Distinctive body perception mechanisms in high versus low symptom reporters: A neurophysiological model for medically-unexplained symptoms.

Abstract Objective The neurophysiological processes involved in the generation of medically-unexplained symptoms (MUS) remain unclear. This study tested three assumptions of the perception-filter model contributing to MUS: (I.) increased bodily signal strength (II.) decreased filter function, (III.) increased perception. Methods In this cross-sectional, observational study, trait MUS were assessed by a web-based survey (N = 486). The upper and lower decile were identified as extreme groups of high (HSR; n = 29; 26 women; Mage = 26.0 years) and low symptom reporters (LSR; n = 29; 21 women; Mage = 28.4 years). Mean heart rate (HR) and heart rate variability (HRV), and cortisol awakening respo…

Die Erfassung von Triggerempfindlichkeit und -vermeidung bei primären Kopfschmerzen: Entwicklung und psychometrische Erprobung einer deutschen Version des Headache Triggers Sensitivity and Avoidance Questionnaire (HTSAQ-G)

<b><i>Hintergrund:</i></b> Die Vermeidung von Kopfschmerzauslösern kann zur Entwicklung primärer Kopfschmerzerkrankungen führen. Daraus können verhaltenstherapeutische Behandlungsoptionen abgeleitet werden, die auf einen differen­zierten Umgang mit Kopfschmerztriggern abzielen. Zur ­Unterstützung der Therapieevaluation und -planung bei primären Kopfschmerzen wurde im englischsprachigen Raum der Fragebogen <i>Headache Triggers Sensitivity and Avoidance Questionnaire</i> (HTSAQ) entwickelt. <b><i>Patienten und Methoden:</i></b> Der HTSAQ wurde ins Deutsche übersetzt. Anhand einer Stichprobe von Patienten der Migräne- und Kopfschmerzk…

Symptoms and the body: Taking the inferential leap

The relationship between the conscious experience of physical symptoms and indicators of objective physiological dysfunction is highly variable and depends on characteristics of the person, the context and their interaction. This relationship often breaks down entirely in the case of "medically unexplained" or functional somatic symptoms, violating the basic assumption in medicine that physical symptoms have physiological causes. In this paper, we describe the prevailing theoretical approach to this problem and review the evidence pertaining to it. We then use the framework of predictive coding to propose a new and more comprehensive model of the body-symptom relationship that integrates ex…

Do Dr. Google and Health Apps Have (Comparable) Side Effects? An Experimental Study

Googling and using apps for health-related information are highly prevalent worldwide. So far, little is known about the emotional, body-related, and behavioral effects of using both Google and health-related apps. In our experimental study, bodily symptoms were first provoked by a standardized hyperventilation test. A total of 147 participants (96.6% students) were then randomly assigned to one of three conditions: Googling for the causes of the currently experienced bodily symptoms, using a medical app to diagnose the experienced symptoms, and a waiting control condition. Health-related Internet use for symptoms led to stronger negative affect, increased health anxiety, and increased nee…

Modern health worries and idiopathic environmental intolerance.

Abstract Objective We conducted two studies to test whether modern health worries (MHWs) were associated with central features of a condition called idiopathic environmental intolerance (IEI) and medical care utilization. Methods In Study 1, 474 Internet users completed an Internet-based questionnaire that assessed MHWs, IEI features, and medical care utilization. In Study 2, the diagnostic specificity of MHWs was investigated by comparing the level of MHWs of three diagnostic groups: 46 people with IEI, 38 people with somatoform disorder but without IEI, and 46 people with neither IEI nor somatoform disorder. Results The good psychometric properties of the MHW scale were confirmed. MHWs we…

When symptoms become side effects: Development of the side effect attribution scale (SEAS)

Objectives\ud \ud Symptom misattribution is a central process in the nocebo effect but it is not accurately assessed in current side effect measures. We have developed a new measure, the Side Effect Attribution Scale (SEAS), which examines the degree to which people believe their symptoms are treatment side effects.\ud \ud \ud \ud Methods\ud \ud The SEAS was tested in three New Zealand studies: a vaccination sample (n = 225), patients with gout or rheumatoid arthritis (n = 102), and patients switching to a generic medicine (n = 69). The internal reliability of the scale was examined using Cronbach's alpha. To assess validity, the Side Effect Attribution Total Score and Side Effect Attributi…

Prospective study of nocebo effects related to symptoms of idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF).

The exact causes of Idiopathic Environmental Intolerance Attributed to Electromagnetic Fields (IEI-EMF, i.e., experience of somatic symptoms attributed to low-level electromagnetic fields) are still unknown. Psychological causation such as nocebo effects seem plausible. This study aimed to experimentally induce a nocebo effect for somatic symptom perception and examined whether it was reproducible after one week. We also examined whether these effects were associated with increased sympathetic activity and whether interoceptive accuracy (IAcc) moderated these relationships. Participants were recruited from the general population and instructed that electromagnetic exposure can enhance somat…

Supplemental Material, JEP059716_supplement - Sensory and affective components of symptom perception: A psychometric approach

Supplemental Material, JEP059716_supplement for Sensory and affective components of symptom perception: A psychometric approach by Marta Walentynowicz, Michael Witthöft, Filip Raes, Ilse Van Diest, and Omer Van den Bergh in Journal of Experimental Psychopathology

Abnormalities in cognitive-emotional information processing in idiopathic environmental intolerance and somatoform disorders

Idiopathic environmental intolerance (IEI) represents a functional somatic syndrome marked by diverse bodily complaints attributed to various substances in the environment. Evidence for abnormalities in affective information processing similar to somatoform disorders (SFD) has recently been found in people with IEI. In order to further investigate these cognitive-emotional abnormalities, we compared people with IEI (n=49), SFD only (n=43), and non-somatoform controls (n=54) with respect to their performance in the extrinsic affective Simon task (EAST). This task allowed us to dissociate indicators of automatic affective associations and emotional intrusion effects of both bodily complaints …

Sensory and affective components of symptom perception: A psychometric approach

Psychological accounts of symptom perception put forward that symptom experiences consist of sensory-perceptual and affective-motivational components. This division is also suggested by psychometric studies investigating the latent structure of symptom reporting. To corroborate the view that the general and symptom-specific factors of a bifactor model represent affective and sensory components, respectively, we performed bifactor models applying confirmatory factor analytic approaches to the Patient Health Questionnaire-15 and the Checklist for Symptoms in Daily Life completed by 1053 undergraduate students. Additionally, we explored the association of latent factors with negative affectivi…

Idiopathic Environmental Intolerance: A Treatment Model

Idiopathic environmental intolerance (IEI) refers to a health condition characterized by the presence of multiple symptoms in different organ systems in response to a variety of environmental cues, such as chemical exposures, electromagnetic radiation, infrasound from windmill farms, (parts of) buildings, foods, etc. Typically, the symptoms arise in response to triggers and at dosages that do not cause symptoms in the majority of people, and no clear link with any physiological dysfunction can be found. The condition varies in a dimensional way from very mild, for which no medical help is sought, to very disabling, compromising normal life. The condition is controversial, but several indica…

Predictors of Psychological Distress and Coronavirus Fears in the First Recovery Phase of the Coronavirus Disease 2019 Pandemic in Germany

Objectives: While previous research has mainly focused on the impact of the first acute phase of the COVID-19 pandemic on mental health, little empirical knowledge exists about depression, anxiety, and somatic symptom levels and possible predictors of symptom levels in the pandemic’s recovery phase. The present study aimed to analyze the mental burden of a convenience ample of the general German population during the first recovery phase of the pandemic and to identify significant predictors of symptom levels.Methods: Standardized measures of anxiety (GAD-2), depression (PHQ-2), somatic symptoms (PHQ-15), and health anxiety, as well as measures of COVID-19 fears and possible vulnerability f…

Somatosensory Illusions Elicited by Sham Electromagnetic Field Exposure: Experimental Evidence for a Predictive Processing Account of Somatic Symptom Perception

OBJECTIVE According to the predictive processing theory of somatic symptom generation, body sensations are determined by somatosensory input and central nervous predictions about this input. We examined how expectations shape predictions and consequently bodily perceptions in a task eliciting illusory sensations as laboratory analogue of medically unexplained symptoms. METHODS Using the framework of signal detection theory, the influence of sham Wi-Fi on response bias (c) and somatosensory sensitivity (d') for tactile stimuli was examined using the somatic signal detection task (SSDT). A healthy student sample (n = 83) completed the SSDT twice (sham Wi-Fi on/off) in a randomized order after…

What Predicts Outcome, Response, and Drop-out in CBT of Depressive Adults? A Naturalistic Study

Background: The efficacy of CBT for unipolar depressive disorders is well established, yet not all patients improve or tolerate treatment. Aims: To identify factors associated with symptomatic outcome, response, and drop-out in depressive patients under naturalistic CBT. Method: 193 patients with major depression or dysthymia were tested. Sociodemographic and clinical variables were entered as predictors in hierarchical regression analyses. Results: A higher degree of pretreatment depression, early improvement, and completion of therapy were identified as predictors for symptomatic change and response. Drop-out was predicted by concurrent personality disorder, less positive outcome expectan…

Der Cognitive Emotion Regulation Questionnaire (CERQ)

Zusammenfassung. Theoretischer Hintergrund: Der Cognitive Emotion Regulation Questionnaire (CERQ; Garnefski, Kraaij & Spinhoven, 2001 ) erfasst neun Dimensionen kognitiver Emotionsregulation. Fragestellung: Es wurde eine deutsche Adaption des CERQ entwickelt und hinsichtlich Reliabilität, Dimensionalität und Zusammenhängen mit Depressivität und Angstsensitivität getestet. Methode: Die Studie wurde als postalische Fragebogenstudie durchgeführt. Von den zufällig ausgewählt und angeschriebenen 3000 Personen, sendeten 423 den Fragebogen zurück, die finale Stichprobe umfasste N = 414. Angstsensitivität und Depressivität wurden mit dem ASI-3 und dem PHQ-9 erfasst. Ergebnisse: Das 9-Faktorenm…

Cough is dangerous : neural correlates of implicit body symptoms associations

The negative interpretation of body sensations (e.g., as sign of a severe illness) is a crucial cognitive process in pathological health anxiety (HA). However, little is known about the nature and the degree of automaticity of this interpretation bias. We applied an implicit association test (IAT) in 20 subjects during functional magnetic resonance imaging (fMRI) to investigate behavioral and neural correlates of implicit attitudes towards symptom words. On the behavioral level, body symptom words elicited strong negative implicit association effects, as indexed by slowed reaction times when symptom words were paired with the attribute harmless (incongruent condition) relative to a control …

