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Schröder B, Kroczek A, Kroczek LOH, Ehlis AC, Batra A, Mühlberger A. Cigarette craving in virtual reality cue exposure in abstainers and relapsed smokers. Sci Rep 2024; 14:7538. [PMID: 38553517 PMCID: PMC10980682 DOI: 10.1038/s41598-024-58168-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/26/2024] [Indexed: 04/02/2024] Open
Abstract
Cue exposure therapy (CET) in substance-use disorders aims to reduce craving and ultimately relapse rates. Applying CET in virtual reality (VR) was proposed to increase its efficacy, as VR enables the presentation of social and environmental cues along with substance-related stimuli. However, limited success has been reported so far when applying VR-CET for smoking cessation. Understanding if effects of VR-CET differ between future abstainers and relapsing smokers may help to improve VR-CET. Data from 102 participants allocated to the intervention arm (VR-CET) of a recent RCT comparing VR-CET to relaxation in the context of smoking cessation was analyzed with respect to tolerability, presence, and craving during VR-CET. Cue exposure was conducted in four VR contexts (Loneliness/Rumination, Party, Stress, Café), each presented twice. Relapsed smokers compared to abstainers experienced higher craving during VR-CET and stronger craving responses especially during the Stress scenario. Furthermore, lower mean craving during VR-CET positively predicted abstinence at 6-month follow-up. Attempts to improve smoking cessation outcomes of VR-CET should aim to identify smokers who are more at risk of relapse based on high craving levels during VR-CET. Specifically measuring craving responses during social stress seems to be well suited to mark relapse. We propose to investigate individualized treatment approaches accordingly.
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Affiliation(s)
- Benedikt Schröder
- Department for Psychology, Clinical Psychology and Psychotherapy, University of Regensburg, Universitätsstraße 31, 93053, Regensburg, Germany.
| | - Agnes Kroczek
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Section for Addiction Research and Medicine University Hospital Tübingen, Tübingen, Germany
| | - Leon O H Kroczek
- Department for Psychology, Clinical Psychology and Psychotherapy, University of Regensburg, Universitätsstraße 31, 93053, Regensburg, Germany
| | - Ann-Christine Ehlis
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), partner site Tübingen, Tübingen, Germany
| | - Anil Batra
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University Hospital Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Section for Addiction Research and Medicine University Hospital Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), partner site Tübingen, Tübingen, Germany
| | - Andreas Mühlberger
- Department for Psychology, Clinical Psychology and Psychotherapy, University of Regensburg, Universitätsstraße 31, 93053, Regensburg, Germany
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Laicher H, Int-Veen I, Woloszyn L, Wiegand A, Kroczek A, Sippel D, Leehr EJ, Lawyer G, Albasini F, Frischholz C, Mössner R, Nieratschker V, Rubel J, Fallgatter A, Ehlis AC, Rosenbaum D. In situ fNIRS measurements during cognitive behavioral emotion regulation training in rumination-focused therapy: A randomized-controlled trial. Neuroimage Clin 2023; 40:103525. [PMID: 37839195 PMCID: PMC10589893 DOI: 10.1016/j.nicl.2023.103525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/06/2023] [Accepted: 10/07/2023] [Indexed: 10/17/2023]
Abstract
Repetitive negative thinking (RNT), including rumination, plays a key role in various psychopathologies. Although several psychotherapeutic treatments have been developed to reduce RNT, the neural correlates of those specific treatments and of psychotherapy in general are largely unknown. Functional near-infrared spectroscopy (fNIRS) offers the potential to investigate the neural correlates of psychotherapeutic techniques in situ. Therefore, in this study we investigated the efficacy and neural correlates of a fNIRS adapted Mindfulness-based Emotion Regulation Training (MBERT) for the treatment of depressive rumination in 42 subjects with major depressive disorder (MDD) in a cross-over designed randomized controlled trial. Using psychometric measures, subjective ratings and fNIRS, we analyzed in situ changes in depressive symptom severity, ruminative thoughts and cortical activity in the Cognitive Control Network (CCN). Our results show that MBERT is effective in treating depressive symptoms and rumination. On a neural level, we found consistently higher cortical activation during emotion regulation training compared to control trials in the bilateral inferior frontal gyrus (IFG) and dorsolateral prefrontal cortex (DLPFC). Furthermore, cortical oxygenation decreased from session to session in the bilateral DLPFC. The relevance of the results for the psychotherapeutic treatment of MDD as well as further necessary investigations are discussed.
