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See detailA theory-driven design framework for smartphone applications to support healthy and sustainable grocery shopping
Blanke, Julia; Billieux, Joel; Vögele, Claus

in Human Behavior and Emerging Technologies (in press)

See detailCognitive processes underlying impaired decision-making in gambling disorder.
Brevers, Damien; Vögele, Claus; Billieux, Joël

in Zaleskiewicz, Thomas (Ed.) Psychological Perspectives on Financial Decision Making. (in press)

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See detailWell-being and working from home during COVID-19
Schifano, Sonia; Clark, Andrew; Greiff, Samuel; Vögele, Claus; d'Ambrosio, Conchita

in Information Technology and People (in press)

Purpose – The authors track the well-being of individuals across five European countries during the course of the coronavirus disease 2019 (COVID-19) pandemic and relate their well-being to working from home. The authors also consider the role of pandemic-policy stringency in affecting well-being in Europe. Design/methodology/approach – The authors have four waves of novel harmonised longitudinal data in France, Italy, Germany, Spain and Sweden, covering the period May–November 2020. Well-being is measured in five dimensions: life satisfaction, a worthwhile life, loneliness, depression and anxiety. A retrospective diary indicates whether the individual was working in each month since February 2020 and if so whether at home or not at home. Policy stringency is matched in per country at the daily level. The authors consider both cross- section and panel regressions and the mediating and moderating effects of control variables, including household variables and income. Findings – Well-being among workers is lower for those who work from home, and those who are not working have the lowest well-being of all. The panel results are more mitigated, with switching into working at home yielding a small drop in anxiety. The panel and cross-section difference could reflect adaptation or the selection of certain types of individuals into working at home. Policy stringency is always negatively correlated with well-being. The authors find no mediation effects. The well-being penalty from working at home is larger for the older, the better-educated, those with young children and those with more crowded housing. Originality/value – The harmonised cross-country panel data on individuals’ experiences during COVID-19 are novel. The authors relate working from home and policy stringency to multiple well-being measures. The authors emphasise the effect of working from home on not only the level of well-being but also its distribution.

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See detailImproving food shopping behaviour: a model-based review of mobile applications to assist with healthy and sustainable grocery shopping
Blanke, Julia; Billieux, Joel; Vögele, Claus

in Computers in Human Behavior (2021)

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See detailBrief mindfulness training can mitigate the influence of prior expectations on pain perception
Vencatachellum, Shervin; van der Meulen, Marian; van Ryckeghem, Dimitri; van Damme, Stefaan; Vögele, Claus

in European Journal of Pain (2021), 25(9), 2007-2019

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See detailAssessing the clinical utility of the DSM-5 internet gaming disorder criteria by using supervised machine learning
Infanti, Alexandre; Vögele, Claus; Deleuze, Jory; Baggio, Stéphanie; Billieux, Joël

Poster (2021, May 21)

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See detailGastric interoception and gastric myoelectrical activity in bulimia nervosa and binge eating disorder
van Dyck, Zoé; Schulz, André; Blechert, Jens; Herbert, Beate M.; Lutz, Annika; Vögele, Claus

in International Journal of Eating Disorders (2021), 54(7), 1106-1115

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.

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See detailMood-induced changes in the cortical processing of food images in bulimia nervosa
Lutz, Annika; Dierolf, Angelika; van Dyck, Zoé; Georgii, Claudio; Schnepper, Rebekka; Blechert, Jens; Vögele, Claus

in Addictive Behaviors (2021), 113

Background Negative mood often triggers binge eating in bulimia nervosa (BN). We investigated motivational salience as a possible underlying mechanism using event-related potentials (ERPs) as indicators of motivated attention allocation (P300) and sustained processing (LPP). Methods We collected ERPs (P300: 350–400 ms; LPP: 600–1000 ms) from 21 women with full-syndrome or partially remitted BN and 21 healthy women (HC), matched for age and body mass index. Idiosyncratic negative and neutral situations were used to induce corresponding mood states (counterbalanced), before participants viewed images of high- and low-calorie foods and neutral objects, and provided ratings for pleasantness and desire to eat. Results P300 was larger for foods than objects; LPP was largest for high-calorie foods, followed by low-calorie foods, then objects. The BN group showed an increased desire to eat high-calorie foods under negative mood and stronger mood induction effects on ERPs than the HC group, with generally reduced P300 and a small increase in LPP for high-calorie foods. Effects were limited to circumscribed electrode positions. Exploratory analyses showed clearer effects when comparing high vs. low emotional eaters. Conclusion We argue that negative mood decreased the availability of cognitive resources (decreased P300) in BN, thereby facilitating disinhibition and food cravings (increased desire-to-eat ratings). Increased sustained processing might be linked to emotional eating tendencies rather than BN pathology per se, and reflect approach motivation, conflict, or regulatory processes. Negative mood appears to induce complex changes in food image processing, whose understanding may contribute to the development of tailored interventions in the future.

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See detailBrain mechanisms underlying prospective thinking of sustainable behaviours
Brevers, Damien; Baeken, Chris; Maurage, Pierre; Sescousse, Guillaume; Vögele, Claus; Billieux, Joel

in Nature Sustainability (2021)

The preservation of our environment requires sustainable ways of thinking and living. Here, we aimed to explore the core network of brain regions involved in the prospective thinking about (un)sustainable behaviours. Using a neuroimaging cue-exposure paradigm, we requested participants (n = 86) to report behaviours that were the most feasible for them to implement (sustainable behaviour) or diminish (unsustainable behaviour) in the future. We find that increasing sustainable behaviours was perceived to be more feasible than reducing unsustainable ones. Consistent with the role of the ventromedial prefrontal cortex and hippocampus in providing access to new representations of past behaviours, we observed stronger activation of these regions when picturing an increase in sustainable behaviours. Critically, simulating the reduction of unsustainable behaviours triggered activation within the right dorsolateral prefrontal cortex (a key region for inhibitory-control processes), which was negatively associated with hippocampal activation (a key region for memory). These findings suggest that the dorsolateral prefrontal cortex downregulates brain regions that support memory retrieval of unsustainable behaviours. This mechanism could inhibit the access to episodic details associated with unsustainable behaviours and in turn allow for prospective thinking of sustainable behaviours. These findings provide an initial step towards a better understanding of the brain networks that are involved in the adoption of sustainable habits.

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See detailInteroceptive Approaches to Embodiment Research
Schulz, André; Vögele, Claus

in Robinson, Michael D.; Thomas, Laura E. (Eds.) Handbook of Embodied Psychology: Thinking, Feeling, and Acting. (2021)

Interoception refers to the processing and perception of signals arising from inside the body. Currently, there are two alternative conceptualizations of interoception: (1) an ‘inclusive’ view considering all bodily signals from inside the body as relevant for interoception, and (2) an ‘exclusive’ view, which is based on receptor types and neurophysiology, and, therefore, a focus on visceroception. These conceptualizations have different implications for the underlying neurophysiology and, therefore, the mechanisms behind embodiment. Thereafter, we discuss current models of interoception and provide definitions of the most common interoceptive terms, which include interoceptive accuracy, sensibility, sensitivity, awareness, and prediction error. We then present examples of interoceptive paradigms to assess different elements of interoception models. Typical interoceptive indicators include self-reports, behavioral measures, and neurophysiological indices. Finally, we discuss the link between interoceptive indicators and emotional experience and emotion regulation, consciousness, and decision-making. These findings illustrate the relevance of interoceptive indicators for embodiment.

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See detailSmartphone-based interventions for physical activity promotion: scoping review of the evidence over the last 10-years.
Domin, Alex; Spruijt-Metz, Donna; Theisen, Daniel; Ouzzahra, Yacine; Vögele, Claus

in Journal of Medical Internet Research (2021), 9(7), 24308

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See detailA randomized controlled trial of an Internet-based emotion regulation intervention for sexual health: study protocol
Fischer, Vinicius Jobim; Andersson, Gerhard; Billieux, Joel; Vögele, Claus

in Trials (2021), 22

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See detailOn the construct validity of interoceptive accuracy based on heartbeat counting: cardiovascular determinants of absolute and tilt-induced change scores
Schulz, André; Back, Sarah N.; Schaan, Violetta K.; Bertsch, Katja; Vögele, Claus

in Biological Psychology (2021), 164(1), 108168

Interoceptive accuracy (IAcc) as assessed with the heartbeat counting task (IAccHBCT) may be affected by a range of factors including (1.) the ability to adequately detect cardiac signals, indicated by IAcc in a heartbeat discrimination task (IAccHBDT), (2.) cardiac signal properties, affected by sympathetic and parasympathetic tone, and (3.) non-interoceptive processes, including time estimation accuracy (TEAcc). In the current study we investigated the contribution of these factors to absolute and Δ IAccHBCT scores, induced by passive head-up and head-down tilt in 49 healthy individuals. A set of hierarchical regression models showed IAccHBDT scores as the strongest and, across different orthostatic (tilt) conditions, most stable (positive) predictor of absolute and Δ IAccHBCT scores. Neither indicators of cardiac signal properties (except for HR in head-down-tilt), nor TEAcc predicted absolute or Δ IAccHBCT scores. These findings support the convergent and discriminant validity of absolute and Δ IAccHBCT scores.

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See detailAltered regulation of negative affect in patients with fibromyalgia : a diary study
Rost, Silke; Crombez, Geert; Stefan Sütterlin, Stefan; Vögele, Claus; Veirman, Elke; van Ryckeghem, Dimitri

in EUROPEAN JOURNAL OF PAIN (2021)

Background Fibromyalgia is characterized by widespread musculoskeletal pain and often accompanied by cognitive and emotional problems. Adaptation to fibromyalgia may therefore also rely on one's ability to regulate emotional problems. In this study, we examined two indices of emotion regulation, that is, (a) affective instability, involving frequent large fluctuations in self-reported affect, and (b) resting heart rate variability (HRV). 45.4 years; 39 females) and 46 matched healthy controls (M-age = 44.9 years; 37 females). Heart rate was monitored under resting conditions to derive HRV. Subsequently, participants completed an electronic end-of-day diary for 14 consecutive days assessing daily levels of pain, disability, negative affect (NA) and positive affect (PA). Affective instability was operationalized as the mean square of successive differences in daily mood. Results Results indicate increased levels of NA instability and reduced levels of HRV in patients with fibromyalgia in comparison with healthy controls. Furthermore, HRV and NA instability were inversely related. Finally, in patients, higher NA instability was related to increased pain disability. Conclusions Current findings support the idea that patients with fibromyalgia are confronted with fluctuating emotions. These results may have important implications for treatment as they provide support for the use of emotion regulation skills training in patients with fibromyalgia to impact upon NA instability. Significance This study provides novel insight in the link between emotion regulation indices,that is, heart-rate variability and negative affective (NA) instability, in patients with fibromyalgia, and presents evidence for differences in both emotion regulation indices between patients with fibromyalgia and healthy people. Furthermore, results link increased NA instability with increased levels of daily disability in patients with fibromyalgia. Together, these findings offer support for a key role of emotion regulation in fibromyalgia outcomes, providing pathways for clinical practice.

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See detailNoradrenergic activation induced by yohimbine decreases interoceptive accuracy in healthy individuals with childhood adversity
Schulz, André; Deuter, Christian E.; Breden, Ion-Hideo; Vögele, Claus; Wingenfeld, Katja; Otte, Christian; Kuehl, Linn K.

in Development and Psychopathology (2021)

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.

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See detailQuality of life among adult patients living with diabetes in Rwanda: a cross-sectional study in outpatient clinics
Lygidakis, Charilaos; Uwizihiwe, Jean Paul; Bia, Michela Gianna; Uwinkindi, Francois; Kallestrup, Per; Vögele, Claus

in BMJ Open (2021), 11

Objectives To report on the disease-related quality of life of patients living with diabetes mellitus in Rwanda and identify its predictors. Design Cross-sectional study, part of the baseline assessment of a cluster-randomised controlled trial. Setting Outpatient clinics for non-communicable diseases of nine hospitals across Rwanda. Participants Between January and August 2019, 206 patients were recruited as part of the clinical trial. Eligible participants were those aged 21–80 years and with a diagnosis of diabetes mellitus for at least 6 months. Illiterate patients, those with severe hearing or visual impairments, those with severe mental health conditions, terminally ill, and those pregnant or in the postpartum period were excluded Primary and secondary outcome measures Disease-specific quality of life was measured with the Kinyarwanda version of the Diabetes-39 (D-39) questionnaire. A glycated haemoglobin (HbA1c) test was performed on all patients. Sociodemographic and clinical data were collected, including medical history, disease-related complications and comorbidities. Results The worst affected dimensions of the D-39 were ‘anxiety and worry’ (mean=51.63, SD=25.51), ‘sexual functioning’ (mean=44.58, SD=37.02), and ‘energy and mobility’ (mean=42.71, SD=20.69). Duration of the disease and HbA1c values were not correlated with any of the D-39 dimensions. A moderating effect was identified between use of insulin and achieving a target HbA1c of 7% in the ‘diabetes control’ scale. The most frequent comorbidity was hypertension (49.0% of participants), which had a greater negative effect on the ‘diabetes control’ and ‘social burden’ scales in women. Higher education was a predictor of less impact on the ‘social burden’ and ‘energy and mobility’ scales. Conclusions Several variables were identified as predictors for the five dimensions of quality of life that were studied, providing opportunities for tailored preventive programmes. Further prospective studies are needed to determine causal relationships.

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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; Schaan, Violetta; Vögele, Claus

in Development and Psychopathology (2020)

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.

See detailFamily violence and COVID19
Gomez Bravo, Raquel; Mariani Borrero, Yusianmar; Dascal-Weichhendler, Hagit; Kopcavar Gucek, Nena; Jobim Fischer, Vinicius; Lygidakis, Charilaos; Vögele, Claus

in Self and Society in the Corona Crisis (2020)

According to WHO, violence against women tend to increase during any type of emergency, such as the COVID19 outbreak, impacting not just women but also children and their families health . Although data on family violence during crisis is scarce, existing reports from China, UK and USA already suggest an increase of intimate partner violence. As social distancing measures are taken and people forced or encourage to stay at home, we could expect that the increase of tension at many homes will unfortunately end up in new cases of family violence or exacerbations of existing ones. Such context of an overloaded health system facing the crisis may imply in extra challenges for victims to seek help. This article aims to summarize the existing evidence regarding family violence during crisis and the resources available that can help to mitigate the impact of violence.

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See detailInteroception, stress and physical symptoms in stress-associated diseases
Schulz, André; Schultchen, Dana; Vögele, Claus

in European Journal of Health Psychology (2020), 27(1), 132-153

The brain and peripheral bodily organs continuously exchange information. Exemplary, interoception refers to the processing and perception of ascending information from the body to the brain. Stress responses involve a neurobehavioral cascade, which includes the activation of peripheral organs via neural and endocrine pathways and can thus be seen as an example for descending information on the brain-body axis. Hence, the interaction of interoception and stress represents bi-directional communication on the brain-body axis. The main hypothesis underlying this review is that the dysregulation of brain-body communication represents an important mechanism for the generation of physical symptoms in stress-related disorders. The aims of this review are, therefore, (1.) to summarize current knowledge on acute stress effects on different stages of interoceptive signal processing, (2.) to discuss possible patterns of abnormal brainbody communication (i.e., alterations in interoception and physiological stress axes activation) in mental disorders and chronic physical conditions, and (3.) to consider possible approaches to modify interoception. Due to the regulatory feedback loops underlying brain-body communication, the modification of interoceptive processes (ascending signals) may, in turn, affect physiological stress axes activity (descending signals), and, ultimately, also physical symptoms.

See detailMental health issues in health care professionals facing a pandemic.
Gomez Bravo, Raquel; Jobim Fischer, Vinicius; Lygidakis, Charilaos; Vögele, Claus

in The Ends of Humanities (2020), 2

The Sars-CoV-2 pandemic puts an extreme strain on health care professionals, who are at a high risk of psychological distress and other mental health problems. Contributing factors include facing uncertainty, the often unbearable workload, shortages in personal protective equipment and treatments, an overwhelming flow of information, and changes in habitual roles and tasks. Existing studies show that in similar situations, they also experience stigmatization, as well as fear of infection for themselves and their families. This article summarizes the existing research on the mental health issues in health care professionals in this context, including risk factors, and interventions that can be implemented to promote mental well-being in front line professionals.

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See detailTwin Research in the Post-Genomic Era: Dissecting the Pathophysiological Effects of Adversity and the Social Environment
Turner, Jonathan; D'Ambrosio, Conchita; Vögele, Claus; Diewald, Martin

in International Journal of Molecular Sciences (2020), 21

The role of twins in research is evolving as we move further into the post-genomic era. With the re-definition of what a gene is, it is becoming clear that biological family members who share a specific genetic variant may well not have a similar risk for future disease. This has somewhat invalidated the prior rationale for twin studies. Case co-twin study designs, however, are slowly emerging as the ideal tool to identify both environmentally induced epigenetic marks and epigenetic disease-associated processes. Here, we propose that twin lives are not as identical as commonly assumed and that the case co-twin study design can be used to investigate the effects of the adult social environment. We present the elements in the (social) environment that are likely to affect the epigenome and measures in which twins may diverge. Using data from the German TwinLife registry, we confirm divergence in both the events that occur and the salience for the individual start as early as age 11. Case co-twin studies allow for the exploitation of these divergences, permitting the investigation of the role of not only the adult social environment, but also the salience of an event or environment for the individual, in determining lifelong health trajectories. In cases like social adversity where it is clearly not possible to perform a randomised-controlled trial, we propose that the case cotwin study design is the most rigorous manner with which to investigate epigenetic mechanisms encoding environmental exposure. The role of the case co-twin design will continue to evolve, as we argue that it will permit causal inference from observational data.

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See detailThe Measurement of Resilience
Asheim, Geir; Bossert, Walter; d'ambrosio, Conchita; Vögele, Claus

in Journal of Economic Theory (2020), 189

Resilience has become an important topic in many social sciences. Numerous individual choices and economic and demographic outcomes are likely to be influenced by people’s resilience. School performance, work absenteeism and burnout, longevity, the quality of sleep and health-risk behaviors such as substance abuse are some examples. Similarly, it is of high policy relevance to understand the determinants of both individual resilience (such as educational, marital and occupational status) and ecological resilience (such as climate change). Empirical work designed to uncover such relationships suffers from the absence of a resilience measure applicable in the context of large data sets. We fill this gap by proposing a specific measure that is characterized by a set of natural properties. After an introduction to the notion of resilience and its attributes, we argue why these conditions have intuitive appeal. Finally, we provide illustrating examples and derive our main characterization result.

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See detailMentalization and Criterion A of the AMPD: Results from a clinical and nonclinical sample
Zettl, M.; Volkert, J.; Vögele, Claus; Kubera, K.; Taubner, S.

in Personality Disorders: Theory, Research, and Treatment (2020), 11(3), 191-202

Objective: Criterion A of the alternative model for the classification of personality disorders in the DSM-5 introduced the Level of Personality Functioning Scale (LPFS), a dimensional model for the assessment of impairments in self and interpersonal functioning. The LPFS was developed based on a review of different measures of personality functioning, such as the Reflective Functioning Scale, a measure of mentalizing. This study investigated the empirical overlap between LPFS and mentalization. Methods: The study sample included adult inpatients (n = 55) with a mental disorder and a healthy adult control group (n = 55). All participants were examined regarding the LPFS using the Semi-Structured Interview for Personality Functioning DSM-5 (STiP-5.1); mentalizing was assessed with the Brief Reflective Functioning Interview and coded with the Reflective Functioning Scale. We used structural equation modeling to investigate the relationship between LPFS domains and mentalization. Correlation analysis was used to examine the agreement between interview-rated LPFS and self-report measures of personality dysfunction. Results: All domains of the LPFS were significantly related to mentalizing. Interview-rated LPFS was significantly associated with self-reported personality dysfunction. Conclusion: The findings support the notion that the LPFS and mentalization share a strong conceptual and operational overlap by demonstrating that both constructs are empirically interrelated. The results yield further support for the validity of the LPFS as a dimensional model for the assessment of personality disorder severity.

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See detailEffects of rejection intensity and rejection sensitivity on social approach behavior in women
Schaan, Violetta; Schulz, André; Bernstein, Michael; Schächinger, Hartmut; Vögele, Claus

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 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.

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See detailNon-problematic and problematic binge-watchers do not differ on prepotent response inhibition: A preregistered pilot experimental study
Flayelle, Maèva; Verbruggen, Frederick; Schiel, Julie; Vögele, Claus; Maurage, Pierre; Billieux, Joël

in Human Behavior and Emerging Technologies (2020), 2

Binge‐watching (i.e., watching multiple episodes of a TV series back‐to‐back) has become standard viewing practice. Yet, this phenomenon has recently generated concerns regarding its potential negative outcomes on the long run. The presumed addictive nature of this behavior has also received increasing scientific interest, with preliminary findings reporting associations between binge‐watching, self‐control impairments, and heightened impulsivity. Nevertheless, previous studies only relied on self‐report data. The current preregistered study therefore investigated whether non‐problematic and problematic binge‐watchers differ not only in self‐report but also in experimental measures of behavioral impulsivity. Based on their viewing characteristics, 60 TV series viewers were allocated to one of three predetermined groups: non‐binge‐watchers, trouble‐free binge‐watchers (absence of negative impact) and problematic binge‐watchers (presence of negative impact). Participants performed tasks assessing response inhibition (Stop‐Signal Task) and impulsive reward seeking (Delay Discounting Task), and completed self‐reported questionnaires on sociodemographics, affect, symptoms of problematic binge‐watching, and impulsive personality traits. According to the preregistered analytic plan, one‐way analyses of covariance (ANCOVAs) were computed to compare the predetermined groups. With gender being controlled for, no differences were identified in self‐report impulsivity and response inhibition abilities. Trouble‐free binge‐watchers reported higher rates of delay discounting than non‐binge‐watchers. Although preliminary, our results challenge the notion that problematic binge‐watching is characterized by the same neuropsychological impairments as in addictive disorders as, contrary to our preregistered hypotheses, no differences emerged between non‐problematic and problematic binge‐watchers regarding self‐control variables considered as hallmarks of the latter. These results suggest the need for formulating and testing alternative conceptualizations of problematic binge‐watching.

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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; Vögele, Claus; Bertsch, Katja; Bernard, Sam; Münch, Eva E.; Hansen, Greta; Naumann, Ewald; Schächinger, Hartmut

in International Journal of Psychophysiology (2020), 157(1), 70-81

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

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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; Van Dyck, Zoé; Eysteinsson, Thor; Thorleifsdottir, Björg; Vögele, Claus

in Environment and 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 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).

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See detailBinge-Watching: What Do we Know So Far? A First Systematic Review of the Evidence
Flayelle, Maèva; Maurage, Pierre; Ridell Di Lorenzo, Kim; Vögele, Claus; Gainsbury, Sally M.; Billieux, Joël

in Current Addiction Reports (2020), 7(1), 44-60

Purpose of Review: Along with the expansion of on-demand viewing technology, the practice of binge-watching (i.e., watching multiple episodes of TV series back-to-back) has recently gained increasing research interest, given its potential harmfulness and presumed addictive characteristics. The present article provides the first systematic review of the evidence regarding this increasingly widespread behavior. Recent Findings: The results of this systematic review (including 24 studies and 17,545 participants) show that binge-watching remains an ill-defined construct as no consensus exists on its operationalization and measurement. Although such methodological disparities across studies hinder the comparability of results, the preliminary findings gathered here mainly point to the heterogeneous nature of binge-watching which covers at least two distinct realities, i.e., high but non-harmful engagement and problematic involvement in TV series watching. Summary: In these early stages of research, there is a major need for more consistency and harmonization of constructs and their operationalizations to move forward in the understanding of binge-watching. Just as important, future research should maintain the distinction between high and problematic involvement in binge-watching to avoid overpathologizing this common behavior.

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See detailMotivational Interviewing to Increase Physical Activity Behavior in Cancer Patients: A Pilot Randomized Controlled Trials
Lion, A; Backes, A; Duhem, C; Ries, F; Delagardelle, C; Urhausen, A; Vögele, Claus; Theisen, Daniel; Malisoux, L

in Integrative Cancer Therapies (2020), 19

OBJECTIVE: This pilot randomized controlled trial (RCT) aimed at evaluating the feasibility and potential efficacy of a motivational interviewing (MI) intervention to increase physical activity (PA) behavior in cancer patients. METHODS: Participants were randomly assigned to an experimental group with standard care plus 12 MI sessions within 12 weeks or a control group with standard care only. The number of recruited participants and the modality of recruitment were recorded to describe the reach of the study. The acceptability of the study was estimated using the attrition rate during the intervention phase. The potential efficacy of the intervention was evaluated by analyzing the PA behavior. RESULTS: Twenty-five participants were recruited within the 16-month recruitment period (1.6 participants per month). Five participants (38.5%) from the experimental group (n = 13) and one participant (8.3%) from the control group (n = 12) dropped out of the study before the end of the intervention phase. No group by time interaction effect for PA behavior was observed at the end of the intervention. CONCLUSION: Due to the low recruitment rate and compliance, no conclusion can be drawn regarding the efficacy of MI to increase PA behavior in cancer patients. Moreover, the current literature cannot provide any evidence on the effectiveness of MI to increase PA in cancer survivors. Future RCTs should consider that the percentage of uninterested patients to join the study may be as high as 60%. Overrecruitment (30% to 40%) is also recommended to accommodate the elevated attrition rate.

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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; Vögele, Claus; Witthöft, Michael; Van Diest, Ilse; Schulz, André

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 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.

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

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 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.

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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; Schulz, André; Vögele, Claus; Spaderna, Heike

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 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.

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See detailFight, Flight, – Or Grab a Bite! Trait Emotional and Restrained Eating Style Predicts Food Cue Responding Under Negative Emotions
Schnepper, Rebekka; Georgii, Claudio; Elchin, Katharina; Arend, Ann-Kathrin; Wilhelm, Frank H.; Vögele, Claus; Lutz, Annika; van Dyck, Zoé; Blechert, Jens

in Frontiers in Behavioral Neuroscience (2020), 14

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See detailDistinctive body perception mechanisms in high versus low symptom reporters: a neurophysiological model for medically-unexplained symptoms
Schulz, André; Rost, Silke; Flasinski, Tabea; Dierolf, Angelika; Lutz, Annika; Münch, Eva E.; Mertens, Vera C.; Witthöft, Michael; Vögele, Claus

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 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.

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See detailAltered interoceptive awareness in high habitual symptom reporters and patients with somatoform disorders
Flasinski, Tabea; Dierolf, Angelika; Rost, Silke; Lutz, Annika; Voderholzer, Ulrich; Koch, Stefan; Bach, Michael; Asenstorfer, Carina; Münch, Eva Elisabeth; Mertens, Vera-Christina; Vögele, Claus; Schulz, André

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 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.

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See detailGlucocorticoid receptor signaling in leukocytes after early life adversity.
Elwenspoek, M.; Hengesch, X.; Leenen, F.; Sias, K.; Fernandes, S.; Schaan, Violetta; Mériaux, S.; Schmitz, S.; Bonnemberger, F.; Schächinger, H.; Vögele, Claus; Muller, C.P.; Turner, J.D.

in Development and Psychopathology (2020), 32(3), 853-863

Early life adversity (ELA) has been associated with inflammation and immunosenescence, as well as hyporeactivity of the HPA-axis. As the immune system and HPA-axis are tightly intertwined around the glucocorticoid receptor (GR) we examined peripheral GR functionality in the EpiPath cohort, where participants had either been exposed to ELA (separation from parents and/or institutionalization followed by adoption) (n=40) or had been reared by their biological parents (n=72). Expression of the strict GR target genes FKBP5 and GILZ as well as total and 1F and 1H GR transcripts were similar between groups. Furthermore, there were no differences in GR sensitivity, examined by the effects of dexamethasone on IL6 production in LPS-stimulated whole blood. Although we did not find differences in methylation at the GR 1F exon or promoter region, we identified a region of the GR 1H promoter (CpG 1-9) that showed lower methylation levels in ELA. Peripheral GR signaling was unperturbed in our cohort and the observed immune phenotype does not appear to be secondary to an altered glucocorticoid receptor response to glucocorticoids. To identify signaling pathways that may underlie the ELA immune phenotype, future research should focus on unbiased approaches, such as investigating whole genome methylation profiles.

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See detailTowards a cross-cultural assessment of binge-watching: Psychometric evaluation of the “watching TV series motives” and “binge-watching engagement and symptoms” questionnaires across nine languages
Flayelle, Maèva; Castro-Calvo, Jesús; Vögele, Claus; Astur, Robert; Ballester-Arnal, Rafael; Challet-Bouju, Gaëlle; Brand, Matthias; Cárdenas, Georgina; Devos, Gaëtan; Elkholy, Hussien; Grall-Bronnec, Marie; James, Richard J. E.; Jiménez-Martínez, Martha; Khazaal, Yasser; Valizadeh-Haghi, Saeideh; King, Daniel; Liu, Yueheng; Lochner, Christine; Steins-Loeber, Sabine; Long, Jiang; Potenza, Marc N.; Rahmatizadeh, Shahabedin; Schimmenti, Adriano; Stein, Dan J.; Tóth-Király, István; Tunney, Richard; Wang, Yingying; Zhai, Zu Wei; Maurage, Pierre; Billieux, Joël

in Computers in Human Behavior (2020), 111

In view of the growing interest regarding binge-watching (i.e., watching multiple episodes of television (TV) series in a single sitting) research, two measures were developed and validated to assess binge-watching involvement (“Binge-Watching Engagement and Symptoms Questionnaire”, BWESQ) and related motivations (“Watching TV Series Motives Questionnaire”, WTSMQ). To promote international and cross-cultural binge-watching research, the present article reports on the validation of these questionnaires in nine languages (English, French, Spanish, Italian, German, Hungarian, Persian, Arabic, Chinese). Both questionnaires were disseminated, together with additional self-report measures of happiness, psychopathological symptoms, impulsivity and problematic internet use among TV series viewers from a college/university student population (N = 12,616) in 17 countries. Confirmatory factor, measurement invariance and correlational analyses were conducted to establish structural and construct validity. The two questionnaires had good psychometric properties and fit in each language. Equivalence across languages and gender was supported, while construct validity was evidenced by similar patterns of associations with complementary measures of happiness, psychopathological symptoms, impulsivity and problematic internet use. The results support the psychometric validity and utility of the WTSMQ and BWESQ for conducting cross-cultural research on binge-watching.

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See detailChildhood trauma affects stress-related interoceptive accuracy
Schaan, Violetta; Schulz, André; Rubel, Julian A.; Bernstein, Michael J.; Domes, Gregor; Schächinger, Hartmut; Vögele, Claus

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 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.

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See detailCommunity- and mHealth-based integrated management of diabetes in primary healthcare in Rwanda: the protocol of a mixed-methods study including a cluster randomised controlled trial (D²Rwanda)
Lygidakis, Charilaos; Uwizihiwe, JP; Kallestrup, P; Bia, M; Condo, J; Vögele, Claus

in BMJ Open (2019), 9(7), 028427

Introduction In Rwanda, diabetes mellitus prevalence is estimated between 3.1% and 4.3%. To address non-communicable diseases and the shortage of health workforce, the Rwandan Ministry of Health has introduced the home-based care practitioners (HBCPs) programme: laypeople provide longitudinal care to chronic patients after receiving a six-month training. Leveraging technological mobile solutions may also help improve health and healthcare. The D²Rwanda study aims at: (a) determining the efficacy of an integrated programme for the management of diabetes in Rwanda, which will provide monthly patient assessments by HBCPs, and an educational and self-management mHealth patient tool, and; (b) exploring qualitatively the ways the interventions will have been enacted, their challenges and effects, and changes in the patients’ health behaviours and HBCPs’ work satisfaction. Methods and analysis This is a mixed-methods sequential explanatory study. First, there will be a one-year cluster randomised controlled trial including two interventions ((1) HBCPs’ programme; (2) HBCPs’ programme + mobile health application) and usual care (control). Currently, nine hospitals run the HBCPs’ programme. Under each hospital, administrative areas implementing the HBCPs’ programme will be randomised to receive intervention 1 or 2. Eligible patients from each area will receive the same intervention. Areas without the HBCPs’ programme will be assigned to the control group. The primary outcome will be changes in glycated haemoglobin. Secondary outcomes include medication adherence, mortality, complications, health-related quality of life, diabetes-related distress and health literacy. Second, at the end of the trial, focus group discussions will be conducted with patients and HBCPs. Financial support was received from the Karen Elise Jensens Fond, and the Universities of Aarhus and Luxembourg. Ethics and dissemination Ethics approval was obtained from the Rwanda National Ethics Committee and the Ethics Review Panel of the University of Luxembourg. Findings will be disseminated via peer-reviewed publications and conference presentations. Trial registration number NCT03376607; Pre-results.

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

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 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.

