Can glucose facilitate fear exposure? Randomized, placebo-controlled trials on the effects of glucose administration on fear extinction processes.

Previous studies showed that glucose has beneficial effects on memory function and can enhance contextual fear learning. To derive potential therapeutic interventions, further research is needed regarding the effects of glucose on fear extinction. In two experimental studies with healthy participants (Study 1: N = 68, 39 females; Study 2: N = 89, 67 females), we investigated the effects of glucose on fear extinction learning and its consolidation. Participants completed a differential fear conditioning paradigm consisting of acquisition, extinction, and return of fear tests: reinstatement, and extinction recall. US-expectancy ratings, skin conductance response (SCR), and fear potentiated startle (FPS) were collected. Participants were pseudorandomized and double-blinded to one of two groups: They received either a drink containing glucose or saccharine 20 min before (Study 1) or immediately after extinction (Study 2). The glucose group showed a significantly stronger decrease in differential FPS during extinction (Study 1) and extinction recall (Study 2). Additionally, the glucose group showed a significantly lower contextual anxiety at test of reinstatement (Study 2). Our findings provide first evidence that glucose supports the process of fear extinction, and in particular the consolidation of fear extinction memory, and thus has potential as a beneficial adjuvant to extinction-based treatments. Registered through the German Clinical Trials Registry (https://www.bfarm.de/EN/BfArM/Tasks/German-Clinical-Trials-Register/_node.html; Study 1: DRKS00010550; Study 2: DRKS00018933).

A Relaxed Horse-A Relaxed Client? An Experimental Investigation of the Effects of Therapy Horses' Stress on Clients' Stress, Mood, and Anxiety.

Equine-assisted therapies are becoming increasingly popular for addressing physical and psychological disabilities in clients. The role of the horse's welfare in equine-assisted service receives increasing attention in research. Several studies have shown that horses are able to perceive human emotions and respond to human stress responses. However, no research has yet looked at the other side of the coin-whether and how humans perceive and react to equine stress levels during equine-assisted services. To fill this gap in the research, we employed a within-subjects design, in which horse-naïve participants had a standardized interaction with both an experimentally stressed horse and an experimentally relaxed horse. We assessed physiological indicators of stress (heart rate, heart rate variability, and salivary cortisol) in participants and horses, as well as psychological indicators of stress (state anxiety and positive and negative affect) in participants. Although our stress and relaxation manipulations were successful (indicated by horses' physiological indicators of stress), we did not find any difference in the participants' physiological or psychological indicators of stress between the interaction with a stressed and the interaction with a relaxed horse. Together with results from previous studies, this suggests that humans cannot intuitively recognize the (physiological) stress level of horses, which has important implications for effective communication and bonding between humans and horses and for the safety of equine activities.

Childhood emotional maltreatment and sensitivity to social rejection in emerging adults.

BACKGROUND: Enhanced responsiveness to social rejection may be a transdiagnostic mechanism through which childhood emotional maltreatment predisposes individuals to interpersonal and mental health problems. To investigate this mechanism, as a first step, more detailed investigations are needed regarding the assumed association of childhood emotional maltreatment with rejection sensitivity in later life. OBJECTIVE: The present work examines the hypothesis that among different subtypes of childhood maltreatment, in particular forms of emotional maltreatment (emotional abuse and neglect) relate to rejection sensitivity in emerging adults. PARTICIPANTS AND SETTING: In study 1, 311 emerging adults (18-25 years) participated in a retrospective cross-sectional assessment. In study 2, 78 emerging adults (18-25 years) were included in an experiment (O-Cam paradigm) which involved the experience of social rejection (vs. inclusion). METHODS: Study 1 investigates whether intensities of childhood emotional abuse and neglect have unique associations with trait rejection sensitivity, when considering all maltreatment subtypes (emotional abuse, sexual abuse, physical abuse, emotional neglect, physical neglect) simultaneously. Study 2 examined whether childhood emotional abuse and neglect moderate the experience of social rejection in terms of need depletion, sadness and anger after social rejection (vs. inclusion). RESULTS: Study 1 indicates that emotional abuse and neglect have unique associations with rejection sensitivity. Study 2 results show that only a higher intensity of emotional abuse has extensive effects on need depletion and sadness after social rejection (vs. inclusion). CONCLUSIONS: In particular, experiences of childhood emotional abuse may relate to rejection sensitivity in young adulthood.

