Statusbericht 2013-2014 - Fachrichtung Psychologie

Transcription

2
0
1
4
Institut für Klinische Psychologie und Psychotherapie
Technische Universität Dresden
Chemnitzer Strasse 46
01187 Dresden
Webseite: www.psychologie.tu-dresden.de/klinische
Institute of Clinical Psychology and Psychotherapy
Chemnitzer Str. 46
01187 Dresden
email: hans-ulrich.wittchen@tu-dresden.de
webpage: www.psychologie.tu-dresden.de/klinische
15th birthday Status Report 2013/14
STATUS REPORT 2013/14 INSTITUTE OF CLINICAL PSYCHOLOGY AND PSYCHOTHERAPY
2
0
1
4
Status Report 2013/14
Celebrating our 15th birthday
Institute of Clinical Psychology
and Psychotherapy
KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE DER TU DRESDEN
Inhalt, Aufbereitung und Gestaltung: Hans-Ulrich Wittchen, Doreen Opitz, LOOP kommunikations-design
Drucktechnische Umsetzung und Druckabwicklung: LOOP kommunikations-design
Chemnitzer Str. 46
01187 Dresden, Germany
phone: +49 (351) 46 33 69 83
fax:
+49 (351) 43 63 69 84
Institut für klinische Psychologie und Psychotherapie
Chemnitzer Str. 46
01187 Dresden
Tel.: +49 (351) 46 33 69 83
Fax: +49 (351) 43 63 69 84
E-Mail: hans-ulrich.wittchen@tu-dresden.de
Institutsambulanz und Aufbaustudiengang
„Psychologischer Psychotherapeut“
Hohe Str. 53
01187 Dresden
Tel.: +49 (351) 46 33 69 86
Fax: +49 (351) 46 33 69 55
E-Mail: juergen.hoyer@tu-dresden.de
www.psychologie.tu-dresden.de/aufbaustudiengang
INHALTSVERZEICHNIS/TABLE OF CONTENTS
Seite
Mitarbeiter/Mitarbeiterinnen/Staff
1
Einleitung/Introduction 2
Celebrating our 15th birthday/15-Jahre Institut für Klinische Psychologie und Psychotherapie
Aufgaben, Ziele und Struktur/Mission, Goals and Structure
6
Lehre und Ausbildung/Teaching and Curricula
11
Abschlussarbeiten/Theses
19
Aufbaustudiengang Psychologische Psychotherapie/Postgraduate Psychotherapy Program
33
Strukturelle Ressourcen/Structural Ressources
Institutsambulanz/Outpatient Clinic for Psychotherapy (Prof. Dr. Jürgen Hoyer)
39
Center of Clinical Epidemiology and Longitudinal Studies (CELOS) (Prof. Dr. Katja Beesdo-Baum)
44
Neuroimaging Center and BMBF Research Group “The Adolescent Brain”
46
Epidemiological Research Unit (Prof. Dr. Jürgen Rehm)65
Professuren/Chairs
49
Klinische Psychologie und Psychotherapie/Clinical Psychology and Psychotherapy (Prof. Dr. Hans-Ulrich Wittchen)
Behaviorale Psychotherapie/Behavioral Psychotherapy (Prof. Dr. Jürgen Hoyer)
50
Behaviorale Epidemiologie/Behavioral Epidemiology (Prof. Dr. Katja Beesdo-Baum)
52
Grundlagen und Interventionen von Essstörungen und assoziierten
57
Störungen/Eating Disorders (Prof. Dr. Corinna Jacobi)
Suchtforschung/Addiction Research (Prof. Dr. Gerhard Bühringer)
60
Veranstaltungsreihen, Kongresse und Preise/Exhibitions, Congress and Prizes
67
Arbeitsgruppen und Ergebnisse/Workgroups and Findings
77
Überblick/Overview 78
Publikationen/Publications
205
Publikationsauflistung nach Impaktfaktor/Impact peer review publications
206
Publikationen/Peer review publications
207
Bücher und Buchkapitel/Books and Book Chapters
216
Ausgewählte Konferenzbeiträge und Poster/Selection of Conference Presentations and Poster
217
Öffentlichkeitsarbeit/Public Relations 225
MITARBEITER/MITARBEITERINNEN/STAFF
Professoren/ Habilitierte Mitarbeiter
Beesdo-Baum Katja, Prof. Dr. rer. nat.
Bühringer Gerhard, Prof. Dr. rer. soc.
Hoyer Jürgen, Prof. Dr. phil.
Jacobi Corinna, Prof. Dr. rer. biol. hum.
Jacobi Frank, Prof. Dr. rer. nat. (-2014)
Lüken Ulrike, PD. Dr. rer. nat.
Rehm Jürgen, Prof. Dr. phil.
Wittchen Hans-Ulrich, Prof. Dr. phil.
Wissenschaftliche und Projektmitarbeiter
Anacker Kristin, Dipl.-Psych.
Asselmann Eva, Dipl.-Psych.
Behrendt Silke, Dr. Dipl.-Psych.
Beintner Ina, Dr. Dipl.-Psych.
Bensmann Thekla, Dipl.-Psych.
van den Berg Linda, M.Sc.
von Bloh Paula, Dipl.- Psych.
Bräuer David, Dipl.- Psych. (-2012)
von Consbruch Katrin, Dr. Dipl.-Psych.
Crawcour Stephen, Dr. Dipl.-Psych. (-2013)
Einsle Franziska, Prof. Dr. rer. medic. (-2014)
Emmrich Angela, Dipl.-Psych.(-2012)
Eiterich Nadine, M.Sc.
Evens Ricarda, Dipl.-Psych.
Forberger Sarah, Dr. phil.
Fröhlich Christine, Dipl.-Psych. (-2012)
Frommelt Anne-Marie, Dipl.-Psych. (-2012)
Furka Nadine, Dipl.-Psych.
Gerschler Anja, Dipl.-Psych.
Götzel Thomas, Dipl.-Psych. (-2014)
Groch Claudia, MPH
Härtling Samia, Dr. Dipl.-Psych.
Heidrich Sabrina, Dipl.-Psych. (-2013)
Heinig Ingmar, Dipl.-Psych.
Heinrich Anke, Dipl.-Psych.
Heinze Simone, Dipl.-Psych. (-2014)
Hergesell Katja, Dipl.-Psych.
Hilbert Kevin, Dipl.-Psych.
Hoyer Jana, Dipl.-Psych.
Höfler Michael, Dr. Dipl.-Stat.
Jahnke Sara, Dipl.-Psych.
Knappe Susanne, Dr. Dipl.-Psych.
Knothe Lisa, Dipl.-Psych.
Kohlmann, Anne, Dipl.-Psych.
Kräplin Anja, Dipl.-Psych.
Kullmann Jana, Dipl.- Psych. (-2012)
Lange Susann, Dipl.-Psych.
Langer Cornelia, Dipl.-Psych. (-2012)
Lochmann Esther, Dipl.-Psych.
Mack Simon, Dipl.-Psych.
Mark Kathleen, Dipl.-Psych. (-2012)
Martini Julia, Dr. Dipl.-Psych.
Maslowski Nina, Dipl.-Psych.
Meißner Gisa, Dipl.-Psych. (-2014)
Meyer Friederike, Dipl.-Psych. (-2013)
Möser Manuela, Dipl.-Psych. (-2014)
Mühlhan Markus, Dr. Dipl.-Psych.
Nagl Michaela, Dipl.-Psych. (-2013)
Neumann Maria, Dipl.-Psych.
Neustadt Katrin, Dipl.-Psych. (-2014)
Paul Martin, Dipl.-Psych.
Paul Sören, Dipl.-Psych.
Petersen Mirijam, Dipl.-Psych. (-2012)
Petzoldt Johanna, Dipl.-Psych.
Pieper Lars, Dr. Dipl.-Psych.
Pietzner Diana, Dipl.-Math.
Pixa Anja, Dipl.-Psych.
Probst Charlotte, Dipl.-Psych.
Probst Christian, Dipl.-Psych.
Riedel Oliver, Dr. Dipl.-Psych. (-2014)
Rietzel Sylvia, Dipl.-Psych. (-2013)
Rus Oana Georgiana, Dipl.-Psych. (-2012)
Schäfer Judith, Dipl.-Psych.
Schierz Katharina, Dipl.-Psych.
Schmidt Henning, Dipl.-Biol.
Schönfeld Sabine, Dr. Dipl.-Psych.
Scholl Lucie, Dipl.-Psych.
Schuster Katrin, Dipl.-Psych. (-2013)
Stankevich Yulia, Dipl.-Psych.
Stolzenburg Eva, MTA
Stoylar Veronika, Dipl.-Psych. (-2012)
Strehle Jens, Dipl.-Math.
Schweden Tabea, M.Sc.
Tesch Josephine, Dipl.-Psych. (-2013)
Thurau Christin, Dipl.-Psych. (-2013)
Trautmann Sebastian, Dipl.-Psych.
Venz John, M.Sc.
Völker Ulrike, Dipl.-Psych. (-2014)
Voss Catharina, M.Sc.
Weber Fanny, Dipl.-Psych.
Westphal Dorte, Dipl.-Psych.
Wieder Gesine, Dipl.-Psych.
Wittich Julia, Dipl.-Psych. (-2013)
Wolf Cornelia, Dipl.-Psych. (-2012)
Ziegler Juliane, Dipl.-Psych. (-2013)
Zafar Mudaser, B.M.
Nichtwissenschaftliche Mitarbeiter
Ahnert Heike, M.A. (-2013)
Bäger Anne, (Dok. Ass.) (-2014)
Beyer Lisa, (Verw.) (-2014)
Biedermann Anne, (Sek. Prof. Jacobi)
Bley Karina, Dipl.- Betrw. BA (Verw.)
Debitz Grit, Dipl.- Ing. FH (Verw./Ambulanz)
Heinze Andrea, (Ambulanz)
Henrich Catherine, (Sek. Ambulanz) (-2012)
Hillger Ulrich, (Ambulanz)
Liebscher Tina, (Sek. Prof. Beesdo-Baum)
Mutscher Ramona, (Ambulanz)
Opitz Doreen, (Dok. Ass.)
Raabe Romane, (Sek. Prof. Wittchen)
Raum Kerstin, Dipl.-Ing. (Verw.)
Reith Beate, (Sek. Ambulanz)
Rödel Elke, (Sek.)
Schwartz Regine, (Sek. Prof. Wittchen)
Terbonsen Heike, (Ambulanz)
Vogler Heike, (Sekr. Prof. Bühringer)
Wenk Gabriele, (Ambulanz) (-2013)
1
MITARBEITER/MITARBEITERINNEN/STAFF
Studentische Hilfskräfte und Werkstudenten
Adam Peggy
Albrecht Dennis
Anacker Christine
Anwar Rina
Atzendorf Josefine
Barthel-Kraus Elke
Bauer Charlotte
Baum Petra
Baumann Steffi
Bayat Yasmine
Baycelebi Kübra
Behrendt Anne
Berg Corinna
Bergholz Anne
Berner Marie
Bernstein Lars
Beyer Lara
Bielefeldt Franziska
Bockreiß Lena
Bohl Martha
Boltz Sonja-Sabine
Breitrück Christin
Brodocz Magdalena
Bruntsch Sarah
Burkhardt Birgit
Byer Lara-Elena
Dekoj Marie-Christine
Demele Ulrike
Dietrich Torsten
Dieterichs Tim
Dietsch Florian
Effenberg Saskia
Ernd Jana
Faasch Vivian
Fach Bettina
Firl Alexandra
Flecke Katharina
Freitag Laura
Friebel Pascal
Friedemann Alexandra
Gädtke Franziska
Gebler Franziska
Gehrke Markus
Gröne Daniel
Grove Maren
Gruner Carolin
Hansche Yvonne
Hassler Melanie
Hauer Marlies
2
Hein Joachim
Heinrich Linda
Helbig Friederike
Hendrich Elisa
Heppner Anke
Hermann Inga
Hertle Claudia
Huang Guanyu
Irrgang Sabrina
Jung Linda
Jurkschat Stephanie
Kant Lisa-Sophie
Kanzler Viktoria
Kästner Senta
Keil Gerda
Keßler Franziska
Kim Darina
Kircheis Stefanie
Klaus Markus
Klawonn Konrad
Kleeberg Paula
Koch Franziska
Koch Sandra
Koos Linda
Kopp Marie
Korn Annelie
Kriegel Francie
Kristlib Marta
Kuitunen Paula
Kulbe-Asadi Eva
Kümmling Petra
Kunzel Mario
Langhammer Marie
Liebchen Kevin
Lindt Benjamin
Lohberg Sindy
Lorenz Isabel
Luther Claudia
Manz-Bretherick Martina
Martens Mirja
Meier Jan
Neykow Julian
Nicklisch Constanze
Nitzsche Katharina
Otto Kristina
Paasch Silvio
Pape Jaqueline
Petersen Swantje
Peukert Maximilian
Pickenbach Andreas
Philipp Kathleen
Pomplun Beatrice
Poppe Lilith
Pralat Christin
Preiß Stephanie
Rädlinger Konrad
Rautschek Judith
Reinhardt Anne-Kathrin
Rezvani Farhad
Richter Lisa
Richter Dominique
Rupschuß Sophia
Sach Mareike
Sarnowsky Stephan
Sauer Karoline
Schulz Anna
Schieck Diana
Schnapka Charlotte
Schneider Romy
Scholze Vivien
Schultze-Naumburg Iris
Seuffert Julian
Slanina Anne
Störel Margarete
Suchert Vivien
Sura Charis
Tenner Ulrike
Thieme Juliane
Ulbricht Vera
Vollert Bianka
Wagner Anna Elisabeth
Walter Isabelle
Walther Jonathan
Wenzel Christin
Wersch Paul
Wilke Melanie
Wolf Clara
Wolfram Stephanie
Zehlein Laura
Zenker Monique
Zettler Carolin
Zobel Monique
Zschieschang Myriam
Zunft Annemarie
EINLEITUNG/INTRODUCTION
Executive English Summary
With this 6th bi-annual Report we celebrate our 15 th anniversary and look back to two exciting and successful years.
- We implemented a new (W3) chair of Behavioural Psychotherapy to support the existing research agenda
in mechanism of action of psychological interventions. Prof. Dr. Jürgen Hoyer was appointed on April 1st, 2013.
The new chair is responsible for the still growing clinical outpatient and day-care centre for Psychotherapy (IAPTUD), the Psychotherapy Postgraduate Education Centre and the clinical research program.
- The German Government (BMBF; program “Health-Related Epidemiological Research”) granted us substantial funds to implement a new (W3) chair for “Behavioural Epidemiology”, jointly with funding for a large-scale
research project, to structurally support our research infrastructure and agenda. Prof. Dr. Katja Beesdo-Baum
was appointed on April 1st, 2014. The new chair strengthens our epidemiologic research and teaching agenda
and manages and directs the “Center for Clinical Epidemiological and Longitudinal Studies” (CELOS).
- Since 2012 the Deutsche Forschungsgemeinschaft (DFG) has been granting the Department of Psychology
a Collaborative Research Centre (940; 2012-2016, PI: Prof. Dr.Thomas Goschke) to launch a longterm program on “Volition and Cognitive Control: Mechanisms, Modulators and Dysfunctions” that involves several
large-scale projects from staff members of the Institute.
- Additionally we were granted in 2012 a DFG Research Group together with the Charite in Berlin (FOR
1617, Speakers: Prof. Heinz, Charité Berlin and Prof. Wittchen, Dresden) “Learning and Habitization as
Predictors of the Development and Maintenance of Alcoholism). Both highly successful and productive
DFG programs will apply for a second funding period in 2015 and 2016.
- We also launched a new large scale research program to develop and test a new psychological treatment
approach targeting improved extinction processes in anxiety and depression. This program is one of several components of the German Government large-scale funding program “Research network for Mental
Disorders” covering a broad spectrum of disorders (anxiety, schizophrenic- depressive- addictive disorders
as well as ADHD and autism spectrum disorders). In the first four year funding period (2015-2019) we participate in three of the topic areas, namely depression, anxiety and addiction, taking also a lead role in the
overarching phenotypic program component.
We also celebrate the first three years of “TUD as an University of Excellence in Germany” and are extremely proud
that we have moved in international rankings to a top 150 position overall and in some ratings (U.S. News & World
Report Best Global Universities Ranking) even to a top 75 position in the field of psychology/psychiatry, being listed
among the top most highly cited in the biomedical literature. Our achievements were also recognized by top 3 national ranks regarding teaching quality (CHE) and top positions regarding clinical services and treatment (Focus-Doctors
Ranking).
Overall, the Institute has consolidated it governance structure, maintained - despite increasing pressure by teaching responsibilities and administration - its strong emphasis on research with over 100 research projects funded
by the Federal government, the European Union, the German research fund (DFG), non-governmental organizations (NGOs) and Industry (overall volume of 10 million). We also maintained a high publication output with over
150 peer reviewed publications per/-year. The work of the Institute is well received internationally with over 3000
citations per year and is the only work group at the TUD listed in the Web of Science as “highly-cited” in the
fields of psychiatry, psychology and neuroscience.
The Institutes major research focus remains the identification of causal factors and mechanisms responsible for
the onset and progression of mental disorders, with particular emphasis on anxiety, depressive and substance use
disorders and the derivation of improved psychological interventions. Main characteristics are the extensive use of
descriptive and causal-analytic epidemiological methods, linked to experimental psychological and neurobiological
(e.g. family genetic, molecular genetic, neuroimaging, stress) measures, longitudinal research designs, diagnostic
classification and instruments, and intervention research, particularly with regard to identifying the active ingredients and mechanisms of action of Cognitive-Behavioral Therapies (CBT).
We hope that our new Research Report 2013/2014 is stimulating and informative and promotes further collaborations and support by all our friends and colleagues.
3
15 Jahre - Institut für Klinische Psychologie und Psychotherapie
Mit diesem 6. Zwei-Jahresbericht feiern wir das 15-jährige Bestehen unseres Instituts und blicken auf zwei aufregende Jahre zurück!
- Strukturell gelang es uns einen neuen Lehrstuhl (W3) für Behaviorale Psychotherapie einzurichten, der nun
unser facettenreiches Psychotherapie-Programm in Forschung und Lehre weiterentwickelt und damit das
Institut nachhaltig stärkt. Wir freuen uns das Prof. Dr. Jürgen Hoyer den Ruf 2013 annahm und nach seiner
Berufung am 01.04.2013 seine Arbeit in dieser neuen Funktion aufnahm.
- Überaus glücklich waren wir auch über die Entscheidung des BMBF-Gutachterausschusses im Programm
“Gesundheitsbezogene epidemiologische Forschung”, uns Mittel für die Einrichtung eines W3-Lehrstuhls
“Behavioral Epidemiology” sowie eines damit verbundenen mehrjährigen Forschungsprogramms zu bewilligen. Frau Prof. Dr. Katja Beesdo-Baum wurde zum 01.04.2014 berufen und übernahm zugleich die Leitung
des „Centers for Clinical Epidemiology and Longitudinal Studies“ (CELOS).
- Seit 2012 fördert die Deutschen Forschungsgemeinschaft (DFG) die Fachrichtung Psychologie mit dem
Sonderforschungsbereich 940 (2012-2016, Sprecher Prof. Dr. Thomas Goschke) zum Thema “Volition and
Cognitive Control: Mechanisms, Modulators and Dysfunctions”. Damit konnten wir ein facettenreiches
Langzeit-Forschungsprogramm realisieren, an dem eine Reihe von Institutsmitgliedern mit eigenen klinischen
Grundlagenprojekten beteiligt sind.
- Nahezu zeitgleich hat die DFG uns darüber hinaus 2012 die Einrichtung einer DFG-Forschergruppe (FOR1617,
Sprecher: Prof. Dr. Andreas Heinz, Charite‘ Berlin und Prof. Dr. Hans-Ulrich Wittchen) zum Thema “Learning and
Habitization as Predictors of the Development and Maintenance of Alcoholism“, bewilligt. Beide äußerst erfolgreichen und produktiven DFG Projekte bereiten derzeit die Verlängerungsanträge für eine zweite Förderphase vor.
- Wir freuen uns auch über die Bewilligungen des Bundesministeriums für Bildung und Forschung (BMBF) im
Forschungsprogramm „Forschungsnetze für Psychische Störungen“. Dieses Programm umfasst insgesamt
30 universitäre und außeruniversitäre Forschungseinrichtungen, die an der Erforschung von Depression,
Angststörungen, Sucht, Schizophrenie, Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) und Autismus
zusammen arbeiten. Unser Institut war erfolgreich mit einem Forschungsantrag zu Angststörungen und
Depression (PROTECT-AD), einem alle Verbünde umfassenden Antrag (Phenotypic, Diagnostic and Clinical
Domain Assessment Network, Germany (PD-CAN) sowie Teilprojekten in den Schwerpunkten Depression und
Sucht. Der PROTECT-AD Verbund (Sprecher: Prof. Dr. Hans-Ulrich Wittchen) versucht neue Therapiestrategien
durch Optimierung des Extinktionslernen zu entwickeln und ermöglicht die intensive Zusammenarbeit von sieben Universitätsinstituten, die deutschlandweit führend im Bereich Angststörungen sind.
- Wir feiern auch die ersten drei Jahre der TUD als Exzellenzuniversität und sind in diesem Zusammenhang
stolz darauf, durch unsere Forschungs- und Publikationsperformance zu einer substantiellen Verbesserung
der TUD in internationalen Rankings beigetragen zu haben. Das kürzliche „US News & World Report Best
Global University“ Ranking positioniert Psychology/Psychiatry national auf Platz 2 und international auf
Platz 71. Ferner wurden wir unter die „most highly-cited scientists in the biomedical literature gelistet, und
erhielten mehrere Top-Platzierungen hinsichtlich unserer klinisch-therapeutischen Qualität im Focus Ranking.
- Weitere Höhepunkte im Berichtszeitraum waren die Einführung des Masterstudiengangs „Klinische
Psychologie & Psychotherapie“ im Wintersemester 2013/14 in neuen Vorlesungs- und Seminarräumen, mehrere Berufungen von Institutsmitarbeitern (Oliver Riedel, Franziska Einsle, Ulrike Lüken) und Dissertationen
sowie mehrere auch international viel beachtete Pressekonferenzen zu unseren Großprojekten.
Das Institut hat sich nun strukturell durch die Berufungen und einer neuen Leitungsstruktur nachhaltig konsolidiert
und über ein unverändert hohes Drittmittelaufkommen und große wissenschaftliche Produktivität seine Rolle in der
international scientific community ausgebaut. Mit weit über 100 peer review Publikationen pro Jahr und über 5000
Zitationen pro Jahr gehören wir zu den ISI-WOS „highly-cited“ Institutionen.
Schwerpunkt und Leitthema bleibt die Identifikation von Kausalfaktoren und Schlüsselmechanismen für die
Entwicklung psychischer Störungen, um verbesserte, gezielte Interventionsprinzipien für Prävention, Therapie
und Rehabilitation abzuleiten. Unser Ziel ist die Psychologie und Klinische Psychologie als „Mutterwissenschaft“
4
der Psychotherapie zu etablieren. Dabei greifen wir auf unser immer vollständiger werdendes Kompetenz- und
Infrastrukturprofil auf den Gebieten Epidemiologie, Neurobiologie und Neuroimaging sowie der klinischen
Wirkfaktorenforschung zurück und intensivieren die Zusammenarbeit mit der Allgemeinen Psychologie, der
Biopsychologie, der Psychiatrie und den Neurowissenschaften. Dabei gilt es eine ausgewogene Balance zwischen
Grundlagen-, Anwendungs- und klinischer Forschung zu erhalten und diesen „Dreiklang“ des Fachs Klinische
Psychologie und Psychotherapie nachhaltig zu sichern. Unverzichtbar auf diesem Weg sind dabei der Ausbau
unserer Institutsambulanz für Forschung und Lehre, die postgradualen Studiengänge, der Ausbau des Neuroimaging
- Zentrums, sowie die Strukturierung mit selbstständigen Arbeitsgruppen und –bereichen. Dieser Weg ermöglichte
es uns die Forschungs- und Lehrqualität im Diplom-, Bachelor- und Masterstudiengang auf hohem Niveau auszubauen. Zahlreiche Lehrpreise vieler Mitarbeiter/Mitarbeiterinnen, ebenso wie die Ergebnisse des Hochschulrankings des
CHE unterstreichen wie erfolgreich uns dies bislang gelungen ist. Seit 2001 haben wir in ganz erheblichem Maße
dazu beigetragen das Fach Psychologie an der TUD aus dem Mittelfeld in eine nationale Spitzenposition zu bringen.
Für diese beeindruckende Bilanz sind wir allen Mitarbeiterinnen und Mitarbeitern ebenso wie dem freundschaftlichen und kollegialen Umfeld in der Psychologie und der TUD mit ihren herausragenden Entwicklungsoptionen als
Ganzes zu Dank verpflichtet. Zugleich ist das Erreichte für uns Auftrag, diese Spitzenpositionen weiter auszubauen
und das Fach Psychologie weiter inhaltlich und strukturell zu stärken.
Dresden 31.10.2014
Hans-Ulrich Wittchen Jürgen Hoyer
Katja Beesdo-Baum
Corinna Jacobi
Gerhard Bühringer
Im Frühjahr 2015 und damit zu unserem 15-Jahres Jubiläum
richtet das Institut zum 2. Male den Workshop-Kongress
„Klinische Psychologie und Psychotherapie“ aus.
Nehmen Sie teil und feiern Sie mit uns ein spannendes
Programm!
5
AUFGABEN, ZIELE UND STRUKTUR/MISSION, GOALS AND STRUCTURE
Aufgaben, Ziele und Struktur des Instituts für Klinische Psychologie und Psychotherapie an der TU-Dresden
1. Lehre im 2013 neu eingeführten Masterstudiengang „Klinische Psychologie und Psychotherapie“
2. Lehre im Bachelorstudiengang Psychologie sowie im auslaufenden Diplomstudiengang Psychologie
3. sowie Lehre in den weiteren psychologischen Masterstudiengängen Cognitive-Affective Neuroscience (CAN)
und Human Performance in Socio-Technical Systems (HPSTS) im Vertiefungsbereich “Klinische Psychologie
und Psychotherapie”
4. einschließlich der Betreuung von Bachelor-, Diplom- und Masterarbeiten
5. Postgraduale 3- (bzw. optional 5-jährige) Ausbildung zum Heilberuf des Psychologischen Psychotherapeuten“
nach dem Psychotherapeutengesetz
6. Postgraduale Ausbildung „European Graduate School in Addiction“ Research (Doktoranden Schule; ESADD
seit 2009)
7. Fort- und Weiterbildung
8. sowie Wissenschaft und Forschung auf dem Gesamtgebiet des Faches.
Struktur und Aufgaben
Zur Erfüllung dieser Aufgabe hat sich das Institut in 4 Arbeitsbereichen organisiert:
-
-
-
-
6
Arbeitsbereich
Arbeitsbereich
Arbeitsbereich
Arbeitsbereich
1:
2:
3:
4:
Lehre und Ausbildung
Institutsambulanz und Tagesklinik (patientenbezogene Aufgaben)
Wissenschaft und Forschung
Kongresse, Tagungen, Fort- und Weiterbildung
Das Institut ist an zwei benachbarten Standorten untergebracht. Alle patientenbezogenen Aufgaben für den
Diplom-Studiengang und die Psychotherapeutenausbildung sind im Gebäude Hohe Straße 53 konzentriert, das
ausschließlich der klinischen, d.h. direkt patientenbezogenen Forschung und Lehre gewidmet ist. Präklinische
und epidemiologische Forschungsaufgaben, das Neuroimaging Center (NIC), ebenso wie die Lehre im
Diplom-Studiengang sind zusammen mit Sekretariat und Administration sowie allen Professuren im Gebäude
Falkenbrunnen untergebracht.
Forschungsthemen werden ungeachtet der jeweiligen Zuordnung der Mitarbeiter zu Projekten oder Funktionsbereichen in flexiblen themenbezogenen klinischen und/oder präklinischen Arbeitsgruppen unter der Verantwortung
der jeweiligen Arbeitsgruppenleiter bearbeitet. Alle Mitarbeiter sind entsprechend flexiblen Arbeitsgruppen zugeordnet. Die Arbeitsgruppen stehen unter der Verantwortung von Arbeitsgruppenleitern, die zumeist für mehrere
Projekte inhaltliche und wirtschaftliche Verantwortung tragen.
Alle Mitarbeiter, auch die Kollegen aus Drittmittel - finanzierten Forschungsprojekten, beteiligen sich direkt
oder indirekt an der Lehre im Masterstudiengang Klinische Psychologie und Psychotherapie und dem Aufbaustudium „Psychologische Psychotherapie“ sowie an Versorgungs- und Forschungsaufgaben im Bereich der
Institutsambulanz und Tagesklinik. Dieses Organisationsprinzip ermöglicht eine eng verzahnte anwendungs- wie
auch forschungsbezogene Lehre und Ausbildung der Studenten wie auch der Postgraduierten (Promovenden,
Ausbildungskandidaten). Zugleich wird dadurch allen Mitarbeitern die Gelegenheit zu einer breiteren Qualifizierung
und Kompetenzerweiterung gegeben.
Darüber hinaus leisten Mitarbeiter des Instituts auch Exportleistungen innerhalb der Psychologie in Dresden, z.B. im
Zusammenhang mit Klinischen Modulen für die Masterstudiengänge Psychologie: Cognitive-Affective Neuroscience
(CAN) und Human Performance in Socio-Technical Systems (HPSTS), wie auch in anderen Fachbereichen (z.B.
Sozialpädagogik, Sozialarbeit und Wohlfahrtswissenschaften). Ferner beteiligen sie sich auch an außeruniversitären
Angeboten.
Arbeitsbereiche und Arbeitsgruppen:
1. Arbeitsbereich: Lehre und Ausbildung
- Forschungs- und anwendungs-/praxisorientierte
Lehre für Studierende im Masterstudiengang
Klinische Psychologie und Psychotherapie sowie in
anderen Psychologie-Studiengängen (Bachelor, CAN,
HPSTS, auslaufender Diplomstudiengang) verbunden
mit Unterstützung und Betreuung von Bachelor,
Master- und Diplomarbeiten sowie Dissertationen.
Pro Studienjahr nehmen 120 Studenten/Studentinnen
das Bachelorstudium Psychologie an der TU Dresden
auf. 60 Studenten/Studentinnen kann ein Studienplatz
im Masterstudiengang „Klinische Psychologie und
Psychotherapie“ bereitgestellt werden; weitere 30
ein „Submasterplatz in Verbindung mit den anderen Masterstudiengängen. Die Wahl von Modulen
der Klinischen Psychologie und Psychotherapie in
den anderen Masterstudiengängen (CAN/HPSTS)
ist überdurchschnittlich hoch. Die Lehre wird durch
ein integriertes Lehrbuch und computerisiertes
Lernprogramm Konzept unterstützt und strukturiert.
7
Das Aufbaustudium „Psychologische Psychotherapie“ (gemäß PTG) bietet ein berufsqualifizierendes 3-jähriges
(bzw. optional 5-jähriges) Curriculum an. Es schließt mit Staatsexamen und Approbation ab. NEU! Ab 2014 bieten
wir in Zusammenarbeit mit der Deutschen Gesellschaft für Verhaltenstherapie (DGVT) auch ein Curriculum für
„Kinder- und Jugendlichenpsychotherapeuten“ an.
Seit 2009 nehmen wir auch aus allen Ländern der EU Bewerber/Bewerberinnen für das Postgraduierten
Curriculum „Suchtforschung“ auf. Dieses 2-jährige Curriculum für maximal 15 Teilnehmer pro Jahrgang wird
durch die „Dresden International University“ im Kurssystem, in der Regel berufsbegleitend zur Anfertigung einer
Promotion unter Leitung von Professor Dr. G. Bühringer durchgeführt und derzeit von der VW-Stiftung gefördert.
8
2. Arbeitsbereich: Institutsambulanz und Tagesklinik (Leitung Prof. Dr. Jürgen Hoyer)
Die Institutsambulanz und Tagesklinik ist integraler Bestandteil des Instituts. Sie ist verantwortlich für die formale
und inhaltliche Sicherstellung des geregelten Patientenzugangs für die Lehre und alle klinischen (d.h. am Patienten
durchgeführten) Forschungsprojekte (u.a. Therapieforschung). Der Bereich ist hinsichtlich der sich nicht unmittelbar auf den Master-, bzw. Diplomstudiengang bezogenen Aufgaben privatrechtlich organisiert (Institutsambulanz
und Tagesklinik für Psychotherapie der TU Dresden, IAP-TU Dresden GmbH) und umfasst alle patientenbezogenen
Aufgaben, d.h. die kassenrechtlich ermächtigte Ambulanz und Tagesklinik für Forschung und Lehre sowie die
Ausbildungsambulanz für Kandidaten des Aufbaustudienganges.
3. Arbeitsbereich: Forschung
„Klinische Psychologie und Psychotherapie“ bezeichnet diejenige Teildisziplin der Psychologie, die sich mit psychischen Störungen und den psychischen Aspekten somatischer Störungen/Krankheiten in der Lehre, in der
Grundlagen- und klinischen Forschung sowie der praktischen Umsetzung der Erkenntnisse befasst. Wesentliche
Teilgebiete des Faches sind: Ätiologie und Pathogenese, Klassifikation, Diagnostik, Epidemiologie, Intervention
(Prävention, Psychotherapie, Rehabilitation, Gesundheitsversorgung, Evaluation). Unser Institut deckt das
Gesamtgebiet der Klinischen Psychologie und Psychotherapie, einschließlich Gesundheitspsychologie ab.
Dabei sind wir stark forschungsorientiert und gleichermaßen der Grundlagen- und Anwendungsforschung im
Rahmen eines Mehrebenenansatzes verpflichtet (neurobiologische, kognitiv-affektive, behaviorale und sozialinteraktionelle Betrachtungsebene). Wir an der TUD arbeiten eng mit dem Schwerpunkt „Cognitive-Affective
Neuroscience“ der Fachrichtung Psychologie sowie darüber hinaus mit den medizinischen Nachbardisziplinen in der
Medizinischen Fakultät zusammen.
Charakteristikum des Instituts ist seine projektbezogene Forschungsorientierung mit vielfältigen Projekten
hinsichtlich:
- der Entwicklung, Ableitung und Überprüfung verbesserter ätiologischer und pathogenetischer Modelle für
psychische Störungen,
- der Untersuchung des Zusammenhangs psychischer mit somatischen Störungen,
- der Ableitung verbesserter diagnostischer Methoden und -modelle, sowie verbesserter Klassifikationsysteme,
- der Ableitung und Evaluation verbesserter Therapieprinzipien (Ziel: Warum und wie wirken psychologische
Interventionen?)
- der Ableitung, Erprobung und Umsetzung neuer therapeutischer Versorgungsstrategien und -modelle.
4. Arbeitsbereich: Kongresse, Tagungen, Fort- und Weiterbildung
In diesem Bereich sind neben Beratung und Gutachten, diverse Fort- und Weiterbildungsangebote gebündelt, z.B. im Zusammenhang mit Trainingsseminaren anlässlich der Dresdener „Verhaltenstherapiewoche“,
Kollaborativ-Aktivitäten im Zusammenhang mit dem Robert Koch-Institut beim Deutschen Epidemiologischen
Gesundheitssurvey, DEGS) oder internationalen Projekten (World Mental Health), wie auch anderen nationalen und
internationalen Tagungen (AGNP, ECNP, DGPPN etc.).
Seit Sommer 2014 wird an unserem Institut der 9. Workshopkongress für Klinische Psychologie und Psychotherapie vorbereitet. Der Kongress wird im Mai 2015 unter dem Thema „Wie viel Psychologie steckt in der
Psychotherapie?“ einen Brückenschlag zwischen Grundlagenforschung und klinischer Praxis leisten. Mit über
100 Workshops, Symposien und Posterclustern ist der Workshopkongress eine in dieser Form einzigartige
Veranstaltung in Deutschland.
9
Arbeitsgruppen und Arbeitsgruppenleiter (Stand: 31.10.2014)
AG 1 Epidemiology and Health Services Research
Leitung: Prof. Dr. Katja Beesdo-Baum, Dr. Lars Pieper, Prof. Dr. J. Rehm &
Prof. Dr. Hans-Ulrich Wittchen
AG 2 Experimental Clinical Psychology and Neuroimaging
Leitung: PD Dr. Ulrike Lüken, Prof. Dr. Katja Beesdo-Baum & Dr. Markus Mühlhan
AG 3 Maternal and Infant’s Health
Leitung: Dr. Julia Martini & Prof. Dr. Hans-Ulrich Wittchen
AG 4 ROAMER - A Roadmap for Mental Health and Well-Being Research in Europe
Leitung: Prof. Dr. Hans-Ulrich Wittchen & Dr. Susanne Knappe
AG 5 Neuropsychology
Leitung: Dr. Oliver Riedel & PD Dr. Ulrike Lüken
AG 6 Addiction Research Unit
Leitung: Prof. Dr. Gerhard Bühringer & Dr. Silke Behrendt
AG 7 Behavioral Medicine
Leitung: Prof. Dr. Hans-Ulrich Wittchen & Dr. Lars Pieper
AG 8 Eating Disorders
Leitung: Prof. Dr. Corinna Jacobi
AG 9 Clinical Research
Leitung: Prof. Dr. Jürgen Hoyer & Prof. Dr. Katja Beesdo-Baum
AG 10 Diagnostic Issues and Psychometrics
Leitung: Prof. Dr. Hans-Ulrich Wittchen, Prof. Dr. Katja Beesdo-Baum,
Dr. Susanne Knappe & Prof. Dr. Jürgen Hoyer
AG 11 Psychotherapie- und Interventionsforschung
Leitung: Prof. Dr. Hans-Ulrich Wittchen & Prof. Dr. Jürgen Hoyer
10
LEHRE UND AUSBILDUNG/TEACHING AND CURRICULA
Studium der Klinischen Psychologie und Psychotherapie
Besucheranschrift/Kontakt
Chemnitzer Str. 46, 01187 Dresden
Beteiligte Professuren/Lehrstühle
Klinische Psychologie und Psychotherapie:
Behaviorale Psychotherapie: Prof. Dr. Jürgen Hoyer
Suchtforschung: Prof. Dr. Gerhard Bühringer
Essstörungen: Prof. Dr. Corinna Jacobi
Behaviorale Epidemiologie: Prof. Dr. Katja Beesdo-Baum
Studiengangskoordination
Prof. Dr. Katja Beesdo-Baum
Tel.: +49 (351) 46 33 69 89
Lehrplanung und Beratung
Dr. Samia Härtling (Vertretung 2013/2014:
Dipl.-Psych. Ingmar Heinig, Dipl.-Psych. Gisa Meißner)
Tel.: +49 (351) 46 33 69 63
Studienbeginn: jährlich im Oktober
Das Institut für Klinische Psychologie und Psychotherapie bietet Lehre in folgenden Studiengängen der TU Dresden an:
- Bachelor-Studiengang Psychologie
- Master-Studiengang Klinische Psychologie und Psychotherapie
- Master-Studiengang Psychologie: Cognitive-Affective Neuroscience (Wahlpflichtmodule)
- Master-Studiengang Psychologie: Human Performance in Sociotechnical Systems (Wahlpflichtmodule)
- Bachelor-Studiengang Sozialpädagogik, Sozialarbeit und Wohlfahrtswissenschaften (Nebenfachmodul)
- Studium Generale (Vorlesungen)
Bachelor-Studiengang Psychologie
Seit dem Wintersemester 2010/2011 gibt es an der TUD den Bachelor-Studiengang Psychologie mit 120 Studienplätzen. Schwerpunkte sind: Erwerb Basiswissen und - kompetenzen in Psychologie und den wichtigsten
Anwendungsbereichen. Im Studienablauf des BA-Studiums werden im 5. und 6. Semester die Vorlesungen
„Einführung in die Klinische Psychologie“, „Forschungs- und Anwendungsfelder der Klinischen Psychologie“
und „Gesundheitspsychologie“ angeboten. Außerdem bieten wir zusammen mit einem BA-Kolloqium spannende
Themen für Bachelor-Arbeiten unter persönlicher fachlicher Betreuung durch Mitarbeiter an.
Master-Studiengangs Klinische Psychologie und Psychotherapie im Wintersemester 2013/2014
Bachelor-Absolventen können in Dresden zwischen drei Master-Studiengängen wählen: Cognitive-Affective
Neuroscience (CAN; 30 Studienplätze), Human Performance in Socio-Technical Systems (HPSTS; 45 Studienplätze) und Klinische Psychologie und Psychotherapie (KPP; 60 Studienplätze). Dresden ist damit eine der wenigen deutschen Universitäten, die mehr Master- als Bachelor-Studienplätze anbieten. So trägt die TUD dazu bei,
den häufig beklagten Engpass beim Übergang zum Masterstudium zu entschärfen.
11
Zielsetzungen des Master-Studiengangs KPP: Die Studierenden…..
- kennen und verstehen über das Bachelor-Niveau hinausgehend zentrale Ansätze, Theorien und Befunde der
Klinischen Psychologie, Psychotherapie und der Gesundheitspsychologie vor dem Hintergrund grundlegender
Gesetzmäßigkeiten und Methoden sowie potenzieller Anwendungen.
- sind auf dieser Basis in der Lage, eigenständige Ideen für Forschungsfragen und –projekte zu entwickeln, diese
methodisch angemessen durchzuführen und auszuwerten sowie deren Ergebnisse kritisch reflektiert darzustellen.
- sind in der Lage, die beschriebenen Fähigkeiten und Fertigkeiten auch in neuartigen interdisziplinären
Forschungs- und Praxiszusammenhängen anzuwenden, so etwa in den Schnittfeldern zwischen kognitivaffektiven Neurowissenschaften, Klinischer Psychologie und Psychotherapie, Human Performance sowie
angrenzenden Feldern der Life Sciences.
- sind befähig, Informationen aus unterschiedlichen inhaltlichen und methodischen Quellen zu integrieren
und dabei mit der Komplexität der jeweils behandelten Sachverhalte aus dem Bereich der psychologischen
Wissenschaft auch dann adäquat und (methoden-)kritisch umzugehen, wenn diese Informationen unvollständig oder widersprüchlich sind. Gleichzeitig verfügen sie über das Rüstzeug, soziale und ethische Aspekte
ihres Handelns in Bezug auf die psychologische Forschung und Praxis verantwortlich zu reflektieren.
- verfügen über die Fähigkeit, die Logik, die Ergebnisse und Schlussfolgerungen ihrer klinisch-psychologischen
Tätigkeit angemessen und eindeutig zu kommunizieren und fachlich vorgebildeten Personen sowie Laien
verständlich zu machen.
- besitzen auf Basis des Studiums diejenigen Lernfähigkeiten, die es ihnen gestatten, sich fortgesetzt selbstgeleitet
und autonom inhaltliches und methodisches Wissen aus dem Bereich der Klinischen Psychologie anzueignen.
- Der Studiengang schließt mit dem Master of Science (M.Sc.) in Psychologie: Klinische Psychologie und
Psychotherapie ab. Die Absolventen sind befähigt, nach entsprechender Einarbeitungszeit in der Berufspraxis
vielfältige und komplexe Aufgabenstellungen im Bereich der Klinischen Psychologie und Psychotherapie zu
bewältigen.
- Zudem erfüllen sie die fachlichen Voraussetzungen für die Aufnahme des postgradualen Studiums zum
„Psychologischen Psychotherapeuten“ (nach Psychotherapeutengesetz PTG).