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See detailSocial Media as an Opportunity for Public Health Interventions: The #Metoo Movement as an Exemplar
Gomez Bravo, Raquel; Gomez Bravo, María; Lygidakis, Charilaos; Vögele, Claus

in Journal of the International Society for Telemedicine and EHealth (2019), 7(e5), 1-7

Background: Social media have been used exponentially and globally, providing a means for billions of users to connect, interact, share opinions and criticise, becoming one of the main channels of communication for users around the world. One of the most popular free social media networks is Twitter, with more than 100 million active users per day worldwide. Purpose: The aim of this study was to analyse a sample of the public conversations generated, using the hashtag #MeToo, around the topic of sexual abuse on Twitter. Methods: Using social media marketing software, the use of the #MeToo hashtag was analysed over a period of 60 days (14 September 2017 to 13 November of 2017). Results: The #MeToo conversation was mainly in English (79.3%), located in the United States (48.2% of cases), but with global repercussions. The volume of mentions of the #MeToo hashtag was far greater (97.7%), compared with other hashtags related to violence over this period of time, using mostly Twitter (96.2%). Conclusions: These results suggest that it is possible to describe different groups using the social media, and analyse their conversations to identify opportunities for successful public health interventions. If the topic is relevant for the general public, it will generate interest and conversations at the global level, supported by a universal and borderless channel such as Twitter.

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See detailDie Rolle von Sport und Bewegung für die körperliche und psychische Gesundheit.
Vögele, Claus

in Schneider, Silvia; Margraf, Jürgen (Eds.) Lehrbuch der Verhaltenstherapie, Band 3: Psychologische Therapie bei Indikationen im Kindes- und Jugendalter (2019)

Physical activity plays an important role in children’s growth and development. Understanding why a child is active or inactive is, therefore, essential for prevention of and intervention in childhood obesity. This narrative review provides an up-to-date summary of the literature pertaining to biological, psychosocial and environmental factors affecting young children’s acquisition of physical activity behaviour. Physical activity-related traits are characterized by familial aggregation and influenced by genetic factors. Nevertheless, the genetic contribution to physical activity shows increasing expression with age, supporting the need for interventions in early childhood. In addition to genetic factors, a range of psychosocial and environmental factors that are associated with physical activity in children have been identified: boys are more active than girls, and children with active parents tend to be more active. Overall physical activity support provided by parents predicts children’s organized physical activity. Perceived road safety and threat posed by strangers are major causes of parental anxiety in relation to their children’s safety in the neighbourhood. Programmes designed to increase physical activity should promote the importance of physical activity to parents. In addition, improving perceived safety may help to ease parental restriction of their children's active transport and physical activity.

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See detailHerzschlag-evozierte Potenziale bei Bulimia nervosa
Lutz, Annika; Van Dyck, Zoé; Schulz, André; Vögele, Claus

Poster (2019)

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.

See detailWas Hänschen erlebt - erlebt Hans immer wieder - Auswirkungen elterlicher Scheidung auf psychische Gesundheit im jungen Erwachsenenhalter
Schaan, Violetta; Schulz, André; Vögele, Claus

in Brisch, Karl Heinz (Ed.) Bindung - Scheidung - Neubeginn (2019)

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See detailInteroception in Bulimia Nervosa: Evidence at cortical and self-report levels
Lutz, Annika; Van Dyck, Zoé; Schulz, André; Vögele, Claus

in Psychophysiology (2019), 56(S1), 117

Bulimia nervosa (BN) is characterized by recurrent episodes of binge eating and compensatory behaviors, such as self- induced vomiting. Body image disturbance is also prominent in BN. Current research is trying to determine which dimensions and sensory domains of body perception are affected in BN. Regarding heartbeat perception, findings are inconclusive, with some studies reporting reduced and others reporting unaltered interoceptive accuracy in BN. The current study contributes further data on heartbeat perception by using an indicator of the cortical processing of cardio- afferent signals (heartbeat evoked potentials, HEPs). We investigated 22 women with current or partially remitted BN (BMI 23.94[3.61]; age 31.86[11.20]) and 22 healthy women (HC; BMI 24.24[3.37]; age 31.00[10.15]). Participants performed a heartbeat perception task (according to Schandry) with concurrent 64- channel- EEG and ECG recording. HEPs were calculated as mean EEG amplitudes in the interval 455- 595ms after the R- peak of the ECG. Results show no significant differences between the BN and HC groups, neither for heartbeat perception, HEPs, or mean heartrate. These results confirm previous findings of intact heartbeat perception in BN. In addition, cortical processing of cardio- afferent signals is unaltered. Heartbeat perception is particularly relevant for emotion processing and regulation. The previously reported emotion- regulation deficits in BN appear not to be based on altered CNS processing of cardiac signals

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See detailHerzschlag-evozierte Potenziale bei Bulimia nervosa
Lutz, Annika; Van Dyck, Zoé; Schulz, André; Vögele, Claus

in Kirschbaum, C. (Ed.) 45. Jahrestagung Psychologie und Gehirn - Abstractband (2019)

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 Herzschlagwahr nehmung 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.

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See detailThe role of alexithymia in parent-child interaction and in the emotional ability of children with autism spectrum disorder
Pinto Costa, Andreia; Steffgen, Georges; Vögele, Claus

in Autism Research (2019)

Children with autism spectrum disorder (ASD) have more emotional difficulties than typically developing (TD) children. Of all the factors that impact children’s emotional development, parents, and the way they interact with their children, are of crucial importance. The present study compared the amount of parent-child interactions among 35 dyads of parents and their children with ASD and 41 dyads of parents and their TD children, aged between 3 and 13 years, during a frustration-eliciting situation. We further examined whether children’s alexithymia is linked to parent-child interactions and whether parent-child interactions are linked to children’s emotional difficulties. We found that parents of children with ASD interacted significantly less with their children than parents of TD children. This reduced interaction was better explained by children’s alexithymia than by children’s ASD diagnosis. Finally, parent-child interaction mediated the relationship between children’s ASD diagnosis and children’s emotion regulation ability, as well as some aspects of children’s emotional reactivity but only if not accounting for children’s alexithymia levels. Our results demonstrate the determinant role children’s alexithymia plays on parent-child interactions and on how these interactions are linked to children’s difficulties in emotion regulation and emotional reactivity. Results are discussed in light of how parent-child interactions and the emotional ability of children with ASD can be improved by targeting children’s alexithymia.

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See detailParental divorce is associated with an increased risk to develop mental disorders in women
Schaan, Violetta; Schulz, André; Schächinger, Hartmut; Vögele, Claus

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 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.

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See detailSurgery
Vögele, Claus; Powell, Rachael; Johnston, Marie

in Llewellyn, C.D.; Ayers, S.; McManus, C.; Newman, S.; Petrie, K.; Revenson, T.A.; Weinman, J. (Eds.) Cambridge Handbook of Psychology, Health and Medicine (2019)

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See detailHospitalisation
Powell, Rachael; Vögele, Claus; Johnston, Marie

in Llewellyn, C.D.; Ayers, S.; McManus, C.; Newman, S.; Petrie, K.; Revenson, T.A.; Weinman, J. (Eds.) Cambridge Handbook of Psychology, Health and Medicine (2019)

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See detailFamily Violence Curricula in Europe (FAVICUE): a cross-sectional descriptive study protocol
Gomez Bravo, Raquel; Lygidakis, Charilaos; Feder, Gene; Reuter, Robert; Vögele, Claus

in BMJ Open (2019), 9

Introduction. Family violence (FV) is a widespread public health problem of epidemic proportions and serious consequences. Doctors may be the first or only point of contact for victims who may be hesitant or unable to seek other sources of assistance, and they tend not to disclose abuse to doctors if not specifically asked. A comprehensive healthcare response is key to a coordinated community-wide approach to FV, but most of the practising physicians have received either no or insufficient education or training in any aspect of FV. Training of medical students concerning FV is often delivered in an inconsistent or ad hoc manner. The main aim of this project, Family Violence Curricula in Europe (FAVICUE), is to (1) describe current FV education delivery in European medical universities (undergraduate period) and during the specialist training in general practice (GP)/family medicine (FM) (postgraduate residency programme), and (2) compare it with WHO recommendations for FV curriculum. Methods and analysis. This is the protocol of a cross-sectional descriptive study consisting of two self-report online surveys (for undergraduate and postgraduate training, respectively) with 40 questions each. For both surveys, general practitioners, residents, medical students and professionals involved in their education from countries of the European region will be identified through the European Regional Branch of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA Europe) and will be invited to provide information regarding the training on FV. Descriptive tests will be carried out and a thematic analysis will be conducted on the open-ended questions. Ethics and dissemination Ethics approval has been obtained by the University of Luxembourg (ERP 17–015 FAVICUE). The results will provide important information concerning current curricula on FV, and can be used for mapping the educational needs and planning the implementation of future training interventions. They will be published and disseminated through WONCA Europe and its networks.

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See detailOvercoming the unitary exploration of binge-watching: A cluster analytical approach.
Flayelle, Maèva; Maurage, Pierre; Karila, Laurent; Vögele, Claus; Billieux, Joël

in Journal of behavioral addictions (2019), 8(3), 586-602

BACKGROUND AND AIMS: Binge-watching (i.e., watching multiple episodes of a TV series in one session) has recently become standard practice among TV series viewers; this expansion generates concerns regarding the potential negative outcomes associated with this habit. However, the investigation of its psychological correlates remains fragmentary, with few initial studies a priori conceptualizing this behavior as a new addictive disorder. This study explored these psychological correlates using cluster analysis of binge-watching behavior based on three key psychological factors: motivations, impulsivity, and emotional reactivity. METHODS: An online survey was completed by 4,039 TV series viewers. Data were analyzed using hierarchical and non-hierarchical cluster analyses, the validity of the clusters being finally determined through mutual comparisons with a selection of external correlates. RESULTS: Four clusters were identified: recreational TV series viewers (presenting low involvement in binge-watching), regulated binge-watchers (moderately involved), avid binge-watchers (presenting elevated but non-problematic involvement), and unregulated binge-watchers (presenting potentially problematic involvement associated with negative outcomes). DISCUSSION AND CONCLUSIONS: This study underlines the heterogeneous and multidetermined nature of binge-watching. Our findings suggest that high engagement in binge-watching is distinct from problematic binge-watching, thus reinforcing the notion that conceptualizing binge-watching as an addictive disorder is of low relevance and might actually lead to the overpathologization of this highly popular leisure activity.

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See detailZur Validität zweier Herzschlagwahrnehmungsaufgaben: Höheres zentrales Blutvolumen durch Kipptischmanipulation verbessert interozeptive Genauigkeit, aber nicht die Genauigkeit zur Schätzung von Zeitintervallen
Back, S.; Schaan, V. K.; Vögele, Claus; Schulz, André

in Kirschbaum, C. (Ed.) 45. Jahrestagung Psychologie und Gehirn - Abstractband (2019)

Kardiale Interozeption wird typischerweise mittels Herzschlagzählaufgaben (Schandry, 1981) oder Herzschlagdiskriminationsaufgaben (Whitehead et al., 1977) erfasst. Jedoch sind die Determinanten der Herzschlagwahrnehmung hinsichtlich Aktivitätsindizes des kardiovaskulären Systems bisher ungeklärt. Die vorliegende Studie untersucht, ob die experimentelle Manipulation kardiovaskulärer Aktivität durch die Variation der Körperposition mittels Kipptisch einen Einfluss auf interozeptive Genauigkeit in Herzschlagzählaufgaben und Herzschlagdiskriminierungsaufgaben hat. Studierende (N=43) führten beide Herzschlagwahrnehmungsaufgaben in drei Körperpositionen (-10°,0° und 10°) durch. Zusätzlich wurde die Fähigkeit zur Einschätzung von Zeitintervallen geprüft (Kontrollaufgabe), da oft kritisiert wurde, dass interozeptive Genauigkeit basierend auf der Herzschlagzählaufgabe mit dieser Fähigkeit konfundiert ist. Die interozeptive Genauigkeit in der Herzschlagzählaufgabe war signifikant höher bei einem Neigungswinkel von -10° (über Kopf), sowie geringer bei 10° (Kopf aufrecht), jeweils im Vergleich zu 0° (horizontale Position). Deskriptiv ist das gleiche Muster bei der Herzschlagdiskriminationssaufgabe zu erkennen, jedoch statistisch nicht signifikant. Die Einschätzungsgenauigkeit von Zeitintervallen bleibt unabhängig von der Körperposition konstant. Regressionsanalysen zeigen, dass die Fähigkeit zur Diskriminierung von Herzschlägen signifikant die Herzschlagzählgenauigkeit vorhersagt und 32% der Gesamtvarianz aufklärt. Herzrate sowie die Einschätzungsgenauigkeit von Zeitintervallen tragen nicht signifikant als Prädiktoren in der Aufklärung der Zählgenauigkeit bei. Die Ergebnisse weisen darauf hin, dass kardiodynamische Parameter, wie z.B. Schlagvolumen, die durch die Variation der Körperposition manipuliert wurden, unabhängig von Variationen der Herzrate, eine Determinante interozeptiver Genauigkeit in Herzschlagzählaufgaben darstellen. Die Einschätzung von Zeitintervallen hat keinen Einfluss auf die Zähl- und Diskriminationsgenauigkeit von Herzschlägen und wird außerdem nicht von der Körperposition beeinflusst. Die Ergebnisse weisen auf gute konvergente und diskriminante Validität der Herzschlagwahrnehmungsaufgaben zur Erfassung kardialer Interozeption hin.

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See detailTime for a Plot Twist: Beyond Confirmatory Approaches to Binge-Watching Research
Flayelle, Maèva; Maurage, Pierre; Vögele, Claus; Karila, Laurent; Billieux, Joël

in Psychology of Popular Media Culture (2019), 8(3), 308-318

The advent of the digital age with its progress in digital technology has been associated in recent years with an increase in binge-watching (i.e., seeing multiple episodes of the same TV series in one session). Binge-watching has now become the new normative way to consume TV shows. Nevertheless, along with its recent massive rise has come concerns about the associated mental and physical health outcomes. Currently available results suggest the potential harmfulness and even addictive nature of binge-watching. The psychological investigation of this behavior, however, is still in its infancy, with most studies using a confirmatory approach and assuming a priori its genuine addictive nature. In contrast, the current perspective paper argues the case for an exploratory approach as an initial step for conducting research on behaviors that − at first sight − look like addiction when applying a symptom-based approach. A qualitative understanding of the phenomenological characteristics of binge-watching as the foundation of an initial comprehensive discussion makes it possible to formulate hypotheses concerning its potentially addictive nature and to emphasize challenges and directions for future research. Here we propose an exploration of the dynamics of binge-watching behavior based on a model involving emotion regulation in the etiology and maintenance of problem binge-watching.

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See detailVisceral-afferent signals from the cardiovascular system, but not urinary urge, affect startle eye blink
Schulz, André; Schilling, Thomas M.; Vögele, Claus; Schächinger, Hartmut

in Physiology and Behavior (2019), 199(1), 165-172

The aim of the current study was to investigate if startle methodology is suitable to reflect urinary urgency. Eighteen healthy men were tested on two separate days, each including an ingestion of fluid until 80% of the subjective urge to micturate was reached. EMG responses to acoustic startle stimuli were assessed before and after micturition, as well as in the early and late cardiac cycle phases (230 vs. 530 ms after a cardiac R-wave). Sonographic assessment confirmed bladder-filling status. Emotional arousal, stress, urge and unpleasantness ratings, as well as mean blood pressure were higher before than after micturition. Startle eye blink responses were lower during the early than during the late cardiac cycle phase, but were not affected by bladder filling status. We conclude that startle methodology is suitable for the investigation of afferent signals from the cardiovascular system, but not to reflect urinary urgency. This result may be due to different neurophysiological mechanisms underlying afferent signals from the bladder compared to other visceral organs or interference with affective states or sympathetic activation associated with bladder filling. Notwithstanding, the present research protocol of fluid intake, sonographic assessment of the bladder, and subjective reports, can be applied to examine visceral-afferent signals from the bladder.

See detailEmotion regulation and sexual health: an online study protocol
Fischer, Vinicius; Andersson, gerhard; Billieux, Joël; Vögele, Claus

in International Journal of Sexual Health (2019), 31

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See detailAssessing binge-watching behaviors: Development and validation of the “Watching TV Series Motives” and “Binge-Watching Engagement and Symptoms” questionnaires
Flayelle, Maèva; Canale, Natale; Vögele, Claus; Karila, Laurent; Maurage, Pierre; Billieux, Joël

in Computers in Human Behavior (2019), 90

The widespread practice of binge-watching (i.e. watching multiple episodes of a TV series in one session) recently generated concerns about associated negative outcomes. Its psychological investigation, however, remains fragmentary. Based on the previous phenomenological investigation of TV series watching, we developed and validated two original assessment instruments, assessing TV series watching motives and binge-watching engagement and symptoms, respectively. Preliminary items were created for each questionnaire, and a focus group with TV series viewers was conducted and analyzed to generate the final instruments. The questionnaires were then administered via an online survey (N=6556), together with complementary measures of affect, problematic Internet use and substance use. Exploratory and confirmatory factor analyses, along with correlational analyses, were performed to examine both structural and external validity of the scales. The factorial analyses resulted in a 4-factor model (i.e. emotional enhancement, enrichment, coping-escapism and social) for the Watching TV Series Motives Questionnaire (WTSMQ), and in a 7-factor model (i.e. engagement, positive emotions, desire-savoring, pleasure preservation, binge-watching, dependency and loss of control) for the Binge-Watching Engagement and Symptoms Questionnaire (BWESQ). The results suggest good psychometric properties for both scales. The current study thus provides theoretically-driven and psychometrically sound instruments for further research on binge-watching behaviors

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See detailEnhanced Cortical Processing of Cardio-Afferent Signals in Anorexia Nervosa
Lutz, Annika; Schulz, André; Voderholzer, U.; Koch, S.; Van Dyck, Zoé; Vögele, Claus

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 (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.

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See detailSomatoforme Symptome: Zusammenhänge mit Low-Frequency-Herzratenvariabilität und Selbstberichte zu chronischem psychosozialen Stress, aber nicht mit HPA-Achsen-Aktivität
Hansen, G.; Larra, M. F.; Vögele, Claus; Schächinger, H.; Schulz, André

in Kirschbaum, C. (Ed.) 45. Jahrestagung Psychologie und Gehirn - Abstractband (2019)

Nach dem Perception-Filter-Modell der somatoformen Störungen (Rief & Barsky, 2005) könnte verstärkte Signalübermittlung von Körperorganen zur Symptomentstehung beitragen. Dabei wurden insbesondere das sympathische Nervensystem und die HPA-Achse als primäre physiologische Stressachsen diskutiert. Aufgrund hoher Heterogenität somatoformer Störungen ist die Befundlage zu beiden Achsen jedoch gemischt, was dafürspricht, größere Populationen ohne Multi-Komorbidität zu untersuchen. 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- und High-Frequency) 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 Perception-Filter-Modells konnten nur hinsichtlich des sympathischen Nervensystems bestätigt werden, was daher als Frühindikator für somatoforme Störungen betrachtet werden könnte. Dennoch sind selbstberichteter chronischer Stress, vor allem „Besorgnis“, bei gesunden Probanden die stärksten Prädiktoren für somatoforme Symptome.

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See detailCardiac cycle phase affect auditory-evoked potentials in response to acoustic startle stimuli, but not perceived intensity ratings
Bernard, Sam; Münch, E. E.; Hansen, G.; Bertsch, K.; Vögele, Claus; Schulz, André

in Kirschbaum, C. (Ed.) 45. Jahrestagung Psychologie und Gehirn - Abstractband (2019)

Startle stimuli presented in the early cardiac cycle phase elicit lower responses than stimuli presented in the late cardiac cycle phase. This effect, named ‚Cardiac modulation of startle (CMS)‘, was proposed to reflect baro-afferent signal processing in the central nervous system. It is yet unclear, however, whether the CMS is due to a general sensory attenuation effect by baro-afferent signal transmission or to a specific neural pathway that selectively attenuates startle stimulus processing, but may eventually enhance other processes. The aim of the present study was, therefore, to address this issue. In this present study 23 female participants were presented acoustic stimuli of varying intensities (95, 100, and 105 dBA) during early (R-wave + 230 ms) and late (R+ 530 ms) cardiac cycle phase. Startle responses (EMG of the M. Orbicularis Oculi), auditory-evoked potentials (AEPs), and perceived intensity ratings of all stimuli were assessed. Higher startle stimulus intensities evoked higher perceived intensity ratings, stronger EMG startle responses, and higher N1, P2, and P3 AEPs. Startle stimuli in the early cardiac cycle phase elicited lower startle responses, and a positive shift of the N1 and P3 components as compared to the late cardiac cycle phase. Intensity ratings were unaffected by the cardiac cycle phases. The present AEP pattern associated with CMS appears to be unique across all startle modulation paradigms, supporting a more specific neural pathway, rather than a general sensory attenuation.

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See detailNahrungsvermeidung versus Nahrungsaversion bei restriktiven Essstörungen.
Garcia-Burgos, David; Wilhelm, Peter; Vögele, Claus; Munsch, Simone

in Zeitschrift für Psychiatrie, Psychologie und Psychotherapie (2019), 67(1), 1-9

The terms food avoidance and food aversion are often used interchangeably in the eating disorders (EDs) literature. However, they represent two different (but closely related) constructs that are the result of different processes. In patients suffering from anorexia nervosa, bulimia nervosa and avoidant / restrictive food intake disorder, food avoidance / restriction is usually assumed to be motivated by fear / anxiety (e. g., “intense fear of gaining weight or becoming fat” or “being afraid to eat after a frightening episode of choking”). In contrast, studies show that taste aversion often leads to food avoidance. Unlike fear-motivated avoidance in which the flavour of food becomes a signal for danger, avoidance produced by taste aversions involves a reduction in the amount consumed due to a hedonic downshift. Here the attractiveness of the flavour changes by its association with a nauseogenic event. It is noteworthy that both sources of food avoidance exhibit different behavioural characteristics, contents of learning, and activate different brain regions and neuromodulators. This is especially important for the understanding and treatment of the EDs and their most serious behavioural manifestation: the life-threatening food refusal. Finally, the clinical implications of such a distinction and promising future research directions are discussed.

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See detailEffects of acute yohimbine administration on interoception in major depression and childhood adversity
Kuehl, L. K.; Deuter, C. E.; Breden, I.-H.; Vögele, Claus; Wingenfeld, K.; Otte, C.; Schulz, André

in Psychoneuroendocrinology (2019), 107(Supplement 1), 4

Acute stress, release of stress hormones and chronic stress can affect the processing of visceral-afferent neural signals at different brain levels, which are important for interoception. However, it remains unclear if these effects are due to activation of the sympatho-adreno-medullary (SAM) axis or hypothalamicpituitary adrenocortical (HPA) axis. With this study, we aimed to investigate the selective effect of SAM axis activation on interoceptive accuracy. Central alpha2-adrenergic receptors represent a negative feedback mechanism of the SAM axis. For major depressive disorder (MDD) and adverse childhood experiences (ACE), alterations in the biological stress systems, including density and sensitivity of central alpha2-adrenergic receptors, have been shown. Healthy individuals without ACE (n = 46), healthy individuals with ACE (n = 23), patients with MDD and without ACE (n = 26) and patients with MDD with ACE (n = 22, all without antidepressant medication) were tested after oral administration of 10mg of yohimbine (alpha2-adrenergic receptors antagonist) and placebo administration in a repeated measures design. Interoceptive accuracy and sensibility were assessed in a heartbeat tracking task. Increases in systolic and diastolic blood pressure after yohimbine administration in all groups confirmed successful activation of the SAM axis. Interoceptive accuracy decreased after yohimbine intake only in the healthy group with ACE, but remained unchanged in all other groups. This ‘group’בdrug’ interaction effect may be due to selective up-regulation of alpha2- adrenergic receptors after experience of childhood trauma, which reduces capacity for attention focus on heartbeats. Suppressed processing of physical sensations in stressful situations may represent an adaptive response in healthy individuals with childhood adversity.

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See detailDo interoceptive deficits contribute to decision-making problems in academic procrastination
Breden, I.-H.; Dincher, K.; Pereira Pedrosa, R.; Rutschmann, Jannis; Valmorbida, L.; Vögele, Claus; Schulz, André

in Kirschbaum, C. (Ed.) 45. Jahrestagung Psychologie und Gehirn - Abstractband (2019)

Interoception plays an important role for intuitive decision-making. One possible explanation is that the perception of somatic markers when simulating the outcome of different action alternatives guides the selection for the potentially best option. In the present study, we aimed at investigating if chronically procrastinating individuals show interoceptive deficits, which may explain poor decision-making performance. We tested 19 chronic procrastinators (14 females) and 22 nonprocrastinating control individuals (14 females), recruited from students and staff of the University of Luxembourg. This study consisted of a laboratory experiment including questionnaires assessing procrastinating behavior and two separate behavioral paradigms. Using the Schandry Heartbeat Perception Task as an indicator for interoceptive accuracy and the Iowa Gambling Task (IGT) for the assessment of decision-making performance. Questionnaire data confirmed significantly higher procrastination scores in that group. While male participants showed a significantly higher interoceptive accuracy score than their female counterparts, procrastinators and non-procrastinators did not differ significantly in interoception. Furthermore, no differences in the choice of deck selections were found between procrastinators and non-procrastinators. Interoceptive accuracy was unrelated to decision-making performance. No significant group differences were found for either analysis regarding the performance development as well as sex differences in the IGT. We observed a learning effect in the IGT, with choices for profitable decks increasing over time and poor choices declining. The current study did neither support reduced decision-making problems, nor interoceptive deficits in procrastination. Future studies should incorporate interoceptive indicators of other organ systems and self-report measures to elucidate possible alterations in procrastination.

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See detailErhöhte Reaktivität Herzschlag-evozierter Potenziale während der Aufmerksamkeits- fokussierung auf den eigenen Herzschlag und erhöhte kardiovaskuläre Aktivität bei Personen mit hoher somatoformer Symptombelastung
Schulz, André; Rost, S.; Dierolf, Angelika; Lutz, Annika; Flasinski, T.; Münch, E. E.; Witthöft, M.; Vögele, Claus

in Kirschbaum, C. (Ed.) 45. Jahrestagung Psychologie und Gehirn - Abstractband (2019)

Die psychobiologischen Mechanismen der Entstehung körperlicher Symptome bei somatoformen Störungen sind weitgehend unklar. Im Perception-Filter-Modell wird postuliert, dass (1.) verstärkte Signalübermittlung von Körperorganen und (2.) verringerte Filterfunktion im ZNS zu (3.) verstärkter Wahrnehmung von Symptomen führt. Bislang existiert jedoch keine Evidenz, die diesen Zusammenhang an einer von somatoformen Symptomen belasteten Population unterstützt. Um diesen Sachverhalt aufzudecken, wurden zunächst 486 Personen aus der Allgemeinbevölkerung anhand einer Online- Version des Screenings für Somatoforme Störungen (SOMS-2) anhand des oberen und unteren Centils in Personen mit hoher (HSB) und niedriger somatoformer Symptombelastung (NSB) geteilt. Jeweils 29 NSB- (21 Frauen; 26,0 J.) und HSBPersonen (27 Frauen; 28,4 J.) wurden im Labor anhand (1.) verstärkter Körpersignale hinsichtlich kardiovaskulärer Aktivität und Cortisol-Aufwachreaktion, sowie (2.) Filterfunktionen im ZNS hinsichtlich Herzschlag-evozierter Potentiale (HEPs) während der Durchführung eines Herzschlagwahrnehmungstests und während Ruhe untersucht. HEPs reflektieren die Repräsentation kardio-afferenter Signale im ZNS. Die HSB-Gruppe zeigte eine höhere Ruhe-Herzrate (72,7 vs. 66,8 bpm) und eine geringere Herzratenvariabilität (RMSSD: 36,8 vs. 52,5 ms) als die LSB-Gruppe. Außerdem zeigten die HSB-Personen bei der Aufmerksamkeitsfokussierung auf den eigenen Herzschlag eine höhere Reaktivität der HEP-Amplitude als die LSB-Personen. Es gab keine Gruppenunterschiede hinsichtlich der Cortisol-Aufwachreaktion. Die Ergebnisse belegen sowohl (1.) die verstärkte Signalübermittlung von Körperorganen, als auch (2.) verringerte Filterfunktionen bei Personen mit hoher somatoformer Symptombelastung. Dies spricht für die Gültigkeit des Perception-Filter-Modells. Die erhöhte HEP-Reaktivität bezüglich der Aufmerksamkeitsfokussierung auf Körperprozesse könnte einen Biomarker für Personen mit hohem Risiko für die Entwicklung von somatoformen Störungen darstellen.

See detailLangzeitkonsequenzen elterlicher Scheidung für die Gesundheit im jungen Erwachsenenalter
Schaan, Violetta; Schulz, André; Vögele, Claus

Presentation (2018, November 23)

See detailLangzeitkonsequenzen elterlicher Scheidung für die Gesundheit im jungen Erwachsenenalter
Schaan, Violetta; Schulz, André; Vögele, Claus

Speeches/Talks (2018)

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See detailTask interference and distraction efficacy in patients with fibromyalgia: an experimental investigation
Van Ryckeghem, Dimitri; Rost, Silke; Kissi, Ama; Vögele, Claus; Crombez, Geert

in Pain (2018), 159(6), 1119-1126

Pain has the capacity to interfere with daily tasks. Although task interference by pain is largely unintentional, it can be controlled to a certain extent. Such top-down control over pain has been thought to be reduced in fibromyalgia patients. In this study, we investigated task interference and distraction efficacy in fibromyalgia patients (FM) and a matched healthy control group. Forty-nine fibromyalgia patients and 49 heathy volunteers performed as quickly as possible (a) a visual localization task in the presence of non-painful vibrating or painful electric somatic stimuli, and (b) a somatosensory localization task (using non-painful or painful stimuli). Participants reported on their experience of the somatic stimuli on some of the trials during both localisation tasks. Results indicated that pain interferes with performance of the visual task, in both FM patients and healthy individuals. Furthermore, participants experienced the pain stimulus as less intense when directing attention away from the pain than when focusing on the pain. Overall, task performance of FM patients was slower compared to the task performance in the healthy control group. In contrast to our hypotheses, FM patients and healthy volunteers did not differ in the magnitude of the interference effect and distraction-efficacy. In conclusion, current study provides support for contemporary theories claiming that attention modulates the experience of pain and vice versa. However, no evidence was however found for an altered attentional processing of pain in fibromyalgia patients. Furthermore, results indicate that task interference and distraction-efficacy are not just two sides of the same coin.

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See detailBlunted endocrine response to a combined physical-cognitive stressor in adults with early life adversity
Hengesch, X.; Elwenspoek, M.M.C.; Schaan, Violetta; Larra, M.F.; Finke, J.B.; Zhang, X.; Bachmann, P.; Turner, J.D.; Vögele, Claus; Muller, C.P.; Schächinger, H.

in Child Abuse and Neglect (2018)

The negative health effects of early life adversity (ELA) continue long into adulthood. Changes in the physiological response to psychosocial stressors have been proposed to mediate this effect. However, many previous studies have come to contradicting conclusions as to whether ELA induces a long-term increase or decrease in stress reactivity. Therefore, we tested the association of ELA exposure and adult stress reactivity in a sample of early life adoptees and controls.Two previously validated stressful elements (bilateral feet CPT and the Paced Auditory Serial Addition Task (PASAT)) were combined in an extended Cold Pressor Test (CPT). This test was performed on 22 participants who had experienced severe ELA (separation from biological parents, institutionalization, and adoption in early childhood), and in 22 age-matched control participants.A prior history of ELA was associated with blunted reactivity of the hypothalamic-pituitary-adrenal (HPA) axis (Cohen´s d = 0.680). Cardiovascular reactivity remained unchanged, and affective reactivity (self-report ratings) were increased in participants exposed to ELA compared to the control group (range Cohen´s d: 0.642–0.879).Our results suggest that the activity of the HPA axis reactivity was inhibited in ELA participants. Importantly, cardiovascular stress responsiveness was not affected by ELA. This separation of the HPA axis and cardiovascular stress responses may best be explained by ELA selectively enhancing central feedback-sensitivity to glucocorticoids, but preserving cardiovascular/ autonomic stress reactivity.

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See detailLate heartbeat-evoked potentials are associated with survival after cardiac arrest
Schulz, André; Stammet, P.; Dierolf, Angelika; Vögele, Claus; Beyenburg, S.; Werer, C.; Devaux, Y.

in Resuscitation (2018), 126(1), 7-13

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. 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 hours 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 reflected by HEPs, is associated with survival after CA. Future studies should address the brain-heart axis in CA.

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See detailThe D²Rwanda Study: March 2018 Report
Kallestrup, Per; Vögele, Claus; Uwizihiwe, JeanPaul; Lygidakis, Charilaos

Report (2018)

The Community- and MHealth-Based Integrated Management of Diabetes in Primary Healthcare in Rwanda: the D²Rwanda Study (which stands for Digital Diabetes Study in Rwanda) is a twin PhD project, developed in collaboration with Aarhus University (AU) and the University of Luxembourg (UL), and under the auspices of the University of Rwanda and Rwanda Biomedical Centre. The project involves two PhD students, Jean Paul Uwizihiwe (enrolled at AU) and Charilaos Lygidakis (enrolled at UL), and is kindly sponsored by the Karen Elise Jensens Foundation, alongside AU and UL. In this report we wished to narrate what we had been working on for the past two years: from the first steps to understanding better the context and mapping the territory; from obtaining the necessary authorisations to developing the app and translating the questionnaires.

