Herzschlag-evozierte Potenziale bei Bulimia nervosa

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

Die ursprüngliche Annahme, dass Essstörungspatient/innen unter einem umfassenden Defizit der interozeptiven Wahrnehmung leiden, wird inzwischen differenzierter betrachtet. Unterschiedliche Befunde ergeben ... [more ▼]

Die ursprüngliche Annahme, dass Essstörungspatient/innen unter einem umfassenden Defizit der interozeptiven Wahrnehmung leiden, wird inzwischen differenzierter betrachtet. Unterschiedliche Befunde ergeben sich je nach betrachtetem Organsystem (Herz, Magen), Verarbeitungsebene (neuronal, Selbstbericht) und Diagnose. Die bisherige Befundlage ist jedoch unübersichtlich und widersprüchlich. Für Bulimia nervosa (BN) wurde sowohl reduzierte, als auch unveränderte Herzschlagwahrnehmung berichtet. Mit dem vorliegenden Beitrag steuern wir weitere Ergebnisse zur Herzschlagwahr nehmung bei und ergänzen diese um einen physiologischen Indikator der kortikalen Verarbeitung kardio-afferenter Signale (Herzschlag-evozierte Potenziale, HEPs). Es wurden 22 Frauen mit akuter oder teilremittierter BN (BMI 23,94±3,61; Alter 31,86±11,20) und 22 gesunde Frauen untersucht (BMI 24,24±3,37; Alter 31,00±10,15). Die Stichproben wurden nach Alter und BMI parallelisiert. Die Teilnehmerinnen führten eine Herzschlagwahrnehmungsaufgabe nach Schandry durch, während ein 64-Kanal-EEG aufgezeichnet wurde. HEPs wurden als mittlere EEG-Amplitude von 455ms bis 595ms nach der R-Zacke berechnet. Die Ergebnisse zeigen keine signifikanten Gruppenunterschiede in Herzschlagwahrnehmung, HEPs und Herzrate. Dies bestätigt vorherige Befunde einer intakten Herzschlagwahrnehmung bei BN. Zusätzlich können wir von einer intakten kortikalen Verarbeitung kardio-afferenter Reize ausgehen. Die Wahrnehmung des Herzschlags ist insbesondere für die Verarbeitung und Regulation von Emotionen relevant. Auf Basis der vorliegenden und früheren Befunde ist davon auszugehen, dass defizitäre Emotionsregulation bei BN nicht auf veränderte Herzschlagwahrnehmung zurückzuführen ist. [less ▲]

Enhanced Cortical Processing of Cardio-Afferent Signals in Anorexia Nervosa

in Clinical Neurophysiology (2019), 130(9), 1620-1627

Objective: To assess cardiac interoception in anorexia nervosa (AN) using a multidimensional approach. Methods: We assessed the physiological dimensions of cardioception, i.e. the peripheral signal itself ... [more ▼]

Objective: To assess cardiac interoception in anorexia nervosa (AN) using a multidimensional approach. Methods: We assessed the physiological dimensions of cardioception, i.e. the peripheral signal itself (heart rate, HR, and heart rate variability, HRV) and its cortical representation (heartbeat evoked potentials, HEPs), and the psychological dimensions of interoceptive accuracy (heartbeat perception) and interoceptive sensibility (confidence ratings). Electroencephalogram (EEG) and electrocardiogram (ECG) were recorded concurrently during rest and while performing a heartbeat perception task in a sample of 19 female in-patients with AN (DSM-5) and 19 healthy control women (HC). Results: HEPs, defined as mean EEG amplitude in a time window of 455-595 ms after the Rpeak of the ECG, were significantly larger in the AN than in the HC group across conditions (p = .002, d = 1.06). There was a trend toward better heartbeat perception in AN, but no group differences in HR, HRV, and confidence ratings. Conclusions: Individuals with AN showed an interoceptive profile of heightened cortical processing, a trend toward heightened interoceptive accuracy, and unaltered cardiac autonomic activation and interoceptive sensibility. Significance: In terms of neurobiological models of AN, enhanced cortical representations of interoceptive signals might reflect a mechanism, which promotes fasting by alleviating negative body states. [less ▲]

Somatoforme Symptome: Zusammenhänge mit Low-Frequency-Herzratenvariabilität und Selbstberichte zu chronischem psychosozialen Stress, aber nicht mit HPA-Achsen-Aktivität

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

Nach dem Perception-Filter-Modell der somatoformen Störungen (Rief & Barsky, 2005) könnte verstärkte Signalübermittlung von Körperorganen zur Symptomentstehung beitragen. Dabei wurden insbesondere das ... [more ▼]