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Affiliation(s)
- Hendrik Laicher
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen Center for Mental Health (TüCMH), Tuebingen, Germany; German Center for Mental Health (DZPG), partner site Tuebingen, Germany.
| | - Isabell Int-Veen
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen Center for Mental Health (TüCMH), Tuebingen, Germany; German Center for Mental Health (DZPG), partner site Tuebingen, Germany
| | - Leonie Woloszyn
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen Center for Mental Health (TüCMH), Tuebingen, Germany; German Center for Mental Health (DZPG), partner site Tuebingen, Germany
| | - Ariane Wiegand
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen Center for Mental Health (TüCMH), Tuebingen, Germany; German Center for Mental Health (DZPG), partner site Tuebingen, Germany; Max-Planck Institute of Psychiatry, Munich, Germany
| | - Agnes Kroczek
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen Center for Mental Health (TüCMH), Tuebingen, Germany; German Center for Mental Health (DZPG), partner site Tuebingen, Germany
| | - Daniel Sippel
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen Center for Mental Health (TüCMH), Tuebingen, Germany; German Center for Mental Health (DZPG), partner site Tuebingen, Germany
| | - Elisabeth J Leehr
- Institute for Translational, University of Muenster, Muenster, Germany
| | - Glenn Lawyer
- Machine Learning Solutions, Luxembourg, Luxembourg
| | - Francesco Albasini
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen Center for Mental Health (TüCMH), Tuebingen, Germany; German Center for Mental Health (DZPG), partner site Tuebingen, Germany
| | - Christian Frischholz
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen Center for Mental Health (TüCMH), Tuebingen, Germany; German Center for Mental Health (DZPG), partner site Tuebingen, Germany
| | - Rainald Mössner
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen Center for Mental Health (TüCMH), Tuebingen, Germany; German Center for Mental Health (DZPG), partner site Tuebingen, Germany
| | - Vanessa Nieratschker
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen Center for Mental Health (TüCMH), Tuebingen, Germany; German Center for Mental Health (DZPG), partner site Tuebingen, Germany
| | - Julian Rubel
- Psychotherapy Research Unit, Department of Psychology, Osnabrueck University, Osnabrueck, Germany
| | - Andreas Fallgatter
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen Center for Mental Health (TüCMH), Tuebingen, Germany; German Center for Mental Health (DZPG), partner site Tuebingen, Germany; LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany
| | - Ann-Christine Ehlis
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen Center for Mental Health (TüCMH), Tuebingen, Germany; German Center for Mental Health (DZPG), partner site Tuebingen, Germany; LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany
| | - David Rosenbaum
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen Center for Mental Health (TüCMH), Tuebingen, Germany; German Center for Mental Health (DZPG), partner site Tuebingen, Germany
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3
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Laicher H, Int-Veen I, Torka F, Kroczek A, Bihlmaier I, Storchak H, Velten-Schurian K, Dresler T, Täglich R, Fallgatter AJ, Ehlis AC, Rosenbaum D. Trait rumination and social anxiety separately influence stress-induced rumination and hemodynamic responses. Sci Rep 2022; 12:5512. [PMID: 35365678 PMCID: PMC8976084 DOI: 10.1038/s41598-022-08579-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 03/07/2022] [Indexed: 12/03/2022] Open
Abstract
We aimed to investigate stress-reactive rumination in response to social stress and its association with social anxiety and trait rumination. From previous investigations we know that people with a certain vulnerability to rumination show increased stress-reactive rumination. However, up to date the possible influence of social anxiety on this relationship is still unclear. Therefore, we reanalyzed the data of two of our previous studies assessing healthy low and high trait ruminators and depressed patients performing the Trier Social Stress Test (TSST). We measured cortical oxygenation using functional Near-Infrared Spectroscopy (fNIRS) as well as different behavioral outcome measures (subjective stress levels, negative affect, state rumination). On a behavioral level, we found an influence of both, social anxiety and trait rumination, on state rumination, even when correcting for the other factor, respectively, implying two potentially independent factors of influence. On a neural level, we observed reduced activation in brain regions of the cognitive control network (CCN) for higher social anxiety and trait rumination, which might be a result of reduced cognitive and attentional control. Results indicate a specific role of social anxiety, at least on a behavioral level, and therefore implicate a crucial factor to be considered in the treatment of depression.