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See detailA Latent State-Trait Analysis of Interoceptive Accuracy
Wittkamp, M.; Bertsch, K.; Vögele, Claus; Schulz, André

in Psychophysiology (2018), e0185802

Interoceptive accuracy (IAc), i.e. the ability to accurately perceive one’s own bodily signals, is widely assumed to be a trait, although experimental manipulations, such as stress, may affect IAc. We used structural equation modeling to estimate the reliability of IAc, and the proportions of individual differences in IAc, explained by a trait and occasion-specific effects of situation and person-situation interactions. We assessed IAc in 59 healthy participants (40 women, MAge = 23.4 years) on three consecutive measurement occasions, approx. one week apart, in a ‘rest’ and ‘poststress’ condition, using a heartbeat counting and a heartbeat discrimination task. The results show fair temporal stability (intraclass correlation coefficients ≥ 0.38) and good reliability (Mdn = .63; range .49-.83) for both methods. While around 40% of the variance of a single IAc measurement could be explained by a trait, approx. 27% were accounted for by occasion-specific effects of situation and person-situation interaction. These results suggest that IAc measures are relatively consistent and that situations and person-situation interactions impact IAc as measured at a certain point in time. An aggregation across at least two measurements is recommended when using IAc as a trait variable.

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See detailOperationsvorbereitung
Vögele, Claus

in Kohlmann, Carl-Walter; Salewski, Christel; Wirtz, Markus Antonius (Eds.) Psychologie in der Gesundheitsförderung (2018)

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See detailTrends and transitions
Vögele, Claus

in European Journal of Health Psychology (2018), 25(1), 1

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See detailDie Erweiterung von Konzepten und Definitionen von Suchtverhalten
Billieux, Joël; Vögele, Claus

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

See detailMental health and wellbeing in adopted adolescents and adolescents with divorced parents: Preliminary results of ATTACH
Decarli, Alessandro; Pierrehumbert, Blaise; Vögele, Claus

Presentation (2018)

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See detailEffects of cold stimulation on cardiac-vagal activation: Randomized controlled trial with healthy participants
Jungmann, Manuela; Vencatachellum, Shervin; Van Ryckeghem, Dimitri; Vögele, Claus

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 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.

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See detailMood, emotions and eating disorders
Vögele, Claus; Lutz, Annika; Gibson, E. Leigh

in Agras, W. Stewart; Robinson, Athena (Eds.) The Oxford Handbook of Eating Disorders, Second Edition (2018)

Mood and emotions are intrinsically involved with eating. This chapter discusses basic mechanisms, findings, and models that help our understanding of the interactions between eating and emotions, in both clinical and nonclinical populations. The finding that negative affect predicts EDs transdiagnostically, and that comorbidity with depressive disorders and anxiety disorders is the norm among patients with EDs suggests that EDs may not necessarily be restricted to domains of eating behavior and body image but may also be associated with significant difficulties in affective functioning. This chapter reviews the evidence relating to the notion that EDs are disturbances of mood regulation, in which regulatory strategies specifically related to eating and the body are used to diminish negative affect associated with food, body image, or stress.

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See detailRespiratory modulation of startle: effects on subjective intensity and psychomotor response times
Münch, Eva Elisabeth; Vögele, Claus; Van Diest, Ilse; Schulz, André

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 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.

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See detailRespiratory modulation of startle: effects on subjective intensity and psychomotor response times
Münch, Eva Elisabeth; Vögele, Claus; Van Diest, Ilse; Schulz, André

in 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 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.

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See detailBinge-watching engagement as determined by motivations, impulsivity and emotional reactivity: A cluster analytic approach.
Flayelle, Maèva; Maurage, Pierre; Vögele, Claus; Karila, Laurent; Billieux, Joël

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

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See detailHow does food taste in anorexia and bulimia nervosa? A protocol for a quasiexperimental, cross-sectional design to investigate taste aversion or increased hedonic valence of food in eating disorders
Garcia-Burgos, David; Maglieri, Sabine; Vögele, Claus; Munsch, Simone

in Frontiers in Psychology (2018), 9

Background. Despite on-going efforts to better understand dysregulated eating, the olfactory-gustatory deficits and food preferences in eating disorders (ED), and the mechanisms underlying the perception of and responses to food properties in anorexia nervosa (AN) and bulimia nervosa (BN) remain largely unknown; both during the course of the illness and compared to healthy populations. It is, therefore, necessary to systematically investigate the gustatory perception and hedonics of taste in patients with AN and BN. To this end, we will examine whether aversions to the taste of high-calorie food is related to the suppression of energy intake in restricting-type AN, and whether an increased hedonic valence of sweet, caloric-dense foods may be part of the mechanisms triggering binge-eating episodes in BN. In addition, the role of cognitions influencing these mechanisms will be examined. Method. In study 1, four mixtures of sweet-fat stimuli will be presented in a sensory two-alternative forced-choice test involving signal detection analysis. In study 2, a full-scale taste reactivity test will be carried out, including psychophysiological and behavioural measures to assess subtle and covert hedonic changes. We will compare the responses of currently-ill AN and BN patients to those who have recovered from AN and BN, and also to those of healthy normal-weight and underweight individuals without any eating disorder pathology. Discussion. If taste response profiles are differentially linked to ED types, then future studies should investigate whether taste responsiveness represents a useful diagnostic measure in the prevention, assessment and treatment of EDs. The expected results on cognitive mechanisms in the top-down processes of food hedonics will complement current models and contribute to the refinement of interventions to change cognitive aspects of food aversions, to establish functional food preferences and to better manage food cravings associated with binge-eating episodes. No trial registration was required for this protocol, which was approved by the Swiss ethics committee (CER-VD, nº2016-02150) and the Ethics Review Panel of the University of Luxembourg.

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See detailKardiale Modulation der Schreckreaktion bei hoher gegenüber niedriger Symptombelastung: afferente Signalübermittlung auf der Hirn-Körper-Achse beein usst frühe Stimulus-Verarbeitung bei hoher Symptombelastung
Dierolf, Angelika; Rost, Silke; Lutz, Annika; Flasinski, Tabea; Münch, Eva Elisabeth; Vögele, Claus; Witthöft, Michael; Schulz, André

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 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.

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See detailAssessing binge-watching behaviors: Development of the « Watching TV Series Motives » and the « Binge-Watching Engagement » questionnaires
Flayelle, Maèva; Canale, Natale; Maurage, Pierre; Vögele, Claus; Karila, Laurent; Billieux, Joël

in Journal of Behavioral Addictions (2018), 7 (Suppl.1)

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See detailLate heartbeat-evoked potentials, indicators of cortical representation of interoceptive signal processing, are associated with survival after cardiac arrest
Schulz, André; Stammet, Pascal; Dierolf, Angelika; Vögele, Claus; Beyenburg, Stefan; Werer, Christophe; Devaux, Yvan

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 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.

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See detailPost-learning cold pressor stress, after a heartbeat perception training, enhances interoceptive accuracy in high blood pressure responders
Breden, Ion-Hideo; Fischbach, Jean; Schenk, Lara; Müller, Ruta; Vögele, Claus; Van Diest, Ilse; Witthöft, Michael; Schulz, André

in Hennig, J.; Stark, R. (Eds.) 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 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.

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See detailSensing Your Body: Interoceptive Awareness and Medically Unexplained Symptoms
Flasinski, Tabea; Dierolf, Angelika; Voderholzer, Ulrich; Koch, Stefan; Bach, Michael; Asenstorfer, Carina; Lutz, Annika; Rost, Silke; Vögele, Claus; Schulz, André

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 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

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See detailLate heartbeat-evoked potentials, indicators of cortical representation of interoceptive signal processing, are associated with survival after cardiac arrest
Schulz, André; Stammet, Pascal; Dierolf, Angelika; Vögele, Claus; Beyenburg, Stefan; Werer, Christophe; Devaux, Yvan

in 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 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 reflected by HEPs, is associated with survival after CA. Cardiovascular autonomic arousal may not be involved in mediating this e ect. 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.

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See detailPost-learning cold pressor stress, after a heartbeat perception training, enhances interoceptive accuracy in high blood pressure responders
Breden, Ion-Hideo; Fischbach, Jean; Schenk, Lara; Müller, Ruta; Vögele, Claus; Van Diest, Ilse; Witthöft, Michael; Schulz, André

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 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.

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See detailImpaired filter function in patients with somatoform disorders and major depression, as reflected by auditory evoked potentials in an oddball and an active distraction paradigm
Hutmacher, Djenna; Dierolf, Angelika; Lutz, Annika; Vögele, Claus; Voderholzer, Ulrich; Koch, Stefan; Bach, Michael; Asenstorfer, Carina; Mertens, Vera-Christina; Schulz, André

in Abstractband Psychologie und Gehirn 2018 (2018)

Introduction: In the in influential perception-filter model of somatoform disorders (SD), three stages of symptom perception are postulated: (1) bodily signals, which may be amplified by stress, (2) a filter system, which distinguishes between relevant and irrelevant stimuli, and (3) cortical perception of physical symptoms. As there is dearth of evidence so far supporting the relationship between (1) bodily signals and (2) filter processes in SD, this study investigated if filter processes are altered in SD and if stress may affect filter mechanisms. Methods: Twenty-four patients with SD, 24 with depression and 24 healthy control individuals were assessed. Event-related potentials (ERPs) with two different auditory distraction procedures were recorded over four blocks, one before and three after either a socially evaluated cold pressor test (SECPT) or a control procedure. We manipulated both the frequency of and the attentional focus on stimuli to reflect filter processes. Results: We found smaller P3b amplitudes (reflecting memory storage) in patients with depression and SD, as compared to healthy controls. Furthermore, both patient groups showed a smaller P3a amplitude (reflecting attention), when counting the infrequent tone ("Oddball task") and a smaller N1 amplitude when counting the frequent tone ("active distraction"). In patients with SD, the SECPT had a decreasing effect on P3a amplitudes. Conclusions: Both late filter processes, reflecting attention (P3a) and memory storage (P3b), may be impaired in SD and depression. As acute stress affected attention in SD patients only, the impact of bodily signals (1) on filter processes (2) may be specific for SD.

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See detailProinflammatory T Cell Status Associated with Early Life Adversity
Elwenspoek, M.M.C.; Hemgesch, X.; Leenen, F.A.D; Schritz, A.; Sias, K.; Schaan, Violetta; Mériaux, S.B.; Schmitz, S.; Bonnemberger, F.; Schächinger, H.; Vögele, Claus; Turner, J.D.; Muller, C.P.

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 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.

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See detailRejection sensitivity as a vulnerability marker for depressive symptom deterioration in men.
De Rubeis, Jannika; Lugo, Ricardo; Witthöft, Michael; Sütterlin, Stefan; Pawelzik, Markus; Vögele, Claus

in PLoS ONE (2017), 12(10), 0185802

Consistent across time and cultures, men and male adolescents older than 14 years of age appear underrepresented in mood disorders, and are far less likely than women to seek psychological help. The much higher rate of suicide amongst males suggests that depression in men might be underreported. One of the core human motives is to seek acceptance by others and avoid rejection. Rejection Sensitivity (RS) has been conceptualized as the cognitive-affective processing disposition to anxiously expect, readily perceive, and intensely respond to cues of rejection in the behavior of others. RS has been previously linked with the onset and course of depression, but - as yet - has not been investigated longitudinally in a clinical population. We investigated the predictive role of RS to symptom deterioration 6 months after end-of- treatment in 72 male inpatients with depressive spectrum disorder. The BDI was administered at intake, end-of-treatment and 6 month follow-up. RS scores were obtained at intake. Rejection Sensitivity had additional predictive power on BDI scores at 6 months follow-up controlling for BDI scores at end-of-treatment (ΔR2 = .095). The results are discussed in terms of the importance of targeting RS during treatment, and highlight the fact that therapeutic follow-up care is paramount. Future research should investigate possible mediators of the RS- relapse-to-depression association, such as self-blame, rumination, neuroticism, pessimism, emotion dysregulation, and low self-esteem.

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See detailT cell immunosenescence after early life adversity: association with cytomegalovirus infection.
Elwenspoek, M.M.C.; Sias, K.; Hengesch, X.; Schaan, Violetta; Leenen, F.A.D.; Adams, P.; Meriaux, S.B.; Schmitz, S.; Bonnemberger, F.; Ewen, A.; Schächinger, H.; Vögele, Claus; Muller, C.P.; Turner, J.D.

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 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.

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See detailPlace, green exercise and stress: an exploration of lived experience and restorative effects
Olafsdottir, Gunnthora; Cloke, Paul; Vögele, Claus

in Health and Place (2017), 46

This paper reports on inter-disciplinary research designed to investigate the stress-buffering effects of green exercise, and the importance of the context in which exercise takes place. This investigation of context effects examines both individual physiological responses (salivary cortisol) and the phenomenological interpretation of lived experiences of the intervention, reported by a subsample of participants in a randomized, controlled trial, in which healthy, physically inactive university students were randomly allocated to three activities: walking on a treadmill in a gym, walking in semi-natural recreational area, and sitting and watching nature-based videos on TV. The study found clear indications of context effects, notably in the connections between positive appraisals of perceived circumstances, enjoyment in the enacted context, and physiological stress-reduction.

See detailCommunity- and mHealth-based integrated management of diabetes in primary healthcare in Rwanda (D²Rwanda): The study protocol
Uwizihiwe, Jean Paul; Lygidakis, Charilaos; Vögele, Claus; Condo, Jeanine; D'Ambrosio, Conchita; Kallestrup, Per

Scientific Conference (2017, June 29)

Introduction: The diabetes mellitus (DM) prevalence in Rwanda is estimated at 3.5%. In 2013, there were only one medical doctor and one nurse per 15,000 and 1,200 people respectively in Rwanda. A new programme employing frontline workers (Home-Based Community Practitioners (HBCPs)) is currently piloted, aiming at following-up patients with non-communicable diseases in their communities. We hypothesise that the management of DM at community level will improve following the introduction of a HBCP programme with regular monthly assessments and disease management, coupled with integration of a mobile health (mHealth) application with patient diaries, notifications and educational material. Objective: The aim of the study is to determine the efficacy of such an integrated programme in Rwanda. Methods: The study is designed as a one-year, open-label cluster trial of two interventions (arm1: HBCP programme, arm2: HBCP programme + mHealth application) and usual care (control). The primary outcomes will be changes in glycated haemoglobin levels and health-related quality of life. Mortality, complications, health literacy, mental well-being and treatment adherence will be assessed as secondary outcomes. Measurements will be conducted at baseline, 6 and 12 months. An intention-to-treat approach will be used to evaluate outcomes. Before trial onset, ethical approval will be sought in Rwanda, Luxembourg and Denmark, and a cross-cultural adaptation of questionnaires and a pilot will be carried out. Relevance: The project will provide evidence on the efficacy of innovative approaches for integrated management of DM and may spur the development of similar solutions for other chronic diseases in low-resource settings.

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See detailDepression Burden in Luxembourg: Individual Risk Factors, Geographic Variations and the Role of Migration, 2013-2015 European Health Examination Survey
Ruiz-Castell, Maria; Kandala, Ngianga-Bakwin; Perquin, Magali; Bocquet, Valéry; Kuemmerle, Andrea; Vögele, Claus; Stranges, Saverio

in Journal of Affective Disorders (2017), 222

Background: Depression is a complex mental disorder that affects an increasing proportion of the worldwide population. This study aims to estimate the prevalence of depressive symptoms in Luxembourg, associated risk factors and geographic variations. Additionally, it aims to assess whether first and second generation immigrants are at higher risk for depressive symptoms compared to non-immigrants. Methods: Representative cross-sectional data from 1499 residents of Luxembourg, aged 25 to 64 years, were collected from the Luxembourg European Health Survey (EHES-LUX). Depressive symptoms were defined as a score of ≥5 on the Patient Health Questionnaire for depression (PHQ-9) (i.e. mild, moderate or severe). Standard and Bayesian regression models were used to examine associations between depressive symptoms, immigration status and geographic distribution across Luxembourg. Results: The prevalence of depressive symptoms was 21.55% (15.54% mild, 3.54% moderate, and 2.49% moderately severe to severe). The odds of having depressive symptoms was higher among second generation immigrants compared to non-immigrants (OR: 1.58, 95% CI: 1.04, 2.41), independent of socioeconomic and behavioral characteristics. Healthier diet, higher social support and good health perception were protective towards experiencing depressive symptoms. One of the highest likelihoods of reporting depressive symptoms was observed in the South-West of the country with a positive effect at 80% credible region [CR] (1.42 [0.92, 2.73]). Limitations: The participation rate was low (26.7%). The cross-sectional nature of the study does not allow us to establish causality. Conclusions: Depression constitutes an important public health challenge in Luxembourg due to the impact on the overall health of the population. Social programs of health promotion should be developed to improve mental wellbeing in immigrants, especially those of second generation.

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See detailGeneralized hypervigilance in fibromyalgia: normal interoceptive accuracy, but reduced self-regulatory capacity
Rost, Silke; Van Ryckeghem, Dimitri; Schulz, André; Crombez, Geert; Vögele, Claus

in Journal of Psychosomatic Research (2017), 93(2), 48-54

Objective: The factors underlying the aetiology of fibromyalgia (FM) are largely unknown. According to the generalized hypervigilance hypothesis (GHH), FM patients show excessive attention towards pain stimuli and other sensory events, thereby increasing pain perception and dysfunctional behaviour. We tested this notion by assessing interoceptive accuracy (IA) in FM patients and matched healthy controls. We also tested the hypothesis that FM is characterized by reduced self-regulatory capacity as indexed by heart rate variability (HRV). Methods: 47 FM patients (Mage = 45.5, 39 females) and 45 healthy controls (Mage = 44.9, 37 females) completed several self-report scales (Body Vigilance Scale, Depression Anxiety Stress Scales, Pain Catastrophizing Scale). To derive HRV, heart rate was monitored under resting conditions; for the assessment of IA participants performed a heartbeat tracking task in which they were asked to silently count their heartbeats. Results: FM patients reported higher body vigilance than healthy controls, but there were no group differences in IA. FM patients had lower HRV compared with healthy controls. HRV did not predictor IA. Conclusion: In conclusion, our findings do not support the hypothesis of generalized hypervigilance in FM patients. Patients reported a heightened focus on bodily sensations, which was not reflected in IA. It may be that hypervigilance is not a general and stable characteristic but is rather context dependent and modality-specific.

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See detailDigital health in ambulatory assessment
Vögele, Claus

Book published by INSIDE (2017)

In this volume all accepted contributions to the 5th Biennial Conference of the Society for Ambulatory Assessment are published. The number and quality of these contributions testify to the high standard of international research in ambulatory monitoring, the rapid advances in technology and data handling supporting ambulatory assessment, and the importance of these developments for the rapidly expanding area of Digital Health. Converging technologies such as Internet applications, social networks, smartphones and wearable sensors in the area of health, are now beginning to transform our approach to health research, healthcare, and communication and access to information.

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See detailLo sviluppo delle rappresentazioni genitoriali e la loro influenza sull’attaccamento degli adolescenti adottati e non-adottati
Decarli, Alessandro; Vögele, Claus

in Minori Giustizia (2017)

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See detailGrand challenges in eating behavior research: preventing weight gain, facilitating long-term weight maintenance
Meule, Adrian; Vögele, Claus

in Frontiers in Psychology (2017), 8

See detailMental health and wellbeing during adolescence: Research protocol and preliminary results
Decarli, Alessandro; Pierrehumbert, Blaise; Vögele, Claus

Poster (2017)

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See detailLangzeitkonsequenzen von frühkindlichem Stress
Schaan, Violetta; Schulz, André; Vögele, Claus

Poster (2017)

Traumatische Belastungen während der Kindheit können das Risiko für die Entwicklung unsicherer Bindungsstile erhöhen, die bereits mit langfristigen psychischen und körperlichen Gesundheitsproblemen in Beziehung gebracht wurden. Die zugrundeliegenden Prozesse sind allerdings noch weitestgehend unklar. Wir präsentieren zwei Studien, die den Zusammenhang zwischen kindlichem Stress und Gesundheit im Erwachsenenalter sowie Körperwahrnehmung und Gedächtnisfähigkeit untersuchen. In der ersten Studie nahmen 199 Teilnehmer an einer Onlineumfrage teil, bei der Gesundheit, frühkindliches Trauma, Resilienz und Zurückweisungssensitivität gemessen wurden. Teilnehmer mit geschiedenen Eltern berichteten erhöhte psychische Belastungswerte, kindliches Trauma, Zurückweisungssensitivität und weniger Resilienz. Die Beziehung zwischen elterlicher Scheidung und psychischer Gesundheit konnte vollständig durch diese vier Faktoren erklärt werden (Varianzaufklärung 44%). In einer zweiten Studie wurden bei 60 Teilnehmern verschiedene Selbstbericht-Parameter erhoben und die Gedächtnis- und Interozeptionsfähigkeit vor und nach einem Stresstest untersucht. Erwachsene mit einer Vorgeschichte von elterlicher Trennung berichteten mehr bindungsbezogene Angst und Vermeidung als Kontrollpersonen. Das Erlebnis einer elterlichen Scheidung war negativ mit der Gedächtnisleistung nach dem Stresstest korreliert. Weiterhin weisen die Ergebnisse auf einen quadratischen Zusammenhang zwischen Stress und Interozeptionsfähigkeit hin.

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See detailLangzeitkonsequenzen von frühkindlichem Stress: quadratischer Zusammenhang zwischen Stress und Interozeptionsfähigkeit
Schaan, Violetta; Schulz, André; Vögele, Claus

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

Traumatische Belastungen während der Kindheit können das Risiko für die Entwicklung unsicherer Bindungsstile erhöhen, die bereits mit langfristigen psychischen und körperlichen Gesundheitsproblemen in Beziehung gebracht wurden. Die zugrundeliegenden Prozesse sind allerdings noch weitestgehend unklar. Da interozeptive Signale die Regulation negativer Emotionen als Reaktion auf sozialer Zurückweisung begünstigen können, die infolge einer Stressbelastung verändert sein könnten, wurde insbesondere der Effekt von kindlichem Stress auf Interozeption untersucht. Wir präsentieren zwei Studien, die den Zusammenhang zwischen kindlichem Stress und Gesundheit im Erwachsenenalter sowie Körperwahrnehmung und Gedächtnisfähigkeit untersuchen. In der ersten Studie nahmen 199 Teilnehmer an einer Onlineumfrage teil, bei der Gesundheit, frühkindliches Trauma, Resilienz und Zurückweisungssensitivität gemessen wurden. Teilnehmer mit geschiedenen Eltern berichteten erhöhte psychische Belastungswerte, kindliches Trauma, Zurückweisungssensitivität und weniger Resilienz. Die Beziehung zwischen elterlicher Scheidung und psychischer Gesundheit konnte vollständig durch diese vier Faktoren erklärt werden (Varianzaufklärung 44%). In einer zweiten Studie wurden bei 60 Teilnehmern verschiedene Selbstberichts-Parameter erhoben und die Gedächtnis- und Interozeptionsfähigkeit (Schandry Herzschlagwahrnehmungstest/EKG) vor und nach einem sozial-evaluativen Kaltwasser-Stresstest untersucht. Die Reaktion des autonomen Nervensystems wurde mithilfe von Herzraten- und Blutdruckvariabilität bestimmt. Erwachsene mit einer Vorgeschichte von elterlicher Trennung berichteten mehr bindungsbezogene Angst und Vermeidung als Kontrollpersonen. Das Erlebnis einer elterlichen Scheidung war negativ mit der Gedächtnisleistung nach dem Stresstest korreliert. Weiterhin weisen die Ergebnisse auf einen quadratischen Zusammenhang zwischen kindlicher Stressbelastung und Interozeptionsfähigkeit hin. Basierend auf diesen Ergebnissen könnte ein ‚gesunder Normbereich‘ der Interozeptionsfähigkeit existieren. Kindlicher Stress könnte sowohl eine Verringerung, als auch eine Erhöhung der Interozeptionsfähigkeit bewirken, was beides mit gesundheitlichen Problemen assoziiert sein könnte.

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See detailZusammenhang zwischen interozeptiver Genauigkeit und kardiovaskulärer Veränderung nach akutem Stress bei gesunden Frauen
Rost, Silke; Van Dyck, Zoé; Schulz, André; Vögele, Claus

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

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

See detailThe role of parents in children’s emotional ability.
Pinto Costa, Andreia; Steffgen, Georges; Vögele, Claus

Scientific Conference (2017)

Understanding the processes that lead to different emotional responses in children is important for prevention and intervention programs aimed at improving developmental outcomes. Among the many factors that can influence children’s emotional reactivity and emotion regulation, parents and the way they interact with their children can impact children’s emotional responses. Even though the influence of parents in children’s emotional responses has been extensively studied during infancy and toddlerhood, the way parents interact with their preschool and school-aged children during upsetting moments has received little attention. The present study aimed at examining the effects of parental presence and parental interaction during a frustration-eliciting situation on preschoolers’ and school-aged children’s emotional reactivity and emotion regulation. More specifically, it aimed at examining whether parents’ presence during a frustration-eliciting situation (attractive toy removal) influences children’s emotional reactivity and emotion regulation. Moreover, whether children whose parents interact with them differ in emotional reactivity and emotion regulation from those whose parents do not interact with them. A convenience sample of 66 children (19 girls) together with one of their parents participated in the study. Children were aged between 3 and 13 years (Mage=8.65; SDage=2.32) and parents were aged between 26 to 53 years (Mage=40.38; SDage=5.22). For 41 children, parents were present during the frustration-eliciting situation. For the remaining 25 children, parents were absent. Children and parents who were present were videotaped during the situation. Parents’ interaction with their children, children’s emotional reactivity, and children’s emotion regulation during the situation were coded by 2 independent observers. Ethical approval as well as parents’ and children’s informed consent was obtained before conducting the study. It was found that children whose parents were present, compared to children whose parents were absent, expressed more positive emotions [t(63)=3.19, p<.01, r=.37] and less neutral emotions [t(64)=2.92, p<.01, r=.34], but did not differ in the amount of negative emotions [t(64)=0.28, p=.78, r=.03], or in the use of adaptive emotion regulation strategies [t(64)=0.99, p=.33, r=.12]. Regarding parents’ interaction, it was found that children of parents who interacted with them, compared to children of parents who did not interact with them, expressed less neutral emotions [t(39)=2.80, p<.01, r=.41], expressed more positive [t(39)=2.01, p=.05, r=.31] and more negative emotions [t(33)=2.30, p<.05, r=.37], and used more emotion regulation strategies [t(39)=2.55, p<.05, r=.38]. These results show that parents’ presence can have an influence in preschoolers’ and school-aged children’s positive reactivity but not in children’s negative reactivity or in the use of adaptive emotion regulation strategies. Furthermore, when present, parents’ interaction with their children is related to children’s lower neutrality, and to higher positive and negative reactivity. It is also related to children’s use of more adaptive emotion regulation strategies. These results suggest that, either because parents interact more with reactive children, or because children are more expressive with interactive parents, parents’ interaction is related to children’s reactivity and better regulation. Including parents in interventions and providing parents with training on emotional support for their children may be beneficial for improving developmental outcomes in children with emotional difficulties.

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See detailEntwicklung und Validierung eines Fragebogens zur multidimensionalen Erfassung essstörungsspezifischer interozeptiver Körperwahrnehmung: Vorläufige Daten anhand einer gesunden und einer essgestörten Stichprobe
Van Dyck, Zoé; Lutz, Annika; Ortmann, Julie; Schulz, André; Vögele, Claus

in Schorr, A. (Ed.) Abstractband 13. Kongress der Fachgruppe Gesundheitspsychologie der DGPs (2017)

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See detailSleep disturbances and mental strain in university students: results from an online survey in Luxembourg and Germany
Schlarb, Angelika; Claßen, Merle; Grünewald, Julia; Vögele, Claus

in International Journal of Mental Health Systems (2017), 11

OBJECTIVES: This study examined the prevalence of sleep disturbances and mental strain in students from two European countries, Luxembourg and Germany. METHODS: A total of 2831 students took part in an online survey, with 2777 students from Germany and 184 students from Luxembourg. Sleep disturbances were assessed with the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale, and aspects of mental strain using the Patient Health Questionnaire, the Social-Interactive-Anxiety Scale, the self-efficacy questionnaire and the test anxiety questionnaire. In addition, we also assessed students' chronotypes. RESULTS: Across the whole sample mean scores on the sleep questionnaires were above the cut-off for clinically relevant sleep problems, indicating an increased prevalence of sleep disturbances in students from both countries. Sleep quality was impaired in 42.8%, and 17.9% showed clinically relevant scores. Overall 25.5% reported elevated depression and 13.3% social phobia symptoms, while 45% indicated elevated stress levels. Sleep quality, daytime sleepiness, chronotype, depression scores, stress levels, test anxiety, and self-efficacy differed significantly between men and women, but there were no differences between countries. CONCLUSIONS: Sleep disturbances and mental strain in students are common, with the current results replicating previous findings. Students from Luxembourg and Germany are affected equally.

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See detailGastric modulation of startle eye blink
Schulz, André; Van Dyck; Lutz, Annika; Rost, Silke; Vögele, Claus

in Biological Psychology (2017), 127(1), 25-33

Abstract: Previous assessment methods of gastric interoception either rely on self-reports, or imply invasive procedures. We investigated the reliability of startle methodology as a non-invasive alternative for the assessment of afferent gastric signals. Twenty-four participants were tested on three separate days, on which they were requested to ingest water (either 0, 300 or 600 ml), after 8 h of fasting. On each assessment day, eye blink responses (EMG) to 10 acoustic startle stimuli (105 dB) were assessed at 4 measurement points (before, 0, 7, 14 min. after ingestion). Increased normogastric responses (EGG), ratings of satiety and fullness, and higher heart rate variability (RMSSD) suggested effective non-invasive induction of gastric distention. Startle responses were lower directly after ingestion of 600 ml as compared to earlier and later measurements. These results suggest that startle methodology provides a reliable method to investigate afferent gastric signals. It could be useful to study possible dissociations between subjective reports and objective afferent gastric signals in eating or somatoform disorders.

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See detailSleep and somatic complaints in university students
Schlarb, Angelika; Claßen, Merle; Hellmann, Sara; Vögele, Claus; Gulewitsch, Marco

in Journal of Pain Research (2017), 10

Background: Sleep problems are common among university students. Poor sleep is associated with impaired daily functioning, increased risk of psychiatric symptoms, and somatic complaints such as pain. Previous results suggest that poor sleep exacerbates pain, which in turn negatively affects sleep. The purpose of the present study was to determine prevalence rates, comorbidity, and role of depression as a factor of moderating the relationship between sleep and physical complaints in German university students. Samples and methods: In total, 2443 German university students (65% women) completed a web survey. Self-report measures included the Pittsburg Sleep Quality Index, three modules of the Patient Health Questionnaire, and a questionnaire on the functional somatic syndromes (FSSs). Results: More than one-third (36.9%) reported poor sleep as assessed by the Pittsburgh Sleep Quality Index. Somatoform syndrome was identified in 23.5%, and the prevalence of any FSS was 12.8%. Self-reported sleep quality, sleep onset latency, sleep disturbances, use of sleep medications, and daytime dysfunctioning were significant predictors of somatoform syndrome, whereas sleep efficiency and sleep duration influenced somatic complaints indirectly. Moderate correlations were found between stress, anxiety, somatoform syndrome, depression, and overall sleep quality. The effect of somatic complaints on sleep quality was associated with the severity of depression. Anxiety shows direct effects on somatization and depression but only indirect associations with sleep quality.

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See detailAffective evaluation of body images in anorexia nervosa
Lutz, Annika; Herbert, Cornelia; Schulz, André; Voderholzer, Ulrich; Koch, Stefan; Vögele, Claus

in Psychophysiology (2017), 54(S1),

Anorexia nervosa is characterized by fear of weight gain. This is reflected in amygdala activation during confrontation with distorted photographs of oneself simulating weight gain. In contrast, photographs of emaciated women induce startle attenuation, suggesting a positive valuation of extreme slimness. To combine these findings, we applied an affective startle modulation paradigm containing photos of the participants simulating weight gain and photos simulating weight loss. We assessed eye-blink startle responses via EMG in 20 women with anorexia nervosa (AN; mean age = 25 years; mean BMI = 23) and 20 healthy control women (HC; mean age = 25 years; mean BMI = 23). We were able to replicate affective startle modulation of standard positive, negative, and neutral pictures, except for an absence of startle attenuation for positive pictures in AN. Body images did not modulate the startle response in either group. This was in contrast to the subjective ratings, in which the AN group indicated negative valence and high arousal for distorted body images. The body photographs used in our study emphasized general body shape and it appears that this was not threatening to AN patients. Photos highlighting body details might produce different results. Considering that body image exposure, a frequently used intervention tool for AN, aims at fear reduction through habituation, it is essential to determine which aspects of the body actually elicit fear responses to maximize therapy outcome.

