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Sitzungsübersicht
Sitzung
Postersession 9 - Disorders and Interventions
Zeit:
Donnerstag, 03.06.2021:
16:00 - 18:00

Ort: Postersaal gather.town

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Präsentationen

P202 - Abnahme der phasischen Herzratenvariabilität mit zunehmender Nähe zur interozeptiven Bedrohung bei Patienten mit Panikstörung und Agoraphobie

Jan Richter, Alfons Hamm, Panik-Netz Konsortium

Universität Greifswald, Deutschland

Theoretisch kann die Pathologie der Panikstörung mit Agoraphobie als eine Kaskade sich dynamisch ändernder Defensivreaktionen auf Bedrohungshinweise aus dem Körperinneren heraus konzipiert werden. Abgelehnt an dieses transdiagnostische Modell testeten wir die Wechselwirkung zwischen defensiver Aktivierung und vagaler Kontrolle als Marker für die präfrontale Hemmung subkortikaler Reagulationskreisläufe. Wir untersuchten ultrakurze Veränderungen der vagal kontrollierten hochfrequenten Herzratenvariabilität (HRV) während einer standardisierten Exposition mit einem bedrohlichen Kontext bei 232 Patienten mit Panikstörung und Agoraphobie sowie deren Wechselwirkung mit verschiedenen Indizes der defensiven Aktivierung. Wir fanden eine starke inverse Beziehung zwischen HRV und Herzrate während der Konfrontation, die zu Beginn der Exposition stärker war. Patienten mit einem starken Anstieg der Herzrate zeigten eine Deaktivierung der präfrontalen Vaguskontrolle, während Patienten mit einer geringeren Herzratenbeschleunigung einen Anstieg der Vaguskontrolle zeigten. Darüber hinaus brach die vagale Kontrolle im Falle einer unmittelbar bevorstehenden Bedrohung zusammen, d.h. wenn die Körpersymptome zunehmen und außer Kontrolle zu geraten scheinen. In diesen Fällen von Abwehrmaßnahmen flohen die Patienten entweder aus der Situation oder erlebten eine Panikattacke. Aktive Vermeidung, Panikattacken und erhöhte sympathische Erregung sind mit der Unfähigkeit verbunden, die vagale Kontrolle über das Herz aufrechtzuerhalten, was darauf hindeutet, dass das Vermitteln solcher Regulationsstrategien während der Expositionsbehandlung hilfreich sein könnte, um die präfrontale Kontrolle aufrechtzuerhalten, insbesondere während der Übergangszone von Verhaltensmodi bei distaler vs. imminenter Bedrohungslage.



P203 - Affective neural signatures do not distinguish women with emotion dysregulation from healthy controls: A mega-analysis across three task-based fMRI studies

Maurizio Sicorello1, Julia Herzog1, Tor D. Wager2, Gabriele Ende1, Maike Müller-Engelmann3, Sabine C. Herpertz4, Martin Bohus1, Christian Schmahl1, Christian Paret1, Inga Niedtfeld1

1Central Institute of Mental Health; 2Dartmouth College; 3Goethe University Frankfurt; 4Heidelberg University

Pathophysiological models are urgently needed for personalized treatments of mental disorders. However, most potential neural markers for psychopathology are limited by low interpretability, prohibiting reverse inference from brain measures to clinical symptoms and traits. Neural signatures—i.e. multivariate brain-patterns trained to be both sensitive and specific to a construct of interest—might alleviate this problem, but are rarely applied to mental disorders. We tested whether previously developed neural signatures for negative affect and discrete emotions distinguish between healthy individuals and those with mental disorders characterized by emotion dysregulation, i.e. Borderline Personality Disorder (BPD) and complex Post-traumatic Stress Disorder (cPTSD). In three different fMRI studies, a total sample of 192 women (49 BPD, 62 cPTSD, 81 healthy controls) were shown pictures of scenes with negative or neutral content. Based on pathophysiological models, we hypothesized higher negative and lower positive reactivity of neural emotion signatures in participants with emotion dysregulation. The expression of neural signatures differed strongly between neutral and negative pictures (average Cohen’s d = 1.17). Nevertheless, a mega-analysis on individual participant data showed no differences in the reactivity of neural signatures between participants with and without emotion dysregulation. Confidence intervals ruled out even small effect sizes in the hypothesized direction and were further supported by Bayes factors. Overall, these results support the validity of neural signatures for emotional states during fMRI tasks, but raise important questions concerning their link to individual differences in emotion dysregulation. Data and annotated scripts to reproduce the analyses can be found on: https://github.com/MaurizioSicorello/MVPAemoDys_Analyses



P204 - Affective Processing During Error Monitoring in Patients With Obsessive-Compulsive Disorder

Franziska Jüres, Luisa Balzus, Norbert Kathmann, Julia Klawohn

Department of Psychology, Humboldt-Universität zu Berlin

Altered performance monitoring, specifically enhanced error monitoring, has been frequently found in obsessive-compulsive disorder (OCD), often apparent in heightened amplitudes of the error-related negativity (ERN). Yet, little is known about how the ERN relates to affective action appraisal. This study aimed to extend previous findings of a relation between ERN and affective action evaluation (i.e., affective labeling of own actions) by investigating affective priming on trial-level in OCD. Electroencephalography was recorded while 28 patients with OCD and 28 healthy control (HC) participants performed an affective priming paradigm in which responses in a go/no-go task served as primes for the subsequent affective categorization (positive or negative) of words. Mixed-effects models revealed an action-based affective priming effect in both groups, indicating faster categorization of words when preceded by an action of the same assigned valence (e.g., negative words after errors). Patients with OCD showed a diminished priming effect after errors compared to HC participants. Contrary to our expectations, the priming effect was not related to the amplitude of the ERN and there was also no group difference in this association. We found no evidence that the ERN is linked to automatic, affective evaluation of self-generated actions, with trial-by-trial ERN variation reflecting emotional significance of errors. In OCD, affective appraisal of errors seems to be hampered, possibly resulting from processes interfering with internal action appraisal (e.g., worry). Altogether, our findings imply that alterations in the affective appraisal of actions may be implicated in altered error monitoring in OCD.



P205 - Altered Event Processing in Persons with Parkinson's Disease

Michelle Wyrobnik1,2,3, Elke van der Meer1,2, Fabian Klostermann2,3

1Institute of Psychology, Humboldt-Universität zu Berlin; 2Berlin School of Mind and Brain, Humboldt-Universität zu Berlin; 3Department of Neurology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin

Persons with Parkinson’s disease (PD) often show particular problems in seemingly simple routines despite relatively preserved cognitive function. Therefore, the processing of everyday events was investigated on behavioral and neurophysiological levels in persons with versus without PD. Both groups had to indicate per button press whether three sequentially presented sub-events described a previously defined event (e.g., going grocery shopping). Sub-event sequences were either correct, or one of them did not belong to the event (content violation), or was chronologically wrong (temporal violation). During task execution event-related potentials (ERP) were recorded. Generally, task performance was slower and more inaccurate in persons with compared to persons without PD, independently from task conditions. In response to temporal violations, healthy persons expressed a late positive component (LPC), which in persons with PD had an earlier, novelty-P3a-like onset and was diffusely broadened. Upon content violations, healthy persons showed a right lateralized N400 effect, followed by a LPC response. For persons with PD, the N400 was missing and, again, the LPC was of broader distribution. Together, these findings show impaired performance and task condition-related ERP alterations in persons with PD. Decreased error detection and missing N400 indicate poor event prediction in PD which might originate from weak event representation or retrieval, partially compensated for by extended signal re-analysis reflected by LPC enhancement and possibly related to prevalent behavioral dysfunctions in PD.



P206 - Assoziationen zwischen einer serotonergen Modulation und dem Belohnungslernen in Anorexia nervosa - eine fMRT-Studie

Julius Steding1, Franziska Ritschel1, Ilka Boehm1, Daniel Geisler1, Joseph A. King1, Veit Roessner2, Michael N. Smolka3, Florian D. Zepf4, Stefan Ehrlich1,5

1Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Deutschland; 2Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Dresden, Deutschland; 3Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Deutschland; 4Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University, Jena, Deutschland; 5Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Deutschland

Die Serotonin-(5-HT)-Hypothese der Anorexia nervosa (AN) beschreibt, dass ein zentralnervöser hyperserotonerger Zustand bei der Entwicklung sowie beim Rückfall der AN eine Rolle spielt. Die Reduktion der Essenszufuhr könnte dementsprechend als Mittel betrachtet werden, die 5-HT-Verfügbarkeit zu reduzieren (über eine verminderte Versorgung mit Tryptophan-Vorläufern) und damit assoziierte negative Stimmungszustände zu verbessern. Wichtig ist, dass das 5-HT-System auch allgemein mit der Belohnungsverarbeitung in Verbindung gebracht wird, die bei AN ebenfalls nachweislich verändert ist.

