How acute physical and psychological stress differentially influence the kynurenine pathway: A randomized cross-over trial.

Abstract Psychological stress is associated with the pathogenesis of several neuropsychiatric disorders. In contrast, physical stress, as provoked by exercise, counteracts symptoms and potentially also disease progression. The kynurenine pathway, which is imbalanced in neuropsychiatric disorders, responds to both psychological and physical stress. Here, we compared the acute effects of psychological versus physical stress on the kynurenine pathway and inflammatory mediators. Thirty-five healthy males (mean age: 24.09±3.39 years) underwent both the Trier Social Stress Test (psychological stressor) and the Wingate-Test (physical stressor). The kinetics of tryptophan and its metabolites as wel…

A New Routine for Analyzing Brief Symptom Inventory Profiles in Chronic Pain Patients to Evaluate Psychological Comorbidity

Question: Comorbidity, i.e., additional psychological distress in patients already suffering from chronic somatic diseases (e.g., orthopedic conditions) is of growing importance. The quality of analyzing and interpreting the often used Brief Symptom Inventory (BSI) used with orthopedic patients should improve by employing a new “case definition” of four groups (instead of two) of differentially psychologically distressed patients instead of two groups as before.Methods: Four groups with the different psychological distress definitions of “no,” “mild,” “remarkable,” and “severe” were to be analyzed from a group of 639 orthopedic patients in inpatient rehabilitation clinics. The BSI is transf…

Stress-induced pro- and anti-inflammatory cytokine concentrations in panic disorder patients

Abstract Background An attenuated responsivity of the hypothalamus–hypophysis-adrenal (HPA) axis upon challenge and an increased risk for cardiac events are relatively consistent findings in panic disorder (PD) patients. Due to cytokine-HPA interactions, an altered HPA-axis responsivity may be accompanied by altered cytokine concentrations. Immunological reactions under stress might be considered the missing link for explaining an increased cardiac risk. This study analyzed stress-induced cytokine levels in PD patients. Methods A total of n = 32 PD patients and n = 32 healthy control individuals performed the Trier Social Test (TSST). Blood sample collection accompanied the TSST for the col…

Air Quality and Chronic Stress: A Representative Study of Air Pollution (PM2.5, PM10) in Germany.

Objective With rising attention on climate change and the aftermath of burning fossil fuels, there is much concern regarding the effects of air pollution on physical and psychological health. However, the relationship between chronic stress and air pollution is relatively unexplored in humans. Methods By combining German representative data with national pollution data and using step-wise regression analyses, this study investigates how air pollution (particulate matter 2.5 and 10 [PM2.5 and PM10]) impacts ones' chronic stress levels (TICS). Results Results show PM2.5 fine-dust particles significantly affect chronic stress, while PM10 has no such effect. Air pollution (PM2.5), age, and inco…

Hair cortisol predicts avoidance behavior and depressiveness after first-time and single-event trauma exposure in motor vehicle crash victims

The role of cortisol as a premorbid vulnerability factor for trauma sequelae remains unclear. Furthermore, the onset of long-term endocrine changes in response to first-time trauma as a function of later psychopathology is not clarified yet. Thus the predictive value of pre- and post-traumatic hair cortisol concentrations (HCCs) for psychological trauma sequelae was investigated in response to motor vehicle crash (MVC). A total of

Frequency of somatic symptoms in the general population: Normative values for the Patient Health Questionnaire-15 (PHQ-15).

The PHQ-15 is widely used as an open access screening instrument for somatic symptoms in different health care settings. The objectives of the study were to contribute to the construct validity and to generate normative data for the PHQ-15.The survey was conducted in the general population in Germany from August 2011 to November 2014 (n=9250). All participants underwent an extensive core assessment including a set of questionnaires.Men reported significantly less (p0.001) physical symptoms than women (4.6 [SD=3.6] vs. 6.3 [SD=4.1]). The PHQ-15 total score was strongly correlated with the physical component of quality of life (r=-0.58), fatigue (r=0.56), anxiety (r=0.54) and sleep problems (…

Psychometric Properties of Two Brief Versions of the Hopkins Symptom Checklist: HSCL-5 and HSCL-10

The Hopkins Symptom Checklist–25 (HSCL-25) is a widely applied measure of depression and anxiety. The present study examines two of its short forms—the HSCL-5 and HSCL-10, which have been proposed by previous research—in a representative sample of the German general population. To this end, we conducted exploratory and confirmatory analysis on two subsamples ( n = 1,246 and n = 1,216). Our results suggest that, compared with the HSCL-25, both short forms represent economical ways of assessing depression and anxiety. Model fit was good and correlations with established measures demonstrate convergent validity. Both HSCL short forms are strongly invariant across sex, and we found evidence fo…