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See detailAngst vor körperlicher Bewegung bei Patienten mit Herzinsuffizienz und gesunden Senioren – Ein psychophysiologisches Experiment basierend auf dem Schreckreflex-Paradigma
Hoffmann, Jeremy; Finke, Johannes; Vögele, Claus; Schulz, André; Spaderna, Heike

in Schorr, A. (Ed.) Abstractband 13. Kongress der Fachgruppe Gesundheitspsychologie der DGPs (2017)

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See detailGreen exercise is associated with better cell ageing profiles
Olafsdottir, Gunnthora; Cloke, Paul; Epel, Elissa; Lin, Jue; Van Dyck, Zoé; Thorleifsdottir, Björg; Eysteinsson, Thor; Gudjonsdottir, Marta; Vögele, Claus

in The European Journal of Public Health (2016, November 01), 26(Suppl 1), 165021

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See detailResilience and rejection sensitivity mediate long-term outcomes of parental divorce
Schaan, Violetta; Vögele, Claus

in European Child and Adolescent Psychiatry (2016), 25(11), 1267-1269

Introduction: Increasing divorce rates leave more and more children to deal with the separation of their parents. Recent research suggests that children of divorced parents more often experience psychological and physical symptoms than children of non-divorced parents. The processes that mediate the relationship between parental divorce and ill-health, however, are still elusive. The current study investigated the mediating role of psychological factors such as resilience and rejection sensitivity on the long-term consequences of parental divorce in young adults. Methods: One hundred and ninety-nine participants (mean age 22.3 years) completed an online survey including measures of mental health, childhood trauma, resilience and rejection sensitivity. Results: Participants with divorced parents (33%) reported increased levels of psychological symptoms, childhood trauma, rejection sensitivity and lower levels of resilience. The association between parental divorce and mental health was fully mediated by resilience, rejection sensitivity and childhood trauma. The mediation model explained up to 44% of the total variance in mental health symptoms. Discussion: Resilience and rejection sensitivity are crucial factors for successful coping with the experience of parental separation. Prevention programs that help to boost children’s resilience might help to reduce the long-term effects of parental divorce on their attachment style (e.g. rejection sensitivity), thereby improving their mental health on the long run. Furthermore, the results call for parental awareness and counseling to target and reduce the observed increased level of childhood trauma. Limitations concern the cross-sectional and retrospective design of the study.

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See detailThe Water Load Test As a Measure of Gastric Interoception: Development of a Two-Stage Protocol and Application to a Healthy Female Population
Van Dyck, Zoé; Vögele, Claus; Blechert, Jens; Lutz, Annika; Schulz, André; Herbert, Beate M.

in PLoS ONE (2016), 11(9), 0163574

The sensitivity for one’s own internal body signals (i.e., interoception) has been demonstrated to play an important role in the pathogenesis of eating and weight disorders. Most previous measures assessing interoceptive processing have not, or only partly, captured perception of hunger and satiety cues, which is a core aspect of interoceptive deficits in eating disorders. In addition, methods used to measure sensitivity to gastric signals are heterogeneous and findings inconsistent. The primary aim of the present study was to establish a standardised test to measure gastric interoception, and to provide normative data using a non-clinical adult sample. The two-step Water Load Test (WLT-II) involves ingestion of non-caloric water until perceived satiation (step 1) and until maximum fullness (step 2). The WLT-II consists of several variables: Besides volumes of water ingested until satiation and maximum fullness expressed in ml, percentage of satiation to maximum fullness is calculated as an individual index of gastric interoception that is not confounded with stomach capacity. Ninety-nine healthy women participated in the study. Measures included the WLT-II, the heartbeat tracking test, a self-report questionnaire assessing subjective sensations, and the Eating Disorder Inventory-2. Twenty-eight participants underwent test-retest of the WLT-II. Results suggest that the WLT-II is a valid and reliable measure of gastric interoception. Importantly, satiation volume and percentage of satiation to maximum fullness were strongly positively related to self-reported bulimic symptoms, indicating that the WLT-II could emerge as a useful clinical tool to measure interoceptive processing in the field of eating disorders.

See detailInterozeption bei Anorexia nervosa: Befunde auf subjektiver und elektrophysiologischer Ebene
Lutz, Annika; Schulz, André; Voderholzer, Ulrich; Koch, Stefan; Vögele, Claus

Scientific Conference (2016, September)

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See detailCardiac modulation of startle is altered in depersonalization-/derealization disorder: evidence for impaired brainstem representation of baro-afferent neural traffic
Schulz, André; Matthey, J. H.; Vögele, Claus; Schaan, Violetta; Schächinger, H.; Adler, J.; Beutel, M.; Michal, M.

in Psychiatry Research (2016), 240(1), 4-10

Patients with depersonalization-/derealization disorder (DPD) show altered heartbeat-evoked brain potentials, which are considered psychophysiological indicators of cortical representation of visceral-afferent neural signals. The aim of the current investigation was to clarify whether the impaired CNS representation of visceral-afferent neural signals in DPD is restricted to the cortical level or is also present in sub-cortical structures. We used cardiac modulation of startle (CMS) to assess baro-afferent signal transmission at brainstem level in 22 DPD and 23 healthy control individuals. The CMS paradigm involved acoustic startle stimuli (105 dB(A), 50 ms) elicited 0, 100, 200, 300, 400 and 500 ms after a cardiac R-wave. In healthy control individuals, we observed lower startle responses at 100 and 300 ms than at 0 and 400 ms after an R-wave. In DPD patients, no effect of the cardiac cycle on startle response magnitude was found. We conclude that the representation of visceral-afferent neural signals at brainstem level may be deficient in DPD. This effect may be due to increased peripheral sympathetic tone or to dysregulated signal processing at brainstem level.

See detailEarly life adversity associates with increased depressive symptoms and few active T cells in adulthood
Elwenspoek, Martha; Schaan, Violetta; Hengesch, Xenia; Vögele, Claus; Schächinger, Hartmut; Muller, Claude; Turner, Jonathan

Poster (2016, June)

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See detailA meta-analysis on resting state high-frequency heart rate variability in Bulimia Nervosa
Peschel, Stephanie K.V.; Feeling, Nicole R.; Vögele, Claus; Kaess, Michael; Thayer, Julian F.; Koenig, Julian

in European Eating Disorders Review (2016), 24(5), 355-365

Objective: Autonomic nervous system (ANS) function is altered in eating disorders. We aimed to quantify differences in resting state vagal activity, indexed by high-frequency heart rate variability (HF-HRV) comparing patients with bulimia nervosa (BN) and healthy controls. Methods: A systematic search of the literature to identify studies eligible for inclusion and meta-analytical methods were applied. Meta-regression was used to identify potential covariates. Results: 8 studies reporting measures of resting HF-HRV in individuals with BN (n=137) and controls (n=190) were included. Random-effects meta-analysis revealed a sizeable main effect (Z=2.22, p=.03; Hedge’s g=0.52, 95%CI[0.06;0.98]) indicating higher resting state vagal activity in individuals with BN. Meta-regression showed that BMI and medication intake are significant covariates. Discussion: Findings suggest higher vagal activity in BN at rest, particularly in un-medicated samples with lower body mass index. Potential mechanisms underlying these findings and implications for routine clinical care are discussed.

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See detailPsychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia
Powell, Rachael; Scott, Neal; Manyande, Anne; Bruce, Julie; Vögele, Claus; Byrne-Davies, Lucie; Unsworth, Mary; Osmer, Christian; Johnston, Marie

in Cochrane Database of Systematic Reviews (Online) (2016), (5), 1-279

In a review and meta-analysis conducted in 1993, psychological preparation was found to be beneficial for a range of outcome variables including pain, behavioural recovery, length of stay and negative affect. Since this review, more detailed bibliographic searching has become possible, additional studies testing psychological preparation for surgery have been completed and hospital procedures have changed. The present review examines whether psychological preparation (procedural information, sensory information, cognitive intervention, relaxation, hypnosis and emotion-focused intervention) has impact on the outcomes of postoperative pain, behavioural recovery, length of stay and negative affect. Selection criteria We included randomized controlled trials of adult participants (aged 16 or older) undergoing elective surgery under general anaesthesia. We excluded studies focusing on patient groups with clinically diagnosed psychological morbidity. We did not limit the search by language or publication status. We included studies testing a preoperative psychological intervention that included at least one of these seven techniques: procedural information; sensory information; behavioural instruction; cognitive intervention; relaxation techniques; hypnosis; emotion-focused intervention. We included studies that examined any one of our postoperative outcome measures (pain, behavioural recovery, length of stay, negative affect) within one month post-surgery. Data collection and analysis One author checked titles and abstracts to exclude obviously irrelevant studies. We obtained full reports of apparently relevant studies; two authors fully screened these. Two authors independently extracted data and resolved discrepancies by discussion. Where possible we used random-effects meta-analyses to combine the results from individual studies. For length of stay we pooled mean differences. For pain and negative affect we used a standardized effect size (the standardized mean difference (SMD), or Hedges’ g) to combine data from different outcome measures. If data were not available in a form suitable for meta-analysis we performed a narrative review. Main results Searches identified 5116 unique papers; we retrieved 827 for full screening. In this review, we included 105 studies from 115 papers, in which 10,302 participants were randomized. Mainly as a result of updating the search in July 2015, 38 papers are awaiting classification. Sixty-one of the 105 studies measured the outcome pain, 14 behavioural recovery, 58 length of stay and 49 negative affect. Participants underwent a wide range of surgical procedures, and a range of psychological components were used in interventions, frequently in combination. In the 105 studies, appropriate datawere provided for themeta-analysis of 38 studiesmeasuring the outcome postoperative pain (2713 participants), 36 for length of stay (3313 participants) and 31 for negative affect (2496 participants). We narratively reviewed the remaining studies (including the 14 studies with 1441 participants addressing behavioural recovery). When pooling the results for all types of intervention there was low quality evidence that psychological preparation techniques were associated with lower postoperative pain (SMD -0.20, 95% confidence interval (CI) -0.35 to -0.06), length of stay (mean difference -0.52 days, 95% CI - 0.82 to -0.22) and negative affect (SMD -0.35, 95% CI -0.54 to -0.16) compared with controls. Results tended to be similar for all categories of intervention, although there was no evidence that behavioural instruction reduced the outcome pain. However, caution must be exercised when interpreting the results because of heterogeneity in the types of surgery, interventions and outcomes. Narratively reviewed evidence for the outcome behavioural recovery provided very low quality evidence that psychological preparation, in particular behavioural instruction, may have potential to improve behavioural recovery outcomes, but no clear conclusions could be reached. Generally, the evidence suffered from poor reporting, meaning that few studies could be classified as having low risk of bias. Overall,we rated the quality of evidence for each outcome as ‘low’ because of the high level of heterogeneity in meta-analysed studies and the unclear risk of bias. In addition, for the outcome behavioural recovery, too few studies used robust measures and reported suitable data for meta-analysis, so we rated the quality of evidence as ’very low’. Authors’ conclusions The evidence suggested that psychological preparation may be beneficial for the outcomes postoperative pain, behavioural recovery, negative affect and length of stay, and is unlikely to be harmful. However, at present, the strength of evidence is insufficient to reach firm conclusions on the role of psychological preparation for surgery. Further analyses are needed to explore the heterogeneity in the data, to identify more specifically when intervention techniques are of benefit. As the current evidence quality is low or very low, there is a need for well-conducted and clearly reported research.

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See detailDiscourses of sexual relationships in a sample of German and British young people: A Q methodological study
Franz, Anke; Worrell, Marcia; Vögele, Claus

in Culture, Health and Sexuality (2016), 18(4), 391-404

Young people live in an environment, which sexualises young people, particularly women, along traditional gender roles. This, in parallel with a silence about positive sexuality in policy development, means that sexual double standards prevail in young people’s lives. The aim of this study was to explore the discourses young women and men from two European countries, Germany and England, draw on when making sense of sexual relationships, and how these are steeped in the local cultural climate and messages. The study used Q methodology and included 65 German and English young people between 16 and 19 years of age. Six accounts emerged: sex as responsible, intimate and shared experience; sex as joint fun; ideal versus reality; sex has to be responsible, consensual and shared; caring relationships offer the perfect context for fulfilling sex; and equality between partners. The importance of cultural context in the availability of specific dominant and alternative discourses is discussed with a focus on how this influences young people’s sense-making with regard to sexuality and sexual relationships. Future directions for research are highlighted.

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See detailVerhaltensmedizinische Modelle bei körperlicher Erkrankung
Vögele, Claus; Schulz, André

in Psychotherapie im Dialog (2016), 17(1), 30-33

Die Annahme, dass psychische Faktoren zur Entwicklung körperlicher Krankheiten beitragen könnten, hat eine lange Tradition in den Gesundheitswissenschaften. Verschiedene Teildisziplinen der Psychologie wie die Klinische Psychologie und die Gesundheitspsychologie sowie interdisziplinäre Fachgebiete wie die Verhaltensmedizin widmen sich der Untersuchung ätiologisch bedeutsamer oder aufrechterhaltender Faktoren des menschlichen Verhaltens und Erlebens. Mithilfe der gewonnenen Erkenntnisse über Ursache-Wirkungs-Zusammenhänge können Diagnose- und Behandlungsmethoden entwickelt werden.

See detailThe effects of physical activity on emotion regulation in adolescents
Ouzzahra, Yacine; Vögele, Claus; Mata, Jutta

Scientific Conference (2016, February 27)

A growing body of evidence suggests an important contribution of physical activity to psychological well-being. While much of this research has focused on mood, less is known regarding emotion regulation. The present study investigated acute and chronic effects of exercise on responses to emotional stimuli in adolescents. Male and female students (N=40) aged 15-18 years participated in a two conditions, repeated-measures, fully counterbalanced design. In the first part of each session heart rate, electrodermal activity, respiration rate and heart rate variability were continuously recorded during a 10-min baseline. This was followed by a previously validated anger-provoking video-clip lasting 2-6 minutes. Participants rated the level of arousal and discrete emotions they experienced in response to the clip. The second part of the experiment consisted of a 30 minutes intervention period (rest or stationary cycling), immediately followed by another video-clip and questionnaire. The ongoing data analysis consists of (1) comparisons between conditions (acute effects) and (2) analyses of covariance regarding the physiological changes in response to the emotional stimuli, with participants’ fitness level used as a covariant (chronic effects). Preliminary results indicate that in the exercising condition, participants reported significantly lower levels of arousal, anxiety, anger, surprise and disgust, compared with the resting condition (p≤0.05). In contrast, fear, shame, sadness, and calmness did not differ between conditions. Further analyses will reveal whether participants’ physical fitness and heart rate variability had an impact on their physiological and psychological reactivity to the negative emotional stimuli.

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See detailInterozeption bei Anorexia nervosa: Befunde auf subjektiver und elektrophysiologischer Ebene
Lutz, Annika; Schulz, André; Voderholzer, Ulrich; Koch, Stefan; Vögele, Claus

in 15. Kongress der Deutschen Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation. Verhaltensmedizin 2.0 - von eHealth zu mHealth. 25. bis 27. Februar 2016, Johannes Gutenberg-Universität Mainz. Abstractband (2016, February)

See detailRégulation émotionnelle et activité physique chez les adolescents
Ouzzahra, Yacine; Vögele, Claus

Scientific Conference (2016, January 20)

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See detailFood, eating and emotions: les liaisons dangereuses
Vögele, Claus

in Journal of Behavioral Addictions (2016), 5(Suppl 1), 3

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See detailHerz-Kreislauf-Erkrankungen
Vögele, Claus

in Ehlert, Ulrike (Ed.) Verhaltensmedizin (2016)

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See detailEarly life adversity and rejection sensitivity
Schaan, Violetta; Vögele, Claus

in Early life adversity and rejection sensitivity (2016)

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See detailDoes anyone still understand me? Psychotherapy and multilingualism.
Karp, Mélanie; Vögele, Claus

in Verhaltenstherapie (2016)

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See detailRéactivité physiologique et conscience intéroceptive dans les troubles anxieux pédiatriques : une revue conceptuelle et empirique
Rossignol, Mandy; Philippot, Pierre; Vögele, Claus

in Santé Mentale au Québec (2016), 41(1), 183-222

Objectives: This review summarizes data relative to objective and subjective measures of body responses in children and adolescents with anxiety. Methods: We reviewed 24 studies measuring (1) cardiac responses and (2) interoceptive processes in children and adolescents with anxiety. Results: Anxious children and adolescents generally do not differ from their non-anxious peers on their cardiac parameters and objective physiological reactivity to stressful events but some results suggest reduced autonomic flexibility in pediatric anxiety related to chronic anxiety. Moreover, anxiety does not alter interoceptive accuracy, but youths with anxiety misinterpret the intensity and the visibility of their symptoms. Conclusions: Interoception is biased in pediatric anxiety. Further studies are needed to provide information about the role of perceptual, attentional, and interpretative processes underlying these biases, as well as to determine the respective influence of anxiety type and symptoms intensity.

See detailMit Ärger konstruktiv umgehen
Steffgen, Georges; de Boer, Claudia; Vögele, Claus

Book published by Hogrefe (2016)

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See detailInteroception in anorexia nervosa: evidence at cortical and self-report levels
Lutz, Annika; Schulz, André; Voderholzer, Ulrich; Koch, Stefan; Vögele, Claus

in Appetite (2016), 107

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

in Philosophical Transactions : 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 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.

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See detailGerman version of the Intuitive Eating Scale: Psychometric evaluation and application to an eating disordered population
Van Dyck, Zoé; Herbert, Beate M; Happ, Christian; Kleveman, Gillian V; Vögele, Claus

in Appetite (2016), 105

Intuitive eating has been described to represent an adaptive eating behaviour that is characterised by eating in response to physiological hunger and satiety cues, rather than situational and emotional stimuli. The Intuitive Eating Scale-2 (IES-2) has been developed to measure such attitudes and behaviours on four subscales: unconditional permission to eat (UPE), eating for physical rather than emotional reasons (EPR), reliance on internal hunger and satiety cues (RHSC), and body-food choice congruence (B-FCC). The present study aimed at validating the psychometric properties of the German translation of the IES-2 in a large German-speaking sample. A second objective was to assess levels of intuitive eating in participants with an eating disorder diagnosis (anorexia nervosa, bulimia nervosa, or binge eating disorder). The proposed factor structure of the IES-2 could be confirmed for the German translation of the questionnaire. The total score and most subscale scores were negatively related to eating disorder symptomatology, problems in appetite and emotional awareness, body dissatisfaction, and self-objectification. Women with eating disorders had significantly lower values on all IES-2 subscale scores and the total score than women without an eating disorder diagnosis. Women with a binge eating disorder (BED) diagnosis had higher scores on the UPE subscale compared to participants with anorexia nervosa (AN) or bulimia nervosa (BN), and those diagnosed with AN had higher scores on the EPR subscale than individuals with BN or BED. We conclude that the German IES-2 constitutes a useful self-report instrument for the assessment of intuitive eating in German-speaking samples. Further studies are warranted to evaluate psychometric properties of the IES-2 in different samples, and to investigate its application in a clinical setting.

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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; Larra, M.; Rost, Silke; Mertens, Vera-Christina; Vögele, Claus; Schächinger, H.

in Kubiak, T.; Wessa, M.; Witthöft, M.; Ditzen, B.; Zahn, D. (Eds.) 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) 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.

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See detailGastrische Modulation der Schreckreaktion und gastrisch-evozierte Potenziale: zwei neue psychophysiologische Indikatoren für Interozeption des gastrointestinalen Systems
Schulz, André; Schaan, L.; Van Dyck, Zoé; Lutz, Annika; Trojan, J.; Vögele, Claus

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; Herbert, Cornelia; Schulz, André; Voderholzer, Ulrich; Koch, Stefan; Vögele, Claus

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 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.

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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; Theisen-Flies, Christiane; Federspiel, Carine; Sütterlin, Stefan

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 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.

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See detailMaking sense of what you sense: Disentangling interoceptive awareness, sensibility and accuracy
Forkmann, Thomas; Scherer, Anne; Meessen, Judith; Michal, Matthias; Schächinger, Hartmut; Vögele, Claus; Schulz, André

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 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.

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See detailAffective instability in patients with chronic pain: a diary approach
Rost, Silke; Van Ryckeghem, Dimitri; Koval, Peter; Sütterlin, Stefan; Vögele, Claus; Crombez, Geert

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 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.

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See detailInterozeption bei Depersonalisations-/Derealisationsstörung: veränderte Repräsentation afferenter Körpersignale auf Ebene des Kortex und des Hirnstamms
Schulz, André; Matthey, J. H.; Köster, S.; Rechlein, B.; Beutel, M.; Schächinger, H.; Vögele, Claus; Michal, M.

in Kubiak, T.; Wessa, M.; Witthöft, M.; Ditzen, B.; Zahn, D. (Eds.) 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 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.

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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; Pawelzik, Markus; van Randenborgh, Annette; Victor, Daniela; Vögele, Claus

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 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.

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See detailA systematic review on heart rate variability in Bulimia Nervosa
Peschel, Stephanie K.V.; Feeling, Nicole R.; Vögele, Claus; Kaess, Michael; Thayer, Julian F.; Koenig, Julian

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 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.

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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; Andersson, S; DeSchepper, J; Giess, I; Vanbesien, J; De Waele, K; Van Aken, S; Craen, M; Vögele, Claus; Cools; Haraldsen, IR

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 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.

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See detailGoals in Nutrition Science 2015–2020
Allison, David B.; Bassaganya-Riera, Josep; Burlingname, Barbara; Brown, Andrew W.; le Coutre, Johannes; Dickson, Suzanne L.; van Eden, Willem; Garssen, Johan; Hontecillas, Raquel; Khoo, Chor San H.; Knorr, Dietrich; Kussmann, Martin; Magistretti, Pierre J.; Mehta, Tapan; Meule, Adrian; Rychlik, Michael; Vögele, Claus

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 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.

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See detailInteroception and Stress
Schulz, André; Vögele, Claus

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

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See detailZentralnervöse Verarbeitung von Körpersignalen bei Anorexia nervosa
Lutz, Annika; Schulz, André; Voderholzer, Ulrich; Koch, Stefan; Vögele, Claus

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; Galasso, Francesca; Widhalm, Kurt; Berchialla, Paola; Baldi, Ileana

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 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.

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See detailBehavioral Medicine
Vögele, Claus

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 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.

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See detailPersonalized Medicine
Phillips, Robert; Vögele, Claus

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 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.

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

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; Van Dyck, Zoé; Lutz, Annika; Vögele, Claus

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; Schulz, André; Blechert, J.; Vögele, Claus

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

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See detailEmotions matter: Affektive und kardiale Modulation der Schreckreaktion
Schaan, Violetta; Schächinger, H.; Vögele, Claus; Schulz, André

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

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See detailWahrnehmung körperinterner Signale bei Bulimia Nervosa und Binge-Eating-Störung
Van Dyck, Zoé; Schulz, André; Blechert, J.; Herbert, B.; Vögele, Claus

in Wittchen, H.-U.; Härtling, S.; Hoyer, J. (Eds.) Abstractband - Wieviel Psychologie steckt in der Psychotherapie? (2015)

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See detailZentralnervöse Verarbeitung von Körpersignalen bei Anorexia nervosa
Lutz, Annika; Schulz, André; Voderholzer, U.; Koch, S.; Vögele, Claus

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

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See detailInteroception in anorexia nervosa: evidence at cortical and self-report levels
Lutz, Annika; Schulz, André; Voderholzer, Ulrich; Koch, Stefan; Vögele, Claus

in 45th Annual Congress of the European Association for Behavioural and Cognitive Therapies (EABCT) (2015)

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See detailInteroception and symptom reporting: Disentangling accuracy and bias.
Petersen, Sibylle; Van Staeyen, Ken; Vögele, Claus; Van den Bergh, Omer

in Frontiers in Psychology (2015)

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See detailGastrisch-evozierte Potenziale: ein neurophysiologischer Indikator für die kortikale Repräsentation afferenter Signale aus dem gastrointestinalen System
Schaan, L.; Van Dyck, Zoé; Lutz, Annika; Trojan, J.; Vögele, Claus; Schulz, André

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

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See detailAffektive Bewertung von Körperbildern bei Anorexia nervosa
Lutz, Annika; Herbert, C.; Schulz, André; Voderholzer, U.; Koch, S.; Vögele, Claus

in Wittchen, H.-U.; Härtling, S.; Hoyer, J. (Eds.) Abstractband - Wieviel Psychologie steckt in der Psychotherapie? (2015)

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See detailBody or cup? Alterations in featural and configural body image processing in anorexia nervosa
Lutz, Annika; Herbert, Cornelia; Schulz, André; Voderholzer, Ulrich; Koch, Stefan; Vögele, Claus

in Psychophysiology (2015), 52(supplement 1), 123

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See detailAltered patterns of heartbeat-evoked potentials in depersonalization/derealization disorder: neurophysiological evidence for impaired cortical representation of bodily signals
Schulz, André; Köster, S.; Beutel, M. E.; Schächinger, H.; Vögele, Claus; Rost, Silke; Rauh, M.; Michal, M.

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

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

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See detailInterozeption bei Depersonalisations-/Derealisationsstörung: veränderte kortikale Repräsentation afferenter Körpersignale bei intakter Repräsentation auf Hirnstammebene
Schulz, André; Matthey, J. H.; Köster, S.; Reuchlein, B.; Beutel, M.; Schächinger, H.; Vögele, Claus; Michal, M.

in Wittchen, H.-U.; Härtling, S.; Hoyer, J. (Eds.) Abstractband - Wieviel Psychologie steckt in der Psychotherapie? (2015)

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See detailShort-term food deprivation increases amplitudes of heartbeat-evoked potentials
Schulz, André; Ferreira de Sá, D. S.; Dierolf, Angelika; Lutz, Annika; Van Dyck, Zoé; Vögele, Claus; Schächinger, H.

in Psychophysiology (2015), 52(5), 695-703

Nutritional state, i.e. fasting or non-fasting, may affect the processing of interoceptive signals, but mechanisms underlying this effect remain unclear. We investigated 16 healthy women on two separate days: when satiated (standardized food intake) and after an 18 h food deprivation period. On both days, heartbeat-evoked potentials (HEPs) and cardiac and ANS activation indices (heart rate, nLF HRV) were assessed. The HEP is an EEG pattern that is considered an index of cortical representation of afferent cardiovascular signals. Average HEP activity (R-wave +455-595 ms) was enhanced during food deprivation compared to normal food intake. Cardiac activation did not differ between nutritional conditions. Our results indicate that short-term food deprivation amplifies an electrophysiological correlate of the cortical representation of visceral-afferent signals originating from the cardiovascular system. This effect could not be attributed to increased cardiac activation, as estimated by heart rate and nLF HRV, after food deprivation.

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See detailPhysical activity and depression predict event-free survival in heart transplant candidates
Spaderna, Heike; Vögele, Claus; Barten, Markus J.; Smits, Jacqueline M.A.; Bunyamin, Vina; Weidner, Gerdi; Waiting for a new heart study group

in Health Psychology (2014), 33(11), 1328-1336

Objective: This study prospectively evaluated the relationship of physical activity (PA), depression and anxiety to event-free survival during waiting-time for heart transplantation in ambulatory patients enrolled in the “Waiting for a New Heart Study”. Methods: Data from 227 ambulatory patients newly listed for heart transplantation was analyzed. Everyday PA (number of activities, caloric expenditure), depression, and anxiety at time of listing were assessed via questionnaires. Events were defined as death, high-urgency transplantation, delisting due to clinical deterioration, and mechanical circulatory support device implantation (MCSD). Associations of PA scores, depression and anxiety with event-free survival were analyzed using Cox proportional hazards models. Covariates included age, sex, BMI, and objective indicators of disease severity. Results: After a median follow-up of 478 days (6-1849 days), 132 events occurred (46 deaths, 20 MCSDs, 54 high-urgency transplantations, 12 delistings). A higher number of activities was significantly associated with a reduced hazard ratio (HR) to experience an event (HR=.88, 95% CI .81-.96), while depression increased this risk (HR=1.64, 95% CI 1.16-2.32). Both effects remained significant in multivariate analyses (HR=.91, 95% CI .83-.99; HR=1.60, 95% CI 1.12-2.29, p-values<.02). No significant interactions between PA scores and emotions were observed and anxiety was unrelated to survival. Conclusion: Both everyday physical activity and the absence of depression prolonged event-free survival in ambulatory heart transplant candidates. These findings were independent of objective measures of disease severity. Patients waiting for cardiac transplantation may benefit from interventions focused on increasing their everyday physical activity and reducing depressive symptoms.

See detailElicitation of Negative Emotions in Adolescents using Video Clips
Ouzzahra, Yacine; Vögele, Claus

Poster (2014, September 05)

See detailPerseverative Cognition in Fibromyalgia
Rost, Silke; Van Ryckeghem, Dimitri; Sütterlin, Stefan; Vögele, Claus; Crombez, Geert

Scientific Conference (2014, September 04)

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See detailDreaming and health (Chapter 37)
Vögele, Claus

in Tranquillo, Nicholas (Ed.) Dream consciousness: Allan Hobson's new approach to the brain and its mind (2014)

This book presents three lectures by Allan Hobson, entitled “The William James Lectures on Dream Consciousness”. The three lectures expose the new psychology, the new physiology and the new philosophy that derive from and support the protoconsciousness hypothesis of dreaming. They review in detail many of the studies on sleep and dreaming conducted since the days of Sigmund Freud. Following the lectures are commentaries written by scholars whose expertise covers a wide range of scientific disciplines including, but not limited to, philosophy, psychology, neurology, neuropsychology, cognitive science, biology, and animal sciences. The commentaries each answer a specific question in relation to Hobson’s lectures and his premise that dreaming is an altered state of consciousness. Capitalizing on a vast amount of data, the lectures and commentaries provide undisputed evidence that sleep consists of a well-organized sequence of subtly orchestrated brain states that undoubtedly play a crucial function in the maintenance of normal brain functions. These functions include both basic homeostatic processes necessary to keep the organism alive as well as the highest cognitive functions including perception, decision making, learning and consciousness.

See detailThe role of affective instability on daily chronic pain outcomes
Rost, Silke; Van Ryckeghem, Dimitri; Koval, Peter; Sütterlin, Stefan; Vögele, Claus; Crombez, Geert

Poster (2014, August 21)

See detailThe influence of emotional instability on daily pain outcomes in chronic pain patients
Van Ryckeghem, Dimitri; Rost, Silke; Vögele, Claus; Koval, Peter; Sütterlin, Stefan; Crombez, Geert

Poster (2014, May)

See detailDie Bedeutung der Interozeption für eine gesunde Regulierung des Essverhaltens
Van Dyck, Zoé; Vögele, Claus

Scientific Conference (2014, March 17)

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See detailFood-cue affected motor response inhibition and self-reported dieting success: a pictorial affective shifting task
Meule, Adrian; Lutz, Annika; Krawietz, Vera; Stützer, Judith; Vögele, Claus; Kübler, Andrea

in Frontiers in Psychology (2014), 5(216),

Behavioral inhibition is one of the basic facets of executive functioning and is closely related to self-regulation. Impulsive reactions, i.e. low inhibitory control, have been associated with higher body-mass-index (BMI), binge eating, and other problem behaviors (e.g. substance abuse, pathological gambling, etc.). Nevertheless, studies which investigated the direct influence of food-cues on behavioral inhibition have been fairly inconsistent. In the current studies, we investigated food-cue affected behavioral inhibition in young women. For this purpose, we used a go/no-go task with pictorial food and neutral stimuli in which stimulus-response mapping is reversed after every other block (affective shifting task). In study 1, hungry participants showed faster reaction times to and omitted fewer food than neutral targets. Low dieting success and higher BMI were associated with behavioral disinhibition in food relative to neutral blocks. In study 2, both hungry and satiated individuals were investigated. Satiation did not influence overall task performance, but modulated associations of task performance with dieting success and self-reported impulsivity. When satiated, increased food craving during the task was associated with low dieting success, possibly indicating a preload-disinhibition effect following food intake. Food-cues elicited automatic action and approach tendencies regardless of dieting success, self-reported impulsivity, or current hunger levels. Yet, associations between dieting success, impulsivity, and behavioral food-cue responses were modulated by hunger and satiation. Future research investigating clinical samples and including other salient non-food stimuli as control category is warranted.

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See detailZusammenhänge zwischen Essverhalten und Interozeption: Der Einfluss von kurzzeitiger Nahrungsdeprivation auf die Herzschlagdetektion
Van Dyck, Zoé; Schulz, André; Vögele, Claus

in Verleger, R.; Krämer, U.; Beyer, F.; Schildmann, M.; Tzvi, E.; Wilhoeft, A. (Eds.) Abstractband 40. Tagung "Psychologie und Gehirn" (2014)

Einleitung: Eine reduzierte interozeptive Wahrnehmung ist ein wichtiges Kernmerkmal von Essverhalten, das mit einem erhöhten Risiko für die Entwicklung von Essstörungen und Adipositas einhergeht. Die Wahrnehmung körperinterner Signale von Hunger und Sättigung ist beeinträchtigt und das Essverhalten ist von kognitiver Kontrolle, äußeren Reizen oder auch Affektzuständen gesteuert. Auf der anderen Seite wurde gezeigt, dass die experimentelle Manipulation von Essverhalten durch kurzzeitiges Fasten, die Genauigkeit der Wahrnehmung interozeptiver Signale erhöht. Ziel: Die vorliegende Studie hatte zum Ziel, den Ein-fluss von Nahrungsentzug auf die verschiedenen Dimen-sionen der Interozeption bei Individuen mit angemesse-nem und unangemessenem Essverhalten zu untersuchen. Methode: Insgesamt nahmen 46 gesunde Frauen an zwei unterschiedlichen Tagen an der Studie teil. In randomisierter Reihenfolge wurden sie nach 16-stündigem Fasten und nach einem standardisierten Frühstück getestet. Die Genauigkeit der Wahrnehmung interozeptiver Signale wurde mit Hilfe eines Herzschlagdetektionstests (Schandry) erfasst. Zusätzlich wurde die subjektive Einschätzung der interozeptiven Wahrnehmungsgenauigkeit, sowie intuitives und unangemessenes Essverhalten per Fragebogen erfasst. Ergebnisse: Die Genauigkeit im Herzschlagdetektions-test war nach kurzzeitigem Fasten erhöht. Außerdem konnte eine verringerte Herzfrequenz festgestellt werden. Emotionale Esser zeigten eine verringerte Herz-schlagdetekionsgenauigkeit und intuitives Essverhalten korrelierte positiv mit interozeptiver Genauigkeit. Es ließ sich kein Zusammenhang zwischen selbstberichteter interozeptiver Wahrnehmung und kardialer interozepti-ver Genauigkeit aufzeigen.Diskussion: Unsere Ergebnisse stehen im Einklang mit vorhergehenden Studien die zeigten, dass kurzzeitiges Fasten die Genauigkeit in Herzwahrnehmungsaufgaben erhöht. Allerdings scheint dieser Anstieg unabhängig zu sein von sympathischer Aktivierung. Unsere Ergebnisse legen nahe, dass durch Essverhalten die Wahrnehmung von Körpersignalen verändert werden kann. Dies impliziert weitere Untersuchungen dieses Zusammen-hangs bei Essstörungen.

