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PD Dr. Stefanie Lis

DFG - Deutsche Forschungsgemeinschaft Teilprojekt im DFG- Graduiertenkolleg ‚Der Einfluss von Traumatisierung im Kindes- und Jugendalter auf psychosoziale und somatische Erkrankungen über die Lebensspanne‘ (GRK-2350): Einsamkeit, soziale Zugehörigkeit und Traumatisierung im Kindes- und Jugendalter: Determinanten und Behandlung. 04/2018-03/2021.

DFG - Deutsche Forschungsgemeinschaft Teilprojekt im DFG- Graduiertenkolleg ‚Der Einfluss von Traumatisierung im Kindes- und Jugendalter auf psychosoziale und somatische Erkrankungen über die Lebensspanne‘ (GRK-2350): Traumatisierung im Kindes- und Jugendalter und biologische und psychobiologische Marker entzündlicher Darmerkrankungen. 04/2018-03/2021.

Schmahl C. Universität Heidelberg : Instabilität expliziter und impliziter Selbstwertmaße bei Personen mit Borderline-Persönlichkeitsstörung. 01/2016-10/2017.

Die kategoriale sowie die dimensionale Diagnostik von Persönlichkeitsstörung nach dem aktuellsten Klassifikationssystem psychischer Störungen (DSM-5) sehen die Instabilität des Selbstbildes als ein zentrales Merkmal der Borderline-Persönlichkeitsstörung. Die Betroffenen zeigen darüber hinaus ausgeprägte Selbstabwertungen und einen geringen Selbstwert, der auch nach Remission deutlich unter dem von Gesunden liegt. Dennoch sind die Mechanismen der Selbstabwertungen und der Instabilität des Selbstwerts bei Personen mit Borderline-Persönlichkeitsstörung selten experimentell untersucht worden. Bisherige Befunde deuten darauf hin, dass Personen mit Borderline- Persönlichkeitsstörung einen geringen explizit berichteten Selbstwert bei unauffälligem, implizit gemessenem Selbstwert aufweisen. Hierbei scheint für die Symptomschwere insbesondere die Inkongruenz beider Maße sowie deren Instabilität eine Rolle zu spielen. Das spezifische Ziel des Projekts ist es deshalb zu untersuchen, ob Personen mit Borderline-Persönlichkeitsstörung im Vergleich zu gesunden Probanden. (1) eine stärkere Inkongruenz zwischen explizitem und implizitem Selbstwert, (2) eine stärkere Instabilität des expliziten sowohl auch des impliziten Selbstwerts sowie (3) eine stärkere Instabilität der Inkongruenz zwischen explizitem und implizitem Selbstwert aufweisen. (4) Zudem sollen Zusammenhänge dieser Phänomene zur Schwere der Borderline-Persönlichkeitssymptomatik überprüft werden. Das übergeordnete Ziel des Projekts ist zum besseren Verständnis der Instabilität des Selbstwerts und damit der Symptomatik bei Personen mit Borderline-Persönlichkeitsstörung beizutragen, um konkrete Verbesserungen von Therapiemöglichkeiten vorzuschlagen.

Lis S, Bohus M. DFG - Deutsche Forschungsgemeinschaft KFO 256, 2nd funding period: TP 01 Neurobiological and Psychological Reaction Patterns in Response to Social Rejection in BPD. 08/2015-07/2017.