In dieser doppelblinden Crossover-Studie unterzogen sich 22 ehemalige AN-Patientinnen (recAN) und 25 gesunde Kontrollteilnehmerinnen (HC) einer funktionellen MRT-Messung, während sie ein etabliertes instrumentelles Belohnungslernparadigma in Kombination mit einer akuten Tryptophan-Depletion (ATD; eine diätetische Intervention, die die zentralnervöse 5-HT-Verfügbarkeit senkt) sowie einer Sham-Depletion durchführten.

Auf der Verhaltensebene zeigten sich Haupteffekte von Belohnung und ATD, jedoch keine Gruppenunterschiede. fMRT-Analysen zeigten eine Interaktion von Gruppe × ATD × Belohnungsniveau in der ventralen anterioren Insula während der Belohnungsantizipation sowie im medialen orbitofrontalen Kortex während des Erhalts der Belohnung.

Vor dem Hintergrund der Ergebnisse diskutieren wir Interpretationen der neuralen Antwortmuster und mögliche Implikationen für Modelle zur Ätiologie der AN im Hinblick auf die 5-HT-Hypothese. Außerdem diskutieren wir, wie die Ergebnisse die Entwicklung von Behandlungsansätzen bei AN beeinflussen können.



P207 - Autonomic dysregulation in child social anxiety disorder: An experimental design using CBT treatment

Julia Asbrand1,2, Claus Vögele3, Nina Heinrichs4, Kai Nitschke1, Brunna Tuschen-Caffier1

1Department of Psychology, Albert-Ludwigs-University of Freiburg, Germany; 2Department of Psychology, Humboldt-Universität zu Berlin, Germany; 3Clinical Psychophysiology Laboratory (CLIPSLAB), Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg; 4Department of Psychology, University of Bremen, Germany

Introduction: Etiological models of social anxiety disorder (SAD) stress the relevance of physiological arousal in a disorder-typical situation. Up to date, only limited research has been conducted in children with SAD in experimental designs. Thus, to shed light on the relevance of autonomic physiological arousal children with and without SAD were confronted with a standardized social stressor (Trier Social Stress Test for Children-C; TSST-C). Pre-existing differences to the healthy control (HC) group were expected to decrease in the group receiving CBT.

Method: Children with SAD (n = 64) and HC children (n = 55) completed a TSST-C. Children with SAD participated in a second TSST-C after either cognitive-behavioral treatment or a waitlist-control period (WLC).

Results: In line with previous studies, children with SAD showed blunted reactivity in heart rate compared to HC children. Further, children with SAD had elevated levels of tonic sympathetic arousal as indexed by skin conductance level compared to HC. Finally, children with SAD showed lower parasympathetic arousal during the baseline compared to HC children. Children with SAD receiving treatment did not differ from children in the WLC condition in a repeated social stress test.

Discussion: Psychophysiological differences between children with SAD and HC children could be confirmed as indicated by previous research. The lack of physiological effects of the intervention as an experimental manipulation might be related to slower changes in physiology compared to e.g. cognition. Further implications and limitations of these findings are discussed.



P208 - Broaden the perspective using combined M/EEG and MRI: heritable imaging phenotypes in patients with epilepsy and their siblings

Christina Stier1,2, Markus Loose1, Adham Elshahabi2,3, Raviteja Kotikalapudi1,2,4, Yiwen Li Hegner2, Justus Marquetand2, Christoph Braun5,6, Holger Lerche2, Niels K. Focke1,2

1Clinic of Clinical Neurophysiology, Georg-August University Göttingen, Göttingen, Germany; 2Department of Neurology and Epileptology, Hertie Institute of Clinical Brain Research, University of Tübingen, Tübingen, Germany; 3Department of Neurology, University Hospital Zurich, Zurich, Switzerland; 4Institute of Psychology, University of Bern, Bern, Switzerland; 5MEG-Center, University of Tübingen, Tübingen, Germany; 6CIMeC, Center for Mind/Brain Sciences, University of Trento, Rovereto, Italy

Genetic generalized epilepsy (GGE) is a common epilepsy syndrome and conceptualized as brain network disorder with genetic etiology. Using magnetoencephalography (MEG), we have previously shown that increased brain network levels are heritable and a hallmark of GGE patients (Stier et al., manuscript accepted). In this study, we complement these findings using high density-EEG (hd-EEG) and structural measures for an extended understanding of brain pathology.

We analyzed 5 minutes of cleaned MEG and hd-EEG resting-state data sequentially acquired in 23 GGE patients, 18 unaffected siblings and 35 controls, comparable for age and sex. We computed source-reconstructed connectivity in six frequency bands (1-40 Hz). Cortical thickness measures were derived from individual 3T MRI scans. Group differences were assessed using permutation analysis of linear models using non-parametric combination of modalities.

When combining M/EEG maps, GGE patients had higher connectivity in fronto-temporal and central regions than controls, particularly in theta and low beta frequencies (P < 0.05, familywise error (FWE)-corrected). Medication load was further associated with the network patterns (PFWE < 0.05). GGE patients showed cortical thickness reductions in fronto-central regions and cuneus (Cohen’s d < -0.5, Puncorrected < 0.05). Siblings statistically fell between structural and functional levels of patients and controls.

Combined M/EEG analyses led to a more focused, spatially and spectrally defined GGE imaging phenotype compared to univariate contrasting, encouraging multimodal assessment for predictive modeling and classification. Structural alterations in patients showed spatial correspondence to connectivity increases in fronto-central regions. Similar observations in healthy siblings point to genetic influence on imaging patterns.



P209 - Can worry interventions alter error-related brain activity? Results from a randomized controlled trial

Kai Härpfer, Hannes Per Carsten, Anja Riesel

Institute of Psychology, Universität Hamburg, Germany

Background: Most previous studies utilized cross sectional designs to investigate the association of anxiety and overactive performance monitoring, as measured by the error-related negativity (ERN) and correct-response negativity (CRN). A better understanding of these associations requires intervention studies that allow causal inferences. This preregistered study aimed at replicating and expanding previous findings of an ERN modulation by worry interventions.

Method: A priori, we determined the sample size using a power analysis. Ninety undergraduate students performed a flanker task to assess their baseline ERN (T0). We randomly assigned them to one of three groups: (1) worry induction, (2) worry reduction, and (3) passive control group. Subsequently, participants performed another flanker task to determine potential alterations of their ERN (T1). As a manipulation check, we measured state worry before T0 and T1 and before the interventions.

Results: Groups did not differ regarding demographic or clinical variables. Both experimental groups, but not the control group, reported higher state worry after the interventions. Thus, only the worry induction was successful. However, we found no differences in ERN amplitudes between T0 and T1 in any group. Regarding the CRN, all groups showed smaller amplitudes at T1.

Discussion: The present study investigated the impact of experimental manipulations of state worry on performance monitoring. Worry interventions did not alter ERN or CRN amplitudes. This corresponds with previous results indicating that ERN amplitudes are independent of symptom severity and treatment outcome. Thus, our results support conceptualizing the ERN as a trait-like neural risk marker insensitive to symptom fluctuations.



P210 - Differential effects of gambling-related environments on temporal discounting and model-based reinforcement learning in regular slot-machine gamblers.

Ben Wagner, David Mathar, Jan Peters

Biologische Psychologie, Universität zu Köln

Introduction: Gambling disorder is a behavioral addiction that negatively impacts personal finances, work, relationships and mental health. In this pre-registered study https://osf.io/5ptz9/) we investigated the impact of real-life gambling environments on two putatively trans-diagnostic markers, temporal discounting (Dixon et al., 2006) and model-based reinforcement learning (Daw et al., 2011).

Methods: Regular gamblers (n = 30; DSM-5 score mean[range] = 5.93[3-9]) performed both tasks in a neutral (café) and a gambling-related environment (slot-machine venue) in counterbalanced order. Data were modeled using drift diffusion models for inter-temporal choice (Peters & D’Esposito, 2020) and reinforcement learning (Pedersen et al., 2017) via hierarchical Bayesian estimation.