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

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

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; 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; Schulte-Mecklenbeck, Michael; Blechert, Jens; Vögele, Claus

Scientific Conference (2014)

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See detailImpulsive reactions to food-cues predict subsequent food craving
Meule, Adrian; Lutz, Annika; Vögele, Claus; Kübler, Andrea

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 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.

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See detailCorrelates of food addiction in obese individuals seeking bariatric surgery
Meule, Adrian; Heckel, Daniela; Jurowich, Christian; Vögele, Claus; Kübler, Andrea

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. 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.

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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; Koch, Stefan; Vögele, Claus; Schulz, Stefan M.

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 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.

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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; Gafare, Claudia Elena; Stefanini, Giulia; Widhalm, Kurt

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-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.

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See detailKörperwahrnehmung bei Depersonalisations-/Derealisationsstörung: Übereinstimmungen und Diskrepanzen zwischen subjektiven Berichten, behavioralen und psychophysiologischen Indikatoren
Schulz, André; Köster, S.; Reuchlein, B.; Beutel, M. E.; Schächinger, H.; Vögele, Claus; Michal, M.

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 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.

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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.; Reiner, I.; Beutel, M.; Vögele, Claus; Schächinger, H.; Schulz, André

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 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.

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See detailNeurophysiologische Evidenz für eine veränderte ZNS-Repräsentation afferenter Signale aus dem kardiovaskulären System bei Depersonalisations-/Derealisationsstörung
Schulz, André; Köster, S.; Reuchlein, B.; Beutel, M. E.; Schächinger, H.; Vögele, Claus; Michal, M.

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 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.

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See detailWas ist Gesundheit?
Vögele, Claus

in Verhaltenstherapie (2013), 23

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

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; Van Dyck, Zoé; Vögele, Claus

in André, C; Bohn, T; Evers, D; Hoffmann, L; Soukoulis, C (Eds.) 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-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.

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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

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 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).

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

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

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See detailRestrained eating predicts increased autonomic reactivity during food exposure in young women
Van Dyck, Zoé; Lutz, Annika; Vögele, Claus

in Psychology & Health (2013, August 02), 28

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

in Frontiers in Psychology (2013), 4

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See detailEnhanced cardiac perception is associated with increased susceptibility to framing effects
Sütterlin, Stefan; Schulz, Stefan M.; Stumpf, Theresa; Pauli, Paul; Vögele, Claus

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 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.

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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; Sütterlin, Stefan; Vögele, Claus; Kübler, Andrea

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 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.

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See detailVerhaltensinstruktionen
Vögele, Claus

in Wirtz, Markus (Ed.) Dorsch – Lexikon der Psychologie (2013)

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See detailStress- und Immunreaktion, präoperative.
Vögele, Claus

in Wirtz, Markus (Ed.) Dorsch – Lexikon der Psychologie (2013)

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See detailOperationsvorbereitung, psychologische.
Vögele, Claus

in Wirtz, Markus (Ed.) Dorsch – Lexikon der Psychologie (2013)

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See detailEating healthily: a task for health education?
Vögele, Claus

in Agro Food Industry Hi Tech (2013), 23(6), 3-3

Editorial

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See detail11. Kongress der Fachgruppe Gesundheitspsychologie, Abstractband
Vögele, Claus

Book published by University of Luxembourg (2013)

See detailWenn das Lebkuchenherz höher schlägt: Zusammenhänge zwischen Essverhalten und Interozeption
Van Dyck, Zoé; Vögele, Claus

Poster (2013)

See detailStress und Interozeption: Die Rolle von Aufmerksamkeit und physiologischen Stressindikatoren
Schulz, André; Vögele, Claus; Schächinger, H.

in Vögele, Claus (Ed.) 11. Kongress der Fachgruppe Gesundheitspsychologie - Selbstregulation und Gesundheit (2013)

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See detailHerzratenvariabilität als Indikator für Selbstregulationsprozesse bei gezügeltem Essverhalten
Lutz, Annika; Van Dyck, Zoé; Vögele, Claus

in 11. Kongress der Fachgruppe Gesundheitspsychologie: Selbstregulation und Gesundheit: Abstractband des Kongresses (2013)

EINFÜHRUNG. Gezügelte Esser unterwerfen ihr Essverhalten einer ausgeprägten kognitiven Kontrolle. Sie versuchen andauernd, hochkalorische Nahrungsmittel zu vermeiden und diesen zu widerstehen. Dabei sind sie jedoch sehr anfällig für ein kurzfristiges Versagen der Selbstregulation. Herzratenvariabilität (HRV) ist ein Indikator für Selbstregulationskapazität und -anstrengung. Sie steigt während des Versuchs, einem hochkalorischen Nahrungsmittel zu widerstehen, kurzfristig an. Im Anschluss an eine solche Anstrengung sind die Selbstregulationsressourcen vorübergehend erschöpft. Auf Grundlage dieser Befunde wurden in der vorliegenden Studie Veränderungen der HRV während der Konfrontation mit hoch- vs. niedrigkalorischen Nahrungsmitteln bei gezügelten und ungezügelten Essern untersucht. METHODIK. Nach dreistündigem Fasten wurden 60 Studentinnen entweder mit einem hochkalorischen (Brownie) oder mit einem niedrigkalorischen (Karotte) Nahrungsmittel konfrontiert. Sie wurden gebeten, das Nahrungsmittel zu betrachten und seinen Geruch wahrzunehmen, es aber nicht zu essen. Währenddessen wurde kontinuierlich die Herzrate aufgezeichnet. Zusätzlich fanden Ruhemessungen vor und nach der Konfrontation statt. Gezügeltes Essverhalten wurde mit dem Dutch Eating Behavior Questionnaire erfasst. ERGEBNISSE. Gezügelte Esser zeigten während der Konfrontation mit hochkalorischen Nahrungsmitteln einen stärkeren Anstieg der HRV als während der Konfrontation mit niedrigkalorischen Nahrungsmitteln. Bei ungezügelten Essern stieg die HRV in beiden Bedingungen gleich stark an. SCHLUSSFOLGERUNGEN. Gezügelte Esser setzen bei der Konfrontation mit hochkalorischen Nahrungsmitteln vermehrt Selbstregulationsressourcen ein, um sich zu kontrollieren. Bei der Konfrontation mit niedrigkalorischen Nahrungsmitteln, die den Erfolg ihrer Diät nicht bedrohen, scheint dies nur in geringem Maß nötig zu sein. Möglicherweise handelt es sich hier um eine Strategie zur Schonung von Selbstregulationsressourcen, um diese effektiver für die Vermeidung hochkalorischer Nahrungsmittel einsetzen zu können. Die Verwendung psychophysiologischer Methoden erweist sich als vielversprechender Ansatz zur Untersuchung grundlegender Selbstregulationsprozesse im Bereich des gezügelten Essverhaltens.

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See detailRisk for eating disorders modulates startle-responses to body words
Herbert, Cornelia; Kübler, Andrea; Vögele, Claus

in PLoS ONE (2013), 8(1), 53667

Body image disturbances are core symptoms of eating disorders (EDs). Recent evidence suggests that changes in body image may occur prior to ED onset and are not restricted to in-vivo exposure (e.g. mirror image), but also evident during presentation of abstract cues such as body shape and weight related words. In the present study startle modulation, heart rate and subjective evaluations were examined during reading of body words and neutral words in 41 student female volunteers screened for risk of EDs. The aim was to determine if responses to body words are attributable to a general negativity bias regardless of ED risk or if activated, ED relevant negative body schemas facilitate priming of defensive responses. Heart rate and word ratings differed between body words and neutral words in the whole female sample, supporting a general processing bias for body weight and shape related concepts in young women regardless of ED risk. Startle modulation was specifically related to eating disorder symptoms as was indicated by significant positive correlations with self-reported body dissatisfaction. These results emphasize the relevance of examining body schema representations as a function of ED risk across different levels of responding. Peripheral-physiological measures such as the startle reflex could possibly be used as predictors of females’ risk for developing EDs in the future.

See detailDer Versuchung widerstehen: Konfrontation mit hochkalorischen Nahrungsmitteln verbessert die Inhibitionsfähigkeit gezügelter Esser
Lutz, Annika; Kahlert, Aniko; Van Dyck, Zoé; Vögele, Claus

Poster (2013)

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See detailCold pressor stress induces opposite effects on cardioceptive accuracy dependent on assessment paradigm
Schulz, André; Lass-Hennemann, Johanna; Sütterlin, Stefan; Schächinger, Hartmut; Vögele, Claus

in Biological Psychology (2013), 93(1), 167-174

Interoception depends on visceral afferent neurotraffic and central control processes. Physiological arousal and organ activation provide the biochemical and mechanical basis for visceral afferent neurotraffic. Perception of visceral symptoms occurs when attention is directed toward body sensations. Clinical studies suggest that stress contributes to the generation of visceral symptoms. However, during stress exposure attention is normally shifted away from bodily signals. Therefore, the net effects of stress on interoception remain unclear. We, therefore, investigated the impact of the cold pressor test or a control intervention (each n = 21) on three established laboratory paradigms to assess cardioceptive accuracy (CA): for the Schandry-paradigm, participants were asked to count heartbeats, while during the Whitehead-tasks subjects were asked to rate whether a cardiac sensation appeared simultaneously with an auditory or visual stimulus. CA was increased by stress when attention was focused on visceral sensations (Schandry), while it decreased when attention was additionally directed toward external stimuli (visual Whitehead). Explanations for these results are offered in terms of internal versus external deployment of attention, as well as specific effects of the cold pressor on the cardiovascular system.

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See detailAn Online Platform as a Tool for Surveys by Patient Associations
Lygidakis, Charilaos; Vögele, Claus; Cambiaso, Silvio; Masella, Nicola; Melis, Mauro; Stara, Rita

in Global Telemedicine and eHealth Updates: Knowledge Resources (2013), 6

Patients are increasingly interested in sharing their experiences and learning about their conditions, their prevention and treatments, and are more frequently turning into advocates. The connectivity and the wide availability of data have been shown to support this development enabling patients to play an active role in healthcare. The “Lumos!” platform is a web-based solution that has been designed to facilitate teams of researchers conducting multicentre studies, especially in countries and contexts with low research capacity. Nevertheless, it can be modified and tailored as a tool for research studies carried out by patient organisations. The aim of this study is to assess the feasibility of an online platform as a tool for anonymous surveys conducted by a patient organisation. Methods: A questionnaire is currently being distributed in the Region of Emilia Romagna (Italy) by the Regional Federation of Diabetics with the aim to study the needs of patients that use self-check-up devices. This observational study has been designed online with the use of the “Lumos!” platform, which enables the creation of the questionnaire with adjustable fields and variables, using the expertise of the participants and the creation of reports. Furthermore, a URL and a QR code linking to the questionnaire are being published on Social Networks and websites inviting people to participate in the study. Several data will be retrieved from the logs of the platform, such as the time required to complete a questionnaire by a patient, the number and types of errors, and the percentage of completed items. These variables will be analysed taking into account the demographic characteristics of the patients. Conclusions: By studying the indicators of the implementation and the characteristics of the participants, it will be possible to optimise participation rates and achieve higher engagement from the participants in the future. We expect that with the help of the online platform, patient associations will be supported in their quest to conduct surveys and, as a secondary outcome; they will empower their members to play a more active role in healthcare.

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See detailKurzzeitige Nahrungsdeprivation erhöht Herzschlag-evozierte Potenziale (HEPs) als Indikatoren für kortikale Verarbeitung kardial-interozeptiver Prozesse
Schulz, André; Ferreira de Sá, Diana S.; Strelzyk, Florian; Vögele, Claus; Schächinger, Hartmut

in Trierer Psychologische Berichte (2013), 38(1), 52-53

Interozeption – die Wahrnehmung von Körpervorgängen – spielt bei der Regulation des Essverhaltens möglicherweise eine entscheidende Rolle. Nahrungsdeprivation hat eine Reihe von metabolischen und endokrinologischen Konsequenzen. Bei kurzzeitiger Nahrungsdeprivation zeigt sich eine Erhöhung des sympathischen Tonus, welche dafür verantwortlich sein könnte, dass sich die Interozeptionsgenauigkeit gegenüber kardialer Stimuli gleichzeitig erhöht. Die physiologischen Grundlagen von Interozeption sind die Übermittlung von viszeral-afferenten neuronalen Signalen, während die Wahrnehmung dieser Signale die Lenkung der Aufmerksamkeit auf diese Signale erfordert. Bisherige Ergebnisse gehen auf Leistungen in Herzschlagdetektionsaufgaben zurück. Obwohl diese Methoden mehrfach validiert wurden, sind sie wahrscheinlich ungeeignet dazu, die viszeral-afferente Signalübermittlung und Aufmerksamkeitslenkung auf diese Signale voneinander zu trennen. Daher hatte die vorliegende Studienreihe zum Ziel, den Einfluss von kurzzeitiger Nahrungsdeprivation auf Herzschlag-evozierte Potenziale (HEPs) in Ruhebedingung zu untersuchen. Die HEPs gelten als psychophysiologischer Indikator für die kortikale Verarbeitung kardial-interozeptiver Prozesse. Bislang ist unbekannt, ob metabolische und endokrinologische Prozesse HEPs modulieren können. In einer ersten Studie wurden 16 gesunden Männern (Alter: 23,8 [2,1] Jahre) intravenös sowohl das Stresshormon Cortisol, als auch eine Placebo-Substanz verabreicht. Es zeigte sich, dass Cortisol bei offenen Augen kurzfristig zu einer höheren HEP-Amplitude führte, als bei geschlossenen Augen (p = .03). Daraus kann man ableiten, dass endokrinologische Prozesse das Potenzial haben, die HEP-Amplitude zu modulieren. In der folgenden Studie wurden 16 gesunde Frauen (Alter: 22,6 [1,9] Jahre) sowohl nach standardisierter Nahrungsaufnahme, als auch nach 18-stündiger Nahrungsdeprivation getestet. Es zeigte sich eine Erhöhung der HEP-Amplitude nach Nahrungsdeprivation (p = .02). Gleichzeitig konnten keine Veränderungen der Herzrate, noch der Herzratenvariabilität beobachtet werden. Unsere Ergebnisse legen nahe, dass Nahrungsdeprivation die kortikale Verarbeitung afferenter Signale aus dem kardiovaskulären System intensiviert, was nicht durch eine höhere sympathische Aktivität erklärt werden kann. Mögliche physiologische Signalwege und Implikationen für die Ätiologie von Essstörungen werden diskutiert.

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See detailThe negative affect repair questionnaire: factor analysis and psychometric evaluation in three samples
Scherer, Anne; Eberle, Nicole; Boecker, Maren; Vögele, Claus; Gauggel, Siegfried; Forkmann, Thomas

in BMC Psychiatry (2013), 13(1), 16

Negative affect and difficulties in its regulation have been connected to several adverse psychological consequences. While several questionnaires exist, it would be important to have a theory-based measure that includes clinically relevant items and shows good psychometric properties in healthy and patient samples. This study aims at developing such a questionnaire, combining the two Gross [1] scales Reappraisal and Suppression with an additional response-focused scale called Externalizing Behavioral Strategies covering clinically relevant items. The samples consisted of 684 students (mean age = 23.3, SD = 3.5; 53.6% female) and 369 persons with mixed mental disorders (mean age = 36.0 SD = 14.6; 71.2% female). Items for the questionnaire were derived from existing questionnaires and additional items were formulated based on suggestions by clinical experts. All items start with ―When I don’t feel well, in order to feel better...‖. Participants rated how frequently they used each strategy on a 5-point Likert scale. Confirmatory Factor Analyses were conducted to verify the factor structure in two separate student samples and a clinical sample. Group comparisons and correlations with other questionnaires were calculated to ensure validity. After modification, the CFA showed good model fit in all three samples. Reliability scores (Cronbach’s α) for the three NARQ scales ranged between .71 and .80. Comparisons between students and persons with mental disorders showed the postulated relationships, as did comparisons between male and female students and persons with or without Borderline Personality Disorder. Correlations with other questionnaires suggest the NARQ’s construct validity. The results indicate that the NARQ is a psychometrically sound and reliable measure with practical use for therapy planning and tracking of treatment outcome across time. We advocate the integration of the new response-focused strategy in the Gross’s model of emotion regulation.

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See detailCortisol rapidly affects amplitudes of heartbeat-evoked brain potentials - Implications for the contribution of stress to an altered perception of physical sensations?
Schulz, André; Strelzyk, F.; Ferreira de Sá, D. S.; Naumann, E.; Vögele, Claus; Schächinger, H.

in Psychoneuroendocrinology (2013), 38(11), 2691-2698

Little is known about the impact of stress and stress hormones on the processing of visceral-afferent signals. Clinical data suggest that cortisol may lower the threshold for interoceptive stimuli, while a pharmacological administration of cortisol decreases the sensitivity for physical symptoms. To clarify the role of cortisol for the processing of interoceptive signals, we investigated 16 healthy men on two occasions, once during the infusion of 4mg of cortisol and once during the infusion of a placebo substance. Heartbeat-evoked potentials (HEP; derived from resting EEG and ECG, during open and closed eyes), which are psychophysiological indicators for the cortical processing of cardioceptive signals, were measured over 6-min periods once before, and four times after the infusion (1-7, 11-17, 21-27 and 31-37min). We found that HEP amplitudes were higher during open than during closed eyes between 1 and 17min after cortisol infusion. There was no effect of cortisol on heart rate. We conclude that cortisol may rapidly modulate the cortical processing of cardioceptive neural signals. These results may have relevance for the effects of stress on the development and maintenance of psychosomatic symptoms.

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See detailWas ist Psychotherapie?
Vögele, Claus; Steffgen, Georges

Article for general public (2012)

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See detail30. Symposium Klinische Psychologie und Psychotherapie, Abstractband
Vögele, Claus

Book published by University of Luxembourg (2012)

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See detailPsychophysiologische und behaviorale Korrelate unkontrollierten Essens bei gezügelten Essern
Lutz, Annika; Vögele, Claus

Scientific Conference (2012)

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See detailHands-off the cookie-jar: Success and failure in the self-regulation of eating behaviour
Lutz, Annika; Vögele, Claus

in Psychology & Health (2012), 27(sup1), 20-20

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See detailWho’s that girl? Körperbild, Selbsterkennung und Selbstkonzept bei jungen Frauen mit und ohne Essstörungsrisiko
Lutz, Annika; Herbert, Cornelia; Vögele, Claus

in Abstract book of 30. Symposium Klinische Psychologie und Psychotherapie der DGPS Fachgruppe Klinische Psychologie und Psychotherapie (2012)

See detailWho’s that girl? Body image, self-recognition, and self-concept in young women with high vs. low risk for eating disorders
Lutz, Annika; Herbert, Cornelia; Vögele, Claus

Scientific Conference (2012)

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See detailRestrained eating is related to accelerated reaction to high caloric foods and cardiac autonomic dysregulation.
Meule, Adrian; Vögele, Claus; Kübler, Andrea

in Appetite (2012), 58

Cognitive bias to food-cues and cardiac autonomic dysregulation have both been related to disordered eating behavior in previous research. The present study investigated two possible measures of self-regulatory ability in restrained eaters: resistance to distractor interference and cardiac-vagal control. Young women (N = 47) performed a flanker task involving high caloric food-cues or neutral pictures. Vagal-cardiac activity was calculated from baseline heart rate recordings at rest. Restrained eaters did not differ from unrestrained eaters in resistance to distractor interference. However, restrained eaters showed shorter reaction times to high-calorie food-cues as compared to neutral pictures than unrestrained eaters. This attentional bias was further related to low dieting success. Moreover, restrained eating was associated with low parasympathetic activation and sympathovagal imbalance, independent of current body mass. Both attentional bias and cardiac autonomic dysregulation were related to self-reported weight fluctuations. Results are discussed in terms of possible adverse consequences of weight cycling in young women and low self-regulatory ability in restrained eaters.

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See detailCardiac threat appraisal and depression after first myocardial infarction
Vögele, Claus; Christ, Oliver; Spaderna, Heike

in Frontiers in Psychology (2012), 3:365

The present study investigated cardiac threat appraisal and its association with depression after first myocardial infarction (MI). A semi-structured interview allowing for DSM-IV-Axis I diagnoses was administered to 36 patients after first MI. Patients completed self-reports 5 to 15 days after the MI (time 1), 6 to 8 weeks later (time 2) and again 6 months later (time 3). Assessments at time 1 included indices of cardiac threat appraisal, locus of control, coping, and depression while at time 2 and time 3 only measures of depression were obtained. Cardiac threat appraisal was significantly correlated with depression at time 1, but was unrelated to depression scores at time 2 and time 3. Furthermore, there was a significant inverse association between cardiac threat appraisal and the subscales “search for affiliation” and "threat minimization" of the coping questionnaire. Additionally, “search for affiliation” correlated negatively with depression scores at time 1 and time 3, and "threat minimization" negatively with depression scores at time 1 and time 2. These results suggest a significant association between cardiac threat appraisal and depressive symptoms shortly after MI. Practical implications for treatment are discussed.

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See detailDeutsche Übersetzung und Validierung der Yale Food Addiction Scale - German translation and validation of the Yale Food Addiction Scale
Meule, Adrian; Vögele, Claus; Kübler, Andrea

in Diagnostica (2012), 58

Manche Menschen bezeichnen sich als süchtig nach bestimmten Nahrungsmitteln wie Schokolade. Des Weiteren wurden auf Verhaltens- und neurobiologischer Ebene Überschneidungen zwischen Substanzabhängigkeiten und exzessivem Essen wie es bei Bulimia nervosa (BN), Binge Eating Störung (BES) oder Adipositas auftritt, gefunden (Davis & Carter, 2009). Bisher mangelte es im deutschen Sprachraum jedoch an einem Messinstrument, das spezifisch das Konstrukt Esssucht erfasst. Um diese Lücke zu schließen, stellt die vorliegende Arbeit die deutsche Version der Yale Food Addiction Scale (YFAS) von Gearhardt, Corbin & Brownell (2009) vor. Diese Skala ermöglicht es, Menschen mit ausgeprägten Symptomen einer Abhängigkeit von bestimmten Nahrungsmitteln zu identifizieren. Die Diagnosestellung orientiert sich hierbei an den DSM-IV-Kriterien für Substanzabhängigkeit. Die Reliabilität und Validität dieses Fragebogens wurde an einer Stichprobe von überwiegend Studierenden (N = 752) in einer Onlinebefragung getestet. Die einfaktorielle Struktur der YFAS konnte bestätigt werden, bei einer zufriedenstellenden internen Konsistenz (Cronbach's α = .81). Konvergente Validität zeigte sich in mittleren bis hohen Korrelationen mit anderen Maßen problematischen Essverhaltens, während sich die YFAS hinsichtlich der diskriminanten Validität von anderen, aber dennoch verwandten Konstrukten, wie Alkoholabhängigkeit und Impulsivität, unterschied. Weiterhin zeigte sich die YFAS als signifikanter Prädiktor für die Häufigkeit von Essanfällen. Die YFAS scheint somit ein brauchbares Instrument für die Erfassung essensbezogener Verhaltensweisen darzustellen, die einen suchthaften Charakter aufweisen.

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See detailSelf-reported dieting success is associated with cardiac autonomic regulation in current dieters
Meule, Adrian; Lutz, Annika; Vögele, Claus; Kübler, Andrea

in Appetite (2012), 59(2)

Restrained eating, eating disorders and obesity have been associated with cardiac autonomic dysregulation. The current study investigated cardiac autonomic regulation in current dieters. Female students (N = 50) indicated if they were currently trying to control their weight and completed the Perceived Self-Regulatory Success in Dieting Scale (PSRS). Heart beat intervals were recorded during two 10 min relaxation periods from which parameters of vagal-cardiac control (high frequency power in normalized units, HF n.u.) and sympathovagal balance (ratio of low and high frequency power, LF/HF) were calculated. In current dieters, self-reported dieting success was positively associated with HF and negatively associated with LF/HF. These associations were independent of current body-mass and food deprivation (i.e. hours since the last meal). We conclude that vagal-cardiac control reflects self-regulatory strength, rather than nutritional status, in current dieters.

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See detailWomen with elevated food addiction symptoms show accelerated reactions, but no impaired inhibitory control, in response to pictures of high-calorie food-cues.
Meule, Adrian; Lutz, Annika; Vögele, Claus; Kübler, Andrea

in Eating Behaviors (2012), 13(4), 423-428

Addictive behaviors are accompanied by a lack of inhibitory control, specifically when individuals are confronted with substance-related cues. Thus, we expected women with symptoms of food addiction to be impaired in inhibitory control, when confronted with palatable, high-calorie food-cues. Female college students (N = 50) where divided in low and high food addiction groups based on the symptom count of the Yale Food Addiction Scale. Participants performed a Go/No-Go-task with high-calorie food-cues or neutral pictures presented behind the targets. Self-reported impulsivity was also assessed. The high food addiction group had faster reaction times in response to food-cues as compared to neutral cues and reported higher attentional impulsivity than the low food addiction group. Commission and omission errors did not differ between groups or picture types. Hence, women with food addiction symptoms reported higher attentional impulsivity and reacted faster in response to food-cues, although neither increased self-reported motor impulsivity nor impaired behavioral inhibition were found. Food addiction symptoms seem to be related to attentional aspects of impulsivity but not other facets of impulsivity.

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See detailPerseverative thinking in depression and anxiety
Sorg, Sonja; Vögele, Claus; Furka, Nadine; Meyer, Andrea H.

in Frontiers in Psychology (2012), 3

The current study investigated the impact of worry and brooding as moderators of the tripartite model of depression and anxiety (TMDA). We hypothesized that both types of perseverative thinking would moderate the association between negative affectivity (NA) and both anxiety and depression. Complete data sets for this questionnaire survey were obtained from 537 students. Participants’ age ranged from 16 to 49 years with a mean age of 21.1 years (SD = 3.6). Overall, results from path analyses supported the assumptions of the TMDA, in that negative affectivity was a non-specific predictor for both depression and anxiety whilst lack of positive affectivity was related to depression only. Unexpectedly, perseverative thinking had an effect on the dependency of negative and positive affectivity. Worry was a significant moderator for the path NA – anxiety. All other hypothesized associations were only marginally significant. Alternative pathways as well as methodological implications regarding similarities and differences of the two types of perseverative thinking are discussed.

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See detailFood cravings discriminate differentially between successful and unsuccessful dieters and non-dieters: Validation of the Food Cravings Questionnaires in German
Meule, Adrian; Lutz, Annika; Vögele, Claus; Kübler, Andrea

in Appetite (2012), 1(58), 88-97

Food cravings have been strongly associated with triggering food consumption. However, definitions and measurements of food cravings are heterogeneous. Therefore, Cepeda-Benito and colleagues (2000) have suggested the Food Cravings Questionnaires (FCQs) to measure food cravings as a multidimensional con- struct at trait- and state-level. In the current study, we validated a German version of the FCQs in an online study (N = 616). The factor structure of the state and trait versions could partially be replicated, but yielded fewer than the originally proposed factors. Internal consistencies of both versions were very good (Cronbach’s a > .90), whereas retest reliability of the state version was expectedly lower than that of the trait version. Construct validity of the trait version (FCQ-T) was demonstrated by high correlations with related eating behavior questionnaires and low correlations with questionnaires unrelated to eating. Most importantly, FCQ-T-subscales were able to discriminate between successful and unsuccessful diet- ers and non-dieters. Validity of the state version was supported by positive relations with food depriva- tion and current negative affect. Taken together, the German version of the FCQs has good psychometric properties. Moreover, this study provided first evidence that distinct dimensions of food cravings are differentially related to success and failure in dieting.

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See detailHeart rate variability biofeedback reduces food cravings in high food cravers
Meule, Adrian; Freund, Rebecca; Skirde, Ann Kathrin; Vögele, Claus; Kübler, Andrea

in Applied Psychophysiology and Biofeedback (2012), 37(4), 241-251

Heart rate variability (HRV) biofeedback has been reported to increase HRV while decreasing symptoms in patients with mental disorders. In addition, associations between low HRV and lowered self-regulation were found in non-clinical samples, e.g., in individuals with strong chocolate cravings or unsuccessful dieting. The current study aimed at decreasing food cravings with HRV-biofeedback in individuals frequently experiencing such cravings. Participants (N = 56) with strong or low food cravings associated with a lack of control over eating were selected from the local community. Half of the participants with strong cravings (craving-biofeedback; n = 14) performed 12 sessions of HRV-biofeedback while the other half (craving-control; n = 14) and a group with low cravings (non-craving-control; n = 28) received no intervention. Subjective food cravings related to a lack of control over eating decreased from pre- to post-measurement in the craving-biofeedback group, but remained constant in the control groups. Moreover, only the craving-biofeedback group showed a decrease in eating and weight concerns. Although HRV-biofeedback was successful in reducing food cravings, this change was not accompanied by an increase in HRV. Instead, HRV decreased in the craving-control group. This study provides preliminary evidence that HRV-biofeedback could be beneficial for attenuating dysfunctional eating behavior although specific mechanisms remain to be elucidated.

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See detailHigh-calorie food-cues impair working memory performance in high and low food cravers.
Meule, Adrian; Skirde, Ann Kathrin; Freund, Rebecca; Vögele, Claus; Kübler, Andrea

in Appetite (2012), 59

The experience of food craving can lead to cognitive impairments. Experimentally induced chocolate craving exhausts cognitive resources and, therefore, impacts working memory, particularly in trait chocolate cravers. In the current study, we investigated the effects of exposure to food-cues on working memory task performance in a group with frequent and intense (high cravers, n = 28) and less pronounced food cravings (low cravers, n = 28). Participants performed an n-back task that contained either pictures of high-calorie sweets, high-calorie savory foods, or neutral objects. Current subjective food craving was assessed before and after the task. All participants showed slower reaction times and made more omission errors in response to food-cues, particularly savory foods. There were no differences in task performance between groups. State cravings did not differ between groups before the task, but increased more in high cravers compared to low cravers during the task. Results support findings about food cravings impairing visuo-spatial working memory performance independent of trait cravings. They further show that this influence is not restricted to chocolate, but also applies to high-calorie savory foods. Limiting working memory capacity may be especially crucial in persons who are more prone to high-calorie food-cues and experience such cravings habitually.

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See detailDoes disgust increase parasympathetic activation in individuals with a history of fainting? A psychophysiological analysis of disgust stimuli with and without blood-injection- injury association.
Vossbeck-Elsebusch, Anne N.; Vögele, Claus; Gerlach, Alexander L.

in Journal of Anxiety Disorders (2012), 26(8)

People with blood-injection-injury fear can faint when being confronted with blood, injections or injuries. Page (1994) holds that people with blood-injury phobia faint, because they are disgust sensitive and disgust facilitates fainting by eliciting parasympathetic activity. We tested the following two hypotheses: (1) Disgusting pictures elicit more disgust in blood-injection-injury anxious people with a history of fainting than they do in controls. (2) Disgust causes parasympathetic activation. Subjects were 24 participants with high blood-injection-injury fear and a history of fainting in anxiety relevant situations and 24 subjects with average blood-injection-injury fear and no fainting history. We analyzed self-reported feelings of disgust, anxiety and faintness and reactions in heart rate, skin conductance, blood pressure and respiratory sinus arrhythmia during the confrontation with disgusting pictures with and without blood content.We did not find any evidence that the blood-injection-injury anxious subjects were more disgust sensitive than the control subjects and we also did not find any evidence that disgust elicits parasympathetic activation.

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See detailEffects of resting heart rate variability on performance in the P300 brain-computer interface
Kaufmann, Tobias; Vögele, Claus; Sütterlin, Stefan; Lukito, Steve; Kübler, Andrea

in International Journal of Psychophysiology (2012), 83(3), 336-341

Objective: Brain computer interfaces (BCI) can serve as a communication system for people with severe impairment in speech and motor function due to neurodegenerative disease or injury. Reasons for inter-individual differences in capability of BCI usage are not yet fully understood. Paradigms making use of the P300 event-related potential are widely used. Success in a P300 based BCI requires the capability to focus attention and inhibit interference by distracting irrelevant stimuli. Such inhibitory control has been closely linked to peripheral physiological parameters, such as heart rate variability (HRV). The present study investigated the association between resting HRV and performance in the P300-BCI. Methods: Heart rate was recorded from 34 healthy participants under resting conditions, and subsequently a P300-BCI task was performed. Results: Frequency domain measures of HRV were significantly associated with BCI-performance, in that higher vagal activation was related to better BCI-performance. Conclusions: Resting HRV accounted for almost 26% of the variance of BCI performance and may, therefore, serve as a predictor for the capacity to control a P300 oddball based BCI. Significance: This is the first study to demonstrate resting vagal-cardiac activation to predict capability of P300-BCI usage.