Moderate-intensity aerobic exercise training as an adjunct to trauma-focused psychotherapy in traumatized refugees and asylum seekers: study protocol of a randomized controlled trial.

Background: Refugees with exposure to multiple traumatic events are at high risk for developing posttraumatic stress disorder (PTSD) and depression. Narrative exposure therapy (NET) is an effective treatment for the core symptoms of PTSD, but it does not reliably reduce depressive symptoms. Endurance exercise on the other hand was consistently found to be effective in treating depression making it a promising adjunct to NET. Up to date, no studies exist investigating the combination of NET and endurance exercise in a sample of refugees with PTSD and comorbid depression.Objectives: In the proposed randomized controlled trial, we aim to investigate whether a combination of NET and moderate-intensity aerobic exercise training (MAET) enhances treatment outcome for refugees with PTSD and comorbid depressive symptoms. We expect a greater improvement in psychopathology in participants who receive the combined treatment.Methods and analysis: 68 refugees and asylum seekers with PTSD and clinically relevant depressive symptoms will be recruited in the proposed study. Participants will be randomly assigned to receive either NET only (NET-group) or NET plus MAET (NET+-group). All participants will receive 10 NET sessions. Participants in the NET+-group will additionally take part in MAET. Primary (PTSD, depression) and secondary (general mental distress, agoraphobia and somatoform complaints, sleep quality) outcome measures will be assessed before treatment, after treatment, and at six-month follow-up. The hypotheses will be tested with multiple 2 × 3 mixed ANOVA's.Trial registration: German Clinical Trials Register identifier: DRKS00022145.

Refugees are at particularly high risk of developing posttraumatic stress disorder and comorbid depressive symptoms due to exposure to multiple man-made traumatic events.Narrative exposure therapy reliably reduces symptoms of posttraumatic stress disorder, but many patients retain their clinical diagnosis, untreated comorbid depressive symptoms may interfere with treatment response.The randomized controlled trial aims to investigate whether combining narrative exposure therapy with moderate-intensity aerobic exercise training enhances treatment outcomes for refugees with posttraumatic stress disorder and comorbid depressive symptoms, compared to narrative exposure therapy as a stand-alone treatment.

Generation climate crisis, COVID-19, and Russia-Ukraine-War: global crises and mental health in adolescents.

Climate change, COVID-19, and the Russia-Ukraine War are some of the great challenges of our time. These global crises affect young people in a particularly vulnerable phase of their lives. The current study aimed to assess the impact of these crises on mental health (depression, anxiety, and health-related quality of life) in secondary school students in Germany. Furthermore, we assessed known predictors of mental health, such as socio-economic factors, individual life stressors, and resilience factors (self-efficacy, expressive flexibility) as covariates. In our sample of 3998 pupils, pandemic- and climate-related distress were linked to greater depression and anxiety and reduced health-related quality of life. War-related distress was associated with greater anxiety. Critically, these associations remained significant after controlling for all covariates, supporting the incremental predictive value of the crises measures. The study reveals a significant impact of the crises on the mental health of the current generation of adolescents. As such it suggests that mental health policies should include interventions that help youth to cope with the stress caused by the crises.

To sleep or not to sleep, that is the question: A systematic review and meta-analysis on the effect of post-trauma sleep on intrusive memories of analog trauma.

