Home Research Departments / Research Groups / Institutes Clinical Psychology Projects

Projects: Clinical Psychology

DFG - Deutsche Forschungsgemeinschaft ZA 1133/2-1: BAT – BEWUSSTES ATEMTRAINING Evaluation eines Atem-zentrierten Interventionsprogramms zur Beeinflussung psychologischer und biologischer Mechanismen von Depression und Angst. 09/2020-08/2023.

DFG - Deutsche Forschungsgemeinschaft ZA 1133/2-1: "BAT – BEWUSSTES ATEMTRAINING Evaluation eines Atemzentrierten Interventionsprogramms zur Beeinflussung psychologischer und biologischer Mechanismen von Depression und Angst. 07/2020-06/2023.

Kiefer F, Kirsch P. DFG - Deutsche Forschungsgemeinschaft : CRC TRR 265: Project C04: Modification of cue reactivity by neurofeedback in human addiction. 07/2019-06/2023.

This project will investigate the hypothesis that combining real time fMRI neurofeedback (fMRI-NF) with a mindfulness-based intervention will increase the ability of alcohol dependent patients to deliberately reduce ventral striatal cue reactivity to alcohol. To this end we study the efficiency of fMRI-NF in patients receiving mindfulness-based training vs. patients receiving treatment as usual. We expect that the combination of mindfulness-based training and neurofeedback will boost the ability to regain control over habitual responses to alcohol-associated stimuli.

Kirsch P, Koppe G, Sommer WH. DFG - Deutsche Forschungsgemeinschaft : CRC TRR 265: Project B08: Aversion discounting in behavioral control in animal models and human addiction. 07/2019-06/2023.

To date, reward discounting but not aversion discounting was examined in SUD. Our working hypothesis of increased temporal aversion discounting in AUD patients will be tested by novel tasks for reliable and quantitative assessment of aversion discounting in humans and animal models. We will study the underlying neurobiology of aversion discounting by fMRI in humans and calcium imaging microendoscopy in rats. Computational analyses will be used to model the decision-making processes and deliver a detailed and formal parametrization of aversion discounting on multiple levels of analysis. In the future, such information can be used for the development of therapeutic approaches that strengthen self-regulation and cognitive control

Feld G. DFG - Deutsche Forschungsgemeinschaft GZ: FE 1617/2-1: Advancing the treatment and prevention of addiction by understanding sleep’s basic role. 04/2019-04/2021.

Most people have a “bad habit” they would like to change. This could be smoking cigarettes, drinking alcohol, exercising too little, eating unhealthy or anything that they want to do, but that negatively impacts their wellbeing and induces regret. Wouldn’t it be great to change this unwanted behaviour during sleep? The main goal of this research project is to identify how sleep maintains addiction and to use this knowledge to change it. The brain’s reward centres can be viewed as the neurophysiological basis that emphasizes one behaviour over another. Recently, in healthy young participants, sleep has been shown to interact with these reward signals that strengthen rewarded information more strongly than unrewarded information. The present research aims to show that, during learning, mesolimbic reward signals are bound to hippocampal memory representations of events and actions that led to rewards and that, during subsequent sleep, replay specifically enhances such tagged representations over non-rewarded events and actions. Not all long-term goals can be reached by prioritizing only short-term goals, therefore, animals evolved more complex reinforcement processes that can enhance uncomfortable or even dangerous actions to gain an adaptive advantage in the future. In animals, this powerful force stabilizing instrumental behaviour mostly leads to beneficial pleasurable outcomes, such as increased probabilities of finding food or mates. In modern time humans, it can just as easily drive unhealthy habits and, more dangerously, this type of learning can become the basis of addictive behaviour such as drug abuse and gambling that the person no longer views as pleasurable but still cannot resist. The unconscious sleep phase opens a potential target for interventions that ameliorate or even erase this maladaptive wanting by replacing or redirecting the endogenous tags. Ultimately, the current project proposes linking sleep and addiction memory research in clinical settings to enhance the malleability of these hard to change behaviours.

Kirsch P. DFG - Deutsche Forschungsgemeinschaft KI 576/18-1: How culture shapes our brain: Neural correlates of cultural differences in social cognition. 09/2018-06/2020.