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See detailRumination and age: some things get better
Sütterlin, Stefan; Paap, Muirne C. S.; Babic, Stana; Kübler, Andrea; Vögele, Claus

in Journal of Aging Research (2012), 267327

Rumination has been defined as a mode of responding to distress that involves passively focusing one’s attention on symptoms of distress without taking action. This dysfunctional response style intensifies depressed mood, impairs interpersonal problem solving and leads to more pessimistic future perspectives and less social support. As most of these results were obtained from younger people, it remains unclear how age affects ruminative thinking. Three hundred members of the general public ranging in age from 15 to 87 years were asked about their ruminative styles using the Response Styles Questionnaire (RSQ), depression and satisfaction with life. A Mokken Scale analysis confirmed the two-factor structure of the RSQ with brooding and reflective pondering as sub-components of rumination. Older participants (63 years and older) reported less ruminative thinking than other age groups. Life satisfaction was associated with brooding and highest for the earlier and latest life stages investigated in this study.

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See detailOf larks and hearts – morningness/eveningness, heart rate variability and cardiovascular stress response at different times of the day
Roeser, Karolin; Obergfell, Friederike; Meule, Adrian; Vögele, Claus; Schlarb, Angelika; Kübler, Andrea

in Physiology & Behavior (2012), 106 (2)

Inter-individual differences in the circadian period of physical and mental functions can be described on the dimension of morningness/eveningness. Previous findings support the assumption that eveningness is related to greater impulsivity and susceptibility to stress than morningness. Heart rate variability (HRV) serves as a physiological correlate of self- and emotional regulation and has not yet been investigated in relation to chronotypes. The study explores differences in HRV and other cardiovascular measures in morning- and evening-types at rest and under stress at different times of day (8-11 a.m. or 4-7 p.m.). Students (N = 471) were screened for chronotype and n = 55 females (27 morning- and 28 evening-types) were recruited for testing. These participants performed a mental arithmetic task while heart rate (HR) and blood pressure (BP) were recorded. Spectral components and a time-domain measure of HRV were calculated on HR data from resting and mental stress periods. Evening-types had significantly higher HR and systolic BP, but lower HRV than morning-types both at baseline and during stress. Stress induced in the evening had a significantly stronger impact on absolute and baseline corrected physiological measures in both chronotypes. The interaction of chronotype and testing time did not reach the level of significance for any of the dependent variables. The enhanced physiological arousal in evening-types might contribute to increased vulnerability to psychological distress. Hence, previous behavioral findings are supported by the physiological data of this study.

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See detailEvidence-based recommendations for the development of obesity prevention programs targeted at preschool children
Summerbell, Carolyn; Moore, Helen; Vögele, Claus; Kreichauf, Susanne; Wildgruber, Andreas; Manios, Yannis; Douthwaite, Wayne; Nixon, Catherine; Gibson, E. Leigh

in Obesity Reviews : An Official Journal of the International Association for the Study of Obesity (2012), 13(Suppl 1), 129-132

As previously discussed in other papers in this Supplement of Obesity Reviews, the Toybox intervention was developed using an evidence-based approach, and refined through pilot testing. As part of that evidence base, two pieces of work were carried out. First, a series of narrative reviews of educational strategies and psychological approaches explaining young children’s acquisition and formation of energy-balance related behaviours, and facilitating their management (Gibson et al1; Vögele et al2; Kreichauf et al3, all published in this supplement). Second, a systematic review to identify behavioural models underpinning school-based interventions in pre-school and school settings for the prevention of obesity in children aged 4-6 years (Nixon et al4; published in this supplement). The aim of this short paper is to summarise and translate the findings from these two reviews into practical evidence-based recommendations for researchers and policy makers to consider when developing and implementing interventions for the prevention of overweight and obesity in young (aged 4-6) children.

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See detailA narrative review of psychological and educational strategies applied to young children's eating behaviours aimed at reducing obesity risk
Gibson, E. Leigh; Wildgruber, Andreas; Kreichauf, Susanne; Vögele, Claus; Nixon, Catherine A.; Douthwaite, Wayne; Moore, Helen J.; Manios, Yannis; Summerbell, Carolyn D.; on behalf of the Toybox-study group

in Obesity Reviews : An Official Journal of the International Association for the Study of Obesity (2012), 13(Suppl 1), 85-95

Strategies to reduce risk of obesity by influencing preschool children’s eating behaviour are reviewed. The studies are placed in the context of relevant psychological processes, including inherited and acquired preferences, and behavioural traits, such as food neophobia, ‘enjoyment of food’ and ‘satiety responsiveness’. These are important influences on how children respond to feeding practices, as well as predictors of obesity risk. Nevertheless, in young children, food environment and experience are especially important for establishing eating habits and food preferences. Providing information to parents, or to children, on healthy feeding is insufficient. Acceptance of healthy foods can be encouraged by 5-10 repeated tastes. Recent evidence suggests rewarding healthy eating can be successful, even for verbal praise alone, but that palatable foods should not be used as rewards for eating. Intake of healthier foods can be promoted by increasing portion size, especially in the beginning of the meal. Parental strategies of pressuring to eat and restriction do not appear to be causally linked to obesity, but are instead primarily responses to children’s eating tendencies and weight. Moderate rather than frequent restriction may improve healthy eating in children. Actively positive social modelling by adults and peers can be effective in encouraging healthier eating.

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See detailA systematic review to identify behavioural models underpinning school-based interventions in pre-primary and primary settings for the prevention of obesity in children aged 4-6 years.
Nixon, Catherine A.; Moore, Helen J.; Douthwaite, Wayne; Gibson, E. Leigh; Vögele, Claus; Kreichauf, Susanne; Wildgruber, Andreas; Manios, Yannis; Summerbell, Carolyn D.; on behalf of the Toybox study group

in Obesity Reviews : An Official Journal of the International Association for the Study of Obesity (2012), 13(Suppl 1), 106-117

The aim of this comprehensive systematic review was to identify the most important behavioural models underpinning school-based interventions aimed at preventing or counteracting obesity in 4-6 year olds. Searching was conducted in April 2010, with relevant literature included in the review from 1995 up to and including the search date on MEDLINE, EMBASE, CINAHL, PsycINFO and The Cochrane Library. Epidemiological studies relevant to the research question with controlled assignment of participants were included in the review, if they had follow up periods of six months or longer. Outcomes included markers of weight gain; markers of body composition; physical activity behaviour changes and dietary behaviour changes. A total of twelve individual studies were included in review. The most commonly used model was Social Cognitive Theory (SCT)/Social Learning Theory (SLT) either as a single model or in combination with other behavioural models. Studies that used SCT/SLT in the development of the intervention had significant favourable changes in one, or more, outcome measures. Those interventions that combine (a) high levels of parental involvement and interactive school-based learning and (b) that target physical activity plus dietary change, require further consideration in the development of useful interventions for children aged 4-6 years old.

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See detailCritical narrative review to identify educational strategies promoting physical activity in preschool.
Kreichauf, S.; Wildgruber, A.; Krombholz, H.; Gibson, E.L.; Vögele, Claus; Nixon, C.A.; Douthwaite, W.; Moore, H.J.; Manios, Y.; Summerbell, C.D.; on behalf of the Toybox study group

in Obesity Reviews : An Official Journal of the International Association for the Study of Obesity (2012), 13(Suppl 1), 96-105

The aim of this narrative review is critically to evaluate educational strategies promoting physical activity that are used in the preschool setting in the context of obesity prevention programmes. Literature search was conducted between April and August 2010 in English and German databases (PubMED, PsychINFO, PSYNDEX, ERIC, FIS Bildung). Outcomes considered were time and intensity of physical activity, motor skills or measures of body composition. A total of 19 studies were included. Ten studies added physical activity lessons into their curriculum, one study provided more time for free play, eight studies focused on the social and play environment. Studies reporting positive outcomes implemented physical activity sessions that lasted at least 30 min d(-1). Several studies showed that children are most active in the first 10-15 min. The existence or installation of playground markings or fixed play equipment had no effect, whereas the presence or addition of portable play equipment was positively correlated with moderate-to-vigorous physical activity. Teacher training may be a key element for successful interventions. To overcome time constraints, a suggested solution is to integrate physical activity into daily routines and other areas of the preschool curriculum.

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See detailStressbewältigung bei Kindern und Jugendlichen.
Vögele, Claus

in Meinlschmidt, G.; Schneider, S.; Margraf, J. (Eds.) Lehrbuch der Verhaltenstherapie: Materialien für die Psychotherapie., 4 (2011)

Körperliche und psychische Probleme, die durch Stress verursacht oder begünstigt werden, treten in zunehmendem Maß schon im Kindes- und Jugendalter auf (7 Kap. II/30). So leiden viele Kinder im Grundschulalter unter Stresssymptomen wie Nervosität, Unkonzentriertheit, Bauch- und Kopfschmerzen oder Schlafschwierigkeiten. Jugendliche berichten häufig über Kopfschmerzen, Schlafprobleme und Appetitlosigkeit, aber auch über Gefühle der Anspannung und Überforderung. Die Gründe dafür sind vielfältig, auch wenn die Belastung durch die Schule und soziale Konfliktsituationen mit Geschwistern, Eltern oder Freunden die am häufigsten von Kindern und Jugendlichen genannten Alltagsbelastungen sind. Dazu kommt, dass die Adoleszenz mit ihren vielfältigen körperlichen, psychischen und sozialen Veränderungen eine Lebensphase erhöhter Vulnerabilität für Belastungen darstellt, die erfolgreich bewältigt werden muss. Viele Kinder und Jugendliche bewältigen diese Anforderungen mit Strategien wie Problemlösung, Suche nach sozialer Unterstützung und Ablenkung erfolgreich und nützen die Erfahrung in der Auseinandersetzung mit der Belastung, um ein Bewältigungspotenzial aufzubauen. Andere fühlen sich überfordert und zeigen Fehlanpassungen bzw. reagieren mit Resignation, Aggression, Ruminieren und passiver Vermeidung. Insgesamt sprechen die derzeitigen empirischen Befunde dafür, dass durch die Förderung günstiger Bewältigungsstrategien Belastungssymptome reduziert und das Gesundheitsverhalten oder der Verlauf bereits aufgetretener chronisch-körperlicher Erkrankungen günstig beeinflusst werden (Lohaus et al. 2006a). Wie bei Erwachsenen auch (7 Kap. II/30, Kap. IV/37) bedarf es dazu eines breiten Angebots innerhalb eines Stressbewältigungstrainings. Beispielsweise sind Programme, die nur Entspannungsverfahren oder Problemlösetrainings als alleinige Interventionen einsetzten, langfristig wenig erfolgreich (Seiffge-Krenke u. Lohaus 2007). Deshalb integrieren erfolgreiche Stressbewältigungstrainings für Kinder und Jugendliche mehrere unterschiedliche Interventionsmethoden in multimodalen Programmen. Diese beruhen zum größten Teil auf dem Stressimpfungstraining (SIT) von Meichenbaum (2003; 7 Kap. II/30) und passen es kindgerecht an. Das SIT vermittelt Methoden der Entspannung und übt den Aufbau von sozialen Fertigkeiten und das Erlernen von schulbezogenen oder allgemeinen Problemlösestrategien. Wesentlich ist jedoch die kognitive Umstrukturierung, d. h. die Erfahrung, dass Belastungssituationen nicht als persönliche Bedrohung, sondern als lösbare Probleme bewertet werden sollen. Im vorliegenden Kapitel werden nur wenige ausgewählte übergeordnete Materialien vorgestellt und es wird auf eine Auswahl der wichtigsten deutschsprachigen diagnostischen Verfahren zur Erfassung von Bewältigungsstrategien und therapeutischen Interventionen zur Stressbewältigung im Kindes- und Jugendalter verwiesen.

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See detailVon der Forschung zur Praxis - 13. Kongress der Deutschen Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation - DGVM
Vögele, Claus

in Verhaltenstherapie (2011), 21 (suppl1)

Abstract-Band des 13. Kongresses der Deutschen Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation, Luxemburg, 29.9.-1.10.2011

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See detailStressbewältigung
Vögele, Claus

in Meinlschmidt, G.; Schneider, S.; Margraf, J. (Eds.) Lehrbuch der Verhaltenstherapie: Materialien für die Psychotherapie, 4 (2011)

Das Thema Stressbewältigung (7 Kap. II/30) hat seit den 1960er Jahren einen rasanten Aufschwung genommen. Die damals beginnende Abkehr von dem bis dahin vorherrschenden biologisch-medizinischen Modell, die zunehmende Unzufriedenheit mit der traditionellen Psychiatrie und die wachsende Bedeutung psychologischer Modelle und klinisch-psychologischer Interventionen haben dazu beigetragen, dass über die letzten 50 Jahre mehr als 4.000 wissenschaft liche Artikel zu diesem Th ema veröffentlicht wurden. Dabei finden sich die unterschiedlichsten Anwendungsbereiche, z. B. Stressbewältigung im Arbeitsbereich, in der Psychotherapie, in der Gesundheitsförderung und der medizinischen Versorgung, in der Paartherapie und in der Krisenintervention. Die Breite dieser Anwendungsbereiche ist sicherlich einer unter mehreren Gründen für die Unterschiedlichkeit der Interventionsmethoden, die unter dem Begriff Stressbewältigungstraining (z. B. Kaluza 2004) zusammengefasst werden. Üblicherweise beginnen die Stressbewältigungsprogramme mit einer allgemeinen Einführung zum Thema »was ist Stress«, ergänzt um eine Darstellung psychobiologischer Zusammenhänge und körperlicher Folgen vonchronischem Stress (7 Kap. IV/19). Die einzelnen Module beziehen sich dann auf spezifische Bereiche, die auch in anderen klinischen Kontexten von Relevanz sind. Dazu gehören Entspannungsverfahren (progressive Muskelrelaxation nach Jacobson, Meditation, autogenes Training, Biofeedback, Atementspannung; 7 Kap. IV/6), klinischpsychologische Interventionen (kognitive Umstrukturierung; 7 Kap. IV/11), Problemlösetraining, Training sozialerFertigkeiten (7 Kap. IV/10), Kommunikationstraining, Genusstraining (7 Kap. IV/8), Aufb au von Aktivitäten (7 Kap. IV/34)) und edukative Maßnahmen (Beratung zu Ernährung, Bewegung und Gesundheit sowie Techniken zur Optimierung von Arbeitsabläufen, Lernen oder Zeitmanagement). Bei aller Verschiedenartigkeit haben Stressbewältigungstrainings allerdings ein gemeinsames Ziel: die Förderung der körperlichen und psychischen Gesundheit und des Wohlbefindens durch eine Verbesserung der individuellen Kompetenzen zur Stressbewältigung. Genauer gesagt besteht das Ziel in der Erhöhung der Flexibilität im Umgang mit Belastungen. Um dieses Ziel zu erreichen und den individuellen Bewältigungskompetenzen des Einzelnen gerecht zu werden, bedarf es eines breiten Angebots innerhalb eines Stressbewältigungstrainings. Deshalb integrieren die meisten Stressbewältigungstrainings mehrere unterschiedliche Interventionsmethoden in multimodale Programme. Wie bei anderen Interventionen auch, kann ein auf die einzelne Person zugeschnittenes Stressbewältigungstraining allerdings erst nach einer genauen Diagnostik der individuellen Voraussetzungen und Bedürfnisse durchgeführt werden. Im vorliegenden Kapitel werden nur wenige ausgewählte übergeordnete Materialien vorgestellt und es wird auf eine Auswahl der wichtigsten deutschsprachigen diagnostischen Verfahren zur Erfassung von Bewältigungsstrategien und therapeutischen Interventionen zur Stressbewältigung verwiesen. Verschiedene Bausteine zur Stressbewältigung können zudem – auf die individuellen Bedürfnisse eines Patienten angepasst – aus den o. g. Kapiteln zusammengestellt werden.

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See detailInhibition in Action - Inhibitory Components in the Behavioral Activation System
Sütterlin, Stefan; Andersson, Stein; Vögele, Claus

in Journal of Behavioral and Brain Science (2011), 1(3), 160-166

Over the past two decades, the neurobiological substrates of the reinforcement theory have been discussed in terms of a behavioral activation system (BAS) and a behavioral inhibition system (BIS). While the BAS has been conceptualized as both an activating system and an approach-related system, the empirical evidence for either approach remains inconclusive. In the current study we hypothesize that the inclusion of self-regula-tory capacity contributes to a better understanding of the BAS. In a sample of 29 volunteers motor response inhibition elicited by a stop-signal task and heart rate variability (HRV) as a proxy of self-regulatory capacity were related to BAS scores (BIS/BAS scales [1]). Results show significant positive associations between inhibitory capacity and the sensitivity of the behavioral activation system, suggesting markers of self-regu-lation as components of the BAS.

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See detailPsychometrische Evaluation der deutschen Barratt Impulsiveness Scale - Kurzversion (BIS-15) - Psychometric evaluation of the German Barratt Impulsiveness Scale - Short Version (BIS-15).
Meule, Adrian; Vögele, Claus; Kübler, Andrea

in Diagnostica (2011), 57(3), 126-133

Impulsivity is a personality trait which is characterized by rapid, unplanned actions regardless of possible negative consequences. One of the most widely used methods to assess impulsivity is the Barratt Impulsiveness Scale (BIS-11; Patton, Stanford & Barratt, 1995). The three factors nonplanning, motor, and attentional impulsivity can be measured sufficiently well with a short version of the BIS-11 (BIS-15; Spinella, 2007). The present study introduces the German version of this short version of the BIS-11. Reliability and factorial structure of this questionnaire were determined in a sample of predominantly university students (N = 752). The three-factorial solution was replicated. Internal consistency was good (Cronbach’s α = .81). Associations with another impulsivity questionnaire (UPPS) in a second study (N = 51) proved convergent validity. We recommend the BIS-15 for assessing impulsivity in German-speaking regions because of its good psychometric properties and economic procedure.

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See detail“What am I going to say here?” The experiences of doctors and nurses communicating with patients in a cancer unit.
Cleland, Jennifer A.; McLean, Margaret; Worrell, Marcia; Vögele, Claus

in Frontiers in Psychology (2011), 2

This paper describes a study investigating the provider-patient communication perceptions, experiences, needs and strategies of doctors and nurses working together in a UK cancer setting. This was a qualitative study using individual interviews and 32 focus group discussions. Interpretative Phenomenological analysis (IPA) was used to underpin data collection and analysis. Twenty-six staff participated in the project (18 nurses and 8 doctors). Both professional groups identified an inherent emotional strain in their daily interactions with patients. The strategies they adopted to reduce this strain fell into two main categories: 1) Handling or managing the patient to keep negative emotion at bay; and 2) Managing self to keep negative emotion at bay. These strategies allowed staff to maintain a sense of control in an emotionally-stressful environment. Most believed that their communication skills were sufficient. In conclusion, communicating with and caring for cancer patients causes considerable psycho-social burden for doctors and nurses. Managing this burden influences their communication with patients. Without recognition of the need for staff to protect their own emotional well-being, communication skills training programmes, emphasised in current UK cancer care guidelines, may have little impact on practice.

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See detailARTiiFACT: a tool for heart rate artifact processing and heart rate variability analysis
Kaufmann, Tobias; Sütterlin, Stefan; Schulz, Stefan M.; Vögele, Claus

in Behavior Research Methods (2011), 43(4), 1161-1170

The importance of appropriate handling of artifacts in interbeat interval (IBI) data must not be underestimated. Even a single artifact may cause unreliable heart rate variability (HRV) results. Thus, a robust artifact detection algorithm and the option for manual intervention by the researcher form key components for confident HRV analysis. Here, we present ARTiiFACT, a software tool for processing electrocardiogram and IBI data. Both automated and manual artifact detection and correction are available in a graphical user interface. In addition, ARTiiFACT includes time- and frequency-based HRV analyses and descriptive statistics, thus offering the basic tools for HRV analysis. Notably, all program steps can be executed separately and allow for data export, thus offering high flexibility and interoperability with a whole range of applications.

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See detailEnhanced behavioral inhibition in restrained eaters
Meule, Adrian; Lukito, Steve; Vögele, Claus; Kübler, Andrea

in Eating Behaviors (2011), 12(2), 152-155

Impulsivity has been found to play a decisive role in both addiction and disordered eating. Behavioral and self-report measures show impulsive tendencies to even occur in non-clinical samples, e.g. restrained eaters. Within this group, these traits interact with high reactivity to food-related cues leading to overeating. The aim of the present study was to investigate if restrained eaters show this behavioral disinhibition specifically in response to food-cues. Participants performed a Go/No-Go-task with stimuli encircled by pictures of high caloric foods or neutral objects. In contrast to our hypotheses, participants with medium-to-high restrained eating made less commission errors in response to both food and neutral pictures than unrestrained eaters. Additionally, participants' inhibitory performance in the high-restrained group were enhanced in the presence of food pictures. Results are in line with expanding evidence of counteractive-control mechanisms when restrained eaters are confronted with tempting food-related cues.

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See detailThe allure of the cream gateau: Attentional and response bias towards high calorie foods
Lutz, Annika; Meule, Adrian; Kübler, Andrea; Vögele, Claus

Scientific Conference (2011)

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See detailSelbstregulation und Inhibition von „Food Cravings“
Lutz, Annika; Meule, Adrian; Kübler, Andrea; Vögele, Claus

in Vögele, Claus (Ed.) Von der Forschung zur Praxis 13. Kongress der Deutschen Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation – DGVM (2011)

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See detailFrames, decisions, and cardiac-autonomic control
Sütterlin, Stefan; Herbert, Cornelia; Schmitt, Michael; Kübler, Andrea; Vögele, Claus

in Social Neuroscience (2011), 6(2), 169-177

The “framing effect” (FE) describes the phenomenon whereby human choices are susceptible to the way they are presented rather than objective information. The present study extends common decision-making paradigms with frame variation by including inhibitory control, operationalized as vagally mediated heart rate variability (HRV) at rest and motor response inhibition during a stop-signal task (SST). We hypothesized that inhibitory control is inversely associated with susceptibility to framing effects. Forty adult volunteers performed a risky-choice framing task in which identical information about wins and losses was presented using loss or gain frames. As predicted, there was an inverse association between HRV and framing effects, accounting for 23% of the variance in framing effects. Inhibitory control as indexed by performance in the SST was not associated with framing effects. These results are discussed in terms of the role of inhibitory processes (as indicated by vagal activity) for decision-making processes.

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See detailOvercoming selfishness: Reciprocity, inhibition, and cardiac autonomic control in the ultimatum game
Sütterlin, Stefan; Herbert, Cornelia; Schmitt, Michael; Kübler, Andrea; Vögele, Claus

in Frontiers in Psychology (2011), 2(173), 1-16

The processes underlying decision-making in response to unfair offers in the ultimatum game (UG) have recently been discussed in light of models of reciprocity and fairness-related behavior. It has been suggested that behavior following norm-oriented, internalized expectations of reciprocity requires overcoming economic self-interest. In this study we investigated both, behavioral and peripheral-physiological indicators of inhibitory capacity related to neuronal networks that are likely to be involved in the behavioral response to unfair offers. Both heart-rate variability as an index of inhibitory capacity, and performance in a motor response inhibition task predicted rejection of unfair offers in an ultimatum game, suggesting an important role of inhibitory processes in overcoming economic temptations and regulating behavior conforming to social norms of reciprocity and fairness. The role of parasympathetic activity as a physiological trait-marker predicting inter-individual differences in the rejection of unfair offers is discussed.

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See detailPsychophysiological responses to idiosyncratic stress in Bulimia Nervosa and Binge Eating Disorder.
Hilbert, Anja; Vögele, Claus; Tuschen-Caffier, Brunna; Hartmann, Andrea S.

in Physiology & Behavior (2011), 104

This study examined psychophysiological stress responses to idiosyncratically relevant stress in bulimia nervosa (BN) and binge eating disorder (BED), in relation to autonomic cardiac control and nutritional status. A total of 81 women with BN, BED and healthy controls (HC) took part in an in sensu exposure to idiosyncratic stress. Psychological and peripheral physiological parameters were measured, and tonic heart rate variability, nutritional status, and types of stress were determined. In response to stress exposure, both eating disordered groups showed a stronger reactivity of sadness, and the BED group showed a stronger reactivity of insecurity than the HC group. Desire to binge was increased in the context of interpersonal stress. Stress exposure led to increased cardiovascular activity and reduced electrodermal activity that did not differ by group. The BN-specific symptomatology moderated the association between autonomic cardiac control and psychophysiological stress responses. The results suggest common and specific psychophysiological processes in symptom maintenance through life stress in BN and BED.

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See detailInteroception and inhibitory capacity in panic disorder and somatoform disorders
Grosche, Christian; Sütterlin, Stefan; Koch, Stefan; Schulz, Stefan M.; Vögele, Claus

in 13. Kongress der Deutschen Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation (2011)

Hintergrund: Nach Damasios Theorie der Somatischen Marker werden Entscheidungen in komplexen Situationen durch die Wahrnehmung physiologischer Vorgänge (Interozeption) sowie durch die individuelle Fähigkeit zu dieser Wahrnehmung (Interozeptivität) beeinflusst. Im Sinne zielgerichteten Verhaltens müssen die auf diese Weise gewonnenen, emotional mediierten Informationen bei Bedarf reguliert werden, wofür präfrontal initiierte, inhibitorische Prozesse maßgeblich sind. Die hierfür notwendige Inhibitionskapazität kann durch die vagal mediierte und präfrontal modulierte Herzratenvariabilität (HRV) peripherphysiologisch quantifiziert werden. Die Interaktion interozeptiver und inhibitorischer Fähigkeiten bei Entscheidungen unter emotional ablenkenden Bedingungen ist im klinischen Kontext insbesondere bei Krankheitsbildern mit disinhibitorischen und körperwahrnehmungsbezogenen Symptomen relevant. Die vorliegende Studie untersuchte Entscheidungsprozesse unter emotionalen Einflüssen bei Patienten mit Panikstörung und Somatoformen Störungen. Methode: 17 Patienten mit Panikstörung und 20 Patienten mit Somatoformen Störungen wurden im stationären Setting einer psychosomatischen Klinik untersucht. Die Interozeptivität wurde mit einer Trackingaufgabe des Herzschlages bestimmt, zur HRV-Bestimmung ein EKG unter Ruhebedingung aufgezeichnet. Entscheidungsprozesse wurden mit Hilfe einer emotionalen Flanker Task und der Iowa Gambling Task untersucht. Ergebnisse: Bei Patienten mit Panikstörung zeigte sich eine negative Interaktion zwischen HRV und Interozeptivität, die darüber hinaus mit der Ablenkbarkeit durch emotionale Reize in der Flanker Task assoziiert war. Bei Patienten mit Somatoformen Störungen traten diese Zusammenhänge nicht auf. Patienten mit Panikstörung zeigten eine signifikant niedrigere HRV im Vergleich mit Patienten mit Somatoformen Störungen. Diskussion: Die Ergebnisse legen nahe, dass Interozeptivität und Inhibitionskapazität jeweils allein nicht ausreichend sind, um die untersuchten klinischen Störungen spezifisch zu charakterisieren. Eine negative Interaktion beider Maße allerdings scheint spezifisch mit der Panikstörung assoziiert zu sein und spricht für eine präzise, aber dysfunktionale interozeptive Wahrnehmung bei verminderter Regulationskapazität, was sich in der Beeinflussung der Aufmerksamkeitsausrichtung durch emotionale Prozesse manifestiert.

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See detailPrepubertal gonadotropin-releasing hormone analog leads to exaggerated behavioral and emotional sex differences in sheep
Wojniusz, Slawomir; Vögele, Claus; Ropstad, Erik; Evans, Neil; Robinson, Jane; Sütterlin, Stefan; Erhard, Hans W.; Solbakk, Anne-Kristin; Endestad, Tor; Olbergh, Dag Erlend; Haraldsen, Ira

in Hormones and Behavior (2011), 59(1), 22-27

In mammals, sex specialization is reflected by differences in brain anatomy and function. Measurable differences are documented in reproductive behavior, cognition, and emotion. We hypothesized that gonadotropin-releasing hormone (GnRH) plays a crucial role in controlling the extent of the brain's sex specificity and that changes in GnRH action during critical periods of brain development, such as puberty, will result in altered sex-specific behavioral and physiological patterns. We blocked puberty in half of the 48 same-sex Scottish mule Texel cross sheep twins with GnRH analog (GnRHa) goserelin acetate every 3 weeks, beginning just before puberty. To determine the effects of GnRHa treatment on sex-specific behavior and emotion regulation in different social contexts, we employed the food acquisition task (FAT) and measurement of heart rate variability (HRV). ANOVA revealed significant sex and sex × treatment interaction effects, suggesting that treated males were more likely to leave their companions to acquire food than untreated, while the opposite effect was observed in females. Concordant results were seen in HRV; treated males displayed higher HRV than untreated, while the reverse pattern was found in females, as shown by significant sex and sex × treatment interaction effects. We conclude that long-term prepubertal GnRHa treatment significantly affected sex-specific brain development, which impacted emotion and behavior regulation in sheep. These results suggest that GnRH is a modulator of cognitive function in the developing brain and that the sexes are differentially affected by GnRH modulation.

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See detailPsychische Störungen bei HIV-Infektion und Aids: Klinisch-psychologische Diagnostik und Intervention
Vögele, Claus

in Psychotherapeut (2010), 55(3), 194-202

Noch nie zuvor waren so viele Menschen mit dem „human immunodeficiency virus“ (HIV) infiziert wie heute. Mehr als 39 Mio. Menschen leben mit der HIV-Infektion. Durch die Fortschritte der medizinischen Behandlung leben die Betroffenen heute sehr viel länger als vor der Einführung der modernen Kombinationstherapie („highly active anti-retroviral therapy“, HAART; s. Abschn. „Medizinische Behandlung“). Dadurch ist die HIV-Infektion/Aids zu einer chronischen Erkrankung geworden, die vom betroffenen Patienten ein hohes Maß an Anpassungsleistungen verlangt. Sie ist nicht heilbar und in unserer Gesellschaft immer noch stigmatisiert. Psychische Störungen sind häufig, werden aber oft nicht erkannt oder behandelt. Dabei könnten psychologische Interventionen entscheidend zur Verbesserung der Lebensqualität und Behandlungsadhärenz, zur Behandlung psychischer Begleiterkrankungen und zur Stärkung des Immunsystems beitragen.

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See detailFood choice: reason, drive or learned behaviour?
Vögele, Claus

in Agro Food Industry Hi Tech (2010), 21(3), 2-3

Editorial

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See detailNeuropsychiatric Complications of Efavirenz Therapy: Suggestions for a New Research Paradigm
Sütterlin, Stefan; Vögele, Claus; Gauggel, Siegfried

in Journal of Neuropsychiatry and Clinical Neurosciences (2010), 22

This review gives an up-to-date account of the current state of research on neuropsychiatric complications associated with efavirenz therapy and critiques the methods used in previous studies. The authors suggest an extension of current research strategies using psychophysiological concepts and including behavioral regulation models. From a practical perspective, these may contribute to better screening methods for the identification of those at risk for neuropsychiatric complications and the improvement of neuropsychiatric monitoring during efavirenz treatment. From a theoretical viewpoint, the suggested research paradigms may help to move beyond the current state of descriptive approaches and thus improve our limited understanding of underlying mechanisms.

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See detailMood, emotions and eating disorders
Vögele, Claus; Gibson, E. Leigh

in Agras, W. S. (Ed.) Oxford Handbook of Eating Disorders. (2010)

Mood and emotions are intrinsically involved with eating. The question is in what ways do these normal emotional relations with food contribute to, or shed light on, the development of abnormal relations with food that eventually become clinical eating disorders (EDs). This chapter discusses basic mechanisms, findings, and models that help our understanding of the interactions between eating and emotions, in both clinical and nonclinical populations. The finding that comorbidity with mood and anxiety disorders is the norm among patients with EDs suggests that EDs may not necessarily be restricted to domains of eating behavior and body image but may also be associated with significant difficulties in affective functioning. This chapter reviews the evidence relating to the notion that EDs are disturbances of mood regulation, in which regulatory strategies specifi cally related to eating and the body are used to diminish negative affect associated with food, body image, or stress.

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See detailCardiac autonomic regulation and anger coping in adolescents
Vögele, Claus; Sorg, Sonja; Studtmann, Markus; Weber, Hannelore

in Biological Psychology (2010), (85), 465-471

The current study investigated spontaneous anger coping, cardiac autonomic regulation and phasic heart rate responses to anger provocation. Forty-five adolescents (27 female, mean age 14.7 years) attended the single experimental session, which included monitoring of continuous heart rate and blood pressure responses to anger provocation (receiving an unfair offer) using a modified version of the Ultimatum Game (UG). Vagal activation was operationalized as high frequency component of heart rate variability during rest periods, and spontaneous baroreflex-sensitivity (SBR) during the UG. Adolescents employing cognitive reappraisal showed higher vagal activity under resting conditions and attenuated heart rate deceleration after receiving the unfair offer compared with participants who tended to ruminate about their anger and experienced injustice. Results from SBR suggested vagal withdrawal in anger ruminators during contemplation of the unfair offer. These results provide further support for the specificity and sensitivity of vagal responses to higher cortical functions such as emotion regulation.

