C. Kuehner | Universität Heidelberg (original) (raw)
Papers by C. Kuehner
Computer-based feedback on process and outcome in inpatient psychotherapy: what works for whom?
Psychiatrische Praxis, 2011
Neurobiology of Aging, 2020
Elevated cortisol levels have been associated with poorer cognitive performance in cross-sectiona... more Elevated cortisol levels have been associated with poorer cognitive performance in cross-sectional studies; this may be both a factor contributing to neurodegeneration and cognitive decline and a result of developing brain pathologies. However, it is still unclear (1) whether cortisol measures predict later cognitive decline and (2) whether cortisol changes over the years might be associated with cognitive changes. We analyzed data from CoLaus/PsyCoLaus, a prospective population-based study. Salivary cortisol (4 different measures on 1 day) and neuropsychological assessments were performed at a first visit and a follow-up visit 5 years later in 625 dementia-free participants aged !65 years. Salivary cortisol levels at waking and 30 minutes after waking, as well as longitudinal changes in cortisol 30 minutes after waking, cortisol awakening response, and cortisol AM-PM difference were associated with decline in global cognition. After controlling for potential confounders, only longitudinal changes in cortisol 30 minutes after waking remained associated with cognitive decline. These mostly negative findings indicate absent or subtle association between salivary cortisol and cognitive decline.
Supplementary Material for: Ambulatory Assessment Characteristics Predict the Clinical Course of Premenstrual Dysphoric Disorder
The Journal of clinical endocrinology and metabolism, Jul 4, 2017
Increased evening cortisol levels, observed with aging and psychological stress, have been implic... more Increased evening cortisol levels, observed with aging and psychological stress, have been implicated in bone mineral density (BMD) loss. The effect on bone microarchitecture and fracture risk has never been studied. To study the relationship between salivary cortisol circadian rhythm and: 1) Trabecular Bone Score (TBS), a texture parameter correlated with bone microarchitecture, 2) fracture prevalence. Cross-sectional study including 608 women >50 years old (mean 65.5) from OsteoLaus cohort. Data included: FRAX© questionnaire, BMD, TBS and vertebral fracture (VFx) assessment by dual X-ray absorptiometry, and measures of salivary cortisol circadian rhythm (awakening, 30 minutes thereafter, 11 AM and 8 PM). In the multivariate model, participants in the highest tertile of 8PM salivary cortisol (sc-8PM) (mean 5.7±2.5 nmol/l) versus lowest tertile (1.7±0.4 nmol/l) had lower TBS values (1.27 vs. 1.29; p=0.02), more prevalent VFx grades 2 and 3 (OR 5.34; p=0.012), low-trauma fractures...
Psychosomatic Medicine, 2018
Objective: Objective: Objective: Objective: The complex relationship between psychosocial stress ... more Objective: Objective: Objective: Objective: The complex relationship between psychosocial stress over the lifetime, psychological factors and the cardiometabolic risk is still poorly understood. Accordingly, our aims were to 1) independently assess the associations between childhood adversity, life-event stress in remote (earlier than the last 5 years) and recent adulthood and the cardiometabolic risk, and 2) determine the role of psychological factors including personality, coping and depression in these associations. Methods: Methods: Methods: Methods: The sample included 2674 adults, aged 35 to 66 year, randomly selected from urban area. Participants underwent a physical exam including the assessment of obesity markers, blood pressure as well as blood lipid and glucose levels. Stress during adulthood was determined using the severity scores of 52 stressful life events. Information on adverse childhood experiences and major depressive disorders was collected using semi-structured interviews, whereas personality traits and coping mechanisms were evaluated through questionnaires.
