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Wibbeke D, Köbke C, Wingenfeld K. Übergangsversorgung geriatrischer PatientInnen vom Krankenhaus in die Häuslichkeit - der Nutzen aus Sicht der PatientInnen. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- D Wibbeke
- Institut für Pflegewissenschaft, Universität Bielefeld
| | - C Köbke
- Institut für Pflegewissenschaft, Universität Bielefeld
| | - K Wingenfeld
- Institut für Pflegewissenschaft, Universität Bielefeld
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Böge K, Hahne I, Bergmann N, Zierhut M, Ta T, Wingenfeld K, Bajbouj M, Hahn E. Mindfulness-based group therapy for inpatients with schizophrenia spectrum disorders – feasibility, acceptability, and preliminary outcomes of a rater-blinded randomized controlled trial. Eur Psychiatry 2021. [PMCID: PMC9480089 DOI: 10.1192/j.eurpsy.2021.2130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction The therapeutic effectiveness of mindfulness-based interventions (MBIs) has been shown for various mental disorders. However, for schizophrenia spectrum disorders (SSD), only a few trials have been conducted, mostly in outpatient settings. Objectives This study aimed to investigate feasibility, acceptability, and preliminary effectiveness of a four-week mindfulness-based group therapy (MBGT) for in-patients with SSD. Methods A pre-registered randomized controlled trial (RCT) was conducted at the in-patient ward for SSD. All measures were employed at baseline, post-intervention (4-weeks), and follow-up (12-weeks). The primary outcome was ‘mindfulness’. Secondary outcomes were rater-blinded positive- and negative symptoms, depression, social functioning, as well as self-rated mindfulness, depression, anxiety, psychological flexibility, quality of life, and medication regime. Results N=40 participants were randomized into either four-week treatment-as-usual (TAU; n=19) or MBGT+TAU (n = 21). Protocol adherence was 95.2%, and the retention rate to treatments was 95%. ANCOVA analysis revealed significant improvements in the MBGT+TAU compared to TAU for the primary outcome and negative symptoms. Exploratory analyses showed medium-to-large intervention effects on secondary outcomes mindfulness, positive, negative, and depressive symptoms, psychological flexibility, quality of life, and social functioning for MBGT+TAU and small-to-moderate changes on positive symptoms and social functioning for TAU. No serious adverse effects were reported. Conclusions This study supports the feasibility and acceptability of MBGT for in-patients with SSD, including high protocol adherence and retention rates. A proof of concept of the MBIs and corresponding improvements on various clinical and process parameters warrant a fully powered RCT to determine effectiveness, cost-efficiency, and longitudinal outcomes of MBGT for SSD. Disclosure No significant relationships.
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Kaczmarczyk M, Spitzer C, Wingenfeld K, Wiedemann K, Kühl L, Schultebraucks K, Otte C. No association between major depression with and without childhood adversity and the stress hormone copeptin. PHARMACOPSYCHIATRY 2020. [DOI: 10.1055/s-0039-3403002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - C Spitzer
- Charité Universitätsmedizin, Berlin, Germany
| | | | - K Wiedemann
- Charité Universitätsmedizin, Berlin, Germany
| | - L Kühl
- Charité Universitätsmedizin, Berlin, Germany
| | | | - C Otte
- Charité Universitätsmedizin, Berlin, Germany
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Kaczmarczyk M, Otte C, Wiedemann K, Kuehl LK, Schultebraucks K, Spitzer C, Wingenfeld K. Major depression and atrial natriuretic peptide: The role of adverse childhood experiences. Psychoneuroendocrinology 2019; 101:7-11. [PMID: 30391559 DOI: 10.1016/j.psyneuen.2018.10.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/18/2018] [Accepted: 10/22/2018] [Indexed: 01/04/2023]
Abstract
Atrial natriuretic peptide (ANP) exerts anxiolytic effects in animals and humans. Patients with anxiety, trauma-associated and depressive disorders exhibit lower ANP plasma levels compared to healthy individuals. However, the role of ANP in patients with major depressive disorder (MDD) with and without concomitant adverse childhood experiences (ACE) and in healthy individuals with and without ACE is not clear. We recruited a total of 93 women: 23 women with MDD and ACE, 24 women with MDD without ACE, 22 women with ACE but no current or lifetime MDD, and 24 healthy women without ACE. ANP plasma levels were measured with a radioimmunoassay. The four groups did not differ in demographic and clinical variables. We found a positive correlation between age and plasma levels of ANP (r = .39; p < .001). After controlling for age, there was no significant main effect of MDD or ACE on ANP plasma levels, but a significant interaction between MDD and ACE such that ACE was associated with reduced basal ANP levels in the absence of MDD. We assume that low plasma ANP might be a consequence of ACE in the absence of current psychopathology. Therefore, future studies are needed to replicate our findings and to characterize the influencing factors of ACE on ANP more comprehensively, for example by including a comprehensive trauma and comorbidity anamnesis as well as cardiovascular state and risk factors.