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Affiliation(s)
- Hendrik Laicher
- Department of Psychiatry and Psychotherapy, Tuebingen Center for Mental Health, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tuebingen, Germany.
| | - Isabell Int-Veen
- Department of Psychiatry and Psychotherapy, Tuebingen Center for Mental Health, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tuebingen, Germany.,Department of Psychology, University of Tuebingen, Tuebingen, Germany
| | - Florian Torka
- Department of Psychology, University of Tuebingen, Tuebingen, Germany
| | - Agnes Kroczek
- Department of Psychiatry and Psychotherapy, Tuebingen Center for Mental Health, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tuebingen, Germany
| | - Isabel Bihlmaier
- Department of Psychiatry and Psychotherapy, Tuebingen Center for Mental Health, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tuebingen, Germany
| | - Helena Storchak
- Department of Psychiatry and Psychotherapy, Tuebingen Center for Mental Health, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tuebingen, Germany
| | - Kerstin Velten-Schurian
- Department of Psychiatry and Psychotherapy, Tuebingen Center for Mental Health, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tuebingen, Germany
| | - Thomas Dresler
- Department of Psychiatry and Psychotherapy, Tuebingen Center for Mental Health, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tuebingen, Germany.,LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany
| | - Ramona Täglich
- Department of Psychiatry and Psychotherapy, Tuebingen Center for Mental Health, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tuebingen, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Tuebingen Center for Mental Health, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tuebingen, Germany.,LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany
| | - Ann-Christine Ehlis
- Department of Psychiatry and Psychotherapy, Tuebingen Center for Mental Health, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tuebingen, Germany.,LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany
| | - David Rosenbaum
- Department of Psychiatry and Psychotherapy, Tuebingen Center for Mental Health, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tuebingen, Germany
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4
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Rosenbaum D, Int-Veen I, Laicher H, Torka F, Kroczek A, Rubel J, Lawyer G, Bürger Z, Bihlmaier I, Storchak H, Velten-Schurian K, Dresler T, Täglich R, Schopp B, Nürk HC, Derntl B, Nieratschker V, Fallgatter AJ, Ehlis AC. Insights from a laboratory and naturalistic investigation on stress, rumination and frontal brain functioning in MDD: An fNIRS study. Neurobiol Stress 2021; 15:100344. [PMID: 34124320 PMCID: PMC8173308 DOI: 10.1016/j.ynstr.2021.100344] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/19/2021] [Accepted: 05/18/2021] [Indexed: 11/28/2022] Open
Abstract
Recent research has emphasized rumination as an important maintaining factor in various mental disorders. However, operationalization and therefore induction of rumination in experimental settings poses a major challenge in terms of ecological validity. As stress seems to play a key role in everyday situations eliciting rumination, we conducted two stress paradigms while assessing behavioral and neurophysiological measures. Aiming to replicate previous findings on induced rumination by means of the Trier Social Stress Test (TSST) and comparing them to physiological (pain) stress, a clinical sample of patients with Major Depressive Disorder (MDD; n = 22) and healthy controls (HC; n = 23) was recruited. Cortical blood oxygenation was assessed during the stress paradigms using functional near-infrared spectroscopy (fNIRS). Further, we used ecological momentary assessment (EMA) of stress, rumination and mood to be able to correlate ruminative responses during induced stress and everyday rumination. Our results showed that social stress but not physiological stress induced depressive rumination in MDD but not in HC. Further, rumination reactivity in response to social stress but not to physiological stress was significantly associated with rumination reactivity in everyday life as assessed with EMA. With respect to cortical oxygenation, MDD subjects showed hypoactivity in the Cognitive Control Network during the TSST, which mediated the differences between MDD and HC in post-stress rumination. Our findings emphasize the role of negative social triggers in depressive rumination and validate the TSST as an induction method for depressive rumination. The results inform future developments in psychotherapeutic treatment for depressive rumination.