Sleep Medicine, 2015
Introduction: The aim of this study was to evaluate if there is a significant effect of lunar pha... more Introduction: The aim of this study was to evaluate if there is a significant effect of lunar phases on subjective and objective sleep variables in the general population. Methods: 2125 subjects (51.2% women, age 58.8±11.2 years) participating in a populationbased cohort underwent full polysomnography (PSG) at home. Subjective sleep quality was evaluated by a self-rating scale. Sleep EEG spectral analysis was performed in 759 participants without significant sleep disorders. Salivary cortisol levels were assessed at awakening, 30 minutes after awakening, at 11:00 a.m. and at 8:00 p.m. Lunar phases were grouped into full (FM), waxing/waning (WM) and new moon (NM). Results: Overall, there were no significant differences between lunar phases regarding subjective sleep quality. We found only a non significant (p=0.08) trend towards a better sleep quality during the NM phase. Objective sleep duration was not different between phases (FM: 398 ± 3 min, WM: 402 ± 3 min, NM: 403 ± 3 min; p= 0.31). No differences were found regarding other PSG-derived parameters, EEG spectral analysis or in diurnal cortisol levels. When considering only subjects with apnoea/hypopnoea index <15/h and periodic leg movements index <15/h we found a trend towards shorter total sleep time during FM (FM: 402 ± 4, WM: 407 ± 4, NM: 415 ± 4 min; p=0.06), and shorter stage N2 duration (FM: 178 ± 3, WM: 182 ± 3, NM: 188 ± 3 min; p=0.05). Conclusion: Our large population-based study provides no evidence of a significant impact of lunar phases on human sleep.
Journal of Affective Disorders, 2014
Background: In recent years, the WHO Wellbeing Index (WHO-5) has been used as a screening measure... more Background: In recent years, the WHO Wellbeing Index (WHO-5) has been used as a screening measure for depression. Nevertheless, research on the validity of this measure in the context of clinical depression is sparse. Questions: The aim of the present study was to investigate the measurement invariance of the WHO-5 across depressed and non-depressed individuals, as well as the shape and specificity of its relationship to measures of depression severity. Method: Of the 414 subjects who completed the WHO-5 and the Beck Depression Inventory-II (BDI-II), 207 had a diagnosis of a major depressive episode (MDE). A subsample also completed the Beck Anxiety Inventory (BAI) and was assessed by clinicians using the Hamilton Depression Rating Scale (HAM-D) and the Hamilton Anxiety Rating Scale (HAM-A). Results: The WHO-5 demonstrated strong measurement invariance regarding the presence or absence of a current MDE. The WHO-5 showed a very high negative association with self-and observer-rated measures of depressive symptoms, especially in the range of mild to moderate symptoms. These associations were still substantial after controlling for measures of anxiety symptoms. Limitations: In addition to a diagnostic interview, only one measure for self-and observer-rated symptoms of depression was used. Furthermore, the observer-rated measure was only assessed in one subsample that exhibited a somewhat restricted range of depression severity. Conclusion: Although this index was originally designed as a measure of well-being, the results support the use of the WHO-5 in the context of depression research.
Supplementary Material for: Mindfulness-Based Attention Training Improves Cognitive and Affective Processes in Daily Life in Remitted Patients with Recurrent Depression: A Randomized Controlled Trial
[Stalking--what does the family doctor need to know?]
Stalking is a widespread phenomenon, which for the stalked person is associated with a not incons... more Stalking is a widespread phenomenon, which for the stalked person is associated with a not inconsiderable risk of becoming the victim of an act of violence. Furthermore, stalked persons may develop significant psychological problems, and therefore often seek out a doctor as their first contact. Another reason for this is the still unsatisfactory legal situation and widespread ignorance of the stalking problem on the part of the police and the courts. In the light of the above, it is of great importance that the physician should thoroughly familiarize himself with the problems associated with stalking.
Translational Psychiatry
Repetitive negative thinking (RNT) is a maladaptive response to sadness and a transdiagnostic ris... more Repetitive negative thinking (RNT) is a maladaptive response to sadness and a transdiagnostic risk-factor. A critical challenge hampering attempts to promote more adaptive responses to sadness is that the between-person characteristics associated with the tendency for RNT remain uncharacterized. From the perspective of the impaired disengagement hypothesis, we examine between-person differences in blood-oxygen-level-dependent (BOLD) functional networks underlying cognitive conflict signaling, self-referential thought, and cognitive flexibility, and the association between sadness and RNT in daily life. We pair functional magnetic resonance imaging with ambulatory assessments deployed 10 times per day over 4 consecutive days measuring momentary sadness and RNT from 58 participants (40 female, mean age = 36.69 years; 29 remitted from a lifetime episode of Major Depression) in a multilevel model. We show that RNT increases following sadness for participants with higher than average bet...