Hormonal responsiveness in the Trier Social Stress Test and the dexamethasone‐corticotropin releasing hormone test in healthy individuals

A number of different laboratory procedures investigate the hormonal response in a standardized pharmacological challenge test (dexamethasone-corticotropin releasing hormone; DEX-CRH) or in a psychosocial stress induction on the hypothalamic-pituitary-adrenocortical axis by the Trier Social Stress Test (TSST). However, the magnitude of the response related to the different stressors and the interaction of the responsiveness between the two tests is still unclear. Fifty-two participants underwent both the DEX-CRH test and the TSST on two separate days. The cortisol and the plasma adrenocorticotropic hormone (ACTH) release were assessed before and after the stress tests. For a specification o…

Revised Short Screening Version of the Profile of Mood States (POMS) From the German General Population

The present study was conducted with the aim of constructing and validating a short form of the Profile of Mood States (POMS). The POMS is a widely-applied measure for the assessment of an individual's mood. Thus, it is of great relevance for many research questions in clinical and social psychology. To develop the short scale, we first examined psychometric properties and found the optimal 16-item solution among all valid combinations of the full POMS in an exploratory subsample (n = 1,029) of our complete representative sample of the German general population. We then validated this model in a confirmatory subsample (n = 977). Additionally, we examined its invariance across age groups and…

The effect of restrained eating on acute stress-induced food intake in people with obesity

Abstract Restrained eating, defined as a form of intense dieting or restrictive food intake of specific macronutrients or types of food with sporadic episodes of overeating, results in an increased risk of overweight and obesity. Acute stress situations cause irregular eating patterns and are connected to restrained eating. Therefore, the present study investigates the effect of high/low restrained eating on eating behavior in people with obesity after standardized acute stress induction as well as resting condition. Fifty men and women with obesity (BMI: 33.62 ± 3.93 kg/m2) were categorized into high restrained eaters (HRE) and low restrained eaters (LRE). The total energy intake was measu…

Effect of a Biofeedback Intervention on Heart Rate Variability in Individuals With Panic Disorder: A Randomized Controlled Trial

OBJECTIVE Some individuals with panic disorder (PD) display reduced heart rate variability, which may result in an increased risk of cardiovascular mortality. Heart rate variability-biofeedback (HRV-BF) training has been shown to improve the modulation of the autonomic activity. Therefore, this randomized controlled trial was conducted to investigate the effect of a four-week HRV-BF intervention in individuals with PD. Heart rate variability-biofeedback (HRV-BF) training improved the modulation of the autonomic activity. Therefore, with this randomized controlled trial we aimed to investigate the effect of a four-week HRV-BF intervention in people with PD. METHODS Thirty-six women and sixte…

Incongruence Between Implicit Attachment Schemes and Unconscious Attachment Representations.

Assessments based on reaction time and language-based interviews postulate that unconscious attachment processes be measured. Nevertheless, a possible empirical equivalence of these two approaches has not yet been investigated. To fill this void, the Adult Attachment Interview and the Implicit Association Test were implemented with a group of patients with panic disorder (n = 157, mean age = 29, SD = 2.47) based on the Structured Clinical Interview for DSM-IV, axis I and II disorders and a group of healthy individuals (n = 138). In total, the securely attached individuals showed significantly more positive attitudes toward their mother than the insecurely attached individuals. In the health…

Movement and Emotional Facial Expressions during the Adult Attachment Interview: Interaction Effects of Attachment and Anxiety Disorder

<b><i>Introduction:</i></b> Adult attachment is commonly associated with emotion regulation. Less is known about the nonverbal embodiment of adult attachment. <b><i>Objective:</i></b> We hypothesized that dismissing attachment is related to less movement and fewer facial expressions of emotions, whereas preoccupied attachment is associated with more negative emotional facial expressions. Moreover, the interaction of attachment and the presence of an anxiety disorder (AD) was explored. <b><i>Methods:</i></b> The sample included 95 individuals, 21 with AD without comorbidity, 21 with AD and comorbid major depression (AD-C…

Increase in cortisol concentration due to standardized bright and blue light exposure on saliva cortisol in the morning following sleep laboratory

Research studies on LED light exposure and cortisol are inconsistent and not comparable due to different types of light, exposure times, and sample sizes. Therefore, one hour of standardized exposure LED light at different intensities and the spectral composition during the post-awakening phase at 7:30 were compared. A sample of 23 (Study 1) and 26 (Study 2) healthy males were randomly assigned to: 1) bright white light (414 lux) and 2) dim darkened light (2 lux) as well as 3) red light (235 lux) and 4) blue light (201 lux) exposure conditions. Results from repeated measures ANOVA confirm that light exposure affects the cortisol concentration. Study 1 revealed an increase in the saliva cort…

Effects of a Classroom Training Program for Promoting Health Literacy Among IT Managers in the Workplace: A Randomized Controlled Trial.

