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See detailAdipositas im Kindes- und Jugendalter: Risikofaktoren, Prävention und Behandlung
Platte, Petra; Vögele, Claus UL; Meule, Adrian

in Verhaltenstherapie (2014), 24(3), 182-192

Longer lasting weight loss is only achieved in 10% of obese adults, who try to lose weight. Therefore, prevention programmes for children and adolescents should have highest priority. Proximal and distal ... [more ▼]

Longer lasting weight loss is only achieved in 10% of obese adults, who try to lose weight. Therefore, prevention programmes for children and adolescents should have highest priority. Proximal and distal risk factors for the development of obesity include high-energy intake, low physical activity, high genetic load, low socioeconomic status and migration background. Prevention and intervention programmes need to take psychosocial factors into account and offer a personalized therapy in the respective settings. Even though cognitive behaviour therapy is superior to lifestyle intervention alone, as weight loss during treatment is higher when cognitive behaviour therapy is offered, its long-term success is uncertain. The need to include the family environment into treatment programmes is illustrated by studies showing that treating parents alone has the same effect on children’s weight loss as treating both parents and their children. Fast food, sugar sweetened drinks, hours of watching television and computer use are often discussed in terms of their causative role for obesity. The role of government policies to regulate the availability of fast food or sugar sweetened drinks as a prevention strategy is disputed, with little current empirical evidence as to the efficacy or effectiveness of such an approach. Nevertheless, public health regulations are unlikely to achieve the desired results at a population level, if not supported by families, schools and communities as well as the industry, currently investing more in economic success than responsibility for society. [less ▲]

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See detailÄrgerbezogene Störungen (Band 55, Fortschritte der Psychotherapie)
Steffgen, Georges UL; de Boer, Claudia; Vögele, Claus UL

Book published by Hogrefe (2014)

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See detailState of the Art in der Verhaltensmedizin: Keynote-Beiträge der DGVM-Jahrestagung 2013 - Editorial
Vögele, Claus UL; Leplow, Bernd; Hillert, Andreas

in Verhaltenstherapie (2014)

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See detailInvestigation of the food choice process using hand movements in binge eating disorder
Van Dyck, Zoé UL; Schulte-Mecklenbeck, Michael; Blechert, Jens et al

Scientific Conference (2014)

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See detailImpulsive reactions to food-cues predict subsequent food craving
Meule, Adrian; Lutz, Annika UL; Vögele, Claus UL et al

in Eating Behaviors (2014), 15

Low inhibitory control has been associated with overeating and addictive behaviors. Inhibitory control can modulate cue-elicited craving in social or alcohol-dependent drinkers, and trait impulsivity may ... [more ▼]

Low inhibitory control has been associated with overeating and addictive behaviors. Inhibitory control can modulate cue-elicited craving in social or alcohol-dependent drinkers, and trait impulsivity may also play a role in food-cue reactivity. The current study investigated food-cue affected response inhibition and its relationship to food craving using a stop-signal task with pictures of food and neutral stimuli. Participants responded slower to food pictures as compared to neutral pictures. Reaction times in response to food pictures positively predicted scores on the Food Cravings Questionnaire – State (FCQ-S) after the task and particularly scores on its hunger subscale. Lower inhibitory performance in response to food pictures predicted higher FCQ-S scores and particularly those related to a desire for food and lack of control over consumption. Task performance was unrelated to current dieting or other measures of habitual eating behaviors. Results support models on interactive effects of top-down inhibitory control processes and bottom-up hedonic signals in the self-regulation of eating behavior, such that low inhibitory control specifically in response to appetitive stimuli is associated with increased craving, which may ultimately result in overeating. [less ▲]

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See detailCorrelates of food addiction in obese individuals seeking bariatric surgery
Meule, Adrian; Heckel, Daniela; Jurowich, Christian et al

in Clinical Obesity (2014), 4(4), 228236

Recent evidence suggests that palatable, high-calorie foods may have an addictive potential. Accordingly, obesity and overconsumption of such foods have been associated with addiction-like eating behavior ... [more ▼]