Neural reward processing in individuals remitted from major depression
Psychological Medicine, 2015
Background.Dysfunctional behavioural and neural processing of reward has been found in currently ... more Background.Dysfunctional behavioural and neural processing of reward has been found in currently depressed individuals. However, little is known about altered reward processing in remitted depressed individuals.Method.A total of 23 medication-free individuals with remitted major depressive disorder (rMDD) and 23 matched healthy controls (HCs) performed a reward task during functional magnetic resonance imaging. We also investigated reward dependence, novelty seeking and harm avoidance using the Tridimensional Personality Questionnaire and their association with neural responses of reward processing.Results.Compared to HCs, individuals with rMDD exhibited enhanced responses to reward-predicting cues in the hippocampus, amygdala and superior frontal gyrus. When reward was delivered, rMDD subjects did not significantly differ from HCs. In both groups neural activity during reward anticipation was negatively correlated with harm avoidance.Conclusions.Our results show that rMDD is charac...
Clinical Psychological Science, 2015
Cognitive theories of recurrent depression suggest that the relationship between mood and cogniti... more Cognitive theories of recurrent depression suggest that the relationship between mood and cognition is altered by previous depressive episodes. In individuals remitted from depression (RMD) this would be linked to a larger susceptibility for new depressive symptoms. This study explored whether the association between mood and rumination indeed is different between RMD and non-depressed controls relying on dynamic systems theory (DST). From DST we selected entropy, defined here as the level of unpredictability in the relation between mood and rumination, as main variable of interest. Daily electronic dairy measures of mood and rumination were administered in 31 RMD patients and 32 healthy controls. The results indicate that mean levels of rumination and negative mood were elevated in RMD compared with controls. At the group level, entropy did not differ significantly and entropy was also not associated with the number of episodes. However, entropy predicted depressive symptoms in the RMD group and the brooding subtype of rumination in both groups at six months followup. These data are specific for entropy and were not obtained using mean levels of momentary mood and rumination.
Social cognitive and affective neuroscience, 2014
Behavioral studies suggest a relationship between autobiographical memory, rumination and depress... more Behavioral studies suggest a relationship between autobiographical memory, rumination and depression. The objective of this study was to determine whether remitted depressed patients show alterations in connectivity of the posterior cingulate cortex (PCC, a node in the default mode network) with the parahippocampal gyri (PHG, a region associated with autobiographical memory) while intensively recalling negative memories and whether this is related to daily life symptoms and to the further course of depression. Sad mood was induced with keywords of personal negative life events in participants with remitted depression (n = 29) and matched healthy controls (n = 29) during functional magnetic resonance imaging. Additionally, daily life assessments of mood and rumination and a 6-month follow-up were conducted. Remitted depressed participants showed greater connectivity than healthy controls of the PCC with the PHG, which was even stronger in patients with more previous episodes. Further...
[Stalking--what does the family doctor need to know?]
MMW Fortschritte der Medizin, Jan 6, 2006
Stalking is a widespread phenomenon, which for the stalked person is associated with a not incons... more Stalking is a widespread phenomenon, which for the stalked person is associated with a not inconsiderable risk of becoming the victim of an act of violence. Furthermore, stalked persons may develop significant psychological problems, and therefore often seek out a doctor as their first contact. Another reason for this is the still unsatisfactory legal situation and widespread ignorance of the stalking problem on the part of the police and the courts. In the light of the above, it is of great importance that the physician should thoroughly familiarize himself with the problems associated with stalking.
