Aktuelles

Ein neues Paper von Dr. Sinha Engel wurde akzeptiert:

19..01.2024

Haering, S., Schulze, L., Geiling, A., Meyer, C., Klusmann, H., Schumacher, S., Knaevelsrud, C. & Engel, S. (accepted). Higher risk, less data: A systematic review and meta-analysis on the role of sex and gender in trauma research. Journal of Psychopathology and Clinical Science.

Abstract: Women and men are at different risk for posttraumatic stress disorder (PTSD). It is unclear, however, how studies on PTSD risk factors integrate this knowledge into their research. Moreover, the temporal development of women’s higher PTSD risk is unknown. In this systematic review and meta-analysis, we examine how prospective studies on PTSD development (k=47) consider sex and gender across four domains (samples, terminology, analyses, and reporting). Further, we differentially analyze sex/gender differences within five time-intervals from 1 month to 5 years post-trauma.
PTSD prevalence (OR = 1.72 [1.27 – 2.34]) and severity (g = 0.31 [0.09; 0.53]) were increased for women relative to men at one month post-trauma already, i.e. at the first timepoint of a possible PTSD diagnosis. PTSD severity was elevated for women compared to men across all time intervals, but evidence for increased PTSD prevalence for women relative to men was less stable with longer follow-ups. Despite women’s higher PTSD burdens, they were clearly underrepresented in samples (68.3% male, 31.7% female participants). Only 5.0% of studies explained or described their understanding of sex and gender, and only 2.6% used sex as discovery variable, i.e. investigating sex-dependent risk mechanisms. Sex and gender aspects in design, data, and discussion were considered by only one third of studies each.
Trauma research falls short of its potential to adequately consider sex and gender. Sex- and gender-sensitive practices can advance rigor, innovation and equity in psychopathology research.

 

Dr. Yunbo Yang hat zwei neue Publikationen veröffentlicht:

11.01.2024

Zavorotnyy, M., Klatte, S., Yang, Y., Liu, W., Wagner, U., & Kircher, T. (2023). The effects of a psychiatric clerkship on stigmatizing attitudes toward mental disorders as held by German medical students. Frontiers in Psychiatry14.


Background: According to the United Nations, access to medical care is a fundamental human right. However, there is widespread stigmatization of severe mental illnesses and this appears to seriously hamper the quality of healthcare in people with psychiatric co-morbidity. Thus, interventions that help reduce stigma among healthcare providers are urgently needed.
Purpose: The objective of the current study was to investigate the effects of a psychiatric clerkship on stigmatizing attitudes toward mental disorders held by medical students.
Methods: Between 2018 and 2019, a total of 256 third- and fourth-year students from Marburg University Medical School (Germany) completed two surveys—one before and one after a 2 week clerkship program that was designed to prioritize direct interaction with the patients. For measuring stigma, the questionnaires contained questions about students' attitudes toward psychiatry (ATP), including the Opening Minds Scale for Healthcare Providers (OMS-HC), Community Attitudes Toward the Mentally Ill (CAMI), and measurements according to the Stereotype-Content Model (SCM). We conducted pre-vs.-post comparisons using the Wilcoxon signed rank test with continuity correction or paired t-test and employed the Spearman method for correlational analysis. We considered p < 0.05 significant and adjusted all p-values reported here using the Benjamini-Hochberg procedure to account for family-wise error.
Results: After the clerkship, a significantly reduced stigma was found, as assessed with ATP (mean p < 0.001), OMS-HC (sum and subscale “attitudes” p < 0.001; subscale “disclosure” p = 0.002), and both SCM subscales (p < 0.001). Moreover, we observed significant associations between stigma expression (e.g., OMS-HC sum) and the willingness of students to choose psychiatric residency after finishing medical school (before clerkship: p < 0.001; ρ = −0.35; change after clerkship: p = 0.004; ρ = −0.2).
Conclusion: Our findings indicate that a psychiatric clerkship that involves students in direct interaction with patients may effectively reduce stigma. Therefore, we advocate the incorporation of components of direct interaction in medical education to combat stigma and unequal treatment, as this could improve outcomes in patients with severe mental illnesses.