In times of globalization and increasing intercultural exchange, social understanding between cultures gains tremendously in importance. Recent studies, however, showed that people are better in understanding emotions and mental states of people from their own than from another culture. The purpose of our project is to explore cultural differences in MNS responsivity with a new approach: CN. Specifically, we will study cultural differences in the response profiles of the MNS during social-cognitive and social-emotional processing. To this end, we will investigate the neural basis of imitation, as well as empathy for basic and social emotions, in two different cultures: individualism (Germany) and collectivism (China). Further, we will study the effect of social learning on cultural differences in social cognition with a cross-sectional approach by comparing participants from China and Germany who live abroad with those who never lived abroad.

EU - Europäische Union 668863: SyBil-AA System Biology of Alcohol Addiction. 01/2016-12/2019.

Alcohol addiction ranks among the primary global causes of preventable death and disabilities in human population, but treatment options are very limited. Rational strategies for design and development of novel, evidence based therapies for alcohol addiction are still missing. Alcohol dependence is characterized by cycles of excessive alcohol consumption, interspersed with intervals of abstinence, and frequent relapses. Relapse is a key element of this disease process and blocking relapse is therefore a key objective for the treatment of alcohol dependent patients. In this project we will provide a novel discovery strategy based on the principles of systems medicine that uses mathematical and network theoretical models to identify brain sites and functional networks that can be targeted specifically by therapeutic interventions. To build predictive models of the ‘relapse-prone’ state of brain networks we will use magnetic resonance imaging, electrophysiology and neurochemical data from patients and laboratory animals. The mathematical models will be rigorously tested through experimental procedures aimed to guide the network towards increased resilience against relapse. We expect to identify hubs that promote ‘relapse-proneness’ and to predict how aberrant network states could be normalized. Proof of concept experiments in animals will need to demonstrate this possibility by showing directed remodeling of functional brain networks by targeted interventions suggested by the theoretical models. Thus, our translational goal will be achieved by a theoretical and experimental framework for making predictions based on fMRI and mathematical modeling, which is verified in animals, and which can be transferred to humans. With our highly interdisciplinary EU consortium (PIs from seven European countries and Israel with outstanding expertise) it is expected that after having such a world-wide unique effort in place, new neurobiologically-defined treatment strategies will be delivered to our addicted patients and thus help to address a serious and widespread health problem in our European societies.

BMBF - Bundesministerium für Bildung und Forschung 01EA1605: Verbund iCase: Induvidualisierte kognitive, affektive und soziale Verbesserungen durch Ernährungsinterventionen für ein langes, gesundes Leben.. 07/2016-06/2019.

Kirsch P. DFG - Deutsche Forschungsgemeinschaft KI 576/16-1: Neurobiologische Grundlagen und psychotherapeutische Behandlung des komorbiden Auftretens von Alkoholabhängigkeit und Depression: Von grundlegenden Mechanismen zu erfolgreichen Behandlungsstrategien". 07/2016-06/2019.

BMBF - Bundesministerium für Bildung und Forschung 01EE1409C: Verbund ASD-Net: P3b - Neurobiological markers for SST resonse in ASD. 02/2015-01/2019.

Effects of an oxytocin enhanced social skill training (SST) should be particularly observable in brain regions associated with autism spectrum disorder (ASD) and oxytocin (OXT) like the social brain, particularly the amygdala, and the rewards circuits. We therefore apply a battery of fMRI tasks to examine the effect of OXT administration on neural activation in N = 100 participants before and after SST. We will delineate OXT specific modulation of the social brain using a Theory of Mind (ToM) task to activate the mentalizing network, an affective matching task particularly focusing on the amygdala, and a reward task combining both, social and non-social cues as well as social and non-social rewards. We will identify specific neurobiological mechanisms associated with therapy response as well as particular neurobiological signatures before treatment that are associated with treatment response. Results should further allow us to tailor treatment to different subtypes of ASD and finally to correctly allocate individuals to treatment settings.