Distressing intrusive memories of a traumatic event are one of the hallmark symptoms of posttraumatic stress disorder. Thus, it is crucial to identify early interventions that prevent the occurrence of intrusive memories. Both, sleep and sleep deprivation have been discussed as such interventions, yet previous studies yielded contradicting effects. Our systematic review aims at evaluating existing evidence by means of traditional and individual participant data (IPD) meta-analyses to overcome power issues of sleep research. Until May 16th, 2022, six databases were searched for experimental analog studies examining the effect of post-trauma sleep versus wakefulness on intrusive memories. Nine studies were included in our traditional meta-analysis (8 in the IPD meta-analysis). Our analysis provided evidence for a small effect favoring sleep over wakefulness, log-ROM = 0.25, p < .001, suggesting that sleep is associated with a lower number of intrusions but unrelated to the occurrence of any versus no intrusions. We found no evidence for an effect of sleep on intrusion distress. Heterogeneity was low and certainty of evidence for our primary analysis was moderate. Our findings suggest that post-trauma sleep has the potential to be protective by reducing intrusion frequency. More research is needed to determine the impact following real-world trauma and the potential clinical significance.

The relationship between attachment to pets and mental health: the shared link via attachment to humans.

BACKGROUND: Several studies have investigated the relationship between emotional attachment to pets and mental health with the majority of studies finding a negative relationship between emotional attachment to pets and mental health. Interestingly, attachment to pets differs from attachment to humans with studies showing that humans with an insecure attachment style form a particularly strong emotional attachment to their companion animals. Human attachment style is also related to mental health with secure attachment being associated with superior mental health. Building on those findings, the current study aimed at exploring the role of attachment to humans in the relationship between emotional attachment to pets and mental health. METHODS: In this cross-sectional online survey (N = 610) we assessed the strength of emotional attachment to pets and attachment to humans. We further collected pet specific data as well as mental health burden in a sample of German dog owners (Mage=33.12; 92.79% women). We used a mediation model estimating the indirect link between emotional attachment to pets and mental health burden via human attachment and the direct link between emotional attachment to pets and mental health burden simultaneously. RESULTS: We found that attachment to humans fully mediated the positive association between emotional attachment to pets and mental health burden. A stronger emotional attachment to one's dog was associated with lower comfort with depending on or trusting in others, whereby lower comfort with depending on or trusting in others was related to higher mental health burden. Moreover, a stronger attachment to one's dog was also related to a greater fear of being rejected and unloved (Anxiety), which was, in turn, associated with a higher mental health burden. CONCLUSION: Our findings suggest that the positive link between emotional attachment to pets and mental health burden is fully accounted for by its shared variance with insecure attachment to humans in a sample mostly comprising self-identified women. Future studies need to examine whether strong emotional bonds with pets may evolve as a compensatory strategy to buffer difficult childhood bonding experiences.

Prospective associations between intelligence, working memory capacity, and intrusive memories of a traumatic film: Potential mediating effects of rumination and memory disorganization.

BACKGROUND AND OBJECTIVES: Field research indicates that lower intelligence may predispose trauma-exposed individuals towards the development of re-experiencing symptoms. However, this assumption requires further testing in controlled prospective studies. In the current analog study, we tested whether lower fluid intelligence and lower working memory capacity (WMC) independently contribute to intrusion development. Moreover, we investigated potential mediating effects of trauma memory characteristics and trait rumination. METHODS: 118 healthy participants completed tests measuring fluid intelligence and WMC. Two days later, they were exposed to a film clip depicting traumatic events (i.e., so-called trauma film). After exposure to the film, intrusions were assessed using a diary and an intrusion triggering task. RESULTS: Our analyses revealed a negative correlation between fluid intelligence and intrusions during the intrusion triggering task. WMC did not correlate with any intrusion measure. Moreover, planned analyses did not yield any mediation effects. LIMITATIONS: We used the trauma film paradigm to examine analog posttraumatic stress symptoms. This approach limits the generalizability of our findings with regard to symptom development following real-life traumatic events. CONCLUSIONS: Our results show for the first time that higher fluid intelligence is associated with fewer intrusions of a trauma film. This association was evident for laboratory but not for ambulatory intrusions. By demonstrating this association using a prospective experimental design, our study importantly corroborates previous field research.