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Affiliation(s)
- M Kaczmarczyk
- Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany
| | - C Otte
- Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany
| | - K Wiedemann
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany
| | - L K Kuehl
- Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany
| | - K Schultebraucks
- Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany; Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - C Spitzer
- Asklepios Fachklinikum Tiefenbrunn, Rosdorf, Germany
| | - K Wingenfeld
- Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Berlin, Germany.
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Wingenfeld K, Duesenberg M, Fleischer J, Roepke S, Dziobek I, Otte C, Wolf OT. Psychosocial stress differentially affects emotional empathy in women with borderline personality disorder and healthy controls. Acta Psychiatr Scand 2018; 137:206-215. [PMID: 29417987 DOI: 10.1111/acps.12856] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Deficits in empathy, an important part of social cognition, have been described in patients with borderline personality disorder (BPD). Importantly, psychosocial stress enhances emotional empathy in healthy participants. However, it remains unknown whether stress affects empathy in BPD. METHOD We randomized 47 women with BPD and 47 healthy women to either the Trier Social Stress Test or a control condition. Subsequently, all participants underwent the Multifaceted Empathy Test (MET), a measure of cognitive and emotional facets of empathy. RESULTS Across groups, stress resulted in a significant increase in cortisol and stress ratings. There was a significant stress × group interaction for emotional empathy (Fdf1,92 = 5.12, P = 0.04, ηp2 = 0.05). While there was no difference between patients with BPD and healthy participants after the control condition, patients with BPD had significantly lower emotional empathy scores after stress compared to healthy individuals. There were no effects for cognitive empathy. CONCLUSION The current finding provides first evidence that stress differentially affects emotional empathy in patients with BPD and healthy individuals such that patients with BPD showed reduced emotional empathy compared to healthy women after stress. Given the strong impact of stress on acute psychopathology in patients with BPD, such a response may exacerbate interpersonal conflicts in stress contexts and may be an important target for therapeutic interventions.