Inhalt und Aufbau des Master-Studiengangs
Der Master-Studiengang „Klinische Psychologie & Psychotherapie“ ist modular über 4 Semester aufgebaut. In
sieben Modulen des Pflichtbereiches erwerben die Studierenden alle nötigen Kenntnisse und Kompetenzen zu
Diagnostik, Gesprächsführung, Störungsmodellen, Interventionsverfahren sowie klinischen Forschungsmethoden
und Evaluation. Zur Einführung des Master-Studiengangs gab es zwei Wahlpflicht-Ergänzungsbereiche (CognitiveAffective Neuroscience und Human Performance in Socio-Technical Systems). Ab dem Wintersemester 2014/15
wird dieser Wahlpflichtbereich mit nun elf Wahlpflichtmodulen deutlich erweitert. Die Studierenden wählen hieraus
mindestens drei Module aus können ihre individuellen Interessen in Teilbereichen der Klinischen Psychologie oder
verwandter Disziplinen, z.B. berufsfeldorientiert vertiefen. Um den fristgerechten Abschluss der Master-Arbeit zu
erleichtern, entwerfen die Arbeitsgruppen des Instituts frühzeitig Themenangebote, die den Studierenden schon
im 2. Semester zugänglich gemacht werden. Entwicklungsfelder für den Master-Studiengang sind der Aufbau von
Austauschkooperationen mit ausländischen Universitäten und die stärkere Einbindung der Studierenden in die akademische Selbstverwaltung.
Rückblick: Der erste Master-Jahrgang Immatrikulation 2013
Für den ersten Jahrgang KPP gingen insgesamt ca. 840 Bewerbungen ein. In das aufwändige Auswahlverfahren
fließt nicht nur die Abschlussnote des Bachelor-Studiums ein, sondern es werden Pluspunkte für Vornoten in Klinischer Psychologie, für praktische Tätigkeiten (Praktika, SHK-Tätigkeiten, Ehrenamt etc.), für ein Auslandsstudium,
für eine klinische Bachelor-Arbeit oder für Berufserfahrung vergeben. 10% der Studienplätze sind für geeignete
Bewerber/Bewerberinnen von außerhalb des europäischen Bildungsraums vorgesehen. Die 100 bestplatzierten
Bewerber/Bewerberinnen für das Wintersemester 2013/14 waren zu 90% weiblich, im Mittel knapp 24 Jahre alt
und hatten zu 30% ihr Bachelor-Studium bereits abgeschlossen. Ein hoher Bewerberanteil hatte Probleme wegen
fehlender BA-Prüfungen einen nahtlosen Übergang zum Masterstudium zu sichern.
Am 10.10.2014 wurden die ersten 63 Masterstudenten im Studiengang KPP feierlich begrüßt. Im Rahmen einer
Einführungswoche lernten die Studierenden, die Ihren Bachelor-Abschluss zum überwiegenden Teil nicht in Dresden
abgelegt hatten, die Standorte und Arbeitsgruppen des Instituts kennen. Jedem Studierenden wurde ein Mitarbeiter aus einem ihn interessierenden Arbeitsbereich als „Mentor“ zur Seite gestellt. Die Mentoren sind während des
gesamten Studienablaufs als Ansprechpartner für Rückfragen, bei der Vermittlung von Praktika oder bei Schwierigkeiten im Studienablauf unterstützend tätig.
12
Abbildung 1: Begrüßungsveranstaltung für die Studierenden des Masterstudiengangs KPP (10.Oktober 2013)
Zum Ende des ersten Masterjahres gab es sowohl Feedbackrunden als auch ein Sommer-Kuchen-Buffet mit der
Möglichkeit zum informellen Austausch zwischen Studierenden und Lehrenden. Die Rückmeldungen des ersten
Master-Jahrgangs waren zum Großteil positiv. Viele Studierende hoben das breite Lehrangebot sowie die Möglichkeit, weitgehend alle gewünschten Lehrveranstaltungen auch tatsächlich besuchen zu können hervor. Die Unterteilung in eine eher anwendungsorientiere Vertiefung und eine forschungsorientierte Vertiefung führte zu einer sehr
unausgewogenen Verteilung: 90% der Studierenden wählten die Anwendungsorientierung mit der Möglichkeit mehr
störungs- und verfahrensspezifische Lehrveranstaltungen zu besuchen.
Diejenigen Studierenden, welche die Forschungsvertiefung mit mehr Lerninhalten im Bereich Methoden, Statistik
und Scientific Skills belegten, äußerten sich jedoch äußerst zufrieden und plädierten dafür, diese Vertiefungsrichtung
aufrecht zu erhalten. Mit der Lehrqualität waren die Studierenden zufrieden, viele lobten ins Besondere den Einbezug von Patienten sowie die Möglichkeit, durch externe Dozenten, welche häufig direkt aus der Praxis kommen,
besondere Einblicke in spezielle Anwendungsgebiete wie zum Beispiel Psychoonkologie oder Forensische Psychologie zu bekommen. Zugleich gab es vereinzelt Wünsche nach weiteren Lerninhalten, zum Beispiel aus dem Bereich
Geronto-Psychologie, deren Umsetzungsmöglichkeit aktuell geprüft wird.
Im Eindruck der Studierenden führt die Mischung aus den Besten, bezogen auf die Studiennoten, und den Besten,
bezogen auf praktische Erfahrungen im Berufsleben, zu besonders reichhaltigem Erfahrungsaustausch und lebendigen Gruppenzusammensetzungen.
Im folgenden Studienablaufplan wird verdeutlicht, wie sich die Module und zugehörigen Lehrveranstaltungen auf die
vier Studiensemester verteilen und wann Prüfungsleistungen abzulegen sind:
- Vorlesungen (V) vermitteln einführendes Überblickswissen. Sie werden für größere Studierendengruppen
(bis 120 Hörer vor allem in den ersten Studienabschnitten (BA-Studium, MA- Grundlagenmodule) angeboten.
- Seminare (S) dienen der Vertiefung eines spezifischen Wissensbereichs in kleinen Gruppen (bis 30). Die
Studierenden informieren sich mit ausgewählter Fachliteratur, tragen das Erarbeitete in der Gruppe vor, diskutieren es gemeinsam und erstellen ggf. eine schriftliche Ausarbeitung dazu.
- Erweiterte Seminare (ESE) ermöglichen es den Studierenden, durch eine gegenüber Seminaren halbierte
Teilnehmerzahl praxisrelevante Lerngegenstände unter Anleitung und mit individuellem Feedback zu üben.
- Zusätzlich werden Zeiten des Selbststudiums und betreute Praxiszeiten (Praktika) eingesetzt, in denen die
Studierenden sich vertieft mit den Modul-Inhalten auseinandersetzen und durch den Erwerb praktischer
Fähigkeiten erweitern.
13
Abbildung 2: Eindrücke vom Semesterabschlussbuffet mit Studierenden
und Dozenten des Masterstudiengangs Klinische Psychologie und
Psychotherapie (18. Juli 2014)
Veränderungen und Empfang des zweiten Master-Jahrgangs Immatrikulation 2014
Auf Grundlage der Erfahrungen im ersten Jahr wurden einige Anpassungen im Studienablauf vorgenommen. Diese
beziehen sich vor allem auf Änderungen im Wahlpflichtbereich, der deutlich ausgeweitet werden wird, um den
Studierenden mehr Möglichkeiten zu geben, nach individueller Interessenslage einzelne Module und Lerninhalte
zu besuchen. Bezüglich detaillierter Informationen über die Inhalte der Pflichtmodule (KPP1 – KPP7) und der
Wahlpflichtmodule (KPP-WP1 – KPP-WP11) besuchen Sie bitte unsere Webseite.
14
Basiskompetenzen
Intervention
Klinische Forschungsmethoden und Evaluation
Praktikum und
Projektseminar
Anwendungsorienierte
Vertiefung
Störungsspezifische
Interventionsvertiefung
KPP 3
KPP 4
KPP 5
SWS
[LP/ECTS]
KPP 7
HPSTS-E2
HPSTS E1
CAN E
KPP 6 B2
KPP 6 B1
KPP 6 A2
V <Wahlpflicht> PL
20 SWS
[30 LP]
Masterseminar und
Master-Thesis
SWS
[LP]
V <Wahlpflicht> PL
S <Wahlpflicht> uPL
V <Wahlpflicht> PL
19 SWS
[28 LP]
V <Wahlpflicht> PL
S <Wahlpflicht> uPL
V <bereichsspezifisch>
S <bereichsspezifisch> PL
E Advanced Literature and
Science Soft Skills
V <bereichsspezifisch>
S <störungsspezifisch>
E <störungsspezifisch> PL
S Projektseminar (1 SWS)
E Standardmethoden
(Interventionspraktikum, 4 SWS)
PL
S Angewandte Statistik im
klinischen Kontext PL
2. Semester
V Forschungsfragen der Klinischen
Psychologie und Psychotherapie
PL
S Aktuelle klinisch-psychologische
Forschungsfragen
V Studienplanung, -methodik und
-auswertung
1. Semester
V Störungsmodelle und Intervention
(Klinische Psychologie II)
V Allgemeine und spezielle
Psychotherapielehre PL
E Standardisierte Diagnostik uPL
S Funktionale und Behaviorale
Status- und Prozessdiagnostik
V Psychopathologie PL
E Gesprächsführungstechniken
Advanced Research
Methods
Ergänzungsbereich CAN
Cognitive-Affective
Neuroscience
Ergänzungsbereich HPSTS
Occupational Health
Psychology
Human Factors
Forschungsorientierte
Vertiefung
Interventionsvertiefung
Bereichs- und verfahrensspezifische Interventionsvertiefung
Basiskompetenzen klinischpsychologischer Diagnostik
KPP 2
KPP 6 A1
Modulname
Störungsmodelle und
Interventionslehre
Modulnr.
KPP 1
11 SWS + Praktikum
[30 LP]
V <Wahlpflicht> PL
S <Wahlpflicht> uPL
S Master-Seminar uPL
S Master-Seminar uPL
Master-Arbeit PL
2 SWS + Master-Arbeit
[32 LP]
15
V <Wahlpflicht> PL
S <Wahlpflicht> uPL
120
4
30
9
6
9
9
9
9
2
15
9
9
9
LP/ECTS
9
S Advanced Statistics
S Advanced Methods PL
S <bereichsspezifisch>
S <bereichsspezifisch> PL
S Projektseminar (1 SWS) uPL
P Praktikum wBV
4. Semester
und Psychotherapie
3. Semester
Studienablaufplan für den Masterstudiengang Klinische Psychologie
mit Art, Titel und Umfang der Lehrveranstaltungen sowie erforderlichen Leistungen
15
Masterstudiengang: Zweiter Jahrgang
Für den zweiten Jahrgang KPP mit Beginn im Wintersemester 2014/15 gingen über 900 Bewerbungen ein. Die
Tatsache, dass circa 20% der Bewerber wegen nicht frist- oder formgerechter Bewerbungsunterlagen als ungeeignet abgelehnt werden mussten, zeigt unseres Erachtens den enormen Druck, unter dem die Bachelor-Studierenden
stehen. Um die Wahrscheinlichkeit zu erhöhen, überhaupt einen Master-Studienplatz zu bekommen, bewerben
sich die Studierenden an zahlreichen Universitäten. Sie haben somit einerseits kaum Zeit, besondere Bedingungen
im Bewerbungsverfahren zu berücksichtigen, was zu fehlerhaften Bewerbungen führt. Andererseits ist auch zu
befürchten, dass die Auswahl der Wunsch-Universitäten weniger nach inhaltlichen Kriterien, dem Ruf der Universität in Bezug auf Forschung oder Lehre, oder persönlichen Vorlieben für die spätere Berufswahl erfolgt. Die
100 bestplatzierte Bewerber waren zu 87% weiblich, im Mittel knapp 24 Jahre alt und hatten zu 36% ihr BachelorStudium bereits abgeschlossen. Der Trend des nahtlosen Übergangs zwischen Bachelor- und Masterstudium zeigt
sich also weiterhin.
Der gestiegene Anteil an Bewerbern mit vorliegendem Bachelor-Abschluss deutet aber auch darauf hin, dass unter
den 100 Bestplatzierten nun vermehrt Bewerber sind, die über Berufserfahrung nach Erlangung des BachelorAbschlusses Pluspunkte gesammelt haben.
Akademische Selbstverwaltung
Masterstudiengang Klinische Psychologie und Psychotherapie (KPP):
Prüfungsausschuss:
Prof. Dr. Jürgen Hoyer (Vorsitz)
Prof. Dr. Katja Beesdo-Baum, Prof. Dr. Alexander Strobel, Dr. Markus Mühlhan, Juliane Grätz
Eignungsfeststellungs- und Auswahlausschuss:
Prof. Dr. Hans-Ulrich Wittchen, Prof. Dr. Corinna Jacobi, Prof. Dr. Katja Beesdo-Baum,
Dr. Samia Härtling, Dipl.-Psych. Ingmar Heinig
Studiengangskoordinatorin:
Studienberatung und Lehrplanung:
Dr. Samia Härtling (Vertretung 2013/14: Dipl.-Psych. Ingmar Heinig)
KPP – Vertreter in Kommissionen und Ausschüssen der Fachrichtung Psychologie:
Fachkommission:
Prof. Dr. Hans-Ulrich Wittchen, Studienkommission: Prof. Dr. Katja Beesdo-Baum, Tobias Esche
Kommission Qualitätsmanagement und Lehre:
Prof. Dr. Katja Beesdo-Baum, Dr. Samia Härtling, Tobias Esche
Prüfungsausschuss für den Bachelor-Studiengang Psychologie:
Prüfungsausschuss für den Master-Studiengang Psychologie - CAN:
Bibliothekskommission:
16
Wittchen,
Bensmann,
Lochmann
Depression
KPP-6B1
FAL/101
Wittchen
V Störungs-modelle
und Interventionen
(Klin. II)
KPP-1/
KPP-E1,
FAL/103
Martini
Psy. Störungen
in Kindheit,
FAL/101
Mühlhan
(26.11.-07.02.)
Stand.
Diagnostik,
KPP-2 Gr. 1,
FAL/101
Martini
V Forschungs/Anwendungs-felder
BA-KP ASB 28
Höfler
V Studien-planung,
-methodik &
-auswertung
KPP-4,
FAL/103
Strobel
(14.10-26.11.)
Gesprächsführ.,
KPP-3 Gr. 1,
FAL/101
Wittchen
V Klinische I
BA-KP
ASB 120
Montag
Meißner/
Wieder/N.N.
(26.11.-07.02.)
Stand.
Diagnostik,
KPP-2 Gr. 2,
FAL/102
Rehm
(14.10-26.11.)
Gesprächsführ.,
KPP-3 Gr. 2,
FAL/102
Hoyer
Funkt. und
Behav. Status& Prozessdiagnostik
KPP-2 Gr.1
FAL 101/102
Hoyer
Funkt. und
Behav. Status& Prozessdiagnostik
KPP-2 Gr.2
FAL 101/102
SR A
Basiskompetenzen III:
Interventionsverfahren
Beesdo-Baum
SR A
Prävention &
Gesundheitsförderung
KPP-6B1,
Jacobi
Mühlhan
(26.11.-07.02.)
Stand. Diagnostik,
KPP-2 Gr. 3,
FAL/101
Strobel
(14.10-26.11.)
Gesprächsführ.
KPP-3 Gr. 3
FAL/101
Dienstag
Goschke
V CAN(1) E
ASB120
Heinig
(26.11.-07.02.)
Stand. Diagnostik,
KPP-2 Gr. 4,
FAL 102
Lüken
(14.10-26.11.)
Gesprächsführ., KPP-3
Gr. 4, FAL/102
Bühringer
Klinische
Forschungsmethoden I
(=Dipl.kolloquium)
FAL/101
Jurjanz
V Psychopathologie
KPP-2
FAL/103
FAL/101
Panik-störung
& Agoraphob.
KPP-6A1,
Bühringer,
Maslowski,
Westphal
Wittchen/Jacobi
Klin.-psych. Forschungs-fragen
(Foko) KPP-4,
FAL/103
Jacobi
Essstörung
KPP-6A1
FAL/102
Mittwoch
Körndle
V HPSTS(3)
E1
ASB 120
Oeste
Neuropsychologische
Störungsbilder
KPP-6A2
FAL/101
Hoyer
V
Allg. & spez.
Psychotherap
ielehre KPP1,
FAL/103
Ringvorlesung
V CAN(5) E
BZW A253
Wegge
V HPSTS(1) E1
ASB 120
Donnerstag
Höfler
Statist.
Aspekte
in
Diplomarbeiten
FAL/101
Höfler
Auswert
ung
Studien
daten
FAL/101
Engert
V CAN
(2) E
ASB 28
Bachelo
rkolloqui
um
FAL/102
Freitag
7
18:3020:00
Blockveranstaltungen, Teilblockveranstaltungen und Ergänzungsbereichveranstaltungen:
Jurjanz (ext. LA): Psychopathologie ! Bühringer, Neumann, Probst: Substanzstörungen !"Bühringer, Westphal, Maslowski: Panikstörung und Agoraphobie ! Wittchen, Bensmann, Lochmann: Depression ! Jacobi: Prävention und
Gesundheitsförderung ! Dauer (ext. LA): Forensische Psychiatrie und Psychotherapie ! Hölzel (ext. LA): Psychoonkologie ! Pannasch, V HPSTS(5) E1 ! Schlag, V HPSTS(4) E1 ! Li, V CAN(3) E"! Schlag, V HPSTS(4) E1 !
Bachelorkolloquium
16:4018:10
6
14:5016:20
5
13:0014:30
4
11:1012:40
3
9:20-10:50
2
1
7:30-9:00
Überblick über das Lehrprogramm im Wintersemester 2013/2014
17
18
N.N.
KP E2
Gesprächsführ
ungstechniken
(7 Termine)
Gr. 2 FAL/102
N.N.
KP E2
Standardisierte
Diagnostik (8
Termine) Gr. 2
FAL/102
Pieper
KP E2
Gesprächsführu
ngstechniken
(7 Termine)
Gr. 1 FAL/101
Furka
KP E2
Standardisierte
Diagnostik (8
Termine) Gr. 1
FAL/101
Beesdo-Baum
KPP 3
Standardmethod
en:
Interventionspra
ktikum Gr. 1
FAL/101
Montag
Lüken
KPP 6
A1 / KPP
6 B1 /
KPP E2
S
Rezidivpr
ophylaxe
bei
psychotis
chen
Störunge
n
SR A
Jacobi
KPP 3
Standardmethod
en:
Interventionspra
ktikum Gr. 4
FAL/101
(Leising)
Mühlhan
KP E2
Standardisierte
Diagnostik (8
Termine)
Gr. 3
FAL/101
Rehm
KP E2
Gesprächsführu
ngstechniken
(7 Termine)
Gr. 3
FAL/101
Härtling
KPP 3
Standardmethod
en:
Interventionspra
ktikum Gr. 2
FAL/101
Hoyer
KPP 6 A2 / KPP
6 B1
S
Psychotherapie
FAL/102
N.N.
KP E2
Standardisierte
Diagnostik (8
Termine) Gr. 4
SRA
N.N.
KP E2
Gesprächsführu
ngstechniken
(7 Termine)
Gr. 4
SRA
Jacobi
KPP 3
Standardmethod
en:
Interventionspra
ktikum Gr. 3
FAL/102
Dienstag
Hoyer
KPP 5
Projektseminar
FAL/102
Van den Berg
KPP 6 A1 / KPP 6
B1
S
Störungen im
Kindes- und
Jugendalter
FAL/102
Lüken
KPP 6 B2
Advanced
Literature &
Science Soft Skills
SR A
Lüken
KPP 1
V Forsch.-fragen
der Klin. Psych.
&
Psychotherapie,
FAL/103
Trautmann
KPP 6 A2 / KPP 6 B1
S Enspannungsreaktion und
Entspannungsverfahren
FAL/101
Bühringer
KPP 6 A1
Pathologisches
Glücksspielen
und
vergleichbare
Störungen
ESE
FAL/102
Lüken Aktuelle
klin.-psych.
Forschungsfrag
en KPP 4
FAL/103
Beintner
Klinische
Forschungsmet
hoden in
Abschlussarbeit
en =
Diplomandenkol
loquium
FAL/101
Mittwoch
Mühlhan
KPP 6 A2 / KPP
6 B1 S
Neuroimaging in
Psychiatrie und
Psychotherapie
FAL/101
FAL/101, FAL/102,
FAL/103
Blockseminare
Klinische Psychologie
FAL/101, FAL/102,
FAL/103
Blockseminare
FAL/101, FAL/102,
FAL/103
Blockseminare
FAL/101, FAL/102,
FAL/103
Blockseminare
Höfler/
El Hadad
KPP 4 Angew.
Statistik im klin.
Kontext
Gr. 2, S
SR A
KPP 6 A2 / KPP
6 B1
V Lüken
Neurobiologisch
e Grundlagen
von
Angststörungen
FAL/103
BAKolloquiu
m
FAL/102
Höfler
Auswert,
Darst.
und
Interpret.
von
Studiend
aten
FAL/101
Freitag
Höfler
KPP 4 Angew.
Statistik im klin.
Kontext
Gr. 1, S
SR A
Oeste
KPP 6 A2 / KPP 6 B1
V Neuropsychologische
Störungsbilder
FAL/103
Hoyer
KP-Ba
Gesundhei
tspsycholo
gie und
Gesundhei
tsversorgu
ng V
ASB/120
Knappe
KPP 6 A1
Soziale
Phobie,
ESE
FAL/101
Hilbert
Klin.
Psych. &
Gesundhei
tspsych für
Nebenfach
studenten
FAL/101
Donnerstag
7
FAL/101, FAL/102,
18:30-20:00
FAL/103
Blockveranstaltungen und Teilblockveranstaltungen:
Neudeck (ext. LA): KPP 6 A2 / KPP 6 B1 Konfrontationsverfahren • Langer (ext. LA): KPP 6 A2 / KPP 6 B1 S Psychologische Aspekte im Großschadensfall/Notfallpsychologie • Pixa:. KPP 6 A1 ESE Behandlung cannabisbezogener
Störungen • Bühringer: KPP 6 A1 ESE Pathologisches Glücksspielen und vergleichbare Störungen •Bühringer: KPP 6 A1 / KPP 6 B1 / KPP E2 S Einführung in Substanzstörungen
16:40-18:10
6
14:50-16:20
5
13:00-14:30
4
11:10-12:40
3
9:20-10:50
2
1
7:30-9:00
Überblick über das Lehrprogramm im Sommersemester 2014
LEHRE UND AUSBILDUNG/ABSCHLUSSARBEITEN/THESES
Abgeschlossene Habilitationen
Mitarbeiter(in)Titel
Mentor
Jahr
Dr. Lüken, Ulrike
Exploring the neural signature of anxiety and its mechanisms of change
following cognitive-behavioral psychotherapy
Prof. Wittchen
2013
Dr. Riedel, Oliver
Effekte psychiatrischer Erkrankungen auf die persönliche und sozioökonomische Krankheitslast bei neurodegenerativen Erkrankungen –
Analysen am Beispiel der Parkinson-Krankheit
Prof. Wittchen
2014
Mentor
Jahr
Dr. Knappe, Susanne
Strategies and challenges for improving the diagnostics of anxiety disorders
Prof. Wittchen
2015
Dr. Schönfeld, Sabine Kognitive und emotionale Prozesse als ätiologische und aufrechterhaltende Faktoren bei Traumafolge- und Angststörungen
Prof. Wittchen
2016
Betreuer
Jahr
Beintner, Ina
Self-directed approches to preventing and treating eating disorders adherence, outcomes and their interrelations
Prof. C. Jacobi
2014
Geiger, Martin
Stressreagibilität bei isolierter klinischer Hypertonie - Vergleich zu
Normotonie und primärer Hypertonie
Prof. Einsle;
Dr. Mühlhan
2013
Heinemann, B.-C.
Bedeutung von Trennungsangst bei Personen mit Agoraphobie - Eine
Querschnittsstudie (Medizinische Doktorarbeit)
Prof. Einsle;
Prof. Beesdo-Baum
2012
Kräplin, Anja
Impulsivity in pathological gambling: Decomposing the construct to
detect disorder-specific characteristics
Prof. Bühringer;
Prof. Goschke
2014
Lang, Thomas
Expositionsfokussierte Behandlung der Panikstörung und Agoraphobie:
Untersuchungen zu Wirkfaktoren und Wirkmechanismen
Prof. Wittchen
2013
Hentschel, Annett
Die Validierung der Kernmerkmale von Persönlichkeitsstörung und
Selbstpathologie und interpersonale Pathologie des alternativen DSM-5
Modells anhand des General Assessments of Personality Disorder
(GADP)
Prof. Wittchen;
Prof. Sachse
2013
Schlichthaar, F.
Bedeutung von Ärger und Persönlichkeitseigenschaften bei isolierter
klinischer Hypertonie (Medizinische Doktorarbeit)
Prof. Einsle;
Prof. Beesdo-Baum
2013
Laufende Habilitationsvorhaben
Abgeschlossene Dissertationen
19
Laufende Dissertationsvorhaben
Betreuer
Jahr
Asselmann, Eva
Protective and resilience factors in adolescents and young adults at risk
for psychopathology: A 10-year prospective-longitudinal, clinical-epidemiological cohort and family study
Prof. Beesdo-Baum
…
Baer, Iris
Nicotine dependence in context of exposure therapy for panic disorder
and agoraphobia: Patients impairment, therapy-outcome and change in
nicotine consumption
Prof. Einsle;
Dipl.-Psych. Wieder
…
Bräuer, David
Einfluss genetischer Variation auf den Erfolg der kognitiven Verhaltenstherapie bei der Sozialen Phobie
Prof. Hoyer
…
Emmrich, Angela
The role of depression comorbidity in CBT for panic disorder and agoraphobia
Prof. Beesdo-Baum;
Prof. Wittchen
…
Evens, Ricarda
The relationship between dopamine depletion and cognitive and motivational flexibility in Parkinson’s disease
PD. Lüken
…
Furka, Nadine
Verhaltensaktivierung bei Depression: Effizienzsteigerung durch
Gruppenformate und die Integration neuer Medien
Prof. Hoyer
…
Heinig, Ingmar
Optimierung des Extinktionslernens bei Angststörungen
Prof. Wittchen
…
Heinrich, Anke
Prävalenz, Inzidenz und Determinanten von Schlafstörungen bei
Soldaten der Bundeswehr mit Auslandseinsätzen
Dr. Knappe
…
Hilbert, Kevin
The specificity of neural correlates of generalized anxiety disorder: Differentiation from related disorders and investigation of core clinical characteristics
Prof. Beesdo-Baum
…
Jahnke, Sara
Understanding and challenging stigmatization of people with pedophilia:
Theoretical and empirical groundwork
Prof. Hoyer
…
Kohlmann, Anne
The importance of resources for the treatment of alcohol use disorders
in older adults
Dr. Behrendt;
Prof. Bühringer
…
Krause, Linda
Does maternal mental health before and during pregnancy influence
early infant health
Prof. Einsle;
Dr. Martini
…
Mack, Simon
Beeinträchtigung und Versorgung psychischer Störungen in Deutschland
zu Beginn des 21. Jahrhunderts
Prof. Wittchen;
Prof. F. Jacobi
…
Maslowski, Nina
Neural substrates of interoception
PD Lüken
…
Neumann, Maria
Prädiktoren von Cannabiskonsum und -störungen bei spontanen und
interventionsbezogenen Verläufen
Dr. Behrendt;
Prof. Bühringer
…
Petzoldt, Johanna
Maternal anxiety disorders and excessive crying, feeding and sleeping
disorder in early infancy
Prof. Wittchen;
Dr. Martin
…
Probst, Charlotte
Das sozioökonomische Profil alkoholbedingter Krankheitslast in Südafrika
Prof. Rehm;
Prof. Parry;
Prof. Wittchen
…
Schäfer, Judith
Attentional processing and trauma-related psychopathology
Dr. Schönfeld
…
Schierz, Katharina
Entwicklung und Überprüfung klinischer Interviews zur Diagnostik sexueller Funktionsstörungen bei Frauen und Männern
Prof. Hoyer
…
Schulz, Anja
Social anxiety and online sexual solicitation of minors
Prof. Hoyer
…
Schweden, Tabea
Depersonalisation und Derealisation bei Prüfungs- und Sozialer Angst
Prof. Hoyer
…
Stankevich, Yuliya
Behavioral and neural correlates of cognitive and motivational control in
major depression and parkinson’s disease
PD Lüken
…
Dr. Behrendt;
Dr. Schönfeld
…
Trautmann, Sebastian The relationship between substance use, substance use disorders and
mental disorders in the context of military deployment
van den Berg, Linda
Extinktionslernen bei Angststörungen
Prof. Wittchen;
PD Lüken
…
Völker, Ulrike
Internetgestützte Prävention bei jungen Frauen mit subklinischen Essstörungen
Prof. C. Jacobi
…
Wieder, Gesine
Kommunikation bei Panikstörung mit Agoraphobie
Prof. Wittchen;
Prof. Einsle
…
Winkel, Susanne
Die Bedeutung von Angst- und depressiven Störungen für die körperliche Gesundheit in der Schwangerschaft
Prof. Wittchen;
Dr. Martini
…
20
Abgeschlossene Diplomarbeiten
Diplomand(in)Titel
Gutachter
Betreuer
Jahr
Abel, Katharina
Ausprägung der Progredienzangst bei Eltern krebs- Dr. Martini;
kranker Kinder
Prof. Christiansen
Dipl.-Psych. Schepper; 2014
Dr. Martini
Albrecht, Denis
Valued-living: Erklärt „werteorientiertes
Handeln“ Therapiezufriedenheit besser als bloße
Symptomreduktion?
Prof. Hoyer
2014
Asselmann, Eva
Types of stressful life events and the onset of
Prof. Beesdo-Baum;
depression and anxiety in a prospective-longitudinal Prof. Wittchen
study among adolescents and young adults
Prof. Beesdo-Baum
2012
Aßmann, Alica
Mentales Zeitreisen: Autobiografischer
Gedächtnisabruf und Zukunftssimulation
Prof. Hoyer;
Dr. Schönfeld
Dipl.-Psych. Uhmann 2012
Bannert, Anne
Die Bedeutung der Symptomhierarchie für
die Effektivität der interozeptiven Exposition Untersuchung im Rahmen einer manualisierten
Expositionsbehandlung bei Panikstörung mit
Agoraphobie
Prof. Einsle;
PD Lüken
Dipl.-Psych.
Westphal;
Prof. Einsle
2013
Baum, Judith
Zusammenhänge zwischen familären Beziehungen, Dr. Schönfeld;
Auslandseinsätzen, Posttraumatischer
Prof. Wittchen
Belastungsstörung und Inanspruchnahme familienbezogener Hilfsangebote bei Bundeswehrsoldaten
Dipl.-Psych. Jacob
2012
Behrend, Anne
Paternal rearing - examining unique contributions to Dr. Knappe;
offspring anxiety
Prof. Wittchen
Dr. Knappe
2013
Benusch, Julia
Kindertagesbetreuung und Mutter-Kind-Bindung
16-Monate nach der Geburt
Dr. Martini;
PD Petrowski
Dipl.-Psych. Petzoldt 2014
Boltz, Sonja-Sabine
The relation of obsessive-compulsive symptoms
and the frequency, appraisal and suppression of
intrusive thoughts
Dr. Gloster;
Dr. Schönfeld
Dipl.-Psych. Hummel 2012
Borchardt, Liane
Nikotinabhängigkeitssymptome bei Adoleszenten
und jungen Erwachsenen: Welche Rolle spielen das Alter, die Konsumcharakteristik und das
Geschlecht?
Dr. Behrendt;
Prof. Bühringer
Dr. Behrendt
Böttcher, Kristina
Panikattacken und Panikstörung im
Zusammenhang mit belastenden/traumatischen
Erlebnissen bei Soldatinnen und Soldaten der
Bundeswehr im Auslandseinsatz
Prof. Wittchen;
Dr. Schönfeld
Dipl.-Psych. Heinrich;
Dipl.-Psych.
2013
Trautmann
Brehme, Julia
Einflussfaktoren auf den Verlauf der Postpartalen
Depression
Prof. Einsle;
Prof. Pfennig
Prof. Pfennig; Dipl.Psych. Dekoj
2013
Breitrück, Christin
Lebensqualität bei Parkinson: Neurologische und
Neuropsychologische Korrelate
Dr. Riedel;
Prof. Wittchen
Dr. Riedel
2013
Brüser, Franz
Factors associated with delay discounting-a comparison between nicotine-dependent smokers and
never-smokers
Prof. Bühringer;
Dr. Behrendt
Dipl.-Psych. Kräplin
2014
Conci, Anne
Kognitive Kontrolle bei Nikotinabhängigkeit:
Unterscheiden sich veränderungsbereite und nicht
veränderungsbereite Raucher?
Prof. Bühringer;
Prof. Hoyer
2013
Demele, Ulrike
Therapeutische Allianz in der Expositionstherapie
von Panikstörung und Agoraphobie: Prädiktoren
und Zusammenhang zum Outcome
Prof. Einsle;
PD Lüken
Prof. Einsle;
Dipl.-Psych. Wieder
2014
Eberlein, Linda
Prädiktoren für das Nutzungsverhalten Internetgestützter Nachsorge bei Bulimia nervosa
Prof. C. Jacobi;
Prof. Einsle
Dipl.-Psych. Beintner 2013
Ebser, Nicole
Changes in the anticipation of dyspnoea following
interoceptive exposure: Neurofunctional and autonomic correlates
PD Lüken;
Prof. Rief
PD Lüken;
Dipl.-Psych.
Maslowski
2014
Eiselt, Ulrike
Entwicklung von frühkindlichen Schlafstörungen
Dr. Knappe;
Prof. Einsle
Dr. Knappe
2012
Ende, Sarah
Welche Zusammenhänge bestehen zwischen der
Mutter-Kind-Beziehung und Angststörungen bei
Jugendlichen und jungen Erwachsenen?
Prof. Wittchen;
Dr. Knappe
Dipl.-Psych.
Asselmann
2014
Prof. Hoyer;
Prof. Einsle
2012
21
Diplomand(in)Titel
Gutachter
Betreuer
Jahr
Feilmeier, Christin
The role of perceived parenting style in offspring’s
self-esteem and depressive disorders
Dr. Knappe;
Prof. Wittchen
Dr. Knappe
2013
Feldmann, Julia
Prädiktoren kognitiver Kontrolle bei pathologischen Prof. Bühringer;
Glücksspielern
Prof. Hoyer
2012
Fleischhack, Julia
Food Addiction bei Männern in Zusammenhang mit
Prof. C. Jacobi;
Body-Mass-Index, spezifischer Psychopathologie von Prof. Einsle
Essstörungen, Substanzkonsum und Impulsivität
Dipl.-Psych. Richter
2013
Friedrich, Sylva
Der Zusammenhang zwischen Etikettierung
und Stigmatisierung von Personen mit problematischem Alkoholkonsum - Untersuchung des
Stigmaprozesses
Prof. Hoyer;
Prof. Deutsch
Dipl.-Psych. Jahnke
2014
Gebler, Franziska
Effekte der kognitiven Verhaltenstherapie bei
der Behandlung der Sozialen Phobie in einer
Hochschulambulanz
Prof. Hoyer;
Prof. F. Jacobi
Prof. Hoyer
2012
Götze, Bettina
Fatigue bei Multiple Sklerose Patienten und deren
Prof. Wittchen;
Einfluss auf die gesundheitsbezogene Lebensqualität Dr. Riedel
Dr. Pieper
2012
Große, Julia
The natural course of depression: A prospectivelon- Prof. Beesdo-Baum;
gitudinal study among adolescents and young adults Prof. Wittchen
Prof. Beesdo-Baum
2013
Gußer, Heike
Der Zusammenhang von Nikotindeprivation und
Veränderungsmotivation mit kognitiver Kontrolle
bei Nikotinabhängigkeit
2012
Haase, Rocco
Multimodale Längsschnittuntersuchung des Effekts Prof. Ziemssen;
von Fampridin auf Lebensqualität und Mobilität bei Dr. Pieper
Multiple-Sklerose-Patienten
Dr. Pieper
2014
Hänsel, Jana
Dissoziative Symptome als Prädiktor des Therapie- Prof. Hoyer;
erfolgs bei Sozialer Phobie
Prof. Kirschbaum
Dipl.-Psych. Bräuer
2012
Haronska, Sandra
Kognitive Kontrollfunktionen bei komorbiden und
nichtkomorbiden Personen mit der Diagnose
Pathologisches Glücksspielen
Prof. Bühringer;
Dr. Behrendt
2014
Hausstädtler, Erik
Gibt es ein Leben vor dem Tod? Existentielle
Stressbewältigung im Hier und Jetzt
Prof. Einsle;
Dr. Härtling
Prof. Einsle;
Dr. Härtling
2013
Helbig, Juliane
Der Einfluss des Rauchstatus auf die funktionelle
Prof. Smolka,
Konnektivität bei der Verarbeitung emotionaler Reize Prof. Bühringer
Dr. Krömer
2013
Helling, Franziska
Psychosoziale Korrelate der präpartalenDepresProf. Einsle;
sivität in einer Stichprobe psychisch belasteter Frauen Prof. Weidner
Dipl.-Psych. Galle
2012
Herrmann, Elisabeth
Sensori(motor) gating in children with Tourette
Syndrome - an EEG and EMG study
Dr. Martini
2013
Heyde, Franziska
Psychometric properties of the dimensional anxiety Prof. Beesdo-Baum;
scales for DSM-5 in a non-clinical student sample
Dr. Knappe
Dr. Knappe
2013
Hilse, Lisa
Konfliktüberwachung und Pathologisches
Glücksspielen
Prof. Bühringer;
Prof. Wittchen
2014
Hiob, Sarah
The dimensional anxiety scales for DSM-5:
Sensitivity to change in a clinical sample
Dr. Knappe;
Prof. Beesdo-Baum
Prof. Beesdo-Baum
2013
Hoffmann, Rahel
Reduktion des Alkoholkonsums und Remission
Dr. Behrendt;
von Alkoholstörungen bei Jugendlichen und jungen Prof. Bühringer
Erwachsenen: Altersbedingte Veränderungen in
Abhängigkeit des Geschlechts und Trinkverhaltens
Dr. Behrendt
2013
Höhne, Monique
Attentional Bias im Zusammenhang mit PTBSSymptomatik und Einsatzerfahrungen bei Soldaten
der Bundeswehr
Dr. Schönfeld;
Prof. Wittchen
Dipl.-Psych. Schäfer 2012
Hornemann, Katja
Hausaufgaben-Compliance und Therapieerfolg bei
Patienten mit Errötungsangst
Dr. Härtling;
Prof. Hoyer
Dr. Härtling
2013
Horster, Larissa
The role of pre-treatment depression for psychotherapy outcome in generalized anxiety disorder
Prof. Beesdo-Baum;
Prof. Hoyer
Prof. Beesdo-Baum
2014
Huber, Anja
Neurale Korrelate interozeptiver Verarbeitungsprozesse in
PD Lüken;
einer klinisch unauffälligen Stichprobe - eine fMRT-Pilotstudie Prof. Einsle
Dipl.-Psych.
Maslowski
2012
22
Prof. Bühringer;
Prof. van der Meer
Dr. Martini;
Prof. Rößner
Diplomand(in)Titel
Gutachter
Betreuer
Hütter, Kristian
Evaluation der Wirksamkeit einer hochfrequenten
ambulanten Behandlung von Essstörungen
Prof. C. Jacobi;
Prof. Wittchen
Hütter, Katja
Die Bedeutung einer vorgeburtlichen mütterlichen
Dr. Martini;
Posttraumatischen Belastungsstörung auf das kind- Prof. Einsle
liche Bindungsverhalten 16 Monate nach der Geburt
Dipl.-Psych. Wittich
2013
Jani, Ulrike Maria
Prädiktoren der gesundheitsbezogenen Lebensqualität Prof. Wittchen;
bei Partnern von Patienten mit Multipler Sklerose
Dr. Riedel
Dr. Pieper
2013
Jurkschat, Stephanie
Psychometric properties of the revised dimensional
Prof. Beesdo-Baum;
anxiety scale for DSM-5 in a non-clinical student sample Dr. Knappe
Prof. Beesdo-Baum
2014
Kalina, Anna
Sozialer Stress, soziale Phobie und dissoziative
Symptome
Dipl.- Psych. Bräuer
2012
Kasper, Anne
Nebenwirkungen von Psychotherapie: Die Rolle von Prof. Einsle;
Patientenvariablen und therapeutischer Beziehung
Dr. Knappe
Prof. Einsle
2013
Kircheis, Jeanette
Depressionen und Depressivität bei Lebenspartnern
Prof. Wittchen;
von Multiple Sklerose-Patienten: Einfluss von
Dr. Riedel
Patienten-, Lebenspartner- und vermittelnden Variablen
Dr. Pieper
2013
Kleeberg, Paula
Selbststeuerung bei Jugendlichen und jungen Erwach- Dr. Knappe,
senen mit Zwangssyndrom und Zwangsstörung
Prof. Wittchen
Dr. Knappe
2014
Klotz, Ariane
Gibt es Unterschiede in der Mutter-Kind-Bindung
zwischen sozial phobischen und psychisch gesunden Müttern?
Dr. Martini
2014
Koch, Markus
Untersuchung transgenerationaler Effekte traumaDr. Knappe;
tischer Erfahrungen in Kambodscha unter
Prof. Knaevelsrud
Berücksichtigung genderspezifischer Zusammenhänge
Dr. Knappe
2014
Koos, Linda
Neural and behavioral response to emotional faces Prof. Beesdo-Baum
in generalized anxiety disorder
Dipl.-Psych. Hilbert
2014
Kossack, Andrea
Emotionale Prozesse bei Patienten mit
Amyotropher Lateralsklerose
Dr. Hälbig
2012
Kragen, Carolin
Einfluss eines Interozeptionstrainings auf die
PD Lüken;
Bewertung angstauslösender Stimuli bei Personen Prof. Einsle
mit hoher und niedriger Angstsensivität
Dipl.-Psych.
Maslowski
2014
Krause, Lisa
Development of a measure for the behavioral sym- Prof. Beesdo-Baum;
ptoms of generalized anxiety disorder
Prof. Hoyer
Prof. Beesdo-Baum
2013
Krause, Luisa
Zusammenhang von Misshandlung und
Vernachlässigung in der Kindheit mit postpartelem
psychischen Befinden und Mutter-Kind-Beziehung
Prof. Einsle;
Prof. Weidner
Dipl.-Psych. JungeHofmeister
2014
Krautschuk, Susan
Validierung des Approach-Avoidance-Task zur
Erfassung sexueller Interessen
Prof. Hoyer;
Prof. Deutsch
Dipl.-Psych. Jahnke
2012
Krawczyk, Jana
Die Bedeutung der erinnerten Bindungserfahrung Prof. Wittchen;
mit der eigenen Mutter für die ante- und postnatale Dr. Martini
Bindung an das Kind
Dipl.-Psych. Wittich
2013
Kriegel, Francie
Unterformen von Errötungsangst? - Unterschiede
im Therapieerfolg?