On-line anxiety level detection from biosignals: Machine learning based on a randomized controlled trial with spider-fearful individuals.

We present performance results concerning the validation for anxiety level detection based on trained mathematical models using supervised machine learning techniques. The model training is based on biosignals acquired in a randomized controlled trial. Wearable sensors were used to collect electrocardiogram, electrodermal activity, and respiration from spider-fearful individuals. We designed and applied ten approaches for data labeling considering individual biosignals as well as subjective ratings. Performance results revealed a selection of trained models adapted for two-level (low and high) and three-level (low, medium and high) classification of anxiety using a minimal set of six features. We obtained a remarkable accuracy of 89.8% for the two-level classification and of 74.4% for the three-level classification using a short time window length of ten seconds when applying the approach that uses subjective ratings for data labeling. Bagged Trees proved to be the most suitable classifier type among the classification models studied. The trained models will have a practical impact on the feasibility study of an augmented reality exposure therapy based on a therapeutic game for the treatment of arachnophobia.

Correlates of mental health in occupations at risk for traumatization: a cross-sectional study.

BACKGROUND: Hospitals, police stations, and fire departments are highly demanding workplaces. Staff members are regularly exposed to various stressors including traumatic events. Correspondingly, several studies report high rates of mental health issues among these occupations. Nevertheless, despite these challenging circumstances, some staff members manage to sustain their mental health. The current study is the first to investigate three health-promoting factors simultaneously among three different, highly demanding occupations. METHODS: The present cross-sectional survey investigated health-promoting factors (sense of coherence - SOC, trait-resilience, locus of control - LOC) and mental health outcomes (general psychopathological symptom burden, posttraumatic stress, burnout) in medical staff (n = 223), police officers (n = 257), and firefighters (n = 100). RESULTS: Among all occupations, SOC, trait-resilience, and an internal LOC were negatively associated with general psychopathological symptoms, posttraumatic stress, and burnout symptoms. By contrast, all these outcome measures were positively correlated with an external LOC. Multiple regression models including all health-promoting factors explained 56% of the variance in general psychopathological symptoms and 27% in posttraumatic stress symptoms. Among all occupations, SOC was the strongest predictor of both general psychopathological symptom burden and posttraumatic stress symptoms. Multigroup path analyses revealed minor differences across occupations, mainly driven by a stronger influence of LOC in police officers. CONCLUSION: Across all occupations, SOC was identified as the most important health-promoting factor. Future longitudinal studies should further examine the causal link between health-promoting factors and mental distress in different workplaces. Such studies will also allow for further development and evaluation of resilience promoting programs.

The Relationship between Dog Ownership, Psychopathological Symptoms and Health-Benefitting Factors in Occupations at Risk for Traumatization.

Individuals working in high-risk occupations (e.g., emergency staff) are exposed to high levels of occupational stress including traumatic events. Correspondingly, several studies report high rates of mental health problems among these occupations. Pet ownership has been associated with better mental health. However, to date a study on the association between pet ownership and indicators of mental health in these occupations is missing. The present cross-sectional survey (N = 580) investigated pet ownership, attachment to pets, health-benefitting factors (i.e., sense of coherence, trait-resilience, locus of control) and psychopathological symptoms (i.e., general mental health problems, posttraumatic stress, burnout) in medical staff, police officers, and firefighters. Dog owners and non-dog owners showed comparable levels of psychopathological distress and health-benefitting factors. Compared to cat owners, dog owners demonstrated stronger emotional attachment to their pet. Moreover, a stronger attachment was also linked to higher levels of psychopathological symptoms and lower levels of health-benefitting factors. However, the relationship between attachment to pets and health-benefitting factors could be explained by their overlap with psychopathological symptom levels. Overall, our findings are not in line with the notion that pet ownership generally has a health-benefitting effect. Future studies need to investigate circumstances that modulate positive effects of pet ownership.

Pre-rehabilitation sense of coherence as a predictor of symptom change after rehabilitation.