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See detailPhysical activity and dietary intake of children aged 9-11 years and the influence of peers on these behaviours: a one-year follow-up.
Coppinger, Tara; Jeanes, Yvonne; Dabinett, Jacqueline; Vögele, Claus; Reeves, Sue

in European Journal of Clinical Nutrition (2010), 64(8), 776-781

Background: This study investigated physical activity and dietary intake of children aged 9–11 years, and the influence of peers on these behaviours over a 2-year period. Methods: A total of 106 (64 girls; 42 boys) children were investigated annually, over 2 years. Measures included physical activity (sealed pedometer), self-report measures of dietary intake and physical activity, and a peer influence questionnaire. Anthropometric measures of height and weight were also obtained. Results: The findings reveal insufficient energy intakes, physical activity levels and fruit and vegetable consumption but high intakes of saturated fat and sodium, over time, in both boys and girls. Both male calcium and female iron intakes were also of concern. Throughout the survey, peers were found to influence physical activity behaviour but not dietary intake. Conclusions: The fact that youth consistently failed to meet established nutrition and physical activity recommendations highlights the importance of promoting physical activity and healthy eating to children younger than 9 years of age. The finding that peers significantly influence physical activity behaviour over time should be considered when designing new physical activity interventions aimed at young people.

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See detailEffects of peer influence on dietary intake and physical activity in school children
Finnerty, Tara; Reeves, Sue; Dabinett, Jaqueline; Jeanes, Yvonne; Vögele, Claus

in Public Health Nutrition (2010), 13(3), 376-383

Objective: To investigate the dietary intake and physical activity of boys and girls aged 9–13 years, and the influence of peers on these behaviours. Design: Cross-sectional study. Setting: Nine primary and secondary schools in south-west London. Subjects: A total of 315 children wore sealed pedometers, provided self-report measures of dietary intake and answered a questionnaire relating to peer influence. Anthropometric measures of height and weight were also obtained. Results: Obese children had the lowest reported energy intakes and the lowest step counts per day. Boys took significantly more steps per day than girls, however girls were closer to achieving their recommended cut-offs for physical activity. Girls had lower energy intakes per day and lower BMI Z-scores than boys, however both genders, across all age groups, had higher than recommended intakes of saturated fat. There were significant associations between peer influence and physical activity levels but not between peer influence and dietary intake. Conclusions: Low energy intake and physical activity levels but high saturated fat intakes among boys and girls across all age groups highlight the importance of promoting both physical activity and healthy food choices. The finding that peers have a significant effect on physical activity levels but not on dietary intake offers an important approach for the design of health promotion interventions and obesity prevention programmes. Such designs may be particularly beneficial for obese youth, since the low physical activity levels found could be a major contributing factor to the maintenance of the condition.

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See detailPsychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia (Protocol)
Powell, Rachael; Bruce, Julie; Johnston, Marie; Vögele, Claus; Scott, Neil; Shemar, Manjee; Roberts, Tracey

in Cochrane Database of Systematic Reviews (Online) (2010), (8), 1-15

Objective: To review the effects of psychological preparation on postoperative outcomes in adults undergoing elective surgery under general anaesthetic.

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See detailCognitive mediation of clinical improvement after intensive exposure-based therapy of agoraphobia and social phobia
Vögele, Claus; Ehlers, Anke; Meyer, Andrea H.; Frank, Monika; Hahlweg, Kurt; Margraf, Jürgen

in Depression and Anxiety (2010), (27), 294-301

Background: The present study investigated cognitive mediation of clinical improvement in patients with agoraphobia (N5427) or social phobia (N598) receiving high-density exposure therapy in a naturalistic clinical treatment setting. Methods: Patients were assessed before therapy, 6 weeks after the end of therapy, and 1 year thereafter, using a self-report assessment battery. Lower level mediation analyses provided support for the notion that cognitive changes partially mediate clinical improvement after exposure therapy. Results: Changes in cognitions relating to physical catastrophes mediated treatment outcome only for patients with agoraphobia, whereas changes in cognitions about loss of control mediated outcome for both agoraphobia and social phobia patients. Changes in relationship satisfaction did not mediate symptomatic improvement. Conclusions: The results extend previous findings by demonstrating mediation in an unselected clinical sample and by providing evidence for the specificity of mediation effects. They further support the importance of cognitive changes in cognitive–behavior therapy. Depression and Anxiety 27:294–301, 2010.

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See detailNutritional profiles in a public health perspective: a critical review
Foltran, Francesca; Verduci, Elvira; Ghidina, Marco; Campoy, Cristina; Jany, Klaus-Dieter; Wildham, Kurt; Biasucci, Giacomo; Vögele, Claus; Halpern, Georges M.; Gregori, Dario

in Journal of International Medical Research (The) (2010), 38(2), 318-385

Nutritional profiling is defined as ‘the science of categorizing foods according to their nutritional composition’ and it is useful for food labelling and regulation of health claims. The evidence for the link between nutrients and health outcomes was reviewed. A reduced salt intake reduces blood pressure, but only a few randomized controlled trials have verified the effect of salt on overall and cardiovascular mortality. Evidence linking a reduced fat intake with cardiovascular mortality and obesity is generally nonsignificant. Studies that have examined the relationship between obesity and diet have produced contrasting results. A simulation exercise that demonstrated that the impact of a reduced salt and fat intake on overall mortality would be negligible in the European population was carried out. Consideration of the literature and the results of this simulation exercise suggest that the introduction of nutritional profiles in Europe would be expected to have a very limited impact on health outcomes.

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See detailThe psychology of childhood obesity
Vögele, Claus

in Agro Food Industry Hi Tech (2009), 5(20), 34-37

The prevalence of obesity in children and adolescents has been increasing worldwide at an alarming rate. Childhood obesity is not only associated with significant risks for chronic physical conditions, but also impacts negatively on self-esteem, body-image and quality of life. Psychological factors may contribute to the development and maintenance of overweight and obesity through the family environment, dieting behaviour, stress and negative affect. Among the psychological consequences of obesity in childhood are reduced quality of life, social seclusion and an increased risk for psychopathology, especially anxiety and depression. In addition, psychological factors significantly predict outcome of obesity treatment.

See detailMedizinische Eingriffe und Operationsstress
Vögele, Claus

in Bengel, J.; Jerusalem, M. (Eds.) Handbuch der Gesundheitspsychologie und Medizinischen Psychologie (2009)

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See detailKlinische Psychologie: Körperliche Erkrankungen
Vögele, Claus

Book published by Weinheim: Verlagsgruppe Beltz - Psychologie Verlags Union. (2009)

The book describes in uniformly structured chapters the foundations and the application of psychological assessment and treatment approaches for 8 chronic physical conditions: cardiovascular disorders, COPD, obesity, diabetes, cancer, HIV, musculo-skeletal disorders and chronic pain, and neurological conditions. It is unique in its practical approach by giving advice on empirically based methods from Clinical and Health Psychology. It is also rare to find a monograph on this topic, as most volumes are edited books that attempt to provide a more detailed account of current research, which is usually out-dated by the time the book is published. The current monograph draws almost exclusively on meta-analyses rather than to “get lost in detail”, thereby providing a solid and more lasting empirical foundation that is translated into recommendations for daily practice. It is also low-cost and user friendly as supporting material (e.g. assessment methods, therapeutic formulations, case histories etc.) is published as pdf via the publisher’s web-site.

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See detailOptimism, self-efficacy, and perceived stress as predictors of self-reported health symptoms in college students
Schulz, Heiko; Vögele, Claus; Meyer, Björn

in Zeitschrift für Gesundheitspsychologie (2009), 17

Studies provide support for the notion of increased vulnerability to upper respiratory track infections (URIs) with exposure to psychological stress, but only few have examined whether optimism and self-efficacy might moderate this relationship. The purpose of the present study was to examine (a) the influence of academic exam stress on susceptibility to URIs and (b) the extent to which these personality characteristics buffer against stress-related vulnerability to URIs. Using a repeated-measures design, URI infection status was measured in a sample of 80 college students with self-reports both during an exam period and outside such a period. Results suggested that optimism may protect from the adverse influence of heightened stress and that pessimistic, low self-efficacious participants may be at elevated risk for the development of URIs at times of increased stress.

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See detailDietary restriction, cardiac autonomic regulation and stress reactivity in bulimic women
Vögele, Claus; Hilbert, Anja; Tuschen-Caffier, Brunna

in Physiology & Behavior (2009), 98

Recent !ndings suggest sympathetic inhibition during dietary restriction as opposed to increased sympathetic activity during re-feeding. The present study investigated cardiac autonomic regulation and stress reactivity in relation to biochemical markers of dietary restriction status in women diagnosed with bulimia nervosa. We predicted that bulimic individuals (BN) with a biochemical pro!le indicating dietary restriction exhibit reduced cardiac sympathetic and/or increased vagal activity. We also hypothesized, that BN with a biochemical pro!le within a normal range (i.e. currently not dieting or malnourished) would show heart rate variability responses (HRV) and reactivity to mental stress indicating increased sympathetic activation compared with non-eating disordered controls. Seventeen female volunteers diagnosed with bulimia nervosa were categorized according to their serum pro!le (glucose, pre-albumin, IGF-1, TSH, leptin) into currently fasting versus non-fasting and compared with 16 non-eating disordered controls matched for age and BMI. Spectral components of HRV were calculated on heart rate data from resting and mental stress periods (standardized achievement challenge) using autoregressive analysis. Compared to non-fasting BN and controls, fasting BN showed increased vagal and decreased sympathetic modulation during both resting and recovery periods. Cardiac autonomic regulation was not impaired in response to mental challenge. No differences could be found between non-fasting BN and controls. The results con!rm the notion of cardiac sympathetic inhibition and vagal dominance during dietary restriction and suggest the speci!city of starvation related biochemical changes for cardiac autonomic control. The results are discussed in terms of the higher incidence in cardiac complications in these patients.

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See detailThe potential of including the UK in comparisons with other European countries in research on teenage pregnancy
Franz, Anke; Worrell, Marcia; Gilvarry, Catherine; Vögele, Claus

in Critical Social Policy (2009), 29

This article is a response to Arai (2003) ‘British policy on teenage pregnancy and childbearing: The limitations of comparisons with other European countries’ (Critical Social Policy 23: 89–102). It discusses the arguments put forward by Arai there that cross-cultural comparisons in the area of teenage pregnancy are often problematic due to the unique demographics of the UK. While Arai’s considerations are important for cross-cultural research, they need to be more sensitive to the differences between countries included in these comparisons. Our article illustrates the potential value of cross-cultural research, using Germany as an exam- ple, and concludes that, as long as countries for such comparisons are cho- sen carefully, the merit of cross-cultural research on topics such as teenage pregnancy far exceeds its limitations.

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See detailFamily structure, body mass index and eating behaviour
Hasenböhler, Kathrin; Munsch, Simone; Meyer, Andrea H.; Käppler, Christoph; Vögele, Claus

in International Journal of Eating Disorders (2009), 42

Objective: To explore associations between family structure, children’s body mass index (BMI), and eating behaviors of children and their mothers. Method: Fifty-seven mothers and their children took part in an experimental study. BMI of children was measured. Mothers were asked to provide self- report data on sociodemographic back- ground, mental health, and eating behaviors about themselves and their children. Parent-child-dyads represented their family structure using the Family System Test. Results: We found negative associations in typical family situations between family hierarchy and children’s BMI, mothers’ emotional eating and mothers’ restrained eating. Family cohesion and restrained eating of the children were also negatively correlated. We obtained positive associa- tions in typical and conflict family situa- tions between family cohesion and external eating of the children. Discussion: We found indications that family structure is associated with overweight and with eating behavior in children and their mothers. VC 2008 by Wiley Periodicals, Inc.

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See detailPreference for attractiveness and thinness in a partner: Influence of internalization of the thin ideal and shape/weight dissatisfaction in heterosexual women, heterosexual men, lesbians, and gay men
Legenbauer, Tanja; Vocks, Silja; Schäfer, Corinna; Schütt-Strömel, Sabine; Hiller, Wolfgang; Wagner, Christof; Vögele, Claus

in Body Image (2009), 6

This study assesses whether characteristics of one’s own body image influences preferences of attractiveness in a partner. The role of gender and sexual orientation is also considered. Heterosexual women (n = 67), lesbian women (n = 73), heterosexual men (n = 61) and gay men (n = 82) participated in an internet survey assessing attitudes towards the body and preferences of attractiveness in a partner. Men in particular were found to prefer attractive partners, regardless of sexual orientation. Weight/shape dissatisfaction was found to be a negative predictor for heterosexual men and women. For gay men, preferences were better explained by internalization and weight/shape dissatisfaction. No such associations were found in the lesbian group. Levels of weight/shape dissatisfaction and internalization of socio-cultural slenderness ideals influence expectations of thinness and attractiveness in a partner with this effect being modified by gender and sexual orientation.

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See detailSympathetic activity relates to adenosine A2A receptor gene variation in blood-injury phobia
Hohoff, Christa; Domschke, Katharina; Schwarte, Kathrin; Spellmeyer, Gerd; Vögele, Claus; Hetzel, Günther; Deckert, Jürgen; Gerlach, Alexander L.

in Journal of Neural Transmission (2009), 116

Variation in the candidate genes adenosine A(2A) receptor (A(2A)R), catechol-O-methyl-transferase (COMT), and norepinephrine transporter (NET) has been suggested to influence vulnerability to panic disorder. We therefore investigated patients with another anxiety disorder with an even higher heritability, the blood-injury phobia, for association of these variants and used sympathetic measures during venipuncture, which serve as a naturalistic trigger of anxiety and autonomic hyperarousal, as an intermediate phenotype of anxiety. Patients homozygous for the A(2A)R 1976T allele as compared to patients carrying at least one 1976C allele exhibited a significantly increased respiratory rate with a trend towards elevated measures of systolic and diastolic blood pressure and respiratory minute volume. None of the sympathetic measures were influenced by the COMT or NET polymorphisms.This study provides preliminary data suggesting an influence of the A(2A)R 1976C/T polymorphism on sympathetic psychophysiological indicators of anxiety-related arousal in blood-injury phobia and thereby further supports a role of the A(2A)R gene in the pathogenesis of anxiety disorders.

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See detailHealthy food and healthy choices: a new European profile approach
Azaïs-Braesco, Véronique; Brighenti, Furio; Paoletti, Rodolfo; Peracino, Andrea; Scarborough, Peter; Visioli, Francesco; Vögele, Claus; Azaïs-Braesco, Véronique

in Atherosclerosis. Supplements (2009), 10(4), 1-11

Poor or unbalanced nutrition, or both, is linked to the development of a variety of diseases, including cardiovascular disease, obesity, and diabetes mellitus, which collectively represent significant causes of disability and premature death and impose a substantial economic burden. As a result, health authorities and regulatory bodies across Europe are implementing policies to promote healthy eating habits with the aim to attenuate the burgeoning incidence of diet-related diseases. In order to support these efforts, and within the context of a project dedicated to interrelations between nutrition and atherosclerosis, European experts convened on October 24, 2008 at a Session on “Healthy food and healthy choices: A new European profile approach,” during an international symposium in Venice, Italy. The aim of this session was to review issues relating to dietary policies, eating behaviour, food labelling, and nutritional profiling of foods. The present article highlights the key points of this session. Since eating takes place in a behavioural, social, and cultural context, a more relaxed pattern of interacting with food needs to be fostered, especially in children. Excessive regulation alone is insufficient and probably counter-productive to substantially impact population eating practices because automatic behaviour dominates our decision-making process with respect to food choices. Consumers urgently need simple, practical tools to help them make healthy food choices in a real-life setting. Front of pack labelling allows consumers to see the levels of key nutrients in foods; nevertheless more research is needed to assess how people use the different food labelling systems in real-life contexts. While policy changes including legislation and regulation can play an important role in changing behaviour, individuals need more assistance, education, and tools to help them to increase their personal responsibility for their health particularly with respect to diet.

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See detailMental disorders in Chronic Obstructive Pulmonary Disease
Vögele, Claus; von Leupoldt, Andreas

in Respiratory Medicine (2008), 102

Recent research using questionnaire measures has demonstrated high prevalence rates of mental disorders in chronic obstructive pulmonary disease (COPD). However, clinical interviews and clinical rather than healthy control groups have rarely been employed. The aim of the present study was to assess mental disorders in patients with COPD with advanced methodology, to identify moderating factors explaining mental co-morbidities and to compare results with a clinical control group without COPD. A standardized clinical interview (F-DIPS) and a range of questionnaires were used to assess mental disorders, perceived physical symptoms and cognitions in 20 hospitalized patients with mild-to-moderate COPD (mean FEV(1)/VC (%)=61.3). Results were compared with a hospitalized clinical control group without pulmonary dysfunction (CCG; N=20). Results showed that 55% of patients with COPD received a diagnosis of a mental disorder compared to 30% of CCG patients. All principal mental diagnoses in the COPD group were anxiety disorders (especially Panic Disorder with Agoraphobia), while CCG patients received a wider range of diagnoses (anxiety, pain, alcohol abuse). There was no systematic association between anxiety levels and respiratory function in the whole COPD group, but a positive correlation between anxiety levels and perceived physical symptoms (p<0.001) as well as negative cognitions (p<0.001 and p<0.05, respectively) for COPD patients with anxiety disorder (N=11). The present results confirm the high prevalence rate of anxiety in patients with COPD and suggest further that anxiety in COPD patients may be mediated by cognitive processes. These findings are discussed in terms of their implications for treatment.

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See detailThe role of parental control practices in explaining children’s diet, activity and BMI
Brown, Kerry A.; Ogden, Jane; Vögele, Claus; Gibson, E. Leigh

in Appetite (2008), 50

This paper aimed to investigate which parents use which types of parenting control practices to manage their children's diets and to assess the impact of these practices on children's dietary patterns and their BMI. A cross-sectional survey of 518 parents with children aged 4-7 years was carried out in 18 primary schools across the South of England. Measures included aspects of parental control practices and the child's diet. Results showed that older parents with a lower BMI and who were stay at home parents used more "snack overt control", "snack covert control" and "meal covert control" and those with more education used more covert control strategies. In contrast, male, non-white parents with younger children used more "pressure to eat". In terms of the children's diet, the results showed links between parental and child demographics and aspects of unhealthy and healthy food intake. In addition, links were also found for parental control practices. For example, eating more unhealthy snacks was related to less covert control and more pressure to eat, eating fruit and vegetables was related to higher levels of both overt and covert control over meals and less pressure to eat and being neophobic was related to less covert control over meals and more pressure to eat. The children's BMIs were unrelated to any variables measured in the study.

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See detailDaily hassles and emotional eating in obese adolescents under restricted dietary conditions – the role of ruminative thinking
Kubiak, Thomas; Vögele, Claus; Siering, Mareike; Schiel, Ralf; Weber, Hannelore

in Appetite (2008), 51

Emotional eating is conceptualized as eating in response to negative affect or distress and is discussed as a mechanism leading to eating binges. Recent evidence suggests that eating may not only be triggered by negative affect, but also ruminative thinking. We report results of an experience sampling study examining the role of rumination for emotional eating in 16 obese adolescents (M=15.5 years, S.D.=1.4; range 14-17, body mass index M = 31.1 kgm(-2), S.D.=5.5) under restricted dietary conditions. We hypothesized that daily hassles type of stress predicted the individuals' desire to eat, with the predictive value further increased when negative affect and rumination were accounted for. The results of mixed regression modeling were in line with our predictions, suggesting a significant contribution of ruminative thinking to the mechanisms of negative affect induced eating.

See detailElektrodermale Aktivität
Vögele, Claus

in Gauggel, S.; Herrmann, M. (Eds.) Handbuch der Neuro- und Biopsychologie (2007)

See detailGesundheitsförderung und Gesundheitserziehung
Vögele, Claus

in Kerr, J.; Weitkunat, R.; Moretti, M. (Eds.) ABC der Verhaltensänderung (2007)

See detailKardiovaskuläre Aktivität
Vögele, Claus

in Gauggel, S.; Herrmann, M. (Eds.) Handbuch der Neuro- und Biopsychologie (2007)

See detailKardiovaskuläre Reaktivität und Bluthochdruck
Vögele, Claus

in Leupoldt, A.v.; Ritz, T. (Eds.) Verhaltensmedizin – Perspektiven aus Psychobiologie, Psychopathologie und klinischer Anwendung (2007)

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See detailSurgery
Vögele, Claus

in Ayers, S.; Baum, A.; McManus, C.; Newman, S.; Wallston, K.; Weinman, J.; West, R. (Eds.) Cambridge Handbook of Psychology, Health & Medicine (2007)

See detailSurgery and stress
Vögele, Claus

in Fink, G. (Ed.) Encyclopedia of Stress, 3 (2007)

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See detailCue reactivity in male restrained eaters: the role of negative cognitions as predictors of food intake
Hilbert, Anja; Vögele, Claus; Himmelmann, Uta

in Eating and Weight Disorders (2007), 12

OBJECTIVE: While restrained eating is one of the most well-established risk factors of eating disorders in females, its role for eating disturbances in males remains largely unclear. The present study investigates eating behaviour in response to food cues and negative cognitions in male restrained eaters. METHODS: Twenty-four restrained eaters and 21 unrestrained eaters volunteered in a cue reactivity experiment consisting of two exposure trials with and without response prevention. Food and macronutrient intake were monitored, and negative cognitions were assessed using a self-report cognition inventory. RESULTS: Male restrained eaters consumed a larger amount of food, specifically carbohydrates, than unrestrained eaters. This greater food intake was predicted by negative cognitions about self-esteem and occurred in restrained eaters who had reported binge eating episodes in the diagnostic interview. DISCUSSION: Results suggest marked cue reactivity in male restrained eaters with an increased risk of overeating in those who experience low situational self-esteem and who are binge eaters.

See detailSexualverhalten
Vögele, Claus

in Lohaus, A.; Jerusalem, M.; Klein-Heßling, J. (Eds.) Gesundheitsförderung im Kindes- und Jugendalter (2006)

See detailSport und körperliche Aktivität
Lippke, Sonja; Vögele, Claus

in Renneberg, B.; Hammelstein, P. (Eds.) Gesundheitspsychologie (2006)

See detailErnährung, Über- und Untergewicht
Vögele, Claus; Ellrott, Thomas

in Lohaus, A.; Jerusalem, M.; Klein-Heßling, J. (Eds.) Gesundheitsförderung im Kindes- und Jugendalter (2006)

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See detailChronic illness as a stimulus to eupraxia in patient-centred medicine: The example of long-term diagnosis with HIV
Whitaker, Rupert; Vögele, Claus; McSherry, Kevin; Goldstein, Ellen

in Chronic Illness (2006), 2

The biopsychosocial challenges of living with human immunodeficiency virus (HIV) have changed over time and they dictate the need for relevant medical services. The meaning of an HIV diagnosis has moved from a terminal to a manageable condition with the development of antiretrovirals, bringing profound changes to the experience of living with HIV and the meaning and use of diagnostic labels. Six biological stage-related categories in the literature of psychological medicine of HIV are critiqued. Long-term HIV highlights the inadequacy of physician-centred, acute-care medicine in chronic illness and its exclusion of preventive, psychological and rehabilitative modalities. ‘Eupraxia’ is presented as a conceptual framework for chronic care medicine, referring to best practice, wellbeing, best interests, and (public) welfare, through facilitated but collaborative approaches. A public-centred service model is proposed, using idiographic assessment and treatment by clinicians as patient delegates (proxies), monitoring joined-up care, providing group-based biopsychosocial treatment, facilitating autonomous and self-managing behaviour by the public, removing professional and practice hierarchies, and implementing real-time clinical and managerial accountability with public ownership and involvement. This model is superior in its health- and cost-effectiveness but can only work within a nationalized system that focuses equally on standardized outcomes and evidential and personalized health outcomes.

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See detailBlood phobia with and without a history of fainting: disgust sensitivity does not explain the fainting response
Gerlach, Alexander L.; Spellmeyer, Gerd; Vögele, Claus; Huster, René; Stevens, Stephan; Hetzel, Günther; Deckert, Jürgen

in Psychosomatic Medicine (2006), 68

Objective: Individuals diagnosed with blood-injury phobia respond to venipuncture with strong psychophysiological responses. We investigated whether disgust sensitivity contributes to the fainting response and is associated with parasympathetic activation, as suggested by previous research. Methods: Twenty individuals diagnosed with blood-injury phobia (9 with a history of fainting to the sight of blood, 11 without such a fainting history) and 20 healthy controls were compared. Psychophysiological responses and self-report measures of anxiety, disgust, and embarrassment were monitored during rest, a paced breathing task, and venipuncture. In addition, trait disgust sensitivity and blood-injury fears were assessed. Results: Blood-injury phobics reported enhanced anxiety, disgust, and embarrassment during venipuncture. They also experienced heightened arousal, as indicated by heart rate, respiration rate, and minute ventilation. Blood-injury phobics without a fainting history tended toward higher anxiety and disgust scores. There was no evidence for increased parasympathetic activation in either blood-injury phobic subgroup or of an association of disgust and parasympathetic activation. Conclusion: The tendency to faint when exposed to blood-injury stimuli may suffice as a conditioning event leading into phobia, without specific involvement of disgust sensitivity and parasympathetic activation.

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See detailEducation
Vögele, Claus

in Kerr; Moretti, M.; Weitkunat, R. (Eds.) ABC of Behaviour Change (2005)

See detailEtiology of Obesity
Vögele, Claus

in Munsch, S.; Beglinger, P. (Eds.) Obesity and Binge Eating Disorder (2005)

See detailKinder und Heranwachsende mit HIV oder AIDS
Vögele, Claus

in Schlottke, P. F.; Silbereisen, R. K.; Schneider, S.; Lauth, G. W. (Eds.) Enzyklopädie der Psychologie,D/II/6: Störungen im Kindes- und Jugendalter (2005)

See detailKörperliche Inaktivität als Risikofaktor für die Entstehung von Übergewicht
Vögele, Claus

in Stehle, P.; Matissek, R. (Eds.) Ernährung, Süßwaren und Lebensstil: eine interdisziplnäre Betrachtung (2005)

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See detailKörperbild, Diätverhalten und körperliche Aktivität bei 9-10 jährigen Kindern
Vögele, Claus; Woodward, Heidi

in Kindheit und Entwicklung (2005), 14

The aim of the present study was to investigate body dissatisfaction and eating attitudes and the moderating role of gender, parental influences, body-mass index (BMI), and physical activity in 9 ± 10-year-old children. Sixty-eight 9 ± 10-year-old children (36 boys, 32 girls) were asked to indicate their perceived and ideal body size using the figure drawing scale of Childress et al. (1993). Physical activity levels were assessed with a diary method over 7 consecutive days. Questionnaires were used to collect information on children's eating habits and children's perception of parental weight, parental attitudes towards body size, and eating habits. Children's weight and height were measured and the BMI calculated. 44 % of boys and 34 % of girls wanted to be thinner than they perceived themselves to be. Multiple regression analyses indicated that this desire was predicted by children's BMI, perceived overweight of mother, and eating patterns indicating restraint eating style. Given that only 13 % were overweight, the percentage of children wanting to be thinner is of concern. The current results indicate that there may be an increasing trend for a thinner body ideal in boys compared to previous reports.

See detailElemente der Konfrontationsbehandlung im Ernährungsmanagement und beim Umgang mit Heißhungerattacken bei Frauen mit Bulimia nervosa
Legenbauer, Tanja; Vögele, Claus

in Neudeck, P.; Wittchen, H.-U. (Eds.) Reader Konfrontationstherapie (2005)

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See detailFasten und (Über)-essen: Auswirkungen von Jojo-Diäten auf Parameter der kardialen sympatho-vagalen Balance
Coles, Justine; Vögele, Claus; Hilbert, Anja; Tuschen-Caffier, Brunna

in Zeitschrift für Klinische Psychologie und Psychotherapie (2005), (34), 95-103

Background: Findings from animal studies suggest sympathetic inhibition during dietary restriction as opposed to increased sympathetic activity during re-feeding. Objective: The present study investigated sympatho-vagal balance in relation to endocrinological parameters of malnutrition status in women diagnosed with bulimia nervosa. Methods: Sixteen female volunteers diagnosed with bulimia nervosa were categorised according to their serum profile (glucose, pre-albumin, insuline-like growth factor, TSH, leptin) into currently malnourished (i.e. fasting) versus non-malnourished (not fasting) and compared with fourteen non-eating disordered controls matched for age and BMI. Spectral components of heart rate variability (HRV) were calculated on resting heart rate data using autoregressive analysis. Results: As expected, fasting bulimic women displayed lower values of resting heart rate compared to non-fasting women and controls. Non-fasting bulimic women consistently showed lower results in the vagally mediated component and significantly higher results in the sympathetically mediated component of HRV. Conclusions: These results confirm the notion of cardiac sympathetic inhibition during caloric restriction and increased activity during periods of normal eating or bingeing.

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See detailErnährung, Körpergewicht und Gewichtsregulation
Vögele, Claus

in Schwarzer, R. (Ed.) Enzyklopädie der Psychologie: Gesundheitspsychologie (2004)

See detailHospitalisation and stressful medical procedures
Vögele, Claus

in Kaptein, A.; Weinman, J. (Eds.) Health Psychology (2004)

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See detailAnticipatory effects of food exposure in women diagnosed with bulimia nervosa.
Legenbauer, Tanja; Vögele, Claus; Rüddel, Heinz

in Appetite (2004), (42), 33-40

Objective. To investigate cephalic phase responses (CPRs) in women diagnosed with bulimia nervosa and to test the assumption that eating disordered individuals respond with more marked CPRs and higher increases in psychophysiological arousal to the presentation of food cues. Method. Thirteen female inpatients diagnosed with bulimia nervosa were compared to 15 non-eating disordered female volunteers. Participants were exposed to their preferred binge food in a single laboratory session with the possibility to eat immediately after the exposure trial. Results. The results show greater salivation responses to food exposure and lower sympathetic arousal in patients diagnosed with bulimia nervosa than in non-eating-disordered participants. Distress and feelings of tension and insecurity during food exposure were higher in patients compared to controls. Discussion. These results support the hypothesis that anticipatory cephalic phase responses are more marked in eating disordered individuals and may therefore play a role in the maintenance of binge eating behavior.

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See detailDepression, perceived control, and life satisfaction in university students from central-eastern and western Europe
Wardle, Jane; Steptoe, Andrew; Guliš, Gabriel; Sartory, Gudrun; Sĕk, Helena; Todorova, Irina; Vögele, Claus; Ziarko, Michal

in International Journal of Behavioral Medicine (2004), 11

The poor health and psychological well-being of people in the former socialist states of Centeral-Eastern Europe are of serious concern and may be related to low perceived control. We compared depressive symptoms, life satisfaction, and self-rated health in 3,571 male and female university students from 5 Western European countries and 4,793 students from 5 Central-Eastern European countries. Depression scores (short Beck Depression Inventory; Beck & Beck, 1972) were higher in Central-Eastern than Western European samples. The prevalence of low life satisfaction was also greater in Central-Eastern Europeans, but ratings of self-rated health did not differ. Ratings of perceived control were diminished, but sense of mastery and internal health locus of control were higher in Central-Eastern Europe. Depression and low life satisfaction were associated with low perceived control and mastery and with strong beliefs in the influence of chance over health. However, taking these factors into account did not explain the East-West difference in depressive symptoms and low life satisfaction.

See detailBewegungstherapie bei Adipositas
Vögele, Claus

in Wechsler, J. G. (Ed.) Adipositas, Ursachen und Therapie (2003)

See detailKörperliche Aktivität in der Adipositastherapie
Vögele, Claus

in Schusdziarra, V. (Ed.) Adipositas - Konzepte für ein Langzeitproblem (2003)

See detailSport und Bewegung als Behandlungsansatz
Vögele, Claus

in Petermann, F.; Pudel, V. (Eds.) Adipositas (2003)

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See detailPsychophysiologic effects of applied tension on the emotional fainting response to blood and injury.
Vögele, Claus; Coles, Justine; Wardle, Jane; Steptoe, Andrew

in Behaviour research and therapy (2003), 41

OBJECTIVE: The present study was designed to investigate the psychophysiologic effects of "Applied Tension" (AT) on the emotional fainting response to blood and injury in a controlled experiment. METHOD: Twenty-two persons reporting to generally feel faint or to have fainted at the sight of blood or injury and 22 participants classified as Non-Fainters were randomly allocated to a treatment or control condition. Psychophysiologic responses were continuously monitored while individuals watched a video depicting open-heart surgery and a control film. Prior to the surgery film, participants in the treatment condition were instructed in the use of AT. RESULTS: All participants classified as Fainters showed a diphasic response pattern while watching the surgery film. This response, however, was significantly attenuated in Fainters in the treatment condition. CONCLUSIONS: These results suggest that AT provides an effective treatment strategy for the prevention of fainting responses in persons with a fear of blood and injury.

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See detailPsychological responses to body shape exposure in patients with bulimia nervosa.
Tuschen-Caffier, Brunna; Vögele, Claus; Bracht, Susanne; Hilbert, Anja

in Behaviour research and therapy (2003), 41

One of the unresolved issues regarding research on bulimia nervosa concerns the question as to how patients diagnosed with bulimia nervosa respond to body image exposure. In addition, it remains unclear whether there are differential responses associated with different exposure techniques (e.g. in vivo exposure vs. exposure by visualization). The aim of the present study was to investigate psychological responses to body image exposure. Twenty participants diagnosed with bulimia nervosa (DSM IV) and twenty non-eating disordered individuals were exposed to their body image using a video recording (video confrontation). In addition, they were asked to imagine and describe the appearance of their body (imagery task). Results indicate that self-reported negative emotions increased in response to both, video confrontation and imagery task, in the clinical as well as in the control group. Furthermore, video confrontation led to more pronounced group differences than exposure by visualization (imagery task). Participants diagnosed with bulimia nervosa took less time to describe their waist, hips and bottom compared to non-eating disturbed controls. This last result could be interpreted in terms of avoidance behavior and other mechanisms during body image exposure.