Dr. Härtling
2013
Krug, Susann
Die Bedeutung der elterlichen Depression und famili- Dr. Knappe;
ären Interaktion für das Selbstkonzept im Jugendalter Prof. Wittchen
Dr. Knappe
2013
Krüger, Tina
Verhaltensaktivierung bei unipolarer Depressionen: Prof. Hoyer;
Gesamteffektivität und die Rolle der
Prof. Einsle
Hausaufgabenadhärenz und Wertorientierung
Prof. Hoyer;
Prädiktoren des Therapieerfolgs bei der Kognitiven Dr. Knappe
Verhaltenstherapie der Sozialen Phobie
Dipl.-Psych.
Lochmann
2013
Prof. Hoyer
2012
Kruppe, Martin
Prof. Hoyer;
Prof. Kirschbaum
Dr. Martini;
PD Petrowski
Dr. Riedel;
Dr. Hälbig
Dr. Härtling;
Prof. Hoyer
Jahr
Kuhnert, Marie-Kristin Umgang mit Sterben und Tod bei Pflegekräften
und Angehörigen in Altenpflegeheimen und
Hospizen - eine explorative Studie
Prof. Einsle;
Prof. Strobe
Prof. Einsle
2012
Landsiedel, Julia
Dr. Mühlhan;
Dr. Alexander
Dr. Mühlhan
2014
Associations between trait anxiety and resting
state networks
23
Diplomand(in)Titel
Gutachter
Betreuer
Jahr
Lange, Claudia
Effekte einer tagesklinischen Behandlung auf das
psychische Befinden der Mutter und die MutterKind-Interaktion
Prof. Beesdo-Baum;
Prof. Weidner
Dipl.-Psych. Bittner;
Dipl.-Psych Galle
2013
Lange, Susann
Differences in heart rate variability in subjects high PD Lüken;
and low in anxiety sensitivity before and after an
Dr. Mühlhan
interoceptive exposure training
Dipl.-Psych.
Maslowski
2013
Laurin, Lisa
Einordnung der Prüfungsangst in die klinischen
Störungsgruppen
Dr. Knappe
Dr. Knappe
2013
Lenz, Christina
Zusammenhang zwischen sozialer Unterstützung
und posttraumatischer Belastungsstörung bei
Bundeswehrsoldaten nach Auslandseinsätzen
Dr. Schönfeld;
Prof. Wittchen
Dr. Schönfeld
2012
Löcher, Carolin
Impulsivität bei abhängigen Rauchern und
Niemalsrauchern: Geschlechtsspezifische
Unterschiede in Verhalten und Selbstbericht
Prof. Bühringer;
Prof. Hoyer
2013
Manthey, Johann
Jakob
Evaluation of the lower risk cannabis use
guidelines
Prof. Rehm;
Dr. Behrendt
Dr. Behrendt
2013
Mehlhorn, Sabrina
Laufbandtraining und Exposition: Eine Exploration
möglicher Zusammenhänge bei Panikstörung mit
Agoraphobie
Dr. Einsle;
PD Lüken
Prof. Einsle;
Dipl.-Psych. Wieder
2013
Meißner, Gisa
Die Zusammenhänge zwischen Effort-Reward
Imbalance, Persönlichkeit und depressiver Symptomatik in einer repräsentativen
Erwachsenenstichprobe
Prof. F. Jacobi;
Prof. Hoyer
Prof. F. Jacobi
2013
Mirtschin, Jana
Biopsychological correlates and dissociative symptoms in social anxiety disorder
Prof. Hoyer;
Prof. Kirschbaum
Dipl.-Psych. Bräuer
2012
Müller, Nicole
Und was ist mit Mama und Papa? Die Rolle der
Eltern bei der Psychotherapie von Kindern und
Jugendlichen
Prof. F. Jacobi;
Prof. Beesdo-Baum
Dr. Knappe
2012
Nacke, Barbara
Validierung einer deutschen Version der Drive for
Muscularity Scale
Prof. C. Jacobi;
Prof. Einsle
Nebe, Stephan
Neural correlates of emotional expectancy and
uncertainty in high and low worriers
Prof. Beesdo-Baum;
PD Lüken
Prof. Beesdo-Baum
2013
Nummrich, Sara
Korrelate sexueller Ängste – eine explorative Studie Prof. Hoyer
Dipl.-Psych. Jahnke
2014
Otto, Kristina
Neurale Korrelate interozeptiver Exposition
PD Lüken;
Dr. Mühlhan
Dipl.-Psych.
Maslowski
2014
Paul, Sören
Cannabis Use Motives questionnaire (CANUM-G):
Development, factor structure, and psychometric
properties in a German college student sample
Prof. Bühringer;
Prof. Hoyer
Dipl.-Psych. Noack
2012
Pehle, Ulrike
Misserfolge in der ambulanten Verhaltenstherapie
aus Patientenperspektive
Prof. F. Jacobi;
Prof. Hoyer
Prof. F. Jacobi
2012
Philipp, Kathleen
Entwicklung und Evaluation einer Kurzintervention
zur Destigmatisierung von Menschen mit
Pädophilie für Psychotherapeuten in Ausbildung
Prof. Hoyer;
Prof. Deutsch
Dipl.-Psych. Jahnke
2014
Pilz, Elisabeth
Zusammenhang zwischen mütterlicher Angst- und Dr. Martini;
depressiver Störung vor der Schwangerschaft und Prof. Rößner
psychischer Belastung in der Schwangerschaft mit
den Temperamentsmerkmalen sechszehnmonatiger Kleinkinder
Dr. Martini;
2014
Dipl.-Psych. Petzoldt
Poppe, Lilith
Resilience as a predictor of treatment outcome in Dr. Schönfeld;
U.S. veterans with PTSD and the mediating role of Prof. Roth
dysfunctional cognition about sleep
Dr. Schönfeld
2013
Probst, Charlotte
Unterschiede in der alkoholbedingten Mortalität
nach sozioökonomischem Status - eine
Metaanalyse
Prof. Rehm;
Dr. Behrendt
Dr. Behrendt
2013
Pufe, Thekla
Neural correlates of not chronic and chronic generalized anxiety disorder patients during a classical
fear conditioning task
Prof. Beesdo-Baum;
Prof. Hoyer
2013
24
Diplomand(in)Titel
Gutachter
Betreuer
Jahr
Purucker, Katrin
Bedeutsamkeit der interozeptiven Exposition für
die Gesamtwirksamkeit einer standardisierten
Therapie bei Panikstörung mit Agoraphobie
Prof. Einsle;
Prof. Beesdo-Baum
Dipl.-Psych.
Westphal
2013
Randhan, MarieCharlott
Überprüfung eines Modells zum Zusammenhang
Prof. Wittchen;
von Alkoholkonsum/Alkoholstörung und suiziProf. F. Jacobi
dalem Verhalten bei Soldaten der Bundeswehr mit
Auslandseinsatz
Dipl.-Psych.
Trautmann
2014
Riedel, Elisa
Die Rolle von Impulsivität in der Leistung von
Dr. Behrendt;
abhängigen Rauchern in einer einfachen, zeitbasier- Prof. Bühringer
ten prospektiven Gedächtnisaufgabe
Dr. Behrendt
2013
Roever, Peggy
Beeinflusst Psychotherapie den Bericht von traumatischen Erinnerungen aus der Kindheit
PD Berth;
Prof. Einsle
Dr. Schellong
2014
Rupschuß, Sophia
Der Zusammenhang von Auslandseinsätzen und
Lebensqualität bei Bundeswehrsoldaten
Prof. Wittchen;
Dr. Knappe
Dipl.-Psych. Heinrich 2014
Ruths, Lydia
Differentielle Assoziationen zwischen essentieller Prof. Einsle;
Hypertonie und Depression sowie Angststörungen Prof. Wittchen
bei Hausarztpatienten der DETECT-Studie
Prof. Einsle
2013
Saegeling, Anja
Lebensziele von Sozialphobie-Patienten
Prof. Einsle;
PD Pöhlmann
PD Pöhlmann
2013
Schrader, Anita
Welche Rolle spielen Rumination und
Erholungsfähigkeit für den Zusammenhang von
Arbeitsbedingungen und Burnout?
Prof.(em) Richter;
Prof. Hoyer
PD Horvath
2013
Scherber, Kristin
Alkoholkonsum bei Soldaten der Bundeswehr nach
Dr. Schönfeld;
Auslandseinsätzen im Zusammenhang mit den
Prof. Wittchen
Symptomen der Posttraumatischen Belastungsstörung
Dipl.-Psych.
Trautmann
2012
Schmidt-Zerbst,
Cornelia
Wirksamkeit Kognitiver Verhaltenstherapie für
die Generalisierte Angststörung unter Routinebedingungen in einer Hochschulambulanz
Prof. Beesdo-Baum;
Prof. Hoyer
Prof. Beesdo-Baum
2013
Schober, Ilka
Threat-related attentional bias in anorexia nervosa
Prof. C. Jacobi;
Prof. Schmidt
Prof. Schmidt
2013
Schubert, Judith
Trennungsangst im Erwachsenenalter - Assoziation mit Prof. Einsle;
elterlichem Erziehungsverhalten, Bindungsstil, interper- Dr. Knappe
sonalem Verhalten und Partnerschaftsgestaltung
Dipl.-Psych. Fröhlich; 2012
Prof. Einsle
Sinkwitz, Benno
Haben es Menschen in helfenden Berufen schwe- Dr. Härtling;
rer? - Zur berufsbezogenen und psychischen
Prof. Hinterberger
Belastung sowie Therapie von Menschen helfender Berufe in stationärer psychotherapeutischer
Behandlung der Heiligenfeld Kliniken Bad Kissingen
Dr. Härtling
2013
Skarupka, Julia
Das Inanspruchnahmeverhalten pflegender
Dr. Riedel;
Angehöriger von Alzheimer-Patienten und dessen
Dr. Pieper
Auswirkungen auf die subjektiv erlebte Pflegestiuation
Dr. Riedel
2013
Stebane, Maxi
Alternativ-medizinische Behandlungsmethoden bei Prof. Hoyer;
der generalisierten Angststörung: Eine systemaProf. Beesdo-Baum
tische Übersicht
Dipl.-Psych. Möser
2013
Steffens, Anna
Antidepressiva in der Schwangerschaft Prof. Einsle;
Entwicklungs-verlauf und Selbstregulationsfähigkeit Prof. Pfennig
in utero Antide-pressiva-exponierter Säuglinge im
ersten Jahr post partum
Prof. Pfenning;
Dipl.-Psych. Dekoj
2013
Steinbrecher, Marc
Derived generalization of thought suppression function Dr. Gloster;
in individuals with obsession-related intrusive thoughts Dr. Schönfeld
Dipl.-Psych. Hummel 2012
Stolyar, Veronika
Cross-modal phobogenic stimulus processing in
dental phobia: A fMRI study
PD Lüken;
Prof. Beesdo-Baum
PD Lüken
2012
Taubert, Lisa
Korrelate mütterlichen Erziehungsverhaltens:
Validierung des Fragebogens zu
Erziehungseinstellungen im Säuglings- und
Kleinkindalter (FES)
Prof. Strobel;
Prof. Einsle
Prof. Strobel
2012
Tolmachev, Natalie
Assoziation zwischen essentieller Hypertonie und
Ängstlichkeit: Ergebnisse der DETECT-Studie
Prof. Wittchen;
Prof. Einsle
Prof. Einsle
2012
25
Diplomand(in)Titel
Gutachter
Betreuer
von Bloh, Paula
Wie gut und bei wem wirkt stationäre Therapie?“
Evaluation der kurzfristigen Wirksamkeit stationärer Therapie und Identifikation von Prädiktoren für das Behandlungsergebnis bei Patientinnen mit Bulimia nervosa
Prof. C. Jacobi;
Prof. Einsle
Wagler, Stefan
Political violence and psychological distress: The
Dr. Schönfeld;
roles of collective and personal self-esteem among Prof. Slone
Palestinian young adults
Dr. Schönfeld
2013
Wagner, Anna
Elisabeth
Food Addiction - Der Zusammenhang mit BodyMass-Index, essstörungsspezifischer Psychopathologie, Substanzkonsum und Impulsivität bei
weiblichen Studierenden
Dipl.-Psych. Richter
2013
Walther, Jonathan
Early reactions to first cannabis use and age of
Prof. Hoyer;
onset as risk factors for later cannabis use disorders Prof. Bührunger
Dr. Noack
2014
Wehnert, Julia
„Wie gut und bei wem wirkt stationäre Therapie?“
Prof. C. Jacobi;
Evaluation der kurzfristigen Wirksamkeit stationärer The- Prof. Einsle
rapie und Identifikation von Prädiktoren für das Behandlungs ergebnis bei Patientinnen mit Bulimia nervosa
Willrodt, Christine
Unerwünschte Effekte ambulanter Verhaltenstherapie: Die Rolle von zeit- und inhaltsbezogenen
Therapievariablen
Prof. Einsle;
Dr. Knappe
Prof. Einsle
2013
Wittek, Jitka
Zusammenhänge zwischen Aktivitäten des täglichen
Lebens und Depression bei Parkinson-Patienten
Prof. Wittchen;
Dr. Pieper
Dr. Riedel
2013
Zaba, Monika
Stress reactivity and stress coping in patients with
posttraumatic stress disorder
Dr. Schönfeld;
Dr. Schmidt
Dr. Schönfeld
2012
Zeugner, Anne
Unterschiede im einfachen, zeitbasierten, prospektiven Gedächtnis zwischen nikotinabhängigen
Rauchern und Nichtrauchern
Dr. Behrendt;
Prof. Bühringer
Dr. Behrendt
2013
Zimmermann, Marit
Sozialer Stress und Emotionsregulation
Prof. Strobel;
Prof. Hoyer
Dipl.-Psych. Buruck
2012
Zobel, Monique
Psychometrische Überprüfung der deutschen Version Prof. Hoyer;
der Behavioral Activation for Depression Scale
Prof. Einsle
(BADS) anhand einer nichtklinischen Stichprobe
Prof. Hoyer;
Dipl.-Psych.
Lochmann
2013
Prof. C. Jacobi;
Prof. Einsle
Jahr
Laufende Diplomarbeiten
Diplomand(in)Titel
Gutachter
Betreuer
Jahr
Bauer, Charlotte
Patientenpräferenzen bei der Erfassung psychischer Beschwerden im Hausarztsetting
Dr. Knappe;
Dr. Härtling
Dr. Knappe
…
Bittner, Elizabeth
Charakteristika depressiver Hausarztpatienten mit
und ohne Panikattacken
Prof. Beesdo-Baum
Dipl.-Psych.
Asselmann;
Prof. Beesdo-Baum
…
Böhlke, Nadja
Selbst- und Fremdwahrnehmung früher Merkmale
riskanten Glücksspiels
Prof. Bühringer;
Dipl.-Psych.
Neumann
…
Csiki, Hajnalka
Kognitive Beeinträchtigung bei Patienten mit
Multipler Sklerose: Eine Querschnittsstudie an der
TU Dresden
Prof. Wittchen;
Dr. Pieper
Dr. Pieper
…
Feurle, Theresa
Selbst- und Fremdbeurteilung therapeutischer
Kompetenz
Prof. Hoyer
Dr. von Consbruch
…
Höser, Ruth Sophie
Generalisierte Angststörung bei Hausarztpatienten
Prof. Beesdo-Baum
Prof. Beesdo-Baum, …
Huang, Guanyu
Behavioral avoidance in high worrier: Evidence at
an approach-avoidance task
Prof. Beesdo-Baum
…
Huth, Antonia
Schmerzstörungen bei Parkinson-Patienten:
Dr. Riedel;
Einflüsse auf die Lebensqualität, Depressivität und Dr. Pieper
den Krankheitsverlauf
Dr. Riedel
…
Jäger, Sophie
Prädiktoren für Remission bei Erythrophobie
Dr. Härtling
…
Keil, Gerda
Reconsolidation of fear memories in subclinical
PD Lüken;
anxiety and anxiety disorders - A systematic review Dr. Härtling
26
Dr. Härtling;
Prof. Einsle
M.Sc. van den Berg …
Diplomand(in)Titel
Gutachter
Betreuer
Jahr
Kern, Sarah
Effects of Effort-Reward Imbalance on Mental
Health Care Utilization in a German representative
Prof. F. Jacobi;
Prof. Beesdo-Baum
Prof. F. Jacobi;
Prof. Beesdo-Baum
…
Kotter, Roxana
Schlafprobleme bei Soldaten der Bundeswehr in
Zusammenhang mit Angststörungen
Prof. Wittchen
Dipl.-Psych. Heinrich …
Lubinova, Janka
Erfassung von Angstindikatoren bei Kindern und
Dr. Mühlhan;
Jugendlichen hinsichtlich einer MRT-Erstuntersuchung Prof. Lehmkuhl
Dipl.-Psych. Jaite
…
Mundhenke, Victoria
Ohne Risiko kein Erfolg? Der Zusammenhang zwischen der Bereitschaft unerwünschte Ergebnisse
im Rahmen einer Psychotherapie in Kauf zu nehmen und dem Therapieergebnis
Dr. Härtling
…
Müller, Julia
Spezifität der Kommunikation bei Panikstörung und Prof. Einsle
Agoraphobie
Dipl.-Psych. Wieder; …
Prof. Einsle;
Nestler, Ulrike
Bindung
Dr. Knappe
Dr. Knappe
…
Neufeld, Maria
Unrecorded alcohol consumption in Russia
Prof. Rehm;
Prof. Wittchen
Prof. Rehm
…
Ossapofsky, Alina
Fehlgeburt und Bindung zum nächsten Kind
Dr. Knappe
Dr. Knappe
…
Pepernick, Laura
Interne und externe Schamerinnerungen und ihr
Einfluss auf Indikatoren aktueller sozialer Angst
Prof. Hoyer
Prof. Hoyer; Dr.
Härtling
…
Pielenz, Annemarie
Schädlicher Alkoholkonsum – Das AUDIT-Screening Prof. Bühringer;
bei jungen Männern unter Alkohol-/Placebogabe
Dr. Behrendt
Dipl.-Psych. S. Paul
…
Rähder, Delia
Charakterisierung des Zusammenhangs von
Baroreze-ptorsensitivität, Aufmerksamkeitsprozessen und physiologischer Erregung
Prof. Malberg;
Dr. Zaunseder
Dr. Zaunseder;
Dr. Mühlhan
…
Reinhardt, Anne
Kathrin
Validierung eines prognostischen und diagnostischen Online-Screenings für Essstörungen
Prof. C. Jacobi
Dipl. Psych. Beintner …
Rottstädt, Fabian
Sexuelle Beschwerden bei hausärztlichen Patienten Dr. Knappe;
mit Angst- und depressiven Störungen
Prof. Einsle
Dr. Knappe
…
Rößler, Tina
Cognitive control abilities under different levels of Prof. Beesdo-Baum
worrying: Is there a relationship to worry pervasiveness and controllability?
Prof. Beesdo-Baum
…
Rummler, Josephine
Prüfung der Wirksamkeit eines innovativen kognitiv-behavioralen Therapiemanuals von Insomnie:
Einfluss auf erlebte Tagesaktivität
Dipl.-Psych. Marx
…
Scholz, Lisa
Morphometrische Unterschiede bei verschiedenen PD Lüken;
Subtypen der spezifischen Phobie
Dr. Härtling
PD Lüken;
…
Thieme, Juliane
Evaluation der kurzfristigen Wirksamkeit des internet- Prof. C. Jacobi
gestützten Präventionsprogramms Student BodiesAN für Frauen mit einem erhöhten Risiko für die
Entwicklung einer Anorexia nervosa (Prä-Post-Effekte)
Dipl. Psych. von Bloh …
Vollert, Bianka
Zusammenhang mütterlicher Angst- und depressiver Dr. Martini;
Störungen mit Fütterstörungen bei Säuglingen
Dr. Härtling
Dipl.-Psych. Petzoldt …
Wagner, Tillmann
Welche psychischen Konsequenzen sind mit der
Prof. Hoyer;
Geheimhaltung oder Offenlegung einer pädophilen Prof. Beier
Neigung verbunden? - Erfahrungen aus dem
Präventionsprojekt Dunkelfeld (PPD - „kein-täterwerden“)
Dipl.-Psych. Jahnke
…
Wersch, Paul
Depersonalisationssymptome während sozialem
Stress vor und nach Verhaltenstherapie:
Ergebnisse bei Patienten mit Sozialer Phobie
Prof. Hoyer;
Dr. Härtling
Prof. Hoyer
…
Wolff, Sina
Die Bedeutung symptomspezifischer Subgruppen für Prof. Einsle;
die Effektivität interozeptiver Exposition im Rahmen Dr. Gerlach
einer manualisierten Konfrontationsbehandlung bei
Panikstörung mit Agoraphobie
Dipl.-Psych.
Westphal;
Prof. Einsle
…
Ziebell, Sabrina
Diagnostik sexueller Funktionsstörungen:
Erprobung eines strukturierten Interviews anhand
videographierter Modellszenarien
Dipl.-Psych. Schierz
…
Dr. Härtling;
Prof. Einsle
Prof. Einsle;
Dr. Balck
Prof. Hoyer;
Prof. Deutsch
27
Abgeschlossene Masterarbeiten
StudierendeTitel
Warnecke, Marc
Gutachter
Betreuer
Jahr
Alcohol and nicotine use, abuse and dependence
Prof. Beesdo-Baum;
and associations with depression in a cross-sectio- PD Siegrist
nal study among adults in the general population
Prof. Beesdo-Baum
2014
Laufende Masterarbeiten
StudierendeTitel
Störel, Margarete
Gutachter
Betreuer
Jahr
Therapieeffekte bei Generalisierter Angststörung in Prof. Beesdo-Baum;
der Routineambulanz
Prof. Hoyer
Prof. Beesdo-Baum
....
Abgeschlossene Bachelorarbeiten
Bachelorand(in)Titel
Gutachter
Betreuer
Jahr
Adam, Peggy
Erziehungseinstellungen im Säuglings- und Kleinkindalter: Unterschiede in der mütterlichen Zuwendung und Kontrolle in Abhängigkeit von der
Parität
Dr. Martini;
Prof. Strobel
Dipl. Psych. Wittich
2013
Bär, Juliane
Überprüfung der Gateway-Hypothese bezüglich
der Assoziation von Cannabis- und Kokainkonsum
anhand der EDSP-Studie
Dr. Berendt;
Prof. Bühringer
Dr. Behrendt
2014
Bauer, Lisa
Auswirkungen dispositioneller Ängstlichkeit auf
verschiedene Aufmerksamkeitsfunktionen
Dr. Mühlhan;
Dr. Alexander
Dr. Mühlhan;
Dr. Aexander
2013
Baum, Petra
Der Zusammenhang zwischen Emotionsregulation
und der Entwicklung von Symptomen einer postraumatischen Belastungsstörung nach einem belastenden Ereignis
Prof. Wittchen;
Dr. Schönfeld
Bock, Sophia Kirsten
Zusammenhang PTSD-Symptomatik und
Traumagedächtnis
Dr. Schönfeld;
Prof. Wittchen
Bohnert, Maxi
Die Zusammenhänge zwischen Bindung und mütterlichem postpartalem Befinden
Dr. Knappe
Dr. Knappe
2014
Burrasch, Caroline
Emotional reactivity in smokers and severity of
nicotine dependendce
Prof. Smolka;
Dr. Mühlhan
Prof. Smolka;
Dr. Krömer
2013
Dietsch, Florian
Analogstudie zur Untersuchung des
Prof. Wittchen;
Zusammenhangs zwischen Trait Anxiety und
Dr. Mühlhan
Akuter Speichelkortisolreaktion in Reaktion auf ein
traumatisierendes Ereignis in einer nicht-klinischen
Stichprobe
Dipl.-Psych. Trikojat; 2014
Dr. Mühlhan
Dorner, Eva
ACTIVATE-Eine Gruppentherapie zur VerhaltensProf. Hoyer;
aktivierung: Ein Prä-Untersuchung zur Überprüfung Dr. Härtling
Dipl.-Psych. Furka
2014
Dottermusch, Anja
Geschlechtsunterschiede in der allgemeinen neuropsy- Dr. Martini;
chologischen Entwicklung im Alter von 16 Monaten
Prof. Beesdo-Baum
Dr. Martini
2013
Finke, Sabrina
Funktionelle Amygdala-Insula Kopplung und deren
Zusammenhang mit Angst und Ängstlichkeit
Dr. Mühlhan
2014
Fischbach, Pascale
Christine
Erhöht ein traumatisches Ereignis alkoholbezoDr. Behrendt;
genes Craving in Abhängigkeit von der Ausprägung Prof. Wittchen
der Schwierigkeiten in der Emotionsregulation?
Dipl.-Psych.
Trautmann
2014
Fournes, Valerie
Neural correlates of approach tendencies in nicotine addiction - a clinical investigation
Prof. Smolka;
Dr. Mühlhan
Dipl.- Psych. Wuttig 2014
Friebel, Pascal
Potentielle Unterschiede im Risikostatus für
Anorexia nervosa bei Mädchen im Alter zwischen 11 und 17 Jahren zwischen Töchtern von
teilnehmenden und nicht-teilnehmenden Eltern
an dem internetgestützten familienorientierten
Präventionsprogramm E@T
Prof. C. Jacobi;
Dr. Knappe
Dipl. Psych. Völker
2014
Franzke, Tino
Erfassung der negativen Therapiefolgen in
der Psychotherapie: Ein Vergleich zwischen
Fragebogen und Interview
Prof. Einsle;
Dr. Knappe
Prof. Einsle
2014
Fürtjes, Sophia
Interozeptive Symptomprovokation bei gesunden
Probanden
PD Lüken;
Prof. Einsle
Dipl.-Psych.
Maslowski
2013
28
Dr. Mühlhan;
Prof. Smolka
Betreuer
Jahr
Giller, Franziska
Komorbidität von Störungen des Cannabis- und Nikotin- Prof. Bühringer;
konsums und die Rolle des Endocannabinoid Systems Dr. Behrendt
Gutachter
Dipl.-Psych.
Neumann
2014
Graupner, Marcus
Anwendungsfelder und Wirksamkeit angewandter
Entspannung: Ein systematischer Review
Prof. Beesdo-Baum;
Dr. Knappe
Prof. Beesdo-Baum
2013
Gründel, Lisette
Sexuelle Symptome im Verlauf der Schwangerschaft und nach der Geburt
Prof. Hoyer;
Dr. Knappe
Dipl.-Psych.
Asselmann
2014
Häckl, Sarka
Evaluation eines Manualtrainings und dessen
Prof. Hoyer;
Auswirkung auf die Anwendung von Interventionen Dr. Härtling
in der Therapie der sozialen Angststörung bei
erfahrenen Praktikern
Dipl.-Psych
Crawcour.
2013
Heinrich, Linda
Der Zusammenhang zwischen posttraumatischen
Intrusionen und dem Traumagedächtnis
Hertle, Claudia
Jahreszeitliche Einflüsse auf Depressionsymptome Prof. Hoyer;
- Untersuchung der saisonalen Variabilität im BDI
Dr. Armbruster
Dr. Armbruster
Hochstein, Friederike
Unterschiede in der pränatalen Mutter-Kind-Bindung Dr. Martini;
in Abhängigkeit von vorangegangenen Fehlgeburten Dr. Petrowski
Hofmann-Siegert,
Theresa
Sexualität nach der Geburt: Gibt es Unterschiede in Dr. Martini;
Abhängigkeit von Geburtsverletzungen?
Prof. Wittchen
Dr. Martini
2013
Holitzschke, Teresa
Verhaltensaktivierung bei Depressionen - Vergleich Prof. Hoyer;
therapeutischer Vorgehensweisen
Dr. Knappe
Dipl.-Psych. Furka
2014
Hoppstock, Cynthia
Entscheidungsverhalten bei Nikotinabhängigkeit
Prof. Bühringer;
Dr. Behrendt
2013
Huste, Laura
Wie stark halten sich erfahren Psychotherapeuten
an die Vorgabe eines Manuals? Analysen auf der
Grundlage der SOPHO-PRAX Studie
Prof. Hoyer;
Prof. Einsle
Dipl.Psych. Möser
2014
Huttarsch, Isabel
Unterschiede im Geburtserleben spontan und ope- Dr. Martini;
rativ entbindender Frauen sowie Spontangebärender Prof. Strobel
mit und ohne Inanspruchnahme einer PDA
Dr. Martini
2013
Jung, Linda
Differ patients with a primary diagnosis of posttrau- Dr. Schönfeld;
matic stress disorder (PTSD) concerning various
Prof. Hoyer
aspects of emotion regulation, independent of
comorbid depressive symptoms?
Dr. Schönfeld
2013
Kästner, Senta
Geschlechtsunterschiede im Schreiverhalten von
Säuglingen
Dr. Martini;
Prof. Wittchen
Kebir, Amal
Der Einfluss stressvoller frühkindlicher Lebenserfahrungen auf neurale Korrelate der Emotionsverarbeitung
Dr. Mühlhan;
Dr. Alexander
Dr. Mühlhan
2014
Langer, Sarah
Jahreszeitliche Einflüsse auf Depressionsymptome Prof. Hoyer;
- Untersuchung der saisonalen Variabilität im BDI
Dr. Armbruster
Dr. Armbruster
2014
Liebig, Tina
Unterschiede im Geburtserleben bei Frauen mit
Dr. Martini;
Klinik- vs. Frauen mit außerklinischen Entbindungen Prof. Einsle
Dr. Martini
2013
Mark, Tony
Psychometric properties of the dimensional OCD
and PTSD scales for DSM-5 in a clinical sample
Dr. Knappe;
Prof. Wittchen
Dr. Knappe
2014
Merker, Romy
Gesellschaftliche Grundlagen von Störungen
im Zusammenhang mit Alkoholkonsum: Der
Zusammenhang zwischen Abstinenzraten und
Konsummustern von Alkohol
Prof. Dr. Rehm;
Dr. Pieper
Dipl.-Psych. Probst
2014
Mewes, Laura
Minimally adequate treatment for depressive disor- Prof. Beesdo-Baum;
ders: A systematic review of epidemiological studies Prof. Wittchen
Prof. Beesdo-Baum
2014
Münch, Mareike
Gender aspects in epidemiology, diagnostics and
treatment of generalized anxiety disorder: A systematic review
Prof. Beesdo-Baum;
Prof. Hoyer
Prof. Beesdo-Baum
2014
Naumann, Cornelia
Behaviorale Symptome bei Generalisierter
Angststörung im Vergleich zur Major Depression
Prof. Beesdo-Baum;
Prof. Hoyer
Prof. Beesdo-Baum
2014
Niedzielski, Julia
Unterschiede im Schreiverhalten bei viermonatigen Dr. Martini;
Säuglingen in Abhängigkeit vom Geburtsrang
Prof. Wittchen
Prof. Wittchen;
Dr. Schönfeld
2014
29
Gutachter
Betreuer
Jahr
Ollmann, Theresa
Magdalena
Zusammenhang zwischen der Scheidung der
Eltern und der Depression des JugendlichenAuswirkungen der Existenz eines guten Freundes
des Jugendlichen auf diesen Zusammenhang
Dr. Knappe;
Dr. Riedel
Dr. Knappe
2013
Ortel, Dominice
Ein- und Durchschlafstörungen bei 16 monatigen
Säuglingen in Abhängigkeit vom Geburtsrang
Dr. Martini;
Dr. Knappe
Otte-Köhler, Silvia
Does gender play a role for the relationship between daily stressors and development of depressive disorders in adolescents?
Prof. Beesdo-Baum;
Prof. Wittchen
Dipl.-Psych.
Asselmann
Pätzold, Gina
Zusammenhang zwischen Kindheitstraumata und
Aufmerksamkeitsverzerrungen bei Soldaten
Prof. Wittchen;
Dr. Schönfeld
Petersen, Swantje
Vergleich der Hautleitfähigkeit von High Worriers
und Low Worriers bei der Antizipation und
Perzeption emotionaler Stimuli
Prof. Beesdo-Baum;
PD Lüken
Prof. Beesdo-Baum; 2013
Petrenz, Marika
Ist Habituation within-session eine Voraussetzung
für den Erfolg einer Sorgenexposition?
Prof. Hoyer;
Prof. Beesdo-Baum
Prof. Hoyer
2013
Peukert, Maximilian
Behaviorale und neuronale Korrelate kognitiver
Flexibilität und Stabilität - eine fMRT-Studie
PD Lüken;
Dr. Riedel
Dipl.-Psych. Evens
2014
Piesker, Isabel
Gesellschaftliche Grundlagen von Störungen durch Prof. Rehm;
Alkoholkonsum: Der Zusammenhang zwischen
Dr. Pieper
Lebenszeitabstinenz und Entwicklung eines Landes
Dipl.-Psych. Probst
2014
Pietschmann, Julia
Gruppenprogramm zur Verhaltensaktivierung bei
Prof. Hoyer
Depressionen: Prä-Postvergleich der Symptomatik (BDI)
Dipl.-Psych. Furka
2013
Pralat, Christin
Depression bei Patienten mit der ParkinsonKrankheit - Betrachtung der Unterschiede im
Krankheitsverlauf
Dr. Riedel;
PD Lüken
Dr. Riedel
2013
Rautschek, Judith
Der Zusammenhang von soziodemografischen
Faktoren und der therapeutischen Allianz bei
Panikstörung mit Agoraphobie
Prof. Einsle;
Dr. Härtling
Dipl.-Psych. Wieder; 2013
Prof. Einsle
Rose, Julia
Erinnerungen an elterlichen Erziehungsstil und ihre Dr. Knappe;
zeitliche Stabilität
Prof. Beesdo-Baum
Dr. Knappe
Rothe, Nicole
Wie stabil ist die Beurteilung des erinnerten elterlichen Erziehungsverhaltens bei Adoleszenten?
Prof. Einsle;
Dr. Knappe
Dipl.-Psych. Wieder; 2013
Prof. Einsle
Sarnowsksy, Stephan Beeinflusst das Alter, wie gut Psychotherapie
wirkt?
Prof. Hoyer ;
Prof. Beesdo-Baum
Dipl.-Psych.
Lochmann
2013
Schacht, Franziska
Versorgung von Patienten mit Alkoholstörung in
ambulanter Psychotherapie
Dr. Behrendt;
Prof. Bühringer
Dr. Behrendt
2014
Schmitt, Sabine
Gibt es Subgruppen der sozialen Phobie mit unterschiedlichen Temperamentseigenschaften?
Prof. Hoyer;
Dr. Knappe
Prof. Hoyer
2013
Schwan, Anna
Peripherphysiologische Korrelate und ihr Zusammenhang PD Lüken;
mit neuronalen Aktivierungsmustern während der Antizi- Dr. Riedel
pation und Perzeption einer inspirativen Atemrestriktion
Dipl.-Psych.
Maslowski
2014
Simon, Maria
Einfluss dopaminerger Medikation bei ParkinsonPD Lüken;
patienten auf kognitive Flexibilität und kognitive Stabilität Dr. Riedel
Dipl.-Psych. Evens
2013
Smolny, Leonie
Peripherphysiologische Korrelate interozeptiver
Informationsverarbeitung
PD Lüken;
2014
Dipl.-Psych. Maslowski
Stebane, Maxi
Alternativ-medizinische Behandlungsmethoden bei Prof. Hoyer;
der generalisierten Angststörung: Eine systemaProf. Beesdo-Baum
tische Übersicht
Dipl.-Psych. Möser
2013
Trischel, Ksenia
What are the possible predictors for the development of rearing styles?
Dr. Knappe
2014
Ufert, Thea
Frühe Dropouts vermeiden: Pilotstudie zur Usability Prof. C. Jacobi;
eines Online-screenings für Essstörungen
Prof. F. Jacobi
Vilsmeier, Helene
Weibliches Mitgefühl vs. männliche
Abgrenzung - Geschlechterunterschiede im
Therapeutenverhalten
Prof. Einsle
30
PD Lüken;
Dr. Riedel
Dr. Knappe;
Prof. Beesdo-Baum
Prof. Einsle;
Dr. Knappe
2014
2014
2014
Gutachter
Betreuer
Jahr
Walter, Lisa Silvia
Review über Cannabiskonsum als Risikofaktor für
die Entstehung einer Alkoholstörung: Können wir die
Gateaway-Hypothese verwerfen?
Prof. Bühringer;
Dr. Behrendt
Dipl.-Psych.
Neumann
2014
Wendel, Rosanna
Gaps and advances in clinical research pertaining to Prof. Esser;
methdological issues: A taxonomy of findings from Dr. Knappe
a Delphi survey
Dr. Knappe
2014
Wilke, Melanie
Der Einfluss dopaminerger Medikation auf räumliches Gedächtnis, motorische Dysfunktion und
Depressivität/Impulsivität bei idiopathischer
Parkinson-Krankheit
Dr. Thurm;
PD Lüken
Dr. Thurm
2014
Wieschmann,
Melanie
Auswirkungen endogener Cortisolsekretion
auf neurale und behaviorale Korrelate des
Inkongruenzkonflikts
Dr. Mühlhan;
Dr. Alexander
Dr. Mühlhan
2014
Windemuth,
Katharina
Verlauf von Verhaltensaktivierung und Depression:
Einzelfallanalysen
Prof. Hoyer;
Prof. Einsle
Dr. Mühlhan
2014
Zenker, Monique
Die Rolle der therapeutischen Allianz und der
Adhärenz für die Bereitschaft des Patienten in die
Exposition in vivo zu gehen
Prof. Einsle;
Dr. Härtling
Dipl.-Psych. Wieder
2013
Laufende Bachelorarbeiten
Bachelor(in)Titel
Gutachter
Betreuer
Bär, Dorit
Folgen der Einführung des DMS-5 auf Diagnosen
im Bereich Essstörungen
Prof. C. Jacobi;
Dr. Einsle
Dipl. Psych. Beintner
Böttner, Ute
D-LAYA
Prof. Smolka;
Prof. Bühringer
Dipl.-Psych. Jünger
Bruntsch, Sarah
Extinction learning – a possible mechanism of
exposure therapy for anxiety disorders?
Prof. Hoyer;
Dr. Härtling
M.Sc. van den Berg
Drauscke, Miriam
Zusammenhang von Schlafproblemen und psychischen Störungen bei Soldaten der Bundeswehr
Prof. Wittchen;
Dr. Knappe
Dipl.-Psych. Heinrich
Dschietzig, Anne
Validierung des Inventars zur Erfassung negativer
Effekte in der Psychotherapie (INEP)
Dr. Härtling;
Prof. Einsle
Dr. Härtling
Erler, Luisa
Welcher Zusammenhang besteht zwischen Angstund depressiven Störungen und dem Ausmaß
Sozialer Unterstützung in Prä- und Postpartalzeit
Prof. Hoyer;
Dr. Martini
Dipl.-Psych.
Asselmann
Helbig, Friederike
Evaluation Spezialambulanz für Substanzstörungen
Prof. Hoyer
Prof. Hoyer;
Dipl.-Psych. Pixa
Heumann, Carolin
Schlafprobleme und belastende Einsatzereignisse
bei Soldaten der Bundeswehr
Prof. Wittchen
Dipl.-Psych. Heinrich
Kircheis, Stefanie
Expositionstherapie bei Angststörungen:
Habituation als möglicher Wirkmechanismus
Prof. Hoyer
Dipl.-Psych. Heinig
Koch, Franziska
Zusammenhang von Persönlichkeit, Trinkmotiven
und Alkoholkonsum bei 18jährigen Männern
Dr. Behrendt;
Dr. Härtling
Dipl.-Psych. S. Paul
Kress, Victoria
Dr. Martini;
Die subjektive Schlafqualität während der
Schwangerschaft in Abhängigkeit von mütterlichen Prof. Wittchen
depressiven Störungen in der Vorgeschichtet
Dipl.-Psych. Petzoldt
Kunze, Mario
Dr. Härtling;
Systematische Literaturübersicht zu BegrifflichProf. Einsle
keiten und Definitionen im Bereich Unerwünschte
Ereignisse und Nebenwirkungen von Psychotherapie
Dr. Härtling
Lux, Sophie
Separation anxiety disorder in adults: A literature review Prof. Beesdo-Baum
Prof. Beesdo-Baum
Schnappka, Charlotte Der Zusammenhang von zwei Rekrutierungsstrategien mit Symptomatik und Teilnahmebereitschaft junger Frauen mit subklinischer Anorexia
Nervosa an einer Studie zu Internet-gestützter
Prävention
Prof. C. Jacobi
Dipl. Psych. von Bloh
von Bloh, Laura
Prof. Bühringer;
Dr. Härtling
Prof. Einsle
Inhibition und Zielaufrechterhaltung bei Nikotinabhängigkeit
31
AUFBAUSTUDIENGANG PSYCHOLOGISCHE PSYCHOTHERAPIE/POSTGRADUATE PSYCHOTHERAPY PROGRAM
Aufbaustudiengang Psychologische Psychotherapie
Wissenschaftliche Leitung: Professor Dr. Jürgen Hoyer
Anschrift/Kontakt:
Institutsambulanz und Tagesklinik
für Psychotherapie der TU Dresden
Aufbaustudiengang
Hohe Straße 53
01187 Dresden
Tel.: 0351/463 369 79
Fax: 0351/463 369 55
E-Mail: aufbaupp@psychologie.tu-dresden.de
www. psychologie.tu-dresden.de/aufbaustudiengang
Studienmanagement:
Dipl.-Psych. Christian Probst; Heike Terbonsen
Studienbeginn:
jährlich im Oktober
Bewerbungen:
werden ständig entgegengenommen
Seit 1999 ist der Beruf des Psychologischen Psychotherapeuten staatlich als Heilberuf mit Approbation gesetzlich verankert und seitdem wird der postgraduierte Aufbaustudiengang zum Psychologischen Psychotherapeuten
auf Beschluss der Fachkommission Psychologie in der Institutsambulanz gelehrt. Der Aufbaustudiengang ist ein
Ausbildungsprogramm des Instituts für Klinische Psychologie und Psychotherapie der Technischen Universität
Dresden unter der Trägerschaft der Institutsambulanz und Tagesklinik für Psychotherapie der TU Dresden (IAPTU Dresden GmbH). Formale Zulassungsvoraussetzungen sind ein im Inland abgeschlossenes Hochschulstudium
im Studiengang Psychologie unter Einschluss des Faches Klinische Psychologie oder ein in einem anderen Staat
erfolgreich abgeschlossenes gleichwertiges Hochschulstudium. Ein Wechsel von anderen staatlich anerkannten
Ausbildungsinstituten ist unter den o.g. Voraussetzungen zum jeweiligen Ende des Ausbildungsjahres möglich.
Studienleistungen, die an diesen Ausbildungsstätten erbracht wurden, werden durch die Ausbildungsleitung geprüft
und können auf Antrag anerkannt werden.
Aufbau und Struktur des 3- bzw. 5-jährigen Studienganges entsprechen den Richtlinien des Psychotherapeutengesetzes und der Ausbildungs- und Prüfungsverordnung für Psychologische Psychotherapeuten und berechtigen
nach erfolgreichem Abschluss zum Antrag auf Approbation als „Psychologischer Psychotherapeut“ (Schwerpunkt
Verhaltenstherapie). Das Institut ist Mitglied im Verbund universitärer Ausbildungsinstitute (UniTh) sowie dem
Deutschen Fachverband für Verhaltenstherapie e.V. (DVT). Jährlich beginnen im Herbst 15 Teilnehmer ihre Ausbildung.
Viele Studierende des Aufbaustudienganges haben ein großes Interesse an einer wissenschaftlichen Ausrichtung
ihrer Karriere. Dieses Ziel wird durch unsere Mitarbeiter und unsere Infrastruktur gefördert und unterstützt und
der hohe Anteil von 43 promovierten Ausbildungsteilnehmern ist Erfolg und Ansporn zugleich. Eine Besonderheit
ist, dass die Aufbaustudenten die Möglichkeit haben, als Studientherapeuten unter besonders intensiven Lernbedingungen an Therapiestudien mitzuwirken.