Recent evidence suggests that palatable, high-calorie foods may have an addictive potential. Accordingly, obesity and overconsumption of such foods have been associated with addiction-like eating behavior. The present study investigated whether individuals with obesity can be classified as food addicted and which factors would differentiate between food addicted and non-addicted individuals. We administered the German version of the Yale Food Addiction Scale (YFAS) and other questionnaires to obese individuals seeking bariatric surgery (N = 96). Results showed that 40% of the sample could be diagnosed as food addicted. Food addicted individuals reported more frequent food cravings, higher eating disorder psychopathology, and more depressive symptoms than the non-addicted group. Age, body mass, and gender distribution did not differ between groups. The food addiction group had higher attentional, but similar motor and non-planning impulsivity, and had lower scores on the Alcohol Use Disorders Identification Test (AUDIT) compared to the non-addicted group. Scores on the AUDIT were associated with impulsivity in the non-addicted group only. We conclude that the prevalence of food addiction is higher in candidates for bariatric surgery compared to the general population and obese individuals not seeking bariatric surgery. A diagnosis of food addiction is associated with higher eating pathology and depression. Moreover, only attentional impulsivity, but not other dimensions of impulsivity, is associated with addictive eating. Finally, food addiction and impulsivity interactively predicted alcohol use, suggesting a crucial role of psychological variables and eating style in determining alcohol consumption in pre-bariatric patients, independent of body mass. [less ▲]

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See detailEnhanced cardiac perception predicts impaired performance in the Iowa Gambling Task in patients with panic disorder
Wölk, Julian; Sütterlin, Stefan UL; Koch, Stefan et al

in Brain and Behavior (2014), 4(2), 238-246

Objective: Somatic marker theory predicts that somatic cues serve intuitive decision- making; however, cardiovascular symptoms are threat cues for patients with panic disorder (PD). Therefore, enhanced ... [more ▼]

Objective: Somatic marker theory predicts that somatic cues serve intuitive decision- making; however, cardiovascular symptoms are threat cues for patients with panic disorder (PD). Therefore, enhanced cardiac perception may aid intuitive decision-making only in healthy individuals, but impair intuitive decision-making in PD patients. Methods: PD patients and age- and sex-matched volunteers without a psychiatric diagnosis (n = 17, respectively) completed the Iowa Gambling Task (IGT) as a measure of intuitive decision-making. Inter-individual differences in cardiac perception were assessed with a common mental tracking task. Results: In line with our hypothesis, we found a pattern of opposing associations (Fisher’s Z=1.78, p=.04) of high cardiac perception with improved IGT-performance in matched control-participants (r = .36, n = 14) but impaired IGT-performance in PD patients (r = -.38, n = 13). Conclusion: Interoceptive skills, typically assumed to aid intuitive decision-making, can have the opposite effect in PD patients who experience interoceptive cues as threatening, and tend to avoid them. This may explain why PD patients frequently have problems with decision-making in everyday life. Screening of cardiac perception may help identifying patients who benefit from specifically tailored interventions. [less ▲]

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See detailEvaluating Food Front-of-Pack Labelling: a pan-European Survey on Consumers’ Attitudes Toward Food Labelling
Gregori, Dario; Ballali, Simonetta; Vögele, Claus UL et al

in International Journal of Food Sciences and Nutrition (2014), 65(2), 177-186

Nutrition labels on pre-packaged foods have been widely used as a medium to foster healthier eating habits in the general population, to contribute to a reduction in the incidence and prevalence of diet ... [more ▼]

Nutrition labels on pre-packaged foods have been widely used as a medium to foster healthier eating habits in the general population, to contribute to a reduction in the incidence and prevalence of diet-related conditions. Yet, there is no convincing evidence that food labels are an effective means to achieve the desired effect at population level. Several factors have been suggested to account for this decoupling of efficacy, e.g. difficulties in understanding the information on food-labels. The present paper presents the results of a survey on Europeans’ understanding of nutritional labels and evaluation on the communication tools for their diffusion. A total of 7550 phone interviews were conducted in 16 European Countries: Austria, Belgium, Denmark, France, Germany, Greece, Italy, the Netherlands, Poland, Portugal, Czech Republic, Slovenia, Spain, Sweden, United Kingdom and Hungary. Consumers were asked about their opinion on nutritional information provided at different levels and their commitment to healthy behaviour. [less ▲]