Results: Discounting was steeper in the gambling vs. neutral context, replicating previous results (Dixon et al., 2006). This effect was positively correlated with gambling related cognitive distortions (pre-registered analysis) and shorter non-decision times (exploratory analysis). In contrast to our pre-registered prediction, model-based reinforcement learning was increased in the gambling context.

Discussion: We replicate previous findings of increased temporal discounting in gamblers in the context of gambling venues (Dixon et al., 2006) and link this effect to maladaptive control beliefs. Although gambling disorder is associated with increased temporal discounting (Wiehler & Peters, 2015) and reduced model-based learning (Wyckmans et al., 2019), we show that these effects are modulated in opposite ways by real-life gambling cue exposure. Addiction-related environments potentiate dopamine release (Robinson & Berridge, 1993), suggesting a potential mechanism underlying the observed effects.



P211 - Effects of Attention Focus Modulation in a Virtual Public Speaking Exercise to Reduce Social Anxiety

Theresa F. Wechsler, Rahel E. van Eickels, Michael Pfaller, Andreas Mühlberger

Universität Regensburg, Deutschland

Background. Self-attention is regarded a relevant factor in the maintenance of social anxiety. Therefore, changing the attention focus from internal to external cues is a core component in cognitive behavior therapy. Because different kinds of external cues have not yet been examined, we compared the effects of focusing either on the audience or on neutral objects during a Virtual Reality (VR) public speaking task.

Methods. Highly socially anxious participants were asked to give three short talks (pre-test, intervention, post-test) in front of a virtual audience. They were randomly assigned to either focus on the virtual agents or on neutral objects during the interventional talk. Subjective measures, heart rate, and eye tracking data were measured, and fear of negative evaluation and the subjective anxiety level were analyzed as primary outcomes. Repeated measures ANOVAs were calculated to detect significant time and time*group-interaction effects.

Results. Forty-one participants were included in the analysis sample (audience-focus group: n=21; neutral objects-focus group: n=20). Both groups significantly reduced their level of anxiety and fear of negative evaluation from pre-test to post-test, with no significant differences between them.

Conclusion. We conclude that attention modulation is an important factor for the treatment of social anxiety and can be successfully implemented as VR intervention. VR tasks could be used fruitfully to further investigate the role of the content of external focus in contrast to the mere process of directing attention outward in treating social anxiety, and to guide patients to regulate attention processes during exposure interventions.



P212 - Effects of different craving regulation strategies and re-exposure on cue-induced craving and the late positive potential in smokers.

Solvej Nickel, Tanja Endrass, Raoul Dieterich

Faculty of Psychology, Technische Universität Dresden

Introduction: Craving predicts drug use and relapse. Cognitive strategies to regulate craving are a promising treatment approach. Reappraisal and distraction differ in how deeply craving-inducing cues are processed. Thus, we compared these strategies regarding their longer-term effects on subjective craving and the Late Positive Potential (LPP), which was previously shown to map emotion regulation.

Method: Fifty-seven smokers viewed smoking related pictures and focused on long-term negative (LATER) or short-term positive (NOW) consequences of smoking, or engaged in an arithmetic task to distract themselves from processing the picture (DISTRACT). After a break, all pictures were presented again without regulation instruction (re-exposure). EEG was continuously recorded and subjective craving was rated after each picture.

Results: For the regulation phase, the analysis revealed lower subjective craving in the LATER and DISTRACT than the NOW condition. The LPP was only reduced in the DISTRACT compared to the NOW condition. In the re-exposure phase, lower subjective craving followed pictures connected with LATER compared to DISTRACT and NOW conditions. There were no differences in the LPP.

Discussion: The results show that both distraction and reappraisal reduce subjective craving well in the short term. However, the more complex reappraisal strategy seems to have an advantage over the simpler distraction strategy by inducing a longer-lasting effect. In contrast to emotion regulation, the LPP does not seem to directly reflect craving regulation.



P213 - Going on a space adventure with Manchu the monkey: Reducing preoperative anxiety and postoperative pain in children via a hypnosis audio-intervention

Lisa Erli, Barbara Schmidt

Friedrich-Schiller-Universität Jena

When children must undergo a surgery, they often perceive it as an uncontrollable situation where they feel helpless. This in turn leads to preoperative anxiety which is associated with negative consequences such as pain, vomiting, or delirium upon awakening from anesthesia. Since hypnosis is an effective way to prevent preoperative anxiety in children and has a generally large effect on negative affect and pain during surgery, we developed an auditory hypnosis intervention to reduce preoperative anxiety and postoperative pain in 3–6-year-old children undergoing tonsillotomy or adenotomy. This hypnosis intervention describes the surgery like a space adventure with Manchu the monkey. It suggests feelings of courage, pride, and strength considering the upcoming surgery. The audio intervention was designed according to an already existing comic book explaining the procedures in the hospital with pictures of Manchu the monkey and thus reducing preoperative anxiety. We hypothesize that the auditory hypnosis intervention leads to a reduction of preoperative anxiety, postoperative pain and nausea as well as reported experienced distress. We also expect that it decreases parental preoperative state anxiety which has shown to be a predictor for difficulties occurring after surgical interventions. We compare 40 children in the control group receiving only the comic book with 40 children in the experimental group listening to the auditory hypnosis intervention in addition to the comic book at home before surgery. We anticipate that our auditory hypnosis intervention can serve as a non-pharmacological intervention reducing preoperative anxiety and postoperative pain in children.



P214 - Grey matter changes in patients with Alcohol Use Disorder: Results of an ALE-Meta-Analysis, Behavioral Domain Analysis and Meta-Analytic Connectivity Modeling.

Carolin Spindler1, Sebastian Trautmann1, Nina Alexander1, Sonja Bröning1,2, Sarah Bartscher3, Markus Stuppe4, Markus Muehlhan1

1MSH Medical School Hamburg, Faculty of Human Sciences, Department of Psychology, Hamburg, Germany; 2MSH Medical School Hamburg, Faculty of Health Sciences, Department of Pedagogy, Hamburg, Germany; 3MSH Medical School Hamburg, Hafencity Institute for Psychotherapy, Hamburg, Germany; 4Helios Medical Center Schwerin, Carl-Friedrich-Flemming-Clinic, Department of Addiction Medicine, Schwerin, Germany

Numerous studies indicate widely distributed grey matter (GM) volume reductions in Alcohol Use Disorder patients (AUD) compared to healthy controls. The identified brain regions vary considerably across different studies. To detect above chance convergence of the reported coordinates in voxel-based morphometry imaging studies we applied Anatomical Likelihood Estimation (ALE) and extended our analyses by characterizing the behavioral profile of the resulting clusters using meta-data from the BrainMap database. Finally, we performed a Meta-Analytic Connectivity Modeling analysis (MACM), to determine in which neural networks the resulting clusters could represent potential nodes. Twenty-seven eligible studies, entailing a total of 1,045 AUD patients and 1,054 healthy controls, with 376 reported peak voxel coordinates were included into the ALE-Meta-Analysis. GM alterations were identified in eight clusters covering different parts of the cingulate and medial frontal gyri, paracentral lobes, left post‑ and precentral gyri, left anterior and right posterior insulae and left superior frontal gyrus. The behavioral characterization associated these regions with specific cognitive, emotional, somatosensory and motor functions. MACM shows that these regions represent nodes in the salience, cortico-cerebellar, control, insular, default, fronto-striatal and motor control networks. Our findings suggest that chronic high alcohol consumption is associated with reduction in GM volume in specific brain regions that were associated with processes that may underlie known impairments in AUD (e.g. inhibitory control). Earlier studies have investigated specific neural networks in AUD, but very few studies have considered their interaction. Therefore, our work provides a reliable basis for future functional analyses.