S3-Leitlinie/Nationale Versorgungsleitlinie Unipolare Depression – zentrale Aspekte für die psychotherapeutische Praxis
Frontiers in Human Neuroscience, 2013
Affective state can influence cognition leading to biased information processing, interpretation,... more Affective state can influence cognition leading to biased information processing, interpretation, attention, and memory. Such bias has been reported to be essential for the onset and maintenance of different psychopathologies, particularly affective disorders. However, empirical evidence has been very heterogeneous and little is known about the neurophysiological mechanisms underlying cognitive bias and its time-course. We therefore investigated the interpretation of ambiguous stimuli as indicators of biased information processing with an ambiguous cue-conditioning paradigm. In an acquisition phase, participants learned to discriminate two tones of different frequency, which acquired emotional and motivational value due to subsequent feedback (monetary gain or avoidance of monetary loss). In the test phase, three additional tones of intermediate frequencies were presented, whose interpretation as positive (approach of reward) or negative (avoidance of punishment), indicated by a button press, was used as an indicator of the bias. Twenty healthy volunteers participated in this paradigm while a 64-channel electroencephalogram was recorded. Participants also completed questionnaires assessing individual differences in depression and rumination. Overall, we found a small positive bias, which correlated negatively with reflective pondering, a type of rumination. As expected, reaction times were increased for intermediate tones.
Functional Connectivity of Insula and Anterior Cingulate Cortex During Decision-Making Under Ambiguity
Translational Psychiatry, 2011
Recent genetic studies showed evidence for a role of the single-nucleotide polymorphism rs2522833... more Recent genetic studies showed evidence for a role of the single-nucleotide polymorphism rs2522833 within the PCLO gene in the etiology of major depression, and rs2522833 has been shown to modulate hypothalamic pituitary adrenal (HPA) axis activity during antidepressant treatment. Monoaminergic modulation of the HPA system may be one possible pathomechanism by which PCLO exerts its effect on depression. In the present study, we investigated the effect of rs2522833 on the cortisol awakening response (CAR) in healthy young adults. A total of 66 healthy volunteers from the community (36 men and 30 women) aged 18-25 years without individual or family history of affective disorders and schizophrenia collected saliva cortisol samples at 0, 30, 45 and 60 min after awakening on two consecutive working days. We identified a blunted CAR (AUCinc) in rs2522833 risk-allele (C) carriers, possibly indicating exhausted regulatory mechanisms underlying the HPA system. We also identified higher neuroticism scores in rs2522833 risk-allele carriers but no phenotypic correlation between the CAR (AUCinc) and neuroticism. These findings suggest that the rs2522833 risk variant might increase vulnerability to depression both by physiological and behavioral pathways, which appear, however, not to be substantially overlapped. Replication with larger samples is warranted.
Zur erhöhten Prävalenz des problematischen Alkoholkonsums bei Studierenden
PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie, 2009
To compare the prevalence rates of problematic alcohol consumption in students and in the general... more To compare the prevalence rates of problematic alcohol consumption in students and in the general population. A sample of students (n=1 115) and a population sample (n=631) were assessed with the Patient Health Questionnaire (PHQ). The PHQ probes for problematic alcohol consumption with five questions. An &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;alcohol syndrome&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; is suspected if at least one of these indicators is present. The alcohol syndrome was present more frequently among students than in the population sample (30,1% versus 8,1%). The odds ratio, adjusted for age, gender and education, was OR=3,7. However, when the five indicators were analysed separately, only two of them were significantly more frequent in students than in the comparison sample. Both indicate a neglect of duties as a consequence of alcohol consumption. Intervention strategies aimed at students&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; alcohol consumption should focus on binge drinking and the risks associated with this problematic form of alcohol consumption.
Rumination, distraction and mindful self-focus: effects on mood, dysfunctional attitudes and cortisol stress response
Psychological Medicine, 2009
BackgroundAlthough aggravating effects of rumination on dysfunctional cognitions and endocrine st... more BackgroundAlthough aggravating effects of rumination on dysfunctional cognitions and endocrine stress responses have been proposed, experimental studies testing these assumptions are lacking. In parallel, mindfulness theory suggests beneficial effects of mindfulness on dysfunctional cognitions. This study aimed to investigate the effects of induced rumination, distraction and mindful self-focus on mood and dysfunctional attitudes and to assess the possible impact of induced rumination on participants' cortisol responses.MethodSixty university students were subjected to negative mood induction and subsequently randomly assigned to a rumination, distraction or mindful self-focus condition. The latter included statements focusing on self-acceptance and awareness of the breath. Four saliva cortisol samples were selected during the session.ResultsCompared to induced rumination, distraction showed a clear beneficial effect on the course of dysphoric mood, whereas a mindful self-focus ...