Bisher hat der Aufbaustudiengang 236 Teilnehmer aufgenommen, von denen bereits 133 die Ausbildung erfolgreich
beendet haben. Derzeit sind 77 Ausbildungsteilnehmer immatrikuliert.
Ausbildungscurriculum, Infrastruktur und Kooperationen
Der theoretische Teil der Ausbildung (Hohe Straße 53) umfasst neben 200 Stunden Grundausbildung auch 400
Stunden anwendungsbezogene Inhalte, welche durch einen lehrbezogenen Qualitätszirkel evaluiert werden. Dazu
wurde ein eigenes Rückmelde- und Evaluationssystem entwickelt, mit dem jede Lehrveranstaltung und jeder
Dozent zeitnah nach quantitativ-statistischen und qualitativen Maßstäben bewertet wird.
33
Die Ausbildungsteilnehmer haben über
das Curriculum hinaus die Möglichkeit,
an wissenschaftlichen Projekten des
Instituts für Klinische Psychologie
und Psychotherapie mitzuarbeiten
sowie einschlägige Seminare und
Vortragsangebote zu besuchen. Seit
2002 haben alle Ausbildungsteilnehmer
ferner die Möglichkeit zu Sonderkonditionen an den „Dresdner
Verhaltenstherapiewochen“ teilzunehmen.
In der Institutsambulanz und in der
integrierten Ausbildungsambulanz stehen den Ausbildungskandidaten neben
zwei technisch aufwändig ausgestatten
Seminarräumen 19 Therapieräume zur
Durchführung der Ausbildungstherapien
unter Videokontrolle zur Verfügung sowie Vor- und Nachbereitungsarbeitsplätze. Die diagnostischen Untersuchungen erfolgen weitgehend computerisiert (11 PC Arbeitsplätze). Für die praktische Ausbildung und die
ambulante praktische Tätigkeit wurden erfolgreich Kooperationen mit verschiedensten Versorgungseinrichtungen
in Sachsen und mit praktisch tätigen, besonders qualifizierten Supervisoren aufgebaut (siehe Kapitelende). Der
Weiterbildungsverbund „Psychologische Psychotherapie“ der TU Dresden, in dem leistungsstarke psychiatrische
Kliniken und ambulante Einrichtungen der Region zusammengeschlossen sind, sichert für die Teilnehmer des
Aufbaustudienganges die klinische praktische Tätigkeit (Psychiatrisches Jahr).
Die Ausbildungstherapien werden unter Anleitung und Supervision ebenfalls in der Hohen Str. 53 durchgeführt.
Neben externen Supervisoren stehen Kursbetreuer und Haus-Supervisoren zeitnah als Ansprechpartner zur
Verfügung. Die Ausbildungsteilnehmer werden routinemäßig dazu angeleitet, die an der Institutsambulanz entwickelten standardisierten Diagnose-, Dokumentations- und Qualitätssicherheits-Standards anzuwenden und haben
die Möglichkeit die in klinisch-therapeutischen Forschungsprojekten des Instituts für Klinische Psychologie und
Psychotherapie neu entwickelten innovativen Psychotherapieverfahren kennen zu lernen.
Die Institutsambulanz betreut jährlich über 1.300 Patienten, so dass die Ausbildungsteilnehmer während der praktischen Ausbildung ein großes Störungsspektrum kennenlernen können. Besondere Behandlungsschwerpunkte
liegen in den Bereichen Angststörungen und Depressionen, Akute und Posttraumatische Belastungsstörungen,
Somatoforme und Schlafstörungen, Suchtprobleme und Essstörungen. Spezialambulanzen und innovative
Therapiemodelle runden das attraktive Ausbildungsangebot ab. Die aktuellen behandlungsbezogenen Daten aus
dem Aufbaustudiengang sind den Grafiken im Abschnitt zur Institutsambulanz zu entnehmen.
Dozentenliste 2013/2014
Frau
Frau
Frau
Herr
Herr
Frau
Frau
Frau
Frau
Frau
Herr
Frau
Herr
Herr
Frau
Herr
34
Dr. S. Ahrens-Eipper (Halle)
Dipl.-Psych. K. Anacker (Dresden)
Dr. R. Bauer (Dresden)
Prof. Dr. M. Berking (Marburg)
Prof. Dr. F. Balck (Dresden) Prof. Dr. K. Beesdo-Baum (Dresden)
Dr. S. Behrendt (Dresden) Dipl.-Psych. S. Bojanowski (Berlin)
Dr. A. Boos (Dresden)
Dr. D. Dörfel (Dresden)
Prof. Dr. G. Eifert (Port Angeles, USA) Dr. F. Einsle (Dresden)
Prof. Dr. P. Fiedler (Heidelberg)
Dr. C. Flückiger (Bern)
Dipl.-Psych. C. Fröhlich (Saßnitz)
Prof. Dr. S. Gauggel (Aachen)
Frau
Herr
Frau
Herr
Frau
Herr
Herr
Frau
Herr
Herr
Herr
Herr
Herr
Herr
Herr
Herr
Dr. B. Knab (München)
Dr. C. Koban (Bochum)
Dr. P. Krause (Dresden)
Dipl.-Psych. R. Kroymann (Dresden)
Dr. Y. Kulbartz-Klatt (Berlin)
Dr. C. Kulke (Dresden)
Dr. T. Lang (Bremen)
Dipl.-Psych. A. Mordt-Stoll (Dresden)
Prof. Dr. S. Mühlig (Chemnitz)
Dr. P. Neudeck (Köln)
Dr. H. Niemann (Leipzig)
Dr. A. Poldrack (Dresden)
Dr. H. Richter (Dresden)
PD M. Rinck (Nijmegen)
Dr. J. Roth (Berggießhübel)
Dr. N. Sassim (Dresden)
Frau
Herr
Herr
Frau
Herr
Frau
Frau
Herr
Dipl.-Psych. A. Gerschler (Dresden)
Prof. Dr. J. Hoyer (Dresden)
Prof. Dr. B. Jabs (Dresden)
Prof. Dr. C. Jacobi (Dresden)
Prof. Dr. F. Jacobi (Berlin)
Dr. J. Junge-Hoffmeister (Dresden)
Dr. A. Keller (Dresden)
Prof. Dr. S. Klingberg (Tübingen)
Frau
Herr
Herr
Herr
Herr
Frau
Herr
Herr
Dr. S. Schönfeld (Dresden)
Dr. P. Schuster (Dresden)
PD Dr. K. Seikowski (Leipzig)
Dr. R. F. Tauber (Bad Lausick)
Dr. R. T. Vogel (Ingolstadt)
Dipl.-Psych. D. Westphal (Dresden)
Dr. D. Zedlick (Glauchau)
Prof. Dr. H. Znoj (Bern)
Supervisorenliste 2013/14
Herr
Frau
Frau
Frau
Herr
Frau
Frau
Frau
Frau
Herr
Herr
Herr
Herr
Herr
Herr
Herr
Herr
Herr
Frau
Herr
Frau
Prof. Dr. F. Balck
Prof. Dr. K. Beesdo-Baum
Dr. A. Boos
Prof. Dr. F. Einsle Prof. Dr. J. Hoyer
Prof. Dr. C. Jacobi
Dipl.-Psych. R. John
Dr. A. Keller Dr. P. Krause
Dipl.-Psych. R. Kroymann
Dr. C. Kulke
Dr. R. Leibbrand Dr. P. Neudeck
Dr. A. Poldrack
Dr. J. Roth
Dr. N. Sassim
Dr. P. Schuster
Dr. R. Tauber
Dipl.-Psych. U. Teichmann
Dr. R. Vogel
Dipl.-Psych. D. Westphal
Universitätsklinikum Dresden, Lehrstuhl für Medizinische Psychologie
TU Dresden, Institut für Klinische Psychologie und Psychotherapie
Dresdner Fortbildungszentrum für Traumatherapie
SHR Fachhochschule für Gesundheit, Gera
Freie Praxis, Dresden
Universitätsklinikum Carl Gustav Carus Dresden, Leiterin Tagesklinik
Freie Praxis, Köln
Dresdner Praxis für Angewandte Psychotherapie (DPAP)
MEDIAN-Klinik, Berggießhübel
Krankenhaus Dresden-Friedrichstadt
Sachsenklinik Bad Lausick, Psychosomatik
Freie Praxis, Struppen
Freie Praxis, Ingolstadt
Institutsambulanz und Tagesklinik für Psychotherapie an der TU Dresden
Kooperationskliniken 2013/14
Asklepios Fachklinikum Wiesen GmbH, Wildenfels
Diakoniewerk Zschadraß, Klinik für Psychiatrie und Psychotherapie, Colditz
Celenus-Klinik Carolabad, Med. Rehabilitationszentrum für Psychotherapie, Psychiatrie und Psychosomatik, Chemnitz
Elblandkliniken Meißen-Radebeul GmbH, Klinik für Psychiatrie und Psychotherapie Radebeul
Fliedner Krankenhaus Ratingen, Abt. Allgemeine Psychiatrie und Psychotherapie, Ratingen
Helios Klinik Schwedenstein, Fachklinik für Psychosomatische Medizin, Pulsnitz
Klinik am Waldschlösschen, Fachklinik für Psychosomatische Medizin, Dresden
Klinik Bavaria, Klinik für Psychotherapie und Verhaltensmedizin, Kreischa
Klinikum Chemnitz gGmbH, Klinik für Psychiatrie, Verhaltensmedizin und Psychosomatik, Chemnitz
Klinikum Pirna GmbH, Klinik für Psychiatrie und Psychotherapie, Pirna
Krankenhaus Dresden-Friedrichstadt, Städtisches Klinikum, Klinik für Psychiatrie und Psychotherapie, Dresden
Krankenhaus Spremberg, Fachbereich Psychiatrie, Psychotherapie und Psychosomatik, Spremberg
Kreiskrankenhaus Mittleres Erzgebirge, Abteilung Psychiatrie und Tagesklinik, Zschopau
Martin-Luther-Universität Halle, Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik, Halle
Median Klinik Berggießhübel, Abteilung II Psychosomatik, Berggießhübel
Parkkrankenhaus Leipzig-Südost GmbH, Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Leipzig
Psychosomatische Klinik Windach
Rudolf- Virchow-Klinikum Glauchau, Psychiatrische Klinik, Glauchau
35
Sächsisches Krankenhaus Arnsdorf, Klinik für Psychiatrie und Psychotherapie, Arnsdorf
Sächsisches Krankenhaus Hochweitzschen, Fachkrankenhaus für Psychiatrie und Psychotherapie Bethanien, Hochweitzschen
Sächsisches Krankenhaus für Psychiatrie, Psychotherapie und Neurologie, Großschweidnitz
Sächsisches Krankenhaus Rodewisch Klinik für Psychiatrie und Psychotherapie, Rodewisch
Städtisches Klinikum Görlitz GmbH, Klinik für Psychiatrie und Psychotherapie, Görlitz
Städtisches Krankenhaus Dresden-Neustadt, Klinikum Weißer Hirsch, Klinik für Psychosomatik und Psychotherapie, Dresden
St. Marien-Krankenhaus, Fachkrankenhaus für Psychiatrie, Psychotherapie und Neurologie, Dresden
Universitätsklinikum Carl Gustav Carus Dresden; Klinik und Poliklinik für Psychotherapie und Psychosomatik, Dresden
Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Dresden
Universitätsklinikum Leipzig, Klinik und Poliklinik für Psychiatrie, Leipzig
Universitätsklinikum Leipzig, Tagesklinik für kognitive Neurologie, Leipzig
Vivantes Netzwerk für Gesundheit - Humboldt-Klinikum Klinik für Psychiatrie, Psychotherapie & Psychosomatik, Berlin
Vivantes Klinikum am Urban Berlin, Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Berlin
Warneford Hospital, University of Oxford, Department of Psychiatry, Oxford
36
Ausbildungsräume und Infrastruktur
37
38
INSTITUTSAMBULANZ/OUTPATIENT CLINIC FOR PSYCHOTHERAPY
Forschungs- und Lehrambulanz des Instituts
Prof. Dr. Jürgen Hoyer
Ambulanzleiter
Institutsambulanz und Tagesklinik
für Psychotherapie der TU Dresden
Hohe Str. 53/Chemnitzer Straße 46
01187 Dresden
Tel.: +49 (351) 46 33 69 86
Fax: +49 (351) 46 33 69 55
Spezialambulanz Generalisierte Angststörung
Prof. Dr. Jürgen Hoyer; Prof. Dr. Katja Beesdo-Baum
Spezialambulanz Panik und Agoraphobie
Dipl.-Psych. Dorte Westphal
Spezialambulanz Soziale Phobie
Prof. Dr. Jürgen Hoyer; Dr. Katrin von Consbruch
Spezialambulanz PTSD
Dipl.-Psych. Thekla Bensmann
Therapie bei Essstörungen
Dipl.-Psych. Katja Hergesell
Empfang und Information
Andrea Heinze; Tel.: +49 (351) 46 33 69 57
Sekretariat
Beate Reith; Tel.: +49 (351) 46 33 60 70
Verwaltung
Grit Debitz, Ulrich Hillger
Qualitätssicherung
Ramona Mutscher
Therapie bei Depression
(Gruppentherapie „Verhaltensaktivierung“)
Dipl.-Psych. Esther Lochmann
Diagnostik
Dr. Silke Behrendt; Dipl.-Psych. Anja Gerschler
Therapie bei Substanzstörungen
Dipl.-Psych. Anja Pixa
Ärztlicher Konsiliarius
Prof. Dr. Joachim Morgner
Therapie:
Dipl.-Psych. Anja Gerschler; Dipl.-Psych. Kristin Anacker
Kinder-Jugendlichen-Bereich
Aufgabenspektrum:
• Sicherung einer anwendungs- und praxisorientierten Lehre im Bachelor-, Master- und Diplomstudiengang im
Schwerpunktfach Klinische Psychologie
• Auswahl von Patienten für die praktische Ausbildung im Rahmen des Aufbaustudiums „Psychologischer
Psychotherapeut“ gemäß Psychotherapeutengesetz (PTG)
• Sicherstellung eines optimalen Patientenzugangs für die Durchführung klinischer Forschungsprojekte
• Erprobung neuer und Verbesserung bestehender Interventionen, Strategien und Versorgungsmodelle mittels
kontrollierter Therapie- und Evaluationsstudien
• Bereitstellung eines hinreichend umfassenden und auf höchster Qualitätsstufe stehenden therapeutischen
Versorgungsangebots mit den jeweils aktuellsten und besten therapeutischen Interventionen
• Weiterbildung aller Mitarbeiter des Instituts für Klinische Psychologie und Psychotherapie auf der Grundlage
des Scientist-Practitioner-Modells
Die Institutsambulanz bietet umfassende diagnostische und psychotherapeutische Hilfe bei allen Formen psychischer Störungen mit Krankheitswert und unterhält störungsspezifische Spezialangebote, auch und insbesondere bei
komorbiden und chronifizierten Krankheitsverläufen.
Das Grundprinzip der Institutsambulanz ist es, basierend auf einer besonders sorgfältigen, standardisierten und z.T.
computerisierten klassifikatorischen und klinisch-therapeutischen Erstdiagnostik, zu einer optimal abgestimmten
Auswahl der Therapiemethoden zu kommen.
39
Es wird für jeden Patienten ein differenzierter und individuell abgestimmter Therapie- bzw. Interventionsplan erstellt
und standardisiert dokumentiert. Dazu gehört die Festlegung der bestmöglichen Zeitdauer und Dichte der Therapie.
Es ist ein Charakteristikum, dass
wir als Kompetenzzentrum für
Differentialdiagnostik häufig auch
Patienten an andere Einrichtungen
weitervermitteln (Optimierung der
Versorgung). Die Therapiedurchführung
wird in jedem Einzelfall routinemäßig besonders sorgfältig hinsichtlich
der Qualität dokumentiert und wissenschaftlich begleitet. In einzelnen
Indikationsbereichen ist die Therapie
eng mit der Therapieforschung verbunden, um zukünftig noch bessere
Therapien anbieten zu können.
Ein zentrales Ziel der Forschungs- und
Lehrambulanz liegt in der wissenschaftlichen Weiterentwicklung psychotherapeutischer Verfahren. Dabei werden
sowohl inhaltliche Verbesserungen
störungsspezifischer Therapieverfahren als auch innovative, strukturell neue Versorgungsmodelle (z.B. hinsichtlich Anzahl und Dauer der Therapiesitzungen) konsequent verfolgt (siehe hierzu Forschungsergebnisse der
Arbeitsgruppen).
Das Behandlungskonzept der Institutsambulanz stellt wissenschaftlich begründete, gegenwartsbezogene und problemlösungsorientierte, verhaltenstherapeutische Behandlungskonzepte in den Mittelpunkt. Schwerpunktmäßig
kommen je nach Indikation Methoden der Kognitiven Verhaltenstherapie und insbesondere Expositionsverfahren
zur Anwendung. Behandelt wird je nach Problemlage in Einzel- und Gruppentherapien; wenn notwendig werden
Bezugspersonen mit einbezogen.
Der bei den meisten psychischen Störungen erforderliche Erwerb neuer und hilfreicher Denk-, Erlebens- oder
Verhaltensweisen sowie Problemlösungsstrategien bedarf oft nicht nur der üblichen Standardtherapie in Form
von 1-3maligen einstündigen Sitzungen pro Woche. Vor allem bei komplizierteren (z. B. komorbiden und chro40
nischen) psychischen Störungen ist vielmehr häufig eine intensivere Verhaltenstherapie erforderlich. Diese
wird in unserer Ambulanz entweder in Form von mehrstündigen Sitzungen an einem Tag oder als intensive
Wochenendbehandlungen (z. B. bei Berufstätigen oder Auswärtigen) durchgeführt. Nur so ist es in vielen Fällen
möglich, das neue Verhalten (Zielverhalten) so zu etablieren, dass es im Alltag ständig verfügbar ist und zuverlässig
eingesetzt werden kann.
Eine Besonderheit ist der seit 2009 mit der Deutschen Angestellten Krankenkasse (DAK) etablierte Vertrag zur integrierten Versorgung bei Angst- und Essstörungen (§ 140a SGB V). In beiden Störungsbereichen können Patienten
auf dieser sozialrechtlichen Grundlage besonders effizient diagnostiziert und zugewiesen werden, sowie zeitintensiver und damit auch schneller behandelt werden, als dies im Rahmen der Richtlinienpsychotherapie möglich ist.
Weitere Angebote der Institutsambulanz sind:
• Präventionsprojekte und Präventionsberatung (z.B. der Krankenkassen)
• Psychoedukative Kurse für Betroffene und Angehörige
• Zusammenarbeit mit ärztlichen Therapeuten (medikamentöse Kombinationstherapie)
• Zusammenarbeit mit Selbsthilfegruppen
• Differentialdiagnostische Abklärung, Indikationsstellung und Entwicklung eines Gesamtbehandlungsplans
• Hilfe bei Vermittlung anderer Psychotherapeuten sowie der Vermittlung in stationäre Behandlungen
• Innovative Konzepte der Raucherentwöhnung
• Spezielle gruppentherapeutische Angebote (z.B. Gruppentherapie „Verhaltensaktivierung bei Depression“)
Lehre im Diplom-, Bachelor- und Masterstudiengang Psychologie
Die von der Institutsambulanz durchgeführten und dokumentierten Behandlungen, sowie die hier durchgeführten klinischen Studien fließen direkt oder indirekt in die Lehre im Diplom-, Bachelor- und Masterstudiengang
Psychologie, Schwerpunkt Klinische Psychologie, ein. Hierzu zählen:
• die Durchführung und Betreuung von Diplom-, Bachelor- und Masterarbeiten (siehe Liste Diplom-/ Master-/
Bachelorarbeiten)
• ein kontinuierliches Angebot von klinisch-psychologischen Praktika (2 Praktikantenstellen)
• Patientenkontakte, Fallberichte, angeleitete Übungen, Videodemonstrationen etc. im Rahmen von
Lehrveranstaltungen
Neben den Vorlesungen „Klinische Psychologie und Psychotherapie I und II“ wurden und werden folgende
Lehrveranstaltungen in enger Kooperation mit der Institutsambulanz und ihren Mitarbeiter/innen durchgeführt:
•
•
•
•
•
•
•
•
•
•
•
•
Basiskompetenzen II: Klinisch-diagnostisches Praktikum (fortlaufend)
Basiskompetenzen III: Interventionspraktikum (fortlaufend)
Berufsorientierung: Praktiker-/Projektseminar (fortlaufend im SS)
Depression: Ätiologie und Intervention (fortlaufend)
Panikstörung und Agoraphobie (fortlaufend)
Essstörungen (fortlaufend)
Konfrontationsverfahren: Prinzipien, Vorgehen und Einsatzbereiche (fortlaufend jedes 2. Semester)
Psychoedukation (fortlaufend jedes 2. Semester)
Somatoforme Störungen (fortlaufend jedes 2. Semester)
Generalisierte Angststörung (fortlaufend jedes 2. Semester)
Posttraumatische Belastungsstörung (fortlaufend jedes 2. Semester)
Funktionale und behaviorale Status- und Prozessdiagnostik
Die Institutsambulanz ist auch an der weiterführenden Ausbildung von Diplompsychologen/Diplompsychologinnen
und Psychologen/Psychologinnen M.Sc. zum staatlich anerkannten „Psychologischen Psychotherapeuten“ beteiligt.
Die Ausbildungskandidaten nehmen als Co-Therapeuten an Behandlungen teil und führen nach einer gesonderten
Eignungsprüfung auch selbst Therapien unter Supervision eines erfahrenen Therapeuten durch.
Ferner wurden im Rahmen des vom Multimedia-Fonds der TUD geförderten Projekts „Online-Tutorial Klinischpsychologische Gesprächsführung“ Videos nachgestellter Therapieszenen entwickelt. Diese veranschaulichen
bestimmte Gesprächstechniken und fördern den Transfer des theoretisch Gelernten durch wirklichkeitsnahes
41
Material. Das Tutorial enthält Beispiele für a) Grundtechniken der Gesprächsführung und b) für prototypische
Problemsituationen in der Therapie. In einem interaktiven Teil haben die Lernenden die Möglichkeit, zwischen verschiedenen Gesprächsstrategien in schwierigen Situationen zu wählen. Wirkung und Konsequenzen der jeweiligen
Strategie werden am Beispiel zurückgemeldet.
Entwicklungsperspektiven
Die therapeutischen Mitarbeiter der Institutsambulanz verfolgen in ihren jeweiligen Spezialbereichen die Weiterentwicklung und Optimierung bestehender Therapiestrategien. In den letzten Jahren wurden innovative, verhaltenstherapeutische Konzepte in den Bereichen der Posttraumatischen Belastungsstörung, der substanzbezogenen
Störungen (Cannabis), bei der Generalisierten Angststörung und der Panikstörung mit Agoraphobie entwickelt
und zum Teil in Monographien und Patientenratgebern veröffentlicht. Aktuelle Beispiele sind Manuale zur
Behandlung der Panikstörung, zur Modularen Behandlung der Cannabisstörungen sowie das Manual zur Kognitiven
Verhaltenstherapie des Stotterns.
Aktuelle Entwicklungen in der ambulanten Versorgung psychischer Störungen gestaltet die Institutsambulanz aktiv
mit. Die Änderung der Psychotherapierichtlinie im Jahr 2011 brachte für die Berufsgruppe der Psychologischen
Psychotherapeuten eine Erweiterung bezüglich der Indikationen zur Anwendung von ambulanter Psychotherapie.
Bei der Behandlung von Menschen mit Substanzstörungen (schädlicher Konsum, Missbrauch, Abhängigkeit
von z.B. Alkohol) in ambulanter Psychotherapie ist es nunmehr möglich, auch die Störungsbilder schädlicher
Substanzkonsum und Substanzmissbrauch zu behandeln. In unserer Spezialambulanz für Substanzstörungen behandelt Dipl.-Psych. Anja Pixa zusammen mit Ausbildungskandidaten aus dem Aufbaustudiengang Psychologische
Psychotherapie gezielt Menschen, deren Probleme in diese Indikationsgruppe fallen. Die Spezialambulanz kann
dabei auf umfangreiche Untersuchungen zur ambulanten Verhaltenstherapie bei Cannabisstörungen zurückgreifen und ist eng an die Arbeitsgruppe „Epidemiologische und klinische Forschung zu Substanzstörungen“
(Arbeitsgruppenleitung: Dr. Silke Behrendt, Prof. Dr. Gerhard Bühringer) angebunden. Die Auswertung des
Behandlungserfolgs bei den ersten 30 Patienten, die trotz bei Therapieeinschluss bestehender Substanzstörung
eine ambulante Verhaltenstherapie abgeschlossen haben, wird derzeit im Rahmen von Qualifikationsarbeiten vorgenommen.
Im kürzlich abgeschlossenen Projekt „Klinische Spezifität dysfunktionaler habitueller Aufmerksamkeitsprozesse
bei der Erythrophobie und ihre Veränderbarkeit“ (Dr. Samia Härtling) wurden - neben der Bearbeitung von
Forschungsfragen zur Erythrophobie - auch innovative gruppentherapeutische Behandlungswege erprobt. Es
wird in den nächsten Jahren darum gehen, diese zeiteffizienten Behandlungsalternativen angemessen in den
Versorgungsalltag zu integrieren und in die berufspolitische Diskussion zu bringen. Für diesen Ansatz erhielt Frau
Dr. Härtling im Frühjahr 2014 den Nachwuchspreis für neue Entwicklungen in der Verhaltenstherapie, der im ZweiJahres-Rhythmus durch die DGVT verliehen wird.
In den nächsten Jahren werden wir zusätzlich zum bestehenden Schwerpunkt im Bereich der Angststörungen
auch versuchen, den Zugang zur effizienten Psychotherapie für Patienten mit Depression verbessern. Dazu wird
seit 2012 ein systematisches, strukturiertes Behandlungsprogramm in Gruppen(„ACTIVATE“) erprobt, welches die
neuen Befunde zur Verhaltensaktivierung berücksichtigt (Projekt: Verhaltensaktivierung bei Depression – P14 in
Arbeitsgruppe 9 Clinical Research). Das dazugehörige Behandlungsmanual wird 2016 im Beltz Verlag in Buchform
erscheinen.
Die wichtigste neue Herausforderung ist die Durchführung der Therapiestudien im Rahmen des Verbund- Projekts
PROTECT-AD. In dem Teilprojekt „Intensified Psychological Interventions (IPI) for Anxiety Disorders (AD) by
Augmented Extinction Learning” wird untersucht, inwieweit sich Grundlagenbefunde zum Extinktionslernen auf
die Therapie bei erwachsenen Patienten übertragen lassen. Über 1000 Patienten (Erwachsene und Kinder) mit
verschiedenen Angststörungen, 200 davon an der IAP-TUD, werden dabei entweder nach einem neuartigen
Behandlungsmanual behandelt, das die Befunde zum Extinktionslernen systematisch berücksichtig und das
Vorgehen diesbezüglich optimiert, oder nach den Regeln der bisher bewährten kognitiven Verhaltenstherapie. Eine
Beschreibung des Vorgehens und der Studie findet sich in AG 11 Psychotherapie- und Interventionsforschung.
42
KINDER-& JUGENDLICHENAMBULANZ/OUTPATIENT CLINIC FOR PSYCHOTHERAPIE
Aufbau einer Ambulanz für die Kinder- und Jugendlichenpsychotherapie
Kinder und Jugendliche können aus vielfältigen Gründen psychische Probleme entwickeln. Wenn die Probleme
sich verstärken, können sie sowohl die Kinder und Jugendlichen selbst, als auch ihre Eltern und ihr Umfeld belasten. Deswegen ist es wichtig, rechtzeitig zu handeln. Je nach Störungsbild und Schweregrad der Symptomatik
passen wir die Behandlung speziell an die Bedürfnisse von Kindern und Jugendlichen und ihren Familien an. Vor
diesem Hintergrund wird derzeit zusammen mit unserem Kooperationspartner, dem Regionalinstitut Sachsen der
DGVT, eine Forschungs- und Lehrambulanz für Kinder- und Jugendlichenpsychotherapie am Institut für Klinische
Psychologie und Psychotherapie aufgebaut. Damit verbunden ist ein entsprechendes Curriculum im Rahmen des
Postgraduiertenstudiums.
Die „KiJu-Ambulanz“ wurde räumlich im Falkenbrunnen eingerichtet und stellt neben Einzeltherapieräumen auch
Gruppenräume für die Arbeit in Familien zur Verfügung. Die derzeitigen Behandlungen werden in Kooperation mit
dem Regionalinstitut Dresden der Deutschen Gesellschaft für Verhaltenstherapie durchgeführt (Lehrpraxis) sowie
unseren Therapeutinnen: Prof. Dr. Katja Beesdo-Baum, Dr. Susanne Knappe, Prof. Dr. Franziska Einsle, Dipl.-Psych.
Thekla Bensmann und Dr. Julia Martini.
Die KiJu-Ambulanz bietet umfassende diagnostische und psychotherapeutische Hilfe bei allen Formen von
Verhaltensauffälligkeiten und psychischen Störungen mit Krankheitswert bei Kindern und Jugendlichen von 3 bis
16 Jahren. Unter anderem bei: nicht altersgemäßen Einnässen/Einkoten, Trennungsangst-Störungen, Schulangst,
Phobien, stressbezogenen Störungen, Depression, Aufmerksamkeits- und Hyperaktivitätsstörungen, Trotz- und
sozial unangepasstes Verhalten und Suchtprobleme (Alkohol, Nikotin, Cannabis).
Nach einer sorgfältigen Diagnostik, in die auch Eltern und ggfs. Lehrer und Erzieher eingebunden werden, erfolgt
eine detaillierte Problemanalyse. Gemeinsam mit den Kindern und Jugendlichen und ihren Familien wird entschieden, welche Behandlung am besten geeignet ist und wie häufig und wie lange die Behandlung erfolgen
soll. Schwerpunktmäßig werden Methoden der kognitiven Verhaltenstherapie angewandt. Wir behandeln je nach
Problemlage in Einzel- und Gruppentherapien und beziehen bei Bedarf Angehörige mit ein. Alle Therapien können
auch in englischer Sprache stattfinden.
43
CELOS
Center for Clinical Epidemiology and Longitudinal Studies (CELOS)
Prof. Dr. Katja Beesdo-Baum, Dr. Lars Pieper
Dr. Michael Höfler, Prof. Dr. Hans-Ulrich Wittchen
Mission: To facilitate, promote and to conduct clinical and behavioural epidemiological
studies with particular focus on longitudinal and family genetic studies in the
community, primary care and clinical cohorts.
- To provide and develop state of the art methods for use in clinical epidemiological and longitudinal research
including survey and laboratory-based assessment techniques and diagnostic tools.
- To provide biometric and statistical expertise with particular focus on causal-analytic statistical methods within
complex designs.
- To provide state of the art expertise in sampling, survey methodology and field work procedures, data collection and data bank management.
Organisation
The Center for Clinical Epidemiology and Longitudinal Studies (CELOS) is a laboratory platform of the Institute of
Clinical Psychology and Psychotherapy in the Faculty of Mathematics and Natural Sciences, located on 156 sqm (6
rooms, adjacent to the Institute). It includes field work-, CATI- and CAPI-administration labs. With the appointment
of a new chair of behavioural epidemiology in spring 2014 (Prof. Dr. K. Beesdo-Baum) and the Funding of a new
epidemiological cohort study (BMBF), the laboratory platform will be supplemented by new behavioural observation
and experimental labs. The CELOS center has extensive experience in the management of large-scale data banks
and multi-center longitudinal data sets (comprising genetic, endocrine, clinical and experimental data with thousands
of subjects). Concerning the statistical data processing there is excellent expertise in sampling theory and weighting
procedure, as well as statistical expertise, particularly with regard to modeling causal pathways, psychometric analyses, sensitivity and specificity analyses and complex multivariate statistics.
CELOS survey lab
The survey lab is part of the CELOS centre. Its purpose is the field work and
computer-assisted telephone interviewing.It consists of 10 workstations in
two rooms. Each work station is separated by partition panels and equipped with a telephone (with headset) connected via USB to a desktop PC or
Laptop. Phones are completely controlled by PC, therefore hand-free calling
is possible. Calling and data entry runs with a Microsoft Access application.
Collected data can be exported in several fileformats and further data processing with standard statistical software (Stata) is possible.
CELOS survey lab – examples of use
(a) computerized standard assessment tools of integrated interview, self-report and neuropsychological packages
Computer Assisted Personal Interview
Computerized questionnaires
Use of mobile devices
(b) Phone data base and direct data entry
Phone database: information
about all contacts, about actual
respondent, contact history
44
Calendar function to assign and
manage appointments for telephone or
personal interviews
Software solution for direct data entry
during the phone call
CELOS
Assessment Unit
Diagnostic tools and psychometrics: Dr. Lars Pieper, Prof. Dr. Hans-Ulrich Wittchen, Prof. Dr. Katja Beesdo-Baum,
Dr. Susanne Knappe, Dipl.-Psych. Eva Asselmann
Computer assisted interviewing (CAPI, CATI): Dipl.-Math. Jens Strehle
Survey Lab (CATI): Dr. Lars Pieper
EMA: Dr. Lars Pieper
Biometrics, Statistics, Data Bank Management
Causal analytic designs and methods: Dr. Dipl.-Stat. Michael Höfler
Biometrical and statistical issues: Dr. Dipl.-Stat. Michael Höfler, Dipl.-Math. Jens Strehle, M.Sc. John Venz
E-CRF, databank management, informatics: Dipl.-Stat. Jens Strehle, Dipl.-Ing. Eckhard Schulz; Torsten Tille
Collaboration with the KKS Dresden
Field Work Unit
Sampling and proband tracking: Dipl.-Psych. Simone Heinze, Dipl.-Biol. Henning Schmidt
Monitoring: Dr. Lars Pieper; Quality Assurance: 3P Consulting, PD Dr. David Pittrow
Current and past Projects
- National Survey on Health Care of Depression in German Primary Care Practices, ongoing since 2014: >250 physicians,
>3000 patients (cross-sectional), >1000 patients longitudinal (3 times, over 1 year); Funding: Federal Ministry of Health
- DfG Research Group “Learning and habitisation as predictors of the Development and Maintenance of Alcoholism”,
Z-Project, n=1200 subjects in Dresden and Berlin, cross-sectional and longitudinal; Funding: DFG
- Alcohol dependence in primary care in Europe (APC), 2400 patients in German primary care, 1500 personal interviews, cross-sectional and longitudinal; Funding: Lundbeck GmbH
- German Epidemiologic Health Survey (Deutscher epidemiologischer Gesundheitssurvey) DEGS - Zusatzsurvey psychische Gesundheit, 5000 subjects in 120 sample points, personal interviewing; Funding: BMBF
- Trauma and Stress-related disorders in German Soldiers with and without Foreign Deployment, n=1600 soldiers,
cross-sectional and longitudinal; Funding: BMVg
- Prevalence, 1-year incidence and symptom severity of mental disorders in the elderly: Relationship to impairment,
functioning (ICF) and service utilisation (MentDis65+); Funding: EU
- DSM-5 dimensional measures for depression and anxiety. N=250, cross-sectional study
- PanicNet: Improving CBT for panic by identifying the active ingredients and understanding the mechanisms of action
– a multicenter study. 400 subjects, longitudinal; Funding: BMBF
- Predictors, Moderators and Outcomes of Substitution Treatment (PREMOS), 2.694 patients; Funding: BMBF.
- Improving Alzheimer Dementia Treatment: Epidemiological Appraisal of Doctors, Patients and Caregivers Unmet
Needs (IDEA), N=500 physicians and N=2.500 patients; Funding: Novartis GmbH
- The German National Health Interview and Examination Survey - Mental health supplement (BGS): 1998-2005,
N=4.181; Funding: BMBF
- EDSP family genetic program (EDSP-FG, 1998-2005, N=2.100; Funding BMBF and NGF
- Allocation in Substitution Treatments (COBRA/ASAT): 2002-present, 2.546 patients, 2 waves; Funding: ScheringPlough, BMBF/BMG
- Smoking and Nicotine Dependence Awareness Study (SNICAS): 2001-2006, 28.000 patients, 813 primary care sites;
Funding: GSK and BMBF
- Depression 2000 and GAD-P: 2000-2005, 35.000 patients in over 800 primary care sites; Funding: Organon, Wyeth
- Renocardial Syndrome RCS - heart and kidney in patients in dialysis facilities - A nationwide clinical epidemiological
cross-sectional study in dialysis facilities: N=200 physicians and N=1000 patients; Funding: Abbott GmbH
- Severe Asthma: Prevalence and Current Treatment Needs (SAP-Needs), phase I: N=681 physicians and N=13,066
patients, phase II: N=157 physicians and N=570 patients; Funding: Novartis GmbH
- Multiple Sclerosis Patients and their Caregivers Psychopathological and General Burden of Disease (MS Caregiver
Burden), structured interview of N=400 multiple sclerosis patients and 400 care givers; Funding: Norvartis GmbH
- Expert Based Survey to Investigate the Health Care Situation of Patients with Multiple Sclerosis (MS-Expert),
N=2.000 multiple sclerosis healthcare provider, mail and telephone survey; Funding: Novartis GmbH
- Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment (DETECT):
2003-present, N=55.000, 3.795 primary care sites, 3 waves; Funding: Pfizer GmbH
- Hypertension and Diabetes Risk Screening and Awareness Study (HYDRA): 2001-2006, N=43.000, 1912 primary
care Settings; Funding: Sanofi Aventis GmbH
45
NEUROIMAGING CENTER
Neuroimaging Center (NIC)
The NIC was established in 2005 via a BMBF (Ministry of Research, Education and Technology) grant within the
Institute´s successful Addiction Research Network ASAT (Speaker Prof. Wittchen). Joining forces with the BMBFendowed Chair of Addiction Research (Prof. Bühringer) and the Chair of General Psychology (Prof. Goschke), and in
close cooperation with colleagues from the Medical Faculty, Prof. Wittchen as the Principal Investigator applied for
its establishment. The University and an international review board approved our research concept and programme
in April 2006. The BMBF provided us with a generous research grant to acquire a 3T-MRI-system (Magnetom Trio
A Tim system 3 T [Siemens] with whole body suite). Since December 2006 the NIC is operational. It is located
conveniently adjacent to the Institute of Clinical Psychology and Psychotherapy on the Falkenbrunnen Campus. The
NIC hosts several add-on labs (e.g. psychophysiology lab, a training lab for anxious subjects – the mock scanner)
and is run by a physician and two medical-technical radiology assistants.
Facilities & Tools
Lab Infrastructure: 750 sqm, 22 experimental rooms, 1 psychophysiological lab, 2 preparatory rooms one of which
equipped with a mock scanner, 3 rooms staff members, 1 meeting room, lecture hall
System: Magnetom Trio A Tim system 3 T (Siemens); Whole body suite
Further infrastructure: 64 channel EEG (simultanous recording), Psychophysiological lab, A wide range of stimulation and response units for f-MRI, 2 internal and 2 external work stations, endocrionological lab,TMS, Mock scanner
Faculty
The NIC is now managed by a board of Directors, that oversee the center’s basic and clinical research groups. The
Board of Directorsis chaired by Prof. Dr. T. Goschke, Prof. Dr. H.-U. Wittchen and Prof. Dr. M. N. Smolka.
Mission of the NIC and current profile
It is the central aim of the NIC to offer excellent scientific and structural conditions to promote interdisciplinary,
multi-level, and multi-method collaborations of research groups. The NIC is dedicated to research on psychological
and neurobiological mechanisms underlying the interplay of emotion, motivation, and volition in the regulation of
adaptive and non-adaptive behaviour in subjects with and without mental disorders. We are specifically interested
in how higher-order cognitive and volitional processes interact with basic emotional and motivational systems in
decision-making and action control, and how dysfunctions in the underlying neural circuits contribute to the development of pathological conditions.
Current focus are the projects of the DFG-SFB 640. “Volition and Cognitive Control: Mechanisms, Modulators
and Dysfunctions” that involves several large-scale projects from staff members of the Institute and the propjects
of the DFG Research Group (FOR 1617, together with the Charite in Berlin; Speakers: Prof. Dr. A. Heinz, Berlin &
Prof. Dr. H.-U. Wittchen, Dresden) “Learning and Habitization as Predictors of the Development and Maintenance of
Alcoholism). Both highly successful and productive programs will apply for a second funding period in 2015 and 2016.
Emphasis of the “BMBF Addiction f-MRI Research Lab” is laid for example upon the question how the lack of
impulse control contribute to the developmental pathways in addictive behaviors (for example: changes occurring
during the transition from experimental to dependent use of nicotine and cannabis, as well as during discontinuation with and without therapeutic interventions).
Other associated work groups focus on the role of vulnerability and risk interactions (family genetic and temperamental dispositions), concurrent anxiety and mood disorders (“Mood and Anxiety Group”), neural mechanism in eating
disorders and obesity (“Obesity Group”), as well as neurological and neurosurgical conditions (“Neurological Group”).