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Affiliation(s)
- K Wingenfeld
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany
| | - M Duesenberg
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany
| | - J Fleischer
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany
| | - S Roepke
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany
| | - I Dziobek
- Berlin School of Mind and Brain, Humboldt University Berlin, Berlin, Germany
| | - C Otte
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany
| | - O T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Ruhr-University Bochum, Bochum, Germany
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Rombold F, Wingenfeld K, Renneberg B, Hellmann-Regen J, Otte C, Roepke S. Influence of the noradrenergic system on the formation of intrusive memories in women: an experimental approach with a trauma film paradigm. Psychol Med 2016; 46:2523-2534. [PMID: 27335220 DOI: 10.1017/s0033291716001379] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Intrusive memories of traumatic events are a core feature of post-traumatic stress disorder but little is known about the neurobiological formation of intrusions. The aim of this study was to determine whether the activity of the noradrenergic system during an intrusion-inducing stressor would influence subsequent intrusive memories. METHOD We conducted an experimental, double-blind, placebo-controlled study in 118 healthy women. Participants received a single dose of either 10 mg yohimbine, stimulating noradrenergic activity, or 0.15 mg clonidine, inhibiting noradrenergic activity, or placebo. Subsequently, they watched an established trauma film which induced intrusions. The number of consecutive intrusions resulting from the trauma film, the vividness of the intrusions, and the degree of distress evoked by the intrusions were assessed during the following 4 days. Salivary cortisol and α-amylase were collected before and after the trauma film. RESULTS A significant time × treatment interaction for the number of intrusions and the vividness of intrusions indicated a different time course of intrusions depending on treatment. Post-hoc tests revealed a delayed decrease of intrusions and a delayed decrease of intrusion vividness after the trauma film in the yohimbine group compared with the clonidine and placebo groups. Furthermore, after yohimbine administration, a significant increase in salivary cortisol levels was observed during the trauma film. CONCLUSIONS Our findings indicate that pharmacological activation of the noradrenergic system during an emotionally negative event makes an impact on consecutive intrusive memories and their vividness in healthy women. The noradrenergic system seems to be involved in the formation of intrusive memories.
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Affiliation(s)
- F Rombold
- Department of Psychiatry and Psychotherapy,Charité - Universitätsmedizin Berlin,Campus Benjamin Franklin,Berlin,Germany
| | - K Wingenfeld
- Department of Psychiatry and Psychotherapy,Charité - Universitätsmedizin Berlin,Campus Benjamin Franklin,Berlin,Germany
| | - B Renneberg
- Department of Psychology,Freie Universitaet Berlin,Berlin,Germany
| | - J Hellmann-Regen
- Department of Psychiatry and Psychotherapy,Charité - Universitätsmedizin Berlin,Campus Benjamin Franklin,Berlin,Germany
| | - C Otte
- Department of Psychiatry and Psychotherapy,Charité - Universitätsmedizin Berlin,Campus Benjamin Franklin,Berlin,Germany
| | - S Roepke
- Department of Psychiatry and Psychotherapy,Charité - Universitätsmedizin Berlin,Campus Benjamin Franklin,Berlin,Germany
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Wolf OT, Atsak P, de Quervain DJ, Roozendaal B, Wingenfeld K. Stress and Memory: A Selective Review on Recent Developments in the Understanding of Stress Hormone Effects on Memory and Their Clinical Relevance. J Neuroendocrinol 2016; 28. [PMID: 26708929 DOI: 10.1111/jne.12353] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 12/14/2015] [Accepted: 12/16/2015] [Indexed: 01/23/2023]
Abstract
Stress causes a neuroendocrine response cascade, leading to the release of catecholamines and glucocorticoids (GCs). GCs influence learning and memory by acting on mineralocorticoid (MR) and glucocorticoid (GR) receptors. Typically, GCs enhance the consolidation of memory processing at the same time as impairing the retrieval of memory of emotionally arousing experiences. The present selective review addresses four recent developments in this area. First, the role of the endocannabinoid system in mediating the rapid, nongenomic effects of GCs on memory is illustrated in rodents. Subsequently, studies on the impact of the selective stimulation of MRs on different memory processes in humans are summarised. Next, a series of human experiments on the impact of stress or GC treatment on fear extinction and fear reconsolidation is presented. Finally, the clinical relevance of the effects of exogenous GC administration is highlighted by the description of patients with anxiety disorders who demonstrate an enhancement of extinction-based therapies by GC treatment. The review highlights the substantial progress made in our mechanistic understanding of the memory-modulating properties of GCs, as well as their clinical potential.