Computer-based feedback on process and outcome in inpatient psychotherapy: what works for whom?
Psychiatrische Praxis, 2011
Neurobiology of Aging, 2020
Elevated cortisol levels have been associated with poorer cognitive performance in cross-sectiona... more Elevated cortisol levels have been associated with poorer cognitive performance in cross-sectional studies; this may be both a factor contributing to neurodegeneration and cognitive decline and a result of developing brain pathologies. However, it is still unclear (1) whether cortisol measures predict later cognitive decline and (2) whether cortisol changes over the years might be associated with cognitive changes. We analyzed data from CoLaus/PsyCoLaus, a prospective population-based study. Salivary cortisol (4 different measures on 1 day) and neuropsychological assessments were performed at a first visit and a follow-up visit 5 years later in 625 dementia-free participants aged !65 years. Salivary cortisol levels at waking and 30 minutes after waking, as well as longitudinal changes in cortisol 30 minutes after waking, cortisol awakening response, and cortisol AM-PM difference were associated with decline in global cognition. After controlling for potential confounders, only longitudinal changes in cortisol 30 minutes after waking remained associated with cognitive decline. These mostly negative findings indicate absent or subtle association between salivary cortisol and cognitive decline.
Supplementary Material for: Ambulatory Assessment Characteristics Predict the Clinical Course of Premenstrual Dysphoric Disorder
The Journal of clinical endocrinology and metabolism, Jul 4, 2017
Increased evening cortisol levels, observed with aging and psychological stress, have been implic... more Increased evening cortisol levels, observed with aging and psychological stress, have been implicated in bone mineral density (BMD) loss. The effect on bone microarchitecture and fracture risk has never been studied. To study the relationship between salivary cortisol circadian rhythm and: 1) Trabecular Bone Score (TBS), a texture parameter correlated with bone microarchitecture, 2) fracture prevalence. Cross-sectional study including 608 women >50 years old (mean 65.5) from OsteoLaus cohort. Data included: FRAX© questionnaire, BMD, TBS and vertebral fracture (VFx) assessment by dual X-ray absorptiometry, and measures of salivary cortisol circadian rhythm (awakening, 30 minutes thereafter, 11 AM and 8 PM). In the multivariate model, participants in the highest tertile of 8PM salivary cortisol (sc-8PM) (mean 5.7±2.5 nmol/l) versus lowest tertile (1.7±0.4 nmol/l) had lower TBS values (1.27 vs. 1.29; p=0.02), more prevalent VFx grades 2 and 3 (OR 5.34; p=0.012), low-trauma fractures...
Psychosomatic Medicine, 2018
Objective: Objective: Objective: Objective: The complex relationship between psychosocial stress ... more Objective: Objective: Objective: Objective: The complex relationship between psychosocial stress over the lifetime, psychological factors and the cardiometabolic risk is still poorly understood. Accordingly, our aims were to 1) independently assess the associations between childhood adversity, life-event stress in remote (earlier than the last 5 years) and recent adulthood and the cardiometabolic risk, and 2) determine the role of psychological factors including personality, coping and depression in these associations. Methods: Methods: Methods: Methods: The sample included 2674 adults, aged 35 to 66 year, randomly selected from urban area. Participants underwent a physical exam including the assessment of obesity markers, blood pressure as well as blood lipid and glucose levels. Stress during adulthood was determined using the severity scores of 52 stressful life events. Information on adverse childhood experiences and major depressive disorders was collected using semi-structured interviews, whereas personality traits and coping mechanisms were evaluated through questionnaires.