Kühner C, Kirsch P. DFG - Deutsche Forschungsgemeinschaft KU 1464/4-2, KI 576/12-2: Experimental studies on rumination and mindfulness: A multilevel approach using fMRI and ambulatory assessment in clinical and nonclinical samples. 01/2014-02/2018.

During the first funding period (2010-2013), the project investigated functional connectivity and neural correlates of induced attention foci (rumination, mindfulness) using fMRI, and effects of spontaneous and induced attention foci on emotional, cognitive and endocrinological processes in daily life in remitted depressed patients (≥2 episodes) and healthy controls. In this context, we examine the relationship between results of both measurement levels (fMRI, ambulatory assessment, AA) and their predictive value for the course of symptoms. By integrating both research approaches, our project pursues an as yet completely new approach in the area of rumination and mindfulness research. In the second funding period (2014-2016) we aim at investigating AA- and fMRI-based predictors identified during the first funding period with regard to their potential to predict the long-term symptom course and risk of relapse/recurrence in patients, as well as at investigating intervention effects of a specific mindfulness-based attention training on neural and everyday parameters in a new sample of patients. Substudy 1 intends to conduct a concluding three-year-follow-up of the remitted depressed patients investigated in study period 1. This allows an examination of long-term predictive effects of depression-related alterations in AA- and fMRI-based variables for the longterm course of symptoms in this already extensively characterized sample. Amongst others, we assume that increased daily rumination, worse mood states and a decreased cortisol response towards subjective experiences in daily life will predict a worse course of symptoms and an increased risk of relapse/recurrence. We also expect that the increased functional connectivity identified within the Default Mode Network (DMN) in patients during negative mood and rumination induction will predict a disadvantageous course of symptoms over the three-year period. Finally, we expect that the relationship between degree of functional connectivity at baseline and the course of symptoms will be mediated by the degree of daily rumination at baseline. Substudy 2 aims to investigate the short-term effects of a four-week mindfulness-based attention training compared to a time-matched relaxation training (progressive muscle relaxation) in a randomised experimental intervention study on changes in functional connectivity of the DMN as well as rumination, emotional processes, and cortisol activity in daily life in a new sample of remitted recurrent depressed patients.

Kühner C, Kirsch P. DFG - Deutsche Forschungsgemeinschaft KU 1464/4-2, KI 576/12-2: Experimentelle Untersuchungen zu Rumination und Achtsamkeit: Ein Mehrebenenansatz mit fMRI und ambulantem Assessment in klinischen und nichtklinischen Stichproben. 01/2014-02/2018.

Das Projekt untersuchte in der 1. Förderphase (2010-2013) funktionelle Konnektivität unter und neuronale Korrelate von induzierten Aufmerksamkeitsfoki (Rumination, Achtsamkeit) mit fMRT und Auswirkungen spontaner und induzierter Aufmerksamkeitsfoki auf emotionale, kognitive und endokrinologische Prozesse im Alltag bei remittiert depressiven Patienten (≥2 Episoden) und Kontrollen. Die Ergebnisse beider Messebenen (fMRT, Ambulantes Assessment) werden zusammengeführt und ihr Prädiktionswert für den Symptomverlauf wird untersucht. Durch die Integration beider Forschungszugänge verfolgt unser Projekt einen bis dato völlig neuen Ansatz im Bereich der Ruminationsforschung. In der 2. Förderphase (2014-2016) möchten wir die bislang identifizierten AA- und fMRT-basierten Prädiktoren hinsichtlich ihrer Vorhersagekraft für den längerfristigen Symptomverlauf der Patienten untersuchen und Interventionseffekte eines achtsamkeitsbasierten Aufmerksamkeitstrainings auf neuronale und alltagsbezogene Parameter an einer neuen Patientenstichprobe überprüfen. Teilstudie 1 intendiert ein abschließendes Drei-Jahres-Follow-Up der in Studienphase 1 untersuchten remittiert Depressiven. Dies erlaubt, prädiktive Effekte der im AA und fMRT identifizierten depressionstypischen Auffälligkeiten über einen ausreichenden Zeitraum zu untersuchen, um damit auch deren Funktion als Rückfallprädiktoren identifizieren zu können. Wir nehmen an, dass höhere Alltagsrumination, schlechtere Alltagsstimmung und eingeschränkte Cortisolreagibilität gegenüber subjektivem Erleben mit schlechterem Symptomverlauf assoziiert sind. Zudem erwarten wir, dass die bei den Patienten identifizierte verstärkte funktionelle Konnektivität innerhalb des Default Mode Netzwerks (DMN) einen ungünstigeren Symptomverlauf vorhersagt, und dass der Zusammenhang zwischen Grad der funktionellen Konnektivität und Symptomverlauf durch das Ausmaß der Alltagsrumination mediiert wird. Teilstudie 2 möchte im Rahmen einer randomisierten experimentellen Interventionsstudie an einer neuen Stichprobe remittiert Depressiver Effekte eines vierwöchigen achtsamkeitsbasierten Aufmerksamkeitstrainings gegenüber einem strukturierten Entspannungstraining (Progressive Muskelentspannung) auf die Veränderung funktioneller Konnektivität des DMN unter negativer Stimmungsinduktion und Rumination (fMRT), auf Rumination, emotionale Prozesse und Cortisolaktivität im Alltag sowie auf die Spezifität des autobiographischen Gedächtnisses und habituelle Achtsamkeit untersuchen.