P215 - Heart Rate and Heart Rate Variability During Spontaneous Posttraumatic Dissociation

Sarah Beutler1, Tabea Kejal Jamshididana1, Julia Schellong1, Kerstin Weidner1, Judith Daniels3, Ilona Croy1,2

1Department of Psychotherapy and Psychosomatic Medicine, TU Dresden Faculty of Medicine Carl Gustav Carus; 2Department of Psychology, Friedrich Schiller University of Jena; 3Department of Psychology, Division of Clinical Psychology and Experimental Psychopathology, University of Groningen

Introduction: Recurring posttraumatic dissociation is a known phenomenon in patients suffering from chronic posttraumatic stress disorder (PTSD). Especially, symptoms of depersonalization and derealization were reported, which describe out-of-body experiences, or the feeling, that the surrounding seems to be unreal. These reactions can be interpretated as attenuation in the sensory and emotional self-experience, to mentally escape dangerous (or later) stressful situations, when fight or flight reactions are impossible. A growing body of research indicates that stress response is generally impaired in PTSD. This impairment is associated with autonomic nervous system dysregulation, reflected by higher heart rate (HR) and lower heart rate variability (HRV). Although dissociation seems to diminish sensory, emotional, and motor activity, little is known about psychophysiological reactivity during posttraumatic dissociation. Therefore, we examined, if there is an association between posttraumatic dissociation and psychophysiological reactions under non-laboratory conditions.

Method: To assess spontaneous dissociation, we used an event sampling method via smartphone application in female in-patients with PTSD and dissociative experiences. Patients tracked quality, intensity, and duration of every experience, they indicated as dissociation. Meanwhile, they wore a mobile ECG device within 12h during waketime, over 5 to 10 days. Regarding HR and HRV (RMSSD, HF-HRV), dissociative events and baseline were compared.

Results: Preliminary data of 36 patients, who tracked in total 117 dissociative events, are presented.

Discussion: To our knowledge this is the first study that examines spontaneous posttraumatic dissociation and associated physiological reactions. Due to the field study design, methodological limitations must be discussed.



P216 - Impaired dominance judgement in Huntington's disease despite over-activation of the social cognition network

Katharina Klink1, Stephan Furger2, Reiner Sprengelmeyer3, Georg Grön4, Jessica Peter1, Michael Orth5,6

1University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.; 2Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland.; 3Department of Neurology, University of Ulm, Ulm, Germany; School of Psychology and Neuroscience, University of St Andrews, St Andrews, Scotland, UK.; 4Section for Neuropsychology and Functional Imaging, Department of Psychiatry, Ulm University, Ulm, Germany.; 5Department of Neurology, Ulm University, Ulm, Germany.; 6SwissHuntington's Disease Centre, Neurozentrum Siloah, Gümligen bei Bern, Switzerland.

Background

Huntington's disease (HD) is a hereditary, progressive neurodegenerative disorder, characterized by involuntary movements, cognitive deterioration, and impaired emotional processing. In this context, patients are less able to judge trustworthiness and dominance in the faces of others at the time when they need to rely increasingly on others as they lose their autonomy. In the current study, we investigated the neural correlates of this inability.

Methods

We included 13 patients with early manifest HD (2 females; age mean + SD, 47.07 + 8.94) and 14 healthy volunteers (3 females; age mean + SD, 43.26 + 7.49). Similar to our previous study, we applied a social cognition task, in which the participants needed to rate trustworthiness, dominance, and gender of computer-generated faces. The task was applied both outside and inside a 3T MRI scanner while participants underwent structural and functional imaging.

Results

Patients with HD consistently rated faces as more dominant than healthy volunteers. Additionally, during dominance ratings, functional activity in the insula and the fusiform gyrus increased in patients with HD. We found no significant differences between groups for trustworthiness or the control task.

Conclusion

HD patients over-activate the insula and fusiform gyrus, two regions known to be involved in social cognition, and exaggerate in their judgement of dominance in faces. Over-activity at important hubs for the social cognition network is either inefficient to maintain normal network function or directly related to misreading dominance.



P217 - Interozeption und der Einfluss traumatischer Kindheitserlebnisse bei Patienten mit PTBS, Major Depression und Somatic Symptom Disorder

Marius Schmitz1,2, Sarah N. Back2, Katja I. Seitz1, Sabine C. Herpertz1, Katja Bertsch1,2

1Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Germany; 2Department of Psychology and Psychotherapy, LMU Munich, Germany

Hintergrund: Traumatische Kindheitserlebnisse (ACE) können zu emotionaler Dysregulation und assoziierten Störungen wie posttraumatischer Belastungsstörung (PTBS), Major Depression (MD) und Somatischer Belastungsstörung (SSD) führen. Ein möglicher vermittelnder Faktor könnten Defizite in der Interozeption sein. Der Einfluss von ACE auf Interozeption ist bislang wenig erforscht. Ziel der vorliegenden Studie war die Untersuchung interozeptiver Dimensionen und der Zusammenhang zu ACE und emotionaler Dysregulation.

Methode: ACE, emotionale Dysregulation und Interozeption wurden mittels Fragebögen, einer etablierten Herzschlagperzeptionsaufgabe und Elektrokardiogramm bei Patienten mit MD (n = 35), SSD (n = 34) und PTSD (n = 33) und gesunden Kontrollen (HC; n = 34) erhoben. Einschlusskriterium für die vorliegende Studie war das Vorliegen mindestens eines ACEs.

Ergebnisse: Die Gruppen unterschieden sich nicht hinsichtlich der objektiven Herzschlagwahrnehmung und der metakognitiven Bewusstheit der eigenen Wahrnehmung. Die Analyse der Selbstberichte zeigte, dass Patienten mit SSD dazu neigten die eigenen interozeptiven Fähigkeiten zu überschätzen und alle Patientengruppen höhere Körperdissoziationswerte berichteten als HC. Patienten mit MD wiesen niedrigere Herzratenvariabilitäten im Vergleich zu HC und Patienten mit SSD auf. Es zeigten sich keine signifikanten Korrelationen zwischen ACE und der Herzschlagwahrnehmung, jedoch für interozeptive Selbstberichte, darunter Körperbewusstsein und Körperdissoziation. Eine Mediationsanalyse ergab, dass der Zusammenhang zwischen ACE und emotionaler Dysregulation durch Körperdissoziation mediiert wurde.

Diskussion: Die Ergebnisse legen Unterschiede in subjektiven Körperüberzeugungen anstelle objektiver interozeptiver Defizite nahe. Da die Patienten in der PTSD Gruppe höhere ACE Werte aufwiesen und nur gesunde Kontrollen mit ACE erhoben wurden, sind weitere Studien notwendig. Integrative therapeutische Interventionen könnten Betroffen helfen Schwierigkeiten in der Emotionswahrnehmung und -regulation zu überwinden.



P218 - Multidimensional assessment of interoceptive abilities, emotional processing and the role of early life stress in inflammatory bowel diseases

Konstantina Atanasova1, Tobias Lotter2, Wolfgang Reindl2, Stefanie Lis1

1Zentralinsitut für Seelische Gesundheit, Mannheim, Deutschland; 2Medizinische Fakultät der Universität Heidelberg, Mannheim

Introduction: Perception of bodily sensations includes three dissociable constructs: interoceptive accuracy, interoceptive sensibility, and interoceptive awareness. Interoception plays a crucial role in emotional processing and impairments of these processes have been observed in several psychiatric disorders. The aim of the study was to investigate the associations between the different dimensions of interoception and emotional processing in Inflammatory Bowel Disease (IBD), while taking childhood traumatization into account.

Methods: We recruited 35 remitted IBD patients and 35 healthy control participants (HC) matched for age, sex and education. Interoception was assessed as a multidimensional construct using the heartbeat tracking task and the Multidimensional Assessment of Interoceptive Awareness questionnaire. Emotional processing was measured using an experimental task, where participants were asked to rate the valence and arousal when presented with affective stimuli. Childhood traumatization was assessed using the Childhood Trauma Questionnaire.

Results: IBD patients reported greater awareness of the connection between bodily sensations and emotional states and showed a stronger tendency to use distraction from unpleasant sensations compared to HC. Our findings suggest that emotional processing in IBD is linked to interoceptive sensibility and not to interoceptive accuracy. The association between interoception and emotional processing was modulated by the severity of childhood traumatization.

Discussion: This is the first study showing that IBD patients did not differ in their ability to detect visceral signals but in their subjective perception of these. Psychotherapeutic interventions might profit from taking the interplay between emotion processing, interoception and childhood trauma into account.



P219 - Neural fingerprints of emotion processing in bipolar disorder – a meta-analytic approach

Katharina Förster1, Lara Maliske1, Matthias Schurz2,3, Philipp Kanske1

1Klinische Psychologie und Behaviorale Neurowissenschaft, Fakultät für Psychologie, Technische Universität Dresden, Deutschland; 2Digital Science Center und Fachbereich für Klinische Psychologie II, Institut für Psychologie, Universität Innsbruck, Österreich; 3Donders Institute for Brain, Cognition, & Behaviour Radboud University, Nijmegen, The Netherlands

Bipolar disorder (BD) manifests in alternating episodes of euphoric-irritated and depressed moods. To test putative mechanisms behind these extreme affective fluctuations, neuroscientists have studied how BD-patients process emotions. Functional magnetic resonance imaging studies found that BD-patients show increased activity in limbic-striatal brain areas and decreased activity in inferior frontal areas when viewing emotional stimuli compared to healthy participants. However, due to the very small and heterogeneous samples, it remains unclear whether BD-patients process positive and negative stimuli differently and to what extent their mood state influences emotion processing.