 

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Bruin, W. B., Zhutovsky, P., van Wingen, G. A., Bas-Hoogendam, J. M., Groenewold, N. A., Hilbert, K., Winkler, A. M., Zugman, A., Agosta, F., Åhs, F., Andreescu, C., Antonacci, C., Asami, T., Assaf, M., Barber, J. P., Bauer, J., Bavdekar, S. Y., Beesdo-Baum, K., Benedetti, F., Bernstein, R., Björkstrand, J., Blair, R. J., Blair, K. S., Blanco-Hinojo, L., Böhnlein, J., Brambilla, P., Bressan, R. A., Breuer, F., Cano, M., Canu, E., Cardinale, E. M., Cardoner, N., Cividini, C., Cremers, H., Dannlowski, U., Diefenbach, G. J., Domschke, K., Doruyter, A. G. G., Dresler, T., Erhardt, A., Filippi, M., Fonzo, G. A., Freitag, G. F., Furmark, T., Ge, T., Gerber, A. J., Gosnell, S. N., Grabe, H. J., Grotegerd, D., Gur, R. C., Gur, R. E., Hamm, A. O., Han, L. K. M., Harper, J. C., Harrewijn, A., Heeren, A., Hofmann, D., Jackowski, A. P., Jahanshad, N., Jett, L., Kaczkurkin, A. N., Khosravi, P., Kingsley, E. N., Kircher, T., Kostic, M., Larsen, B., Lee, S.-H., Leehr, E. J., Leibenluft, E., Lochner, C., Lui, S., Maggioni, E., Manfro, G. G., Månsson, K. N. T., Marino, C. E., Meeten, F., Milrod, B., Jovanovic, A. M., Mwangi, B., Myers, M. J., Neufang, S., Nielsen, J. A., Ohrmann, P. A., Ottaviani, C., Paulus, M. P., Perino, M. T., Phan, K. L., Poletti, S., Porta-Casteràs, D., Pujol, J., Reinecke, A., Ringlein, G. V., Rjabtsenkov, P., Roelofs, K., Salas, R., Salum, G. A., Satterthwaite, T. D., Schrammen, E., Sindermann, L., Smoller, J. W., Soares, J. C., Stark, R., Stein, F., Straube, T., Straube, B., Strawn, J. R., Suarez-Jimenez, B., Sylvester, C. M., Talati, A., Thomopoulos, S. I., Tükel, R., van Nieuwenhuizen, H., Werwath, K., Wittfeld, K., Wright, B., Wu, M.-J., Yang, Y., Zilverstand, A., Zwanzger, P., Blackford, J. U., Avery, S. N., Clauss, J. A., Lueken, U., Thompson, P. M., Pine, D. S., Stein, D. J., van der Wee, N. J. A., Veltman, D. J., Aghajani, M. (2024). Brain-based classification of youth with anxiety disorders: transdiagnostic examinations within the ENIGMA-Anxiety database using machine learning. Nat. Mental Health 2, 104–118. https://doi.org/10.1038/s44220-023-00173-2

Abstract
Neuroanatomical findings on youth anxiety disorders are notoriously difficult to replicate, small in effect size and have limited clinical relevance. These concerns have prompted a paradigm shift toward highly powered (that is, big data) individual-level inferences, which are data driven, transdiagnostic and neurobiologically informed. Here we built and validated supervised neuroanatomical machine learning models for individual-level inferences, using a case–control design and the largest known neuroimaging database on youth anxiety disorders: the ENIGMA-Anxiety Consortium (N = 3,343; age = 10–25 years; global sites = 32). Modest, yet robust, brain-based classifications were achieved for specific anxiety disorders (panic disorder), but also transdiagnostically for all anxiety disorders when patients were subgrouped according to their sex, medication status and symptom severity (area under the receiver operating characteristic curve, 0.59–0.63). Classifications were driven by neuroanatomical features (cortical thickness, cortical surface area and subcortical volumes) in fronto-striato-limbic and temporoparietal regions. This benchmark study within a large, heterogeneous and multisite sample of youth with anxiety disorders reveals that only modest classification performances can be realistically achieved with machine learning using neuroanatomical data.