1 Results of the first funding period The aim of this project was to add to the understanding of the mechanism underlying the pervasive experience of social exclusion in BPD which is assumed to contribute to severe interpersonal problems. In sum, our findings of the first funding period suggest that interpersonal problems in BPD may be primarily linked to an imbalance in the experiences of negative and positive events in every-day life. This is less caused by alterations in the processing of social rejection, but in the processing of positive social cues. In particular, we found that BPD patients experience happy faces as less intense and are less confident during their evaluation. They evaluate particularly positive information referenced to themselves as less positive and this has been related to an internal, negative and global attributional style. They feel less included during positive and neutral social encounters, expect less positive feedback of social co-players, fail to adjust their expectancies particularly in case of positive feedback and react with a drop of cooperative behavior in case of a provocation when previously included by social partners. Brain imaging data suggest that these behavioral data may be linked to a lack in the modulation of the engagement of brain structures depending on the nature of a social encounter. Rejection sensitivity, i.e. a cognitive-affective disposition, which is increased in both acute as well as remitted BPD patients, influenced the intensity of many of these alterations. These distinct maladaptive mechanisms may result in a pervasive disruption of the sense of belonging, feeling different and separated from others, as well as feelings of loneliness and a reduced level of social functioning. 2 New questions and work schedule The findings in funding period 1 emphasize the importance of alterations in the processing of positive social information in BPD. The planned project of funding period serves 2 aims: 1) Transferring these experimental findings into a modular, adaptive computer-assisted therapeutic intervention. This should provide an intensive, cost-efficient training, targeting the improvement of processing positive social information. This program will be evaluated within a randomized controlled trial. 2) Investigating further patho-mechanism in the development of feeling of belonging in BPD. During funding period 1 we had primarily studied features from the receiver perspective (i.e. the perception and evaluation of social rejection and inclusion). In period 2 we will focus on bidirectional processes incl. the sender perspective (i.e. behavioral expression of social signals; the adjustment of social behavior to social context and its consequences for the sense of belonging). We hypothesize, that basal affiliative processes such as behavioral matching, i.e. mimicry and synchronized action, and their interplay with the sensitivity to social reward, the storage of positive social information in memory, and the guidance of action based on positive social experiences are impaired in BPD patients. Effects will be measured by means of overt behavior, psychophysiological parameters (HR, EMG) and its neural correlates (fMRI). Work schedule: For this project, we will collect data from 60 female patients with BPD (age 18-45). For participating in study 2, we will recruit additionally a sample of 40 age, sex and educationally matched female healthy control subjects (age 18-45) and a clinical control group of 40 female patients with social phobia.

Bohus M, Schmahl C. DFG - Deutsche Forschungsgemeinschaft SFB 636: TP C05: Der Einfluss kognitiver und sensorischer Informationsverarbeitung während der Rekonsolidierung des Furcht-Gedächtnisses. 01/2012-12/2015.

The overall aim of this project is to elucidate the role of dysfunctional memory reconsolidation for the stabilization and persistence of traumatic memory and its potential role in the development and aintenance of posttraumatic stress disorder (PTSD). Memory reconsolidation is a putative neuronal, protein-synthesis-dependent process in which the retrieval of a previously consolidated memory returns to a plastic state. During reconsolidation memory can be disrupted, modified or even enhanced. It has recently been demonstrated that oral administration of the β-adrenergic receptor antagonist propranolol during memory reconsolidation in humans erased the behavioral expression of fear memory 24 h later and prevented the return of fear (Kindt et al., 2009). There is ample evidence that after traumatic experience acute memories for these events are repeatedly reactivated for a certain amount of time which allows for the incorporation of new information into trauma related memories and attenuation of the impact of trauma related stimuli. Failures during these automatized reconsolidation processes should lead to over-consolidation of traumatic memories. Since clinical studies have suggested that peri- and posttraumatic dissociation might be a risk factor for the development of PTSD, one could argue that dissociation might impact these automatized reconsolidation processes. During the first funding periods of the SFB we could show on experimental levels that dissociative experience attenuates both sensory processing and learning processes. Hence, one could argue that dissociation attenuates the sensory input driven adaptive memory accommodation during reconsolidation processes which leads to over-consolidation of trauma-associated memories in PTSD. The focus of this study is to test this hypothesis. In a first step we plan i) to examine to what extent sensory information processing during reconsolidation of recently learned fear enhances extinction and whether these effects are comparable to the recently reported effects of propranolol application during reconsolidation (Kindt et al., 2009); ii) to what extent purely cognitive reappraisal during reconsolidation weakens fear memory; and iii) to what extent acute dissociative features during reconsolidation hinder the modification of recently stored memory. We will examine healthy subjects and unmedicated patients with high proneness for dissociation (patients with BPD and complex PTSD). Differential fear conditioning will be applied following an established protocol by Kindt et al. (2009). After the acquisition phase, subjects will go through a reconsolidation paradigm under different conditions including, propranolol, cognitive, sensory and dissociative stimulation. The effects will be tested during extinction and reinstatement. We expect that sensory and cognitive input during reconsolidation weakens initially consolidated memory as well as propranolol. Whereas acute dissociation inhibits these putative sensory and cognitive effects, leading to stabilization of fear memory and enhanced reinstatement.

Zentralinstitut für Seelische Gesundheit (ZI) -