To integrate previous results, we conducted a systematic literature search for journal articles in the Web of Science Core Collection including MEDLINE databases and employed a coordinate-based-meta-analysis of functional-MRI studies comparing emotion-processing in BD-patients with controls using seed-based d mapping with the linear model function to test for between-subjects-effects. We included 32 studies published before 05/2020 containing N=724 BD-patients and N=871 controls.

The meta-analysis revealed mood-state- and valence-specific neural activations of BD-patients: The processing of positive compared to negative stimuli was associated with higher neural activity in the insula and lower neural activity in the cuneus and the medial frontal gyrus. Depressed in comparison to manic BD-patients showed higher activity in middle temporal gyrus, parahippocampal gyrus and medial cingulate cortex, while they showed lower activity in the anterior insula, striatum and right thalamus.

In sum, the meta-analysis indicates differential neural fingerprints of emotion processing in BD-patients during manic and depressive episodes as well as for positive and negative stimuli.



P220 - Oxygenierung des Präfrontalkortex im Ruhezustand bei Jugendlichen mit nichtsuizidalem selbstverletzendem Verhalten

Saskia Höper1,2, Julian Koenig1,3, Patrice van der Venne1,2, Ines Mürner-Lavanchy3, Franz Resch2, Michael Kaess3

1Sektion Experimentelle Kinder- und Jugendpsychiatrie, Klinik für Kinder- und Jugendpsychiatrie, Zentrum für Psychosoziale Medizin, Universität Heidelberg, Heidelberg, Deutschland; 2Klinik für Kinder- und Jugendpsychiatrie, Zentrum für Psychosoziale Medizin, Universität Heidelberg, Heidelberg, Deutschland; 3Universitätsklinik für Kinder- und Jugendpsychiatrie, Universitäre Psychiatrische Dienste, Universität Bern, Bern, Schweiz

Einleitung: Dem Präfrontalkortex (PFK) wird ein Großteil der Inhibitionskontrolle zugeschrieben und er ist häufig Gegenstand der Erforschung psychischer Störungen. Insbesondere bei nichtsuidzidalem selbstverletzendem Verhalten (NSSV) wird der Einfluss von Inhibitionskontrolle diskutiert. Bei jugendlichen PatientInnen mit NSSV gibt es bislang kaum bildgebende Untersuchungen zur Funktion des PFK. In dieser Studie wurde die Oxygenierung des PFK im Ruhezustand und deren Zusammenhang mit der klinischen Symptomschwere bei Jugendlichen mit NSSV und gematchten gesunden Kontrollen untersucht.

Methoden: Jugendliche (12-17 Jahre) mit regelmäßigem NSSV (n = 170) und Kontrollen (n = 43) haben eine Baseline Aufgabe bearbeitet, während die PFK Oxygenierung und die funktionelle Konnektivität im PFK mithilfe eines 8-Kanal funktionellen Nahinfrarot Spektroskopie (fNIRS) Geräts gemessen wurde. Klinische Variablen aus Selbstauskunftsfragebögen und diagnostischen Interviews wurden berücksichtigt, um potenzielle Zusammenhänge mit der PFK Oxygenierung und der Konnektivität zu untersuchen.

Ergebnisse: Jugendliche mit NSSV zeigten eine signifikant verringerte PFK Oxygenierung im Vergleich zu den Kontrollprobanden im oxygenierten Hämoglobin (t = -2.33; p = .021). Niedrigere PFK Oxygenierung korrelierte mit mehr negativen Kindheitserlebnissen (r = -.155; p = .034), während stärkere PFK Oxygenierung mit einer besseren selbstberichteten gesundheitsbezogenen Lebensqualität korrelierte (r = .154; p = .049). Bei der Untersuchung der Konnektivität wurden keine Gruppenunterschiede gefunden.

Diskussion: Die Befunde tragen zum Wissensstand zur PFK Oxygenierung bei Jugendlichen mit NSSV bei. Mögliche Einflüsse von Psychotherapie und Alter auf die Oxygenierung im PFK werden diskutiert. Weitere Untersuchungen sind notwendig, um einzuordnen, inwiefern die gefundenen Unterschiede in der Oxygenierung mit Psychopathologie allgemein oder mit spezifischen Kriterien von NSSV im Besonderen zusammenhängen.



P221 - Phonetic perception but not perception of speaker gender is impaired in chronic tinnitus

Nils Frisius1, Romi Zäske1,2, Daniela Ivansic3, Stefan R. Schweinberger2, Orlando Guntinas-Lichius1, Christian Dobel1

1Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena; 2Lehrstuhl für Allgemeine Psychologie und kognitive Neurowissenschaften, Institut für Psychologie, Friedrich-Schiller-Universität Jena; 3Tinnitus-Zentrum, Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena

Introduction. While tinnitus is known to compromise the perception of speech, it is unclear if the same holds for extralinguistic speaker information. Furthermore, research with simple tone stimuli showed that unilateral tinnitus binds spatial attention, thereby impeding the detection of auditory changes in the non-affected ear.
Methods. Using dichotic listening tasks, we tested left-ear tinnitus patients and control patients for their ability to ignore speech and speaker information in the task-irrelevant ear. To this end they heard vowel-consonant-vowel (VCV) syllables simultaneously spoken by gender-ambiguous voices in one ear and male or female voices in the contralateral ear. They selectively attended to speech (Exp. 1) or speaker (Exp. 2) information in a designated target ear, by classifying either the consonant (/b/ or /g/) in VCV syllables or voice gender (male or female) while ignoring distractor voices in the other ear.
Results. While performance was comparable across groups in the gender task, tinnitus patients responded slower than controls in the consonant task, with no effect of target ear.
Discussion. This suggests that tinnitus hampers phonetic perception in speech, while preserving the processing of extralinguistic speaker information. These findings support the growing evidence for speech perception impairments in tinnitus.



P222 - Predicting Response to Cognitive-Behavioral Therapy in Patients with Obsessive-compulsive Disorder: Association with Emotional Processing Measured with the Late Positive Potential

Janika Wolter-Weging1, Julia Klawohn1, Anja Riesel2, Rosa Grützmann1, Björn Elsner1, Norbert Kathmann1

1Institut für Psychologie, Humboldt-Universität zu Berlin, Deutschland; 2Institut für Psychologie, Universität Hamburg, Deutschland

The efficacy of cognitive-behavioral therapy (CBT) for treatment of obsessive-compulsive disorder (OCD) is well established. However, a number of patients do not respond to the treatment. In order to improve this situation, it is important to identify psychological and biological markers associated with individual differences in CBT response. Previous findings have shown an association between altered emotional processing and therapy response in several disorders, such as depression and anxiety. With the current study, we investigated whether emotional processing could be used to predict therapy response in a relatively large sample of patients with OCD (n = 133). To assess emotional processing, the late positive potential (LPP) was recorded while the patients were presented with emotional stimuli (i.e., IAPS pictures). The LPP is an event-related brain potential (ERP) that reflects sustained attention to emotional stimuli. Severity of OCD symptoms was measured with the Yale-Brown Obsessive-compulsive Scale before and after CBT, and therapy response was estimated using the Reliable Change Index.

Initial results from multiple moderation models show a gender-moderated prediction of therapy response by LPP to negative, but not positive, emotional stimuli. Specifically, female patients with higher sustained attention to negative stimuli seem to be more likely to benefit from CBT. Further associations with clinical and psychometric variables will be presented. The current findings have the potential to improve our understanding of individual predictors for therapy response in OCD, highlighting the relevance of biological indicators of emotional processing in this context.