Nach dem Perception-Filter-Modell der somatoformen Störungen (Rief & Barsky, 2005) könnte verstärkte Signalübermittlung von Körperorganen zur Symptomentstehung beitragen. Dabei wurden insbesondere das sympathische Nervensystem und die HPA-Achse als primäre physiologische Stressachsen diskutiert. Aufgrund hoher Heterogenität somatoformer Störungen ist die Befundlage zu beiden Achsen jedoch gemischt, was dafürspricht, größere Populationen ohne Multi-Komorbidität zu untersuchen. Bei einer studentischen Stichprobe (N=217; 113 w; Alter: 18-33 [M=23.0; SD=2.9] Jahre; BMI=22.2 [SD=2.8]) wurden selbstberichteter chronischer Stress (Trierer Inventar für Chronischen Stress/TICS) und somatoforme Symptome (Screening für Somatoforme Störungen/SOMS-2) erhoben. Alle Probanden lieferten Cortisol- Aufwachreaktionen (Erwachen, +15,+30,+45,+60 Min.) an zwei aufeinanderfolgenden Tagen, sowie ein Cortisol-Tagesprofil. Zusätzlich wurde im Labor in einer 10-minütigen Ruhemessung EKG zur Bestimmung der Ruhe-Herzratenvariabilität (RMSSD, pNN50, SDNN; Low- und High-Frequency) als Indikatoren des zentralen sympathischen und parasympathischen Tonus erfasst. Diejenigen TICS-Skalen, die psychosozialen Stress reflektieren, sowie „Chronische Besorgnis“ waren zwischen r=.16 und .26 mit somatoformen Symptomen korreliert. Die Skala „Chronische Besorgnis“ korrelierte außerdem positiv mit dem Tagescortisolspiegel (r=.19), sowie negativ mit SDNN (r=-.20), RMSSD (r=-.17), pNN50 (r=-.17), LF-Power (r=-.19) und HF-Power (r=-.16; alle ps < .05). Somatoforme Symptome korrelierten hingegen nicht mit Indikatoren der physiologischen Stressachsen. In einem Regressionsmodell mit Somatisierungsindex als Kriterium zeigte sich nur für die TICS-Skalen „Mangel an sozialer Anerkennung“ (b=.19) und „Chronische Besorgnis“ (b=.25), sowie LF-HRV (b=.20) signifikante Vorhersagekraft. Die Annahmen des Perception-Filter-Modells konnten nur hinsichtlich des sympathischen Nervensystems bestätigt werden, was daher als Frühindikator für somatoforme Störungen betrachtet werden könnte. Dennoch sind selbstberichteter chronischer Stress, vor allem „Besorgnis“, bei gesunden Probanden die stärksten Prädiktoren für somatoforme Symptome. [less ▲]

Effects of acute yohimbine administration on interoception in major depression and childhood adversity

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

Acute stress, release of stress hormones and chronic stress can affect the processing of visceral-afferent neural signals at different brain levels, which are important for interoception. However, it ... [more ▼]

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

Die Rolle von Sport und Bewegung für die körperliche und psychische Gesundheit.

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

Physical activity plays an important role in children’s growth and development. Understanding why a child is active or inactive is, therefore, essential for prevention of and intervention in childhood ... [more ▼]

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

Interoception in Bulimia Nervosa: Evidence at cortical and self-report levels

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

Bulimia nervosa (BN) is characterized by recurrent episodes of binge eating and compensatory behaviors, such as self- induced vomiting. Body image disturbance is also prominent in BN. Current research is ... [more ▼]

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

The role of alexithymia in parent-child interaction and in the emotional ability of children with autism spectrum disorder

in Autism Research (2019)

Children with autism spectrum disorder (ASD) have more emotional difficulties than typically developing (TD) children. Of all the factors that impact children’s emotional development, parents, and the way ... [more ▼]

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

Was Hänschen erlebt - erlebt Hans immer wieder - Auswirkungen elterlicher Scheidung auf psychische Gesundheit im jungen Erwachsenenhalter

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

Langzeitkonsequenzen elterlicher Scheidung für die Gesundheit im jungen Erwachsenenalter

Presentation (2018, November 23)

Task interference and distraction efficacy in patients with fibromyalgia: an experimental investigation

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

Pain has the capacity to interfere with daily tasks. Although task interference by pain is largely unintentional, it can be controlled to a certain extent. Such top-down control over pain has been thought ... [more ▼]

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