Several research groups from the Department of Psychology have been formed that are currently conducting comprehensive studies focussing on cognitive-affective interactions in healthy individuals and patients with mental disorders. The Clinical Psychology and Neuroimaging group (Cooridnators: PD Dr. U. Lüken and Prof. Dr. K. BeesdoBaum) encompasses several several local work groups and extramural research partners (i.e. Prof. Dr. Tilo Kircher,
Dept. of Psychiatry and Psychotherapy, University Hospital Marburg, Prof. Dr. Andreas Ströhle, Dept. of Psychiatry
and Psychotherapy, Campus Charité Mitte, Prof. Dr. Alfons Hamm, Ernst Moritz Arndt Universität Greifswald,
Daniel S. Pine, M.D., National Institutes of Mental Health). Research activities of this work group focus on the
functional neuroanatomy of anxiety and comorbid mood disorders and their neural plasticity following psychological
treatment. In particular, the following areas of interest are targeted by ongoing projects:
a) Neuronal plasticity following cognitive-behavioral therapy in patients with panic disorder with agoraphobia: A multicenter 3 Tesla study using fMRI (see Research P1)
b) Neuroimaging markers of treatment response to cognitive-behavioral therapy in panic disorder with agoraphobia (see
Research P2)
46
NEUROIMAGING CENTER
c)
d)
e)
g)
Therapygenetics and genetic imaging in panic disorder with agoraphobia (see Research P3)
Psychophysiological reactivity during uncertainty and ambiguity processing in high and low worriers (see Research P4)
Neural und endocrine emotion- und stress regulation in generalized anxiety disorder (see Research P6)
Differential neuro-biological correlates of emotion- and stress regulation in Generalized Anxiety Disorder compared to
Major Depression and Social Phobia (see Research P7) and the specificity of neural correlates of generalized anxiety
disorder: differentiation from related disorders and prediction of diagnosis using neuroimaging data (see Research P8)
Current Research Groups and Projects at the NIC
Bereich
Projektleiter
Appetite (Food)
SeSyN
Dipl.-Psych. Franziska Wuttig
Nicotine and Emotion
SeSyN
IMAGEN
SeSyN
Dipl.-Psych. Nora Vetter
Emotion. und Motiv. Effekte des Rauchens
SeSyN
SFB A7 real-time fMRI-based neurofeedback
SeSyN
Dr. Mark Jacob
Emotionsverarbeitung und Sozialverhalten ADHS
SeSyN/KJP Dipl.-Psych. Nora Vetter
Die Rolle von Lernvorgängen für die Entwicklung und
SeSyN
Dipl.-Psych. Stephan Nebe
Aufrechterhaltung der Alkoholabhängigkeit
SFB B3 Dopaminergic modulation of meta-control parameters
SeSyN/AllgPsy Dipl.-Inf. Lydia Hellrung
and the stability flexibility
SFB B4 Serotonergic modulation of meta-control parameters
SeSyN
Dr. Nils Kroemer
SFB C2 Affective modulation of cognitive control in bipolar disorder
PSY/SeSyN Prof. Andrea Pfennig,
Prof. Michael Bauer
Differentielle neuro-biologische Korrelate der Emotions- und
KlinPsy
Prof. Katja Beesdo-Baum
Stressverarbeitung bei Generalisierter Angststörung im Vergleich
Dipl.-Psych. Kevin Hilbert
zu Major Depression und Sozialer Phobie
Neuronale Plastizität im Rahmen einer kognitiv-verhaltenstherapeutischen Intervention bei Patienten mit Panikstörung
(Multicenter-Studie/3 Tesla fMRT)
KlinPsy
PD Ulrike Lüken
Neuronale Plastizität infolge interozeptiver Exposition bei Pat.
mit Panikstörung und Personen mit niedriger vs. Erhöhter Angstsensibilität KlinPsy
PD Ulrike Lüken
Neurale und endokrine Emotions- und Stressregulation bei
Klein Psy Prof. Katja Beesdo-Baum
Generalisierter Angststörung
SFB C4 Fronto-striatal dysregulation of motivational and cognitive flexibility KlinPsy
PD Ulrike Lüken
SFB C1 Volitional dysfunction in self-control failures and addictive behaviours KlinPsy/AllgPsy/
SeSyN
Dr. Martin Krönke
Gen - Umwelt Interaktion
KlinPsy
Dr. Markus Mühlhan
Neuronale Grundlagen negativer Emotionalität
DiffPsy
Dipl.-Psych. Kersten Diers
SFB A5 Pilotstudie
DiffPsy
Dipl.-Psych. Kersten Diers
SFB A5 Volitional emotion regulation: The costs of control
DiffPsy
Prof. Alexander Strobel, Dipl.- Psych. Kersten Diers, Dr. Sabine Schönfeld, Prof. Burkhard Brocke
Neurokognitive Mechanismen der Grundlagen zielgerichteten Verhaltens 1 AllgPsy
Dr. Hannes Ruge, Dipl.-Psych. Steffi Frimmel
SFB A2 Neurokognitive Prozesse stimulusbasierter und
AllgPsy
Dipl.-Psych. Katharina Zwosta
zielgerichteter Handlungskontrolle
Dr. Hannes Ruge
SFB A2 Schnelles instruktionsbasiertes Lernen neuer S-R-Regeln
AllgPsy
Dr. Uta Wolfensteller
SFB Z1 Piloting simultaneous EEG-fMRI measurement
AllgPsy
Dr. Hannes Ruge, Dipl.-Psych. Fabian Baum
Neurokogn. Mechanismen der Grundlagen zielgerichteten Verhaltens 2 AllgPsy
Dr. Uta Wolfensteller,
Dipl.-Psych. Steffi Frimmel
SFB A2 Schnelles instruktionsbasiertes Reversal von S-R-Regeln
AllgPsy
Dr. Uta Wolfensteller, Dr. Hannes Ruge, Dr. Yiquan Shi
SFB B1 Emotional modulation of cognitive control
AllgPsy
PD Annette Bolte, Dipl.-Psych. Ulrike Schulz
SFB A2 Decomposing instruction-based learning (Exp. 1)
AllgPsy
Dr. Hannes Ruge, Dr. Uta Wolfensteller
SFB A2 Decomposing instruction-based learning (Exp. 3)
AllgPsy
Dr. Hannes Ruge, Dr. Uta Wolfensteller
SFB A6 Mechanisms of self-control: The role of anticipated emotions AllgPsy
Dr. Stefanie Beck, Dr. Uta
and future thinking in reward regulation
Wolfensteller
Sensorische Vorgefühle bei Patienten mit Tourette Syndrom
KJP
Prof. Veit Rössner,
und Zwangserkrankungen
Dipl.-Psych. Judith Buse
SFB C3, Teil 1 Informations- und Emotionsverarbeitung bei Anorexia Nervosa KJP
Prof. Stefan Ehrlich
SFB C3, Teil 2
KJP
Prof. Stefan Ehrlich
TMS (keine MRT Effekte von TMS auf modellbasierte
EntwPsy Prof. Ben Eppinger,
Entscheidungsprozesse) Prof. Su-Chen Li, Dr. Franziska Korb
MRI of the vocal tract of professional singers - a longitudinal study
UKD
Prof. Michel Laniado, Dr. Ivan Platzek
47
KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE/CLINICAL PSYCHOLOGY AND PSYCHOTHERAPY
Professur Klinische Psychologie und Psychotherapie
Direktor des Instituts für Klinische Psychologie
und Psychotherapie
Chemnitzer Straße 46; 01187 Dresden
Tel.: +49 (351) 46 33 69 89; Fax: (351) 46 33 69 84
E-Mail: hans-ulrich.wittchen@tu-dresden.de
Sekretariat
Regine Schwartz
Tel.: +49 (351) 46 33 85 77; Fax: + (351) 46 33 69 84
regine.schwartz@tu-dresden.de
Romane Raabe
Tel.: +49 (351) 46 33 69 83; Fax: + (351) 46 33 69 84
raabe@psychologie.tu-dresden.de
Verwaltung
Dipl.-Ing. Grit Debitz; Tel.: +49 (351) 46 33 69 98
grit.debitz@psychologie.tu-dresden.de
Dipl.-Ing.(FH) Kerstin Raum; Tel.: (351) 46 33 69 82
kerstin.raum@tu-dresden.de
Dipl.-Betrw. (BA) Karina Bley; Tel.: (351) 46 33 69 88
karina.bley@tu-dresden.de
Elke Rödel; Tel.: +49 (351) 46 33 85 74
elke.roedel@tu-dresden.de
Doreen Opitz; Tel.: +49 (351) 46 33 85 96
doreen.opitz@tu-dresden.de
Lehre
Dr. Samia Härtling; Tel.: +49 (351) 46 33 69 63
samia.haertling@tu-dresden.de
Forschung
PD Dr. Ulrike Lüken; Tel.: +49 (351) 46 33 85 99
ulrike.lueken@tu-dresden.de
Dr. Samia Härtling; Tel.: +49 (351) 46 33 69 63
samia.haertling@tu-dresden.de
Dr. Susanne Knappe; Tel.: +49 (351) 46 33 97 27
susanne.knappe@ tu-dresden.de
Dr. Julia Martini; Tel.: +49 (351) 46 33 25 55
matini@psychologie.tu-dresden.de
Dipl.-Psych. Ricarda Evens; Tel.: +49 (351) 46 33 74 68
Richarda.evens@tu-dresden.de
Dipl.-Psych. Ingmar Heinig; Tel.: +49 (351) 46 33 69 52
ingmar.heinig@ tu-dresden.de
M.Sc. Simon Mack; Tel.: +49 (351) 46 33 69 52
simon.mack@tu-dresden.de
Dipl.-Psych. Nina Maslowski; Tel.: +49 (351) 46 34 22 25
maslowski@psychologie.tu-dresden.de
Dipl.-Psych. Sören Paul; Tel.: +49 (351) 46 33 69 90
soeren.paul@ tu-dresden.de
Dipl.-Psych. Johanna Petzold; Tel.: +49 (351) 46 33 74 68
johanna.petzold@tu-dresden.de
Dipl.-Psych. Judith Schäfer; Tel.: +49 (351) 46 34 22 33
judith.schaefer@.tu-dresden.de
Dipl.-Psych. Lucie Scholl; Tel.: +49 (351) 46 33 69 90
lucie.scholl@ tu-dresden.de
Dipl.-Psych. Yulia Stankevich; Tel.: +49 (351) 46 34 22 25
yulia.stankevich@tu-dresden.de
Dipl.-Psych. Sebastian Trautmann; Tel.: (351) 46 34 24 64
sebastian.trautmann@ tu-dresden.de
Dipl.-Psych. Fanny Weber; Tel.: +49 (351) 46 34 22 74
weber@psychologie.tu-dresden.de
Dr. Markus Mühlhan; Tel.: +49 (351) 46 33 69 53
markus.muehlhan@ tu-dresden.de
Statistik
Dr. Michael Höfler; Tel.: +49 (351) 46 33 69 21
hoefler@psychologie.tu-dresden.de
M.Sc. Linda van den Berg; Tel.: +49 (351) 46 33 69 52
linda.vandenberg@ tu-dresden.de
Dipl.-Math. Jens Strehle; Tel.: +49 (351) 46 33 74 62
strehle.jens@tu-dresden.de
Nach einem Freisemester, in dem ich mich - neben vielen forschungspolitischen Aktivitäten - vor allem der Beantragung
der neuen Forschungsprogramme (BMBF, DFG) und der Herausgabe der deutschen Version des Diagnostic and Statistic
Manual of Mental Disorders (DSM-5) gewidmet habe, bin ich wieder zurück im Alltag von Forschung und Lehre. Mit meinen alten und vielen neuen Mitarbeitern freue ich mich auf die vor uns liegenden Aufgaben.
49
BEHAVIORALE PSYCHOTHERAPIE/BEHAVIORAL PSYCHOTHERAPY
Professur für Behaviorale Psychotherapie/Behavioral Psychotherapy
Prof. Dr. Jürgen Hoyer
Professur für Behaviorale Psychotherapie
Hohe Str. 53, 01187 Dresden
Tel.: +49 (351) 46 33 69 86
Fax: +49 (351) 46 33 69 55
Sekretariat
Beate Reith
Tel.: +49 (351) 46 33 6070; Fax: +49 (351) 46 33 69 55
beate.reith@tu-dresden.de
Montag-Freitag: 08:00-12:00 Uhr
Wissenschaftliche Mitarbeiter
Dipl.-Psych. Nadine Furka, Tel.: +49 (351) 46 33 69 64
nadine.furka@tu-dresden.de
Dipl.-Psych. Sara Jahnke; Tel.: +49 (351) 46 33 69 78
sara.jahnke@tu-dresden.de
Dipl.-Psych. Katharina Schierz; Tel.: +49 (351) 46 33 69 56
katharina.schierz@tu-dresden.de
Promotionsstudenten
Dipl.-Psych. David Bräuer
Dipl.-Psych. Anja Schulz
M.Sc. Tabea Schweden; Tel.: +49 (351) 46 33 69 54
tabea.schweden@ tu-dresden.de
Die W3-Professur Behaviorale Psychotherapie wurde an der Fachrichtung im Jahr 2013 neu geschaffen. Prof. Dr.
Jürgen Hoyer wurde zum 1. April 2013 auf die Professur berufen. Die Antrittsvorlesung mit dem Titel „Warum
brauchen wir Psychotherapieforschung“ fand im Oktober 2013 im Rektoratssaal der TU Dresden statt (ausführlich:
Psychotherapeutenjournal 4/2013; www.opk-info.de/red_tools/download_dokument.php?id=772).
Behaviorial Psychotherapy is the application of learning principles in a more considered and systematic way for
responsible people who participate actively in developing their own potentialities” (Albert Bandura)
Die neuberufenen Professoren
der TU Dresden 2013. Links die
neuberufenen Professoren der
Psychologie (v.l.n.r.): Sebastian
Pannasch, Daniel Leising, Jürgen
Hoyer, Ben Eppinger
Credo und Forschungsprogramm der Professur folgen der Formel „vom Funktionsverständnis zum
Veränderungswissen“:
• Wie können wir behaviorale und neuronale Funktionsmechanismen noch besser beschreiben, um psychologische Behandlungen zu optimieren?
• Was sind die entscheidenden Wirkmechanismus bei komplexen Interventionsprogrammen?
• Wie kann der Transfer behavioraler Methoden in Ausbildung und Praxis noch besser gelingen?
50
BEHAVIORALE PSYCHOTHERAPIE/BEHAVIORAL PSYCHOTHERAPY
Unsere Forschungskonzeption sieht eine enge Verknüpfung der subjektiv-psychologischen mit der bio- und neuropsychologischen Ebene vor. Sie verknüpft eine genaue Statusdiagnostik mit longitudinalen Daten. Dem entspricht
eine enge Zusammenarbeit des Arbeitsbereichs Behaviorale Psychotherapie mit den angrenzenden Fachgebieten
innerhalb und außerhalb der Psychologie (insbesondere mit der Medizin) und mit Netzwerk- und Verbundstrukturen
auf nationaler und internationaler Ebene.
Unsere thematisch ineinander greifenden Forschungsmodule:
1)
2)
3)
4)
5)
Entwicklung und Prüfung innovativer behavioraler Methoden psychotherapeutischer Veränderung.
Entwicklung und Überprüfung neuer Formate und Settings behavioraler Psychotherapie.
Translationale Studien zur Behavioralen Psychotherapie (einschl. Design-Entwicklung).
Naturalistische Studien zur Psychotherapie und Ausbildungsforschung.
Entwicklung und Überprüfung diagnostischer Methoden zur Messung klinisch relevanter Merkmale.
Die Professur Behaviorale Psychotherapie nimmt für die Fachrichtung eine wichtige Verbindungsfunktion in
die Klinische Forschung wahr. Der Inhaber der Professur ist in Personalunion auch Leiter der Institutsambulanz
und Tagesklinik für Psychotherapie der Dresden und des Aufbaustudiengangs Psychologische Psychotherapie.
Ausführliche Darstellungen zu diesen Funktionseinheiten finden sich in eigenen Kapiteln dieses Berichts. Further
information and all previous publications on this program can be found on the units webpage:
http://www.psychologie.tu-dresden.de/i2/klinische/index.htm
Projects of Behavioral Psychotherapy are primarily clinical projects and are described in AG 9 Clinical
Reseach, AG 10 Diagnostic Processes and Psychometrics and AG11 AG 11 Psychotherapie- und
Interventionsforschung
Behavioral psychotherapy: Ongoing projects (10/2014)
Transfer of exposure-based interventions into the routine provider system (PROTECT-AD)
Short-term psychodynamic psychotherapy (STPP) and cognitive-behavioral therapy (CBT) in social phobia
– a randomized controlled multicenter study
Patient characteristics predicting attrition and outcome in CBT for social phobia: Results
from a large multicenter trial Transfer of manualized CBT for social phobia into clinical practice (SOPHOPRAX)
Psychoneuroendocrinology of social phobia
Dissociative symptoms in social phobia during a stressful social performance situation
Task concentration training vs. cognitive behavioral therapy: A randomized controlled
trial for social anxiety disorder with fear of blushing
Specialized outpatient clinic for generalized anxiety disorder
The role of pre-treatment depression for psychotherapy outcome in generalized anxiety disorder
Steroid hormone levels in hair: Longterm endocrine changes after CBT for PTSD
Behavioral activation for depression in groups
Enhancing the effects of BA for depression by using electronic apps
Sexual abuse of children and adolescents: Aetiology, dunkelfeld research and the
consequences for victimsa (Including sub-projects)
Social anxiety and loneliness in social and sexual online communication with strangers –
an international study
BMBF
BMBF
BMBF
BMBF
DFG
DFG
DFG
IAP-TUD
DFG
DFG
IAP-TUD
IAP-TUD
BMFSFJ
BMFSFJ
51
BEHAVIORALE EPIDEMIOLOGIE/BEHAVIORAL EPIDEMIOLOGY
Professur für Behaviorale Epidemiologie
Professur für Behaviorale Epidemiologie
Institut für Klinische Psychologie
und Psychotherapie
Tel.: +49 (351) 46 33 69 89
Fax: +49 (351) 46 33 85 80
E-Mail: katja.beesdo-baum@tu-dresden.de
Studiengangskoordinatorin Masterstudiengang KPP
Mitglied in:
- Studienkommission der FR Psychologie
- Kommission Qualitätsmanagement Studium und Lehre
- Eignungsfeststellungs- & Auswahlausschuss KPP
- Prüfungsausschüsse MA KPP & CAN sowie
Bachelorstudiengang Psychologie
- Bibliothekskommission
Sekretariat und Verwaltung
Tina Liebscher; Tel.: +49 (351) 46 33 68 86
Fax: +49 (351) 46 33 85 80
tina.liebscher@tu-dresden.de
Dipl.-Psych. Kevin Hilbert; Tel.: +49 (351) 46 34 25 89
kevin.hilbert@tu-dresden.de
Dipl.-Psych. Jana Hoyer; Tel.: +49 (351) 46 33 75 98
jana.hoyer@tu-dresden.de
Dipl.-Psych. Lisa Knothe; Tel.: +49 (351) 46 33 85 75
lisa.knothe@tu-dresden.de
Dr. Lars Pieper; Tel.: +49 (351) 46 33 85 83
lars.pieper@tu-dresden.de
Center for Clinical Epidemiology and
Longitudinal Studies (CELOS)
Co-Leitung: Dr. Lars Pieper; Tel. +49 (351) 46 33 85 83
lars.pieper@tu-dresden.de
Dipl.-Biol. Henning Schmidt; Tel.: +49 (351) 46 33 76 61
h.schmidt@psychologie.tu-dresden.de
M.Sc.-Math. John Venz; Tel.: +49 (351) 46 33 69 00
john.venz@tu-dresden.de
M.Sc. Catharina Voss; Tel.: +49 (351) 46 33 75 88
catharina.voss@tu-dresden.de
Dipl.-Psych. Gesine Wieder; Tel.: +49 (351) 46 33 85 75
gesine.wieder@tu-dresden.de
Präventionsangebote/Center for Preventive
Intervention Studies (CEPRIS)
Co-Leitung: Dr. Susanne Knappe; Tel. +49 (351) 46 33 68 86 Dipl.- Wi.-Math. Diana Pietzner; Tel.: +49 (351) 46 33 69 51
diana.pietzner @tu-dresden.de
CEPRIS@psychologie.tu-dresden.de
Eva Stolzenburg, MTA; Tel.: +49 (351) 46 33 76 40
Forschungsmitarbeierinnen und -mitarbeiter
Dipl.-Psych. Eva Asselmann; Tel.: +49 (351) 46 33 68 95 eva.stolzenburg@tu-dresden.de
eva.asselmann@tu-dresden.de
Assoziierte Mitarbeiter
Torsten Tille (Programmierer); Karina Bley (Verwaltung)
Claudia Groch, MPH; Tel.: +49 (351) 46 33 19 48
Doreen Opitz (Dokumentationsassistentin)
claudia.groch1@tu-dresden.de
Aufbau der Professur
Die Professur wurde zum 1. April 2014 neu an der TU Dresden zur Stärkung der epidemiologischen Forschung und
Lehre eingerichtet. Sie wird seit 1.6.2014 über eine Anschubfinanzierung des Bundesministeriums für Bildung
und Forschung (BMBF) zunächst für 3 Jahre über das Projekt „The epidemiology of functional and dysfunctional behavioral and psychological factors in mental health and disease“ finanziert. Die Professur ist am Institut
für Klinische Psychologie und Psychotherapie der Fachrichtung Psychologie an der Fakultät Mathematik und
Naturwissenschaften der TU Dresden angesiedelt und mit der Leitung des seit 2008 etablierten Centers for Clinical
Epidemiology and Longitudinal Studies (CELOS) verbunden. Sie ist die einzige Professur dieser Art in Deutschland.
52
In den ersten Monaten seit Einrichtung der Professur erfolgte - neben Renovierungsarbeiten in den CELOS-Räumen
und den neuen Mitarbeiterräumen - der personelle Aufbau der Arbeitsgruppe und die Schaffung der notwendigen Forschungsinfrastruktur. Seit Juni laufen die Vorbereitungen für das BMBF-geförderte behavioral-epidemiologische Kohortenprojekt. Zudem wurde bereits im Juli durch Implementierung eines Lehrmoduls „Behaviorale
Epidemiologie und Intervention“ in den Studienordnungen aller drei Masterstudiengänge Psychologie der erste
Schritt zum Aufbau eines curricularen Programms beschritten.
1. Lehrangebot
Mit der Etablierung der Professur soll die universitäre Lehre im Bereich Epidemiologie gestärkt werden. Durch die
Ansiedlung der Professur im Fachbereich Psychologie der Fakultät Mathematik und Naturwissenschaften besteht
an der TU Dresden für Psychologie-Studierende bundesweit die einzigartige Möglichkeit, solide Grundlagen- und
Anwendungskenntnisse im Fach Behaviorale Epidemiologie zu erwerben. Aufgrund der Drittmittelfinanzierung
der Professur werden jedoch erst nach 3 bzw. 6 Jahren mit der dauerhaften Übernahme der Professur durch den
Freistaat Sachsen umfangreichere Lehrressourcen zur Verfügung stehen. Daher hat die TU Dresden für die sofortige Etablierung eines Lehrprogramms zusätzliche personelle Ressourcen bereitgestellt, so dass bereits im WS
2014/15 erste Lehrveranstaltungen angeboten werden können.
Ab dem WS 2014/15 werden im Rahmen eines Wahlpflichtmoduls Lehrveranstaltungen für Studierende der folgenden Masterstudiengänge angeboten:
- Klinische Psychologie und Psychotherapie (KPP)
- Psychologie: Cognitive-Affective Neurosciences (CAN)
- Psychologie: Human Performance in Sociotechnical Systems (HPSTS)
Modul
-
-
-
im WS 2014/15: Behavioral Epidemiology and Intervention (BEI, 6 SWS/9 ECTS):
Vorlesung: Einführung in die Behaviorale Epidemiologie
Seminar: Klinische Entwicklungsepidemiologie
Seminar: Behaviorale Epidemiologie und Intervention
Das Lehrangebot wird in enger Anbindung an Forschungsvorhaben wissenschaftlich fundiert sein und Möglichkeiten
für einen praktischen Einblick in die epidemiologische Forschung (z.B. durch Exkursionen ins CELOS) ermöglichen.
Zudem haben Studierende die Möglichkeit, im Rahmen von Forschungspraktika bzw. Abschlussarbeitsprojekten
an der Professur für Behaviorale Epidemiologie Kenntnisse und Kompetenzen in der behavioral-epidemiologischen
Forschung einschließlich Intervention zu vertiefen. Wir ermöglichen einen praxisnahen Einblick in die klinischepidemiologische Forschung und vermitteln Kompetenzen in der Planung, Durchführung und Auswertung epidemiologischer Forschungsprojekte im Zusammenhang mit psychischen Störungen bzw. psychologischen und verhaltensbezogenen Faktoren bei körperlichen Erkrankungen. Durch den Zugang zu den diversen Laboren (z.B. CATI/
CAPI-Lab, Experimental-Lab) des CELOS, die Anbindung des Centers for Preventive Interventions Studies (CEPRIS)
und unsere Projekte im NIC sowie der IAP bestehen vielfältige Möglichkeiten von der Grundlagen- bis hin zur translationalen Interventionsforschung.
2. Center for Clinical Epidemiology and Longitudinal Studies (CELOS)
Das CELOS ist eine Laborplattform des Instituts für Klinische Psychologie und Psychotherapie an der Fakultät für
Mathematik und Naturwissenschaften an der TU Dresden. Es besteht aus Laboren für die Feldarbeit klinischer und
epidemiologischer Studien und umfasst die Infrastruktur für computergestützte persönliche (CAPI) und telefonische
Interviews (CATI). Im Rahmen der Vorbereitung für die Feldphase des vom BMBF geförderten Projekts „The epidemiology of functional and dysfunctional behavioral and psychological factors in mental health and disease“ wird das
CELOS derzeit um Laborräume für experimentelle Untersuchungen, behaviorale Beobachtungen und die Entnahme
von Bioproben (Blut, Speichel) ergänzt. Nähere Informationen finden sich unter Strukturelle Ressourcen/Structural
Ressources, Celos.
3. Präventionsangebote/Center for Preventive Intervention Studies (CEPRIS)
Eines der Ziele der Professur ist, Erkenntnisse aus der epidemiologischen Grundlagenforschung bzgl. Risikofaktoren und Entwicklungsstadien von psychischen Störungen, insb. Angst- und depressive Störungen, in
gezielte Interventionen „zu übersetzen“. Für die Entwicklung und Prüfung neuartiger gezielter präventiver
Interventionen wird derzeit das CEPRIS aufgebaut. Zudem werden am CEPRIS ab August 2014 bereits etablierte
Präventionsprogramme für Kinder, Jugendliche und Erwachsene angeboten.
53
4. Forschung
Die Professur für Behaviorale Epidemiologie beschäftigt sich mit der Häufigkeit, dem Beginn und Verlauf psychischer Störungen in der Bevölkerung sowie den psychologischen und verhaltensbezogenen, einschließlich kognitivaffektiven Determinanten von Gesundheit und Krankheit, unter Berücksichtigung von Interaktionen mit genetischen
und umweltbezogenen Faktoren. Im Fokus stehen:
-
Psychische Störungen sowie psychologische und verhaltensbezogene Faktoren bei körperlichen Erkrankungen
Identifizierung kritischer Entwicklungspfade und Trajektorien
Identifizierung von Risiko- und Schutzfaktoren
Prüfung von Kausalitäten im Rahmen translationaler Interventionsstudien (gezielte Prävention und
Frühintervention, Therapie)
Versorgung und Identifizierung von Barrieren für frühe Interventionen und Behandlung
Die Forschungsprojekte an der Professur für Behaviorale Epidemiologie werden in folgenden, partiell überlappenden
Arbeitsbereichen durchgeführt und infrastrukturell durch das Center for Clinical Epidemiology and Longitudinal
Studies (CELOS), das Center for Preventive Intervention Studies (CEPRIS), die Institutsambulanz für Psychotherapie
(IAP) sowie das Neuroimaging Center der Fachrichtung Psychologie (NIC) unterstützt.
Die epidemiologischen und translationalen Forschungsprojekte der Professur werden in Kooperation mit anderen Professuren und Arbeitsgruppen an der TU Dresden durchgeführt, insbesondere Prof. Wittchen (Klinische
Psychologie und Psychotherapie), Prof. Hoyer (Behaviorale Psychotherapie, Klinische Forschung), Prof. Jacobi
(EDSP-Essstörungen), Dr. Behrendt (EDSP-Suchtforschung), Prof. Goschke (SFB 940, Volition und kognitive
Kontrolle), Prof. Kirschbaum (Biopsychologie, Stressforschung), Prof. Pfennig (Psychiatrie, Bipolare Störungen,
Früherkennung) und Prof. Bergmann (Allgemeinmedizin) sowie mit einer Reihe nationaler und internationaler
Arbeitsgruppen (z.B. Danny Pine, NIMH; Ron Kessler, Harvard).
Im Folgenden wird ein Überblick über die Forschungsprojekte der Professur und deren Mitarbieter gegeben; eine
ausführliche Darstellung der Projekte findet sich unter AG 1 bzw. AG7, wo auch alle weiteren Projekte aus dem
Bereich Epidemiologie und Versorgungsforschung des Instituts für Klinische Psychologie und Psychotherapie der
letzten zwei Jahre aufgeführt sind.
CELOS
CELOS
(Leitung:
(Leitung:
Beesdo-Baum,
Beesdo-Baum,
Pieper
Pieper &&
Wittchen)
Wittchen)
Epidemiologie
Epidemiologie
und
und
Versorgungs
Versorgungs
forschung
forschung
Klinische
Klinische
EntwicklungsEntwicklungsEpidemiologie
Epidemiologie
Psychischer
Psychischer
Störungen
Störungen
Behavioral
Behavioral
Health
&&
Health
Behavioral
Behavioral
Medicine
Medicine
CEPRIS
CEPRIS
(Leitung:
(Leitung:
Beesdo-Baum
Beesdo-Baum&&
Knappe)
Knappe)
Behaviorale
Behaviorale
Epidemiologie
Epidemiologie
NIC
NIC
(Leitung:
(Leitung:
Goschke,
Goschke,
Smolka
Smolka &&
Wittchen)
Wittchen)
Translationale
Translationale
InterventionsInterventionsforschung
forschung
Behavioral
Behavioral
Neurosciene
Neurosciene
IAP
IAP
(Leitung:
(Leitung:
Hoyer)
Hoyer)
Diagnostik
&&
Diagnostik
Psychometrie
Psychometrie
Forschungsbereich 1: Klinische Entwicklungsepidemiologie psychischer Störungen
Grundlage dieses Forschungsbereichs sind epidemiologische Kohortenstudien Jugendlicher und junger
Erwachsener, die aufgrund ihres prospektiv-longitudinalen Designs und einer umfassenden psychopathologischen
Charakterisierung der Teilnehmer sowie der Erfassung einer Vielzahl distaler und proximaler Variablen ermöglichen, entwicklungssensitive Analysen bezüglich des Beginns und Verlaufs psychischer Störungen durchzuführen, ihre Vorläufer
und Konsequenzen zu ermitteln sowie zentrale Vulnerabilitäts- und Risikofaktoren zu identifizieren. (s.a. AG 1)
Projekt 1. The Epidemiology of Functional and Dysfunctional Behavioral and Psychological Factors in Mental
Health and Disease (EBP) (Pl: Prof. Dr. Katja Beesdo-Baum; Staff: Dr. L. Pieper, Dipl.-Psych. J. Hoyer, M.Sc. C.
Voß, Dipl.-Math. J. Venz, MTA E. Stolzenburg, T. Tille (programmer); Funding: BMBF. Duration: 06/2014 - 05/2017)
54
Projekt 2. Early Developmental Stages of Psychopathology (EDSP): Natural course, etiology, and pathogenesis of mental and substance use disorders (PI: Prof. Dr. Hans-Ulrich Wittchen, Prof. Dr. Roselind Lieb (Co-PI),
Prof. Dr. Katja Beesdo-Baum (Co-PI/Work Group Leader Dresden); Current Staff – Dresden workgroup: Dipl.-Psych.
E. Asselmann, Dr. S. Knappe, Dr. S. Behrendt. Duration: 2003 - 2012, data analysis and publication ongoing)
Projekt 3. The role of fearful spells as risk factor for panic pathology and other mental disorders (Pl: Dipl.Psych. E. Asselmann (Doctoral thesis project); Supervision: Prof. Dr. K. Beesdo-Baum. Funding: Studienstiftung des
Deutschen Volkes. Duration: 01/2013 - 12/2014)
Forschungsbereich 2: Epidemiologie und Versorgungsforschung
In diesem Forschungsbereich werden Häufigkeit, Komorbidität und Krankheitslast psychischer Störungen sowie
Fragen der Inanspruchnahme von Gesundheitsdiensten und das Ausmaß leitlinienorientierter Behandlung untersucht. (s. AG 1)
Projekt 4. Bundesweite Studie zum Versorgungsverlauf bei Depression in Arztpraxen (VERA) (PI: Prof. Dr.
Katja Beesdo-Baum, Co-PI: Prof. Dr. Franziska Einsle, Dr. Susanne Knappe; Staff: Dipl.-Psych. G. Wieder, Dipl.Psych. L. Krause, M.Sc. Wi-Math. Diana Pietzner, Dipl.-Biol. H. Schmidt, T. Tille, D. Küster, J. Quittschalle; Funding:
Bundesministerium für Gesundheit (BMG). Duration: 04/2013 - 04/2016)
Projekt 5. The prevalence and disease burden of depression as well as service use and treatment barriers
– Analyses of data from the German Health Interview and Examination Survey for Adults – Mental Health
Supplement (DEGS1-MH) (PI: Prof. Dr. H.-U. Wittchen & Prof. Dr. K. Beesdo-Baum; Staff: Prof. Dr. F. Jacobi,
M.Sc. S. Mack, Dipl.-Math. J. Strehle. Duration: 12/2013 – 12/2014)
Forschungsbereich 3: Behavioral Health and Behavioral Medicine
Dieser Forschungsbereich beschäftigt sich mit den komplexen Interaktionen zwischen behavioralen Faktoren und
der körperlichen und/oder psychischen Gesundheit von Personen. (s.a. AG 7)
Projekt 6. Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of
Treatment (DETECT) (PI: Prof. Dr. Hans-Ulrich Wittchen, Dr. Lars Pieper; Staff: Dr. J. Klotsche, Dr. T. Eichler, Dr.
H. Glaesmer, E. Katze, Dipl.-Psych. A. Bayer; Funding: Pfizer GmbH. Duration: 09/2002 – 08/2008, data analysis
ongoing)
Projekt 7. Alcohol dependence in primary and specialist care in Europe (APC) (PI: Prof. Dr. Jürgen Rehm
& Prof. Dr. Hans-Ulrich Wittchen). Staff: Dr. L. Pieper, Dipl.-Psych. J. Manthey, Dipl.-Psych. Ch. Probst. Funding:
Lundbeck. Duration: 07/2012 – 04/2014)
Projekt 8. Isolated Clinical Hypertension – Clinical Significance, Psychological and Psychophysiological
correlates (PI: Prof. Dr. Franziska Einsle, Prof. Dr. Katja Beesdo-Baum; Staff: Dipl.-Psych. A. Schilling, Dipl.-Psych.
N. Meissner, Dipl.-Psych. J. Schneider, M. Geiger, L. Haas, F. Schlichthaar, Dr. D. Langer, Dr. A. Sennewald, Dr.
P. Muckermann, Dr. C. Groß; Funding: Anreizmittel des Universitätsklinikums Carl Gustav Carus der Technischen
Universität Dresden. Duration: 01/2005 – 03/2008, data analysis ongoing)
Projekt 9. Psychological and Biological Risk Factors of Burnout (ROB) (PI: Prof. Dr. Clemens Kirschbaum, Dr.
Lars Pieper; Staff: Prof. Dr. A. Buske-Kirschbaum, Prof. Dr. J. Schmitt, Dr. R. Miller, Dipl.-Psych. R. Hoffmann.
Funding: Support-the-best Pool (TU Dresden). Duration: 01/2014 - ongoing)
Forschungsbereich 4: Behavioral Neuroscience
In diesem Forschungsbereich werden anhand experimenteller Paradigmen behaviorale und neurobiologische
Korrelate psychischer Störungen untersucht. (s.a. AG 2)
Projekt 10. Differentielle neuro-biologische Korrelate der Emotions- und Stressverarbeitung bei
Generalisierter Angststörung im Vergleich zu Major Depression und Sozialer Phobie (PI: Prof. Dr. Katja
Beesdo-Baum; Staff: Dipl.-Psych. K. Hilbert, Dr. S. Schmiedgen, PD Dr. U. Lüken, Dr. M. Mühlhan; Funding:
Deutsche Forschungsgemeinschaft (DFG). Duration: 01/2014 - 12/2016)
55
Projekt 11. Psychophysiological and neural reactivity during uncertainty and ambiguity processing in high
and low worriers (PI: Prof. Dr. Katja Beesdo-Baum, PD Dr. Ulrike Lüken; Staff: Dipl.-Psych. H. Kirschner, Dipl.Psych. K. Hilbert, Dipl.-Psych. St. Nebe. Funding: Internal Resources (Lehrpreispool). Duration: 05/2010 – 05/2013,
data analysis ongoing)
Projekt 12. The specificity of neural correlates of Generalized Anxiety Disorder: differentiation from related
disorders and prediction of diagnosis using neuroimaging data (PI: Dipl.-Psych. Kevin Hilbert (Doctoral thesis
project). Supervision: Prof. Dr. K. Beesdo-Baum, PD Dr. U. Lüken. Funding data collection (10/2008 - 10/2013):
Anschubfinanzierung FR Psychologie, Forschungspool TU Dresden. Duration thesis: 06/2013 – ongoing)
Projekt 13. Behavioral Avoidance and cognitive control abilities in high and low worriers (PI: Dipl.-Psych.
Kevin Hilbert); Staff: G. Huang, T. Rößler. Funding: Internal Resources (Lehrpreispool). Duration: 07/2014 – ongoing)
Forschungsbereich 5: Diagnostik und Psychometrie
In diesem Forschungsbereich werden diagnostische Instrumente zur Erfassung von psychischen Störungen sowie
ihrer behavioralen Teilkomponenten entwickelt und/oder psychometrisch geprüft. (siehe unter AG 10)
Projekt 14. Psychometric Properties of the Dimensional Anxiety Scales for DSM-5 (PI: Prof. Dr. Katja BeesdoBaum, Prof. Dr. Hans-Ulrich Wittchen, Prof. Dr. Jürgen Hoyer, Dr. Susanne Knappe; Funding: Internal resources.
Duration: 01/2011 - ongoing)
Projekt 15. Development of a measure for the behavioral symptoms of Generalized Anxiety (PI: Dipl.-Psych.
Lisa Knothe, Prof. Dr. Katja Beesdo-Baum; Funding: Internal resources. Duration: 01/2013 - ongoing)
Forschungsbereich 6: Translationale Interventionsforschung
In diesem Forschungsbereich wird untersucht, wann, bei wem und wie behaviorale Interventionen am besten
durchgeführt werden, um die Entwicklung psychischer Störungen zu verhindern (gezielte Prävention) bzw.
eine Chronifzierung und Progression zu vermeiden (Therapie). Während in enger Kooperation mit der IAP die
behaviorale Therapie der Generalisierten Angststörungen bereits etablierter Forschungsschwerpunkt ist, ebenso die Untersuchung der Rolle von Komorbiditäten bei psychotherapeutischen Angstbehandlungen (für nähere
Informationen vgl. AG 9: Clinical Research), wird sich die Arbeitsgruppe in nächster Zeit verstärkt auch Fragen der
populationsbasierten Früherkennung und gezielten Prävention und Frühintervention im Zusammenhang mit psychischen Störungen und gesundheitsrelevanten Verhaltensweisen widmen.
Projekt 16. Die Behandlung der Generalisierten Angststörung im Rahmen einer Spezialambulanz (Pl: Prof.
Dr. Katja Beesdo-Baum, Prof. Dr. Jürgen Hoyer; Staff: Th. Bensmann, S. Heidrich, E. Lochmann, S. Behrendt, Ch.
Probst, Ch. Thurau, J. Schlapphof, U. Lüken, S. Baumbach, F. Einsle, K. Anacker, K. Hummel, St. Crawcour, F.
Harder, S. Jahnke, A. Müller, M. Jendrusch, S. Knappe, Th. Rische, M. Einert, S. Steudte, M. Wolf, N. Maslowski,
M. Leckscheidt, Ch. Kämpfe, Ch. Sura; Funding: internal resources. Duration: 08/2005 - ongoing. Cooperation:
Institutsambulanz und Tagesklinik für Psychiatrie der TU Dresden.)
Projekt 17. The effect of type, severity and combinations of comorbid conditions on treatment outcome and
process (Pl: Prof. Dr. Katja Beesdo-Baum, Prof. Dr. Hans-Ulrich Wittchen; Staff: Dipl.-Psych. A. Emmrich, Dr. F.
Einsle; Dipl.-Psych. G. Wieder; Dr. A. Gloster, Dipl.-Psych. J. Tesch, Dr. U. Lüken, Dipl.-Psych. L. Horster)
Projekt 18. Aufbau eines Zentrums zur Prävention und gezielten Frühintervention im Zusammenhang mit
psychischen Störungen und riskanten Gesundheitsverhaltens (Center for Preventive Intervention Studies,
CEPRIS) (Pl: Prof. Dr. Katja Beesdo-Baum, Dr. Susanne Knappe; Staff: Dipl.-Psych. E. Asselmann, MPH C. Groch, A.
Nitschke. Funding: Internal Resources; Duration: 07/2014 – ongoing)
56
GRUNDLAGEN UND INTERVENTIONEN VON ESSSTÖRUNGEN UND ASSOZIIERTEN STÖRUNGEN/EATING DISORDERS
Professur „Grundlagen und Interventionen von Essstörungen und assoziierten
Störungen“ und Ambulanz und Tagesklinik für Essstörungen
Prof. Dr. Corinna Jacobi, Dipl.-Psych.
und Psychotherapie
Tel. +49 (351) 46 33 85 76; Fax: +49 (351) 46 33 72 08
E-Mail: corinna.jacobi@tu-dresden.de
Mitglieder der Arbeitsgruppe
Dr. Ina Beintner; Tel. +49 (351) 46 33 74 60
ina.beintner@tu-dresden.de
Dipl.-Psych. Paula von Bloh; Tel. +49 (351) 46 33 85 70
paula.von_bloh@tu-dresden.de
M.Sc. Nadine Eiterich; Tel. +49 (351) 46 -338573
nadine.eitrich@tu-dresden.de
Dipl.-Psych. Martin Paul; Tel. +49 (351) 46 33 85 78
martin.paul@tu-dresden.de
Sekretariat
Anne Biedermann; Tel. +49 (351) 46 33 74 69
anne.biedermann@tu-dresden.de
Therapeutische Leitung des Behandlungsschwerpunkts Essstörungen an der IAP-TUD
Dipl.-Psych. Katja Hergesell; Tel. +49 (351) 46 33 69 34
Hohe Str. 53; 01187 Dresden
hergesell@psychologie.tu-dresden.de
Die Professur „Grundlagen und Interventionen bei Essstörungen und assoziierten Störungen“ wurde 2004 als
Stiftungsprofessur erstmals neu eingerichtet (Stifter: Ingvild und Stephan Goetz). Die Finanzierung durch die Stifter
wurde zunächst für 5 Jahre gewährt. Im Rahmen eines internationalen Symposiums für Essstörungen wurden im
Oktober 2008 die wesentlichen Projekte und die Ergebnisse der Evaluation des tagesklinischen Konzepts vorgestellt. Die Stifter erklärten sich im Anschluss daran bereit, die Professur für weitere 3 Jahre (bis 2012) zu fördern.
Seit diesem Zeitpunkt wird die Professur nun aus Mitteln des Landes und der Technischen Universität Dresden
finanziert.
Mit der Professur verbunden ist die Leitung einer tagesklinischen Modelleinrichtung (im folgenden kurz
Tagesklinik genannt) für Essstörungen (Anorexia nervosa, Bulimia nervosa, Binge-Eating-Störung und andere nicht näher bezeichnete Essstörungen), die Etablierung eines ambulanten Behandlungsschwerpunkts für
Essstörungen sowie der Aufbau eines Forschungsprogramms, das sowohl Grundlagenforschung wie auch
Interventionsforschung umfasst.