Die Erfassung allgemeiner Wirkfaktoren in der Psychotherapie

Zusammenfassung: Theoretischer Hintergrund. Stundenbögen dienen einer standardisierten Prozessdiagnostik und Verlaufsdokumentation. Bislang vorliegende Instrumente werden in der Praxis häufig nicht eingesetzt, haben einen eingeschränkten Geltungsraum oder weisen psychometrische Schwächen auf. Der Mainzer Stundenbeurteilungsbogen (MSB) versucht allgemeine Wirkfaktoren ökonomisch zu erfassen. Ziel der Studie ist die Untersuchung des MSB in der Patienten- und Therapeutenversion hinsichtlich Faktorenstruktur, Itemstatistiken und Gütekriterien. Methoden: Der MSB wurde zu zwei Zeitpunkten (5. und 20. therapeutische Sitzung) in einer Stichprobe ambulanter Psychotherapiepatienten ( N = 4.608, N = …

Are media reports able to cause somatic symptoms attributed to WiFi radiation? An experimental test of the negative expectation hypothesis

People suffering from idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) experience numerous non-specific symptoms that they attribute to EMF. The cause of this condition remains vague and evidence shows that psychological rather than bioelectromagnetic mechanisms are at work. We hypothesized a role of media reports in the etiology of IEI-EMF and investigated how somatosensory perception is affected. 65 healthy participants were instructed that EMF exposure can lead to enhanced somatosensory perception. Participants were randomly assigned to watch either a television report on adverse health effects of EMF or a neutral report. During the following experiment…

Implicit Affect after Mental Imagery: Introduction of a Novel Measure and Relations to Depressive Symptoms in a Non-Clinical Sample

Mental imagery can critically influence our emotional state. In contrast to commonly used explicit measures, implicit measures are promising for objectively assessing automatic emotional processes beyond deliberate control. In two studies with non-clinical samples, we tested the Affect Misattribution Procedure (AMP) to measure implicit affect induced by mental imagery. In a first study (N = 145), the implicit measure showed that mental imagery elicits significantly stronger negative affect than verbally processed stimuli (F(1, 144) = 3.94, p≤.05, η2p = 03). In Study 2 (N = 71), we refined the implicit measure and found that mental images can induce implicit affective reactions at least as …

Medically unexplained symptoms in children and adolescents: Illness-related self-concept and parental symptom evaluations

According to cognitive-behavioral models, illness-related symptom evaluations and self-concepts play a pivotal role in the development and maintenance of medically unexplained somatic symptoms (MUS). However, illness-related cognitions related to MUS have rarely been studied in children/adolescents and their parents.Seventy-eight children and adolescents (M = 14.2 years; 59% female) performed two versions of the Implicit Association Test (IAT) to measure the implicit illness-related and the implicit anxiety-related self-concept. Illness-related evaluations of unspecific symptoms were assessed via the Health Norms Sorting Task (HNST), and MUS as well as characteristics of somatic symptom dis…

Methods matter: Testing competing models for designing short-scale Big-Five assessments

Abstract Many psychological instruments are psychometrically inadequate because derived person-parameters are unfounded and models will be rejected using established psychometric criteria. One strategy towards improving the psychometric properties is to shorten instruments. We present and compare the following procedures for the abbreviation of self-report assessments on the Trait Self-Description Inventory in a sample of 14,347 participants: (a) Maximizing reliability/main loadings, (b) Minimizing modification indices/cross loadings, (c) the PURIFY Algorithm in Tetrad, (d) Ant Colony Optimization, and (e) a genetic algorithm. Ant Colony Optimization was superior to all other methods in imp…

Hypochondriasis, Somatoform Disorders, and Anxiety Disorders

The question of whether hypochondriasis (HYP) should be considered a somatoform disorder (SFD) or classified as an anxiety disorder (ANX) has recently been raised. To empirically provide information on this issue, we compared patients with HYP (n = 65) with those with other SFDs (n = 94) and those with ANX (n = 224) regarding sociodemographic and biographical variables, general psychopathology, and naturalistic cognitive-behavioral therapy treatment effects. Compared with SFD, patients with HYP were younger and had fewer comorbid affective disorders and less impaired life domains, suggesting a closer connection between HYP and ANX. Regarding cognitive-behavioral therapy treatment effects, a…

Modern health worries and idiopathic environmental intolerance attributed to electromagnetic fields are associated with paranoid ideation.

Paranoid ideation is assumed to characterize worries about possible harmful effects of modern technologies (MHWs) and idiopathic environmental intolerances (IEIs), such as IEI attributed to electromagnetic fields (IEI-EMF). Empirical evidence on these associations is scarce.In a cross-sectional on-line survey, participants of a community sample (n = 700; mean age: 28.4 ± 12.0; 434 females) completed the Somatosensory Amplification Scale, the Modern Health Worries Scale, and the Paranoid Ideation scale of the Symptom Checklist 90 Revised. They were considered IEI-EMF if (1) they categorized themselves so, (2) they had experienced symptoms that they attributed to the exposure to electromagnet…

The European Training Network ETUDE (Encompassing Training in fUnctional Disorders across Europe): a new research and training program of the EURONET-SOMA network recruiting 15 early stage researchers

Contains fulltext : 232532.pdf (Publisher’s version ) (Open Access)

Modul 1: Behandlungsmotivation

Wie bereits in vorherigen Kapiteln erwahnt, weisen Patienten mit medizinisch unerklarten Korperbeschwerden z. T. eine eher skeptische Haltung gegenuber Psychotherapie auf. In diesem ersten Modul des einzeltherapeutischen Behandlungskonzepts stehen deshalb daher verschiedene Strategien im Vordergrund, die dem Patienten das Therapiekonzept transparent machen sollen. Dazu gehort, dass mit dem Patienten zunachst die Therapieinhalte kurz umrissen werden. Damit der Patient sich validiert fuhlt, ist es zudem sinnvoll, seine Vorstellungen zu den Ursachen seiner Beschwerden zu explorieren. Die Klarung und Formulierung von Therapiezielen hilft dem Patienten, seine Therapieerwartungen realistisch zu r…

Efficacy of short-term psychotherapy for multiple medically unexplained physical symptoms: a meta-analysis.

Multiple medically unexplained physical symptoms (MUPS) are considered to be difficult and costly to treat. The current meta-analysis therefore investigates the efficacy of short-term psychotherapy for MUPS. Based on a multiple-phase literature search, studies were selected according to a-priori defined inclusion criteria. The standardized mean gain was used as the effect size index. Separate data aggregation of between- and within-group contrasts was performed on the basis of a mixed effects model. Outcome variables were physical symptoms, disorder specific emotions, cognitions and behaviors, depressive symptoms, general psychopathology, functional impairment, and health care utilization. …

Types of Triggers in Migraine - Factor Structure of the Headache Triggers Sensitivity and Avoidance Questionnaire and Development of a New Short Form (HTSAQ-SF).

OBJECTIVE: To examine the factor structure of the Headache Triggers Sensitivity and Avoidance Questionnaire (HTSAQ) and its German version (HTSAQ-G), in order to identify potential different types of triggers. Furthermore, a short form of the questionnaire was developed. BACKGROUND: The HTSAQ includes 24 of the most commonly reported headache triggers (eg, stress, odors, lack of sleep). Both the HTSAQ and HTSAQ-G appeared to be reliable and valid measures of sensitivity to and avoidance of headache triggers. METHODS: In a cross-country collaboration, data from 2 cross-sectional studies including N = 391 individuals diagnosed with migraine from Australia (n = 222) and Germany (n = 169) were …

Rasch scalability of the somatosensory amplification scale: a mixture distribution approach.

Abstract Objective Somatosensory amplification refers to a person's tendency to experience somatic sensations as inappropriately intense and involves hypervigilance concerning bodily sensations. We applied the Somatosensory Amplification Scale (SSAS) in an Internet sample of young adults (N = 3031) to test whether the SSAS is Rasch scalable. Methods We applied mixture distribution extensions of the partial credit and rating scale models to identify possible subgroups that use the response set of the SSAS in different ways. Results A partial credit model, with two latent classes, showed a superior fit to all other models. Still, one of the SSAS items had to be removed because it showed sever…

Dynamic relations among COVID-19-related media exposure and worries during the COVID-19 pandemic

Objectives: This study investigated how COVID-19-related media exposure during the COVID-19 crisis was related to same-day and next-day COVID-19-related worries. Design: A 21-day diary study was conducted between late March and late April 2020 in Germany. Main Outcome Measures: Hypotheses were tested in a sample of 561 participants (Mage = 42.79, SDage = 6.12). Every evening, participants indicated their exposure to COVID-19-related media (e.g., TV, print, online) and their COVID-19-related worries. Results: Same-day analyses showed that participants reported more COVID-19-related worries on days with higher exposure to COVID-19-related media. Dynamical structural equation models provided e…

Ergebnisse der Evaluation des Einzeltherapiekonzepts

In diesem Kapitel werden die ersten Ergebnisse zur Wirksamkeit des in Kap. 5 bis 12 dargestellten kognitiv-verhaltenstherapeutischen Behandlungskonzepts vorgestellt. Die Befunde basieren auf einer Stichprobe von Patienten mit multiplen unerklarten Korperbeschwerden, die in der Poliklinischen Institutsambulanz fur Psychotherapie der Johannes Gutenberg-Universitat Mainz entsprechend dem beschriebenen manualisierten Vorgehen behandelt wurden. Neben den klassischen Ergebnismasen zur Intensitat der Korperbeschwerden werden Veranderungen auch in anderen Patientenmerkmalen berichtet – wie z. B. hypochondrischen Einstellungen, korperbezogenen dysfunktionalen Kognitionen, Krankheitsverhalten, allgem…

Adult age differences in inhibitory processes and their predictive validity for fluid intelligence.