Sense of coherence (SOC) constitutes the key component of salutogenesis theory. It reflects individuals' confidence that their environment is comprehensible and manageable and that their lives are meaningful. Research demonstrates a strong cross-sectional relationship between SOC and mental health. However, little is known about SOC's temporal stability and its potential to predict changes in psychopathological symptom severity in different settings. The goal of the current study was to address this gap. The sample of the two-wave longitudinal study consists of 294 patients receiving inpatient psychotherapeutic (and psychopharmacological) treatment for various psychological disorders at a German psychosomatic rehabilitation clinic. SOC (Antonovsky, Social Science & Medicine, 1993, 36, 725-733) and outcome measures (i.e., general mental health problems, depression and anxiety symptoms) were assessed within two days of arrival and at the end of rehabilitation (week 5/6). SOC was significantly enhanced after treatment whereas psychopathological symptoms were significantly reduced. Regression analyses revealed that pre-treatment SOC was a significant negative predictor of post-treatment symptom severity for all outcome measures even after controlling for pre-treatment symptoms. The current findings provide first evidence that SOC is a significant unique predictor of symptom change. Future studies need to further investigate longitudinal associations between SOC and mental health outcomes in different settings.

Differential effects of sleep on explicit and implicit memory for potential trauma reminders: findings from an analogue study.

Background: Recent findings suggest that disruptions of sleep-related memory processing are involved in the development of posttraumatic stress symptoms. More specifically, exposure to an analogue traumatic event resulted in fewer intrusive memories, when it was followed by sleep instead of continued wakefulness. However, competing evidence suggests that sleep deprivation may reduce intrusive re-experiencing. To address these conflicting accounts, we examined how sleep - as opposed to partial sleep deprivation - modulates explicit and implicit trauma memory using an analogue procedure. Methods: Healthy participants (N = 41) were assigned to a Sleep or Partial sleep deprivation group. Prior to nocturnal sleep, both groups were exposed to "traumatic" picture stories. After sleep or partial sleep deprivation, participants were subjected to tests of explicit and implicit memory for potential trauma reminders. Thereafter, participants completed an intrusion triggering task that was embedded in a distractor task. Results: Analyses revealed higher explicit memory for potential trauma reminders after sleep as compared to partial sleep deprivation. No group differences were found for implicit memory. Participants responded with fewer intrusions after sleep than following partial sleep deprivation. Conclusions: The current findings support a protective role of sleep in trauma memory processing, which may be evident after the first night of sleep post-trauma. Although more research is needed, our results corroborate the importance of promoting restful sleep in trauma-exposed individuals.

Antecedentes: hallazgos recientes sugieren que las interrupciones del procesamiento de la memoria relacionada con el sueño están involucradas en el desarrollo de los síntomas de estrés postraumático. Más específicamente, la exposición a un evento traumático análogo resultó en menos recuerdos intrusivos, cuando fue seguido por el sueño en lugar de la vigilia continua. Sin embargo, evidencia contraria sugiere que la falta de sueño puede reducir la reexperimentación intrusiva. Para abordar estos reportes en conflicto, examinamos cómo el sueño, en lugar de la privación parcial del sueño, modula la memoria de trauma explícita e implícita mediante un procedimiento análogo.Métodos: los participantes sanos (N = 41) se asignaron a un grupo de deprivación de sueño total o parcial. Antes del sueño nocturno, ambos grupos fueron expuestos a historias de imágenes 'traumáticas'. Después de la privación total o parcial del sueño, los participantes fueron sometidos a pruebas de memoria explícita e implícita para posibles recuerdos traumáticos. A partir de entonces, los participantes completaron una tarea activadora de recuerdos intrusivos, que se integró en una tarea distractora.Resultados: los análisis revelaron una mayor memoria explícita para recuerdos potencialmente traumáticos después del sueño en comparación con la privación parcial del sueño. No se encontraron diferencias de grupo para la memoria implícita. Los participantes respondieron con menos intrusiones después del sueño que después de la privación parcial del sueño.Conclusiones: Los hallazgos actuales apoyan un papel protector del sueño en el procesamiento de la memoria del trauma, que puede ser evidente después de la primera noche de sueño después del trauma. Aunque se necesita más investigación, nuestros resultados corroboran la importancia de promover el sueño reparador en personas expuestas a traumas.