Forschungsschwerpunkte
Risikofaktoren psychischer Störungen
• Anwendung und Prüfung theoretischer Modelle zu Risikofaktoren psychischer Störungen. Weiterentwicklung
einer Taxonomie zu Risikofaktoren
• Identifikation von Risikofaktoren für Essstörungen und ihrer Interaktionen im Längsschnitt
• Zusammenhänge zwischen Risikofaktoren für gestörtes Essverhalten bzw. Essstörungen und Suchtverhalten
bzw. Suchterkrankungen
57
Psychotherapieforschung und Prävention
• Therapieforschung bei Essstörungen: Vergleich psychotherapeutischer, pharmakologischer und kombinierter
Behandlungsansätze bei Bulimia nervosa
• Entwicklung und Evaluation tagesklinischer Behandlung für Essstörungen
• Adaptation und Evaluation eines Internet-gestützten Präventionsprogramms „Student Bodies“ für junge
Mädchen und Frauen mit erhöhtem Risiko für Essstörungen
• Evaluation eines Internet-gestützten Programms zur Prävention von Essstörungen und affektiven Störungen
• Entwicklung und Evaluation eines Internet-gestützten Rückfallprophylaxe-Moduls für Patientinnen mit
Essstörungen im Anschluss an ambulante und/oder stationäre Behandlung
• Internet-gestützte Früherkennung und Prävention von Anorexia nervosa bei jungen Mädchen und Frauen
• Moderatoren und Mediatoren von Psychotherapie bei Essstörungen
• Erarbeitung wissenschaftlich gestützter Behandlungsleitlinien für Essstörungen
Grundlagenforschung und Diagnostik bei Essstörungen
• Körperschemastörungen bei Männern
• Häufigkeit von Essstörungssyndromen und Symptomen im Kindesalter
• Zusammenhang zwischen Auffälligkeiten des Essverhaltens im Kindesalter und anderen psychischen
Auffälligkeiten
• Zusammenhang zwischen elterlichen Essstörungen und kindlichen Auffälligkeiten des Essverhaltens
• Wählerisches Essen bei Kindern, Zusammenhang mit anderen psychischen Störungen und
Beeinträchtigungen des Geruchs- und Geschmackssinns
• Entwicklung eines Screening-Instruments für Frauen mit erhöhtem Risiko für Essstörungen
Internet-gestützte Interventionen
• Entwicklung und Weiterentwicklung Internet-gestützter Interventionen im Bereich der Gesundheitsförderung
und Therapie
• Spezifische Aspekte Internet-gestützter Interventionen (z.B. Moderatoren, Mediatoren (incl. Adhärenz))
Schwerpunkte in der Lehre
Klinische Psychologie (Störungsbilder, Interventionsverfahren), Psychotherapieforschung, Klinische Diagnostik
(Problemanalyse, strukturierte Diagnostik anhand des DSM-IV/V), Klinische Intervention (Verhaltenstherapeutische
Verfahren; Interventionspraktikum), Teilaspekte der Gesundheitspsychologie (Risikofaktoren, Prävention)
Aktuelle Entwicklungen in der Forschung
Innerhalb der letzten beiden Jahre wurden zwei randomisierte kontrollierte Studien zur Überprüfung der Wirksamkeit Internet-gestützter Präventions- und Nachsorgeangebote durchgeführt. Von der Schweizerischen Anorexia
nervosa Stiftung (SANS) wurde die Evaluation eines Programmes zur Internet-gestützten Früherkennung und
-intervention bei jungen Mädchen zwischen 11 und 17 Jahren gefördert. Das Programm baut ursprünglich auf familiengestützten Interventionsansätzen bei bereits erkrankten Patientinnen auf und richtet sich nun an die Eltern der
jungen Mädchen mit ausgewählten Risikomerkmalen für Anorexia nervosa. Die Datenerhebung für diese Studie
wurde Ende Mai 2014 abgeschlossen. Im Rahmen des BMBF-Förderschwerpunkts „Forschungsverbünde zur
Psychotherapie“ wurde das Teilprojekt: „Internet-gestützte Nachsorge für Patientinnen mit Bulimia nervosa“ abgeschlossen. Im Forschungsverbund „Eating Disorders Diagnostic and Treatment Netword (EDNET)“ untersuchen
wir zusätzlich Mediatoren und Moderatoren von Behandlungsoutcomes im Rahmen von Psychotherapiestudien bei
Essstörungen.
Eine laufende randomisierte kontrollierte Studie, die von der Else Kröner-Fresenius-Stiftung gefördert wird,
soll Aufschluss über die Wirksamkeit Internet-gestützter Prävention für junge Frauen mit erhöhtem Risiko für
die Entwicklung einer Anorexia nervosa geben. Im Bereich der Grundlagenforschung führen wir (gemeinsam
mit Prof. Dr. Hans-Ulrich Wittchen) innerhalb des Forschungsverbunds „The Integrated Neurobiology of Food
Intake, Addiction and Stress (NeuroFAST)“ ein Teilprojekt fort, das die Zusammenhänge bzw. Unterschiede von
Suchterkrankungen und (gestörtem) Essverhalten genauer untersucht.
58
Behandlungsschwerpunkt Essstörungen an der IAP-TUD
Essstörungen (Anorexia nervosa, Bulimia nervosa, Binge-Eating-Störung) sind außerordentlich schwerwiegende
Störungen, die ohne Behandlung oftmals einen ungünstigen Verlauf nehmen können und eine hohe Mortalitätsrate
aufweisen. Die Störungen entstehen meist in der Adoleszenz und betreffen weit überwiegend Frauen.
Verbunden sind sie in der Regel mit vielfältigen medizinischen Komplikationen als Folge der dauerhaften
Mangelernährung und der spezifischen Symptome (z.B. Erbrechen, Laxantienabusus etc.) sowie mit anderen psychischen Störungen (z.B. depressive Störungen, Angststörungen, Abhängigkeitserkrankungen). Belastungen im sozialen Umfeld (Familie, Partnerschaft) kommen häufig als Folge hinzu.
Der Behandlungsschwerpunkt Essstörungen ist im Rahmen der Institutsambulanz und Tagesklinik der TU Dresden,
Institut für Klinische Psychologie und Psychotherapie (Träger: IAP-TUD GmbH) etabliert. Bundesweit bestehen
intensive Kontakte zu den führenden Einrichtungen in der Behandlung von Essstörungen (z. B. Prof. Dr. Fichter,
Prof. Dr. Martina de Zwaan, Prof. Dr. Herpertz-Dahlmann). Weiterhin bestehen internationale Kooperationen mit
Zentren in London, (Prof. J. Treasure, Prof. U. Schmidt), Stanford, USA (Prof. W. Stewart Agras, Prof. C. Barr Taylor,
Prof. James Lock).
Behandelt werden Patientinnen mit der Erstdiagnose einer Essstörung (Anorexia nervosa, Bulimia nervosa, BingeEating-Störung) sowie Patientinnen ohne Hauptdiagnose einer Essstörung (z. B. Angsterkrankungen, Depression)
mit sekundärer Problematik im Bereich des Essverhaltens und Gewichts ab 16 Jahren. Ausgeschlossen sind
Patientinnen mit massivem Untergewicht (BMI < 14.5), Alkohol- und/oder Drogenabhängigkeit, Psychosen und
schweren anderen psychischen Störungen mit Selbstgefährdung. Die Behandlung erfolgt orientiert an evidenzbasierten kognitiv-verhaltenstherapeutischen Konzepten.
Das Behandlungskonzept hat folgende Ziele und Schwerpunkte
1. Schaffung günstiger motivationaler Voraussetzungen für Veränderungen
2. Normalisierung von Essverhalten und Gewicht, ggf. Gewichtszunahme oder Gewichtsstabilisierung
3. Verbesserung von Körperwahrnehmung und Förderung von Körperakzeptanz
4. Bearbeitung der individuell zugrunde liegenden oder assoziierten Problembereiche (z.B. niedriges
Selbstwertgefühl, mangelnde Stresstoleranz, eingeschränkte soziale Kompetenzen etc.) bzw. Nachholen von
Entwicklungsdefiziten (z.B. Ablösung, Verbesserung selbständiger Lebensführung).
Die Behandlung findet in enger fachlicher und praktischer Kooperation mit ausgewählten niedergelassenen
Fachärzten für Allgemeinmedizin, Innere Medizin, Psychiatrie bzw. Kinder- und Jugendlichenpsychiatrie, Kinderärzten und ausgewählten psychiatrischen und psychosomatischen Kliniken statt. Die Patientinnen haben die
Möglichkeit zusätzlich zu den psychotherapeutischen Einzelsitzungen eine störungsspezifische Ernährungstherapie
in Anspruch zu nehmen.
59
SUCHTFORSCHUNG/ADDICTION RESEARCH
Professur für Suchtforschung
Prof. Dr. Gerhard Bühringer
Professur für Suchtforschung Institut für Klinische Psychologie
und Psychotherapie Technische Universität Dresden
Chemnitzer Straße 46
01187 Dresden
Tel.: +49 (351) 46 33 98 28; Fax: +49 (351) 46 33 98 30
gerhard.buehringer@tu-dresden.de
Sekretariat
Heike Vogler
Tel.: +49 (351) 46 33 98 27; Fax: +49 (351) 46 33 98 30
heike.vogler@tu-dresden.de
Angebote:
Allgemeine Beratung und Raucherentwöhnung
Tel. +49 (351) 46 33 98
Alkohol, Cannabis
Tel. +49 (351) 46 33 69 57 (IAP-TUD)
Glücksspielen
Tel. +49 (351) 46 33 98 65
Spezialambulanz für Alkohol, Cannabis, pathologisches
Glücksspielen & Raucherentwöhnung
Tel.: +49 (351) 46 33 98 37
spielerambulanz@psychologie.tu-dresden.de (Glücksspielen)
pixa@psychologie.tu-dresden.de (allgemein)
Flugmedizinisches Zentrum (AeMC)
(Teil ORA ME.B055/060); Leiter: Prof. Dr. Gerhard Bühringer
European Graduate School in Addiction Research (ESADD)
Dr. Sarah Forberger
Tel.: +49 (351) 46 33 52 88; Fax: +49 (351) 46 33 58 30
sarah.forberger@tu-dresden.de
Forschungsmitarbeiterinnen und –mitarbeiter
Dr. Silke Behrendt (Leitung)
Tel.: +49 (351) 463-39860
silke.behrendt@tu-dresden.de
Dr. Sarah Forberger
Tel.: +49 (351) 46 33 52 88
sarah.forberger@tu-dresden.de
Dipl.-Psych. Anne Kohlmann
Tel.: +49 (351) 46 33 98 26
anne.kohlmann@mailbox.tu-dresden.de
Dr. Anja Kräplin
Tel.: +49 (351) 46 33 98 48
anja.kraeplin@tu-dresden.de
Dipl.-Psych. Maria Neumann
Tel.: +49 (351) 46 33 85 79
maria.neumann@tu-dresden.de
Dipl.-Psych. Sören Paul
Tel.: +49 (351) 46 33 69 90
soeren.paul@tu-dresden.de
Dipl.-Psych. Charlotte Probst
Tel.: +49 (351) 46 33 87 02
charlotte.probst@tu-dresden.de
Dipl.-Psych. Lucie Scholl
Tel.: +49 (351) 46 33 69 90
lucie.scholl@tu-dresden.de
Externe Doktoranden
Dipl.-Psych. André Schmidt (Glücksspielen)
Dipl.-Psych. Eva Maria Zenses (Computerspielen)
Dipl.-Psych. Anja Hildebrandt (PTBS und Sucht)
Die Professur für Suchtforschung wurde als Stiftungsprofessur des Bundesministeriums für Bildung und Forschung und des Freistaates Sachsen im Rahmen des Suchtforschungsverbundes Sachsen/Bayern ASAT 2005 eingerichtet. Sie ist die einzige Professur dieser Art in Deutschland für das Fachgebiet Psychologie. Im Frühjahr 2012
hat die Universitätsleitung der TUD in Abstimmung mit der Fachrichtung Psychologie beschlossen, die ursprünglich
befristet eingerichtete Stiftungsprofessur zu verstetigen. In den ersten Jahren der Professur erfolgte der Aufbau der
notwendigen Infrastruktur mit einem umfangreichen Lehrangebot und einer Spezialambulanz für Substanzstörungen
sowie die Entwicklung eines Forschungskonzeptes einschließlich der Beantragung von Drittmitteln.
Lehrangebot
Vor dem Hintergrund der hohen individuellen und gesellschaftlichen Belastung durch Substanzstörungen und pathologisches Glücksspielen einerseits und der erheblichen bundesweiten Defizite in der universitären Lehre zu diesen
Themen ist es das Ziel an der TU Dresden exemplarisch ein curricular abgestimmtes Lehrangebot bereitzuhalten.
60
Lehrangebot im Master-Studium
Sommersemester
• Einführung in die Substanzstörungen
• Pathologisches Glücksspielen und
vergleichbare Störungen
• Erforschung der gesellschaftlichen
Auswirkungen des Alkoholkonsums
• Modulare Therapie von Cannabisstörungen
Wintersemester
•
•
•
•
Einführung in die Substanzstörungen
Tabakkonsum und –störungen
Erforschung der gesellschaftlichen
Auswirkungen des Alkoholkonsums
Gesprächsführung
Es soll durch die enge Anbindung an Forschungsvorhaben wissenschaftlich fundiert sein und gleichzeitig durch die
Einbeziehung von Patienten aus der Spezialambulanz die ungelösten Forschungsfragen verständlich machen.
Für Doktoranden mit Themen aus der Suchtforschung wird aus Mitteln der Volkswagenstiftung eine zweijährige
Graduate School für Teilnehmer aus ganz Europa angeboten (European Graduate School in Addiction Research,
ESAAD). Infformationen siehe:
http://www.di-uni.de und
http://tudresden.de/die_tu_dresden/fakultaeten/fakultaet_mathematik_und_naturwissenschaften/fachrichtung_psychologie/i2/suchtforschung
Postgraduales Lehrangebot für Doktoranden aus dem Bereich der Suchtforschung
• Teilnehmer: Doktoranden der Psychologie und Medizin und verwandter Fächer aus einem
europäischen Staat mit einem Dissertationsthema aus der Suchtforschung
• Dauer: 2 Jahre
• 6 einwöchige Seminare in Dresden (4), Amsterdam (1) und Barcelona (1)
• Umfangreiche Hausaufgaben zwischen den Seminaren
• Intranet für die Teilnehmer für den Gedankenaustausch und die Besprechung gemeinsamer Aufgaben
2. Spezialambulanz
Für die Durchführung der Forschungsvorhaben und zur Unterstützung der Lehre betreibt die Professur eine
Spezialambulanz für Alkohol, Cannabis, Tabak sowie pathologisches Glücksspielen. Die Raucherentwöhnung ist eine
gemeinsame Initiative der Professur für Suchtforschung, der Arbeitsgruppe „Systemische Neurowissenschaften“
(Prof. Michael Smolka) und der Sächsischen Landesstelle gegen die Suchtgefahren e.V. (SLS). Die Spezialambulanz
ist Teil der Institutsambulanz und Tagesklinik für Psychotherapie (IAP-TUD GmbH; Leitung Prof. Jürgen Hoyer).
3. Flugmedizinisches Zentrum (AeMC)
Gemäß Teil-ORA Zertifizierung werden im Auftrag zuständiger Behörden Untersuchungen und Gutachten zur Zuverlässigkeit und Tauglichkeit von fliegendem Personal für die Bereiche MED.B.055 (Psychiatrie) und MED.B.060
(Psychologie) mit Schwerpunkt Substanzstörungen durchgeführt.
4. Forschung
Übergeordnete Forschungsthemen sind erstens die Beschreibung und Analyse von Prozessen und Faktoren
(Mediatoren und Moderatoren) im Zusammenhang mit Beginn, Verlauf, Reduzierung und Beendigung des
Gebrauchs psychotroper Substanzen, des Glücksspielens und des Internetgebrauchs sowie der damit verbundenen
Störungen. Insbesondere geht es dabei um Analysen von Gemeinsamkeiten und Unterschieden bei den ätiopathologischen Prozessen und bei den Störungsbildern zwischen Substanzstörungen und „substanzungebundenen“
Störungen. Von besonderem Interesse sind dabei individuelle Risikoprofile, die zur Erklärung beitragen können,
warum nur ein Teil der Substanzkonsumenten bzw. Nutzer von Glücksspielen Störungen entwickelt, und der überwiegende Teil nicht, gegeben die grundsätzlich gleiche Exposition gegenüber psychotropen Substanzen, Internet
und Glückspielangeboten. Zweites übergeordnetes Thema ist die Erforschung von Interventionen zur Reduzierung
abhängigen Verhaltens, sowohl auf der individuellen (Therapie) als auch auf der gesellschaftlichen Ebene
(Gesundheitspolitik, Besteuerung). Die einzelnen Forschungsarbeiten lassen sich dabei vier Themenbereichen
zuordnen (Abb. 1).
61
Entwicklung abhängigen Verhaltens
1. Ätiologie und Verlauf
von Substanzstörungen
und Pathologischem
Glücksspielen
2. Störungen der kognitiven Kontrolle und des
Lernens bei abhängigem
Verhalten
Modifikation abhängigen Verhaltens
3. Entwicklung und
Evaluation von therapeutischen Programmen und
Versorgungssystemen
4. Analyse gesellschaftlicher Einflussfaktoren und Interventionsstrategien für den Bereich
abhängigen Verhaltens
Abb 1: Themenbereiche der Suchtforschung
Suchtforschung wird als Schnittstelle zahlreicher wissenschaftlicher Einzeldisziplinen verstanden. Die Untersuchungen und Forschungsprogramme werden deshalb in enger Kooperation mit Fachkollegen an der TU Dresden
wie Prof. Wittchen (Klinische Psychologie, Epidemiologie, Versorgungsforschung), Prof. Rehm (Gesellschaftliche
Einflussfaktoren), Prof. Goschke (Allgemeine Psychologie, Kognitive Kontrollstörungen), Prof. Brocke/Prof. Strobel
(Beeinflussung von Craving-Prozessen), Prof. Smolka (Raucherentwöhnung) und Prof. Heinz (Charité Berlin; gestörte
Lernprozesse) bzw. in nationalen oder europäischen Arbeitsgruppen durchgeführt. Innerhalb des Instituts für
Klinische Psychologie und Psychotherapie werden die verschiedenen Projekte in einer eigenen Arbeitsgruppe koordiniert (siehe AG 6; dort werden die im Folgenden nur kurz genannten Forschungsprojekte ausführlich dargestellt).
Forschungsbereich 1: Epidemiologische Studien zur Ätiologie von Substanzgebrauch, Glücksspielen und
entsprechenden Störungen
Hier erforscht die Arbeitsgruppe die Risikofaktoren und den Verlauf von Substanzkonsum und –störungen bei
Adoleszenten und jungen Erwachsenen für verschiedene Substanzen anhand der Daten der epidemiologischen
prospektiv-longitudinalen EDSP-Studie. In Projekt 2 werden anhand qualitativer Interviews mit Spielern aus der
Allgemeinbevölkerung erste Hypothesen für die spätere Durchführung epidemiologischer Studien zur Identifikation
von Risikofaktoren und Korrelaten von pathologischem Glücksspiel gewonnen.
Projekt 1. Onset and course of substance use and substance use disorders (Pl: Prof. Dr. Hans-Ulrich Wittchen).
Staff: Dr. S. Behrendt. Funding: BMBF Suchtforschungsverbund ASAT. Duration: 11/2004 - 03/2009 (BMBFFunding), ongoing data analyses
Projekt 2. Relevance of the psychosocial network for the development of pathological gambling (pilot study)
(PI: Prof. Dr. Gerhard Bühringer). Staff: Dipl.-Psych. M. Neumann, Dipl.-Psych. A. Pixa. Duration: 01/2011 – 12/2014.
Funding: bwin party services (unrestricted grant)
Forschungsbereich 2: Störungen der kognitiven Kontrolle und des Lernens als zentrale aetiopathologische
Faktoren für die Entwicklung abhängigen Verhaltens
Trotz zahlreicher neuer Erkenntnisse in der Erforschung von Substanzstörungen werden die genauen Vermittlungsmechanismen, die dem Übergang vom gelegentlichen Substanzkonsum in eine Abhängigkeit oder dem Rückfall
nach erfolgreichem Entzug zu Grunde liegen, nach wie vor unzureichend verstanden. Im Vordergrund dieses
Forschungsbereichs stehen zwei mögliche sich ergänzende Vermittlungsmechanismen: Zum einen beschäftigen
sich die Projekte 3 bis 5 mit Beeinträchtigungen kognitiver Kontrollfunktionen (z.B. Inhibition habitueller Reaktionen)
und Prozessen der Konfliktüberwachung, die einhergehen mit einer mangelnden Ausrichtung des Verhaltens an
langfristigen Zielen und einer reduzierten Fähigkeit, habituelle oder impulsive Reaktionen auf substanzassoziierte
Reize zu unterdrücken. Zum anderen geht es im Projekt 6 um veränderte belohnungsassoziierte Lernprozesse,
die ein zunehmendes Verlangen nach der Substanz trotz negativer Konsequenzen und eine verringerte Belohnung
durch andere Stimuli bedingen.
62
Projekt 3. Impulsivity and cognitive control in pathological gambling (PI: Prof. Dr. Gerhard Bühringer, Prof. Dr.
Thomas Goschke). Staff: Dipl.-Psych. A. Kräplin. Duration: 02/2009 - 12/2011, ongoing data analyses
Projekt 4. Addiction as disorder of volition: Impaired cognitive control functions in nicotine dependence and
pathological gambling (PI: Prof. Dr. Thomas Goschke, Prof. Dr. Gerhard Bühringer). Staff: Dipl.-Psych. A. Kräplin,
Dr. R. Mayer. Duration: 04/2011 - 03/2014 ongoing data analysis. Funding: Deutsche Forschungsgemeinschaft (DFG)
Projekt 5. Volitional dysfunction in self-control failures and addictive behaviors (Pl: Prof. Dr. Gerhard
Bühringer, Prof. Dr. Thomas Goschke, Prof. Dr. Michael Smolka, Prof. Dr. Hans-Ulrich Wittchen). Staff: Dipl.-Psych.
A. Kräplin, Dr. K.-M. Krönke, Dipl.-Psych. M. Wolff, Dr. S. Behrendt. Funding: Deutsche Forschungsgemeinschaft
(DFG), Collaborative Research Centre (CRC) 940; Laufzeit: 07/2012 – 06/2016
Projekt 6. Learning and habitization as predictors of the development and maintenance of alcoholism. Z-Projekt: Coordination and administration (Pl: Prof. Dr. Hans-Ulrich Wittchen, Prof. Dr. Andreas
Heinz, Co-PI: Prof. Dr. Gerhard Bühringer); Staff: Dipl.-Psych. S. Paul, Dipl.-Psych. L. Scholl. Funding: Deutsche
Forschungsgemeinschaft (DFG), Research Group FOR 1617; Duration: 04/2012 - 05/2015
Projekt 7. Complex time-based prospective memory in DSM-V tobacco use disorder (PI: Dr. Silke Behrendt).
Duration: 04/2012 - 01/2013, ongoing data analyses. Funding: Project initiation grant by the Department of
Psychology at Technische Universität Dresden
Forschungsbereich 3: Entwicklung und Evaluation therapeutischer Programme und therapeutischer
Versorgungssysteme
Die Arbeitsgruppe widmet sich der Entwicklung neuer Behandlungsprogramme, wie z.B. des manualisierten Behandlungsprogrammes „Elderly“ für die psychotherapeutische Behandlung von Alkoholstörungen bei
Senioren. Des Weiteren untersucht die Arbeitsgruppe die Implementierung neuer Behandlungsansätze in der
Routineversorgung und beteiligt sich an der Erarbeitung der Richtlinien zur Verbesserung der Versorgung von
Personen mit Substanzstörungen. In Projekt 10 werden der Behandlungserfolg von Substitutionsbehandlung für
Menschen mit Opiatabhängigkeit und dessen Prädiktoren erforscht.
Projekt 8. Efficacy of a targeted cognitive-behavioral treatment program for cannabis use disorders (CANDIS
I) (PI: Dr. Eva Hoch, Prof. Dr. Hans-Ulrich Wittchen, Prof. Dr. Gerhard Bühringer). Staff: Dip.-Psych. J. Henker,
Dipl.-Psych. A. Pixa, Dipl.-Psych. R. Noack, Dipl.-Psych. H. Rohrbacher. Funding: Federal Ministry for Education and
Research (BMBF). Duration: 11/2004 – 10/2007, ongoing data analyses
Projekt 9. Implementation of the program „CANDIS – targeted treatment for cannabis disorders“ in German
outpatient treatment facilities (CANDIS II) (Pl: Dr. Eva Hoch, Co-PI: Prof. Dr. H.-U. Wittchen, Prof. Dr. G.
Bühringer). Staff: Dipl.-Psych. K. Dittmer, Dipl.-Psych. A. Rühlmann, Dipl.-Psych. A. Pixa. Funding: Federal Ministry
of Health (BMG). Duration: 11/2007 – 11/2009, ongoing data analyses
Projekt 10. PREMOS – Predictors, Moderators and Outcomes of Substitution Treatment for opioid
dependence in Germany (Pl: Prof. Dr. Hans-Ulrich Wittchen, Prof. Dr. Gerhard Bühringer, Prof. Jürgen Rehm).
Staff: Dipl.-Psych. A. Träder, Dipl.-Psych. L. Revollar Paredes, Dipl.-Psych. K. Mark, Dipl.-Math. J. Siegert. Funding:
Federal Ministry of Health (BMG). Duration: 11/2007 – 10/2010, ongoing data analyses
Projekt 11. Treatment of substance use disorders in outpatient psychotherapy (PI: Dr. Silke Behrendt).
Funding: internal resources.Duration: 01/2012 - 12/2012
Projekt 12. Project Elderly: Motivational Enhancement Therapy and Community Reinforcement Approach
For Treating Alcohol Problems in the Elderly – an international multicenter study (PI: Prof. Dr. Gerhard
Bühringer, Dr. Silke Behrendt (site coordinator Dresden). Staff: Dipl.-Psych. A. Kohlmann. Funding: Lundbeck.
Duration: 01/2013 - 12/2017
63
Forschungsbereich 4: Analyse der gesellschaftlichen Einflüsse und Interventionsstrategien für den Bereich
abhängigen Verhaltens
Die Projekte aus dem Forschungsverbund ALICE-RAP erforschen wissenschaftliche Konzepte von
Substanzstörungen mit dem Ziel der Entwicklung fachübergreifender integrativer Modelle als Grundlage für eine in
der Zukunft stärker evidenzbasierte Gesundheitspolitik.
Projekt 13. – 18. Addictions and Lifestyles In Contemporary Europe - Reframing Addictions Project (ALICERAP) (PI: Prof. Dr. Jürgen Rehm, Prof. Dr. Gerhard Bühringer). Staff: Dr. S. Forberger, M.A., Dipl.-Psych. M.
Neumann, Dipl.-Psych. Ch. Probst. Funding: European Commission. Duration: 04/2011 – 03/2016
Forschungskooperation mit dem IFT (Institut für Therapieforschung), München
Mit dem IFT, das sich auf anwendungsnahe Forschung im Suchtbereich spezialisiert hat, besteht in verschiedenen Bereichen eine enge Zusammenarbeit. Dazu gehört neben der epidemiologischen Forschung das pathologische Glücksspielen (PD Dr. Ludwig Kraus) und die Raucherentwöhnung (Dr. Christoph Kröger). Zu beiden
Störungsbereichen sind die beteiligten Wissenschaftler umfassend in allen Gebieten tätig, von der ätiologischen
Grundlagenforschung bis zur Versorgungssystemforschung und zu Public Health Fragestellungen.
Transfer von wissenschaftlichen Erkenntnissen in die Praxis und Gesundheitspolitik
Die Unterstützung bei der Nutzung von wissenschaftlichen Erkenntnissen hat einen hohen Stellenwert. Dies
wird verwirklicht durch die Beratung von Abgeordneten, Behörden und Verbänden, durch Stellungnahmen zu
Gesetzesentwürfen, durch die Mitwirkung an der Entwicklung fachlicher Leitlinien sowie durch zahlreiche Vorträge
zu praxisrelevanten Themen.
64
EPIDEMIOLOGICAL RESEARCH UNIT
Epidemiological Research Unit
Prof. Dr. Jürgen Rehm
und Psychotherapie
Tel.: +49 (351) 46 33 98 27
Fax: +49 (351) 46 33 98 30
jtrehm@googlemail.com
Prof. Dr. Jürgen Rehm
Centre for Addictions and Mental Health (CAMH)
Director, Social and Epidemiological
Research Department
Senior Scientist and Head of Group
Population Health Research
33 Russell Street; Toronto, Ontario, Canada, M5S 2S1
Tel: ++1 416 535 8501 ext. 6173
Fax: ++ 1 416 595 6033
e-mail: Jurgen_Rehm@camh.net
Externe Doktoranden
Dipl.-Psych. Charlotte Probst
Dipl.-Psych. Jakob Manthey
Aufbau der Epidemiological Research Unit und Entwicklungen in den letzten Jahren
Die Arbeitsgruppe war in den letzten Jahren sehr erfolgreich in der Einwerbung von Drittmittel vor allem aus
Programmen der EU (FP7 & Public Health calls) und der Pharmaindustrie. In den letzten Jahren wurde Prof. Rehm
unter anderem in die Steering Committees der Großprojekte AMPHORA (Alcohol Public Health Research Alliance
Amphora; http://www.amphoraproject.net/), ALICE-RAP (Addiction and Lifestyles in Contemporary Europe
Reframing Addictions Project; (http://www.alicerap.eu/) und der Studie APC (Alcohol dependence in primary care
in Europe) gewählt. Weiterhin konnte eine Reihe von Masterarbeiten und eine Doktorarbeit abgeschlossen werden.
Zurzeit beantragen wir mehrere Projekte im Rahmen von EU Programmlinie Horizon 2020.
1. Lehrangebot
Die Arbeitsgruppe und Prof. Rehm bereichert das Curriculum des Institutes für Klinische Psychologie und vor allem der
Professur für Suchtforschung um folgende Lehrveranstaltung pro Semester, die im flexiblen Turnus angeboten werden:
- Problemkonsum von Alkohol und Mortalität – Wie erstelle ich eine Metaanalyse
- Gesellschaftliche Belastungen durch Substanzstörungen am Beispiel der Alkoholabhängigkeit
- Einführung in die Substanzstörungen
Zusätzlich übernimmt Prof. Rehm zwei Wochenmodule im Rahmen der European Graduate School in Addiction
Research (ESADD) zum Thema Epidemiology and its consequences: Individual and social burden measurement und
Public Health and Public Policy. für mehr Informationen siehe http://www.di-uni.de und http://tudresden.de/die_tu_
dresden/fakultaeten/fakultaet_mathematik_und_naturwissenschaften/fachrichtung_psychologie/i2/suchtforschung
2. Forschung
Die Arbeitsgruppe hat in den vergangenen Jahren maßgeblich zum Bereich der Suchtforschung beigetragen, und
Prof. Rehm wurde von Thomson Reuters 2014 zum most highly cited researcher gewählt. Er gehörte in den letzten
Jahren konstant zu den 1% der einflussreichsten Forscher im Bereich Sozialwissenschaft und Epidemiologie. Zu
den Schwerpunkten in den letzten Monaten gehörten:
• Entwicklung der Algorithmen für die Quantifizierung des Einflusses von Risikofaktoren auf Mortalität und
Krankheitslast
• Revidierung der Quantifizierung alkoholbedingter Mortalität und Krankheitslast für die WHO
• Weiterentwicklung des Suchtkonzepts und empirische Untersuchungen zu Alkoholabhängigkeit in sechs
europäischen Ländern (Forschungsmittel: € 1.8 Millionen; Förderer: Lundbeck)
• Der Einfluss von sozialer Schicht auf Risikofaktoren und Krankheit
65
VERANSTALTUNGSREIHEN, KONGRESSE UND PREISE/EXHIBITIONS, CONGRESS AND PRIZES
Veranstaltungsreihen,
Kongresse und Preise
Exhibitions,
Congress and Prizes
67
Veranstaltungsreihe: „Innensichten – Über Krankheiten der Seele“
in Kooperation mit dem Deutschen Hygienemuseum
und der Sächsischen Landesärztekammer
09.01.2014 – 05.03.2014
Wissenschaftliche Forschung ist immens wichtig, aber wie bringt man deren Ergebnisse einem großen Publikum
näher und wirbt gleichzeitig für ein besseres Verständnis psychischer Störungen?
Unter der Koordination und Konzeption von Frau Dipl.-Psych. Gesine Wieder in Kooperation mit dem Deutschen
Hygienemuseum und der Sächsischen Landesärztekammer nahm im Januar 2014 eine Veranstaltungsreihe ihren
Beginn, die u.a. diese Ziele verfolgte. In der Auftaktveranstaltung mit dem Titel „Werden wir alle verrückt?“ führte
Herr Prof. Hans-Ulrich Wittchen zusammen mit Herrn Prof. Thomas Bock des Universitätsklinikums HamburgEppendorf in das Thema psychische Störungen ein, indem sie einen Überblick über Häufigkeit, Entwicklung und
Erklärungsansätze psychischer Störungen sowie deren soziale Dimensionen und Auswirkungen gaben.
In den wöchentlichen Folgevorträgen kamen Betroffene
zu Wort, die ihre Erfahrungen mit der Diagnose einer
psychischen Erkrankung künstlerisch verarbeiteten.
Diese Kunstwerke – u.a. Bücher und Filme, Bilder, Vlogs
– wurden vorgestellt und das Gespräch mit spezialisierten Experten und Praktikern gesucht, um die individuellen Erfahrungen auch auf einer wissenschaftlichen
Basis reflektieren zu können. In den Vortragsthemen
spiegelte sich die ganze Bandbreite psychischer
Störungen wider. So gab es Veranstaltungen zu den
Themen Schizophrenie, Bipolare Störung, Depression,
Autismus und Essstörungen. Die Abschlussveranstaltung
und damit auch der Ausblick in die Neuen Medien
wurden von Frau Prof. Dr. Franziska Einsle zum Thema
Angststörungen und deren Verarbeitung mittels Nutzung
des Internets gestaltet. Bis zu 300 Besucher kamen, um
sich die künstlerischen Vorträge anzuhören. Im Publikum
fanden sich Betroffene, Angehörige, Praktiker und viele
weitere am Thema interessierte Menschen. Die zum
Nachdenken und Reflektieren anregenden Beiträge der
Redner, die mit Anekdoten und teils sehr persönlichen
Erfahrungen gespickt waren, trugen wesentlich dazu bei,
dass die Veranstaltungsreihe von den Besuchern sehr
positiv aufgenommen wurde. Lebendig wurde sie, da
viele Besucher rege diskutierten und von eigenen persönlichen Erlebnissen erzählten.
Aufgrund des großen Erfolgs ist es geplant, diese
Veranstaltungsreihe aller 2 Jahre in Kooperation mit dem
Deutschen Hygienemuseum fortzuführen.
69
Veranstaltungsreihe: „Bühlerkolloquium“ der Fachrichtung Psychologie
16.04.2014 – 25.07.2014
Im Sommersemester 2013 organisierte Prof. Dr. Hans-Ulrich Wittchen, Direktor des Instituts für Klinische
Psychologie und Psychotherapie an der TU Dresden das traditionelle Bühlerkolloquium der Fachrichtung Psychologie. Benannt ist das Kolloquium nach Charlotte und Karl Bühler, zwei der bedeutendsten deutschsprachigen
Psychologen des vergangenen Jahrhunderts aus den Bereichen der Kinder- und Jugendpsychologie sowie
Denk- und Sprachpsychologie, die beide maßgeblich in Dresden wirkten. Die Veranstaltungen des vergangenen
Sommersemesters zeichneten sich durch ihre vielfältigen Perspektiven auf die gegenwärtige klinisch-psychologische Forschung, ihre anregenden Präsentationen von international renommierten Experten sowie ihren hohen
Andrang aus und waren somit ein voller Erfolg. Im Anschluss an die Präsentationen hatten zudem Vortragende und
Gäste die Möglichkeit, beim nachfolgenden Postkolloquium die besprochenen Themen in geselliger Runde weiter
zu vertiefen und neue Kontakte zu knüpfen oder bestehende zu intensivieren.
Zu den Referenten gehörten Mitarbeiter und Wegbegleiter des Instituts wie Dr. Franziska Einsle oder Prof. Jürgen
Margraf, langjährige Kollaborationspartner wie Prof. Martin Paulus und Prof. Alfons Hamm sowie maßgebliche
Impulsgeber der klinisch-psychologischen Forschung wie Prof. Kurt Hahlweg. Auch thematisch war das Kolloquium
sehr breit aufgestellt: Von experimentellen Ansätzen zur Erforschung grundlegender Verhaltensparameter (Dr.
Sanne de Wit) über die bio- und neurobiologischen Grundlagen von Angststörungen (Prof. Christoph Mulert & Prof.
Daniel Pine) bis hin zur Erforschung von Markern und Prädiktoren von Therapieerfolg (Dr. Andrea Reinecke) wurde
ein beeindruckend umfangreiches Spektrum an Themen angeboten.
Höhepunkt der Veranstaltungsreihe war die erstmalige Verleihung der Charlotte- und Karl-Bühler-Ehrenmedaille
an Prof. Dr. Heinz Häfner, den Gründungsdirektor und Leiter der Arbeitsgruppe Schizophrenieforschung
des Zentralinstituts für Seelische Gesundheit, im Anschluss an dessen Vortrag „Ein Vierteljahrhundert ABCSchizophreniestudie – eine Auswahl bedeutsamer Ergebnisse“. Professor Häfner wurde bei diesem Anlass insbesondere für seine einflussreichen Arbeiten zur Epidemiologie psychischer Störungen, zur Versorgungs- und Public-HealthForschung sowie für seinen bedeutenden Beitrag für die Therapie und Versorgung psychischer Störungen in Deutschland
insgesamt geehrt. Die Veranstaltung fand am 19. Juni 2013 im Festsaal des Rektorats der TU Dresden statt.
Professor Heinz Häfner und Professor Hans-Ulrich Wittchen bei der feierlichen Übergabe der
Charlotte- und Karl-Bühler-Medaille.
70
VERANSTALTUNGSREIHEN,
KONGRESSE
UND PREISE/EXHIBITIONS,
CONGRESS AND PRIZES
KLINISCHE PSYCHOLOGIE
UND PSYCHOTHERAPIE:
VERANSTALTUNGSREIHEN/EXHIBITIONS
AND CONGRESSES
Veranstaltungsplan des Bühler-Kolloquiums im Sommersemester 2013
Fakultät Mathematik und Naturwissenschaften
Fachrichtung Psychologie
BÜHLERKOLLOQUIUM
Sommersemester 2013
Termin
Organisation: Prof. Dr. Hans-Ulrich Wittchen
Raum
Referent
Titel
Dienstag, 16.04.2013
17:00 Uhr
BZW A
307
Dr. Sanne de Wit,
Klinische Psychologie,
University of Amsterdam
External stimulus control over
instrumental action
(SFB-Lecture)
Mittwoch,
17.04.2013
17:00 Uhr
FAL 103
Prof. Dr. Christoph Mulert,
Klinik und Poliklinik für Psychiatrie und
Psychotherapie, UK Hamburg-Eppendorf
Vom Mapping zu den Mechanismen:
Multimodale Bildgebung mit fMRI, DTI
und EEG (SFB-Lecture)
Mittwoch,
24.04.2013
17:30 Uhr
FAL 103
Prof. Dr. Alfons Hamm
Physiologische und Klinische Psychologie,
Universität Greifswald
Angststörungen und Defense Reactivity
(SFB-Lecture)
FAL 103
Prof. Dr. Martin Paulus,
Department of Psychiatry,
University of California San Diego
Toward individual predictions of
treatment outcomes in anxiety:
application of random forests to
functional magnetic resonance imaging
data (SFB-Lecture)
FAL 103
Prof. em. Dr. Kurt Hahlweg,
Institut für Psychologie,
Technische Universität Braunschweig
Prävention von chronischen
Beziehungskonflikten und Scheidung:
Langfristige Wirksamkeit und
Möglichkeiten der Dissemination”
Mittwoch,
29.05.2013
17:30 Uhr
FAL 103
Prof. Dr. Jürgen Margraf,
Klinische Psychologie und Psychotherapie,
Ruhr-Universität Bochum
Psychologische Therapie der
Angststörungen: Von der
Wirksamkeitsforschung zur Aufklärung
der Mechanismen
Mittwoch,
12.06.2013
17:00 Uhr
FAL 103
Dr. Andrea Reinecke,
Department of Psychiatry,
University of Oxford
Kognitive und neurobiologische Marker
von Psychopathologie und
Behandlungserfolg (SFB-Lecture)
Mittwoch,
19.06.2013
17:00 Uhr
Festsaal
Rektorat
Prof. em. Dr. Dres. h.c. Heinz Häfner,
Psychiatrie und Psychotherapie,
ZI Mannheim
Ein Vierteljahrhundert ABCSchizophreniestudie – eine Auswahl
bedeutsamer Ergebnisse
Mittwoch,
17.07.2013
17:00 Uhr
FAL 103
Dr. Franziska Einsle
Anxiety disorders and hypertension:
patterns, correlates and moderators
FAL 103
Prof. Dr. Daniel Pine,
Development and Affective Neuroscience
Section,
National Institute of Mental Health, Bethesda
The Developmental Neuroscience of
Anxiety: Insights for Novel Therapies /
(SFB-Lecture)
Mittwoch,
08.05.2013
17:00 Uhr
Mittwoch,
15.05.2013
17:00 Uhr
Donnerstag,
25.07.2013
17:00 Uhr
71
Ausblick: Organisation des 9. Workshopkongresses für Klinische Psychologie und Psychotherapie im Mai
2015 an der Technischen Universität Dresden
Die klinische Grundlagenforschung hat in den letzten Jahren eine Fülle von neuen Ansätzen und Erkenntnissen
hervorgebracht, die bislang gar nicht oder unzureichend Eingang in die klinische Praxis gefunden haben. Umgekehrt
ist die Psychotherapie durch viele Ansätze und Verfahren gekennzeichnet, die seitens der wissenschaftlichen
Forschung nicht ausreichend aufgegriffen wurden. Während des 9. Workshopkongresses für Klinische Psychologie
und Psychotherapie und 33. Symposiums der Fachgruppe Klinische Psychologie und Psychotherapie der Deutschen
Gesellschaft für Psychologie vom 14. - 16. Mai 2015 an der Technischen Universität Dresden möchten wir gemeinsam eine kritische Auseinandersetzung zu diesen Fragen stimulieren und Spannungsfelder ansprechen. Ein buntes
Programm aus Workshops, Symposien und Poster aus den Bereichen Grundlagenforschung, Klinische Forschung
– Intervention, Translation, sowie Epidemiologie, und Public Health und Versorgungsforschung, sowie ein breit gefächertes fachliches und soziales Programm erwarten die Gäste.
Wir werden eine anregende Mischung aus anwendungs- und forschungs-bezogenen Aktivitäten planen. Sie sind
herzlich eingeladen, sich aktiv durch Workshops, Symposien, freie Vorträge, Poster sowie durch andere Formate zu
beteiligen und das Spannungsfeld Forschung und Praxis der Klinischen Psychologie und Psychotherapie mit Ihren
eigenen Arbeiten zu beleben – als WorkshopleiterIn, ReferentIn, ZuhörerIn oder DiskutantIn der Beiträge.
72
Preise und Ehrungen
2012, Wien, 14. Tagung der Österreichischen Gesellschaft für Neuropsychopharmakologie und Biologische
Psychiatrie (ÖGPB): Prof. Dr. Hans-Ulrich Wittchen erhielt als Ehrung für sein Lebenswerk die Wagner-JaureggMedaille der ÖGPB.
2012, Wien, 25. Kongress des European College of Neuropsychopharmacology (ECNP): Der Fellowship Award 2012
wurde an Prof. Dr. Katja Beesdo-Baum vergeben.
2012, Wien, 25. Kongress des European College of Neuropsychopharmacology (ECNP): PD Dr. Ulrike Lüken wurde
für ihren Posterbeitrag „What happens in the brain after successful vs. non-successful CBT treatment? A multicenter fMRI study on panic disorder with agoraphobia“ mit einem Award geehrt.
2012, Beijing/China, Annual Meeting of the Organization for Human Brain Mapping: Dr. Markus Mühlhan erhielt
von der „Gesellschaft von Freunden und Förderern der TU Dresden e.V. einen Reisekostenzuschuss in Höhe von
500 € für folgenden Konferenzbeitrag: M. Muehlhan, U. Lueken, H.-U. Wittchen, M. N. Smolka & C. Kirschbaum
(2012). „Sympathetic stress reactions in response to fMRI scanning altered performance and neural activation pattern of interest“.