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Affiliation(s)
- David Rosenbaum
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
| | - Isabell Int-Veen
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany.,Department of Psychology, University of Tuebingen, Germany
| | - Hendrik Laicher
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany.,Department of Psychology, University of Tuebingen, Germany
| | - Florian Torka
- Department of Psychology, University of Tuebingen, Germany
| | - Agnes Kroczek
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
| | - Julian Rubel
- Psychotherapy Research Lab, Psychology and Sport Sciences, Justus-Liebig-University Giessen, Giessen, Germany
| | - Glenn Lawyer
- Machine Learning Solutions, Luxembourg, Luxembourg
| | - Zoé Bürger
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
| | - Isabel Bihlmaier
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
| | - Helena Storchak
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
| | - Kerstin Velten-Schurian
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
| | - Thomas Dresler
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany.,LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany
| | - Ramona Täglich
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
| | - Betti Schopp
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
| | | | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany.,LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany
| | - Vanessa Nieratschker
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany.,LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany.,German Center for Neurodegenerative Disorders, Tuebingen, Germany
| | - Ann-Christine Ehlis
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany.,LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany
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Rosenbaum D, Int-Veen I, Kroczek A, Hilsendegen P, Velten-Schurian K, Bihlmaier I, Fallgatter AJ, Ehlis AC. Amplitude of low frequency fluctuations (ALFF) of spontaneous and induced rumination in major depression: An fNIRS study. Sci Rep 2020; 10:21520. [PMID: 33299001 PMCID: PMC7725822 DOI: 10.1038/s41598-020-78317-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/24/2020] [Indexed: 12/24/2022] Open
Abstract
In the current study, we investigated the amplitude of low frequency fluctuations (ALFF) at rest and during a rumination induction. Specifically, we explored the differences of cortical blood oxygenation using fNIRS in subjects with Major Depressive Disorder (MDD) and healthy controls (HC). Rumination was assessed as state and trait measure, as well as with a qualitative semi-structured interview. Qualitative and quantitative measures of rumination indicated that the MDD group showed elevated rumination regarding state and trait measures. Furthermore, rumination differed qualitatively between the groups. The MDD group showed higher levels of general rumination and increased rumination during the rumination induction. However, the MDD group did not show a carry-over effect of elevated rumination after the induction paradigm to the following resting-state measurement. On a neuronal level, we observed a general hypoactivity in the MDD group compared to the HC group. Moreover, both groups showed increased ALFF during the rumination induction compared to the rest phase, especially in temporo-parietal areas. However, no interaction effect of MDD status and rumination induction was found. The current findings are discussed with respect to the literature of paradigms used in the investigation of rumination and suggestions on general improvements in rumination research are given.
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Affiliation(s)
- David Rosenbaum
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany.
| | - Isabell Int-Veen
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany
| | - Agnes Kroczek
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany
| | - Paula Hilsendegen
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany
| | - Kerstin Velten-Schurian
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany
| | - Isabel Bihlmaier
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany.,LEAD Graduate School and Research Network, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Disorders, Tübingen, Germany
| | - Ann-Christine Ehlis
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany.,LEAD Graduate School and Research Network, University of Tübingen, Tübingen, Germany
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Becker-Sadzio J, Gundel F, Kroczek A, Wekenmann S, Rapp A, Fallgatter AJ, Deppermann S. Trauma exposure therapy in a pregnant woman suffering from complex posttraumatic stress disorder after childhood sexual abuse: risk or benefit? Eur J Psychotraumatol 2020; 11:1697581. [PMID: 33343833 PMCID: PMC7734094 DOI: 10.1080/20008198.2019.1697581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Mental disorders during pregnancy are common and affect the health of mother and child. Despite a relatively high prevalence rate, treatment options have not been investigated systematically. Particularly symptoms of posttraumatic stress disorder (PTSD) may increase significantly during the course of pregnancy. However, proper guidelines for psychotherapeutic treatment of PTSD during pregnancy do not exist. Objective: In this article, we aimed at discussing the effects of untreated PTSD on pregnancy and postpartum mother-child bonding as well as exposure therapy during pregnancy. Method: To do so, we present the case of a pregnant woman with complex PTSD following childhood sexual abuse. At the time of hospitalization, the patient was pregnant in the second trimester and reported intrusive re-experiencing of the traumatic events, nightmares, anxiety and helplessness as well as an impairing level of irritability during social situations. After a careful discussion of the case within our department and at the annual conference of the German Association of Psychiatry, Psychotherapy and Psychosomatics, we decided to treat the patient with dialectical behavior therapy for PTSD (DBT-PTSD) including exposure therapy under the regular observation of a gynecologist. Psychometric measurements (Davidson Trauma Scale (DTS) and Borderline Symptom- List-23 (BSL-23) were used to observe the course of treatment regarding common PTSD-symptoms and disturbances in self-organization (DSO). Results: The intensity of intrusions and hyperarousal increased from the date of admission, reached the maximum when exposure started and decreased below baseline-level at the end of treatment. Avoidance behavior continually decreased from the beginning until the end of therapy. Decreased BSL-23 values show major improvements regarding DSO. To our knowledge, the course of pregnancy was not affected by treatment-induced psychological and physical symptoms.Conclusions: DBT- PTSD is a potential treatment option for patients suffering from PTSD during pregnancy. Yet, further (epigenetic) research in this field is urgently needed.