Cortisol administration after extinction in a fear-conditioning paradigm with traumatic film clips prevents return of fear.

Cortisol is a stress hormone and potent modulator of learning and memory processes. If administered after learning, cortisol can enhance memory consolidation. Yet it is unknown whether cortisol administration after fear extinction learning strengthens extinction memory. Extinction is a crucial mechanism underlying psychotherapy of posttraumatic stress disorder (PTSD). The present study examined whether extinction can be enhanced by administering cortisol after extinction training. In a registered, randomized, double-blind and placebo controlled trial, 50 healthy participants were exposed to a differential fear-conditioning paradigm with neutral faces as conditioned stimuli (CS) and traumatic film clips as unconditioned stimuli (US). They received either cortisol (n = 25) or placebo (n = 25) immediately after extinction. The cortisol group showed less fear during a return of fear manipulation (reinstatement) evidenced by attenuated fear potentiated startle responses and US-expectancy ratings than the placebo group. Results indicate that cortisol administration after fear extinction strengthens extinction memory and suggest that it might be advantageous to administer cortisol subsequent to successful exposure treatment sessions.

[Sensitivity and Specificity of the Reizdarm-Fragebogen]. / Sensitivität und Spezifität des Reizdarm-Fragebogens.

BACKGROUND: The Reizdarm-Fragebogen (RDF) is the first German questionnaire to assess subjectively perceived symptom severity of irritable bowel syndrome (IBS). Thus far, this was only possible in the context of a medical examination by a practitioner. The goal of the current study was to assess differences in RDF scores among IBS patients and other clinical and non-clinical populations. Further, the study aimed to define a cut-off score for the presence of IBS and thereby, to evaluate the RDF as screening instrument in IBS diagnosis. MATERIALS AND METHODS: The study sample consisted of 372 individuals (62.6% male, mean age=41±17 years). 17.5% (of the sample) were IBS patients, 9.9% received treatment for chronic inflammatory bowel disease, 12.1% of the participants were recruited from a psychosomatic clinic, and 50.5% belonged to a control group. All participants filled out the 13 item RDF. RESULTS: The IBS patients' RDF scores differed significantly from those of other clinical and non-clinical subsamples [t(98.82)=13.61, p<0.001]. Except for the subscale "bloating" this difference was consistently found for all RDF subscales ("diarrhea", "constipation", and "pain and feeling of tension"). With respect to the identification of a cut-off for IBS diagnosis, a score of 32 showed both good sensitivity (90.80%) and specificity (75.56%). DISCUSSION AND CONCLUSION: The RDF is an efficient instrument for the assessment of subjectively perceived symptom severity in IBS. Based on the current findings and its good psychometric properties it can be used as a screening instrument for IBS in both clinical practice and research.

REM theta activity predicts re-experiencing symptoms after exposure to a traumatic film.

BACKGROUND: Extensive empirical evidence indicates that sleep plays an active role in memory consolidation. Moreover, sleep has been found to preferentially enhance emotional memories and may modulate affective reactions to previously encountered stimuli. Notably, recent findings suggest that disruptions of sleep-related memory processing could be involved in posttraumatic symptom development such that sleep disturbances may accelerate symptoms of intrusive re-experiencing. METHODS: Based on this emerging evidence, we investigated whether an analogue traumatic event would result in immediate impairments of sleep quality in a group of healthy, robust sleepers. In addition, we examined associations between a specific oscillatory correlate of emotional memory consolidation processes (REM theta activity) and subsequent analogue PTSD symptoms. Thirty-three healthy participants entered the study and were exposed to either "traumatic" or neutral films. Thereafter, participants were subjected to an 8.5-hour-long nocturnal sleep opportunity under standardized laboratory conditions including full-night polysomnographic recordings. Ambulatory intrusive memories and subjective symptom ratings were assessed during a period of three consecutive days. RESULTS AND CONCLUSIONS: Our results provide partial support for impaired sleep quality after exposure to a traumatic film. Correlation analyses further reveal that a longer REM sleep duration after "traumatic" exposure predicts reduced analogue PTSD symptoms. Critically, REM theta activity selectively predicts lower re-experiencing symptoms. As previous findings suggest that REM theta activity is reduced in patients with posttraumatic stress disorder, our findings provide a new perspective on the functional role of REM sleep in trauma memory processing.