According to the inhibition-deficit hypothesis age differences in working memory capacity and fluid intelligence have been attributed to a decline in inhibitory efficiency. Conceptualizing inhibition as multifaceted, 88 participants (49 younger and 39 elderly) completed two versions of the negative priming paradigm (identification and localization), and two variants of the directed forgetting paradigm (listwise and itemwise). Two tasks of the Wechsler Intelligence Test with high loadings on general fluid intelligence (Gf) served as validation criteria. Results revealed task-specific and speed-independent inhibitory deficits in the elderly (lower negative priming in both paradigms; more intr…

The effects of social pressure and emotional expression on the cone of gaze in patients with social anxiety disorder

Abstract Background and objectives Patients with social anxiety disorder suffer from pronounced fears in social situations. As gaze perception is crucial in these situations, we examined which factors influence the range of gaze directions where mutual gaze is experienced (the cone of gaze). Methods The social stimulus was modified by changing the number of people (heads) present and the emotional expression of their faces. Participants completed a psychophysical task, in which they had to adjust the eyes of a virtual head to gaze at the edge of the range where mutual eye-contact was experienced. Results The number of heads affected the width of the gaze cone: the more heads, the wider the …

Anxiety and depression during the first wave of COVID-19 in Germany – results of repeated cross-sectional surveys

Kognitive Emotionsregulation und Psychopathologie: Erste teststatistische Untersuchung des deutschen Cognitive Emotion Regulation Questionnaire (CERQ) in einer klinischen Stichprobe

Zusammenfassung. Ein besseres Verständnis der Rolle von Prozessen und Stilen der Emotionsregulation (ER) im Kontext psychischer Störungen erscheint essentiell, um psychische Störungsmodelle und Behandlungskonzepte zu optimieren. Diese Studie überprüfte den Cognitive Emotion Regulation Questionnaire (CERQ) in einer klinischen Stichprobe von ambulanten Psychotherapiepatienten (N = 156) hinsichtlich seiner teststatistischen Güte sowie im Hinblick auf Zusammenhänge mit Psychopathologie. Der CERQ wies eine gute Reliabilität (.70 ≤ α ≤ .84) sowie faktorielle Validität auf. Im Vergleich zu einer Bevölkerungsstichprobe berichtete die klinische Stichprobe höhere Ausprägungen in dysfunktionalen und …

The Multidimensional Inventory of Hypochondriacal Traits

Severe health anxiety constitutes a disabling and costly clinical condition. The Multidimensional Inventory of Hypochondriacal Traits (MIHT) represents an innovative instrument that was developed according to cognitive-behavioral, cognitive-perceptual, interpersonal, and trait models of hypochondriasis. We aimed at evaluating the psychometric properties of the MIHT in a sample of patients with the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis of hypochondriasis. Using confirmatory factor analysis (CFA), the postulated four-factor structure of the MIHT was found in a first CFA in patients with hypochondriasis ( n = 178) and in a second CFA based on a mixed sample…

Somatosensory amplification - An old construct from a new perspective.

The paper reviews and summarizes the history and the development of somatosensory amplification, a construct that plays a substantial role in symptom reports. Although the association with negative affect has been supported by empirical findings, another key elements of the original concept (i.e. body hypervigilance and the tendency of focusing on mild body sensations) have never been appropriately addressed. Recent findings indicate that somatosensory amplification is connected with phenomena that do not necessarily include symptoms (e.g. modern health worries, or expectations of symptoms and medication side effects), and also with the perception of external threats. In conclusion, somatos…

Health anxiety and attentional bias: the time course of vigilance and avoidance in light of pictorial illness information.

Cognitive-behavioral models of health anxiety stress the importance of selective attention not only towards internal but also towards external health threat related stimuli. Yet, little is known about the time course of this attentional bias. The current study investigates threat related attentional bias in participants with varying degrees of health anxiety. Attentional bias was assessed using a visual dot-probe task with health-threat and neutral pictures at two exposure durations, 175ms and 500ms. A baseline condition was added to the dot-probe task to dissociate indices of vigilance towards threat and difficulties to disengage from threat. Substantial positive correlations of health anx…

Emotion regulation in patients with somatic symptom and related disorders: A systematic review

BackgroundSomatic symptoms and related disorders (SSD) are prevalent phenomena in the health-care system. Disturbances in emotion regulation (ER) are commonly observed in patients suffering from SSD.ObjectivesThis review aimed to examine ER processes that characterize SSD by a systematic analysis of the available empirical studies.Data sourcesPsycINFO and PubMed databases for the articles published between January 1985 and June 2018.Search terms"emotion/al regulation" or "affect regulation" and various forms of SSD.Study eligibility criteriaEmpirical studies that a) assigned adolescent or adult patients suffering from SSD based on a clinical diagnosis, and b) examined the relationship betwe…

Implicit affective evaluation bias in hypochondriasis: findings from the Affect Misattribution Procedure.

Cognitive theories of hypochondriasis (HYP) suggest that catastrophic misinterpretations of benign body sensations are a core feature for the maintenance of the disorder. There is tentative support from an analog sample that the interpretation of illness-related information also involves an implicit affective component. This is the first study to examine this negative affective evaluation bias implicitly in patients with HYP. An adapted version of the Affect Misattribution Procedure (AMP) with illness, symptom and neutral primes was used in 80 patients with HYP, and compared to 83 patients with an anxiety disorder (AD), as well as 90 healthy controls (CG). The HYP group showed significantly…

Kognitiv-verhaltenstherapeutisches Einzeltherapiekonzept für Patienten mit unerklärten Körperbeschwerden: Grundlagen und Eingangsphase

Das vorliegende Therapiemanual ist modulartig gegliedert. Da die Wirksamkeit des Therapiekonzepts unter Einhaltung der Modulabfolge bzw. des strukturierten Vorgehens nachgewiesen werden konnte (► Kap. 6), empfehlen wir Ihnen, sich moglichst an der vorgeschlagenen Reihenfolge der Therapiebausteine zu orientieren. Das Manual umfasst insgesamt sieben Module (◘ Tab. 4.1), die sich auf 20 Einzeltherapiesitzungen aufgliedern.

Are media warnings about the adverse health effects of modern life self-fulfilling? An experimental study on idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF).

article i nfo Objective: Medically unsubstantiated 'intolerances' to foods, chemicals and environmental toxins are com- mon and are frequently discussed in the media. Idiopathic environmental intolerance attributed to electro- magnetic fields (IEI-EMF) is one such condition and is characterized by symptoms that are attributed to exposure to electromagnetic fields (EMF). In this experiment, we tested whether media reports promote the development of this condition. Methods: Participants (N=147) were randomly assigned to watch a television report about the adverse health effects of WiFi (n=76) or a control film (n=71). After watching their film, participants received a sham exposure to a WiFi …

Psychological models of development of idiopathic environmental intolerances: Evidence from longitudinal population-based data.

Abstract The origin of idiopathic environmental intolerances (IEIs) is an open question. According to the psychological approaches, various top-down factors play a dominant role in the development of IEIs. The general psychopathology model assumes a propensity towards mental ill-health (negative affectivity) increases the probability of developing IEIs. The attribution model emphasizes the importance of mistaken attribution of experienced somatic symptoms; thus, more symptoms should lead to more IEIs. Finally, the nocebo model highlights the role of expectations in the development of IEIs. In this case, worries about the harmful effects of environmental factors are assumed to evoke IEIs. We…

Emotional and Behavioral Consequences of the COVID-19 Pandemic: The Role of Health Anxiety, Intolerance of Uncertainty, and Distress (In)Tolerance.

The COVID-19 pandemic represents a worldwide threat to mental health. To optimize the allocation of health care resources, research on specific vulnerability factors, such as health anxiety, intolerance of uncertainty, and distress (in)tolerance, and particularly their effect on the time course of SARS-CoV-2 related anxiety appears crucial for supporting high risk groups suffering from elevated mental distress during the pandemic. N = 887 participants (78.4% female

Proprioception but not cardiac interoception is related to the rubber hand illusion

The rubber hand illusion (RHI) is a widely used tool in the study of multisensory integration. It develops as the interaction of temporally consistent visual and tactile input, which can overwrite proprioceptive information. Theoretically, the accuracy of proprioception may influence the proneness to the RHI but this has received little research attention to date. Concerning the role of cardioceptive information, the available empirical evidence is equivocal. The current study aimed to test the impact of proprioceptive and cardioceptive input on the RHI. 60 undergraduate students (32 females) completed sensory tasks assessing proprioceptive accuracy with respect to the angle of the elbow jo…

sj-pdf-1-cep-10.1177_0333102420928076 - Supplemental material for Determination of psychosocial factors in cluster headache – construction and psychometric properties of the Cluster Headache Scales (CHS)

Supplemental material, sj-pdf-1-cep-10.1177_0333102420928076 for Determination of psychosocial factors in cluster headache – construction and psychometric properties of the Cluster Headache Scales (CHS) by Timo Klan, Anne-Kathrin Bräscher, Annabella Vales, Eva Liesering-Latta, Michael Witthöft and Charly Gaul in Cephalalgia

Psychological Approaches to Origins and Treatments of Somatoform Disorders

Medically unexplained symptoms are the defining feature of somatoform disorders (SFD) as currently included in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and the International Classification of Diseases, Tenth Edition. Cognitive, behavioral, biological, and social variables are important to our understanding of SFD. Research in the past decade has highlighted the central role of (a) prolonged attention allocation to bodily sensations, (b) the dysfunctional role of catastrophizing symptoms as signs of severe illness, (c) neuroendocrine alterations, and (d) the influence of illness behavior (e.g., the avoidance of physical activity) on the maintenance and chronici…

Improving heartbeat perception in patients with medically unexplained symptoms reduces symptom distress.

Abstract Distortions in interoceptive accuracy have been linked to somatoform disorders. In line with cognitive theories of symptom formation in somatoform disorders, decreases in interoceptive accuracy have recently been observed to co-occur with more severe symptom reports. The current study tested the hypothesis that experimentally increasing interoceptive accuracy should decrease symptom severity in somatoform disorders. Twenty-nine patients with somatoform disorders were instructed in a newly developed heartbeat perception training procedure. Heartbeat perception, as a proxy for interoceptive accuracy, was assessed with a mental tracking task. Although there were no significant differe…

Ein exemplarischer Therapieverlauf

Mithilfe eines Fallbeispiels soll dem Therapeuten verdeutlicht werden, wie die Anwendung des in diesem Manual beschriebenen Einzeltherapiekonzepts in der Praxis aussehen kann. Es werden zunachst Informationen uber die Symptomatik, Krankheitsanamnese und lebensgeschichtliche Entwicklung eines Patienten mit multiplen, chronischen unerklarten Korperbeschwerden vermittelt. Danach wird exemplarisch eine Verhaltensanalyse zum vorliegenden Patientenbeispiel beschrieben. Abschliesend werden die Therapieziele abgeleitet und der Therapieverlauf bzw. das Therapieergebnis geschildert. Elemente dieser Falldarstellung konnen auch als Orientierung fur die Erstellung eines Berichts zum Therapieantrag bei e…

Health anxiety and hypochondriasis in the light of DSM-5.