Sleep Medicine, 2015
Introduction: The aim of this study was to evaluate if there is a significant effect of lunar pha... more Introduction: The aim of this study was to evaluate if there is a significant effect of lunar phases on subjective and objective sleep variables in the general population. Methods: 2125 subjects (51.2% women, age 58.8±11.2 years) participating in a populationbased cohort underwent full polysomnography (PSG) at home. Subjective sleep quality was evaluated by a self-rating scale. Sleep EEG spectral analysis was performed in 759 participants without significant sleep disorders. Salivary cortisol levels were assessed at awakening, 30 minutes after awakening, at 11:00 a.m. and at 8:00 p.m. Lunar phases were grouped into full (FM), waxing/waning (WM) and new moon (NM). Results: Overall, there were no significant differences between lunar phases regarding subjective sleep quality. We found only a non significant (p=0.08) trend towards a better sleep quality during the NM phase. Objective sleep duration was not different between phases (FM: 398 ± 3 min, WM: 402 ± 3 min, NM: 403 ± 3 min; p= 0.31). No differences were found regarding other PSG-derived parameters, EEG spectral analysis or in diurnal cortisol levels. When considering only subjects with apnoea/hypopnoea index <15/h and periodic leg movements index <15/h we found a trend towards shorter total sleep time during FM (FM: 402 ± 4, WM: 407 ± 4, NM: 415 ± 4 min; p=0.06), and shorter stage N2 duration (FM: 178 ± 3, WM: 182 ± 3, NM: 188 ± 3 min; p=0.05). Conclusion: Our large population-based study provides no evidence of a significant impact of lunar phases on human sleep.
Journal of Affective Disorders, 2014
Background: In recent years, the WHO Wellbeing Index (WHO-5) has been used as a screening measure... more Background: In recent years, the WHO Wellbeing Index (WHO-5) has been used as a screening measure for depression. Nevertheless, research on the validity of this measure in the context of clinical depression is sparse. Questions: The aim of the present study was to investigate the measurement invariance of the WHO-5 across depressed and non-depressed individuals, as well as the shape and specificity of its relationship to measures of depression severity. Method: Of the 414 subjects who completed the WHO-5 and the Beck Depression Inventory-II (BDI-II), 207 had a diagnosis of a major depressive episode (MDE). A subsample also completed the Beck Anxiety Inventory (BAI) and was assessed by clinicians using the Hamilton Depression Rating Scale (HAM-D) and the Hamilton Anxiety Rating Scale (HAM-A). Results: The WHO-5 demonstrated strong measurement invariance regarding the presence or absence of a current MDE. The WHO-5 showed a very high negative association with self-and observer-rated measures of depressive symptoms, especially in the range of mild to moderate symptoms. These associations were still substantial after controlling for measures of anxiety symptoms. Limitations: In addition to a diagnostic interview, only one measure for self-and observer-rated symptoms of depression was used. Furthermore, the observer-rated measure was only assessed in one subsample that exhibited a somewhat restricted range of depression severity. Conclusion: Although this index was originally designed as a measure of well-being, the results support the use of the WHO-5 in the context of depression research.
Supplementary Material for: Mindfulness-Based Attention Training Improves Cognitive and Affective Processes in Daily Life in Remitted Patients with Recurrent Depression: A Randomized Controlled Trial
[Stalking--what does the family doctor need to know?]
Stalking is a widespread phenomenon, which for the stalked person is associated with a not incons... more Stalking is a widespread phenomenon, which for the stalked person is associated with a not inconsiderable risk of becoming the victim of an act of violence. Furthermore, stalked persons may develop significant psychological problems, and therefore often seek out a doctor as their first contact. Another reason for this is the still unsatisfactory legal situation and widespread ignorance of the stalking problem on the part of the police and the courts. In the light of the above, it is of great importance that the physician should thoroughly familiarize himself with the problems associated with stalking.
Translational Psychiatry
Repetitive negative thinking (RNT) is a maladaptive response to sadness and a transdiagnostic ris... more Repetitive negative thinking (RNT) is a maladaptive response to sadness and a transdiagnostic risk-factor. A critical challenge hampering attempts to promote more adaptive responses to sadness is that the between-person characteristics associated with the tendency for RNT remain uncharacterized. From the perspective of the impaired disengagement hypothesis, we examine between-person differences in blood-oxygen-level-dependent (BOLD) functional networks underlying cognitive conflict signaling, self-referential thought, and cognitive flexibility, and the association between sadness and RNT in daily life. We pair functional magnetic resonance imaging with ambulatory assessments deployed 10 times per day over 4 consecutive days measuring momentary sadness and RNT from 58 participants (40 female, mean age = 36.69 years; 29 remitted from a lifetime episode of Major Depression) in a multilevel model. We show that RNT increases following sadness for participants with higher than average bet...