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See detailKörperwahrnehmung bei Depersonalisations-/Derealisationsstörung: Übereinstimmungen und Diskrepanzen zwischen subjektiven Berichten, behavioralen und psychophysiologischen Indikatoren
Schulz, André UL; Köster, S.; Reuchlein, B. et al

in Zimmermann, T.; Heinrichs, N.; Hahlweg, K. (Eds.) Abstractband Tradition und Aufbruch - 32. Symposium der Fachgruppe Klinische Psychologie und Psychotherapie der DGPs (2014)

Patienten mit Derpersonalisations-/Derealisations-störung (DP/DR) berichten häufig von einer Di-tanzierung der Wahrnehmung des eigenen Körpers sowie Empfindungen, die möglicherweise eng mit ... [more ▼]

Patienten mit Derpersonalisations-/Derealisations-störung (DP/DR) berichten häufig von einer Di-tanzierung der Wahrnehmung des eigenen Körpers sowie Empfindungen, die möglicherweise eng mit Körperprozessen zusammenhängen, wie Emotionen. Es ist unklar, inwiefern diese subjektiven Berichte mit behavioralen Messwerten, wie z.B. die Genauigkeit in experimentellen Interozeptionsparadigmen, oder psychophysiologischen Indikatoren für Interozeption übereinstimmen. 23 Patienten mit DP/DR und 24 gesunde Kontrollprobanden absolvierten eine Herz-schlagzählaufgabe (Schandry-Paradigma) und eine Herzschlagdiskriminationsaufgabe (Whitehead-Para-digma). Weiter wurden Herzschlag-evozierte Hirnpo-tenziale (HEPs) mittels EEG und EKG während einer fünfminütigen Ruhephase und während des Schandry-Paradigmas gemessen. HEPs gelten als elektrophysi-ologischer Indikator für die kortikale Verarbeitung kardial-interozeptiver Prozesse. Die DP/DR-Patienten-gruppe unterschied sich erwartungsgemäß hinsichtlich ihrer DP/DR-Symptome (CDS; S-CDS), subjektiver Wahrnehmung von Körpersignalen (KEKS), Depres-sivität (BDI-II) und State-/Trait-Ängstlichkeit (STAI-S;-T) von der Kontrollgruppe. Es zeigten sich keine Unterschiede hinsichtlich der Genauigkeit in beiden Herzschlagdetektionstests zwischen den Gruppen. Die Kontrollgruppe zeigte höhere HEP-Amplituden während der Herzschlagzählaufgabe als während der Ruhe-phase, wie bereits mehrfach gezeigt. Im Gegensatz dazu zeigte sich dieser Unterschied in der DP/DR-Patientengruppe nicht (p = .03). Die selbstberichteten Defizite in der Wahrnehmung von Körpersignalen bei DP/DR decken sich nicht mit deren tatsächlicher Leistung in experimentellen Interozeptionsaufgaben. Dies könnte auf Probleme von DP/DR-Patienten hinweisen, Körpersignale in die Wahrnehmung des Selbst zu integrieren. Obwohl DP/DR-Patienten vergleichbare Genauigkeit in der Herzschlagdetektion zeigten, konnte jedoch keine Erhöhung der HEPs bei DP/DR während dieser Aufgabe gemessen werden, was auf eine dysfunktionale Repräsentation interozeptiver Signale auf kortikaler Ebene hinweist. Eine mögliche Erklärung könnte sein, dass bei DP/DR die Fokussierung der Aufmerksamkeit auf eigene Körpersignale schwerer fällt, da diese eine negative affektive Valenz haben. [less ▲]

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See detailStriking discrepancy of anomalous body experiences with normal interoceptive accuracy in depersonalization-derealization disorder
Michal, M.; Reuchlein, B.; Adler, J. et al

in PLoS ONE (2014), 9(2), 89823

BACKGROUND: Disembodiment is a core feature of depersonalization disorder (DPD). Given the narratives of DPD patients about their disembodiment and emotional numbing and neurobiological findings of an ... [more ▼]