P223 - Preset to threat: Anxious apprehension influences startle and P300 in threat anticipation

Hannes Per Carsten1, Kai Härpfer1, Brady Nelson2, Anja Riesel1

1Institute of Psychology, Universität Hamburg, Germany; 2Department of Psychology, Stony Brook University, NY, USA

Background: A widely shared framework suggests that anxiety symptomatology maps onto two dimensions: Anxious apprehension and anxious arousal. Previous research associated individual differences on these dimensions with differential neural response patterns in neuropsychological, imaging, and physiological studies. Differential effects of the anxiety dimensions might contribute to inconsistencies in clinical and non-clinical studies that examine neural processes underlying anxiety. The present study therefore tested associations between the anxiety dimensions and the neural processing of threat anticipation.

Method: From a larger online sample (N = 1,603), we oversampled 101 non-clinical subjects with converging and diverging anxious apprehension and anxious arousal profiles. The subjects underwent the NPU-threat test with alternating phases of unpredictable threat, predictable threat, and safety, while physiological responses (i.e., startle reflex, N100, and P300) to auditory startle probes were recorded.

Results: Multilevel regression models revealed that anxious apprehension enhanced startle responses to unpredictable threat relative to safety. Further, anxious apprehension decreased attentional allocation (P300) to predictable threat relative to safety. However, anxious apprehension did not significantly affect automatic sensory processing of startle probes (N100). Further, no evidence emerged for anxious arousal affecting threat anticipation.

Conclusion: These results suggest that trait variations in anxious apprehension shape the dynamics of neural processing of threat stimuli. Specifically, anxious apprehension seems to simultaneously increase the defensive preparation during uncertain threat anticipation and attenuate attentional responding to predictable threat. However, we could not validate a role of anxious arousal in threat processing. Altogether, our data further highlight the role of uncertainty in anxiety.



P224 - Psychobiologische Stressreaktivität bei Grundschulkindern: Effekte zweier Kurzinterventionen

Laura Teresa Bastgen1, Julian Schmitz2, Gregor Domes1, Bernadette von Dawans1

1Biologische und Klinische Psychologie, Universität Trier, Deutschland; 2Klinische Kinder- und Jugendpsychologie, Universität Leipzig, Deutschland

Einleitung: Das Stressniveau und die damit assoziierten körperlichen und psychischen Symptome bei Kindern und Jugendlichen nehmen zu. Während soziale Unterstützung als wichtige stressprotektive Ressource identifiziert werden konnte und die Notwendigkeit und Wirksamkeit verschiedener Stressbewältigungstrainings empirisch belegt wurde, untersucht die aktuelle Studie, ob eine Kurzintervention bereits positive Effekte erzielen kann und ob darüber hinaus die Intervention mit dem Schwerpunkt „soziale Unterstützung“ als Bewältigungsstrategie der aktiven Kontrollgruppe überlegen ist.

Methoden: In einer randomisierten Studie wurden 47 Kinder der 3. & 4. Klassen zufällig einer von zwei Stressmanagementtrainings (4 mal 90 Minuten) zugeteilt. Während die eine Gruppe Psychoedukation zu Stress sowie Übungen der Progressiven Muskelentspannung (PMR) und imaginative Entspannungsübungen enthielt, wurde in der zweiten Gruppe zusätzlich die Suche nach sozialer Unterstützung angeregt. Zur Analyse der Wirksamkeit wurde vor und nach dem Trainingszyklus eine adaptierte Kurzvariante des Trierer sozialen Stresstests für Kinder (engl.: Trier Social Stress Test for Children, TSST-C; Buske-Kirschbaum et al., 1997) durchgeführt, um die Stressreaktivität auf physiologischer (Speichelkortisol) und psychologischer Ebene (Fragebogen) sowie stressassoziierte Symptome und Verhalten zu untersuchen.

Ergebnisse: Die Analysen zeigen unterschiedliche Veränderungen der Stressreaktivität der beiden Gruppen, wobei die Gruppe mit Fokus „soziale Unterstützung“ auf physiologischer Ebene profitiert, während die Vergleichsgruppe auf Ebene der subjektiven Stresswahrnehmung profitiert. Alle Kinder zeigen einen Rückgang stressassoziierter und sozialängstlicher Symptome nach dem Training.

Diskussion: Die Wirksamkeit von Kurzinterventionen auf die kindliche Stressreaktivität und stressassoziierte Symptome konnte in dieser Studie bestätigt werden. Die Interventionen sind auf Umsetzbarkeit im Schulalltag der Kinder konzipiert. Zukünftige Studien sollten prüfen, ob sie zur Stressprävention bei Grundschulkindern eingesetzt werden können.



P225 - Psychophysiologische Reaktionen auf emotionale Erinnerungen bei sozialer Angststörung

Rosa Johanna Seinsche1,2, Susanne Fricke1,2, Marie Kristin Neudert1,2, Raphaela Isabella Zehtner1,2, Bertram Walter2,3, Rudolf Stark1,2,3, Andrea Hermann1,2,3

1Professur für Psychotherapie und Systemneurowissenschaften, Justus-Liebig-Universität Gießen; 2Bender Institute of Neuroimaging, Justus-Liebig-Universität Gießen; 3Center for Mind, Brain and Behavior, Phillips-Universität Marburg und Justus-Liebig-Universität Gießen

Viele PatientInnen mit Sozialer Angststörung (SAD) berichten von sozial bedrohlichen Erfahrungen aus der Vergangenheit, die mit dem Beginn der Störung assoziiert sind. Trotz der Bedeutung dieser Erinnerungen für die SAD, gibt es bisher nur wenige Hinweise auf Unterschiede zwischen gesunden Personen (die ebenfalls sozial bedrohliche Erfahrungen erlebt haben) und PatientInnen mit SAD hinsichtlich der Repräsentation dieser Erinnerungen im Gedächtnis. Das Ziel dieser Studie war zu untersuchen, inwiefern SAD PatientInnen eine Trauma-ähnliche Abspeicherung dieser Erinnerungen in Form von erhöhter emotionaler Reaktivität, sowie Intrusivität und Disorganisation der Erinnerung aufweisen. Zudem wurde untersucht, ob diese Gedächtnischarakteristika mit posttraumatischen Belastungssymptomen (PTBS Symptomen) zusammenhängen.

Die emotionale Reaktivität (subjektiv, psychophysiologisch) von 84 SAD PatientInnen und 84 gesunden Kontrollpersonen wurde mithilfe einer Vorstellungsaufgabe erfasst, während der die ProbandInnen die Aufgabe hatten, sich drei verschiedene Erlebnisse (sozial aversiv, nicht-sozial aversiv, neutral) möglichst lebhaft vorzustellen. Während der Vorstellungsaufgabe wurden psychophysiologische Maße wie die Herzrate (HR), die Hautleitfähigkeit (SCR), sowie die Muskelaktivität im Gesicht (Corrugator supercilii, Zygomaticus major) erfasst.

Die Ergebnisse dieser Studie zeigen, dass SAD PatientInnen während der Imagination der sozial bedrohlichen Situation eine erhöhte autonome Reaktivität (HR, SCR) und mehr negative Gefühle erleben, sowie eine größere Intrusivität der Erinnerung berichten. Zudem mediieren PTBS Symptome teilweise den Zusammenhang zwischen diesen Gedächtnischarakteristika und SAD Diagnose.

Diese Ergebnisse weisen darauf hin, dass SAD PatientInnen im Gegensatz zu gesunden Personen eine Trauma-ähnliche Repräsentation der sozial bedrohlichen Erfahrungen aufweisen, die möglicherweise eine Rolle bei der Entstehung von PTBS Symptomen, sowie schließlich der Entstehung bzw. Aufrechterhaltung der sozialen Ängste spielt.



P226 - Reducing math test anxiety with hypnosis in a school setting

Luisa Schröder, Barbara Schmidt

Friedrich-Schiller-Universität Jena, Deutschland

Research shows that math test anxiety has a significant negative impact on students‘ performance in math exams because it impedes successful knowledge retrieval. Since hypnotherapeutic techniques are highly successful in reducing stress and anxiety, we developed a hypnosis audio-intervention for the school context to reduce math test anxiety and hence improve test results. The intervention starts with the induction of a mild trance in which students are suggested positive feelings like pride and positive expectations like an optimal test performance in upcoming math tests. We plan to test 24 students aged 17-18 from the Grete Unrein School in Jena. The hypnosis audio-intervention is implemented between two math exams. Before taking the first exam, we assess students‘ trait math anxiety with a single item math anxiety scale (SIMA). Before each math test, we measure state anxiety with the State-Trait-Anxiety-Inventory (STAI-S) and record heart rate and breathing frequency as physiological markers of anxiety. Math test performances are also included in the analysis. We expect that our hypnosis audio-intervention decreases anxiety measures before math tests (STAI-S, heart rate, breathing frequency) and therefore improves math test performance. The aim of the study is to provide a successful math anxiety prevention and treatment method that is easy to deliver to students, also during the current corona pandemic. Reducing test anxiety at school will positively affect students’ well-being and might establish successful coping mechanisms leading to general resilience.



