| 1. |
- Schindler, Lena, et al.
(författare)
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Cognitive functioning in posttraumatic stress disorder before and after cognitive-behavioral therapy
- 2020
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Ingår i: Journal of Anxiety Disorders. - : Elsevier BV. - 0887-6185. ; 74
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Tidskriftsartikel (refereegranskat)abstract
- Although substantial evidence suggests altered executive functioning and autobiographical memory in posttraumatic stress disorder (PTSD), the clinical significance of these findings remains unclear. Here, we investigated the effects of cognitive-behavioral therapy (CBT) on different aspects of cognitive functioning (working memory, interference susceptibility, conflict adaptation, autobiographical memory) in PTSD patients in a pre-post control group design with a nested cross-sectional element. Cross-sectional analyses at baseline were conducted on 58 PTSD patients, 39 traumatized (TC), and 45 non-traumatized controls (NTC). Intervention effects were investigated before and after 25 CBT sessions in 25 PTSD and 34 untreated NTC individuals assessed in parallel. At baseline, PTSD patients showed higher conflict adaptation than the NTC group and less autobiographical memory specificity than both control groups, suggesting particularly the latter to be a correlate of PTSD. No consistent evidence for treatment-induced improvements in cognitive functioning emerged on the group level or from associations between intra-individual clinical and cognitive changes. Analyses on the role of cognitive functioning on subsequent treatment effects revealed a predictive effect of backward digit span on CBT-induced reductions of depressiveness, but no other significant effects. Our findings highlight the need for further research to identify more relevant predictors of differential treatment response.
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| 2. |
- Schindler, Lena, et al.
(författare)
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Lifetime Trauma History and Cognitive Functioning in Major Depression and Their Role for Cognitive-Behavioral Therapy Outcome
- 2021
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Ingår i: Clinical Psychology in Europe. - : Leibniz Institute for Psychology (ZPID). - 2625-3410. ; 3:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: While cognitive-behavioral therapy (CBT) is the gold-standard psychological treatment for major depression (MD), non-response and lacking stability of treatment gains are persistent issues. Potential factors influencing treatment outcome might be lifetime trauma history and possibly associated primarily prefrontal-cortex- and hippocampus-dependent cognitive alterations. Method: We investigated MD and healthy control participants with (MD+T+, n = 37; MD-T+, n = 39) and without lifetime trauma history (MD+T-, n = 26; MD-T-, n = 45) regarding working memory, interference susceptibility, conflict adaptation, and autobiographical memory specificity. Further, MD+T+ (n = 21) and MD+T- groups (n = 16) were re-examined after 25 CBT sessions, with MD-T- individuals (n = 34) invited in parallel in order to explore the stability of cognitive. This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License, CC BY 4.0, which permits unrestricted use, distribution, and reproduction, provided the original work is properly cited. alterations and the predictive value of lifetime trauma history, cognitive functioning, and their interaction for treatment outcome. Results: On a cross-sectional level, MD+T+ showed the highest conflict adaptation, but MD+T- the lowest autobiographical memory specificity, while no group differences emerged for working memory and interference susceptibility. Clinical improvement did not differ between groups and cognitive functioning remained stable over CBT. Further, only a singular predictive association of forward digit span, but no other facets of baseline cognitive functioning, lifetime trauma history, or their interaction with treatment outcome emerged. Discussion: These results indicate differential roles of lifetime trauma history and psychopathology for cognitive functioning in MD, and add to the emerging literature on considering cognitive, next to clinical remission as a relevant treatment outcome.
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| 3. |
- Triscoli, Chantal, et al.
