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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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Henze GI, Rosenbaum D, Bärt C, Laicher H, Konzok J, Kudielka BM, Fallgatter AJ, Wüst S, Ehlis AC, Kreuzpointner L. Comparing two psychosocial stress paradigms for imaging environments - ScanSTRESS and fNIRS-TSST: correlation structures between stress responses. Behav Brain Res 2022; 436:114080. [PMID: 36030907 DOI: 10.1016/j.bbr.2022.114080] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022]
Abstract
The present post-hoc analysis of two independent studies conducted in different laboratories aimed at comparing reactions of stress activation systems in response to two different psychosocial stress induction paradigms. Both paradigms are based on the Trier Social Stress Test and suited for neuroimaging environments. In an in-depth analysis, data from 67 participants (36 men, 31 women) from a functional magnetic resonance imaging study implementing ScanSTRESS were compared with data from a functional near-infrared spectroscopy (fNIRS) study implementing the so-called 'fNIRS-TSST' including 45 participants (8 men, 37 women). We tested the equivalence of correlation patterns between the stress response measures cortisol, heart rate, affect, and neural responses in the two samples. Moreover, direct comparisons of affective and neural responses were made. Similar correlation structures were identified for all stress activation systems, except for neural contrasts of paradigm conditions (stress vs. control) showing significant differences in association with cortisol, heart rate, and affective variables between the two samples. Furthermore, both stress paradigms elicited comparable affective and cortical stress responses. Apart from methodological differences (e.g., procedure, timing of the paradigms) the present analysis suggests that both paradigms are capable of inducing moderate acute psychosocial stress to a comparable extent with regard to affective and cortical stress responses. Moreover, similar association structures between different stress response systems were found in both studies. Thus, depending on the study objective and the respective advantages of each imaging approach, both paradigms have demonstrated their usefulness for future studies.
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Affiliation(s)
| | - David Rosenbaum
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany; Tübingen Center for Mental Health (TüCMH), Tübingen, Germany.
| | - Christoph Bärt
- Institute of Psychology, University of Regensburg, Regensburg, Germany.
| | - Hendrik Laicher
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany; Tübingen Center for Mental Health (TüCMH), Tübingen, Germany.
| | - Julian Konzok
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany.
| | | | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany; Tübingen Center for Mental Health (TüCMH), Tübingen, Germany.
| | - Stefan Wüst
- Institute of Psychology, University of Regensburg, Regensburg, Germany.
| | - Ann-Christine Ehlis
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany; Tübingen Center for Mental Health (TüCMH), Tübingen, Germany.
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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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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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