BACKGROUND: Disembodiment is a core feature of depersonalization disorder (DPD). Given the narratives of DPD patients about their disembodiment and emotional numbing and neurobiological findings of an inhibition of insular activity, DPD may be considered as a mental disorder with specific impairments of interoceptive awareness and body perception. METHODS: We investigated cardioceptive accuracy (CA) of DPD patients (n = 24) as compared to healthy controls (n = 26) with two different heartbeat detection tasks ("Schandry heartbeat counting task" and "Whitehead heartbeat discrimination task"). Self-rated clearness of body perception was measured by questionnaire. RESULTS: Contrary to our hypothesis, DPD patients performed similarly to healthy controls on the two different heartbeat detection tasks, and they had equal scores regarding their self-rated clearness of body perception. There was no correlation of the severity of "anomalous body experiences" and depersonalization with measures of interoceptive accuracy. Only among healthy controls CA in the Schandry task was positively correlated with self-rated clearness of body perception. Depersonalization was unrelated to severity of depression or anxiety, while depression and anxiety were highly correlated. Anxiety and depression did not modify the associations of depersonalization with interoceptive accuracy. CONCLUSIONS: Our main findings highlight a striking discrepancy of normal interoception with overwhelming experiences of disembodiment in DPD. This may reflect difficulties of DPD patients to integrate their visceral and bodily perceptions into a sense of their selves. This problem may be considered an important target for psychotherapeutic treatment approaches. [less ▲]

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See detailNeurophysiologische Evidenz für eine veränderte ZNS-Repräsentation afferenter Signale aus dem kardiovaskulären System bei Depersonalisations-/Derealisationsstörung
Schulz, André UL; Köster, S.; Reuchlein, B. et al

in Abstractband Tradition und Aufbruch - 32. Symposium der Fachgruppe Klinische Psychologie und Psychotherapie der DGPs (2014)

Patienten mit Depersonalisations-/Derealisationsstörung (DP/DR) berichten häufig von einer Distanzierung der Wahrnehmung des eigenen Körpers sowie Empfindun-gen, die möglicherweise eng mit Körperprozessen ... [more ▼]

Patienten mit Depersonalisations-/Derealisationsstörung (DP/DR) berichten häufig von einer Distanzierung der Wahrnehmung des eigenen Körpers sowie Empfindun-gen, die möglicherweise eng mit Körperprozessen zu-sammenhängen, wie Emotionen. Während es zahlreiche neurophysiologische Belege für ein verändertes Erleben bei DP/DR gibt, existieren bislang keine derartigen Be-funde für eine veränderte Wahrnehmung des eigenen Körpers. Bei 23 Patienten mit DP/DR und 24 gesunden Kontroll-probanden wurden Herzschlag-evozierte Hirnpotenziale (HEPs) mittels EEG und EKG während einer fünfminü-tigen Ruhephase und während einer Herzschlagzähl-aufgabe (Schandry) gemessen. HEPs gelten als elektro-physiologischer Indikator für die kortikale Verarbeitung kardial-interozeptiver Prozesse. Außerdem wurde die Genauigkeit in dieser Herzschlagzählaufgabe und einer Herzschlagdiskriminationsaufgabe (Whitehead). Die DP/DR-Patientengruppe unterschied sich erwartungsgemäß hinsichtlich ihrer DP/DR-Symptome (CDS; S-CDS), subjektiver Wahrnehmung von Körpersignalen (KEKS), Depressivität (BDI-II) und State-/Trait-Ängstlichkeit (STAI-S;-T) von der Kontrollgruppe. Es zeigten sich keine Unterschiede hinsichtlich der Genau-igkeit in beiden Herzschlagdetektionstests zwischen den Gruppen. Die Kontrollgruppe zeigte höhere HEP-Amplituden während der Herzschlagzählaufgabe als während der Ruhephase, wie bereits mehrfach gezeigt. Im Gegensatz dazu zeigte sich dieser Unterschied in der DP/DR-Patientengruppe nicht (Interaktion: p = .03). Obwohl DP/DR-Patienten vergleichbare Genauigkeit in der Herzschlagdetektion zeigten, konnte jedoch keine Erhöhung der HEPs bei DP/DR während dieser Aufgabe gemessen werden, was auf eine dysfunktionale Reprä-sentation interozeptiver Signale auf kortikaler Ebene hinweist. Dies könnte bedeuten, dass DP/DR-Patienten die gleichen interozeptiven Signale empfangen wie Gesunde, aber diese Signale nicht adäquat in ihr Selbst integrieren können. Die Gruppenunterschiede im HEP-Pattern könnten außerdem damit zusammenhängen, dass Patienten mit DP/DR die Fokussierung der Aufmerk-samkeit auf eigene Körpersignale als aversiv wahrneh-men. [less ▲]