Objective IT managers have received limited attention in health literacy research, although they are subject to special professional demands. The aim of this study was to evaluate a training program designed to promote health literacy among managers. Methods A randomized controlled trial with a sample of 171 industry managers from one IT company was conducted. Effects of classroom training on health literacy, psychological well-being, self-rated health, and cortisol awakening response were investigated using pre- (t0), post- (t1), and follow-up (t2) surveys. Results The intervention effects (time and group) were not significant for the primary outcome of health literacy. At the second measu…

Effects of stress on chewing and food intake in patients with anorexia nervosa

OBJECTIVE The present study investigates the impact of psychosocial stress on chewing and eating behavior in patients with anorexia nervosa (PAN ). METHOD The eating and chewing behavior of PAN were examined in a standardized setting by means of a chewing sensor. These procedures encompassed n = 19 PAN , age, and gender matched to n = 19 healthy controls (HC). Food intake and chewing frequency were assessed in two experimental conditions: rest versus stress (via Trier Social Stress Test). To verify stress induction, two appraisal scales were employed. In addition, chronic stress, psychological distress and eating disorder symptoms were assessed. RESULTS In terms of food intake and chewing f…

Comparison of Cortisol Stress Response in Patients with Panic Disorder, Cannabis-Induced Panic Disorder, and Healthy Controls

<b><i>Background/Aims:</i></b> Little research effort has so far been dedicated to the analysis of the hypothalamic-pituitary-adrenal axis of aetiologically differing subgroups of patients with panic disorder (PD). The current study aimed at a deeper understanding of the cortisol stress response in cannabis-induced PD (CIPD) patients. <b><i>Methods:</i></b> Matched groups of 7 PD patients (mean age ± SD: 32.95 ± 9.04 years), 7 CIPD patients (31.94 ± 8.40 years), and 7 healthy controls (HC) (31.13 ± 8.57 years) were included in the study. The Trier Social Stress Test (TSST) was used for stress induction. Salivary cortisol samples were collected…

Actigraphic and Self-reported Sleep in Traffic Accident Victims

Background: Some accident victims report poorer sleep during the months after the trauma, which may double the risk for and is a mediator of the development of a PTSD. Furthermore, subjective and objective sleep measures are often discrepant in PTSD-patients, which is why a ‘sleep state misperception’ of PTSD patients is often hypothesized. Objective: The goal of this study is to assess differences in sleep quality in victims of a traffic accident compared to healthy participants without an accident history as well as differences between objective and subjective sleep quality measures. Methods: We recruited 25 hospitalized accident victims within ten days of an accident and 31 age and sex-m…

Cortisol reactivity in social anxiety disorder: A highly standardized and controlled study.

Abstract In order to understand the psychopathology of the social anxiety disorder (SAD) at the neuroendocrine level, standardized experimental studies on endocrine and physiological markers are necessary, especially since empirical data are still ambiguous. Hence, differences in both, the autonomic nervous system (ANS) and the endocrine stress responses (ACTH, salivary and plasma cortisol) were investigated in a particularly homogenous sample after a standardized stressor (Trier Social Stress Test). The sample consisted of n  = 35 patients with SAD, age, and gender matched to n  = 35 healthy controls (HC). In terms of the heart rate, the response pattern was comparable in both groups. Conc…

Betreuungsbedarf und subjektiver Unterstützungswunsch von Krebspatientinnen im Längsschnitt – Prädiktoren und Korrelate

The need for psychosocial support and patients' desire for psychosocial support in female cancer patients - predictors and correlates Objectives: The aims of the present study were to determine the need for psychosocial support of cancer patients, the subjective request for support and to examine the relationship between the need for psychosocial counselling, psychological distress and quality of life. Methods: 112 patients (consecutive) answered questionnaires about mental stress (GAD-2 and PHQ-2), quality of life (SF-8) as well as the Hornheide Screening Instrument (HSI) during their hospital stay (T1), two weeks (T2) and three months after their discharge (T3). Results: The need for psyc…