Background: In the DSM-5, the diagnosis of hypochondriasis was replaced by two new diagnositic entities: somatic symptom disorder (SSD) and illness anxiety disorder (IAD). Both diagnoses share high health anxiety as a common criterion, but additonal somatic symptoms are only required for SSD but not IAD.Design: Our aim was to provide empirical evidence for the validity of these new diagnoses using data from a case–control study of highly health-anxious (n = 96), depressed (n = 52), and healthy (n = 52) individuals.Results: The individuals originally diagnosed as DSM-IV hypochondriasis predominantly met criteria for SSD (74%) and rarely for IAD (26%). Individuals with SSD were more impaired,…

Optimizing Exposure Therapy for Pathological Health Anxiety: Considerations From the Inhibitory Learning Approach

Abstract Exposure therapy has demonstrated its efficacy in the treatment of pathological health anxiety—however, psychotherapy research reveals that many patients do not show a clinically significant change. Therefore, improvements are necessary to optimize psychotherapy for pathological health anxiety. Most treatment rationales refer to habituation during exposure as the central mechanism of change. However, there is evidence that extinction learning is mediated by inhibitory learning processes. Targeting these processes may help to improve treatment outcomes in pathological health anxiety. The aim of this review was to adapt, from the inhibitory learning approach and empirical findings, t…

The role of mental imagery in depression : negative mental imagery induces strong implicit and explicit affect in depression

Mental imagery, seeing with the mind's eyes, can induce stronger positive as well as negative affect compared to verbal processing. Given this emotion-amplifying effect, it appears likely that mental images play an important role in affective disorders. According to the subcomponents model of depression, depressed mood is maintained by both negative imagery (which amplifies negative mood) and less efficient positive imagery processes. Empirical research on the link between mental imagery and affect in clinical depression, however, is still sparse. This study aimed at testing the role of mental imagery in depression, using a modified version of the affect misattribution procedure (AMP) and t…

Pharmacological interventions for somatoform disorders in adults, a Cochrane systematic review

Kognitiv-verhaltenstherapeutisches Einzeltherapiekonzept für Patienten mit unerklärten Körperbeschwerden: Therapeutische Phase

Zu Beginn der Stunde ist es empfehlenswert, dem Patienten einen Schnellhefter fur seine Therapieunterlagen zur Verfugung zu stellen. Im Anschluss wird ein grober Uberblick uber Inhalte und Ablauf der Therapie gegeben. Der Patient erhalt ► Arbeitsblatt 1.1 (Inhalte der Behandlung). Der Therapeut erlautert kurz die einzelnen Stichworte.

Contingent biofeedback outperforms other methods to enhance the accuracy of cardiac interoception: A comparison of short interventions.

Abstract Background and objectives Deviations in interoception might contribute to the development and maintenance of mental disorders. The improvement of interoceptive accuracy (IA) is desirable but assessment and training methods remain controversial. For instance, it was assumed that performance increases in heartbeat counting paradigms after cardiac feedback were due to an improvement of knowledge with regard to heart rate rather than due to an actual improvement in IA. Methods Here, we examined effects of contingent cardiac feedback training, non-contingent cardiac feedback, mindfulness practice, and a waiting period with external attentional focus on IA. 100 healthy participants under…

Behandlungsdiagnosen in universitären Ambulanzen für psychologische Psychotherapie im Jahr 2016

Zusammenfassung. Theoretischer Hintergrund: Im Jahr 2013 entstand die Initiative, Daten der universitären Psychotherapieambulanzen zusammenzuführen, um so eine deutschlandweite Forschungsdatenplattform zu schaffen. Der Forschungsverbund KODAP (Koordination der Datenerhebung und -auswertung an Forschungs-‍, Lehr- und Ausbildungsambulanzen für psychologische Psychotherapie) organisiert dieses komplexe Vorhaben. Fragestellung / Methode: In der vorliegenden Studie wird die technische und organisatorische Machbarkeit einer solchen Forschungskooperation im Hinblick auf die Übermittlung und Zusammenführung der Daten dargestellt. Gleichzeitig wird die im Jahr 2016 in den Ambulanzen behandelte Patie…

Modul 2: Stress und Stressbewältigung (Teil 1)

Aufgrund der haufig eher biomedizinisch gepragten Vorstellungen des Patienten zu den Ursachen seiner Korperbeschwerden bietet sich nach dem Aufbau ausreichender Therapiemotivation der Einstieg mit dem Thema »Stressbewaltigung« an. Viele Patienten erleben den Begriff »Stress« wenig bedrohlich und stigmatisierend. Aus der Alltagssprache sind viele Patienten mit dem Thema »Stress« vertraut. Eine einfuhrende Psychoedukation uber »Stress« erlaubt es, in die Behandlung auf einer biologisch-medizinischen Ebene einzusteigen, die in der Regel naher an den Erklarungen des Patienten fur seine Beschwerden steht. Aufgrund der nach aktuellem wissenschaftlichem Stand zentralen Bedeutsamkeit von Stresserle…

“Symptoms associated with environmental factors” (SAEF) – Towards a paradigm shift regarding “idiopathic environmental intolerance” and related phenomena

Health conditions characterized by symptoms associated with chemical, physical and biological environmental factors unrelated to objectifiable pathophysiological mechanisms are often labelled by the general term “idiopathic environmental intolerances”. More specific, exposure-related terms are also used, e.g. “multiple chemical sensitivities”, “electromagnetic hypersensitivity” and “candidiasis hypersensitivity”. The prevalence of the conditions varies from a few up to more than 50%, depending on definitions and populations. Based on evolving knowledge within this field, we provide arguments for a paradigm shift from terms focusing on exposure and intolerance/(hyper-)sensitivity towards a t…

An Integrative Cognitive Behavioral Therapy Program for Adults With Migraine: A Feasibility Study

Objective To present a novel cognitive behavioral therapy program that was developed exclusively for adults with migraine, and to assess the feasibility of this program. Background Unlike previous efforts, we combined different approaches of behavioral therapy into one program: relaxation therapy, cognitive behavioral therapy, trigger management. Methods The treatment program consists of 7 sessions (including psychoeducation, lifestyle counseling, coping with fear of attacks, trigger management, and stress management). The research was conducted in a single-group study with N = 9 completers (age: M = 41.6, SD = 17.6 years; N = 8 female, N = 1 male; N = 5 migraine without aura, N = 2 migrain…

High blood pressure responders show largest increase in heartbeat perception accuracy after post-learning stress following a cardiac interoceptive learning task

Mental disorders with physical symptoms, e.g. somatic symptom disorder, are characterized by altered interoceptive accuracy (IAc), which can be explained by individual differences in interoceptive learning (IL). We investigated if stress facilitates IL. Seventy-three healthy participants performed a heartbeat counting task (HCT: T1) and a heartbeat perception training (HBPT). After exposure to a socially-evaluated cold pressor stress test (SECPT; n = 48) or a control condition (n = 25), two more HCTs were performed (T2: 30 min after SECPT; T3: 24 h later). After the HBPT, all participants showed an increase in IAc. We separated the stress group into high vs. low systolic blood pressures (SB…

Idiopathic Environmental Intolerance: A Comprehensive Model

Idiopathic environmental intolerance refers to a group of poorly understood health conditions characterized by heterogeneous somatic symptoms that occur in response to environmental triggers, but for which no physiological causes can be found. We focus on three varieties, namely symptoms attributed to (a) chemical substances, (b) electromagnetic fields, and (c) infrasound and vibroacoustic sources. As no clear link with organ pathology or dysfunction has been established so far, we review critical evidence about alternative causal mechanisms as a platform for a novel unifying model of these conditions. There is consistent evidence that expectancy and nocebo mechanisms are critically involve…

Elektronische Tagebücher optimieren die Kognitive Verhaltenstherapie bei Krankheitsängsten : eine randomisiert-kontrollierte Studie

Zentrale Komponenten in kognitiv-behavioralen Erklärungsmodellen der Hypochondrie und den daraus abgeleiteten Behandlungen sind eine selektive Aufmerksamkeitslenkung auf körperliche Empfindungen und ein katastrophisierender Symptominterpretationsbias. Wir untersuchten, ob sich die Effektivität einer störungsspezifischen Kognitiven Verhaltenstherapie (KVT) für Patienten mit Hypochondrie durch ein zusätzliches zweiwöchiges elektronisches Tagebuchtraining (TBT), das auf eine Korrektur der Symptominterpretationen abzielt, verbessern lässt. Zu diesem Zweck wurden 35 Patienten mit Hypochondrie randomisiert zwei Interventionsformen zugewiesen: Gruppe 1 (N = 16) erhielt vor der KVT (16 Einzelsitzu…

Context Effects in the Evaluation of Bodily Symptoms: Comparing Three Versions of the Health Norms Sorting Task

The illness-related evaluation of bodily symptoms is considered to be an important maintaining factor in somatoform disorders. However, little is known about context variables that could influence this evaluation process. In the current study, participants completed three versions of the Health Norms Sorting Task (HNST) and evaluated bodily symptoms in different contexts (i.e., different evaluation perspectives and time frames of evaluation). Additionally, the three HNST versions were presented in different orders. Bodily symptoms were evaluated more often as a sign of illness when a specific time frame (i.e., one week) was given. However, this context effect was only large when participan…

Rejection sensitivity as a vulnerability marker for depressive symptom deterioration in men.

Consistent across time and cultures, men and male adolescents older than 14 years of age appear underrepresented in mood disorders, and are far less likely than women to seek psychological help. The much higher rate of suicide amongst males suggests that depression in men might be underreported. One of the core human motives is to seek acceptance by others and avoid rejection. Rejection Sensitivity (RS) has been conceptualized as the cognitive-affective processing disposition to anxiously expect, readily perceive, and intensely respond to cues of rejection in the behavior of others. RS has been previously linked with the onset and course of depression, but - as yet - has not been investigat…

Somatic Symptom Perception From a Predictive Processing Perspective: An Empirical Test Using the Thermal Grill Illusion.

OBJECTIVE In a predictive processing perspective, symptom perceptions result from an integration of preexisting information in memory with sensory input. Physical symptoms can therefore reflect the relative predominance of either sensory input or preexisting information. In this study, we used the thermal grill illusion (TGI), which applies interlaced warm and cool temperatures to the skin to create a paradoxical heat-pain experience. Assuming that the TGI compared with single-temperature stimulation relies more importantly on an active integration process of the brain to create this paradoxical sensation, we tested the hypothesis whether a manipulation of the expectations during TGI would …

Exkurs-Modul: Kommunikation im Alltag und mit dem Arzt

Schwierigkeiten in der Kommunikation in verschiedenen Lebensbereichen stellen bei einer Subgruppe von Patienten mit somatoformen Beschwerden ein wichtiges Problem dar. Sie konnen u. a. in der Beziehung zu Angehorigen, zu Freunden, zum (Ehe-)Partner oder zum Arzt auftreten. Diese Kommunikationsprobleme konnen mit der Entwicklung negativer Emotionen wie z. B. Frustration, Arger oder Enttauschung beim Patienten sowie seinem Umfeld einhergehen, die wiederum zur Aufrechterhaltung der korperlichen und begleitenden Beschwerden beitragen konnen. Es ist wissenschaftlich bewiesen, dass storungsubergreifend 40 % der Varianz im Therapieerfolg durch extratherapeutische Faktoren, einschlieslich der sozia…

Body image avoidance affects interpersonal distance perception: A virtual environment experiment.