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See detailWas ist Gesundheit?
Vögele, Claus UL

in Verhaltenstherapie (2013), 23

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See detailInteroceptive sensitivity in disordered eating behaviours
Van Dyck, Zoé UL; Vögele, Claus UL

Scientific Conference (2013, October 25)

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See detailResisting high calorie foods: Heart rate variability as an indicator of self-regulatory processes in restrained eating behaviour
Lutz, Annika UL; Van Dyck, Zoé UL; Vögele, Claus UL

in André, C; Bohn, T; Evers, D (Eds.) et al Nutrition, chronic health complications, and healthy ageing (2013, October 25)

INTRODUCTION. In our affluent western society many people, especially young women, try to restrict their food intake in order to conform to the society’s thin ideal in spite of the omnipresence of high ... [more ▼]

INTRODUCTION. In our affluent western society many people, especially young women, try to restrict their food intake in order to conform to the society’s thin ideal in spite of the omnipresence of high-calorie foods. However, this dieting behaviour is often linked to eating binges, leads to weight gain in the long run, and is the best established risk factor for eating disorders. Therefore, it is of great importance to study the factors associated with successful vs. unsuccessful control of eating behaviour. Restrained eaters are people who habitually try to resist high calorie foods in order to restrict their food intake and have been shown to be prone to a breakdown of self-regulation. Heart rate variability (HRV) is a psychophysiological measure calculated from heart rate. It serves as an indicator of self-regulatory capacity and effort because of neural linkages between heart and brain. Resisting high calorie foods is associated with an increase of state-HRV and temporarily depletes self-regulatory resources, a mechanism which could explain breakdowns in self-regulation of food intake. Therefore, the current study investigated the changes in HRV during confrontation with high vs. low calorie foods in restrained and unrestrained eaters. METHOD. After a three hour-fast, 60 female university students were exposed to either high (brownie) or low calorie food (carrot). They were asked to look at the food and smell it, but to refrain from eating it. Heart rate was continuously recorded during exposure, as well as during rest before and after exposure. Restrained eating was assessed with the Dutch Eating Behavior Questionnaire. RESULTS. HRV increased during exposure. This increase was characterised by an interaction of exposure condition and restrained eating. In the high-calorie condition, HRV increase was related to restrained eating. The higher the restrained eating scores, the stronger was the increase in HRV. In the low-calorie condition there was no significant association between HRV and restrained eating. DISCUSSION. The results suggest increased self-regulatory effort in highly restrained eaters when exposed to high calorie foods. In addition, restrained eaters seem to have spared their self-regulatory resources when exposed to diet-congruent low calorie food. These findings provide first insights into dietary strategies at a basic self-regulation level, using psychophysiological methods. In the long run, a detailed understanding of basic self-regulatory mechanisms in dietary restriction will help to develop strategies for healthy eating behaviour in normal-weight and over-weight populations. [less ▲]

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See detailIntegrating mixed method data in psychological research: Combining Q methodology and questionnaires in a study investigating cultural and psychological influences on adolescent sexual behavior.
Franz, Anke; Worrell, Marcia; Vögele, Claus UL

in Journal of Mixed Methods Research (2013), 7(4), 370-389

In recent years, combining quantitative and qualitative research methods in the same study has become more and more acceptable in both applied and academic psychological research. However, a difficulty ... [more ▼]