Meyer-Lindenberg A, Kirsch P. DFG - Deutsche Forschungsgemeinschaft KFO 256, 2nd funding period: TP 03 "Neural Mechanisms of Trust and Dyadic Interaction in BPD. 08/2015-07/2017.

1 Results of the first funding period Aim of IP3 is the identification of abnormal activity and connectivity in brain systems associated with trust in BPD by means of a rather new brain imaging method, hyperscanning. Hyperscanning permits the measurements of brain activity simultaneously in two people interacting socially. During the first funding period, we mainly focused on the development of a generalizable, robust and hypothesis-free analysis routine for hyperscanning data while collecting data from both healthy controls and patients. Method development was based on two independently recruited samples of healthy subjects, a sample of 26 subjects (13 pairs) including both sexes, and a sample of 50 female subjects (25 pairs), which also serves as control sample for our BPD patients. A Joint Attention (JA) task was chosen for first investigation, representing a fundamental developmentally early form of specifically human social interaction. Data from both investigated samples showed that during JA, coupling between brain systems does emerge, uniquely to truly interacting subjects, and temporally and spatially highly specific, i.e. based upon function of the right temporo-parietal junction (rTPJ). Remarkably, in our patient study we found that neural coupling parameters during JA were already affected by illness status, suggesting a disruption in fundamental processing of social information in BPD at early developmental and cognitive processing stages. Specifically, in 22 pairs, formed from one subject with BPD interacting with one healthy control participant, we found significantly lower coupling in dyads with a BPD subject during JA. Initial analysis of a multi-round trust game using the same methodology showed a comparable reduction in rTPJ coupling when BPD patients were involved in the interaction. 2 New questions and work schedule The surprising discovery of disrupted basic social information processing in BPD during JA raises several questions. First, since JA arises very early in development (during the first year of life) and is required for the emergence of higher-order social skills, it may predict social dysfunction in adult social interaction requiring those skills. In the coming funding period, we will therefore examine whether JA impairment is predictive of neural coupling during trust and deception in a hyperscanning framework. Secondly, impairment of JA could index a state or trait phenomenon, with differing implications for therapy. To test trait aspects, JA disruption will be related to early environmental exposure data as well as to genotype information available through the KFO, requiring a further buildup of sample size. To examine state properties of JA prediction, we will study the effects of a social interaction training battery, conducted in IP1, on neural synchrony before and after treatment, providing insights into the nature and biological importance of neural coupling parameters. This work should provide an assessment to which degree cross-brain rTPJ-coupling can serve as a predictive biomarker to standard therapy and contribute to the investigation of innovative treatments for baseline social cognition. Further toward this end, induced changes in oxytocin will be related to neural changes in hyperscanning and treatment effects. To achieve these gains in the coming funding period, our data set will be extended from currently female subjects and simple, cooperative interaction within JA to the inclusion of male patient- as well as control samples, an oversampling of early childhood adversity participants to examine the effects of early environmental risk. Our analysis methods will be further developed to characterize cross-brain connections and cross-task predictive interactions in a variety of social settings and according fMRI tasks.