Recalled parental rearing style, self-esteem, and psychopathological symptoms in the general population

The enduring impact of perceived parental behavior on self-esteem as well as anxiety and depression in adults is still unknown. In a large random route sample (age range 18?92), 4,747 subjects were asked to complete questionnaires about recalled parental rearing, selfesteem, anxiety, and depression. Structural equation modeling was used, and the data from the mother and the father version of the FEE (a questionnaire for recalled parental rearing) were analyzed separately. A model proposing that self-esteem mediates the relationship between parental behavior and psychopathological symptoms fits the data rather well (CFI = .95, RMSEA = .05, TLI = .94). Hence, the recalled authoritative parent…

The effects of post-awakening light exposure on the cortisol awakening response in healthy male individuals.

Abstract Background It is assumed that the expression of the cortisol awakening response (CAR) is modulated by light exposure during the peri-awakening period. While initial evidence supports this principal effect, the specific role of the spectral composition of light (brightness and wavelength) is still incompletely understood. Method Two counterbalanced within-subject experiments were conducted in a standardized sleep laboratory setting to investigate the effect of light intensity (study I; two days: dim vs. bright light) and spectral composition (study II; three days: red vs. blue vs. green light) on the CAR. Across studies, light exposure was conducted for one-hour post-awakening and t…

Depression, anxiety and health status across different BMI classes: A representative study in Germany

Abstract Background Changes in body mass index (BMI) over the course of one's lifetime are related to the development of mental disorders. In the current study we compared symptoms of depression, generalized anxiety as well as general health status in the four BMI-classes: underweight, normal weight, overweight and obesity. Furthermore, mediator role of general health status on the relationship between BMI and depression and generalized anxiety was analyzed. Methods A representative sample (random-route sampling) of the German population (N = 2350) was investigated in a cross-sectional survey by measuring the three questionnaires PHQ-9, GAD-7 and EQ-5D-5L. Results The results showed signifi…

Expertenumfrage zu Interventionsarten in psychodynamischen Gruppenpsychotherapien – eine Pilotstudie

Suppressor effects in associations between patient attachment to therapist and psychotherapy outcome

Abstract Objective Several studies propose that patient attachment to therapist is associated with therapy outcome. However, the magnitude of the effect is diverse, which might be explicable by suppressor effects and the new concept of pseudo‐security. Method Associations between patient attachment to therapist (client‐attachment‐to‐therapist‐scale [CATS]) and psychotherapy outcome (“global severity index” of the Symptom Check List) were evaluated in N = 368 patients. Multilevel models were performed. Results When tested in separate models, secure attachment to therapist was associated with a more favourable outcome (p < 0.05), whereas avoidant and preoccupied attachment to therapist were c…

The effects of light exposure on the cortisol stress response in human males.

It is assumed that the production of cortisol is modulated by light exposure. While initial evidence supports this principal effect, the specific effect of light (intensity and wavelength) onto the cortisol stress response is still not completely understood. One between-subject experiment was conducted in a standardized sleep laboratory setting to investigate the effect of light intensity (dim white vs. bright white light) and spectral composition (red vs. blue) on the cortisol response after the Maastricht Acute Stress Test (MAST). 112 healthy young males (24.83 ± 4.10 years of age) were randomly assigned to one of the four light conditions. Across conditions, light exposure was conducted …

Implicit Attachment Schemas and Therapy Outcome for Panic Disorder Treated with Manualized Confrontation Therapy.

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Different studies have shown that a patient’s attachment correlates with the psychotherapy outcome. However, these findings are based on the traditional interview and paper and pencil attachment methods. Latency-based methods like the Implicit Association Test (IAT) have not yet been investigated in clinical attachment research, specifically in therapy outcome research. &lt;b&gt;&lt;i&gt;Objectives:&lt;/i&gt;&lt;/b&gt; It can be hypothesized that patients with positive schemas of their mother and their partner may show a better psychotherapeutic outcome than those with less positive schemas of their mother/partner. &lt;b&gt;&lt;i&gt;Method:&…

Morning and evening type: The cortisol awakening response in a sleep laboratory.