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Affiliation(s)
- O T Wolf
- Department of Cognitive Psychology, Institute for Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - P Atsak
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - D J de Quervain
- Division of Cognitive Neuroscience, Faculty of Medicine, Department of Psychology, University Psychiatric Clinics Basel, Basel, Switzerland
| | - B Roozendaal
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - K Wingenfeld
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité University Medicine Berlin, Berlin, Germany
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Schultebraucks K, Wingenfeld K, Quinkler M, Otte C. Cognitive function in patients with primary adrenal insufficiency (Addison's disease). Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547626] [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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Wingenfeld K, Wolf S, Kunz M, Krieg JC, Lautenbacher S. No effects of hydrocortisone and dexamethasone on pain sensitivity in healthy individuals. Eur J Pain 2014; 19:834-41. [PMID: 25380413 DOI: 10.1002/ejp.610] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND There is some evidence that stress-induced cortisol increase leads to a decrease in pain, while lowering cortisol levels enhances pain sensitivity, but no study has yet investigated both pharmacological enhancement and reduction of cortisol levels in the same individuals. METHODS Firstly, we tested in 16 healthy individuals whether the treatment with hydrocortisone and dexamethasone, respectively, results in altered pain thresholds. Secondly, we aimed to test whether hormone effects are different across the pain range by using ratings for pain stimuli with varying intensity; and thirdly, we tested whether cortisol levels influence the discrimination ability for painful stimuli. RESULTS Despite substantial effects of dexamethasone and hydrocortisone administration on cortisol levels, no effect of these drugs was seen in terms of pain sensitivity (pain threshold, pain rating, pain discrimination ability), although comprehensively examined. However, in the placebo condition, a significant negative correlation between cortisol and pain thresholds was seen. Similarly, there were also strong negative associations between cortisol levels in the placebo condition and pain thresholds after drug treatment (especially after hydrocortisone). CONCLUSION These findings suggest that short-term variations of cortisol do not influence pain sensitivity whereas, in general, high levels of cortisol are associated with increased pain sensitivity, at least for weak to moderate stimuli.
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Affiliation(s)
- K Wingenfeld
- Department of Psychiatry, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany
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Hinkelmann K, Muhtz C, Dettenborn L, Agorastos A, Moritz S, Wingenfeld K, Spitzer C, Gold SM, Wiedemann K, Otte C. Association between cortisol awakening response and memory function in major depression. Psychol Med 2013; 43:2255-2263. [PMID: 23442784 DOI: 10.1017/s0033291713000287] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND While impaired memory and altered cortisol secretion are characteristic features of major depression, much less is known regarding the impact of antidepressant medication. We examined whether the cortisol awakening response (CAR) is increased in depressed patients with and without medication compared with healthy controls (HC) and whether CAR is associated with memory function in each group. METHOD We examined 21 patients with major depression without medication, 20 depressed patients on antidepressant treatment, and 41 age-, sex- and education-matched healthy subjects. We tested verbal (Auditory Verbal Learning Task) and visuospatial (Rey figure) memory and measured CAR on two consecutive days. RESULTS Patient groups did not differ in severity of depression. We found a significant effect of group (p = 0.03) for CAR. Unmedicated patients exhibited a greater CAR compared with medicated patients (p = 0.04) with no differences between patient groups and HC. We found a significant effect of group for verbal (p = 0.03) and non-verbal memory (p = 0.04). Unmedicated patients performed worse compared with medicated patients and HC in both memory domains. Medicated patients and HC did not differ. Regression analyses revealed a negative association between CAR and memory function in depressed patients, but not in HC. CONCLUSIONS While in unmedicated depressed patients the magnitude of CAR is associated with impaired memory, medicated patients showed a smaller CAR and unimpaired cognitive function compared with HC. Our findings are compatible with the idea that antidepressants reduce CAR and partially restore memory function even if depressive psychopathology is still present.