Dietmar Hopp Stiftung gGmbH 23016007: Ein Jahr im Wald - Der Einfluss von naturnahem und bewegungsreichem Schulunterricht auf biologische Indikatoren der Stress-Resilienz. 09/2014-03/2016.

Gegenstand dieses Forschungsvorhabens ist es, zu untersuchen, inwieweit ein Unterrichtsangebot, das durch die Verlagerung eines Teils des Unterrichts in den Wald, eine höhere Naturnähe, eine größeren Bewegungsanteil und weniger sozialen Stress aufweist zu einer Stärkung biologischer Stress-Systeme und zu einer Zunahme des selbst-regulierten Lernens (intrinsische Lernmotivation) führt. Dazu sollen in einem prospektiven Längsschnittansatz Schülerinnen und Schüler des Gymnasiums Englisches Institut in Heidelberg während des 5. Und 6. Schuljahrs untersucht werden. Die Hälfte dieser Schüler Wird ein Jahr lang für einen ganzen Tag in der Woche im Naturkunde- und Sportunterricht Im Wald unterrichtet, während die andere Hälfte der Schüler den normalen Unterricht an Der Schule erhält. Untersucht werden soll, inwieweit sich die Hirnstruktur und Funktion Nach dem Schuljahr zwischen im Wald unterrichten und nicht Wald Unterrichteten Schülern unterscheidet. Darüber hinaus sollen über das Schuljahr hinweg Einflussfaktoren untersucht werden, die den Zusammenhang zwischen der Art des Unterrichts und Veränderung der biologischen Maße vermitteln können. Dies können sowohl akute Stressreaktionen sein, der Umfang der physiologischen Belastung, das Ausmaß an sozialer Interaktion oder auch das Ausmaß an Bewegung. Für all diese potentiellen Moderatorvariablen werden physiologische Marker erhoben. Darüber hinaus soll natürlich auch untersucht werden, inwieweit die Form des Unterrichts auch auf die schulische Leistung und Motivation Einfluss nimmt und inwieweit diese Faktoren die Stressreaktion und die Ausbildung der Stress-Systeme moduliert. Konkret sollen folgende Hypothesen geprüft werden: 1. Schülerinnen und Schüler, die am Waldunterricht teilnehmen zeigen eine größere Zunahme an Hirnstrukturen des limbischen Systems, die mit Stress-Resilienz verbunden sind, als Kinder die nicht am Waldunterricht teilnehmen. 2. Schülerinnen und Schüler, die am Waldunterricht teilnehmen zeigen im Vergleich Zu Schülerinnen und Schüler, die nicht im Wald unterrichtet werden eine reduzierte Aktivität der Stress‐Systeme, gemessen über Speichelcortisol, Haarcortisol und freie DNA Im Speichel. 3. Schülerinnen und Schüler, die im Wald unterrichtet werden zeigen eine höhere Lernmotivation und bessere Lernleistungen in den im Wald unterrichtet Fächern als Die Vergleichsschülerinnen und -schüler. 4. Im Wald unterrichtete Schülerinnen und Schüler weisen eine reduzierte neuronale Und hormonelle Stressreaktion nach dem Schuljahr in einem sozialen Stresstest auf Als Kinder, die am Regelunterricht teilgenommen haben. 5. Die in Hypothese 1 bis 4 formulierten Effekte, sind assoziiert mit einer erhöhte Bewegung in der Natur und mehr direkter sozialer Interaktion während des Schulaltages.

Kiefer F, Kirsch P. DFG - Deutsche Forschungsgemeinschaft SFB 636: TP D06: Reward learning and extinction training in alcohol dependence: impact of. 01/2012-12/2015.