Abstract Background Earlier evidence indicated an association between chronotype and the cortisol awakening response (CAR). However, these earlier data were collected without objective control for participant compliance being available, which, following recent guidelines, is considered critical for ensuring data validity. Here, we are seeking to replicate these earlier findings within a well-controlled sleep laboratory set up. Methods The sample consisted of 103 young males, including 12 participants defined as ‘evening’ (MEQ   59) types. All participants slept for one night in a sleep laboratory and were wakened at 6:30 AM the next morning. Saliva samples for the assessment of the CAR were…

Psychometric Properties of the Multidimensional Fatigue Inventory (MFI-20), Derived From Seven Samples

Abstract Context Fatigue is a frequent symptom in patients suffering from chronic diseases. The Multidimensional Fatigue Inventory (MFI-20) is often used to measure fatigue. The aim of this article was to test the scale structure of the questionnaire. Methods The MFI-20 data were obtained from seven samples, including general population samples and samples of patients with different diseases (N between 122 and 1993). Five confirmatory factor analysis (CFA) models were tested for each sample. Results The scale structure postulated by the original test authors could not be confirmed by the CFAs. The inclusion of a method factor which considers the positive versus the negative orientation of t…

Parental rearing style and socio-demography of married and cohabiting individuals in a representative German sample

ABSTRACTWhereas the number of marriages has decreased, alternatives such as cohabitation have increased in German society. The main goal of the present representative study was to specify the influ...

The effective group size for teaching cardiopulmonary resuscitation skills – A randomized controlled simulation trial

Abstract Aim of the study The ideal group size for effective teaching of cardiopulmonary resuscitation is currently under debate. The upper limit is reached when instructors are unable to correct participants’ errors during skills practice. This simulation study aimed to define this limit during cardiopulmonary resuscitation teaching. Methods Medical students acting as simulated Basic Life Support course participants were instructed to make three different pre-defined Basic Life Support quality errors (e.g., chest compression too fast) in 7 min. Basic Life Support instructors were randomized to groups of 3–10 participants. Instructors were asked to observe the Basic Life Support skills and …

Blood endocannabinoid levels in patients with panic disorder.

Abstract Background The development and maintenance of anxiety disorders is not fully understood. There is consensus in the literature that in addition to genetic factors, social, psychological and neurobiological factors are of crucial importance. The present exploratory study investigates the influence of the endocannabinoids (EC) and related N-acylethanolamines (NA) on the maintenance of panic disorder (PD). Methods A total of n = 36 PD and n = 26 healthy controls (HC) were included in the study. Baseline characteristics showed no differences between the two groups. The participants were exposed to the Trier Social Stress Test (TSST) for reliable laboratory stress induction. Blood sample…

Emergency Treatment of Anaphylactic Reactions in Air Rescue Missions: An Eight-Year Analysis of a German Rescue Helicopter Base.

AbstractIntroduction:Anaphylactic reactions can lead to a life-threatening situation. In the event of anaphylaxis, rapid and targeted emergency treatment is indicated.Study Objective:The study sought to determine the emergency therapy administered for anaphylaxis in children and adults. Focus was placed on therapy with adrenaline. In addition, the study aimed to investigate demographic data, triggers, and hospitalization rates of the different severities of anaphylaxis.Methods:A retrospective analysis of anaphylactic reactions was conducted using data from prehospital emergency missions performed by the Air Rescue Dresden/Germany from 2008 through 2015 using the standardized application pro…

Supplementing sleep actigraphy with button pressing while awake

Objective/backgroundWrist-worn sleep actigraphs are limited for evaluating sleep, especially in sleepers who lie awake in bed without moving for extended periods. Sleep logs depend on the accuracy of perceiving and remembering times of being awake. Here we evaluated pressing an event-marker button while lying awake under two conditions: self-initiated pressing every 5 to 10 minutes or pressing when signaled every 5 minutes by a vibration pulse from a wristband. We evaluated the two conditions for acceptability and their concordance with actigraphically scored sleep.Participants and methodsTwenty-nine adults wore actigraphs on six nights. On nights 1 and 4, they pressed the marker to a vibra…

Recalled parental rearing behavior in adult women and men with depressive and anxiety symptoms: Findings from a community study.

Objectives: Addressing the lack of population-based data, the purpose of this representative study was to assess sex- and age-specific associations of maternal and paternal rearing behavior with depressiveness and anxiety controlling for sociodemographic and somatic variables. Methods: 8,175 subjects participating in a population-based study completed standardized questionnaires measuring Recalled Parental Rearing Behavior and distress. Results: Women recalled their fathers as more controlling and warmer, and their mothers as more rejecting than men. Comparisons between age groups (≤ 60 vs. > 60 years) revealed that younger participants recalled more parental control and emotional warmth. I…