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Affiliation(s)
- K Hinkelmann
- Department of Psychiatry and Psychotherapy, Charité University Medical Center, Campus Benjamin Franklin, Berlin, Germany
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Hinkelmann K, Muhtz C, Dettenborn L, Agorastos A, Wingenfeld K, Spitzer C, Gao W, Kirschbaum C, Wiedemann K, Otte C. Association of low hair cortisol and childhood trauma. Pharmacopsychiatry 2013. [DOI: 10.1055/s-0033-1353282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kuffel A, Terfehr K, Uhlmann C, Schreiner J, Löwe B, Spitzer C, Wingenfeld K. [Repeated measurement of memory with valenced test items: verbal memory, working memory and autobiographic memory]. Fortschr Neurol Psychiatr 2013; 81:390-7. [PMID: 23856944 DOI: 10.1055/s-0033-1335778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A large number of questions in clinical and/or experimental neuropsychology require the multiple repetition of memory tests at relatively short intervals. Studies on the impact of the associated exercise and interference effects on the validity of the test results are rare. Moreover, hardly any neuropsychological instruments exist to date to record the memory performance with several parallel versions in which the emotional valence of the test material is also taken into consideration. The aim of the present study was to test whether a working memory test (WST, a digit-span task with neutral or negative distraction stimuli) devised by our workgroup can be used with repeated measurements. This question was also examined in parallel versions of a wordlist learning paradigm and an autobiographical memory test (AMT). Both tests contained stimuli with neutral, positive and negative valence. Twenty-four participants completed the memory testing including the working memory test and three versions of a wordlist and the AMT at intervals of a week apiece (measuring points 1. - 3.). The results reveal consistent performances across the three measuring points in the working and autobiographical memory test. The valence of the stimulus material did not influence the memory performance. In the delayed recall of the wordlist an improvement in memory performance over time was seen. The tests on working memory presented and the parallel versions for the declarative and autobiographical memory constitute informal economic instruments within the scope of the measurement repeatability designs. While the WST and AMT are appropriate for study designs with repeated measurements at relatively short intervals, longer intervals might seem more favourable for the use of wordlist learning paradigms.
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Affiliation(s)
- A Kuffel
- Universitäre Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf
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Bock J, Poeggel G, Gruss M, Wingenfeld K, Braun K. Infant Cognitive Training Preshapes Learning-Relevant Prefrontal Circuits for Adult Learning: Learning-Induced Tagging of Dendritic Spines. Cereb Cortex 2013; 24:2920-30. [DOI: 10.1093/cercor/bht148] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wingenfeld K, Driessen M, Terfehr K, Schlosser N, Fernando SC, Otte C, Beblo T, Spitzer C, Löwe B, Wolf OT. Effects of cortisol on memory in women with borderline personality disorder: role of co-morbid post-traumatic stress disorder and major depression. Psychol Med 2013; 43:495-505. [PMID: 23171911 DOI: 10.1017/s0033291712001961] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Stress and cortisol administration are known to have impairing effects on memory retrieval in healthy humans. These effects are reported to be altered in patients with major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) but they have not yet been investigated in borderline personality disorder (BPD). METHOD In a placebo-controlled cross-over study, 71 women with BPD and 40 healthy controls received either placebo or 10 mg of hydrocortisone orally before undertaking a declarative memory retrieval task (word list learning) and an autobiographical memory test (AMT). A working memory test was also applied. RESULTS Overall, opposing effects of cortisol on memory were observed when comparing patients with controls. In controls, cortisol had impairing effects on memory retrieval whereas in BPD patients cortisol had enhancing effects on memory retrieval of words, autobiographical memory and working memory. These effects were most pronounced for specificity of autobiographical memory retrieval. Patients with BPD alone and those with co-morbid PTSD showed this effect. We also found that co-morbid MDD influenced the cortisol effects: in this subgroup (BPD + MDD) the effects of cortisol on memory were absent. CONCLUSIONS The present results demonstrate beneficial effects of acute cortisol elevations on hippocampal-mediated memory processes in BPD. The absence of these effects in patients with co-morbid MDD suggests that these patients differ from other BPD patients in terms of their sensitivity to glucocorticoids (GCs).
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Affiliation(s)
- K Wingenfeld
- Department of Psychiatry and Psychotherapy, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany.