Preclinical studies support the critical role of learning and memory processes for the development and maintenance of addictive disorders. Particularly based on the importance of classical and instrumental conditioning in this context, cue-exposure-based extinction training (CET) of conditioned, drug-related responses has been introduced in the treatment of addiction. During the last funding period we gathered data suggestive for an effect of CET on mesolimbic cue-reactivity in abstinent alcohol dependent subjects. However, neuronal pathways involved, especially the role of functional and structural frontostriatal connectivity, remain to be explored. Therefore, we are now aiming to test to what extent extinction of fMRI cue-reactivity in chronic alcohol dependent patients following cue-exposure based training is modulated by frontal-striatal connectivity and reward sensitivity. This will be investigated by studying (a) structural connectivity (DTI) (b) trait like functional connectivity (resting state fMRI) and (c) effective functional connectivity during alcohol cue presentation (event related fMRI). Additionally, in a reward paradigm we will study the general responsivity of reward pathways and their frontal control in alcohol dependent patients prior to extinction training and compare it to healthy controls to identify alterations in reward sensitvity. We expect that these functional and structural measures contributes to a better understanding of neuronal pathways involved in reward extinction, and the definition of factors that predict efficacy of CET in alcohol-dependent subjects.

Kirsch P. BMBF - Bundesministerium für Bildung und Forschung 01GQ1003B: BCCN TP C5: Brain activity in depression & ageing. 05/2010-04/2015.

Zink M, Meyer-Lindenberg A, Kirsch P. DFG - Deutsche Forschungsgemeinschaft DFG ZI 1253/3-2, KI 576/14-2, ME 1591/6-2: Metakognitive Defizite bei Patienten mit erhöhtem Risiko für schizophrene Psychosen und deren Interaktion mit Psychopathologie, Neuropsychologie und funktioneller Bildgebung. 09/2012-02/2015.

Schizophrenia patients suffer from a broad variety of cognitive deficits that are very often resistant to antipsychotic treatment and interfere with the social and vocational rehabilitation. An international consensus initiative elaborated a comprehensive set of neuropsychological tests, the MATRICS battery (Measurement And Treatment Research to Improve Cognition in Schizophrenia) in order to improve treatment research (1). Besides the domains represented in the MATRICS battery, it has been shown that metacognitive capacities are impaired in schizophrenia, leading to a reduced ability to select appropriate responses, to appraise and weigh information effectively and to cope with cognitive limitations. Metacognitive impairments, (2) such as a self-serving attributional bias, hasty decision making (jumping to conclusion: JTC), a bias against disconfirmatory evidence (BADE) (3), overconfidence in errors, metamemory alterations (4;5), and finally deficits in mentalizing and social cognition („theory of mind“: ToM) (6;7), are thought to contribute to development and maintenance of delusions (8-10). Specific therapeutic interventions to improve metacognitive functions have been developed and tested in several controlled trials (11). In the present application, we mainly focus on ToM-deficits and the JTC-bias.

Meyer-Lindenberg A, Kirsch P. DFG - Deutsche Forschungsgemeinschaft ME 1591/4-1: KFO 256 TP 3: Neural Mechanisms of Trust and Dyadic Interaction in BPD . 01/2012-12/2014.

Bailer J. DFG - Deutsche Forschungsgemeinschaft SCHR 443/11-1: A comparison of the Cognitive Behavioural Analysis System of Psychotherapy (CBASP) against supportive psychotherapy. 12/2008-12/2013.

Effective treatment strategies for chronic depression are urgently needed since it is not only a common and particularly disabling disorder, but is also considered treatment resistant by most clinicians. There are only a few studies on chronic depression indicating that traditional interventions are not as effective as in acute, episodic depression. In addition, most of the studies had methodological weaknesses, such as the very short courses of psychotherapy. Usually, chronic depression begins early in life, is often associated with early interpersonal trauma, and results in an even more substantial human capital loss than the late-onset group. Furthermore, it shows a weak response to medication and a high rate of relapse after an initial response. With the present multicentre study, the efficacy of the only specific psychotherapy for chronic depression (Cognitive Behavioural Analysis System of Psychotherapy/CBASP) is compared with a non-specific supportive psychotherapy/SP (a well-designed psychological placebo) in early onset chronically depressives. CBASP faired very well in one large trial but has never been directly compared to a placebo control. Another innovative aspect of the study is the use of an extended course of psychotherapy (32 sessions). Primary hypothesis: CBASP is more effective in reducing depressive symptoms than SP.