2014 Nachwuchsförderpreis der DGVT für Dr. S. Härtling
ÖGPB Verleihung Wagner-Jauregg- Medaille
an Prof. H.-U. Wittchen
2013, New York/USA, 103. Annual Convention der American Psychopathological Association: Prof. Dr. Katja
Beesdo-Baum wurde mit dem Travel Award des National Institute on Drug Abuse (NIDA), Division of Epidemiology,
Statistics and Prevention Research (DESPR) für das Paper „Anxiety Disorders as Early Stages of Malignant
Psychopathological Long-Term Outcomes: Results of the 10-years Prospective EDSP Study“ ausgezeichnet.
2013, Studienstiftung des Deutschen Volkes: Dipl.-Psych. Eva Asselmann erhält seit Januar 2013 ein 2jähriges
Promotionsstipendium.
2013 Prof. Dr. Hans-Ulrich Wittchen wurde als Fellow der ECNP ernannt
2013, Hannover, 2. Herrenhausen Conference: Dr. Susanne Knappe erhielt für die Posterpräsentation
“Externalizing disorders and the risk for anxiety disorders in adolescents and young adults” den Travel Award der
VolkswagenStiftung.
2013, Tutzing 14. Wissenschaftlichen Gespräch der DG-Sucht: Dipl.-Psych. Anja Kräplin nahm an der
Klausurtagung zum Thema „Über das Lernen lernen - neue Impulse für die Behandlung von Abhängigkeiten“ teil.
Die Teilnahmegebühr in Höhe von 130 € übernahm die Gesellschaft von Freunden und Förderern der TU Dresden
e.V..
73
2013, TU Dresden: Dipl.-Psych. Ingmar Heinig wurde für seinen ausgezeichneten Studienabschluss die Lohrmann
- Medaille der TU Dresden verliehen.
2014, Deutschen Gesellschaft für Verhaltenstherapie (DGVT): Dr. Samia Härtling erhielt im Rahmen ihrer
Dissertation für ihr „Spezifisches Behandlungskonzept gegen Angst vor dem Erröten“ den Nachwuchsförderpreis.
2014, Hamburg, 16. Jahrestagung der DeGPT: Dipl.-Psych. Judith Schäfer konnte im Rahmen der
Nachwuchsförderung ein Stipendium für die Teilnahme an der Jahrestagung in Anspruch nehmen.
2014, TU Dresden, Maria-Reiche-Förderprogramm für Habilitandinnen und Postdoktorandinnen: Dr. Susanne
Knappe erhielt im Rahmen des Professorinnenprogramms der TU Dresden ein Habilitationsstipendium.
2014, Ulm, 14. EPA Section Meeting: Dr. Susanne Knappe wurde mit dem Travel Award der Graduiertenakademie
der TU Dresden für eine Posterpräsentation zum Thema “Externalizing, anxiety and depressive disorders:
Co-morbidity, prospective associations, correlates and risk factors in youth” unterstützt.
2014, Dubrovnik/Kroatien, 40th Annual Meeting of the International Academy of Sex Research: Für das Poster
„Challenging the stigma towards people with pedophilia among psychotherapists in training“ wurde der Best
Student Poster Award an Sara Jahnke, Kathleen Philipp und Jürgen Hoyer verliehen.
2014, Den Haag: EABCT-Congress: Dipl.-Psych. Judith Schäfer erhielt für die Teilnahme finanzielle Unterstützung
durch die Gesellschaft von Freunden und Förderern der TU Dresden e.V..
2014, Stiftung der Deutschen Wirtschaft (sdw): Dipl.-Psych. Johanna Petzoldt erhält aktuell ein Stipendium für
ihre Promotion zum Thema „Mütterliche Angststörungen und frühkindliche Regulationsstörungen“.
2014, Swansea (UK), International Marcé Society Biennal Meeting: Dipl.-Psych. Johanna Petzold erhielt einen
Travel Award zur Teilnahme an der Graduiertenakademie.
2014, Berlin, Kongress der Deutschen Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und
Nervenheilkunde (DGPPN): Die Poster-Vorstellung von Dipl.-Psych. Anke Heinrich wird im Rahmen der
Graduiertenakademie durch einen Travel Award gefördert.
2014, Springer US: „Exposure Therapy: Rethinking the Model - Refining the Method“, Neudeck, P. & Wittchen,
H.-U. (Eds.), Dieses Buch gehört mit über 6000 Downloads zu den 25% der am häufigsten heruntergeladenen
E-Books.
2014, Thomson Reuters wählte Prof. Dr. Jürgen Rehm in der der Kategorie „Most highly cited researchers“ zu
einem der einflussreichsten Forscher im Bereich Sozialwissenschaft und Epidemiologie.
2014 Professor Wittchen wurde als einer der höchst zitierten Forscher in der biomedizinischen Literatur aufgenommen
2012, 2013 und 2014, Focus - Gesundheit: Prof. Dr. Corinna Jacobi, Prof. Dr. Jürgen Hoyer und Prof. Dr. HansUlrich Wittchen zählen zu den Psychotherapeuten, die wiederum in die jährlichen Focus-Ärztelisten der deutschen
1700 Top-Mediziner aufgenommen wurden.
Lehrpreis zur finanziellen Unterstützung von Studierenden, Doktoranden und der Lehre
2011 erhielten Dr. Silke Behrendt, Dr. Franziska Einsle, Dr. Sarah Forberger Dr. Susanne Knappe, Dr. Ulrike Lüken
und Dr. Oliver Riedel für den Wettbewerbsbeitrag „Das integrierte Studien- und Lehrkonzept des Instituts für
Klinische Psychologie und Psychotherapie der TU Dresden“. den Lehrpreis der „Gesellschaft von Freunden und
Förderern der TU Dresden e. V..
74
Das Preisgeld in Höhe von 4.000 € wird dafür genutzt, Anschaffungen für Lehrveranstaltungen zu finanzieren
und Studierende in eigenen kleinen Projekten, wie z.B. BA-, MA- oder Diplomarbeiten, zu unterstützen. Seit dem
Sommersemester 2012 wurden aus diesen Mitteln folgende Personen gefördert:
- Benno Sinkwitz: Reisekostenzuschuss für die Diplomarbeit: „Zur berufsbezogenen und psychischen
Belastung sowie Therapie von Menschen helfender Berufe in stationärer psychotherap. Behandlung der
Heiligenfeld Kliniken Bad Kissingen“
- Lisa Krause. Aufwandsentschädigungen für eine Befragung Psychologischer Psychotherapeuten zum Thema
„Development of a measure for the behavioral symptoms of generalized anxiety disorder”
- Erik Hausstädler: Materialkosten für die Entwicklung des Stressbewältigungsprogramms „Loslassen lernen
und Stress bewältigen. Ein Stressmanagementtraining für Gesunde“
- Guanyu Huang: Versuchspersonengelder für die Diplomarbeit “Behavioral Avoidance in High Worrier:
Evidence at an Approach-Avoidance Task“.
- Tina Rößler: Versuchspersonengelder für die Diplomarbeit „Cognitive control abilities under different levels
of worrying: Is there a relationship to worry pervasiveness and controllability?
- Markus Mühlhan. Materialkosten für das Seminar “Diagnostik psychischer Störungen“
- Samia Härtling & Torsten Tille: Erstellung einer Datenbank zur Verwaltung der Prüfungsfragen verschiedener
Studiengänge
Karl-und-Charlotte-Bühler-Preis für ausgezeichnete Lehre
Die Lehreveranstaltungen werden von den Studierenden sehr positiv eingeschätzt. Das zeigen die zahlreichen
Lehrpreise, welche die Mitarbeiter des Lehrstuhls basierend auf den turnusmäßigen Lehrevaluationen erhalten
haben. Den Karl-und-Charlotte-Bühler-Preis der Fachrichtung Psychologie für ausgezeichnete Lehre erhielten im
Berichtszeitraum WS 2011/12 bis WS 2013/14 folgende Lehrveranstaltungen und Dozenten:
DozentLehre
Semester
Dipl.-Psych. Thekla Bensmann Depressionsseminar
SS 2012
Dipl.-Psych. Dorte Westphal
Konfrontationsseminar
SS 2012
PD Dr. Ulrike Lüken
Praktikum: Basiskompetenzen I: Gesprächsführung
SS 2012
Praktikum: Basiskompetenzen III: Interventionsverfahren
SS 2012
Dr. Julia Martini
Psychische Störungen im Kindes- und Jugendalter
SS 2012
Dr. Samia Härtling
Basiskompetenzen II: Klinische Diagnostik
SS 2012
Dr. Samia Härtling
SS 2012
Dr. Julia Martini
WS 2012/13
WS 2012/13
Praktikum: CANDIS - Modulare Therapie von Cannabisstörungen
WS 2012/13
Dr. Markus Mühlhan
Generierung u. Auswertung von fMRT Daten in der klinische Forschung WS 2012/13
Dr. Samia Härtling
WS 2012/13
Prof. Dr. Gerhard Bühringer Pathologisches Glücksspiel
SS 2013
SS 2013
Seminar: Angststörungen: Klinische Entwicklungspsychologie
SS 2013
& Dipl.-Psych. Sören Paul
Dipl.-Psych. Johanna Petzoldt Basiskompetenzen II: Klinische Diagnostik
SS 2013
75
ARBEITSGRUPPEN UND ERGEBNISSE/WORKGROUPS AND FINDINGS
Arbeitsgruppen und Ergebnisse
Workgroups and Findings
77
ARBEITSGRUPPEN UND ERGEBNISSE/WORKGROUPS AND FINDINGS
Arbeitsgruppen und Arbeitsgruppenleiter (Stand: 31.10.2014)
AG 1 Epidemiology and Health Services Research
79
Leitung: Prof. Dr. Katja Beesdo-Baum, Dr. Lars Pieper, Prof. Dr. J. Rehm & Prof. Dr. Hans-Ulrich Wittchen
103
Leitung: PD Dr. Ulrike Lüken, Prof. Dr. Katja Beesdo-Baum & Dr. Markus Mühlhan
115
Leitung: Dr. Julia Martini & Prof. Dr. Hans-Ulrich Wittchen
AG 4 ROAMER - A Roadmap for Mental Health and Well-Being Research in Europe 123
Leitung: Prof. Dr. Hans-Ulrich Wittchen & Dr. Susanne Knappe
AG 5 Neuropsychology127
Leitung: Dr. Oliver Riedel & PD Dr. Ulrike Lüken
AG 6 Addiction Research Unit139
Leitung: Prof. Dr. Gerhard Bühringer & Dr. Silke Behrendt
AG 7 Behavioral Medicine 151
Leitung: Prof. Dr. Hans-Ulrich Wittchen & Dr. Lars Pieper
AG 8 Eating Disorders163
Leitung: Prof. Dr. Corinna Jacobi
AG 9 Clinical Research171
Leitung: Prof. Dr. Jürgen Hoyer & Prof. Dr. Katja Beesdo-Baum
193
Leitung: Prof. Dr. Hans-Ulrich Wittchen, Prof. Dr. Katja Beesdo-Baum, Dr. Susanne Knappe & Prof. Dr. Jürgen Hoyer
AG 11 Psychotherapie- und Interventionsforschung Leitung: Prof. Dr. Hans-Ulrich Wittchen & Prof. Dr. Jürgen Hoyer
78
200
AG 1 EPIDEMIOLOGIE UND VERSORGUNGSFORSCHUNG/EPIDEMIOLOGY AND HEALTH SERVICE RESEARCH
K. BEESDO-BAUM, L. PIEPER, J. REHM & H.-U. WITTCHEN
AG 1 Epidemiologie und Versorgungsforschung/Epidemiology
and Health Services Research
Prof. Dr. Katja Beesdo-Baum, Dr. Lars Pieper, Prof. Dr. Jürgen Rehm & Prof. Dr. Hans-Ulrich Wittchen
Overview
Population based data about the prevalence of mental and somatic disorders, as well as data on associated impairment, health care utilization and societal burden are not only of core importance for health care reporting and planning, but also contribute significantly to etiologic and pathogenetic research. The work group continuously provides
such data from national and international studies in several research fields (e.g. general population, primary care).
Our work group also focusses on the complex interactions between behavioural, psychological, genetic/neurobiological and environmental factors and the mental and/or physical health and disease of people.
Arecent application for a new chair/professorship “Behavioral Epidemiology” (Federal Ministry of Education and
Research, BMBF) has been successful (appointment of Prof. Dr. Katja Beesdo-Baum in April 2014) which will
further advance research and training in this important field within Clinical Psychology. The new chair has also
taken over the directorship of the Institutes´s “Center of Clinical Epidemiology and Longitudinal Studies” (CELOS)
that provides resources and competences to conduct high quality large-scale clinical epidemiological studies. This
also includes a biometrics and statistics group (Dr. Michael Höfler, Jens Strehle, John Venz) and linkages to Prof.
Rehm´s Epidemiological Unit to support the analyses of our group and collaborating partners. Current core projects
with respective workgroups are:
1. The Epidemiological Functional and Dysfunctional Behavioral and Psychological Factors in Mental Health and
Disease (EBP)
2. Early Developmental Stages of Psychopathology (EDSP): Natural course, etiology, and pathogenesis of mental and substance use disorders
3. The German Health Interview and Examination Survey for Adults – Mental Health Supplement (DEGS1-MH)
4. German Health Interview and Examination Survey 1998 – Mental Health Supplement (GHS-MHS)
5. National Survey on Health Care of Depression in German Primary Care Practices (VERA)
6. Trauma and Stress-related disorders in German Soldiers with and Without Foreign Deployment
7. Mental Disorders in the elderly: Relationship to impairment, functioning (ICF) and service utilisation
(MentDis_ICF65+)
P1. The Epidemiology of Functional and Dysfunctional Behavioral and Psychological Factors in Mental
Health and Disease (EBP)
PI: Prof. Dr. Katja Beesdo-Baum; Staff: Dr. L. Pieper, Dipl.-Psych. J. Hoyer, M.Sc. C. Voß, M.Sc. J. Venz, E.
Stolzenburg (MTA), T: Tille (programmer Funding: BMBF, Duration: 06/2014 - 05/2017; Extramural Cooperations:
Dr. Daniel S. Pine (National Institute of Mental Health, Bethesda, US), Dr. Ron Kessler (Harvard University, Boston,
US), Dr. Jürgen Rehm (Center for Addiction and Mental Health, University of Toronto, Canada), Prof. Dr. Katharina
Domschke (Universität Würzburg), Prof. Dr. Andreas Meyer-Lindenberg (ZI Mannheim)
Aim of the project: Although it is well established that behavioral factors, including cognitive-affective factors, are
a core contributor to almost all diseases, their assessment and consideration in epidemiological studies is up to
now deficient. The aim of this research project is to unravel the role of behavioral and psychological factors in the
development of the most prevalent mental disorders (anxiety disorders, depression, behavioral and substance use
disorders) as well as their interactions with biological and social-environmental factors. A data-bank repository that
integrates available datasets with select behavioral indicators will be designed for combined analyses. Standardized
measures of subjects’ behavior in real life as well as behavioral experimental measures in controlled environments
will be developed for use in epidemiological studies and incorporated in a new cohort study of adolescents and
young adults sampled from the general population. Work plan: A data-bank will be designed and subsequently
available cross-sectional and longitudinal datasets will be integrated for joint analyses. New experimental and nonexperimental behavioral measures for behavioral epidemiology studies will be developed and piloted. A new cohort
of 1000 individuals aged 14-30 years sampled from the general population will be assessed cross-sectionally and
longitudinally using behavioral (real life experience/ actigraphic/ geographic monitoring; experimental paradigms e.g.
on cognitive control), interview and self-report measures. Additional components will be the collection of bio-samples and a nested family-genetic study. Use of Results: The research will result in high impact scientific publications
on the status and predictors of mental health and disease as well as the trajectories and pathways to the most
prevalent mental disorders. The large-scale integrative behavioral-epidemiologic databank will be available for joint
statistically well-powered re-analyses of data allowing for new insights on questions that cannot be answered by
79
single studies with limited sample sizes. The new cohort study will provide unique data on the functional and dysfunctional behavioural and psychological factors in mental health and disease and their interactions with genetic and
environmental factors. Findings will contribute to the development of new concepts for prediction, targeted prevention and early interventions. The research program will strengthen interdisciplinary collaboration of regional, national
and international scientists in the fields of epidemiology, psychology, psychiatry and related disciplines.
Current Status: The workgroup has been formed and preparations and piloting for the new cohort study (Dresden
Behavior and Mind Health Study, BeMIND) are currently ongoing.
P2. Early Developmental Stages of Psychopathology (EDSP): Natural course, etiology, and pathogenesis of
mental and substance use disorders - Overview Preface
PI: Prof. Dr. Hans-Ulrich Wittchen, Prof. Dr. Roselind Lieb (Co-PI), Prof. Dr. Katja Beesdo-Baum (Co-PI Dresden);
Current Staff at TUD: Dipl.-Psych. E. Asselmann, Dr. S. Knappe, Dr. S. Behrendt, Dr. M. Höfler; Funding: BMBF,
DFG; Duration: 2003-2012, data analysis and publication ongoing; Extramural Cooperation: Max Planck Institute of
Psychiatry Munich (M. Ising, P. Zimmermann, H. Pfister, T. Brückl, A. Nocon), Prof. Dr. Roselind Lieb (Universität
Basel, Schweiz), Dr. Lydia Fehm (Humboldt Universität Berlin), Dr. Daniel S. Pine & Dr. Ellen Leibenluft (National
Institute of Mental Health, Bethesda, US), Dr. Ron Kessler (Harvard University, Boston, US), Dr. Jürgen Rehm
(Centre for Addiction and Mental Health, University of Toronto, Canada), Dr. Murray D. Stein (University of California
San Diego, La Jolla, US), Prof. Jim van Os (University of Maastricht, Niederlande), Dr. Renee D. Goodwin (Columbia
University, US), Dr. Nancy Low (McGill University, Montreal, Canada), Dr. Jitender Sareen (University of Manitoba,
Canada)
The EDSP program has been launched in 1994 to study the prevalence, vulnerability and risk factors, comorbidity
and consequences of mental disorders in a large community sample of over 3000 adolescents and young adults,
aged 14-24 at the outset of the study, along with an examination of their parents and selected family members by
direct interview and family history methods. Since the baseline investigation there have been 3 further study waves
with a concluding final follow-up at ten years, completed late 2005. Nested in this design, several laboratory studies
were completed as well as work packages related to family genetic factors and neuropsychological markers.
In this status report we address the more recent findings from the EDSP-study in the following topic areas:
1) Anxiety and depression
2) The role of fearful spells as risk factor for panic pathology and other mental disorders
3) Substance use and substance use disorders
4) Familial Transmission and developmental psychopathology
5)Methodology
Beesdo-Baum, K., Knappe, S., Zimmermann, P., Brückl, T., Höfler, M., Behrendt, S., Lieb, R., & Wittchen, H.-U. (in press). The ‘Early Developmental Stages of Psychopathology (EDSP) study’: A 20 years review of methods and findings. Social Psychiatry and Psychiatric Epidemiology.
EDSP Topic area: Anxiety and Depression
P2.1. Differential Familial Liability of Panic Disorder and Agoraphobia (S. Knappe, K. Beesdo-Baum, A. Nocon,
& H.-U. Wittchen)
Background: Controversy surrounds the question of whether agoraphobia (AG) exists as an independent diagnostic
entity apart from panic. In favour of this position, AG without panic disorder (PD) was observed to transmit independently of panic conditions, albeit it may enhance the familial transmission of PD (Nocon et al., Depression and
Anxiety 25: 422-434, 2008). However, a recent behavioral genetic analysis (Mosing et al., Depression and Anxiety
26: 1004–1011, 2009) found an increased risk for both PD and AG in siblings of those with AG without PD, casting
doubt on whether AG exists independently of PD. Convincing evidence for either position notably requires considering also other anxiety disorders to establish the position of AG relative to the panic/anxiety-spectrum. Methods:
Familial transmission of panic attacks (PA), PD and AG was examined in a 10-year prospective-longitudinal community study of 3,021 adolescents and young adults including completed direct and indirect information on parental
psychopathology using the Munich-Composite International Diagnostic Interview to generate exclusive diagnostic
groups apart from diagnostic hierarchy rules. Results: Parental PD without AG was associated with an increased
risk for PA and PD+AG, but not for AG without PD or PD without AG in offspring. Parental AG without PD as well
80
as parental PD+AG were not associated with the offspring’s’ risk for PA, either exclusive PD or AG or PD+AG.
Findings were largely unaffected by adjustment for other offspring anxiety disorders. Conclusions: Findings provide
further evidence for the independence of AG apart from the PD-spectrum.
Graphic visualization of parent-to-offspring associations of panic attacks (PA), panic disorder (PD), and agoraphobia (AG)
Knappe, S., Beesdo-Baum, K., Nocon, A., & Wittchen, H.-U. (2012). Re-examining the differential familial liability of agoraphobia and panic disorder. Depression and Anxiety,
29, 931-3938.
P2.2. Danger and loss events and the incidence of anxiety and depressive disorders: A prospective-longitudinal community study of adolescents and young adults (E. Asselmann, H.-U. Wittchen, R. Lieb, M. Höfler, K.
Beesdo-Baum)
Background: There are inconclusive findings whether danger and loss events differentially predict the onset of
anxiety and depression. Methods: A community sample of adolescents and young adults (N=2,304, age 14-24 at
baseline) was prospectively followed up in up to 4 assessments over 10 years. Incident anxiety and depressive disorders were assessed at each wave using the DSM-IV/M-CIDI. Life events (including danger, loss, and respectively
mixed events) were assessed at baseline using the Munich Event List. Logistic regressions were used to reveal
associations (Odds Ratios, OR) between event types at baseline and incident disorders at follow-up. Results: Loss
events merely predicted incident “pure” depression (OR=2.4 per standard deviation; 95% CI: 1.5; 3.9; p<.001),
while danger events predicted incident “pure” anxiety (OR=2.3; 95% CI: 1.1; 4.6; p=.023) and “pure” depression
(OR=2.5; 95% CI: 1.7; 3.5; p<.001). Mixed events predicted incident “pure” anxiety (OR=2.9; 95% CI: 1.5; 5.7;
p=.002), “pure” depression (OR=2.4; 95% CI: 1.6; 3.4; p<.001), and their comorbidity (OR=3.6; 95% CI: 1.8; 7.0;
p<.001). Conclusions: Our results provide further evidence for differential effects of danger, loss, and respectively
mixed events on incident anxiety, depression, and their comorbidity. Since most loss events referred to death/separation from significant others, particularly interpersonal loss appears to be highly specific in predicting depression.
Asselmann, E., Wittchen, H.-U., Lieb, R., Höfler, M. & Beesdo-Baum, K. (2014). Danger and loss events and the incidence of anxiety and depressive disorders. A prospectivelongitudinal community study of adolescents and young adults. Psychological Medicine.
81
P2.3. The role of behavioral inhibition and parenting for an unfavorable emotional trauma response and
PTSD (E. Asselmann, H.-U. Wittchen, R. Lieb, M. Höfler, K. Beesdo-Baum)
Background: The role of behavioral inhibition (BI) and parenting for an unfavorable emotional trauma response
(DSM-IV criterion A2) and PTSD development is unclear. Methods: A community sample of adolescents and young
adults (aged 14-24) was followed up over 10 years (N=2,378). Traumatic events, criterion A2, and PTSD (according to DSM-IV-TR) were assessed using the M-CIDI. BI and parenting were assessed using the Retrospective
Self-Report of Inhibition and the Questionnaire of Recalled Parenting Rearing Behavior. Multiple logistic regressions adjusted for sex, age, and number of traumata were used to examine associations of BI as well as maternal
and paternal overprotection, rejection, and reduced emotional warmth with (a) criterion A2 in those with trauma
(N=1,794) and (b) subsequent PTSD in those with criterion A2 (N=1,160). Results: BI (Odds Ratio, OR=1.32) and
paternal overprotection (OR=1.27) predicted criterion A2 in those with trauma, while only BI (OR=1.53) predicted
subsequent PTSD. BI and paternal emotional warmth interacted on subsequent PTSD (OR=1.32), i.e. BI only predicted PTSD in those with low paternal emotional warmth. Conclusion: Our findings suggest that BI and adverse
parenting increase the risk for an unfavorable emotional trauma response and subsequent PTSD. Paternal emotional
warmth buffers the association between BI and PTSD development.
Asselmann, E., Wittchen, H.-U., Lieb, R., Höfler, M. & Beesdo-Baum, K. (2014). The role of behavioral inhibition and parenting for an unfavorable emotional trauma response
and PTSD. Acta Psychiatrica Scandinavica.
P2.4. The role of the mother-child relationship for anxiety and depressive disorders - Results from a
prospective-longitudinal study in adolescents and their mothers (E. Asselmann, H.-U. Wittchen, R. Lieb, K.
Beesdo-Baum)
Purpose: To examine whether (a) low child valence (emotional connectedness) within the mother-child relationship increases the risk for offspring depression, (b) low child potency (individual autonomy) increases the risk for
offspring anxiety, and (c) maternal psychopathology pronounces these associations. Methods: We used data from
a prospective-longitudinal study of adolescents (aged 14-17 at baseline) and their mothers (N=1,015 mother-child
dyads). Anxiety and depression were assessed repeatedly over 10 years in adolescents (T0, T1, T2, T3) and their
mothers (T1, T3) using the DSM-IV/M-CIDI. Valence and potency were assessed in mothers (T1) with the Subjective
Family Image Questionnaire. Odds ratios (OR) from logistic regression were used to estimate associations between
low child valence/potency and offspring psychopathology (cumulated lifetime incidences; adjusted for sex and
age). Results: In separate models (low valence or low potency as predictor), low child valence predicted offspring
depression only (OR=1.26 per SD), while low child potency predicted offspring anxiety (OR=1.24) and depression
(OR=1.24). In multiple models (low valence and low potency as predictors), low child valence predicted offspring
depression only (OR=1.19), while low child potency predicted offspring anxiety only (OR=1.22). Low child potency
interacted with maternal anxiety on predicting offspring depression (OR=1.49), i.e. low child potency predicted offspring depression only in the presence of maternal anxiety (OR=1.33). Conclusion: Our study suggests that low
child valence increases the risk for offspring depression, while low child potency increases the risk for offspring
anxiety and depression and interacts with maternal psychopathology on predicting offspring depression.
Asselmann, E., Wittchen, H.-U., Lieb, R., & Beesdo-Baum, K. (2014). The role of the mother-child-relationship for anxiety and depressive disorders - Results from a prospective-longitudinal study in adolescents and their mothers. European Child and Adolescent Psychiatry.
P2.5. Anxious and non-anxious forms of major depression: Familial, personality and symptom characteristics (D. P. Goldberg, H.-U. Wittchen, P. Zimmermann, H. Pfister and K. Beesdo-Baum)
Background: Earlier clinical studies have suggested consistent differences between anxious and non-anxious
depression.The aim of this study was to compare parental pathology, personality and symptom characteristics in
three groups of probands from the general population: depression with and without generalized anxiety disorder
(GAD) and with other anxiety disorders. Because patients without GAD may have experienced anxious symptoms
for up to 5 months, we also considered GAD with a duration of only 1 month to produce a group of depressions
largely unaffected by anxiety. Method: Depressive and anxiety disorders were assessed in a 10-year prospective longitudinal community and family study using the DSM-IV/M-CIDI. Regression analyses were used to reveal
associations between these variables and with personality using two durations of GAD: 6 months (GAD-6) and 1
month (GAD-1). Results: Non-anxious depressives had fewer and less severe depressive symptoms, and higher
odds for parents with depression alone, whereas those with anxious depression were associated with higher harm
82
avoidance and had parents with a wider range of disorders, including mania. Conclusions: Anxious depression is a
more severe form of depression than the non-anxious form; this is true even when the symptoms required for an
anxiety diagnosis are ignored. Patients with non-anxious depression are different from those with anxious depression in terms of illness severity, family pathology and personality. The association between major depression and
bipolar disorder is seen only in anxious forms of depression. Improved knowledge on different forms of depression
may provide clues to their differential aetiology, and guide research into the types of treatment that are best suited
to each form.
Goldberg, D., Wittchen, H. U., Zimmermann, P., Pfister, H., & Beesdo-Baum, K. (2014). Anxious and non-anxious forms of major depression: Familial, personality and symptom characteristics. Psychological Medicine, 44, 1223-1234.
P2.6. The natural course of unipolar depression: A prospective-longitudinal study in a general population
cohort of adolescents and young adults (K. Beesdo-Baum, J. Große, R. Lieb, M. Höfler & H.-U. Wittchen)
Background and Objectives: While many studies examined the prevalence of depression in the general population
and general course measures as well as predictors in clinical samples, thorough description of the natural course
of depression in adolescents and young adults from the community is sparse. The purpose of this study is to prospectively examine the natural course of unipolar threshold and subthreshold depression in a community sample
of adolescents and young adults. Methods: A representative community sample (N=3021, initial age: 14-24) was
assessed at baseline and in up to three follow-up waves over a time range of 10 years using the standardized DSMIV Munich Composite International Diagnostic Interview (M-CIDI). Diagnoses of Minor Depression, Dysthymia, and
Major Depression (mild, moderate, severe) were considered at each time point to describe the prevalence and the
proportion of (re-)occurrence at subsequent assessment waves. Prospective-longitudinal associations (Odds Ratios,
OR) between prior forms of depression and subsequent occurrences were revealed using logistic regression analyses. A score for overall persistence and severity was generated, describing the proportion of time spent in episode
since first onset while also considering depression severity (number of symptoms). Results: Cumulated lifetime
incidences are 21.8% for Major Depression, 5.0% for Dysthymia and 14.7% for Minor Depression. Overall, 34.0%
meet criteria for any form of depression, of which 20% experience multiple forms across time. Any form of prior
depression significantly predicts any subsequent depression (all ORs significant at p<.05). The odds ratios for subsequent depression increase with greater severity of prior depression. The odds rations among those who met criteria for depression before are higher for more severe subsequent forms than for less severe forms. Regarding the
whole time range, however, 69.6% of all participants with depression remit, i.e. they do not reveal any depression
diagnosis at follow-up, while the majority of the remaining cases (14.2%) fluctuates between forms. The overall persistence/severity score indicates that among cases with at least subthreshold depression an average of 16.1% of
the full pathology (regarding time in episode and number of symptoms) is shown since onset. The value increases
with severity in episodic depression from minor depression (6.4%) to severe depression (26.7%) and is highest for
cases with initial dysthymia (27.6%). Conclusion: Given the considerable incidence of unipolar depression up to
young adulthood and the increased risk for future, more severe, episodes, this time period is crucial to target early
interventions in order to alleviate current depressive symptomatology and possibly prevent future pathology. Yet,
the high proportion of remitted cases indicates that adolescent-onset depression is not necessarily re-occurring, at
least not over the time course of a decade. Long-term follow-up studies are necessary to reveal the natural course of
depression over the long run. Particular emphasis should be laid on identification of factors which distinguish remitting
cases and those with continuing depression to indicate risk profiles and target groups for early intervention.
Beesdo-Baum, K., Große, J., Lieb, R, Höfler, M. & Wittchen, H.-U. (in prep.). The natural course of unipolar depression: A prospective-longitudinal study in a general population cohort of adolescents and young adults. Journal of Affective Disorders
Große, J. (2013). The natural course of depression: A prospective-longitudinal study among adolescents and young adults (Supervision: Beesdo-Baum). Diplomarbeit (psychology diploma thesis), TU Dresden.
EDSP Topic area: The role of fearful spells as risk factor for panic pathology and other mental disorders
(Dissertation: E. Asselmann; Supervisor: K. Beesdo-Baum, Funding: Studienstiftung des Deutschen Volkes 01/201312/2014)
The major aim of this dissertation project is to investigate whether (a) fearful spells only (FS-only; spells of anxiety
with less than 4 panic symptom and/or lacking crescendo in symptom onset) are useful predictors for more severe
psychopathology in addition to DSM-IV full-blown panic attacks (PA) and (b) the associations of panic pathology with
developmental precedents and subsequent mental disorders increases as a function of panic severity.
83
P2.7. Associations of fearful spells and panic attacks with incident anxiety, depressive, and substance
use disorders: A 10-year prospective-longitudinal community study of adolescents and young adults (E.
Asselmann, H.-U. Wittchen, R. Lieb, M. Höfler, K. Beesdo-Baum)
Objective: The concept of fearful spells (FS) denotes distressing spells of anxiety that might or might not qualify for
criteria of panic attacks (PA). Few studies examined prospective-longitudinal associations of FS not meeting criteria
for PA with the subsequent onset of mental disorders to clarify the role of FS as risk markers of psychopathology.
Method: A representative community sample of adolescents and young adults (N=3,021, age 14-24 at baseline)
was prospectively followed up in up to 3 assessment waves over (up to) 10 years. FS, PA, anxiety, depressive,
and substance use disorders were assessed using the DSM-IV/M-CIDI. Odds Ratios (OR) from logistic regressions
were used to examine the predictive value of FS-only (no PA) and PA at baseline for incident disorders at follow-up.
Results: In logistic regressions adjusted for sex and age, FS-only predicted the onset of any subsequent disorder,
any anxiety disorder, panic disorder, agoraphobia, GAD, social phobia, any depressive disorder, major depression,
and dysthymia (ORs 1.54-4.36); PA predicted the onset of any anxiety disorder, panic disorder, GAD, social phobia,
any depressive disorder, major depression, dysthymia, any substance use disorder, alcohol abuse/dependence, and
nicotine dependence (ORs 2.08-8.75; reference group: No FS-only and no PA). Associations with psychopathology
were slightly smaller for FS-only than for PA, however, differences in associations (PA compared to FS-only) only
reached significance for any anxiety disorder (OR=3.26) and alcohol abuse/dependence (OR=2.26). Conclusions:
Findings suggest that compared to PA, FS-only have similar predictive properties regarding subsequent psychopathology and might be useful for an early identification of high-risk individuals.
Asselmann, E., Wittchen, H.-U., Lieb, R., Höfler, M. & Beesdo-Baum, K. (2014). Associations of fearful spells and panic attacks with incident anxiety, depressive, and substance use disorders: A 10-year prospective-longitudinal community study of adolescents and young adults. Journal of Psychiatric Research, 55, 8-14.
P2.8. Characteristics of initial fearful spells and their associations with DSM-IV panic attacks and panic disorder in adolescents and young adults from the community (E. Asselmann, C. Pané-Farré, B. Isensee, H.-U.
Wittchen, R. Lieb, M. Höfler, K. Beesdo-Baum)
Background: Few studies examined characteristics of initial fearful spells (FS) or panic attacks (PA) and their
relation to DSM-IV PA and panic disorder (PD). Methods: A community sample of adolescents and young adults
(N=3,021) was followed up in 4 waves (T0-T3) over up to 10 years. FS, PA, and PD were assessed at each wave
using the DSM-IV/M-CIDI. Characteristics of the initial FS/PA including perceived reasons/triggers, appraisal, duration, and behavioral/emotional consequences of the initial FS/PA were retrospectively assessed at T1 and T2 in those
reporting the experience of lifetime FS or PA at this wave (N=363). Multinomial logistic regressions adjusted for
sex and age were used to reveal associations between initial FS/PA characteristics (aggregated data from T1 and
T2) and the outcomes PA only (N=88) and PD (N=62; lifetime incidences cumulated across assessment waves)
vs. no PA/PD (reference group). Results: Alcohol consumption, drugs/medication, and physical illness as perceived
reasons for the initial FS/PA were associated with PA-only (OR 2.46-5.44), while feelings of depression, feelings of
anxiety, and having always been anxious/nervous as perceived reasons for the initial FS/PA, appraising the initial
FS/PA as terrible and long-term irritating/burdensome, subsequent feelings of depression, subsequent avoidance,
and subsequent consumption of medication, alcohol, or drugs were associated with PD (OR 2.64-4.15). A longer
duration until “feeling okay again” was associated with both PA-only (OR=1.29 per category) and PD (OR=1.63).
Limitations: Initial FS/PA characteristics were necessarily assessed retrospectively by self-report only. Thus, our
data may be subject to recall/evaluation biases. Aggregated data were used and strictly prospective-longitudinal studies are necessary that replicate our findings. Conclusion: Assessing initial FS/PA characteristics might be useful to
identify high-risk individuals for full panic pathology.
Asselmann, E., Pané-Farré, C., Isensee, B., Wittchen, H.-U., Lieb, R., Höfler, M. & Beesdo-Baum, K. (2014). Characteristics of initial fearful spells and their associations with
DSM-IV panic attacks and panic disorder in adolescents and young adults from the community. Journal of Affective Disorders, 165, 95-102.
P2.9. Risk factors for fearful spells and panic: A 10-year prospective-longitudinal study among adolescents
and young adults (E. Asselmann, H.-U. Wittchen, R. Lieb, M. Höfler, K. Beesdo-Baum)
Objective: To examine similarities and differences in risk constellations for (a) FS-only (spells of anxiety not meeting full criteria for DSM-IV panic attacks, PA), PA, and panic disorder (PD) and (b) different types of subsequent
psychopathology in those with panic. Method: A representative community sample of adolescents and young
adults (N=3,021, age 14-24 at baseline) was prospectively followed up in up to 3 assessment waves over 10 years.
84
FS-only, PA, PD, and other mental disorders were assessed at each wave using the DSM-IV/M-CIDI. Putative risk
factors (sex, parental disorders, temperament/personality, coping/self-esteem, parental rearing, family functioning,
early adversities, and childhood problems/disorders) were assessed with the M-CIDI, scales, and questionnaires.
Hazard Ratios from Cox regressions were used to estimate associations between putative risk factors and onset
of FS-only, PA, and PD (reference group no FS/PA/PD). Results: Female sex, parental anxiety and depressive disorders, behavioral inhibition, harm avoidance, lower coping efficacy, and parental rejection predicted FS-only, PA, and
PD (Hazard Ratios 1.2-3.0). Associations with other risk factors were partially different and tended to be stronger for
PD (and PA) than for FS-only. In panickers (i.e. those with FS-only, PA, or PD) partially different risk factors predicted
subsequent anxiety and depressive vs. substance use disorders. Conclusions: Well-established risk factors were
shared by FS-only, PA, and PD, suggesting that FS-only, PA, and PD reflect qualitatively similar, albeit differently
severe forms of panic pathology. In panickers, partially different risk constellations appear to exist for different types
of subsequent psychopathology.
Asselmann, E., Wittchen, H.-U., Lieb, R., Höfler, M., & Beesdo-Baum, K. (submitted). Risk factors for fearful spells, panic and subsequent psychopathology: A 10-year prospective-longitudinal study among adolescents and young adults.
P2.10. Does help-seeking alter the risk for incident psychopathology in adolescents and young adults with
and without fearful spells or panic attacks? Findings from a 10-year prospective-longitudinal community
study (E. Asselmann, H.-U. Wittchen, R. Lieb, M. Höfler, K. Beesdo-Baum)
Background: Although fearful spells (FS) and panic attacks (PA) increase the risk for various mental disorders,
few studies examined whether help-seeking in those with FS/PA attenuates the risk for incident psychopathology.
Methods: A community sample of adolescents and young adults (N=2,978, aged 14-24 at baseline) was followed
up in up to 3 assessment waves over 10 years. FS, PA, psychopathology, and help-seeking were assessed using
the DSM-IV/M-CIDI. Logistic regressions with interaction terms (adjusted for sex and age) were used to test interactions between FS/PA and help-seeking at baseline on predicting incident psychopathology at follow-up. Cases
with panic disorder (PD) at baseline were excluded from all analyses.
Figure 1: Interaction between FS/
PA and help-seeking at baseline on
predicting (a) incident panic disorder
and (b) any incident depressive disorder at follow-up.
Note: FS, fearful spell; PA, panic
attack; PD, panic disorder.
Results: FS/PA at baseline predicted the onset of any disorder, any anxiety disorder, PD, agoraphobia, generalized
anxiety disorder, social phobia, and any depressive disorder at follow-up (Odds Ratios, ORs 1.62-5.80). FS/PA interacted with help-seeking at baseline on predicting incident PD (OR=0.09) and depression (OR=0.22) at follow-up.
That is, FS/PA only predicted the respective disorders in individuals not seeking help at baseline. In those with
FS/PA at baseline, a higher number of panic symptoms interacted with help-seeking on predicting incident PD at
follow-up (OR=0.63), i.e. a higher number of panic symptoms only increased the risk for PD in those without helpseeking at baseline. Conclusions: Findings suggest that early help-seeking might modify psychopathology trajectories and prevent incident disorders Limitations: Help-seeking at baseline was not restricted to panic-specific interventions, but included other forms of treatment due to other medical conditions as well.
Asselmann, E., Wittchen, H.-U., Lieb, R., Höfler, M., & Beesdo-Baum, K. (2014). Does helpseeking alter the risk for incident psychopathology in adolescents and young adults
with and without fearfull spells or panic attacks? Findings from a 10-year prospective-longitudinal community study. Journal of Affective Disorders, 169, 221-227.
85
EDSP Topic area: Substance Use and Substance Use Disorders
P2.11. Characteristics of developmentally early alcohol use disorder symptom reports: A prospective-longitudinal community study (Behrendt, S., Bühringer, G., Perkonigg, A., Lieb, R., Beesdo-Baum, K.)
Background: Symptoms of DSM-IV alcohol use disorders (alcohol abuse and dependence; AUD) occur as early as
in adolescence and early adulthood. Relatively little is known from longitudinal epidemiological studies on characteristics of AUD symptomatology in this age group. Aims: We aim to investigate single AUD symptoms taking into
account prevalence rates, symptom counts, and stability. We also aim to identify positive predictive values (PPVs)
of single AUD symptoms for a full diagnosis of alcohol dependence cross-sectionally at each assessment wave.
Methods: N=2,039 community subjects (baseline age 14 – 24 years) from Metropolitan Munich, Germany, participated in a baseline assessment and two follow-up assessments about four and ten years after baseline. Single
AUD symptoms, craving, and full AUD diagnoses were assessed with the DSM-IV/M-CIDI. Results: Tolerance and
much time were most and role obligations and withdrawal least frequent over the assessment waves. Between
47.2 and 55.1% of subjects with DSM-IV-AUDS reported only one symptom. PPV for DSM-IV-AD only exceeded
70% for activities, problem, withdrawal, and desired control. The lowest PPV showed for tolerance and hazardous
use. AUDS report compared to non-report was associated with elevated drinking frequency and amounts for most
of the AUDS. Stability rates of baseline AUDS at four-year and ten-year follow-up did not raise above 36.4% for any
symptom. Conclusions: The overall pattern of most/least frequent AUDS reported in adolescence and early adulthood resembles findings in older adults. This finding does not suggest a developmentally specific symptom pattern
in adolescence and early adulthood. Moderate AUDS-stability and considerable remission rates may indicate that
AUDS in this age group are transient for a considerable proportion of subjects. However, the associations with elevated consumption indicate that AUDS reports early in life need to be taken seriously in prevention and intervention.
Behrendt S, Buehringer G, Perkonigg A, Lieb R. & Beesdo-Baum K. (2013). Characteristics of developmentally early alcohol use disorder symptom reports: a prospectivelongitudinal community study. Drug and Alcohol Dependence.131.308-15.