(författare)
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Heart rate variability is enhanced by long-lasting gentle touch
- 2017
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Ingår i: International Convention of Psychological Science (ICPS). Vienna, Austria: 23-25 march.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The affective dimension of touch, as coded by the C tactile afferents, plays an important role in the maintenance of the physical and social well-being of the individual. The present study investigates whether long-lasting pleasant touch performed at the velocity which elicits the highest CT firing frequency has a positive effect on autonomic responses and stress hormones. In a between-subjects design, 40 participants received either 40 minutes of brush stroking or vibration on the forearm, and rated the perceived pleasantness and intensity of the tactile stimulation in regular intervals. Salivary cortisol and alpha amylase levels, as well as measures of reward responsiveness, tactile sensitivity and interoceptive awareness were collected prior and after the tactile stimulation. Heart rate was registered throughout the whole experimental session. The pleasantness ratings decreased over continuous stimulation for both groups, with the brush stroking being perceived as more pleasant than vibration. The heart rate variability index “SDNN” increased over time for touch only, whereas it remained stable for vibration. Salivary cortisol levels decreased over time regardless the type of the tactile stimulation. These results indicate that prolonged pleasant touch at the CT optimized stroking velocity has a beneficial effect on the autonomic system, as shown by the increased SDNN, which is associated with wellbeing. The decrease in salivary cortisol levels for both touch and vibration suggests that several kinds of tactile stimulation may reduce stress. The above findings highlight the importance of long-lasting social touch interactions for improving the physiological state of the individual.
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| 4. |
- Triscoli, Chantal, et al.
(författare)
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Heart rate variability is enhanced by long-lasting pleasant touch at CT-optimized velocity
- 2017
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Ingår i: Biological Psychology. - : ELSEVIER SCIENCE BV. - 0301-0511 .- 1873-6246. ; 128, s. 71-81
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The present study explores whether long-lasting pleasant touch has positive effects on the stress response, reward sensitivity, mood, and interoceptive awareness. Methods: 40 participants received either 35 min of brush stroking targeting C-tactile fibres (CT) or vibration on the forearm, and rated pleasantness and intensity. Prior and after, stress response (cortisol and heart rate variability), reward sensitivity, mood and interoceptive awareness were measured. Results: Pleasantness decreased over time for both groups, with brush stroking being perceived as more pleasant and intense than vibration. Heart rate variability (SDNN) increased for brush stroking only, and was related to the higher pleasantness and intensity. No significant effect of CT-optimal touch was observed on any of the other measures. Discussion: The beneficial effect of pleasant touch on heart rate variability suggests a neuronal link between CTfibre stimulation and autonomic regulation, and highlights the potential of long-lasting touch to improve the physiological response.
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| 5. |
- Woud, Marcella L., et al.
(författare)
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Augmenting inpatient treatment for post-traumatic stress disorder with a computerised cognitive bias modification procedure targeting appraisals (CBM-App) : protocol for a randomised controlled trial
- 2018
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Ingår i: BMJ Open. - : BMJ PUBLISHING GROUP. - 2044-6055. ; 8:6
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Influential theories of post-traumatic stress disorder (PTSD) suggest that dysfunctional appraisals of trauma play a key role in the maintenance of symptoms, and this suggestion is increasingly supported by research. Experimental studies have indicated that a simple computerised cognitive training procedure, here termed cognitive bias modification-appraisals (CBM-App), can modify trauma-relevant appraisals and reduce analogue trauma symptoms among healthy volunteers. This suggests the possibility that CBM-App could improve outcomes in PTSD via targeting the key process of dysfunctional appraisals, for example, if applied as an adjunct to treatment. Methods and analysis The study is a randomised controlled trial with two parallel arms. It is planned to randomise 80 patients admitted for treatment for PTSD to an inpatient treatment clinic to complete either sessions of CBM-App or a sham-training control condition, the peripheral vision task. Both interventions comprise eight sessions scheduled over a 2-week period and are completed in addition to the standard treatment programme in the clinic. Outcome assessment occurs pretraining, after 1 week of training, post-training, at discharge from the inpatient clinic and 6 weeks and 3 months postdischarge. The primary outcome is dysfunctional trauma-relevant appraisals at post-training, measured using a scenario completion task. Secondary outcomes include symptom measures and hair cortisol. Outcome analyses will be primarily via mixed linear models and conducted with both intention to treat and per protocol samples. Ethics and dissemination The trial has been approved by the Ethics Committee for the Faculty of Psychology, Ruhr-Universitat Bochum (approval no 204) and the Ethics Committee for the Faculty of Medicine, Ruhr-Universitat Bochum (approval no 15-5477). Results will be published in peer-reviewed journals and will inform future clinical and experimental studies into targeting maladaptive appraisals for the reduction of PTSD symptoms.