Bailer J. DFG - Deutsche Forschungsgemeinschaft BA 1597/5-2: Attentionale, kognitive und emotionale Aspekte bei Krankheitsangststörungen. 05/2010-04/2012.

Zentrale Komponenten in kognitiv-behavioralen Erklärungs-modellen der Krankheitsangst und der daraus abgeleiteten Behandlungen sind a) eine selektive Aufmerksamkeitslenkung (SAL) auf körperliche Empfindungen und b) ein kata-strophisierender Interpretationsbias (KIB). Experimentalpsychologisch wurden SAL und KIB jedoch bei diesen Störungen selten und zudem mit widersprüchlichen Ergebnissen unter-sucht. Fragestellung: Lassen sich SAL und KIB mit verschiedenen experimentalpsychologi-schen Versuchsanordnungen nachweisen und welche neuronalen Aktivitätsmuster korres-pondieren damit? Wie ändern sich SAL und KIB auf der Verhaltensebene durch eine gezielte Veränderung des Interpretationsbias und welche Aktivierungsänderungen auf der neuro-nalen Ebene gehen mit dieser Änderung einher? Methode: 52 Probanden (Pbn) ohne und 52 Pbn mit Hypochondrie sollen über Arztpraxen und Zeitungswerbung rekrutiert werden. Zur Prüfung der SAL wird der Emotionale Stroop Test (EST) eingesetzt, zur Erfassung des KIB der Implicit-Associations-Test (IAT). Zusätzlich werden bei 30 hypochondrischen und 15 nichthypochondrischen Pbn EST und IAT während einer funktionellen Magnetresonanztomo-graphie (fMRT) durchgeführt. Bei der Hälfte (N=26) der hypochondrischen Pbn soll der KIB durch das 14-tägige Führen eines speziellen Symptomtagebuchs systematisch reduziert werden. Die zweite Gruppe (N=26) erhält keine Intervention. Nach dieser Phase werden erneut SAL, KIB und Symptomstatus bestimmt, wiederum unter Einschluss der fMRT bei einer Teilgruppe von je 15 Personen. Erste Ergebnisse: Aus 200 gescreenten Pbn wurden bis jetzt 36 Pbn mit Hypochondrie und 35 Kontrollprobanden rekrutiert, zusätzlich auch 19 krankheitsängstliche, aber nicht hypochondrische Pbn. Bei Pbn mit Krankheitsangst sind SAL und KIB überwiegend erwartungskonform verstärkt, im Vergleich zu nicht-krankheits-ängstlichen Pbn. Die Reaktionszeitbefunde zu veränderten attentionalen Mechanismen werden durch im fMRT gefundene Aktivierungsänderungen in jenen Regionen unterstützt, die an der emotional-kognitiven Modulation von Aufmerksamkeitsprozessen beteiligt sind. Ziele des Fortführungsantrags: Die vorliegenden Befunde sind vielversprechend. Für die verlässliche statistische Prüfung der Hypothesen müssen allerdings mehr hypochondrische Pbn in die Studie eingeschlossen werden als ursprünglich geplant. Dies kann durch die Verlängerung der Projektförderung um 24 Monate erreicht werden. Die ursprünglichen Fragestellungen sollen außerdem in zweifacher Hinsicht erweitert werden: a) Zur Prüfung der Spezifität der Befunde zu KIB und SAL soll die jetzt bereits teilweise rekrutierte Gruppe von Pbn mit positivem Screeningbefund, aber Nichterfüllung der Hypochondriekriterien auf 52 ergänzt werden, und eine Gruppe depressiver Patienten ohne Krankheitsangst (N=52) rekrutiert werden. b) Therapierelevant ist die Frage nach der Veränderung von KIB und SAL bei jenen Patienten, die nach den ersten beiden Untersuchungen sich noch einer längeren Psychotherapie (KVT) unterziehen. Bei diesen Patienten (N=50) soll eine dritte Messung (IAT, EST) nach Abschluss der Behandlung durchgeführt werden.

Zentralinstitut für Seelische Gesundheit (ZI) - https://www.zi-mannheim.de