See detailHIV und AIDS bei Kindern
Vögele, Claus

in Schwarzer, R.; Jerusalem, M.; Weber, H. (Eds.) Gesundheitspsychologie von A bis Z (2002)

See detailKörpergewicht und Gewichtsregulation
Vögele, Claus

in Schwarzer, R.; Jerusalem, M.; Weber, H. (Eds.) Gesundheitspsychologie von A bis Z (2002)

See detailStress und kardiovaskuläre Reaktion
Vögele, Claus

in Schwarzer, R.; Jerusalem, M.; Weber, H. (Eds.) Gesundheitspsychologie von A bis Z (2002)

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See detailPsychosomatic pathways to essential hypertension: the combined effect of anger and family history of cardiovascular disorders on cardiovascular reactivity
Vögele, Claus

in Excerpta Medica International Congress Series1241 (2002)

Previous results from our laboratory suggest a combined effect of anger-suppression and family history of cardiovascular disorders in determining cardiovascular responses to mental stress. The present study was designed to determine the effect sizes in cardiovascular reactivity associated with biological risk, psychological risk and the combination of these risk factors using meta-analytical techniques. Results from three independent studies with almost identical experimental procedures provided the basis for the calculation of d, the difference between the means of two groups, divided by the pooled within-group standard deviation. Effect sizes were calculated for the comparison of high versus low biological hypertension risk, high versus low anger suppression, and high versus low combined risk. The results show the largest effect sizes for the comparison of high versus low combined risk. The effect sizes associated with the combination of risk factors were larger than the sum of the effect sizes associated with either factor alone. We conclude that the combination of biological and psychological risk factors in determining cardiovascular reactivity to mental stress is more than the sum of its parts. These findings are discussed in terms of a better understanding of the over-additive effects of multiple cardiovascular risk factors on cardiovascular morbidity and mortality.

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See detailEffects of prolonged and repeated body image exposure in binge eating disorder
Hilbert, Anja; Tuschen-Caffier, Brunna; Vögele, Claus

in Journal of Psychosomatic Research (2002), 52

OBJECTIVE: The purpose of the present study was to investigate psychological mechanisms associated with prolonged and repeated body image exposure. METHOD: In an experimental design, 30 female volunteers diagnosed with binge-eating disorder (BED) (DSM-IV) and 30 non-eating-disordered controls (NC) were exposed to their physical appearance in a mirror. The confrontation procedure was guided by a standardized interview manual and took place on two separate days. Self-reported mood, appearance self-esteem, and frequency of negative cognitions were assessed repeatedly throughout the experiment. RESULTS: During body image exposure sessions, binge-eating-disordered individuals showed significantly lower mood than controls while appearance self-esteem was diminished in both groups. During the second body image exposure session, higher levels of mood and appearance self-esteem were observed in both groups, and negative cognitions occurred less frequently. CONCLUSION: Results are discussed with regard to the therapeutic use of body image exposure.

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See detailPsychophysiological effects of relaxation training in children
Lohaus, Arnold; Klein-Hessling, Johannes; Vögele, Claus; Kuhn-Hennighausen, Christiane

in British Journal of Health Psychology (2001), 6

OBJECTIVES: This study compares the effects of progressive muscle relaxation and an imagery-based relaxation training on childrens' physiological and subjective responses in a randomized controlled trial. DESIGN: Sixty-four children aged 9 to 13 years were randomly allocated to either one of three experimental conditions: progressive muscle relaxation, imagery-based relaxation or a control condition (neutral story). There were five training sessions in each condition. METHOD: Heart rate (HR), skin conductance level (SCL), and skin temperature (ST) were measured continuously during a 5-minute baseline period, an 8-minute relaxation training period, and a 5-minute follow-up in each session. In addition, subjective ratings of mood and physical well-being were collected intermittently. RESULTS AND CONCLUSIONS: A physiological pattern indicating relaxation was most clearly associated with the imagery-based relaxation approach (decreases in HR and SCL), although ST remained unchanged. In contrast, progressive muscle relaxation led to an increase in HR during the training. The neutral story condition showed a similar trend as the imagery-based relaxation approach (although not reaching statistical significance). Furthermore, children's ratings of positive mood and physical wellbeing increased during baseline and training periods, but there were no differences between training conditions. The results indicate psychophysiological effects of relaxation instructions which, however, are not specific for systematic relaxation training.

See detailPower Kids. Ein ambulantes Trainingsprogramm für übergewichtige Kinder
Pudel, Volker; Ellrott, Thomas; Lichtenstein, Silke; Vögele, Claus; Koletzko, Berthold; Dokoupil, Katharina; Knoppke, Birgit

Book published by AOK-Verlag (2001)

See detailSurgery and stress
Vögele, Claus

in Fink, G. (Ed.) Encyclopedia of stress (2000)

See detailPsychologische Operationsvorbereitung Erwachsener
Vögele, Claus

in Hygiene und Medizin (1999), (24), 184-188

See detailBewegung
Vögele, Claus

in Das OPTIFAST TM 52-Programm. Allgemeines Handbuch (1999)

See detailKörperliche Aktivität bei Adipositas
Vögele, Claus

in Schusdziarra, V. (Ed.) Adipositas (1999)

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See detailKardiovaskuläre Reaktivität und die Entwicklung der essentiellen Hypertonie
Vögele, Claus

in Verhaltensmodifikation und Verhaltensmedizin (1999), (20), 321-342

Psychophysiological experiments show large individual differences in physiological reactivity to mental stress. Hyperreactivity refers to the propensity for an individual to exhibit increased cardiovascular activity during exposure to external stimuli when compared to controls. Essential hypertensives show cardiovascular hyperreactivity that is not reflected in electrodermal or respiratory activity. This result indicates that cardiovascular reactivity could be an important component in the development of essential hypertension. This article provides an overview of conceptual issues and empirical findings concerning the role of cardiovascular reactivity and the development of essential hypertension.

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See detailPsychological and physiological reactivity to stress: an experimental study on bulimic patients, restrained eaters and controls
Tuschen-Caffier, Brunna; Vögele, Claus

in Psychotherapy & Psychosomatics (1999), 68

BACKGROUND: Binge eating behavior in bulimic patients is thought to play a crucial role in the regulation of psychophysiological arousal in stressful situations. Previous results suggest that interpersonal stress and achievement challenge are perceived as particularly stressful by bulimic individuals. It is not clear, however, whether bulimic individuals respond to stress with an increased desire to binge, and whether this increase is accompanied by higher psychophysiological reactivity compared to healthy controls. METHODS: Twenty-seven patients with bulimia nervosa (DSM-IV), 27 restrained eaters, and 27 controls participated in two experimental sessions in which continuous measures of heart rate, blood pressure, respiration rat e, and ecectrodermal activity were monitored under conditions of achievement challenge (mental arithmetic, Stroop test) and interpersonal stress provoking feelings of loneliness and social rejection (film, imagery task). Ratings of desire to binge, negative mood, and hunger were obtained between experimental trials. Groups were matched for age and body mass index. RESULTS: There was a marked difference in subjective ratings during interpersonal stress. Bulimic patients responded to the imagery task with increases in both desire to binge and hunger, whereas restrained eaters and controls showed no change. There were no substantial group differences in psychophysiological reactivity. CONCLUSIONS: The dissociation between emotional responses and physiological activation may have important therapeutic implications.

See detailStreß und Streßbewältigung
Kaluza, Gert; Vögele, Claus

in Flor, H.; Birbaumer, N.; Hahlweg, K. (Eds.) Enzyklopädie der Psychologie, 3 (1999)

See detailVerhaltensmedizin. Eine Einführung
Florin, Irmela; Vögele, Claus; Tuschen-Caffier, Brunna

in Flor, H.; Birbaumer, N.; Hahlweg, K. (Eds.) Enzyklopädie der Psychologie, 3 (1999)

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See detailSerum lipid concentrations, hostility, and cardiovascular reactions to mental stress
Vögele, Claus

in International Journal of Psychophysiology (1998), 28

The objective of the present study was to determine whether serum lipid concentrations interact with hostility to affect cardiovascular responses to mental stress. One-hundred and seventy-four male subjects were screened with the Cook and Medley hostility scale (Ho), the anger expression inventory by Spielberger and a general health questionnaire. Subjects in the upper (n = 22) and lower (n = 22) quartile of the Ho score distribution were asked to take part in a laboratory experiment. Continuous measures of heart rate, blood pressure, respiration and electrodermal activity were taken while participants carried out a series of behavioral maneuvres, including mental arithmetic and mirror star tracing. Prior to the experiment fasting blood samples were taken for lipid determinations. The results show higher heart rate reactivity in high hostile than low hostile subjects. High hostile subjects also reported more anger and frustration in response to tasks. Hostility groups differed in lipid levels in that high hostiles had higher triglyceride and VLDL-c concentrations than low hostiles. Cholesterol levels showed an inverse association with cardiovascular reactivity but only in low hostile subjects. No such associations could be found in high hostiles. We conclude that there is partial support for both, the hyperreactivity and the health behavior model linking hostility and cardiovascular disorder.

See detailBewegung. Ein Arbeitskreis zur Erstellung von Diagnose- und Therapieempfehlungen zur Indikation Adipositas für die Praxis des Hausarztes im Auftrag des BDA
Vögele, Claus

in Adipositas Manual (1998)

See detailDie Interozeption körperlicher Empfindungen bei somatoform gestörten Patienten
Vögele, Claus

in Margraf, J.; Neumer, S.; Rief, W. (Eds.) Somatoforme Störungen: Ätiologie, Diagnose und Therapie (1998)

See detailGewicht bewegen
Vögele, Claus

in Margraf, J.; Ullrich, A.; Schneider, S. (Eds.) Xeni-calculiertes Abnehmen. Ein Gruppenprogramm für Adipöse - Trainermanual (1998)

See detailKlinische Psychophysiologie: Psychophysiologische Methoden in der Diagnostik und Therapie psychischer und psychophysiologischer Störungen
Vögele, Claus

in Rösler, F. (Ed.) Enzyklopädie der Psychologie, 5 (1998)

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See detailCardiovascular effects of Org 9487 under isoflurane anaesthesia in man
Osmer, Christian; Wulf, Kay; Vögele, Claus; Zickmann, Bernfried; Hempelmann, Gunther

in European Journal of Anaesthesiology (1998), (15), 585-589

The cardiovascular effects of Org 9487 during isoflurane anaesthesia have been evaluated using three doses around its ED90 for neuromuscular blockade, i.e. 1 mg kg-1, 2 mg kg-1 and 3 mg kg-1. Heart rate increased to 110%, 115% and 118% in patients receiving 1 mg kg-1, 2 mg kg-1 and 3 mg kg-1 respectively. There were no significant effects on systolic and diastolic blood pressures for the two lower dose groups. Patients receiving Org 9487 3 mg kg-1 displayed significant decreases in systolic and diastolic blood pressures (91% and 82% of the control values respectively). Except for heart rate in the group receiving 3 mg kg-1, all measurements returned to baseline after a maximum of 15 min. Six patients experienced a transient increase in airway pressure after administration of Org 9487, which was accompanied by a decrease in oxygen saturation in two out of six subjects, but there was no audible wheezing. These episodes were self-limiting and required no treatment. There were no other adverse reactions to this drug during this study.

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See detailPsychophysiological responses to food exposure: an experimental study in binge eaters
Vögele, Claus; Florin, Irmela

in International Journal of Eating Disorders (1997), (21), 147-157

Objective: The aim of the present study was to investigate psychophysiological responses to food exposure in binge eaters. Method: Thirty female volunteers reporting regular binge attacks were compared with 30 nonbinge eaters. Subjects attended individually for the single laboratory session. Continuous measures of heart rate (HR), blood pressure (BP), electroder- mal activity (EDA), and respiration rate were taken during rest and exposure to their favorite binge food. In addition, psychophysiological monitoring continued while subjects were al- lowed to eat after food exposure. Participants also completed inventories assessing restrained eating style (FEV, Revised Restraint Scale). Ratings of nervousness, distress, desire to binge, and hunger were collected repeatedly throughout the experiment. Results: The results indi- cate higher psychophysiological arousal in binge eaters than in nonbinge eaters. Binge eaters maintained a higher arousal level in BP and EDA throughout the food exposure trial than controls. HR during food exposure predicted the relative amount of food consumed during the eating trial across all subjects. This relationship, however, was more pronounced in binge eaters than controls and in restrained compared to unrestrained binge eaters. Discussion: The implications of these results are discussed in terms of conditioning and arousal models of cue reactivity in binge eating. © 1997 by John Wiley & Sons, Inc. Int J Eat Disord 21: 147–157, 1997.

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See detailAnger suppression, reactivity and hypertension risk: Gender makes a difference
Vögele, Claus; Cheeseman, Karen; Jarvis, Ann

in Annals of Behavioral Medicine : A Publication of the Society of Behavioral Medicine (1997), 19

The present study investigated gender-related differences in cardiovascular reactivity and the role of anger inhibition and risk for future hypertension. Tonic blood pressure served as an index of hypertension risk. Twenty-eight female and 26 male college students with high and low normal blood pressure were recruited on the basis of their mean arterial pressure. Continuous measures of heart rate and blood pressure were taken while participants carried out a series of behavioral manoeuvres including mental arithmetic, interpersonal challenge, a frustrating psychomotor test, and the cold pressor test. Participants also completed inventories assessing trait anxiety, trait anger, anger expression, and Type A. The results are in concordance with previous findings and show higher cardiovascular reactivity in men than in women and in subjects at risk for hypertension. Within the male group, a combination of hypertension risk and anger suppression led to the highest reactivity, whereas in female subjects, differences in anger-in had no effect on reactivity. The implications of these results are discussed in light of sex differences in cardiovascular morbidity and mortality.

See detailVerhaltensmedizin in der Pädiatrie: Welchen Beitrag leistet die Psychologie?
Florin, Irmela; Vögele, Claus; Gauggel, Siegfried; Tuschen-Caffier, Brunna

in Birner, U.; Döhring, E.; Schweisfurth, H. (Eds.) Qualitätsmanagement und Interdisziplinarität in der pädiatrischen Rehabilitation (1997)

See detailComparative use of muscle relaxants and their reversal in three European countries: a survey in France, Germany and Great Britain
Osmer, Christian; Vögele, Claus; Zickmann, Bernfried; Hempelmann, Gunther

in European Journal of Anaesthesiology (1996), 13

A survey was conducted among British, French and German anaesthetists to evaluate possible national differences in the peri-operative use of muscle relaxants and their reversal agents. The same non-depolarizing relaxants are used in all three countries, with the exception of d-tubocurarine, which is only available in Great Britain, and alcuronium which is mainly used in Germany. The French anaesthetists seem to use significantly less succinylcholine than their peers in Great Britain or Germany for both elective and emergency intubation. Monitoring of neuromuscular blockade still relies mainly on "clinical judgement'. Reversal of non-depolarizing muscle relaxants is performed routinely in Great Britain, while a substantial number of French anaesthetists avoid the use of a reversal. Dose regimes for neostigmine vary largely, with German anaesthetists administering the lowest, and British anaesthetists administering the highest doses. Side effects of reversal agents are reported by colleagues from all three countries in too high a percentage to justify uncritical administration of these drugs. In Germany there seems to be a noteworthy lack of recovery facilities.

See detailPsychophysiological responses to cue-exposure in binge eaters
Vögele, Claus; Florin, Irmela

in Tuschen, B.; Florin, I. (Eds.) Current Research in Eating Disorders (1995)

See detailIs the desire to binge triggered by interpersonal stress and achievement challenge? An experimental study on bulimics
Tuschen, Brunna; Vögele, Claus; Kuhnhardt, Karin

in Tuschen, B.; Florin, I. (Eds.) Current Research in Eating Disorders (1995)

See detailSteigern psychische Belastungen das Eßbedürfnis? Eine experimentelle Studie an Bulimikerinnen
Tuschen-Caffier, Brunna; Vögele, Claus; Kuhnhardt, Karin; Cleve-Prinz, Wolfgang

in Zeitschrift für Klinische Psychologie, Psychopathologie und Psychotherapie (1995), 24

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See detailTesticular self-examination: Attitudes and practices among young men in Europe
Wardle, Jane; Steptoe, Andrew; Burckhardt, Ruth; Vögele, Claus; Vila, Jaime; Zarczynski, Zbigniew

in Preventive Medicine (1994), 23

BACKGROUND: Testicular self examination (TSE) is recommended for the early detection of testicular cancer. Evidence from North America suggests there is only limited public awareness of its importance among the young male population. Compliance with regular TSE is found in only a small minority of young men. Attitudes toward and practice of TSE have rarely been studied outside North America. METHOD: Attitudes to TSE were evaluated by questionnaire in a sample of 16,486 students. Frequency of TSE practice was reported by the 7,304 men in the sample. The data were collected as part of the European Health Behavior Survey, an international study on health beliefs and health behavior. RESULTS: Eighty-seven percent of men reported never having practiced TSE. Regular practice (monthly) was reported by only 3% of the sample, with another 10% reporting occasional TSE. Significant differences emerged between countries, ranging from 76% of German men to 98% of Icelandic men reporting no TSE. Men rated TSE as less important to health than women. Attitude toward TSE among men was a significant predictor of TSE practice. CONCLUSION: Both the low levels of TSE and the low ratings of the importance of TSE suggest that young men in Europe are unaware of the value of this comparatively simple method of early detection of cancer. If a highly educated population group in the "at risk" age category is not carrying out the recommendations, it is unlikely that there are higher levels of compliance in other groups. These results suggest an important role for health education in the early detection of testicular cancer.

See detailÄrger, Feindseligkeit und kardiovaskuläre Reaktivität: Implikationen für essentielle Hypertonie und koronare Herzkrankheit
Vögele, Claus; Steptoe, Andrew

in Hodapp, V.; Schwenkmezger, P. (Eds.) Ärger und Ärgerausdruck (1993)

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See detailAnger inhibition and family history as modulators of cardiovascular responses to mental stress in adolescent boys
Vögele, Claus; Steptoe, Andrew

in Journal of Psychosomatic Research (1993), 37

Sixty boys aged 12-16 took part in an experiment in which physiological and subjective measures were obtained at rest and in response to mental arithmetic and mirror drawing tasks. Blood pressure was recorded from biological parents, and subjects were subsequently categorized as being at high family risk for cardiovascular disease if either parent had a history of coronary heart disease or hypertension, or a resting blood pressure > or = 140/85 mmHg. Twenty boys were classified as high family risk and forty as low risk. A significant interaction between family risk and a disposition towards anger inhibition was observed, with the greatest systolic blood pressure responses to tasks being recorded in high risk boys who reported high levels of anger inhibition. This effect was maintained after controlling for initial blood pressure level, age and body mass. The cardiac baroreceptor reflex was inhibited during tasks, and was lower in high than low family risk subjects. The results suggest that the tendency to inhibit anger expression interacts with familial factors in determining reactivity patterns that may be indicative of raised risk of future cardiovascular disease.

See detailÄrgerunterdrückung und Hypertonieprädisposition als Determinanten kardiovaskulärer Reaktivität
Vögele, Claus; Steptoe, Andrew

in Müller, M. (Ed.) Psychophysiologische Risikofaktoren bei Herz-/Kreislauferkrankungen: Grundlagen und Therapie (1993)

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See detailBenefits of psychological preparation for surgery: a meta-analysis
Johnston, Marie; Vögele, Claus

in Annals of Behavioral Medicine : A Publication of the Society of Behavioral Medicine (1993), 15

Analyzed the results of randomized controlled trials of different methods of psychological preparation of adult patients for surgery to determine the benefits sought from psychological preparation, whether they were achieved, and whether they were likely to be gained. The following 8 outputs were measured in 38 published/unpublished studies: negative affect, pain, pain medication, length of stay, behavioral and clinical indices of recovery, physiological indices, satisfaction, and costs and other outcomes. All benefits analyzed were demonstrated at a level greater than chance in the studies. Procedural information and behavioral instructions showed the most wide-ranging effects in improving measures of all 8 outcomes. Relaxation was also effective, showing benefit on all outcomes except behavioral recovery. Sensory-information, hypnotic, and emotion-focused approaches were not effective in improving outcomes.

See detailVerhaltensmedizin. Ein psychobiologischer Ansatz zur Behandlung körperlicher Krankheiten
Florin, Irmela; Tuschen-Caffier, Brunna; Vögele, Claus

in Verhaltensmodifikation und Verhaltensmedizin (1993), 1/2

See detailThe relationship between heart rate responsiveness in the laboratory and in the field: two studies
Johnston, Derek William; Vögele, Claus; Anastasiades, Pavlos; Kitson, Cathy; McSorley, Kevin; Steptoe, Andrew

in Journal of Psychophysiology (1993), (7), 217-229

See detailPerioperativer Streß
Vögele, Claus

in Schmidt, L. R. (Ed.) Psychologie medizinischer Eingriffe (1992)

See detailEmotional coping and tonic blood pressure as determinants of cardiovascular reactions to mental stress
Vögele, Claus; Steptoe, Andrew

in Journal of Hypertension (1992), 10

OBJECTIVES: The aim was to assess the combined influence of biological risk for hypertension and patterns of emotional control upon cardiovascular responses to mental stress tests. DESIGN: The study involved the administration of mental stress tests in the laboratory, designed to elicit substantial blood pressure and heart rate responses accompanied by suppression of cardiac baroreflex sensitivity. METHODS: Thirty-seven young men were selected as being at relatively high or low risk through having high or low normal blood pressure. Blood pressure, recorded continuously using the Finapres, heart rate, cardiac baroreflex sensitivity, skin conductance and respiration rate were monitored at rest and during mental arithmetic and mirror drawing tasks. RESULTS: Hypertension risk category had no overall effect upon cardiovascular reactions to mental stress. Two dimensions of emotional coping were identified through factor analysis of psychological questionnaires--anxious emotional inhibition (ratings of trait anxiety, anger in and self-concealment), and anger experience and expression (ratings of trait anger and anger out). Subjects with high and low scores on these dimensions were equally represented in the two blood pressure risk categories. Hypertensive risk interacted with anxious emotional inhibition, with the greatest systolic blood pressure and heart rate responses (accompanied by cardiac baroreflex inhibition) being recorded in subjects at high risk coupled with high anxious emotional inhibition. Anger experience and expression did not interact with hypertension risk, but had a direct effect upon cardiovascular responses to mental stress. No differences were seen in skin conductance or respiratory responses, suggesting specific disturbances of cardiovascular regulation. CONCLUSIONS: The results suggest that normotensives at risk for future hypertension are likely to show heightened stress-related cardiovascular responses if they also tend to inhibit the expression of negative emotions. This pattern may be relevant to the postulated links between hypertension and emotional inhibition.

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See detailIndividual differences in the perception of bodily sensations: The role of trait anxiety and coping style
Steptoe, Andrew; Vögele, Claus

in Behaviour research and therapy (1992), 30

Thirty young women participated in an experiment in which heart rate, blood pressure, respiration rate, skin conductance level and palmar sweat index were monitored at rest and during the administration of mental arithmetic, mirror drawing and cold pressor tasks. The accuracy of perception of somatic states was estimated by calculating within-subject correlations between four bodily sensations (racing heart, high blood pressure, shortness of breath and sweaty hands) and corresponding physiological parameters, assessed on eight occasions during the experiment. The accuracy of heart rate perception was highest, with a mean correlation between actual heart rate and ratings of racing heart of 0.76 and 66% of participants showing significant within-subject effects. The mean accuracy was 0.55 for systolic blood pressure, 0.48 for respiration rate, 0.47 for skin conductance level, and 0.64 for palmar sweat index. Accurate perception across physiological parameters did not cluster within individuals, and was not dependent on the range either of physiological changes or sensation ratings. Trait anxiety was not significantly associated with accuracy of somatic perception. Subjects with high trait anxiety reported larger increases in shortness of breath during tasks than did low anxious subjects, but this was not reflected in objective physiological measures. Information-seeking coping style, indexed by the monitoring scale of the Miller Behavioral Style Scale, was related to the accuracy of perception of skin conductance level and heart rate. The use of within-subject correlational strategies for assessing individual differences in perception of bodily states is discussed.

See detailEmotion and Stress
Steptoe, Andrew; Vögele, Claus

in Weller, M.; Eysenck, M. (Eds.) The Scientific Basis of Psychiatry, 2 (1992)

See detailWelchen Nutzen hat psychologische Operationsvorbereitung? Eine Meta-Analyse der Literatur zur psychologischen Operationsvorbereitung Erwachsener
Johnston, Marie; Vögele, Claus

in Schmidt, L. R. (Ed.) Psychologie medizinischer Eingriffe (1992)

See detailThe relationship between cardiovascular responses in the laboratory and in the field: the importance of Active Coping
Johnston, Derek William; Anastasiades, Pavlos; Vögele, Claus; Clark, David M.; Kitson, Cathy; Steptoe, Andrew

in Schmidt, Th.; Engel, B.; Blümchen, G. (Eds.) Temporal Variations of the Cardiovascular System (1992)

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See detailThe methodology of mental stress testing in cardiovascular research.
Steptoe, Andrew; Vögele, Claus

in Circulation (1991), 83(Suppl II), 14-24

Many issues related to the selection, reliability, and validity of mental stress testing in cardiovascular research are discussed. Five categories of mental stress testing are distinguished: problem-solving tasks, information-processing tasks, psychomotor tasks, affective conditions, and aversive or painful conditions. A series of practical and theoretical criteria are outlined for the selection of appropriate tests, and the measurement of a range of dependent variables is emphasized. The temporal stability of cardiovascular responses to mental stress tests is examined through an analysis of test-retest correlations (weighted for sample size) in 28 comparisons with intervals between sessions varying from 1 day to more than 1 year. Heart rate reactions to tasks show an average-weighted Z of 0.732 +/- 0.031 (r = 0.62), with Z = 0.575 +/- 0.034 (r = 0.52) for systolic blood pressure and Z = 0.313 +/- 0.035 (r = 0.30) for diastolic blood pressure. It is argued that the validity of mental stress tests can be judged in relation to several different aspects, specifically, methodological, ecological, diagnostic, prognostic, and therapeutic validities. The nature of these standards is described, and pertinent literature is presented.

See detailDiagnostisches Urteil und therapeutische Ausrichtung
Daumenlang, Konrad; Vögele, Claus

in Andre, K. (Ed.) Psychologisch-pädagogische Beiträge. Forschungsberichte und Diskussionen zu aktuellen Themen (1991)

See detailStress e disturbi cardiovasculari. Problemi metodologici nell'utilizo della tecnica dello stress mentale (Mental Stress Test)
Pruneti, Carlo A.; Vögele, Claus; Steptoe, Andrew

in Medicina Psicosomatica (1991), 36

See detailCardiac baroreflex sensitivity assessment using spontaneous sequence analysis of continuous non-invasive blood pressure recordings in man.
Steptoe, Andrew; Vögele, Claus

in Journal of Physiology (1990), 422

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See detailCardiac baroreflex function during postural change using non-invasive spontaneous sequence analysis in young men.
Steptoe, Andrew; Vögele, Claus

in Cardiovascular Research (1990), 24

STUDY OBJECTIVE: The aim was to assess the value of baroreflex sensitivity estimates calculated from analyses of spontaneous systolic blood pressure and pulse interval sequences derived from continuous non-invasive finger blood pressure recordings during sitting and active standing. DESIGN: Continuous recordings of digital systolic blood pressure and pulse interval were obtained non-invasively using a Finapres FD5 during 5 min trials of sitting and standing. SUBJECTS: Subjects were healthy males aged 19-28, divided into those with "high" normal (n = 18) and "low" normal (n = 17) blood pressure. MEASUREMENTS AND MAIN RESULTS: Recordings were scanned for spontaneous sequences of three or more cardiac cycles over which systolic blood pressure increased progressively in conjunction with prolonged pulse interval, or decreased while pulse interval became shorter. Regressions between blood pressure and pulse interval (r greater than 0.80) provided estimates of cardiac baroreceptor reflex control. Computations were carried out with concurrent blood pressure and pulse interval measurements, and with a delay or lag of one and two cycles between the two variables. Pulse interval was reduced from an average 870.3 ms sitting to 571.3 ms on standing. Mean baroreflex sensitivity while sitting averaged 17.5 ms.mm Hg-1 at a delay of one cycle, failing to 7.65 ms.mm Hg-1 with standing. The decrease in sensitivity was correlated with the change in pulse interval between trials. The number of sequences was also significantly reduced with standing as opposed to sitting. Three cycle sequences were most frequent, with a lesser number of sequences involving 4, 5, and 6 or more cycles. No significant differences between "high" and "low" normal blood pressure groups were observed. CONCLUSIONS: The analysis of spontaneous sequences from non-invasive recordings may provide useful information concerning cardiac baroreflex control in different postural and behavioural states. A lag of one cycle between systolic blood pressure and pulse interval may provide the most representative estimates of baroreflex sensitivity.

See detailThe behaviour of the PSI (palmar sweat index) during two stressful laboratory situations.
Köhler, Thomas; Weber, Dittmar; Vögele, Claus

in Journal of Psychophysiology (1990), (4), 281-287

See detailLaboratory studies on a potential stress indicator in field research: The palmar sweat index
Köhler, Thomas; Vögele, Claus

in Bond, N. W.; Siddle, D. A. T. (Eds.) Psychobiology: Issues and Applications (1989)

See detailDie Zahl der aktiven palmaren Schweißdrüsen (PSI, palmar sweat index) als psychophysiologischer Parameter.
Köhler, Thomas; Vögele, Claus; Weber, Dittmar

in Zeitschrift für Experimentelle und Angewandte Psychologie (1989), 36

Two laboratory studies were carried out to assess the behavior of the active palmar sweat glands in both an active and a passive coping situation. Stressor in study I was watching a distressing film, in study II mental arithmetic. Subjects were male students, 17 in experiment I, 20 in experiment II. Both experiments involved a 10-minute baseline phase, a 10-minute stress period, and a follow-up of 10 minutes. PSI was assessed at 90-sec intervals and averaged across phases, as were readings in SCL, SCR, heart rate, diastolic and systolic blood pressure. PSI could be determined in 16 subjects of each study. In both experiments PSI increased significantly from baseline to stress (p less than 0.1%) and decreased from stress to follow-up (p less than 0.1%), and thus proved to be the most sensitive indicator for stress. The interrater reliability for counting the number of active sweat glands was high when the area for evaluation was defined unambiguously. Since the assessment of the PSI does not require a sophisticated technology and is thus also applicable in field research, we suggest giving more consideration to this variable.

See detailPerioperativer Stress. Eine psychophysiologische Untersuchung zu prä- und postoperativen Reaktionen chirurgischer Patienten.
Vögele, Claus

Book published by Peter Lang (1988)

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See detailAre stress responses influenced by cognitive appraisal? An experimental comparison of coping strategies.
Steptoe, Andrew; Vögele, Claus

in British Journal of Psychology (1986), 77

An investigation of the role of cognitive appraisal in emotional responses was carried out, in which psychological and physiological reactions to a distressing film were recorded in three groups of volunteers. Subjects in the intellectualization condition were given instructions to appraise the film in a detached, analytic fashion. The sensation-focusing group were asked to focus on physical sensations and to experience them fully, and controls were given no specific instructions. Heart rate, skin conductance and respiration rate were monitored continuously, while ratings of psychological distress and physical sensations were collected periodically. No significant differences were found in the subjective or physiological reactions of the intellectualization and control groups, thus failing to replicate previous reports. Sensation focusing led to a diminution of cardiac and electrodermal reactions, but did not affect subjective experience. Limitations to the concept of cognitive appraisal are suggested, while explanations of the results are offered in terms of external vs. internal deployment of attention, and desynchrony of emotional responses.

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See detailPhysiological and subjective stress responses in surgical patients.
Vögele, Claus; Steptoe, Andrew

in Journal of Psychosomatic Research (1986), 30

Autonomic responses, mood and psychological coping were assessed in two groups of orthopaedic patients during hospitalisation for major or minor surgery. Eight patients admitted for total hip replacement and seven patients undergoing knee arthroscopy were seen daily for two days before surgery until discharged from hospital. Mood and coping questionnaires were administered on each session, while pain, heart rate, blood pressure, skin conductance level, palmar sweat prints and forearm EMG were also recorded. Heart rate increased from pre- to post-operative assessments, while skin conductance and palmar sweating fell to low levels on the days immediately following surgery, returning to basal values only after several days. Self ratings of anxiety, fatigue, depression and pain were highest on the immediate post-operative days. Patients utilised the coping factors Rational Cognition and Behavioural Action to the greatest extent, but ratings on coping factors fluctuated little over the study period. The interrelations between these measures and possible explanations of the results are discussed.

See detailBiofeedbacktherapie
Vögele, Claus

in Daumenlang, K.; Andre, K. (Eds.) Taschenbuch der Schul- und Erziehungsberatung (1983)

See detailEinzelfallhilfe
Vögele, Claus

in Daumenlang, K.; Andre, K. (Eds.) Taschenbuch der Schul- und Erziehungsberatung (1983)