OBJECTIVE Eating disorders have a considerable influence on social contacts. The avoidance towards the own body may result in the avoidance of others. Previous research has found a preference for larger interaction distances in individuals with eating disorders (ED) as compared to control participants (CG). We aimed to replicate these findings and to investigate whether the body weight of the interactant moderates the effect. METHOD We recruited a female sample with mixed ED subtypes (n = 21) and a female CG (n = 28). Participants were immersed in a virtual environment and engaged in a number of fictitious social interactions. They approached a virtual person until a comfortable distance fo…

On the origin of worries about modern health hazards: Experimental evidence for a conjoint influence of media reports and personality traits

Objective: Worries about health threatening effects of potential health hazards of modern life (e.g. electric devices and pollution) represent a growing phenomenon in Western countries. Yet, little is known about the causes of this growing special case of affective risk perceptions termed Modern Health Worries (MHW). The purpose of this study is to examine a possible role of biased media reports in the formation of MHW. Design: In two experiments, we investigated whether typical television reports affect MHW. In Study 1, 130 participants were randomly assigned to a film on idiopathic environmental intolerance (IEI) or a control film about cystic fibrosis. In Study 2, 82 participants were ra…

The widening of the gaze cone in patients with social anxiety disorder and its normalization after CBT

Gaze plays a crucial role in social interactions. Social Anxiety Disorder (SAD), which is associated with severe impairment of social interactions, is thus likely to exhibit disturbances of gaze perception. We conducted two experiments with SAD-patients and healthy control participants using a virtual head whose gaze could be interactively manipulated. We determined the subjective area of mutual gaze, the so-called gaze cone, and measured it prior to and after a psychotherapeutic intervention (Exp. 1). Patients exhibited larger gaze cones than control subjects. Exp. 2 varied the emotional expression of the virtual head. These data were validated using a real person (professional actor) as s…

A multidimensional approach to the reporting of somatic symptoms: The Somatic Symptom Questionnaire Five (SSQ-5G)

The latent structure of the functional dyspepsia symptom complex: A taxometric analysis

OBJECTIVES: Rome III introduced a subdivision of functional dyspepsia (FD) into postprandial distress syndrome and epigastric pain syndrome, characterized by early satiation/postprandial fullness, and epigastric pain/burning, respectively. However, evidence on their degree of overlap is mixed. We aimed to investigate the latent structure of FD to test whether distinguishable symptom-based subgroups exist. METHODS: Consecutive tertiary care Rome II FD patients completed the dyspepsia symptom severity scale. Confirmatory factor analysis (CFA) was used to compare the fit of a single factor model, a correlated three-factor model based on Rome III subgroups and a bifactor model consisting of a g…

The implicit health-related self-concept in somatoform disorders.

Abstract Background and objective Dual-process theories stress the importance of explicit as well as implicit cognitive processes for the development of somatoform disorders (SFDs). 1 In particular, the self-concept has been demonstrated to be a key factor in SFD. Yet, the self-concept in SFDs has been studied only on an explicit but not on an implicit level. Methods The present study empirically examined the implicit health-related self-concept in SFDs by using the Implicit Association Test (IAT). Twenty-two patients with SFDs (according to DSM-IV) and 27 healthy control participants (CG) completed an IAT to assess associations of the self with illness- versus health-related words. Results…

Somatic Symptom Perception and Interoception

Abstract. Models of chronic somatic symptoms assume that abnormalities in interoception are related to the development and maintenance of symptom distress. Different models, however, disagree on the exact nature of the assumed abnormality: cognitive-behavioral models stress a hypervigilant cognitive style (predicting higher interoceptive accuracy) whereas predictive processing models assume a less detailed sensory processing (predicting lower interoceptive accuracy). This study aimed at testing the relationship between interoception and symptom perception. Using structural equation modeling, associations between cardiac interoception and symptom perception were tested in a sample of studen…

Modul 5: Krankheitsverhalten

Nach dem funktionalen Modell somatoformer Storungen spielt Krankheitsverhalten vor allem bei der Aufrechterhaltung von Korperbeschwerden eine wichtige Rolle. Krankheitsverhaltensweisen konnen bei somatoformen Patienten extrem vielfaltig und subtil sein. Zugleich sind somatoforme Patienten hinsichtlich ihres Krankheitsverhaltens sehr heterogen – nicht zwangslaufig mussen alle bekannten dysfunktionalen Verhaltensweisen bei allen Patienten vorhanden sein. In den vier Sitzungen des funften Moduls legen wir den Schwerpunkt auf diejenigen Krankheitsverhaltensweisen, die am haufigsten bei somatoformen Patienten nachgewiesen sind. Die vier Sitzungen fokussieren auf Vermeidungs- und Schonungsverhalt…

Nocebo hyperalgesia induced by implicit conditioning.

abstract Background and objectives Nocebo hyperalgesia (i.e., increased pain sensitivity based on expectations) can be induced by conditioning, but is supposed to be mediated by conscious expectation. Although recent evidence points to the feasibility of subliminal conditioning of nocebo hyperalgesia with masked faces, face processing might be a special case and the practical implications of subliminal conditioning remain questionable. This study aimed to implicitly condition nocebo hyperalgesia using supraliminal cues. Methods Implicit differential nocebo conditioning (N = 48 healthy participants) was implemented by coupling high and low painful electric stimuli to varying visual stimuli t…

Reduction of depressive symptoms during inpatient treatment is not associated with changes in heart rate variability

Vagally mediated heart rate variability (HRV) is a psychophysiological indicator of mental and physical health. Limited research suggests there is reduced vagal activity and resulting lower HRV in patients with Major Depressive Disorder (MDD); however little is actually known about the association between HRV and symptoms of depression and whether the association mirrors symptom improvement following psychotherapy. The aim of this study was to investigate the association between antidepressant therapy, symptom change and HRV in 50 inpatients (68% females; 17–68 years) with a diagnosis of MDD. Severity of depressive symptoms was assessed by self-report (Beck Depression Inventory II) and the …

The role of therapist and patient in-session behavior for treatment outcome in exposure-based cognitive behavioral therapy for panic disorder with agoraphobia.

Objective There is a very limited amount of research on the relationship between therapist and patient in-session behavior and treatment outcome in cognitive behavioral therapy (CBT) for panic disorder with agoraphobia (PD/AG). Additionally, the findings tend to be inconclusive. This study investigates the association between therapist competence, adherence, patient interpersonal behavior, and therapeutic alliance and outcome in a low-control CBT setting by using comprehensive measures. Methods Twenty-six patients with PD/AG received 12 sessions of exposure-based CBT. With regard to the outcome, treatments were classified either as problematic or nonproblematic by means of distinct criteria…

Modul 4: Bewertungsprozesse

Nach dem funktionalen Modell somatoformer Storungen spielen Bewertungen und Gedanken der Patienten zu ihren korperlichen Beschwerden eine zentrale Rolle in der Entwicklung und Aufrechterhaltung der Symptome. In der Regel benotigt die Arbeit an Kognitionen viel Zeit und ist mit 5 Sitzungen im vorliegenden Modul eher knapp bemessen. Mithilfe eines Verhaltensexperiments und Strategien des geleiteten Entdeckens werden die Patienten zunachst mit der Rolle von Gedanken bez. ihrer Korperbeschwerden vertraut gemacht und in das ABC-Schema eingefuhrt. In der zweiten Sitzung des Moduls ist die Exploration der individuellen, wenig hilfreichen Gedanken des Patienten vordergrundig. In der dritten und vie…

Pharmacological interventions for somatoform disorders in adults

BACKGROUND: Somatoform disorders are characterised by chronic, medically unexplained physical symptoms (MUPS). Although different medications are part of treatment routines for people with somatoform disorders in clinics and private practices, there exists no systematic review or meta-analysis on the efficacy and tolerability of these medications. We aimed to synthesise to improve optimal treatment decisions.OBJECTIVES: To assess the effects of pharmacological interventions for somatoform disorders (specifically somatisation disorder, undifferentiated somatoform disorder, somatoform autonomic dysfunction, and pain disorder) in adults.SEARCH METHODS: We searched the Cochrane Depression, Anxi…

Modul 6: Stress und Stressbewältigung (Teil 2)

Das Thema Stress und Stressbewaltigung wurde bereits im sechsten Kapitel behandelt und wird nun im Therapieverlauf wieder aufgegriffen. Im zweiten Teil der Stressbewaltigung steht die Rolle von Gedanken im Zusammenhang mit Stresserleben im Vordergrund. Dementsprechend wird der Patient uber Strategien des geleiteten Entdeckens in der ersten Sitzung dieses Moduls in die Rolle von der Bewertung des Stressors und eigener Kapazitat zur Stressbewaltigung eingefuhrt. Verschiedene Formen des Umgangs mit Stress werden abgeleitet und individuelle Stressoren in der zweiten Sitzung exploriert. Die dritte Sitzung des sechsten Moduls widmet sich ubergeordneten kognitiven Schemata, die Stresserleben verst…

Störungstheorien, Modelle und Konzepte unerklärter Körperbeschwerden und somatoformer Störungen

Im Folgenden werden die wichtigsten derzeit bekannten Ansatze zur Erklarung der Entstehung und Aufrechterhaltung somatoformer Beschwerden und Storungen skizziert. Die Kenntnis zentraler Entstehungsmechanismen erscheint hierbei nicht nur aus theoretischer Perspektive interessant, sondern stellt eine zentrale Voraussetzung dar, in der therapeutischen Arbeit mit Patienten sukzessive differenzierte (z. B. kognitionspsychologisch und psychobiologisch fundierte) Modelle als Alternativen zu einem meist monokausalen organischen Krankheitsmodell erarbeiten und vermitteln zu konnen.

Benchmarking of cognitive-behavioral therapy for depression in efficacy and effectiveness studies--how do exclusion criteria affect treatment outcome?