 

Dr. Sinha Engel hat eine neue Publikation veröffentlicht:

23.11.2023

Klusmann, H., Kapp, C., Engel, S., Schumacher, T., Bücklein, E., Knaevelsrud, C. & Schumacher, S. (accepted). Higher depressive symptoms in irregular menstrual cycles - converging evidence from cross-sectional and prospective assessments. Psychopathology.

Background: Menstrual cycle regularity is an important marker of reproductive health and associated with physiological and psychological illnesses, as well as experiencing stress. We hypothesized that individuals with irregular menstrual cycles report higher depressive symptom severity, after controlling for stress occurrence.
Methods: The hypothesis was examined through two measurement approaches: a cross-sectional and a prospective, longitudinal study. In the cross-sectional study, participants (n = 394) reported depressive symptoms and their overall menstrual cycle regularity. In the longitudinal study, participants (n = 77) completed questionnaires on depressive symptoms and stress during the mid-follicular and periovulatory phase of one menstrual cycle. Depressive symptoms were compared between participants with regular and irregular cycles through a Welch t-test and an ANCOVA.
Results: Participants with irregular menstrual cycles reported more depressive symptoms in the cross-sectional analysis. Similarly, in the longitudinal analysis, the group with a current irregular menstrual cycle reported more depressive symptoms after controlling for stress occurrence. When including only complete data sets without multiple imputation (n = 52), the direction of the effects remained, but did not reach statistical significance.
Limitations: Although we investigated the menstrual cycle prospectively, it would have been more precise to include two or more cycles and daily sex hormone measurements. Further limitations were the suboptimal statistical power and the data collection during the COVID pandemic.
Conclusions: The results indicate an association between depressive symptoms and menstrual cycle irregularity. We give recommendations on how to incorporate this in future study designs on women’s mental health.

 
Prof. Dr. Jan Richter hat eine neue Publikation veröffentlicht: 19.10.2023

Heinig, I., Weiß, M., Hamm, A. O., Hein, G., Hollandt, M., Hoyer, J., Kankse, P., Richter, J., Wittchen, H.-U., Pittig, A. (in press). Exposure Tracked in Daily Life: Improvements in Ecologically Assessed Social and Physical Activity following Exposure-Based CBT for Anxiety Disorders. Journal of Anxiety Disorders. IF: 10.3

Background: Although exposure-based cognitive-behavioral therapy for anxiety. disorders has frequently been proven effective, only few studies examined whether it. improves everyday behavioral outcomes such as social and physical activity.

Methods: 126 participants (85 patients with panic disorder, agoraphobia, social anxiety. disorder, or specific phobias, and 41 controls without mental disorders) completed. smartphone-based ambulatory ratings (activities, social interactions, mood, physical. symptoms) and motion sensor-based indices of physical activity (steps, time spent. moving, metabolic activity) at baseline, during, and after exposure-based treatment.

Results: Prior to treatment, patients showed reduced mood and physical activity. relative to healthy controls. Over the course of therapy, mood ratings, interactions with. strangers and indices of physical activity improved, while reported physical symptoms. decreased. Overall esults did not differ between patients with primary panic. disorder/agoraphobia and social anxiety disorder. Higher depression scores at. baseline were associated with larger changes in reported symptoms and mood ratings,. but smaller changes in physical activity

Conclusions: Exposure-based treatment initiates increased physical activity, more. frequent interaction with strangers, and improvements in everyday mood. The current. approach provides objective and fine-graded process and outcome measures that may. help to further improve treatments and possibly reduce relapse.