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Spitzer C, Hammer S, Löwe B, Grabe H, Barnow S, Rose M, Wingenfeld K, Freyberger H, Franke G. Die Kurzform des Brief Symptom Inventory (BSI -18): erste Befunde zu den psychometrischen Kennwerten der deutschen Version. Fortschr Neurol Psychiatr 2011; 79:517-23. [DOI: 10.1055/s-0031-1281602] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Schulz M, Damkröger A, Voltmer E, Löwe B, Driessen M, Ward M, Wingenfeld K. Work-related behaviour and experience pattern in nurses: impact on physical and mental health. J Psychiatr Ment Health Nurs 2011; 18:411-7. [PMID: 21539686 DOI: 10.1111/j.1365-2850.2011.01691.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Nursing is associated with high levels of emotional strain and heavy workloads. Changing working conditions raise the importance of investigating job satisfaction, stress and burnout and its consequences for nurses. The aim of the study was to investigate whether work-related behaviour and experience patterns are associated with mental and physical health status in nurses. A sample of 356 nurses in four German hospitals were interviewed using questionnaires regarding work-related behaviour and experience patterns, work stress, depression, anxiety and physical symptoms ('Work-related Behaviour and Experience Pattern'--AVEM and ERI). The main result of this study is that unhealthy work-related behaviour and experience patterns (i.e. the excessive ambitious type and the resigned type) are associated with reduced mental and physical health. Preventive, as well as intervention, strategies are needed that focus both on the individual as well as on working conditions.
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Affiliation(s)
- M Schulz
- Department of Psychiatry and Psychotherapy Bethel, Bielefeld, Germany.
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Wingenfeld K, Löwe B, Driessen M, Wolf OT. Autobiographisches Gedächtnis und Dysregulation der Hypothalamus-Hypophysen-Nebennierenrinden-Achse bei der Borderline-Persönlichkeitsstörung. Psychother Psychosom Med Psychol 2011. [DOI: 10.1055/s-0031-1272452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schulz M, Damkröger A, Heins C, Wehlitz L, Löhr M, Driessen M, Behrens J, Wingenfeld K. Effort-reward imbalance and burnout among German nurses in medical compared with psychiatric hospital settings. J Psychiatr Ment Health Nurs 2009; 16:225-33. [PMID: 19291150 DOI: 10.1111/j.1365-2850.2008.01355.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to investigate whether nurses' efforts and rewards, as well as the effort-reward imbalance (ERI) and burnout, differ between subjects working in psychiatric vs. medical hospitals and between nurses under education and examined nurses respectively. Furthermore, the relationship between ERI and burnout was evaluated. Nursing is associated with high levels of emotional strain and heavy workloads. Burnout and a negative ERI can result in high absenteeism and turnover and have been identified as reasons why nurses leave their profession. In the last decade, working conditions of the nursing profession have changed in Germany, but somatic and psychiatric hospitals developed in different ways. This development may lead to different profiles. A sample of 389 nurses (78.8% female) in four German hospitals was investigated. A total of 147 nurses worked in psychiatric hospitals and 236 nurses worked in medical (somatic) hospitals. Fifty participants were still under education. The Effort-Reward Imbalance Inventory measures effort, reward and overcommitment at job and provides an imbalance score between effort and reward. The Maslach Burnout Inventory with the subscales, emotional exhaustion, lack of accomplishment and depersonalization, was also used. Nurses working in medical hospitals reported more burnout and had higher ERI scores. Subjects under education were comparable to examined nurses in terms of burnout but had lower ERI scores. Multiple regression analyses showed all ERI scales to be significant predictors for emotional exhaustion, while age, field of work and educational status further predict effort or ERI respectively. At present, the working situation of nurses in different settings appears to be characterized by a perceived imbalance of effort and reward and is associated with a high risk of developing burnout symptoms.