P227 - Responsibility for others’ outcomes differentially affects reinforcement learning in Social Anxiety Disorder

Michael P.I. Becker, Annika Dehler, Judith Diele, Leonie Pfaff, Charlotte Leonie Stöckmann, Jacqueline Todorova, Thomas Straube

WWU Münster, Deutschland

Learning to reconcile our own interests with those of others is crucial for successful social interactions. Moreover, worsening the outcome of others by making a wrong decision is stressful. Individuals with Social Anxiety Disorder (SAD) fear evaluation by others. This fear can be triggered if they are responsible for a bad outcome that affects the whole group.

75 adult participants (35 diagnosed with SAD and 40 age-, gender-, and education-matched healthy controls (HC)) underwent event-related functional magnetic resonance imaging while having to weigh the outcomes for a group of people they had just met against their own outcomes during a learning task known to elicit robust Reward Prediction Errors (RPE). We fit different reinforcement learning models to choice data and compared them using Hierarchical Bayesian Inference. BOLD data were analysed in SPM, restricted to predefined ROIs and corrected for multiple comparisons using permutation tests.

Contrasting RPE-related activation between SAD and HC, we found excess activation of a region of the left Inferior Parietal Lobule (caudal A40) for RPEs regarding participants own outcomes. RPEs related to the outcomes of others’ differentially activated medial Area 9 in SAD.

Overall, these findings elucidate differences in the employment of learning mechanisms in cortical areas in SAD when taking responsibility for others’ outcomes, a mechanism that closely corresponds with neurobiological endophenotypes recently proposed for SAD.



P228 - Slow-wave sleep predicts treatment outcomes in trauma patients

Mojgan Ehsanifard, Klaus Junghanns, Ines Wilhelm

Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany

Introduction. Successful psychotherapy essentially relies on a person’s ability to integrate and store new adaptive information. Basic research indicates that these processes of memory formation are supported by sleep. However, most psychiatric patients suffer from sleep disturbances questioning that they can optimally benefit from psychological interventions. In this study, we aim to investigate whether objective and subjective sleep parameters prior to psychotherapy can predict treatment outcomes in traumatized patients.

Method. Forty-five patients suffering from post-traumatic stress symptoms spent two nights in our sleep laboratory before receiving disorder-specific psychotherapeutic treatment. Subjective sleep was assessed with the PSQI (Pittsburgh Sleep Quality Index) questionnaire and objective sleep was measured using standard polysomnography. Pre-to-post-treatment change scores were calculated for relevant symptoms such as anxiety, depression, emotion-regulation, and post-traumatic symptoms using standard questionnaires (i.e., Beck Depression and Anxiety Inventory (BDI, BAI), Emotion Regulation Questionnaire (ERQ), Post-traumatic Diagnostic Scale (PDS)).

Preliminary results. Psychological symptoms (BDI, BAI, and PDS) and subjective sleep quality substantially improved after psychological treatment (all p < 0.001) while Subjective sleep parameters did not change pre- to post-treatment. The amount of slow-wave sleep prior to psychotherapy was correlated with reductions in anxiety-related symptoms (p=.004) as well as in dysfunctional emotion regulation strategies (p = 0.006) pre-to-post-treatment.

Discussion. Our findings underline the essential role of slow-wave sleep in psychotherapeutic success. Future studies are needed to investigate whether improving sleep quality using sleep-related interventions prior to psychotherapy can improve treatment outcomes.



P229 - Subjective, behavioral and physiological cue-reactivity in virtual reality environments in gambling disorder

Luca-Rene Bruder, Jan Peters

University of Cologne, Deutschland

Introduction: In recent years, the emergence of high-performance virtual reality (VR) technology has opened up new possibilities for the examination of contextual effects in psychology. In this preregistered study (https://osf.io/4mrta), we investigated subjective, physiological and behavioral effects of exposure to gambling-related and neutral VR environments in regular gamblers agreeing to at least one of the DSM-5 criteria for gambling disorder (mean = 5.4, range: 1 to 8) and non-gambling controls.

Methods: Gamblers (n=31) and matched controls (n=29) completed testing sessions on three different days. On two days, participants explored two rich and navigable VR-environments (neutral [café] vs. gambling-related [casino/sports-betting facility]), while electrodermal activity (EDA) and heart rate were measured using remote sensors. Within the VR-environments, participants performed a temporal discounting task and a sequential decision-making task (Daw et al., 2011).

Results: In line with prior results (Wiehler & Peters, 2015), we found strong evidence for increased temporal discounting in the group of regular gamblers. Subjective craving increased significantly in gamblers when exposed to the gambling-related VR environment, but there was little evidence for increased temporal discounting (Dixon et al., 2006). Similarly, the EDA increased in response to immersion in VR in general, but there was no evidence for physiological cue-reactivity towards the gambling-related VR-environment.

Discussion: The results suggest that gambling-related virtual environments can induce subjective craving in participants reporting frequent or pathological gambling. Why a similar effect wasn’t observed for behavioral measures of cue-reactivity (e.g., temporal discounting, see Dixon et al., 2006) or the physiological measures remains open for debate.



P230 - Targeted Extinction of Drug Cues During Sleep

Cagatay Gürsoy, Gordon Feld

Central Institute of Mental Health, Mannheim, Germany

Introduction
It is well established that memories undergo consolidation during sleep via repeated reactivation of newly encoded information, which offers a unique opportunity to manipulate memories. In patients suffering from disorders linked to maladaptive reward memory (e.g. substance use disorders), memory consolidation during sleep may be used to attenuate addiction memories. Using targeted memory reactivation (TMR), sensory stimuli paired with memories during wake can be used to reactivate corresponding memory traces during sleep. Recently, TMR has successfully been applied to extinguish conditioned fear responses. Thus, we aimed to transfer this method to alcohol use disorder patients and to extinguish addiction related maladaptive memories by presenting addiction related odour cues during sleep.

Methods
Patients (N = 172) will receive either alcohol or neutral (unlinked) odours during Non-REM sleep, whilst polysomnography is recorded. Before and after sleep, cued reactivity of each patient towards alcohol and neutral will be recorded using fMRI.

Results
We hypothesize that cue reactivity towards alcohol stimuli may be reduced by TMR. Moreover, we will record activations focusing on the following RoIs: in hippocampus and dorsolateral prefrontal cortex as memory related RoIs, in striatum and insula as reward related RoIs and in anterior cingulate cortex and ventrolateral prefrontal cortex as cognitive control related RoIs. After the intervention we expect a higher activation in memory and cognitive control regions and lower activity in reward regions.

Discussion
If effective, TMR can be used to accompany conventional treatment options and might be especially useful for patients who find alternative treatments ineffective.



P231 - Vagus nerve stimulation normalizes food ratings and improves food liking in people with anhedonia

Vincent Koepp1,2, Johannes Klaus1, Magdalena Ferstl1, Franziska K. Müller1, Anne Kühnel1,3, Nils B. Kroemer1

1University of Tübingen, Department of Psychiatry and Psychotherapy, Germany; 2Otto-von-Guericke University Magdeburg, Institute for Psychology, Germany; 3Max Planck Institute of Psychiatry and International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany

Introduction: The vagus nerve plays a prominent role in the regulation of food intake and metabolic processes. Previous studies on vagus nerve stimulation yielded conflicting results as to whether it affects reactivity to food cues in healthy participants and participants with major depressive disorder (MDD), for which vagal nerve stimulation has proven as an effective treatment. Here, we investigated the acute effects of right transcutaneous auricular vagus nerve stimulation (taVNS) on subjective ratings of wanting and liking of various food and non-food items in a sample of 65 participants, including 31 patients with MDD.

Methods: To test for tVNS-induced changes and compare effects between healthy participants and patients with MDD, we performed linear mixed-effects analysis including either group (MDD) or questionnaire scores on anhedonia. In addition, we assessed whether tVNS-induced changes (“slopes”) were dependent on average ratings (“intercepts”).

Results: We found that taVNS increased liking of food cues in MDD, but not in healthy participants. Across participants, taVNS reduced the variance of food liking compared to sham, suggesting that taVNS normalizes extreme ratings towards moderate levels of liking. In line with this convergence effect, taVNS induced larger improvements in liking ratings with increasing scores of anhedonia.