In recent years, combining quantitative and qualitative research methods in the same study has become more and more acceptable in both applied and academic psychological research. However, a difficulty for many mixed methods researchers is how to integrate findings consistently. The value of using a coherent framework throughout the research process is discussed. Arguments are illustrated by referring to a study on individual- and cultural-level influences on attitudes to sexual health behaviours conducted with adolescents in Germany and England between 2005 and 2009. The article concludes that using an appropriate framework throughout the research process can ensure integration of findings in a consistent and coherent way. This can improve mixed-methods research and produce greater “yield’ (O’Cathain et al., 2007, 147). [less ▲]

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See detailHeart rate variability as an indicator of self-regulatory processes in restrained eating behaviour
Lutz, Annika UL; Van Dyck, Zoé UL; Vögele, Claus UL

in Psychophysiology (2013, September), 50(S1), 81

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See detailThe psychology of eating. Speciality Grand Challenge article.
Meule, Adrian; Vögele, Claus UL

in Frontiers in Psychology (2013), 4

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See detailEnhanced cardiac perception is associated with increased susceptibility to framing effects
Sütterlin, Stefan UL; Schulz, Stefan M.; Stumpf, Theresa et al

in Cognitive Science (2013), 37

Previous studies suggest in line with dual process models that interoceptive skills affect controlled decisions via automatic or implicit processing. The "framing effect" is considered to capture implicit ... [more ▼]

Previous studies suggest in line with dual process models that interoceptive skills affect controlled decisions via automatic or implicit processing. The "framing effect" is considered to capture implicit effects of task-irrelevant emotional stimuli on decisionmaking. We hypothesized that cardiac awareness, as a measure of interoceptive skills, is positively associated with susceptibility to the framing effect. Forty volunteers performed a risky-choice framing task in which the effect of loss vs. gain frames on decisions based on identical information was assessed. The results show a positive association between cardiac awareness and the framing effect, accounting for 24 % of the variance in the framing effect. These findings demonstrate that good interoceptive skills are linked to poorer performance in risky choices based on ambivalent information when implicit bias is induced by task irrelevant emotional information. These findings support a dual process perspective on decision-making and suggest that interoceptive skills mediate effects of implicit bias on decisions. [less ▲]

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See detailQuality of life, emotion regulation, and heart rate variability in individuals with intellectual disabilities and concomitant impaired vision
Meule, Adrian; Fath, Katharina; Real, Ruben et al

in Psychology of Well-Being: Theory, Research and Practice (2013), 3

Background: Positive associations have been found between quality of life, emotion regulation strategies, and heart rate variability (HRV) in people without intellectual disabilities. However, emotion ... [more ▼]

Background: Positive associations have been found between quality of life, emotion regulation strategies, and heart rate variability (HRV) in people without intellectual disabilities. However, emotion regulation and HRV have rarely been investigated in people with intellectual disabilities. Assessment of subjectively reported quality of life and emotion regulation strategies in this population is even more difficult when participants are also visually impaired. Methods: Subjective and objective quality of life, emotion regulation strategies, and HRV at rest were measured in a sample of people with intellectual disabilities and concomitant impaired vision (N = 35). Heart rate was recorded during a 10 min resting period. For the assessment of quality of life and emotion regulation, custom made tactile versions of questionnaire-based instruments were used that enabled participants to grasp response categories. Results: The combined use of reappraisal and suppression as emotion regulation strategies was associated with higher HRV and quality of life. HRV was associated with objective quality of life only. Emotion regulation strategies partially mediated the relationship between HRV and quality of life. Conclusions: Results replicate findings about associations between quality of life, emotion regulation, and HRV and extend them to individuals with intellectual disabilities. Furthermore, this study demonstrated that quality of life and emotion regulation could be assessed in such populations even with concomitant impaired vision with modified tactile versions of established questionnaires. HRV may be used as a physiological index to evaluate physical and affective conditions in this population. [less ▲]

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