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| 6. |
- Woud, Marcella L., et al.
(författare)
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Investigating d-cycloserine as a potential pharmacological enhancer of an emotional bias learning procedure
- 2018
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Ingår i: Journal of Psychopharmacology. - : SAGE PUBLICATIONS LTD. - 0269-8811 .- 1461-7285. ; 32:5, s. 569-577
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Tidskriftsartikel (refereegranskat)abstract
- The partial N-methyl-D-aspartate receptor agonist d-cycloserine may enhance psychological therapies. However, its exact mechanism of action is still being investigated. Cognitive bias modification techniques allow isolation of cognitive processes and thus investigation of how they may be affected by d-cycloserine. We used a cognitive bias modification paradigm targeting appraisals of a stressful event, Cognitive Bias Modification-Appraisal, to investigate whether d-cycloserine enhanced the modification of appraisal, and whether it caused greater reduction in indices of psychopathology. Participants received either 250 mg of d-cycloserine (n=19) or placebo (n=19). As a stressor task, participants recalled a negative life event, followed by positive Cognitive Bias Modification-Appraisal training. Before and after Cognitive Bias Modification-Appraisal, appraisals and indices of psychopathology related to the stressor were assessed. Cognitive Bias Modification-Appraisal successfully modified appraisals, but d-cycloserine did not affect appraisals post-training. There were no post-training group differences in frequency of intrusions. Interestingly, d-cycloserine led to a greater reduction in distress and impact on state mood from recalling the event, and lower distress post-training was associated with fewer intrusions. Therefore, d-cycloserine may affect emotional reactivity to recalling a negative event when combined with induction of a positive appraisal style, but via a mechanism other than enhanced learning of the appraisal style.
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| 7. |
- Woud, Marcella L., et al.
(författare)
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The Effects of Modifying Dysfunctional Appraisals in Posttraumatic Stress Disorder Using a Form of Cognitive Bias Modification : Results of a Randomized Controlled Trial in an Inpatient Setting
- 2021
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Ingår i: Psychotherapy and Psychosomatics. - : S. Karger. - 0033-3190 .- 1423-0348. ; 90:6, s. 386-402
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Dysfunctional appraisals about traumatic events and their sequelae are a key mechanism in posttraumatic stress disorder (PTSD). Experimental studies have shown that a computerized cognitive training, cognitive bias modification for appraisals (CBM-APP), can modify dysfunctional appraisals and reduce analogue trauma symptoms amongst healthy and subclinical volunteers.Objective We aimed to test whether CBM-APP could reduce dysfunctional appraisals related to trauma reactions in PTSD patients, and whether this would lead to improvements in PTSD symptoms.Methods We compared CBM-APP to sham training in a parallel-arm proof-of-principle double-blind randomized controlled trial amongst 80 PTSD patients admitted to an inpatient clinic. Both arms comprised a training schedule of 8 sessions over a 2-week period and were completed as an adjunct to the standard treatment programme.Results In intention-to-treat analyses, participants receiving CBM-APP showed a greater reduction in dysfunctional appraisals on a scenario task from pre- to posttraining (primary outcome) assessments, compared to those receiving sham training (d = 1.30, 95% CI 0.82-1.80), with between-group differences also found on the Posttraumatic Cognitions Inventory (PTCI; d = 0.85, 95% CI 0.39-1.32) and the PTSD Checklist for DSM-5 (PCL-5; d = 0.68, 95% CI 0.23-1.14), but not for long-term cortisol concentrations (d = 0.25, 95% CI -0.28 to 0.78). Reductions in dysfunctional appraisals assessed via the scenario task correlated with reductions on the PTCI, PCL-5, and hair cortisol concentrations from pre- to posttraining time points.Cocnclusions Results support dysfunctional appraisals as a modifiable cognitive mechanism, and that their proximal modification transfers to downstream PTSD symptoms. These findings could open new avenues for improving present therapeutic approaches.
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