Neural reward processing in individuals remitted from major depression
Psychological Medicine, 2015
Background.Dysfunctional behavioural and neural processing of reward has been found in currently ... more Background.Dysfunctional behavioural and neural processing of reward has been found in currently depressed individuals. However, little is known about altered reward processing in remitted depressed individuals.Method.A total of 23 medication-free individuals with remitted major depressive disorder (rMDD) and 23 matched healthy controls (HCs) performed a reward task during functional magnetic resonance imaging. We also investigated reward dependence, novelty seeking and harm avoidance using the Tridimensional Personality Questionnaire and their association with neural responses of reward processing.Results.Compared to HCs, individuals with rMDD exhibited enhanced responses to reward-predicting cues in the hippocampus, amygdala and superior frontal gyrus. When reward was delivered, rMDD subjects did not significantly differ from HCs. In both groups neural activity during reward anticipation was negatively correlated with harm avoidance.Conclusions.Our results show that rMDD is charac...
Clinical Psychological Science, 2015
Cognitive theories of recurrent depression suggest that the relationship between mood and cogniti... more Cognitive theories of recurrent depression suggest that the relationship between mood and cognition is altered by previous depressive episodes. In individuals remitted from depression (RMD) this would be linked to a larger susceptibility for new depressive symptoms. This study explored whether the association between mood and rumination indeed is different between RMD and non-depressed controls relying on dynamic systems theory (DST). From DST we selected entropy, defined here as the level of unpredictability in the relation between mood and rumination, as main variable of interest. Daily electronic dairy measures of mood and rumination were administered in 31 RMD patients and 32 healthy controls. The results indicate that mean levels of rumination and negative mood were elevated in RMD compared with controls. At the group level, entropy did not differ significantly and entropy was also not associated with the number of episodes. However, entropy predicted depressive symptoms in the RMD group and the brooding subtype of rumination in both groups at six months followup. These data are specific for entropy and were not obtained using mean levels of momentary mood and rumination.
Social cognitive and affective neuroscience, 2014
Behavioral studies suggest a relationship between autobiographical memory, rumination and depress... more Behavioral studies suggest a relationship between autobiographical memory, rumination and depression. The objective of this study was to determine whether remitted depressed patients show alterations in connectivity of the posterior cingulate cortex (PCC, a node in the default mode network) with the parahippocampal gyri (PHG, a region associated with autobiographical memory) while intensively recalling negative memories and whether this is related to daily life symptoms and to the further course of depression. Sad mood was induced with keywords of personal negative life events in participants with remitted depression (n = 29) and matched healthy controls (n = 29) during functional magnetic resonance imaging. Additionally, daily life assessments of mood and rumination and a 6-month follow-up were conducted. Remitted depressed participants showed greater connectivity than healthy controls of the PCC with the PHG, which was even stronger in patients with more previous episodes. Further...
[Stalking--what does the family doctor need to know?]
MMW Fortschritte der Medizin, Jan 6, 2006
Stalking is a widespread phenomenon, which for the stalked person is associated with a not incons... more Stalking is a widespread phenomenon, which for the stalked person is associated with a not inconsiderable risk of becoming the victim of an act of violence. Furthermore, stalked persons may develop significant psychological problems, and therefore often seek out a doctor as their first contact. Another reason for this is the still unsatisfactory legal situation and widespread ignorance of the stalking problem on the part of the police and the courts. In the light of the above, it is of great importance that the physician should thoroughly familiarize himself with the problems associated with stalking.
