definition of goals in Nutrition Science, we are taking a brave step and a leap of faith with regard to predicting the scope and direction of nutrition science over the next 5 years. The content of this editorial has been discussed, refined, and evaluated with great care by the Frontiers in Nutrition editorial board. We feel the topics described represent the key opportunities, but also the biggest challenges in our field. We took a clean-slate, bottom-up approach to identify and address these topics and present them in eight categories. For each category, the authors listed take responsibility, and deliberately therefore this document is a collection of thoughts from active minds, rather than a complete integration or consensus. At Frontiers in Nutrition, we are excited to develop and share a platform for this discussion. Healthy Nutrition for all – an ambition too important to be handled by detached interest groups. [less ▲]

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See detailInteroception and Stress
Schulz, André UL; Vögele, Claus UL

in Frontiers in Psychology (2015), 6(1), 993

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See detailZentralnervöse Verarbeitung von Körpersignalen bei Anorexia nervosa
Lutz, Annika UL; Schulz, André UL; Voderholzer, Ulrich et al

Scientific Conference (2015, April)

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See detailWhat is the Value Given by Consumers to Nutritional Label Information? Results from a Large Investigation in Europe
Gregori, Dario; Ballali, Simonetta; Vögele, Claus UL et al

in Journal of the American College of Nutrition (2015), Epub ahead of print

Rational. Nutrition labels on pre-packaged foods have been widely advocated as a medium to foster healthier eating habits in the general population. Objective. The study aimed at understanding how people ... [more ▼]

Rational. Nutrition labels on pre-packaged foods have been widely advocated as a medium to foster healthier eating habits in the general population. Objective. The study aimed at understanding how people value nutritional information on food labels, in particular front-of-pack labelling. Methods. A phone-assisted survey on 7550 consumers in 16 European countries was conducted. People were asked about their opinion on nutritional information provided at different levels, from the media to public institutions, and their commitment to healthy behavior. The value of pack labelling was estimated using a willingness-to-pay (WTP) elicitation technique. Results. Older age groups (>45 years old), members of a larger family, low income or low education level people and those who perceived themselves to be obese, valued front-of-pack nutritional labelling positively. WTP estimates across all countries provided an average accepted added price of 3.46€, additionally to the overall yearly food expenditure (95% C.I.: 3.33-3.68). Conclusions. Overall, perceived value of labelling is small. However, factors affecting the value for consumer of nutritional labelling appear to be strictly linked to the socio-economic and health status of the respondents. [less ▲]

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See detailBehavioral Medicine
Vögele, Claus UL

in Wright, James D. (Ed.) International Encyclopedia of the Social and Behavioral Sciences (2015)

Behavioral Medicine is the interdisciplinary field of study of behavior in health and disease. Based on often-experimental investigations of behavior, behavioral medicine contributes to a better ... [more ▼]

Behavioral Medicine is the interdisciplinary field of study of behavior in health and disease. Based on often-experimental investigations of behavior, behavioral medicine contributes to a better understanding of etiological factors and mechanisms, but also to clinical applications aimed at systematically improving health in clinical and at-risk populations. As the literature summarized in this chapter illustrates, behavioral medicine has shown tremendous progress in achieving these goals since its inception in 1977. Nevertheless, the successful translation of research results into clinical practice remains a challenge for the future. [less ▲]

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See detailPersonalized Medicine
Phillips, Robert; Vögele, Claus UL

in Wright, James D. (Ed.) International Encyclopedia of the Social and Behavioral Sciences (2015)

The rapid advances in medical science over the past two decades have already changed the way medicine is practiced, but the acceleration of advances suggests that health care systems worldwide are facing ... [more ▼]

The rapid advances in medical science over the past two decades have already changed the way medicine is practiced, but the acceleration of advances suggests that health care systems worldwide are facing a tsunami of new advances in understanding and in technology that will require radical reorganization of the health care system. The improved possibility of personalizing health care is one of the major drivers of change. Unfortunately, health care systems respond very slowly to innovation, and radical changes are almost impossible. In this article, we outline various changes that are expected to happen in the future in relation to personalized medicine, and discuss why behavioral scientists must participate in the reshaping of health care systems and the successful delivery of personalized care at the individual level. [less ▲]

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See detailDie Rolle von Persönlichkeitszügen für Gesundheit und Krankheit
Vögele, Claus UL

in Rief, Winfried; Henningsen, Peter (Eds.) Psychosomatik und Verhaltensmedizin: Eine Einführung in die Psychosomatische Medizin und Gesundheitspsychologie (2015)

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See detailGastrische Modulation der Schreckreaktion: eine prä-attentive Methode zur Abbildung afferenter Signale aus dem gastrointestinalen System
Schulz, André UL; Van Dyck, Zoé UL; Lutz, Annika UL et al

in Kaiser, J.; Fiebach, C. (Eds.) 41. Tagung Psychologie und Gehirn - Abstracts der Beiträge (2015)

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See detailInterozeptive Sensitivität bei Bulimia Nervosa und Binge-Eating-Störung
Van Dyck, Zoé UL; Schulz, André UL; Blechert, J. et al

in Kaiser, J.; Fiebach, C. (Eds.) 41. Tagung Psychologie und Gehirn - Abstracts der Beiträge (2015)

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