 

 
Prof. Dr. Jan Richter und Dr. Yunbo Yang haben eine neue Publikation veröffentlicht: 19.10.2023

Hilbert, K., Boeken, O. J., Langhammer, T., Groenewold, N. A., Bas-Hoogendam, J. M., Aghajani, M., …, Richter, J., …, Yang, Y., …, Lueken, U. (in press). Cortical and subcortical brain alterations in specific phobia and its animal and blood-injection-injury subtypes: a mega-analysis from the ENIGMA- Anxiety Working Group. American Journal of Psychiatry. IF: 17.7

Objective: Specific phobia is a common anxiety disorder, but the literature on associated brain structure alterations exhibits substantial gaps. The ENIGMA-Anxiety Working Group examined brain structure differences between subjects with specific phobias and healthy controls as well as between animal and blood-injection-injury (BII) subtypes. Additionally, the authors investigated associations of brain structure with symptom severity and age (youth vs. adults).
Methods: Datasets from 31 original studies were combined to create a final sample with nphobia=1452 phobia subjects and ncontrol=2991 healthy participants (62.7% female, 5-90yrs). Imaging processing and quality control were conducted using established ENIGMA-protocols. Subcortical volumes as well as cortical surface area and thickness were examined in a preregistered analysis (osf.io/n6bhz).
Results: Phobia subjects compared to healthy controls showed mostly smaller subcortical volumes, mixed surface differences and larger cortical thickness across a substantial number of regions. Phobia subgroups also showed differences, including, as hypothesized, larger medial orbitofrontal cortex thickness in BII phobia compared to animal phobia (nBII=182; nanimal=739). All findings were driven by adult subjects; the authors found no significant results in children and adolescents.
Conclusions: Brain alterations associated with specific phobia exceeded those of other anxiety disorders in comparable analyses in extent and effect size and were not limited to reductions in brain structure. Moreover, phenomenological differences between phobia subgroups were reflected in diverging neural underpinnings, including brain areas related to fear processing and higher cognitive processes. The findings implicate brain structure alterations in specific phobia, although subcortical alterations in particular may also relate to broader internalizing psychopathology.

 

Prof. Dr. Jan Richter im Gesundheitsministerium bei Karl Lauterbach

Am 29.09.2023 übergab Prof. Dr. Jan Richter zusammen mit Kolleg*innen von der DGPs, unith und DPtV dem Gesundheitsminister Prof. Dr. Karl Lauterbach…

Neues Teammitglied:

Wir begrüßen ganz herzlich Cindy Gerberding als neue studentische Mitarbeiterin in der Arbeitsgruppe und freuen uns auf die gemeinsame Arbeit!

Dr. Sinha Engel hat eine neue Publikation veröffentlicht:

Cortisol response to traumatic stress to predict PTSD symptom development – a systematic review and meta-analysis of experimental studies. European…

Dr. Sinha Engel hat eine neue Publikation veröffentlicht:

Menstrual cycle-related changes in HPA axis reactivity to acute psychosocial and physiological stressors - a systematic review and meta-analysis of…

Neues Teammitglied:

Neue Teammitglieder: Wir begrüßen ganz herzlich Doreen Kreykenbohm als neue Mitarbeiterin im Sekreteriat der Arbeitsgruppe. Wir freuen uns auf die…

Angststörungen: Neue intensivierte Psychotherapie reduziert ambulante Behandlungsdauer drastisch

In den vergangenen 15 Jahren konnte eine ambulante Psychotherapie für Angststörungen entwickelt und in Forschungsstudien erfolgreich angewendet…

Neue Teammitglieder:

Neue Teammitglieder: Wir begrüßen ganz herzlich Amélie Schnellecke und Michelle Witschel als neue studentische Mitarbeiterinnen in der Arbeitsgruppe.…

Dr. Sinha Engel hat eine neue Publikation veröffentlicht:

The effect of an internet-based intervention for depression on cortisol and alpha-amylase. Psychoneuroendocrinology

Prof. Dr. Jan Richter hat eine neue Publikation veröffentlicht:

Physiological and neural synchrony in emotional and neutral stimulus processing: A study protocol. Frontiers in Psychiatry.

Prof. Dr. Jan Richter und Edgar Nazarenus haben eine neue Publikation veröffentlicht:

Biologisch unterstützte psychotherapeutische Interventionen bei therapieresistenten Depressionen - in: Therapieresistenz bei Depressionen und…