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Affiliation(s)
- M Schulz
- Department of Psychiatry and Psychotherapy Bethel, Remterweg 69-71, Bielefeld, Germany.
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Driessen M, Wingenfeld K, Rullkoetter N, Mensebach C, Woermann FG, Mertens M, Beblo T. One-year functional magnetic resonance imaging follow-up study of neural activation during the recall of unresolved negative life events in borderline personality disorder. Psychol Med 2009; 39:507-516. [PMID: 18466663 DOI: 10.1017/s0033291708003358] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Recall of adverse life events under brain imaging conditions has been shown to coincide with activation of limbic and prefrontal brain areas in borderline personality disorder (BPD). We investigate changes of functional magnetic resonance imaging (fMRI) activation patterns during the recall of unresolved adverse life events (ULE) over 1 year. METHOD Thirteen female BPD patients participated in the study. During fMRI measurement subjects recalled ULE and negative but resolved life events (RLE) after individual cue words to stimulate autobiographical memory retrieval. Subjective intensity of emotional and sensoric experiences during recall was assessed as well as standardized measures of psychopathology. RESULTS A 2x2 factorial analysis of fMRI data (Deltat1/t2xDeltaULE/RLE) revealed major right more than left differences of activation (i.e. t1>t2) of the posterior more than anterior cingulate, superior temporal lobes, insula, and right middle and superior frontal lobes (second-level analysis, t=3.0, puncorrected=0.003). The opposite contrast (Deltat2/t1xDeltaULE/RLE) did not reveal any differences. We did not find changes of emotional or sensoric qualities during recall (ULE versus RLE) or of psychopathology measures over the 1-year period. CONCLUSIONS Although subjective and clinical data did not change within 1 year, we observed a substantial decrease of temporo-frontal activation during the recall of ULE from t1 to t2. If future research confirms these findings, the question arises whether the decrease of neural activation precedes clinical improvement in BPD.
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Affiliation(s)
- M Driessen
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Bielefeld, Germany.
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Wingenfeld K, Schmidt I, Hellhammer DH, Heim C. Der Zusammenhang zwischen lebensgeschichtlich frühem Stress, aktuellen Belastungen und körperlichen Beschwerden bei Patienten mit chronischen Schmerzen. Psychother Psych Med 2009. [DOI: 10.1055/s-0029-1208169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Abstract. Whereas learning in every day life requires the inhibition of irrelevant information, standardized memory tests usually do not contain interfering stimuli. The present study aims at an initial evaluation of a new verbal learning paradigm that considers learning with emotionally neutral or negative interference, and learning without interference. In three learning trials, 82 healthy subjects learned three 15-item word lists derived from the Auditory Verbal Learning Test. Word recall in both conditions with interference was decreased, especially in the first learning trial and regardless of emotional valence. Working memory, therefore, might be more affected by interference than learning. These first promising results indicate the usability of the new verbal paradigm for clinical purposes.
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Affiliation(s)
- T. Beblo
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany
| | - C. Mensebach
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany
| | - K. Wingenfeld
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany
| | - N. Rullkötter
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany
| | - M. Driessen
- Department of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld, Germany
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Abstract
In the 1990s, the debate surrounding the issue of quality in outpatient nursing care was given a remarkable boost. Also the conviction steadily grew that quality assurance should be more adjusted to values and expectations of people in need of nursing care, the addressees of such services. But a critical analysis is required to determine to what extent the role of "customer" or "consumer", a role often ascribed to them in this context, can actually be reconciled with their possibilities, expectations and interests. Based on the results of empirical studies, the following article shows that the patient's view, his expectations and evaluations largely depend on some specific consequences of being in need of care and using outpatient nursing care. The article goes into the divergent perspectives that, on the one hand, are characteristic of patients and, on the other, of the nursing staff and other bodies concerned with quality of care.
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Affiliation(s)
- K Wingenfeld
- Institut für Pflegewissenschaft an der Universität Bielefeld Universitätsstr. 25 33615 Bielefeld, Germany
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