Abstract Objective: Little is known about how exclusion criteria applied in randomized controlled trials (RCTs) affect the transfer of psychotherapy outcome research to naturalistic settings. This study evaluated the effects of naturalistic depression therapies and benchmarked them with published RCTs. Method: Commonly used exclusion criteria were applied to n=338 depressive patients receiving cognitive-behavioral therapy. Outcomes of the resulting subsample eligible for RCTs were compared to those reported in RCTs. Results: Treatment outcomes of the total sample (d=1.16) and the subsample eligible for RCTs (d=1.15) were highly similar. Therapy outcome was worse than in high-quality RCTs (d…

Emotion dysregulation in hypochondriasis and depression

Background The aim of this study was to explore whether certain aspects of emotion dysregulation (i.e., facets of alexithymia and rumination) are more closely linked to hypochondriasis than to depression and vice versa. Methods Nineteen patients with hypochondriasis (HYP), 33 patients with depression, and 52 healthy control participants completed the Toronto Alexithymia Scale, the Response Styles Questionnaire, and additional symptom and illness behaviour scales. A clinical interview was used to establish DSM-IV diagnoses and to exclude all cases with more than one axis I diagnosis. Results Depression patients reported more difficulties describing feelings and more symptom- and self-focused…

Modul 3: Aufmerksamkeit

Aufmerksamkeitsprozesse spielen in der Entstehung und Aufrechterhaltung somatoformer Beschwerden eine zentrale Rolle. Mithilfe von Verhaltensexperimenten und Metaphern werden dem Patienten im Rahmen der ersten beiden Sitzungen dieses Moduls die Funktion unseres Aufmerksamkeitssystems und die Wirkweise von Aufmerksamkeitslenkung und deren Einfluss auf korperliche Wahrnehmungen verdeutlicht. Geleitetes Entdecken spielt in diesen Sitzungen eine besonders wichtige Rolle. Das Modul wird mit einer dritten Sitzung zur Erarbeitung von individuellen Ablenkungsstrategien abgerundet. In diesem Kontext bietet es sich an, besonders ressourcenorientiert zu arbeiten und das Konzept von »Genuss und Genusss…

The affective response to health-related information and its relationship to health anxiety: An ambulatory approach

Affective reactions to health-related information play a central role in health anxiety. Therefore, using ambulatory assessment, we analysed the time course of negative affect in a control group (CG, n = 60) which only rated their negative affect and an experimental group (EG, n = 97) which also rated the presence of somatic symptoms (e.g., back pain). By means of mixed regression models, we observed a decline of negative affect following the symptom self-ratings in the EG and a stable affect in the CG. The decline of negative affect was not moderated by the degree of health anxiety. Our findings might indicate that evaluating one's health status leads to a general reduction of negative aff…

Interpersonal Emotion Dynamics in Couples With Somatic Symptom Disorder: Dyadic Coherence in Facial Temperature During Emotional Interactions

OBJECTIVE: Disturbances in emotional processes are commonly reported in patients with a somatic symptom disorder (SSD). Although emotions usually occur in social interactions, little is known about interpersonal emotion dynamics of SSD patients during their actual emotional encounters. This study examined physiological coherence (linkage) between SSD patients and their partners, and in healthy couples during their emotional interactions. Secondarily, we explored group-level relationships between participants' and their partners' subjective affect. METHODS: Twenty-nine romantic couples (16 healthy and 13 SSD patient-couples) underwent a dyadic conversation task with neutral and anger-eliciti…

Determination of psychosocial factors in cluster headache - construction and psychometric properties of the Cluster Headache Scales (CHS).

Background Cluster headache (CH) is clinically associated with considerable psychosocial burden. However, instruments to assess and characterize psychosocial factors in cluster headache more specifically are lacking. This study aimed to develop a self-report questionnaire, which assesses the broadest possible spectrum of psychosocial factors in cluster headache, the Cluster Headache Scales (CHS). Method Items of the Cluster Headache Scales were constructed based on a literature review and semi-structured interviews with several experts (including persons with cluster headache). A cross-sectional online survey was conducted to determine the psychometric properties and the factor structure of…

HiTOP Assessment of the Somatoform Spectrum and Eating Disorders

We report on Phase 1 efforts of the Hierarchical Taxonomy of Psychopathology (HiTOP) measurement subgroup tasked with developing provisional scales for the somatoform spectrum and eating disorders. In Study 1, items were written to assess five somatoform spectrum constructs (bodily distress symptoms, conversion symptoms, health anxiety, disease conviction, and somatic preoccupation). Scale development analyses were conducted on 550 university students. The conversion symptom items were too infrequently endorsed and were set aside for Phase 2. Analyses of the other items yielded four scales corresponding closely to their hypothesized structure. In Study 2, we delineated 15 specific feeding a…

Modul 7: Störungsmodell

Zunachst mag es ungewohnlich erscheinen, dass ein kognitiv-verhaltenstherapeutisches Behandlungskonzept mit einem Storungsmodell abgeschlossen und nicht eingefuhrt wird. Insbesondere fur Patienten, die zu Beginn der Behandlung stark ausgepragte somatomedizinische Annahmen zu ihren Korperbeschwerden aufweisen, kann es uberfordernd sein, wenn Sie mit einem biopsychosozialen Behandlungsmodell konfrontiert werden. Die Module des vorliegenden Behandlungsansatzes sind so aufgebaut, dass sie immer mit psychoedukativen Abschnitten eingeleitet werden, sodass dem Patienten das Storungsmodell uber den Therapieverlauf Schritt fur Schritt vermittelt wird. Das zusammenfassende Storungsmodell in der letzt…

Modern health worries: A systematic review.

Modern health worries (MHWs) refer to people's concerns about possible harmful effects of modern technologies, and are widespread in the developed countries. The aim of the present work was to provide comprehensive, yet integrated understanding for MHWs and associated factors.Following the PRISMA guideline, a systematic review was conducted based on 48 empirical articles published between 2001 and 2018 (Prospero registration number: CRD42018103756). All empirical studies were included that (1) were published between 2001 and 2018 in peer-reviewed scientific journals in English, German, or Hungarian, (2) used the Modern Health Worries Scale or any of its sub-scales, and (3) assessed associat…

Tactile perceptual processes and their relationship to medically unexplained symptoms and health anxiety

Abstract Objective The Somatic Signal Detection Task (SSDT; Lloyd, Manson, Brown and Poliakoff, 2008) is an innovative paradigm to study perceptual processes related to physical symptoms. It allows examining touch illusions as a laboratory analog of medically unexplained symptoms (MUS) according to the cognitive model of MUS proposed by Brown (2004). The present study compared psychopathologic measures of MUS and health anxiety with SSDT parameters. Furthermore, we aimed to define a reliable measurement of tactile perception threshold. Methods 67 participants of a student population reported whether they detected tactile stimuli at their fingertip which were presented in half of the test tr…

Therapieansätze für unerklärte Körperbeschwerden und somatoforme Störungen

Bis Patienten mit medizinisch unerklarten Korperbeschwerden eine psychotherapeutische Behandlung aufsuchen, haben sie in der Regel bereits eine lange Behandlungsvorgeschichte hinter sich, die haufig von widerspruchlichen Informationen zu Diagnostik und Interventionsansatzen gepragt ist. Es ist deshalb nicht verwunderlich, dass Patienten mit somatoformen Storungen im ersten Kontakt mit einem Psychotherapeuten haufig sehr verunsichert sind. Damit die psychotherapeutischen Therapeuten und Arzte die Patienten angemessen beraten konnen, ist ein fundiertes Wissen uber psychologische wie auch psychopharmakologische Behandlungsansatze und ihre Wirksamkeit von groser Bedeutung. Orientiert am aktuell…

sj-pdf-2-cep-10.1177_0333102420928076 - Supplemental material for Determination of psychosocial factors in cluster headache – construction and psychometric properties of the Cluster Headache Scales (CHS)

Supplemental material, sj-pdf-2-cep-10.1177_0333102420928076 for Determination of psychosocial factors in cluster headache – construction and psychometric properties of the Cluster Headache Scales (CHS) by Timo Klan, Anne-Kathrin Bräscher, Annabella Vales, Eva Liesering-Latta, Michael Witthöft and Charly Gaul in Cephalalgia

Network Analysis of Persistent Somatic Symptoms in Two Clinical Patient Samples

OBJECTIVE Previous attempts to group persistent somatic symptoms (PSS) with factor-analytic approaches have obtained heterogeneous results. An alternative approach that seems to be more suitable is the network theory. Compared to factor analysis, which focuses on the underlying factor of symptoms, network analysis focuses on the dynamic relationships and interactions among different symptoms. The main aim of this study is to apply the network approach to examine the heterogeneous structure of PSS within two clinical samples. METHODS The first dataset consisted of N = 254 outpatients who were part of a multicentre study. The second dataset included N = 574 inpatients, both with somatoform di…

The interplay of interoceptive accuracy, facets of interoceptive sensibility, and trait anxiety: A network analysis

Abstract Interoception is the sense of the body's physiological state. Both the ability to accurately perceive bodily signals, and the self-reported sensibility for the body were assumed to be reciprocally associated with negative affect. Up to now, the specific interplay between dimensions of interoception and negative affect remains largely unknown. We investigated the interplay of cardioceptive accuracy assessed by a heartbeat tracking task, facets of interoceptive sensibility as measured by the Multidimensional Assessment of Interoceptive Awareness, and trait anxiety as measured by the trait version of the State-Trait-Anxiety inventory across two studies (n = 243) using a network analyt…

The relations between social anxiety and social intelligence: A latent variable analysis

Social anxiety has been associated with biases in cognitive processing and deficits in social performances. Yet, it remains unclear if these variations may be partly attributable to deficits in fundamental social abilities: for example, social intelligence (SI). Using the Magdeburg Test of Social Intelligence (MTSI) as an objective and performance based SI measure, we examined the relationship between social anxiety and SI in a general population sample (N=110) using Structural Equation Modeling. Dimensions of social anxiety as postulated by Clark and Wells (1995) and facets of SI (social understanding, social memory, and social perception), were negatively correlated. Use of safety-behavio…

Emotional interference and attentional processing in premenstrual syndrome

Abstract Background and objectives Premenstrual syndrome (PMS) is characterized by menstrual cycle-related affective, behavioral, and/or somatic symptoms. By applying the emotional Stroop task (EST) the current study examined if changes in processing emotional information, which have been demonstrated in affective disorders, are also present in PMS. Methods Via online screening, telephone interviews, and daily records over two months 55 women for the PMS group (on the basis of the specific inclusion criteria and a prospectively confirmed PMS) and 55 ‘non-PMS’ controls were recruited. All participants completed three emotional Stroop tasks (EST) with neutral and negative word, picture, and f…

Jungmann_Open_Practices_Disclosure – Supplemental material for Do Dr. Google and Health Apps Have (Comparable) Side Effects? An Experimental Study

Supplemental material, Jungmann_Open_Practices_Disclosure for Do Dr. Google and Health Apps Have (Comparable) Side Effects? An Experimental Study by Stefanie M. Jungmann, Sebastian Brand, Johanna Kolb and Michael Witthöft in Clinical Psychological Science

Cognitive and emotional variables predicting treatment outcome of cognitive behavior therapies for patients with medically unexplained symptoms: A meta-analysis.

Cognitive behavior therapy (CBT) is the best-evaluated psychological approach to treat patients with medically unexplained symptoms (MUS). We still need a better understanding of what characterizes patients with MUS who benefit more or less from CBT. This systematic review aimed to identify patients' cognitive-emotional characteristics predicting the outcome of CBT for MUS.A systematic literature search (PubMed, PsycINFO, Web of Science) revealed 37 eligible studies, 23 of these provided data for meta-analyses. Mean correlation coefficients between predictor variables and the outcomes (symptom intensity, physical or social-emotional functioning) were calculated using a random-effects model.…

Assessment of Counseling Self-Efficacy: Validation of the German Counselor Activity Self-Efficacy Scales-Revised.