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Affiliation(s)
- Julia Becker-Sadzio
- Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, Calwerstr. 14, Tuebingen, Germany
| | - Friederike Gundel
- Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, Calwerstr. 14, Tuebingen, Germany
| | - Agnes Kroczek
- Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, Calwerstr. 14, Tuebingen, Germany
| | - Stefanie Wekenmann
- Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, Calwerstr. 14, Tuebingen, Germany
| | - Alexander Rapp
- Department of Psychiatry and Psychotherapy, Klinikum Stuttgart, Stuttgart, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, Calwerstr. 14, Tuebingen, Germany
| | - Saskia Deppermann
- Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, Calwerstr. 14, Tuebingen, Germany
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Rosenbaum D, Leehr EJ, Kroczek A, Rubel JA, Int-Veen I, Deutsch K, Maier MJ, Hudak J, Fallgatter AJ, Ehlis AC. Neuronal correlates of spider phobia in a combined fNIRS-EEG study. Sci Rep 2020; 10:12597. [PMID: 32724128 PMCID: PMC7387441 DOI: 10.1038/s41598-020-69127-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/29/2020] [Indexed: 11/08/2022] Open
Abstract
Specific phobia is associated with aberrant brain activation in confrontation paradigms with phobic stimuli. In previous EEG research enhanced event-related potentials (ERPs) in the late-positive potential (LPP) window have been observed. Further, studies with functional near-infrared spectroscopy (fNIRS) and fMRI suggest that spider phobia is associated with enhanced activation within cortical and subcortical areas. In the current study we investigated the neuronal correlates of spider phobia in a combined fNIRS-EEG study. To this end, 37 spider phobic patients (PP) and 32 healthy controls (HC) underwent a symptom provocation paradigm during which subjects watched video clips of spiders and domestic animals (confrontation phase) after being primed on the content of the video (anticipation phase). Simultaneously, fNIRS, EEG, electromyography (EMG), electrocardiography and behavioral measures were assessed. Results showed increased LPP amplitudes, increased hemodynamic responses in the cognitive control network, and increased EMG activity and heart rate during spider conditions in PP in comparison to HC. Furthermore, in behavioral ratings PP showed higher emotional distress and avoidance. Behavioral ratings, fNIRS and EEG data showed positive correlations on a between-subject as well as on a within-subject level. Our results merge the existing data on neurophysiological correlates of phobic stimulus processing in hemodynamic and electrophysiological research and extend those of static visual material (pictures) to dynamic visual material (videos).
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Affiliation(s)
- David Rosenbaum
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany.
| | | | - Agnes Kroczek
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany
| | - Julian A Rubel
- Department of Psychotherapy Research, Justus-Liebig-University Giessen, Giessen, Germany
| | - Isabell Int-Veen
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany
| | - Kira Deutsch
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany
| | - Moritz J Maier
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany
| | - Justin Hudak
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, UT, 84112, USA
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany
- LEAD Graduate School and Research Network, University of Tuebingen, Tuebingen, Germany
| | - Ann-Christine Ehlis
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Calwerstraße 14, 72076, Tübingen, Germany
- LEAD Graduate School and Research Network, University of Tuebingen, Tuebingen, Germany
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Deppermann S, Notzon S, Kroczek A, Rosenbaum D, Haeussinger F, Diemer J, Domschke K, Fallgatter A, Ehlis AC, Zwanzger P. Functional co-activation within the prefrontal cortex supports the maintenance of behavioural performance in fear-relevant situations before an iTBS modulated virtual reality challenge in participants with spider phobia. Behav Brain Res 2016; 307:208-17. [DOI: 10.1016/j.bbr.2016.03.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 01/24/2016] [Accepted: 03/14/2016] [Indexed: 12/17/2022]
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9
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Notzon S, Deppermann S, Fallgatter A, Diemer J, Kroczek A, Domschke K, Zwanzger P, Ehlis AC. Psychophysiological effects of an iTBS modulated virtual reality challenge including participants with spider phobia. Biol Psychol 2015; 112:66-76. [DOI: 10.1016/j.biopsycho.2015.10.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 09/28/2015] [Accepted: 10/08/2015] [Indexed: 12/21/2022]
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10
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Metzger F, Hagen K, Kroczek A, Polak T, Ehlis AC, Fallgatter A. V43. Vagus somatosensory evoked potentials in elderly: A potential risk marker for neurodegeneration and its relation to Subjective Memory Impairment. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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11
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Deppermann S, Notzon S, Britz R, Wirsing D, Kroczek A, Haeussinger F, Zwanzger P, Fallgatter A, Ehlis AC. P73. Can iTBS modulate subjective and objective parameters of emotional processing in fear-relevant situations? A pilot study with spider phobics. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Engster KM, Stengel A, Rose M, Kroczek A, Kobelt P. Blockade of dopaminergic signaling does not alter ghrelin-induced food intake in rats. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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