Mental Health in Anesthesiology and ICU Staff: Sense of Coherence Matters.

Background: Hospitals, and particularly intensive care units (ICUs), are demanding and stressful workplaces. Physicians and nurse staff are exposed to various stressors: emergency situations, patients' deaths, and team conflicts. Correspondingly, several studies describe increased rates of PTSD symptoms and other mental health problems in hospital staff. Therefore, it is important to identify factors that lower the risk of psychopathological symptoms. High levels of sense of coherence (SOC) and general resilience as well as an internal locus of control (LOC) have already been identified as important health-benefitting factors in medical staff. The current study aimed to evaluate their unique impact in an ICU and an anesthesiology unit. Method: The cross-sectional online survey investigated SOC, LOC, general resilience, general mental health problems as well as PTSD symptoms in nurses and physicians within an ICU and an anesthesiology unit (N = 52, 65.4% female). General mental health problems were assessed using the ICD-10-Symptom-Rating (ISR) and PTSD symptoms were measured using the PTSD Checklist for DSM-5 (PCL-5). The Sense of Coherence Scale (SOC-L9) assessed SOC, the Resilience Scale (RS-11) measured general resilience, and LOC was determined using a 4-item scale for the assessment of control beliefs (IE-4). Results: As expected, SOC, r = -0.72, p < 0.001, general resilience, r = -0.46, p < 0.001, and internal LOC, r = -0.51, p < 0.001, were negatively correlated with general mental health problems while an external LOC showed a positive association, r = 0.35, p = 0.010. However, in a multiple regression model, R 2 = 53.9%, F (4, 47) = 13.73, p < 0.001, only SOC significantly predicted general mental health problems by uniquely accounting for 13% of the variance. For PTSD symptoms, which were highly correlated with general mental health problems, a similar pattern of results was found. Conclusion: SOC was found to be the most important correlate of both general mental health problems and PTSD symptoms in an ICU and an anesthesiology unit. Thus, if further evidenced by longitudinal studies, implementing interventions focusing on an enhancement of SOC in training programs for ICU and anesthesiology unit staff might be a promising approach to prevent or reduce psychopathological symptoms.

Therapy Dogs as a Crisis Intervention After Traumatic Events? - An Experimental Study.

Animal-assisted therapy has been proposed as a treatment adjunct for traumatized patients. In animal-assisted crisis response, dogs are used directly after a traumatic event to reduce stress and anxiety. However, to date there are few controlled studies investigating the effects of therapy dogs on PTSD symptoms and to our knowledge there is no study investigating the effects of a therapy dog intervention directly after a traumatic event. In this study, 60 healthy female participants were randomly assigned to one of three groups: after exposure to a "traumatic" film clip (trauma-film paradigm), one group of participants interacted with a friendly dog for 15 min, another group of participants watched a film clip showing a person interacting with a friendly dog and the last group was instructed to relax. Participants who had interacted with the dog after the film reported lower anxiety levels, less negative affect, and more positive affect after the intervention as compared to the other two groups. However, the participants who interacted with the dog showed a smaller decrease in physiological arousal after the traumatic film clip compared to both other groups. There were no differences in intrusion symptoms between the three groups. Our results show that dogs are able to lessen subjectively experienced stress and anxiety after a "traumatic" stress situation.

Effects of heart rate variability biofeedback during exposure to fear-provoking stimuli within spider-fearful individuals: study protocol for a randomized controlled trial.