Background: Many authors regard counseling self-efficacy (CSE) as important in therapist development and training. The purpose of this study was to examine the factor structure, reliability, and validity of the German version of the Counselor Activity Self-Efficacy Scales-Revised (CASES-R). Method: The sample consisted of 670 German psychotherapy trainees, who completed an online survey. We examined the factor structure by applying exploratory and confirmatory factor analysis to the instrument as a whole. Results: A bifactor-exploratory structural equation modeling model with one general and five specific factors provided the best fit to the data. Omega hierarchical coefficients indicated o…

Early Adverse Effects of Behavioural Preventive Strategies During the COVID-19 Pandemic in Germany: An Online General Population Survey

Background Quarantine and physical distancing represent the two most important non-pharmaceutical actions to contain the COVID-19 pandemic. Comparatively little is known about possible adverse consequences of these behavioural measures in Germany. This study aimed at investigating potential early adverse effects associated with quarantine and physical distancing at the beginning of the countrywide lockdown in Germany in March 2020. Method Using a cross-sectional online survey (N = 4,268), adverse consequences attributed to physical distancing, symptoms of psychopathology, and sociodemographic variables were explored in the total sample as well as in high-risk groups (i.e., people with a ph…

Neuronal and Behavioral Correlates of Health Anxiety: Results of an Illness-Related Emotional Stroop Task

<b><i>Background:</i></b> Health anxiety (HA) is defined as the objectively unfounded fear or conviction of suffering from a severe illness. Predominant attention allocation to illness-related information is regarded as a central process in the development and maintenance of HA, yet little is known about the neuronal correlates of this attentional bias. <b><i>Methods:</i></b> An emotional Stroop task with body symptom, illness, and neutral words was employed to elicit emotional interference in healthy participants with high (HA+, n = 12) and low (HA–, n = 12) HA during functional magnetic resonance imaging. <b><i>Results:</i>…

Grundlagen der kognitiven Verhaltenstherapie

Verhaltenstherapie hat sich als eigener Forschungs- und Praxisbereich historisch seit ca. 1950 kontinuierlich entwickelt. Dies geschah in etwa zeitgleich in den USA, in England und in Sudafrika, aber mit unterschiedlichen Schwerpunktsetzungen. In den USA wurden verhaltenstherapeutische Interventionen bevorzugt als praktische Anwendung der Gesetzmasigkeiten des operanten Lernens entwickelt. Aus dieser Zeit stammt der wichtige Ansatz der funktionalen Analyse von problematischem Verhalten hinsichtlich seiner Kontrolle durch vorausgehende und nachfolgende Bedingungen. Funktionale Analysen lieferten die Basis fur erfolgreiche Interventionen bei einer Vielzahl von Verhaltensstorungen, z. B. Stott…

Emotionserleben und somatische Beschwerden

Zusammenfassung. Theoretischer Hintergrund: Aktuelle Modelle der Wahrnehmung körperlicher Beschwerden gehen davon aus, dass negative emotionale Zustände (z. B. Angst und Traurigkeit) eine zentrale Rolle bei der Symptomwahrnehmung spielen. Eine kausale Wirkung von Ärger auf den körperlichen Symptombericht wurde hingegen noch nicht ausreichend nachgewiesen. Fragestellung: Führt eine experimentelle Induktion von Ärger und Traurigkeit zu einem verstärkten Bericht körperlicher Beschwerden? Methode: 90 Studienteilnehmende wurden zufällig drei experimentellen Bedingungen zugewiesen. Mit einer autobiografischen Methodik wurden Ärger (n = 30) und Traurigkeit (n = 30) induziert. Eine dritte Gruppe (…

Cognitive emotion regulation and psychopathology across cultures: A comparison between six European countries

Abstract Use of cognitive emotion regulation strategies in response to stressful life events varies by country, though research has been limited to comparisons between American and Asian cultures. This study aimed to compare six European countries to investigate cross-cultural differences in the use of cognitive strategies and test if the relationship between specific strategies and psychopathology varies across countries. Data arrays were collected from the Netherlands, Hungary, Spain, Italy, Portugal and Germany (N = 1553) and cross-cultural measures of cognitive emotion regulation using the Cognitive Emotion Regulation Questionnaire (CERQ) were included. Measures of depression and anxiet…

Fear of hypoglycemia in patients with type 2 diabetes: The role of interoceptive accuracy and prior episodes of hypoglycemia.

Abstract Objective Fear of hypoglycemia (FoH) is a limiting factor for diabetes self-management and can have detrimental effects on quality of life. However, relatively little is known about its underlying mechanisms. In line with findings on patients with anxiety disorders, we hypothesized that interoceptive accuracy (IA) might be positively linked to FoH in patients with type 2 diabetes (T2DM). Methods 133 patients with T2DM were screened according to the extreme quartiles of the Hypoglycemia Fear Survey worry subscale (HFS-W). Overall, 66 participants (HFS-W   17) were included in the present study. Participants completed questionnaires on sociodemographic and diabetes-related measures. …

Validation of the Hungarian PHQ-15. A latent variable approach

Somatic symptoms without a clear-cut organic or biomedical background, also called "medically unexplained" or "somatoform" symptoms, are frequent in primary and secondary health care. They are often accompanied by depression and/or anxiety, and cause functional impairment. The Patient Health Question-naire Somatic Symptom Scale (PHQ-15) was developed to measure somatic symptom distress based on the frequency and bothersomeness of non-specific somatic symptoms. The study aimed to (1) evaluate the Hungarian version of the PHQ-15 from a psychometric point of view; (2) replicate the bifactor structure and associations with negative affect described in the literature; and (3) provide the Hungari…

sj-pdf-1-asm-10.1177_10731911211020825 – Supplemental material for HiTOP Assessment of the Somatoform Spectrum and Eating Disorders

Supplemental material, sj-pdf-1-asm-10.1177_10731911211020825 for HiTOP Assessment of the Somatoform Spectrum and Eating Disorders by Martin Sellbom, Kelsie T. Forbush, Sara R. Gould, Kristian E. Markon, David Watson and Michael Witthöft in Assessment

The Underestimated Significance of Conditioning in Placebo Hypoalgesia and Nocebo Hyperalgesia

Placebo and nocebo effects are intriguing phenomena in pain perception with important implications for clinical research and practice because they can alleviate or increase pain. According to current theoretical accounts, these effects can be shaped by verbal suggestions, social observational learning, and classical conditioning and are necessarily mediated by explicit expectation. In this review, we focus on the contribution of conditioning in the induction of placebo hypoalgesia and nocebo hyperalgesia and present accumulating evidence that conditioning independent from explicit expectation can cause these effects. Especially studies using subliminal stimulus presentation and implicit con…

Body-related attentional biases in patients with posttraumatic stress disorder resulting from childhood sexual abuse with and without co-occurring borderline personality disorder.

Abstract Background and objectives Disturbed body perception is a common characteristic of patients with posttraumatic stress disorder (PTSD) after childhood sexual abuse (CSA). We examined the extent to which biased information processing of body related stimuli was related to CSA. Methods Patients with PTSD after CSA (PTSD group; n = 61) were compared to healthy controls (HC group; n = 30). The PTSD group was subdivided into patients with comorbid Borderline Personality Disorder (BPD; PTSD+ group) and patients without BPD (PTSD-group). We used an emotional Stroop task (EST) with body-related words to assess biased information processing. Results Only patients in the PTSD+ group but not in…

sj-pdf-2-cep-10.1177_0333102420928076 - Supplemental material for Determination of psychosocial factors in cluster headache – construction and psychometric properties of the Cluster Headache Scales (CHS)

Supplemental material, sj-pdf-2-cep-10.1177_0333102420928076 for Determination of psychosocial factors in cluster headache – construction and psychometric properties of the Cluster Headache Scales (CHS) by Timo Klan, Anne-Kathrin Bräscher, Annabella Vales, Eva Liesering-Latta, Michael Witthöft and Charly Gaul in Cephalalgia

sj-pdf-2-cep-10.1177_0333102420928076 - Supplemental material for Determination of psychosocial factors in cluster headache – construction and psychometric properties of the Cluster Headache Scales (CHS)

Supplemental material, sj-pdf-2-cep-10.1177_0333102420928076 for Determination of psychosocial factors in cluster headache – construction and psychometric properties of the Cluster Headache Scales (CHS) by Timo Klan, Anne-Kathrin Bräscher, Annabella Vales, Eva Liesering-Latta, Michael Witthöft and Charly Gaul in Cephalalgia

The cortisol awakening response at admission to hospital predicts depression severity after discharge in MDD patients.

Major Depressive Disorder (MDD) is associated with hypothalamic-pituitary-adrenal axis (HPA) dysregulation and altered cortisol awakening response (CAR), a non-invasive biomarker for HPA axis reactivity. We theorized that the CAR resembles the accumulated effects of depression over time, and may therefore predict depressive symptom severity once patients return home following inpatient treatment. Two studies are reported. In Study 1 (n = 101; 57% female), the CAR was measured at intake and self-ratings of depression severity was assessed six weeks following discharge. Study 2 (n = 127; 58% female) was a replication and extension of Study 1 where a follow-up assessment of self-rated depressi…

Conceptualizations of Cyberchondria and Relations to the Anxiety Spectrum: Systematic Review and Meta-analysis

Background Cyberchondria describes the detrimental effects of health-related internet use. Current conceptualizations agree that cyberchondria is associated with anxiety-related pathologies and may best be conceptualized as a safety behavior; however, little is known about its exact underlying mechanisms. Objective This systematic review and meta-analysis aims to give an overview of the conceptualizations of cyberchondria and its relation to anxiety-related pathologies, quantify the strength of association to health anxiety by using meta-analyses, highlight gaps in the literature, and outline a hypothetical integrative cognitive-behavioral model of cyberchondria based on the available empi…

Evaluation des Einzeltherapiekonzepts

In diesem Kapitel werden die ersten Ergebnisse zur Wirksamkeit des in ► Kap. 4 und 5 dargestellten kognitiv-verhaltenstherapeutischen Behandlungskonzepts vorgestellt. Die Befunde basieren auf einer Stichprobe von Patienten mit multiplen unerklarten Korperbeschwerden, die in der Poliklinischen Institutsambulanz fur Psychotherapie der Johannes Gutenberg-Universitat Mainz entsprechend dem beschriebenen manualisierten Vorgehen behandelt wurden.