Discussion: Our results show that taVNS acutely ameliorates hedonic responses suggesting that it could provide an effective treatment of anhedonia, one of the cardinal symptoms of MDD. As symptoms of anhedonia are difficult to treat with conventional therapies, taVNS may provide a powerful adjuvant to rapidly improve motivational deficiencies.



P232 - Verbessern Entspannungsverfahren die Interozeptionsfähigkeit? – Eine 1-wöchige Intervention

Angelika Dierolf, Lilia Gorji, Benita Gräfin von Königsmarck, Marlene Haarhaus, Clara Thies, Carolin Weis, Kim Opdensteinen, Tanja Hechler

Universität Trier, Deutschland

Interozeption, die Wahrnehmung und Verarbeitung körpereigener Signale, ist ein zentraler Aspekt von Gesundheit und Krankheit. Eine gestörte Interozeptionsfähigkeit zeigt sich bei verschieden psychischen Erkrankungen, wie Depression oder auch Essstörungen.

In der vorliegenden Studie wurde an 76 gesunden Studenten untersucht, ob sich die interozeptive Genauigkeit und das interozeptive Bewusstsein durch eine 5-tägige körperbezogene Imaginationsübung (Bodyscan) per Audiodatei verbessern lassen. Als Kontrollbedingung diente eine nicht-körperbezogene Traumreise und nicht-entspannungsbezogene Podcasts der Serie ZeitWissen. Die Erhebung erfolgte online. Vor und nach der 5-tägigen Intervention wurden interozeptive Genauigkeit (Interoceptive Accuracy Scale (IAs)) und interozeptives Bewusstsein (Multidimensional Assessment of Interoceptive Awareness (MAIA)) erfasst.

Erste Ergebnisse zeigen eine interventionsunabhängige Zunahme der interozeptiven Genauigkeit und des interozeptiven Bewusstsein nach allen Interventionen. Unabhängig von Intervention und Messzeitpunkt scheinen allerdings depressive, Angst- und Stresssymptome, gemessen mit Depressions-Angst-Stress-Skalen (DASS), sowie psychische Belastungen durch die aktuelle Covid-19 Pandemie insbesondere interozeptives Bewusstsein und in geringerem Ausmaß interozeptive Genauigkeit negativ zu beeinflussen. Die wöchentliche Häufigkeit, mit der generell eigene Achtsamkeits- oder Entspannungsübungen durchgeführt werden, wirkt sich positiv auf das interozeptive Bewusstsein aus.

Insgesamt scheint Interozeptionsfähigkeit auch durch eine körperbezogene kurze, intensive imaginative Entspannungsübung in gesunden jungen Erwachsenen nicht verbessert zu werden, im Gegensatz zu regelmäßigem Yoga-, Mediations- oder Achtsamkeitstraining, welches interozeptives Bewusstsein positiv beeinflusst.



P233 - Wirksamkeit eines computergestützten Flexibilitätstrainings bei Zwangsstörung

Rosa Grützmann1, Nobert Kathmann1, Stephan Heinzel2

1Humboldt- Universität zu Berlin, Deutschland; 2Freie Universität Berlin, Deutschland

Die Zwangsstörung (OCD) führt zu deutlichen Beeinträchtigungen und Leid bei den Betroffenen und ist mit erheblichen gesellschaftlichen Kosten verbunden. Obwohl sich die Kognitive Verhaltenstherapie mit Exposition und Reaktionsverhinderung als eine effektive Intervention etabliert hat, brechen zahlreiche Patienten die Behandlung ab oder profitieren nicht ausreichend davon. Aus diesem Grund sind zusätzliche Augmentationen der Psychotherapie erforderlich.

Bei Patienten mit OCD wurde wiederholt eine Überaktivität der Handlungsüberwachung festgestellt. Diese manifestiert sich in einer gegenüber Gesunden erhöhten Amplitude des ereigniskorrelierten Potentials „error-related negativity“ (ERN) im EEG. Darüber hinaus scheint auch die Flexibilität der Handlungsüberwachung reduziert. So zeigen sich bei Patienten mit Zwangsstörung Hinweise auf eine verringerte adaptive Anpassung der neuronalen Aktivierungsmuster und des Verhaltens an den Aufgabenkontext. Die Überaktivität der Handlungsüberwachung findet sich auch bei nichterkrankten erstgradigen Angehörigen von OCD Patienten und reflektiert daher möglicherweise einen Risikofaktor für diese Störung und somit einen fruchtbaren Ansatzpunkt für augmentative Interventionen.

Im Vortrag werden erste Daten aus einer Interventionsstudie zur Untersuchung der Wirksamkeit eines computergestützten Trainings bei OCD Patienten vorgestellt. In einem Prä-Post-Design wird überprüft ob ein dreiwöchiges internetbasiertes Training bei OCD Patienten zu einer verbesserten behavioralen Leistung (Reaktionszeiten, Fehlerraten), einer Flexibilisierung der neuro-kognitiven Handlungsüberwachung (ereigniskorrelierte Potentiale von Fehlerverarbeitung und Konfliktüberwachung) und zu einer Veränderung der Zwangssymptomatik führt. Zudem wird geprüft, inwieweit diese Outcome-Variablen im Zusammenhang stehen.



P234 - Zusammenhang von neuronalen Korrelaten kontextabhängiger Furchtkonditionierung und Intrusionen in Reaktion auf aversive Lebensereignisse

Marie Kristin Neudert1,2, Axel Schäfer2,3, Raphaela I. Zehtner1,2, Susanne Fricke1,2, Rosa J. Seinsche1,2, Onno Kruse1,2, Rudolf Stark1,2,3, Andrea Hermann1,2,3

1Professeur für Psychotherapie und Systemneurowissenschaften, Justus-Liebig-Universität Gießen; 2Bender Institute of Neuroimaging, Justus-Liebig-Universität Gießen; 3Center for Mind, Brain and Behavior, Phillips Universität Marburg und Justus-Liebig-Universität Gießen

Intrusionen rufen Gefühle und Reaktionen hervor, als ob sich eine traumatische Situation im Hier und Jetzt wiederholen würde, obwohl sich die Person in einer sicheren Umgebung befindet. Obwohl Intrusionen ein Kernsymptom der Posttraumatischen Belastungsstörung (PTBS) sind, treten sie auch bei anderen furchtbezogenen Störungen nach störungsspezifischen aversiven Ereignissen auf und sind daher von hoher transdiagnostischer Relevanz. Ätiologische Modelle nehmen Schwierigkeiten in der kontextabhängigen Modulation von konditionierten Furchtreaktionen als Erklärung für intrusive Symptome an. Diese Studie untersucht daher, ob Unterschiede in den neuronalen Korrelaten kontextabhängiger Furchtkonditionierungsprozesse zwischen Personen mit und ohne Intrusionen in Reaktion auf aversive Lebensereignisse bestehen.

In dieser funktionellen Magnetresonanztomographie-Studie durchliefen 74 gesunde Frauen ein 2-tägiges kontextabhängiges differentielles Furchtkonditionierungsparadigma mit Furchtakquisition in Kontext A und Extinktionslernen in Kontext B (Tag 1) sowie Extinktionsabruf im sicheren Kontext B und Furchtabruf in einem neuen Kontext (Kontext C) einen Tag später. Als abhängige Variablen wurden die elektrodermale Reaktion (EDA) sowie die neuronale Aktivität in furcht- und extinktionsassoziierten Arealen gemessen. Intrusives Wiederleben wurden mittels der „Posttraumatic Diagnostic Scale“ in Reaktion auf das aversivste Lebensereignis der Teilnehmerinnen erfasst.

Erste Ergebnisse sprechen dafür, dass Frauen mit im Vergleich zu Frauen ohne Intrusionssymptome in Reaktion auf das aversivste Lebensereignis einen reduzierten Extinktionsabruf aufweisen. Ein reduzierter Extinktionsabruf zeigte sich in Form einer stärkeren konditionierten EDA und einer reduzierten vmPFC- und Amygdala-Aktivierung. Diese Befunde stehen im Einklang mit früheren Studien zu neuronalen Korrelaten des Extinktionsabrufs bei PTBS. Ein reduzierter Extinktionsabruf könnte auf Schwierigkeiten in der Nutzung von Kontextinformationen zur Modulation von Furchtreaktionen hindeuten.



 
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