BACKGROUND: Specific phobias are among the most common anxiety disorders. Exposure therapy is the treatment of choice for specific phobias. However, not all patients respond equally well to it. Hence, current research focuses on therapeutic add-ons to increase and consolidate the effects of exposure therapy. One potential therapeutic add-on is biofeedback to increase heart rate variability (HRV). A recent meta-analysis shows beneficial effects of HRV biofeedback interventions on stress and anxiety symptoms. Therefore, the purpose of the current trial is to evaluate the effects of HRV biofeedback, which is practiced before and utilized during exposure, in spider-fearful individuals. Further, this trial is the first to differentiate between the effects of a HRV biofeedback intervention and those of a low-load working memory (WM) task. METHODS: Eighty spider-fearful individuals participate in the study. All participants receive a training session in which they practice two tasks (HRV biofeedback and a motor pseudo-biofeedback task or two motor pseudo-biofeedback tasks). Afterwards, they train both tasks at home for 6 days. One week later, during the exposure session, they watch 16 1-min spider video clips. Participants are divided into four groups: group 1 practices the HRV biofeedback and one motor pseudo-task before exposure and utilizes HRV biofeedback during exposure. Group 2 receives the same training, but continues the pseudo-biofeedback task during exposure. Group 3 practices two pseudo-biofeedback tasks and continues one of them during exposure. Group 4 trains in two pseudo-biofeedback tasks and has no additional task during exposure. The primary outcome is fear of spiders (measured by the Fear of Spiders Questionnaire and the Behavioral Approach Test). Secondary outcomes are physiological measures based on electrodermal activity, electrocardiogram and respiration. DISCUSSION: This RCT is the first one to investigate the effects of using a pre-trained HRV biofeedback during exposure in spider-fearful individuals. The study critically contrasts the effects of the biofeedback intervention with those of pseudo-tasks, which also require WM capacity, but which do not have a physiological base. If HRV biofeedback is effective in reducing fear of spiders, it would represent an easy-to-use tool to improve exposure-therapy outcomes. TRIAL REGISTRATION: Deutsches Register Klinischer Studien, DRKS00012278 . Registered on 23 May 2017, amendment on 5 October 2017.

From neuroscience to evidence based psychological treatments - The promise and the challenge, ECNP March 2016, Nice, France.

This ECNP meeting was designed to build bridges between different constituencies of mental illness treatment researchers from a range of backgrounds with a specific focus on enhancing the development of novel, evidence based, psychological treatments. In particular we wished to explore the potential for basic neuroscience to support the development of more effective psychological treatments, just as this approach is starting to illuminate the actions of drugs. To fulfil this aim, a selection of clinical psychologists, psychiatrists and neuroscientists were invited to sit at the same table. The starting point of the meeting was the proposition that we know certain psychological treatments work, but we have only an approximate understanding of why they work. The first task in developing a coherent mental health science would therefore be to uncover the mechanisms (at all levels of analysis) of effective psychological treatments. Delineating these mechanisms, a task that will require input from both the clinic and the laboratory, will provide a key foundation for the rational optimisation of psychological treatments. As reviewed in this paper, the speakers at the meeting reviewed recent advances in the understanding of clinical and cognitive psychology, neuroscience, experimental psychopathology, and treatment delivery technology focussed primarily on anxiety disorders and depression. We started by asking three rhetorical questions: What has psychology done for treatment? What has technology done for psychology? What has neuroscience done for psychology? We then addressed how research in five broad research areas could inform the future development of better treatments: Attention, Conditioning, Compulsions and addiction, Emotional Memory, and Reward and emotional bias. Research in all these areas (and more) can be harnessed to neuroscience since psychological therapies are a learning process with a biological basis in the brain. Because current treatment approaches are not fully satisfactory, there is an imperative to understand why not. And when psychological therapies do work we need to understand why this is the case, and how we can improve them. We may be able to improve accessibility to treatment without understanding mechanisms. But for treatment innovation and improvement, mechanistic insights may actually help. Applying neuroscience in this way will become an additional mission for ECNP.