Self-Reported Cognitive Failures

Investigated measurement models of self-report measures of cognitive failures in 5 studies (total of 3,122 participants aged 14-70). The Cognitive Failure Questionnaire (CFQ) is a well-known and frequently used self-report measure of cognitive lapses and slips (e.g., throwing away the candy bar and keeping the wrapper). Measurement models of individual differences in cognitive failures have failed to produce consistent results so far. Therefore, in the present studies, the CFQ is compared to measures of competing measurement models: a measure of identical measurement intention (Short Inventory of Minor Lapses, SIML), a neuroticism test, a questionnaire on functional and dysfunctional self-c…

Matching research and practice: Prediction of individual patient progress and dropout risk for basic routine outcome monitoring.

OBJECTIVE Despite evidence showing that systematic outcome monitoring can prevent treatment failure, the practical conditions that allow for implementation are seldom met in naturalistic psychological services. In the context of limited time and resources, session-by-session evaluation is rare in most clinical settings. This study aimed to validate innovative prediction methods for individual treatment progress and dropout risk based on basic outcome monitoring. METHODS Routine data of a naturalistic psychotherapy outpatient sample were analyzed (N = 3902). Patients were treated with cognitive behavioral therapy with up to 95 sessions (M = 39.19, SD = 16.99) and assessment intervals of 5-15…

Erfolgreiche Supervision in der Psychotherapieausbildung

Zusammenfassung. Theoretischer Hintergrund: Supervision fand als Forschungsgegenstand in der Kognitiven Verhaltenstherapie vergleichsweise wenig Beachtung. Fragestellung: Ziel der explorativen Studie war es, Voraussetzungen und Auswirkungen erfolgreicher Supervision zu erheben. Methode: Elf Supervisor_innen und zehn Supervisand_innen des Weiterbildungsstudiengangs Psychologische Psychotherapie (Verhaltenstherapie) wurden mittels halbstrukturierter Leitfadeninterviews befragt. Die Auswertung erfolgte anhand der qualitativen Inhaltsanalyse nach Mayring. Ergebnisse: Es wurden Personenmerkmale (z. B. Kritikfähigkeit, Offenheit, Strukturiertheit), eine tragfähige Supervisionsbeziehung (z. B. ve…

Changes in negative implicit evaluations in patients of hypochondriasis after treatment with cognitive therapy or exposure therapy

Abstract Background and Objectives Previous studies using modified versions of the Affect Misattribution Procedure (AMP; Payne, Cheng, Govorun, & Stewart, 2005) have revealed that there is an implicit negative evaluation bias of illness-related information in patients with hypochondriasis (HYP), which might be a maintaining feature of HYP. However, there is no evidence on whether this bias might be targeted successfully by effective treatments, such as exposure therapy (ET) or cognitive therapy (CT). This is the first study to examine the change in negative implicit evaluations in a randomized controlled trial, including individual CT and ET, compared to a wait-list control group for HYP. M…

No evidence for interactions between modern health worries, negative affect, and somatic symptom distress in general populations

Three theoretically grounded hypotheses were tested that predict interactions between modern health worries (MHWs), somatic symptom distress, and negative affect.Cross-sectional.Hypotheses were tested in a representative German sample (According to the results obtained from the two samples, MHWs were only weakly associated with somatic symptoms and negative affectivity. Frequentist and Bayesian linear regression analyses showed an interaction only in one case. All other factors being equal, individuals high on somatic symptoms and MHWs did not experience disproportionately less anxiety or depression; those high on MHWs and negative affect were characterized by disproportionately more sympto…

Sensorik Inventar (SI) – Selbstbeurteilung der sensorischen Sensitivität für Erwachsene und Jugendliche

ZusammenfassungEine adäquate Wahrnehmung der Umwelt repräsentiert eine der Grundvoraussetzungen adaptiven Verhaltens. Gleichzeitig existieren individuelle Unterschiede in der sensorischen Sensitivität, die wiederum eine zentrale Rolle bei der Entstehung und Aufrechterhaltung diverser psychischer Störungen spielen können. Die Fragestellung war die Entwicklung eines Fragebogens zur multidimensionalen Erfassung von sensorischer Sensitivität. Das Sensorik Inventar (SI) wurde von 1417 Personen ausgefüllt. Die faktorielle Validität wurde mit Hilfe explorativer Faktorenanalysen sowie mit Exploratory-Structural-Equation-Modeling überprüft. Es ergab sich eine 6-faktorielle Struktur und eine hohe int…

Topics and techniques in clinical supervision in psychotherapy training

AbstractClinical supervision is regarded as one of the most important components of psychotherapy training. In clinical practice, it has been found that the implementation of clinical supervision varies substantially and often differs from the recommendations made in the literature. The objective of the current study was to investigate the frequency of topics (e.g. ethical issues) and techniques (e.g. role play) in the clinical supervision of psychotherapy trainees in Germany. To this end, we considered supervisions in cognitive behavioural therapy (CBT) and psychodynamic therapy (PT). A total of 791 psychotherapy trainees (533 CBT and 242 PT) were asked via the internet to provide informat…

Health anxiety – An indicator of higher interoceptive sensitivity?

Abstract Background and objectives According to cognitive-behavioral models, health anxiety arises from the misattribution of normal bodily sensations as signs of a severe illness. Consequently, higher levels of interoceptive accuracy might be critically involved in the development of health anxiety. Methods To test this central assumption of cognitive behavioral models of health anxiety, we assessed interoceptive accuracy in a sample of college students ( N  = 100). Two interoceptive tasks (detection of one's own heartbeat using the Schandry paradigm and detection of nonspecific skin conductance fluctuations, NSCFs) were used. Results We found no indication for a positive association betwe…

Assessing therapist development: Reliability and validity of the Supervisee Levels Questionnaire (SLQ-R).

BACKGROUND Therapist development is a crucial target for clinical training in order to ensure high-quality psychotherapy. A major challenge in examining therapeutic development is the assessment of developmental processes. The Supervisee Levels Questionnaire (SLQ-R) was analyzed in this study to examine its validity, reliability, and underlying dimensional structure. METHOD Seven hundred and sixty therapists participated in an online survey concerning their current psychotherapy training. The factor structure as well as the validity of the SLQ-R were investigated using exploratory and confirmatory factor analysis. RESULTS In line with the results of the exploratory factor analyses, a Bifact…

Unerklärte Körperbeschwerden und somatoforme Störungen

Medizinisch unerklarte Korperbeschwerden, somatoforme Storungen, funktionelle somatische Syndrome … Das Fachgebiet zu korperlichen Symptomen, fur die kein organischer Befund nachweisbar ist, hat eine – zum Teil verwirrende – Vielfalt an Fachbegriffen hervorgebracht. Die Klarung und Abgrenzung dieser Begrifflichkeiten und diagnostischen Konzepte ist eine notwendige Voraussetzung, um das zugrunde liegende Problem des Patienten verstehen und einen erfolgversprechenden Therapieplan erstellen zu konnen. Dazu stellen die ersten drei Abschnitte des ersten Kapitels eine Hilfe dar: Zunachst wird mithilfe von zwei Fallbeispielen ein Einblick in die Vielseitigkeit unerklarter Korpersymptome und beglei…

Do patients with pathological health anxiety fear COVID-19? A time-course analysis of 12 single cases during the “first wave” of the COVID-19 pandemic in Germany

Objective Pre-existing health anxiety is associated with an intensified affective response to the novel COVID-19 pandemic in the general population. Still, results on the reaction of people with a diagnosis of pathological health anxiety (i.e., hypochondriasis) are scarce. Methods In the present study, we investigated the course of (health) anxiety related to SARS-CoV-2/COVID-19 in comparison to (health) anxiety related to other severe diseases (e.g., cancer) in a sample of 12 patients with the diagnosis of pathological health anxiety during the “first wave” of the COVID-19 pandemic in Germany. Both SARS-CoV-2 related anxiety and anxiety related to other severe diseases were assessed weekly…

Cognitive Biases in Pathological Health Anxiety

Pathological health anxiety refers to the medically unfounded fear of suffering from a severe illness. Differences in cognitive processes related to attention, memory, and evaluation of health threat have been hypothesized to underlie pathological health anxiety. In no study, however, have researchers systematically and simultaneously assessed different cognitive biases. On the basis of the idea that multiple cognitive biases simultaneously contribute to psychopathology (the combined-cognitive-bias hypothesis), we compared 88 patients with pathological health anxiety, 52 patients with depressive disorder, and 52 healthy participants on their performance in several cognitive tasks involving…

Health anxiety, cyberchondria, and coping in the current COVID-19 pandemic: Which factors are related to coronavirus anxiety?

Highlights • First study on anxiety and cyberchondria during the COVID-19 pandemic. • The increase in virus anxiety was particularly strong with elevated health anxiety. • Health anxiety, cyberchondria, and virus anxiety are positively associated. • Combined health anxiety and cyberchondria is associated with strong virus anxiety. • Being informed and adaptive emotion regulation can have a beneficial effect.

Neural correlates of an attentional bias to health-threatening stimuli in individuals with pathological health anxiety

Background: An attentional bias to health-threat stimuli is assumed to represent the primary pathogenetic factor for the development and maintenance of pathological health anxiety (PHA; formerly termed “hypochondriasis”). However, little is known about the neural basis of this attentional bias in individuals with PHA.Methods: A group of patients with PHA, a group of depressed patients and a healthy control group completed an emotional Stroop task with health-threat (body symptom and illness) words and neutral control words while undergoing functional MRI.Results: We included 33 patients with PHA, 28 depressed patients and 31 controls in our analyses. As reflected in reaction times, patients…

Evidence for a specific link between the personality trait of absorption and idiopathic environmental intolerance.

Absorption as a personality trait refers to the predisposition to get deeply immersed in sensory (e.g., smells, sounds, pictures) or mystical experiences, that is, to experience altered states of consciousness. Absorption is markedly related to constructs openness to experiences, hypnotic suggestibility, imagination, and dissociation. Although absorption was hypothesized to be a risk factor for medically unexplained symptoms (MUS), the construct has yet not been investigated in individually suffering from idiopathic environmental intolerance (IEI), formerly better known as multiple chemical sensitivity (MCS). IEI is a complex condition marked by MUS, which patients attribute to various chem…

ICPM NEWS: The European Training Network ETUDE (Encompassing Training in Functional Disorders across Europe) Is Recruiting 15 Early-Stage Researchers

Jungmann_Supplemental_Material – Supplemental material for Do Dr. Google and Health Apps Have (Comparable) Side Effects? An Experimental Study

Supplemental material, Jungmann_Supplemental_Material for Do Dr. Google and Health Apps Have (Comparable) Side Effects? An Experimental Study by Stefanie M. Jungmann, Sebastian Brand, Johanna Kolb and Michael Witthöft in Clinical Psychological Science