S3-Leitlinie/Nationale Versorgungsleitlinie Unipolare Depression – zentrale Aspekte für die psychotherapeutische Praxis
Frontiers in Human Neuroscience, 2013
Affective state can influence cognition leading to biased information processing, interpretation,... more Affective state can influence cognition leading to biased information processing, interpretation, attention, and memory. Such bias has been reported to be essential for the onset and maintenance of different psychopathologies, particularly affective disorders. However, empirical evidence has been very heterogeneous and little is known about the neurophysiological mechanisms underlying cognitive bias and its time-course. We therefore investigated the interpretation of ambiguous stimuli as indicators of biased information processing with an ambiguous cue-conditioning paradigm. In an acquisition phase, participants learned to discriminate two tones of different frequency, which acquired emotional and motivational value due to subsequent feedback (monetary gain or avoidance of monetary loss). In the test phase, three additional tones of intermediate frequencies were presented, whose interpretation as positive (approach of reward) or negative (avoidance of punishment), indicated by a button press, was used as an indicator of the bias. Twenty healthy volunteers participated in this paradigm while a 64-channel electroencephalogram was recorded. Participants also completed questionnaires assessing individual differences in depression and rumination. Overall, we found a small positive bias, which correlated negatively with reflective pondering, a type of rumination. As expected, reaction times were increased for intermediate tones.
Functional Connectivity of Insula and Anterior Cingulate Cortex During Decision-Making Under Ambiguity
Translational Psychiatry, 2011
Recent genetic studies showed evidence for a role of the single-nucleotide polymorphism rs2522833... more Recent genetic studies showed evidence for a role of the single-nucleotide polymorphism rs2522833 within the PCLO gene in the etiology of major depression, and rs2522833 has been shown to modulate hypothalamic pituitary adrenal (HPA) axis activity during antidepressant treatment. Monoaminergic modulation of the HPA system may be one possible pathomechanism by which PCLO exerts its effect on depression. In the present study, we investigated the effect of rs2522833 on the cortisol awakening response (CAR) in healthy young adults. A total of 66 healthy volunteers from the community (36 men and 30 women) aged 18-25 years without individual or family history of affective disorders and schizophrenia collected saliva cortisol samples at 0, 30, 45 and 60 min after awakening on two consecutive working days. We identified a blunted CAR (AUCinc) in rs2522833 risk-allele (C) carriers, possibly indicating exhausted regulatory mechanisms underlying the HPA system. We also identified higher neuroticism scores in rs2522833 risk-allele carriers but no phenotypic correlation between the CAR (AUCinc) and neuroticism. These findings suggest that the rs2522833 risk variant might increase vulnerability to depression both by physiological and behavioral pathways, which appear, however, not to be substantially overlapped. Replication with larger samples is warranted.
Zur erhöhten Prävalenz des problematischen Alkoholkonsums bei Studierenden
PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie, 2009
To compare the prevalence rates of problematic alcohol consumption in students and in the general... more To compare the prevalence rates of problematic alcohol consumption in students and in the general population. A sample of students (n=1 115) and a population sample (n=631) were assessed with the Patient Health Questionnaire (PHQ). The PHQ probes for problematic alcohol consumption with five questions. An &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;alcohol syndrome&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; is suspected if at least one of these indicators is present. The alcohol syndrome was present more frequently among students than in the population sample (30,1% versus 8,1%). The odds ratio, adjusted for age, gender and education, was OR=3,7. However, when the five indicators were analysed separately, only two of them were significantly more frequent in students than in the comparison sample. Both indicate a neglect of duties as a consequence of alcohol consumption. Intervention strategies aimed at students&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; alcohol consumption should focus on binge drinking and the risks associated with this problematic form of alcohol consumption.
Rumination, distraction and mindful self-focus: effects on mood, dysfunctional attitudes and cortisol stress response
Psychological Medicine, 2009
BackgroundAlthough aggravating effects of rumination on dysfunctional cognitions and endocrine st... more BackgroundAlthough aggravating effects of rumination on dysfunctional cognitions and endocrine stress responses have been proposed, experimental studies testing these assumptions are lacking. In parallel, mindfulness theory suggests beneficial effects of mindfulness on dysfunctional cognitions. This study aimed to investigate the effects of induced rumination, distraction and mindful self-focus on mood and dysfunctional attitudes and to assess the possible impact of induced rumination on participants' cortisol responses.MethodSixty university students were subjected to negative mood induction and subsequently randomly assigned to a rumination, distraction or mindful self-focus condition. The latter included statements focusing on self-acceptance and awareness of the breath. Four saliva cortisol samples were selected during the session.ResultsCompared to induced rumination, distraction showed a clear beneficial effect on the course of dysphoric mood, whereas a mindful self-focus ...