EDSP Topic area: Bipolar and Psychotic Liability
P2.12. Evidence that psychotic symptoms are prevalent in disorders of anxiety and depression, impacting
on illness onset, risk, and severity-implications for diagnosis and ultra-high risk research (J.T. W. Wigman,
M. van Nierop, W. A. M. Vollebergh, R. Lieb, K. Beesdo-Baum, H.-U. Wittchen, J. van Os)
Background: It is commonly assumed that there are clear lines of demarcation between anxiety and depressive
disorders on the one hand and psychosis on the other. Recent evidence, however, suggests that this principle may
be in need of updating. Methods: Depressive and/or anxiety disorders, with no previous history of psychotic disorder, were examined for the presence of psychotic symptoms in a representative community sample of adolescents
and young adults (Early Developmental Stages of Psychopathology study; n=3021). Associations and consequences
of psychotic symptomatology in the course of these disorders were examined in terms of demographic distribution,
illness severity, onset of service use, and risk factors. Results: Around 27% of those with disorders of anxiety and
depression displayed one or more psychotic symptoms, vs 14% in those without these disorders (OR 2.23, 95% CI
1.89–2.66, P < .001). Presence as compared with nonpresence of psychotic symptomatology was associated with
younger age (P < .0001), male sex (P < .0058), and poorer illness course (P < .0002). In addition, there was greater
persistence of schizotypal (P < .0001) and negative symptoms (P < .0170), more observable illness behavior (P <
.0001), greater likelihood of service use (P < .0069), as well as more evidence of familial liability for mental illness (P
< .0100), exposure to trauma (P < .0150), recent and more distant life events (P < .0006–.0244), cannabis use (P <
.0009), and any drug use (P < .0008). Conclusion: Copresence of psychotic symptomatology in disorders of anxiety
and depression is common and a functionally and etiologically highly relevant feature, reinforcing the view that psychopathology is represented by a network or overlapping and reciprocally impacting dimensional liabilities.
Wigman, J. T. W., Nierop, M. v., Vollebergh, W. A. M., Lieb, R., Beesdo-Baum, K., Wittchen, H.-U., & Os, J. v. (2012). Evidence that psychotic symptoms are prevalent in
disorders of anxiety and depression, impacting on illness onset, risk and severity - Implications for Diagnosis and Ultra–High Risk Research Schizophrenia Bulletin, 38(2),
247-257.
86
P2.13. Disturbed sleep as risk factor for the subsequent onset of bipolar disorder – data from the EDSP
Study (P.S. Ritter, M. Höfler, H.-U. Wittchen, R. Lieb, M. Bauer, A. Pfennig & K. Beesdo-Baum)
Background: There is ample data suggesting that patients with bipolar disorder more frequently suffer from
symptoms of insomnia even when euthymic. Since sleep is a process that is crucial for affective homeostasis,
disturbed sleep in healthy individuals may be a risk factor for the subsequent onset of bipolar disorder. Aims:
Utilizing data from a large cohort study of adolescents and young adults) this study tests the hypothesis that the
symptoms of insomnia constitute a risk factor for the later onset of bipolar disorder. Method: A representative
community sample of N=3021 adolescents and young adults (baseline age 14-24) was assessed using the standardized composite international diagnostic interview (DIA-X/M-CIDI) and followed-up prospectively up to 3 times
over up to 10 years. Three sleep items extracted from the self-report inventory SCL-90 were used to quantify
sleep disturbances (falling asleep, early morning awakening, restless or disturbed sleep) at baseline. The compound value (insomnia score) as an ordinal parameter for severity of insomnia was used to assess associations
with the incidence of bipolar disorder among participants free of major mental disorder at baseline (N=1943)
(odds ratios from logistic regressions, adjusted for sex and age). Supplementary analyses were dedicated to
analyse the longitudinal relationship with incident major depression and the associations between individual
sleep items and the two incident diagnoses. Results: During follow-up, 41 patients developed bipolar disorder.
The odds per unit increase (i.e., per one category in an SCL item) in insomnia score were 1.75 (CI: 1.25, 2.45;
p=0.001) after adjusting for relevant confounding variables (sex, age, substance use & family history mood disorders). The association was not modulated by family history. There was also an association of symptoms of
insomnia with the subsequent onset of major depression. For bipolar disorder, there was no relevant difference
in the predictive power of individual sleep items; whereas for major depression trouble falling asleep and restless/disturbed sleep but were predictive, while early morning awakening was not. Conclusion: Symptoms of
insomnia in persons otherwise free of major mental disorders appear to confer an increased risk for the subsequent onset of bipolar disorder. The established longitudinal association between insomnia and unipolar depression was confirmed.
Ritter, P.S., Höfler, M., Wittchen, H.-U., Lieb, R., Bauer, M., Pfennig A. & Beesdo-Baum, K. (in prep). Disturbed Sleep as Risk Factor for the subsequent onset of Bipolar Disorder - Data from the EDSP Study.
Further Projects/Publications in this topic area
Schutters, S. I. J., Dominguez, M. d. G., Knappe, S., Lieb, R., v. Os, J., Schruers, K. R., & Wittchen, H.-U. (2012). The association between social phobia, social anxiety cognitions and paranoid symptoms. Acta Psychiatrica Scandinavica, 125(3), 213-227.
Smeets, F., Lataster, T., Dominguez, M. d. G., Hommes, J., Lieb, R., Wittchen, H.-U., & van Os, J. (2012). Evidence that onset of psychosis in the population reflects early
hallucinatory experiences that through environmental risks and affective dysregulation become complicated by delusions. Schizophrenia Bulletin, 38(3), 531-542
Lataster, J., Myin-Germeys, I., Lieb, R., Wittchen, H.-U., & van Os, J. (2012). Adversity and psychosis: A 10-year prospective study investigating synergism between early and
recent adversity in psychosis. Acta Psychiatrica Scandinavica, 125(5), 388-399.
Kaymaz, N., Drukker, M., Lieb, R., Wittchen, H.-U., Werbeloff, N., Weiser, M., Lataster, T., & van Os, J. (2012). Do subthreshold psychotic experiences predict clinical outcomes in unselected non-help-seeking population-based samples? A systematic review and meta-analysis, enriched with new results. Psychological Medicine, 57(6), 1-15.
EDSP Topic area: Familial Transmission and Developmental Psychopathology
P2.14. Maternal nicotine dependence, prenatal smoking and risk of offspring mental disorders in the community (R.D. Goodwin, J. Martini, S. Knappe, S. Behrendt, M. Höfler, R. Lieb, H.-U. Wittchen & K. Beesdo-Baum)
Background: A number of studies suggest a link between prenatal smoking and offspring mental disorders,
though findings to date are inconclusive. The goal of the current study is to disentangle the impact of maternal
nicotine dependence from that of prenatal smoking on the risk of mental health problems among offspring, taking
into account the potential effects of offspring smoking status prior to the disorder and maternal psychopathology. Methods: Data come from a 10-year prospective-longitudinal community and family study. Prenatal smoking, maternal nicotine dependence, and mental disorders were assessed using the DSM-IV Munich Composite
International Diagnostic Interview (DIA-X/M-CIDI) in a community cohort of 1,017 individuals aged 14-17 years
at baseline and their biological mothers. The assessments were administered face-to-face by clinically trained
interviewers. Results: Prenatal smoking was associated with increased risk of offspring mood and substance use
disorders, independently from maternal nicotine dependence, while maternal nicotine dependence was associated with increased risks of offspring externalizing disorders, ADHD, and anxiety disorders. Adjusting for maternal mental disorders and offspring smoking behaviors had little effect on these associations. Further, only few
additional risks for onset of offspring disorders emerged when both risk factors – prenatal smoking and maternal
lifetime nicotine dependence – were present. Conclusion: Prenatal smoking and maternal nicotine dependence
87
appear to independently confer risks to offspring that extend beyond the prenatal period. Our results suggest that
treating nicotine dependence before conception and postnatally may be as important as smoking cessation during pregnancy in terms of mental health risk to offspring.
Goodwin, R.D., Martini, J., Knappe, S., Behrendt, S., Höfler, M., Lieb, R., Wittchen, H.-U. & Beesdo-Baum, K. (in revision). Maternal nicotine dependence, prenatal smoking
and risk of offspring mental disorders in the community. Psychological Medicine.
P2.15. Age-specific cumulative incidence risk for mental disorders as a function of familial liability (K.
Beesdo-Baum, N.C.P. Low, S. Knappe, S. Behrendt, M. Höfler, R. Lieb, H.-U. Wittchen)
Background and Purpose: Many studies have documented that mental disorders, including anxiety, mood and
substance use disorders, ‘run in families’. Our knowledge about offspring cumulative incidence risk patterns for
mental disorders, however, is limited by few studies using multi-generational family data, a quantification of familial
aggregation and examination of representative, population-based samples. In addition, the specificity of the familial
aggregation of mental disorders and the role of familial liability for development of comorbidity remains unresolved.
The purpose of this study is to examine the cumulative incidence risk for mental disorders in offspring from the
community by familial liability and the specificity of transmission pathways. This also includes examination of the
independent role of familial liability and early forms of psychopathological expressions in offspring (e.g. primary anxiety disorders) in predicting onset of comorbid complications (e.g. subsequent mood or substance use disorders).
Method: A cohort of 1,053 adolescents (baseline age 14−17 years) from a representative community study (Munich
area, Germany) was prospectively followed-up (three follow-up assessments) over up to 10 years. Offspring’ and
parental psychopathology were assessed using the DSM-IV Munich Composite International Diagnostic Interview
(M-CIDI). If direct parental diagnostic interviews were not available, family history reports were used. Diagnostic
information on grandparents were based on family history reports. Results: Findings revealed some degree of
specificity in the familial aggregation of mental disorders: After adjusting for familial liability for other psychopathology, parental anxiety disorders, parental mood disorders and parental substance use disorders were specifically
associated with the incidence of a pure or primary condition of the same disorder group in offspring (Hazard Ratio
from Cox-Regression: HR = 1.39 for anxiety disorders, HR = 2.02 for mood disorders, HR = 1.96 for substance use
disorders, p-values <0.05). A higher parental disorder load (both parents affected) increases the risk for offspring
mood and substance use disorders, but not anxiety disorders. Further, there were additional indications that mood
and substance use disorders in grandparents are related to increased disorder risk in offspring. The examination of
the risk for comorbid disorder development among offspring with a primary anxiety, mood or substance use disorder revealed heterotypic predictions for all disorder groups, except that primary mood disorders did not predict subsequent onset of anxiety disorders. Besides homotypical predictions of parental disorders in offspring comorbidity
development, parental substance use disorders also reveal heterotypic associations to anxiety and mood disorders
among offspring. Conclusion: Findings suggest disorder-specificity in the familial transmission to primary occurring
anxiety, mood, and substance use disorders. The familial aggregation of mood and substance use disorders, but not
anxiety disorders, is particularly pronounced in families with multiple affected ancestors. Primary occurring disorders
in offspring increase the risk for subsequent (comorbid) heterotypic disorders independent of familial liability, providing supporting evidence for ‘staging models of psychopathology’. Parental substance use disorders also appear
related to subsequent heterotypic disorder development. These findings have implications for studies on aetiology
including the neurobiologic basis for anxiety, mood and substance use disorders as well as for targeting prevention
and early intervention programs.
Beesdo-Baum, K., Low, N. C. P., Knappe, S., Behrendt, S., Höfler, M., Lieb, R., & Wittchen, H. U. (2012). Age-specific cumulative incidence risk for mental disorders as a
function of familial liability. European Neuropsychopharmacology, 22(Suppl. 2), S423-S424.
P2.16. Anxiety disorders as early stages of malignant psychopathological long-term outcomes: Results of
the 10-years prospective EDSP Study (K. Beesdo-Baum, R. Lieb & H.-U. Wittchen)
Introduction: Epidemiological studies consistently evidence that anxiety, depressive and substance use disorders
are the most frequent mental disorders in adults with high rates of comorbidity. Little long-term outcome research
has examined the psychopathological developmental trajectories which would allow for conclusions regarding
improved early identification and targeted intervention. Methods: A representative community sample (N=3,021;
age 14-24) was prospectively followed-up over 10 years. Mental disorders were assessed using a standardized
diagnostic interview (DSM-IV/M-CIDI). Results: While anxiety disorders reveal the earliest onset in childhood
88
More Anxiety Diagnoses predict
worse Long-Term Outcomes
Survival analyses with Cox regressions
revealed that the higher the overall number of
anxiety diagnoses, the greater the risk for
subsequent substance use disorders,
depression, and suicidality.
and adolescents, the incidence for depressive and substance use disorders increases in adolescence and young
adulthood. Two thirds of those with an anxiety, depressive, or substance use disorder reveal comorbidity with an
average of 3.3 diagnoses (SD=1.7). Among those with any comorbidity, 79.1% meet criteria for a substance use
disorder, 52.8% for a depressive disorder, and 59.6% for an anxiety disorder. While anxiety disorders emerge
temporally primary in the majority of comorbid cases (74.2%), substance use (67.5%) and depressive disorders
(71.8%) are mostly secondary onset conditions. Circumscribed phobias (specific phobia, social phobia, phobia NOS)
and panic attacks increase the risk for onset of comorbid – more complex – anxiety disorders (GAD, panic disorder,
agoraphobia, OCD, PTSD) (HR=2.5, p<.001). Survival analyses with Cox regressions revealed that the higher the
overall number of anxiety diagnoses, the greater the risk for subsequent substance use disorders (Hazard Ratio
(HR)1 vs 0 Anx=1.5, HR2 vs 0 Anx=2.3, HR3+ vs 0 Anx=2.6; p-values <.001), depression (HR1 vs 0 Anx=2.0, HR2 vs 0 Anx=2.6,
HR3+ vs 0 Anx=3.6; p-values <.001), and suicidality (HR1 vs 0 Anx=3.8, HR2 vs 0 Anx=4.8, HR3+ vs 0 Anx=21.8; p-values <.001).
Conclusions: Childhood and adolescent anxiety syndromes and disorders are an important gateway for unfavourable long-term psychopathological outcomes. Findings support ‚sequential comorbidity‘ or ‚staging models of psychopathology‘ which suggest that an early cascade of anxiety conditions contributes to a substantial proportion of adult
substance use and depressive disorders, possibly due to self-medication and demoralization. Such models are of
potential usefulness for diagnostic and treatment planning purposes, emphasizing the need for early identification
and targeted interventions to prevent the onset of anxiety disorders and a cascade of secondary psychopathology.
Beesdo-Baum, K., Lieb, R., & Wittchen, H.-U. (2013). Anxiety Disorders as Early Stages of Malignant Psychopathological Long-Term Outcomes: Results of the 10-years Prospective EDSP Study . (Abstract). Comprehensive Psychiatry. 54; e16.
P2.17. Mental disorders in adolescence and young adulthood: Homotypic and heterotypic longitudinal associations (K. Beesdo-Baum, D.S. Pine, R. Lieb & H.-U. Wittchen)
Background: Few epidemiologic studies examined prospectively the longitudinal associations of narrowly defined
mental disorders in childhood, adolescence and young adulthood. These studies find homotypic longitudinal associations for several mental disorders, demonstrating persistence or recurrence over time. Many mental disorders
also show heterotypic longitudinal associations, predicting elevated risks for other mental disorders. However, our
89
current knowledge on the specificity and non-specificity in the course of narrowly defined mental disorders from
adolescence to young adulthood remains limited for several reasons: First, only few prospective studies starting in
childhood or adolescence have extended their follow-up to age 25 or higher. Second, only few studies considered
a broader range of disorders and accounted for comorbidity when assessing homotypic and heterotypic longitudinal
predictions. Third, most studies are based on cross-sectional diagnoses rather than lifetime or between-assessment-interval diagnostic information which might influence association patterns particularly for episodic disorders.
Therefore, the current study examines the homotypic and heterotypic longitudinal associations of a range of specific
DSM-IV defined mental disorders from adolescence (up to age 20) to young adulthood (age 21 to 34) while considering lifetime/interval diagnostic information and accounting for comorbidity. Methods: A representative community sample of 3,021 adolescents and young adults aged 14 to 24 at baseline (T0) was prospectively followed-up
in up to 4 assessment waves (T1, T2, T3) over a time period of up to 10 years. Mental disorders (anxiety, mood,
substance use, eating, and somatoform disorders) were assessed according to DSM-IV criteria using the computerized lifetime (T0) and interval versions (T1, T2, T3) of the Munich Composite International Diagnostic Interview
(DIA-X/M-CIDI); separation anxiety (T0/T1), conduct problems (T1/T2), antisocial personality (T2) and psychotic symptoms (T2/T3) were assessed using embedded assessment modules. Longitudinal associations (Odds Ratios, OR)
with 95% Confidence Interval were examined via logistic regression analyses. To account for comorbidity, multiple
logistic regression analyses containing all predictor disorders were conducted in addition to the univariate analyses
examining the crude associations. Results: Univariate analyses revealed strict homotypic predictions (same diagnosis later in time) for most disorders under consideration (exceptions: Generalized Anxiety Disorder and Obsessive
Compulsive Disorder). Broader homotypic predictions (disorder of same diagnostic class) and heterotypic predictions (across disorder classes) were also found, but these were usually weaker than the strict homotypic associations. Multiple logistic regression analyses accounting for comorbidity revealed overall fewer associations. While the
strict homotypic predictions largely remained, many broader homotypic and heterotypic associations were attenuated to non-significance. Discussion: Findings suggest strong homotypic longitudinal predictions for most mental disorders from adolescence to young adulthood even when accounting for comorbidity. Some homotypic associations
may have been underestimated in previous studies. For example, our study revealed homotypic predictions also for
depression even when accounting for comorbidity. Overall, findings suggest disorder-specificity in course of mental
disorders albeit comorbidity or development of other conditions across time is a frequent phenomenon.
Beesdo-Baum, K., Pine, D. S., Lieb, R., & Wittchen, H. U. (2012, 02.-06.12.). Mental disorders in adolescence and young adulthood: homotypic and heterotypic longitudinal
associations. Paper presented at the American College of Neuropsychopharmacology (ACNP) 51st Annual Meeting Hollywood, Florida, US.
Beesdo-Baum, K., Pine, D. S., Hoefler, M., Lieb, R., & Wittchen, H.-U. (2013, 22.-27.10.). What do child and adolescent psychiatric disorders predict? Prospective-longitudinal
associations with adult psychopathology. Paper presented at the 60th Annual Meeting of the American Academy of Child & Adolescent Psychiatry (AACAP), Orlando,
Florida, US.
P2.18. The co-occurrence of externalizing and anxiety disorders in youth: Prospective associations, correlates and risk factors (S. Knappe, R. Lieb, H.-U. Wittchen, K. Beesdo-Baum)
Background: In contrast to substantial evidence on the co-morbidity between anxiety and depressive disorders,
the co-morbidity of these conditions with externalizing disorders has been studied less systematically. The temporal relationships and predictors of the co-occurrence of externalizing, anxiety and depressive disorders may
though have important value for diagnostics and classification, aetiology and clinical characteristics of childhood and
adolescent psychopathology. Methods: Data are based on a subsample of 1,053 adolescents from the 10-year prospective-longitudinal Early-Developmental Stages of Psychopathology Study. Parents were interviewed about core
symptoms and onset age of offsprings’ early externalizing disorders (ADHD, conduct disorder CD, oppositional defiant disorder ODD). Anxiety and other mental disorders were assessed at baseline and 2, 4 and 10 year follow-up
using the Munich-Composite International Diagnostic Interview (DIA-X/M-CIDI). The M-CIDI was supplemented by a
comprehensive response booklet to assess putative correlates and risk factors for mental disorders. Regression and
Kaplan-Meier-Survival analyses revealed cross-sectional and longitudinal associations between the disorders and
their predictors. Results: Rates of core symptoms of early externalizing disorder were 9.1% and 6.4% among those
with and without an anxiety disorder. Late externalizing disorders were reported by 50.3% and 26.6% of those with
an early externalizing disorder and those with an anxiety disorder. After adjusting for gender and comorbid depressive disorders, numerous associations between early and late externalizing conditions with anxiety disorders were
observed. Externalizing disorders preceded anxiety disorders more often than vice versa, indicating an increased
risk for incident anxiety disorders by prior externalizing disorders. Parental mental disorders, behavioral inhibition,
and volitional components were related to ADHD and anxiety disorders, but only higher parental rejection, lower
volitional inhibition and higher volitional avoidance predicted incident anxiety disorders among those with early
90
externalizing disorders. Discussion: Findings point to the notable co-morbidity of externalizing and anxiety disorders
in youth. As anxiety disorders are known to reveal itself an increased risk for a cascade of later psychopathology,
prior externalizing disorders in childhood appear to be useful targets for prevention and early intervention of incident
anxiety disorders.
Knappe, S., Lieb, R., Wittchen, H.-U. & Beesdo-Baum, K. (in prep) The co-occurrence of externalizing and anxiety disorders in youth: Prospective associations, correlates and
risk factors
Knappe, S., Lieb, R., Wittchen, H.-U. & Beesdo-Baum, K. (2014, 21.-24.05.). Externalizing, anxiety and depressive disorders: Co-morbidity, prospective associations, correlates
and risk factors in youth. Poster presented at the 17th EPA section meeting, Ulm/Neu-Ulm.
Knappe, S., Beesdo-Baum, K., Lieb, R., & Wittchen, H.-U. (2013, 03.-05-.04.). Externalizing disorders and the risk for anxiety disorders in children and adolescents. Paper presented at the 2nd Herrenhausen Conference, Hanover.
P2.19. Does low coping efficacy mediate the association between negative life events and incident psychopathology? A prospective-longitudinal community study in adolescents and young adults (E. Asselmann,
H.-U. Wittchen, R. Lieb, M. Höfler, K. Beesdo-Baum)
Background: Research suggests that low coping efficacy (CE) increases the risk for psychopathology and mediates
the associations between negative life events (NLE) and incident disorders. However, few studies directly examined this issue. Methods: A representative community sample of adolescents and young adults (N=3,017, age
14-24 at baseline) was prospectively followed up in up to 3 assessment waves over 10 years. Anxiety, depressive,
and substance use disorders were assessed at each wave using the DSM-IV/M-CIDI. NLE and CE were assessed
at baseline using the Munich Event List and the Scale for Self-Control and Coping Skills. Logistic regressions were
used to reveal associations of NLE and CE at baseline with incident disorders at follow-up. Results: NLE at baseline predicted the onset of any disorder, any anxiety disorder, panic disorder, agoraphobia, GAD, any depressive
disorder, major depression, dysthymia, any substance use disorder, nicotine dependence, and abuse/dependence
of illicit drugs at follow-up (Odds Ratios, ORs 1.02 - 1.09 per one NLE more). Low CE at baseline predicted the
onset of any disorder, any anxiety disorder, agoraphobia, GAD, any depressive disorder, major depression, dysthymia, any substance use disorder, alcohol abuse/dependence, nicotine dependence, and abuse/dependence of illicit
drugs at follow-up (ORs 1.16 - 1.72 per SD). Low CE explained 9.46%, 13.39%, 12.65%, and 17.31% of the associations between NLE and any disorder, any depressive disorder, major depression, and dysthymia, respectively.
Conclusions: Findings suggest that NLE and low CE increase the risk for various disorders and low CE specifically
mediates the association between NLE and incident depression.
Asselmann, E., Wittchen, H.-U., Lieb, R., Höfler, M., & Beesdo-Baum, K. (in press). Does low coping effiacy mediate the association between negative life events and incident psychopathology? A prospective-longitudinal community study in adolescents and young adults. Epidemiologiy and Psychiatric Sciences.
EDSP Topic area: Methodology
P2.20. Stability of recalled parental rearing behavior in a community sample of adolescents and young
adults (E. Asselmann, Knappe, S., H.-U. Wittchen, R. Lieb, K. Beesdo-Baum)
This study examined the temporal stability of recalled parental rearing behavior (RPRB) in a community sample of
adolescents and young adults (aged 15-19 at T1, N=945) over a period of nearly 2 years. RPRB (overprotection/
control, rejection/punishment, and emotional warmth, separately for mother and father) was assessed at T1 and T2
(time interval: M=21.18 months, SD=0.09 months) using the Questionnaire of Recalled Parental Rearing Behavior.
Intraclass correlations (ICCs) between T1 and T2 were examined. ICCs were similar for maternal and paternal
RPRB and slightly higher for emotional warmth (mother: .70; father: .70) than for rejection/punishment (mother: .69;
father: .68) and overprotection/control (mother: .66; father: .62). These findings suggest an at least moderate temporal stability of RPRB in adolescents of the community.
Asselmann, E., Knappe, S., Wittchen, H.-U., Lieb, R., Höfler, M., & Beesdo-Baum, K. (2014). Stability of recalled parental rearing behavior in a community sample of adolescents and young adults. Journal of Research on Adolescence.
91
P3. The German Health Interview and Examination Survey for Adults – Mental Health Supplement (DEGS1-MH)
PI: Hans-Ulrich Wittchen, Frank Jacobi ; Funding: Federal Ministry of Health/Robert Koch Institute and DGPPN;
Duration field phase: 09/2009 – 03/2012; Collaboration: Robert Koch Institut (RKI, Berlin); Deutsche Gesellschaft
für Psychiatrie, Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN); Klinik für Psychiatrie und
Psychotherapie, Universität Bonn; Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Heinrich-HeineUniversität, Düsseldorf
Upon completion of our work involvement of the German children survey (KIGGS, conducted by the Robert-KochInstitute, RKI, Berlin) and the „World Mental Health Survey“ (WHO, Harvard Medical School) we prepared a replication and follow-up of a mental health module within the new Federal German health survey (German acronym:
DEGS). Unlike to the previous German survey, our new DEGS mental health module includes the elderly (65-85) and
longitudinal components (follow-up of participants from the 1998 GHS-MHS). The new DEGS sample will further be
used as a baseline for future investigations within the DEGS cohort.
Current status: Field work - nationwide computer assisted personal interviews (DEGS-CIDI) and neuropsychological
assessment - completed (N=5317); since then data preparation (including linkage to DEGS1 main survey) and publication and presentation of basic results.
P3.1. Mental disorders in the general population. Study on the health of adults in Germany and the additional module mental health (DEGS1-MH)
Background and objectives: The German health interview and examination survey for adults (DEGS1) with the
mental health mod¬ule (DEGS1-MH) is the successor to the last survey of mental disorders in the general German
population 15 years ago (GHS-MHS). Jacobi et al. (2013) give a comprehensive overview of design and methods,
Jacobi et al. (2014a,b) report the basic findings on the 12-month prevalence of mental disorders and associated
disabilities, and Mack et al. (2014) give an overview of self-reported healthcare utilization. Methods: A representative national cohort (age range 18–79 years, n=5,317) was selected and individuals were personally examined
(87.5% face to face and 12.5% via tele¬phone) by a comprehensive clinical interview using the composite international diagnostic interview (CIDI) questionnaire. Results: The overall 12-month prevalence of mental disorders was
27.7% with substantial differences between subgroups (e.g. sex, age, socioeconomic status). Mental disorders
were found to be particularly impairing (elevated number of disability days). Less than 50 % of those affected
reported to be in contact with health services due to mental health problems within the last 12 months (range
10–40% depending on the number of diagnoses). Conclusions: Mental disorders were found to be commonplace
with a prevalence level comparable to that found in the 1998 predecessor study but several further adjustments
will have to be made for a sound methodological comparison between the studies. Apart from individual distress,
elevated self-reported disability indicated a high societal disease burden of mental disorders (also in comparison
with many somatic diseases). Despite a relatively comprehensive and well developed mental healthcare system in
Germany there are still optimization needs for treatment rates.
webpage: www.rki.de/DE/Content/Gesundheitsmonitoring/Studien/Degs/degs_w1/degs_w1_node.html
Jacobi, F., Mack, S., Gerschler, A., Scholl, L., Höfler, M., Siegert, J., Bürkner, A., Preiss, S., Spitzer, K., Busch, M., Hapke, U., Gaebel, W., Maier, W., Wagner, M., Zielasek,
J., Wittchen, H.-U. (2013). The design and methods of the mental health module in the German Health Interview and Examination Survey for Adults (DEGS1-MH). International Journal of Methods in Psychiatric Research, 22(2), 83-99.
Jacobi, F., Höfler, M. Siegert, J., Mack, S., Gerschler, A., Scholl, L., Busch, M., Hapke, U., Maske, U., Gaebel, W., Maier, W., Wagner, M., Zielasek, J, Wittchen, H.-U. (2014).
Psychische Störungen in der Allgemeinbevölkerung: Studie zur Gesundheit Erwachsener in Deutschland und ihr Zusatzmodul „Psychische Gesundheit“ (DEGS1-MH). Der
Nervenarzt, 85, 77-87.
Jacobi, F., Mack, S., Gerschler, A., Scholl, L., Höfler, M., Siegert, J., Bürkner, A., Preiss, S., Spitzer, K., Busch, M., Hapke, U., Gaebel, W., Maier, W., Wagner, M., Zielasek,
J., Wittchen, H.-U. (2013). The design and methods of the mental health module in the German Health Interview and Examination Survey for Adults (DEGS1-MH). International Journal of Methods in Psychiatric Research, 22(2), 83-99.
Mack, S., Jacobi, F., Gerschler, A., Strehle, J., Höfler, M. Busch, M., Maske, U., Hapke, U., Seiffert, I., Gaebel, W., Zielasek, J, Maier, W., Wittchen, H.-U. (2014). Self-reported utilization of mental health services in the adult German population - evidence for unmet needs? Results of the DEGS1-MentalHealthModule (DEGS1-MH). International Journal of Methods in Psychiatric Research.
Jacobi, F. & Kessler-Scheil, S. (2013). Epidemiologie psychischer Störungen. Zur Frage der Häufigkeit und Krankheitslast psychischer Störungen in unserer Gesellschaft.
Continuing-Medical-Education (CME) Beitrag. Psychotherapeut 2, 191-206.
Wittchen, H.-U. & Maier, W. (2013, 28.11.). 1. Wittchen: Welches sind die Hochrisikogruppen und -Konstellationen für psychische Störungen? 2. Jacobi: Was sind die sozialen
und gesundheitsökonomisch relevanten Implikationen psychischer Morbiditätsmuster? 3. Mack: Die Behandlungssituation psychischer Störungen: Hat sich in der letzten
Dekade etwas verändert? Psychische Störungen in der Allgemeinbevölkerung: Aktuelle Fragen der Studie zur Gesundheit Erwachsener in Deutschland und ihrem Zusatzmodul „Mental Health“ (DEGS1-MH). Symposium auf dem DGPPN-Kongress.
Gaebel, W. & Hapke, U. (2013, 30.11.): 1. Wagner et al.: Soziale Faktoren und neuropsychologische Einschränkungsprofile: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1-MH). 2. Gaebel et al.: Soziale Faktoren und die Häufigkeit psychotischer Syndrome und psychoseähnlicher Erfahrungen: Ergebnisse der Studie
92
zur Gesundheit Erwachsener in Deutschland (DEGS1). 3. Jacobi et al.: Der „soziale Gradient“ psychischer Störungen im Kohortenvergleich. 4. Hapke et al.: Affektive Störungen, chronischer Stress und soziale Lage: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1) Soziale Faktoren und psychische Funktionsstörungen in der Allgemeinbevölkerung: Befunde der Studie zur Gesundheit Erwachsener in Deutschland und ihrem Zusatzmodul „Mental Health“ (DEGS1-MH). Symposium
auf dem DGPPN-Kongress.
Jacobi, F. & Hapke, U. (2013, 05.-08.06.). Jacobi et al.: How to establish evidence for possible changes between 1998 and 2012 in the morbidity spectrum of the longitudinal
DEGS1-MH cohort. 2. Mack et al.: Determinants of help-seeking and health care utilization in patients with mental disorders. 3. Zielasek et al.: Psychotic experiences in
the community: prevalence and relation to DSM-IV diagnoses. 4. Wagner et al.: Cognitive epidemiology and mental health in the Mental Health Supplement of the “German Health Interview and Examination Survey for Adults” (DEGS1-MH). The Mental Health Supplement of the “German Health Interview and Examination Survey for
Adults” (DEGS1-MH). Symposium at the 14th International Congress of the IFPE, Leipzig.
Jacobi, F. & Beesdo-Baum, K. (2014, 21.-24.05.). Jacobi et al.: Work situation of people with mental disorders. 2. Beesdo-Baum et al.: Depression: Prevalence, Disease Burden, Service Use and Treatment Barriers. 3. Maske et al.: Comorbidity of mental disorders and chronic somatic conditions in a population-based sample of adults
aged 18-79 years in Germany: first results and methodological challenges. Mental disorders in the German Health Interview and Examination Survey for Adults (DEGS1-MH):
Disease burden and service use. Symposium at the 17th EPA Section Meeting, Ulm.
Wittchen, H.-U. (2013, 08.05.). Ergebnisse des deutschen epidemiologischen Gesundheitssurvey (DEGS): Was ist relevant für Psychotherapeuten? Vortrag auf dem 22. Deutschen Psychotherapeutentag, Berlin.
Professor Dr. Frank Jacobi was appointed to a professorship in Clinical Psychology at the Psychologische Hochschule Berlin (since 10/2010; www.psychologische-hochschule.de) but maintained his formal position as work group leader in projects at the TUD
P4. German Health Interview and Examination Survey 1998 – Mental Health Supplement (GHS-MHS)
Pl: Prof. Dr. Hans-Ulrich Wittchen, Prof. Dr. Frank Jacobi; Funding: initial funding by German Ministry of Education
and Science (BMBF); Duration: Ongoing; Extramural Cooperations: Robert-Koch-Institut (RKI; Berlin), Max-PlanckInstitut für Psychiatrie (MPI-P; München), Columbia University/Mailman School of Public Health (New York; Dr.
Renee Goodwin); University of Manitoba/Mood and Anxiety disorders Research Group (Winnipeg; Dr. Brian Cox, Dr.
Jitender Sareen), University of California at San Diego (Dr. Murray Stein)
The predecessor of DEGS1-MH was a landmark study providing for the first time representative epidemiological
data on mental disorders for the German adult population. Analyses of this data base are still ongoing (also in conjuction with data from the core survey on physical conditions), involving numerous external partners and will be further continued when data can be linked to the DEGS study by end of 2014.A list of more than 100 publications from
that study between 1998 and 2014 (along with abstracts) can be downloaded here: www.psychologie.tu-dresden.
de/i2/klinische/bgs98-mhs-publikationen_1998-2011.pdf
Goodwin, R.D., Cowles, R.A., Galea, S., Jacobi, F. (2013). Gastritis and mental disorders. Journal of Psychiatric Research, 47(1), 128-132.
Goodwin, R.D., Galea, S., Perzanowski , M., Jacobi, F. (2012). Impact of allergy treatment on the association between allergies and mood and anxiety in a population sample.
Clinical and Experimental Allergy, 42, 1765–1771.
Michalak, J., Zhang, X.C., Jacobi, F. (2012). Vegetarian diet and mental disorders: Results from a representative community survey. International Journal of Behavioral Nutrition and Physical Activity, 9:67.
Tomenson, B., Essau, C. Jacobi, F., Ladwig, K.-H., Keiknes, K.A., Lieb, R., Meinlschmidt, G., McBeth, J., Rosmalen, J., Rief, W., Sumathipala, A., Creed, F. (2013). Total
somatic symptom score as a predictor of health outcome in somatic symptom disorders. British Journal of Psychiatry, 203(5), 373-380.
P5. Bundesweite Studie zum Versorgungsverlauf bei Depression in Arztpraxen/National survey on health
care of depression in German primary care practices (VERA)
PI: Prof. Katja Beesdo-Baum, Co-PIs: Dr. Susanne Knappe, Prof. F. Einsle; Funding: Bundesministerium für
Gesundheit (BMG) / German Ministry of Health; Duration: 04/2013 - 04/2016; Staff: Dipl.-Psych. G. Wieder,
Dipl.-Psych. L. Knothe, M.Sc. John Venz, Dipl.-Biol. H. Schmidt, T. Tille, D. Küster, J. Quittschalle; External
Collaborations: Bündnis gegen Depression e.V. (Leipziger Bündnis gegen Depression e.V. - Dipl.-Psych. Nicole
Koburger, Akademie für Suizidprävention des Gesundheitsnetz Osthessen e.V. - Dr. med. Ulrich Walter, Harburger
Bündnis gegen Depression e.V. - Dr. med. Hans-Peter Unger, Charité – Universitätsmedizin Berlin - PD. Dr. med.
Meryam Schouler-Ocak, Münchner Bündnis gegen Depression e.V. - Rita Wüst/Dr. Joachim Hein), Deutsches
Bündnis gegen Depression e.V. (Prof. Dr. Ulrich Hegerl, Ines Heinz), Stiftung Deutsche Depressionshilfe (PD
Dr. Christine Rummel-Kluge, Janine Quittschalle), Universitätsklinikum Carl Gustav Carus an der TU Dresden:
Lehrstuhl für Allgemeinmedizin (Prof. A. Bergmann), Zentrum für evidenzbasierte Gesundheitsversorgung (ZEGV),
Professur für Sozialmedizin und Versorgungsforschung (Prof. Dr. med. J. Schmitt, Denise Küster), Psychiatrische
Epidemiologie und Verlaufsforschung (Prof. Dr. med. A. Pfennig), Sächsische Gesellschaft für Allgemeinmedizin
(SGAM, Dr. J. Dietrich, Dr. Andreas Schuster), AOK Plus (Dr. Ulf Maywald, Andreas Fuchs), Dipl.-Psych. Christian
Klesse, Universitätsklinikum Freiburg, Mitglied der S3 Leitlinien-Gruppe
93
Ziel: Es wird eine mehrstufige, bundesweite prospektiv-longitudinale Studie zum Versorgungsverlauf bei Depression
in Arztpraxen (VERA) zur Untersuchung der Umsetzung der S3-Leitlinie Unipolare Depression in der primärärztlichen Versorgung mit Schwerpunkten auf die versorgerbezogene Perspektive (Awareness, Kenntnis, Akzeptanz,
Adhärenz, fördernde/hemmende Faktoren), die patientenbezogene Perspektive (Alter, Geschlecht, Art/Schwere
der Depression) sowie sektorenbezogene Schnittstellen (von primärärztlicher zu spezialisierter Versorgung,
Regionseffekte) vorgeschlagen. Geplant ist eine regions-geclusterte Zufallsstichprobe von 300 Arztpraxen
(Praktische Ärzte/Allgemeinärzte; und deren Patienten zu Baseline) mit genesteter Interventionskomponente.
Ziele sind: (1) Erfassung der Rezeption und Adhärenz zur S3-Leitlinie im primärärztlichen Sektor sowie assoziierte
Arztmerkmale, (2) Ermittlung der Stichtagsprävalenz und Determinanten erkannter vs. nicht-erkannter, behandelter vs. nicht-behandelter Depression und Vergleich mit Ergebnissen der Depression-2000 Studie, (3) prospektivlongitudinale Untersuchung erkannter Fälle (Arztdiagnose/ Fragebogen-Cutoff) nach 1.5, 3 und 12 Monaten unter
Berücksichtigung leitliniengerechter Versorgung, (4) Beurteilung von Verlauf und Ausgang der Erkrankung in
Abhängigkeit von Leitlinienadhärenz und assoziierten Kosten; (5) Prüfung der Effektivität verfügbarer niederschwelliger leitlinienbezogener supportiver Maßnahmen (NILS; genestete Intervention) zur verbesserten Dissemination
und Adhärenz in zufällig ausgewählten Arztpraxen. Aktueller Status: Im Berichtszeitraum wurden die Feldarbeit
vorbereitet (Erstellung der Erhebungsinstrumente und des Operationshandbuchs, Ethik, Pilotierungsstudie, Aufbau
der Datenbanken, Training der Studienmonitore, Sampling, Rekrutierung) und die Erhebungen der Vorstudie und
der Stichtagsstudie in sechs Regionen Deutschlands (Dresden, Leipzig, Berlin, München, Fulda/Kassel/Frankfurt,
Hamburg) nahezu vollständig durchgeführt. Aktuell sind N=268 Ärzte eingeschlossen, mit ca. 3000 Patienten.
Bei N=46 Ärzten wurde die NILS-Komponente durchgeführt. Derzeit gehen noch Untersuchungsmaterialien im
Studienzentrum ein. Die Daten werden eingegeben und die 6- und 12-Wochen-Nachbefragungen finden statt. Erste
Ergebnisse sind für 2014 zu erwarten.
P6. Trauma and stress-related disorders in German soldiers with and without foreign deployment
PI: Prof. H.-U. Wittchen, Co-PIs: Prof. C. Kirschbaum, Dr. S. Schönfeld; Funding: German Ministry of Defense;
Duration: 2009 - 2013; Collaboration: Prof. Dr. J. Zohar (Israel), Prof. Dr. R.C. Kessler (Boston, US)
Methods overview paper: Prevalence, incidence and determinants of PTSD and other mental disorders:
design and methods of the PID-PTSD+³ study
Within the relatively young history of foreign deployment in the German Federal Armed Forces (“Bundeswehr”)
there has so far been no comprehensive study to monitor possible psychological consequences of stressful experiences related to military deployment. There are concerns that available administrative statistics dramatically underestimate the true rates of trauma and stress-related disorders on one side and having not allocated sufficient treatment and intervention resources for those affected. From a scientific viewpoint, studying this sample will also allow
the investigation of mechanisms behind the transition between stressful experiences and psychopathology.
The project was conducted in two steps. The first step was a cross-sectional study comparing soldiers with recent
deployment (n=1.483) to those without (n=889). The focus of this study was to obtain prevalence data of trauma
and deployment-related disorders such as posttraumatic stress disorder, somatic syndromes, depression, anxiety,
suicide attempts as well as comorbidities. The impact of personal variables (e.g. gender), military specific variables
(e.g. unit) as well as proximal and distal correlates were also taken into account. Finally, help-seeking behavior and
the quality of services provided by the military were assessed.A second, longitudinal study was built upon these
results investigating the direct impact of deployment-related stressors within a prospective design. Soldiers (n=476)
were assessed before and 12 months after their return from deployment. Here we obtained data on a potential
increase of number of trauma experience and posttraumatic symptoms directly related to deployment, the course
of symptom development, and the possible functional mechanisms behind this. Additionally to variables which have
been found relevant in the first study component, cognitive and biological data were obtained in a supplementary
experimental session, including several aspects of memory and attention as well as hormonal variables.
Taken together both studies will hopefully not only increase our understanding of the mechanisms underlying the
development of deployment-related disorders but also provide useful information for a possible adaptation of healthcare and psychosocial support in the armed forces health system, and be a foundation for the development of adequate interventions.
94
Figure: Methods and design of the cross-sectional and the prospective-longitudinal study component
Results
P6.1. Traumatic experiences and posttraumatic stress disorder in soldiers following deployment abroad:
How big is the hidden problem?
Background: Little is known about the frequency of traumatic event exposure and the development of
Posttraumatic Stress Disorder (PTSD) among German soldiers serving in Afghanistan. Methods: Stratified (deployment location, unit) random sample of 1.599 soldiers of the 2009/2010 ISAF mission in Afghanistan. 889 comparable soldiers without deployment were further examined. 12 months after deployment, the Composite International
Figure: 12-months
prevalence and
incidence of PTSD
in deployed and
never deployed
soldiers (controls)
95
Diagnostic Interview (CIDI) was used to derive diagnoses of mental disorders and PTSD according to DSM-IVTR.
Results: 49.2% (KI: 46.4% - 52.1%) of all soldiers experienced at least one, 13% multiple traumatic events during
deployment. 2.9% (KI: 2.1%-4.1%) of soldiers met the criteria for PTSD 12 months after return (12-months prevalence), 0.9% (KI: 0.5%-1.6%) were incident cases. This means an increase of PTSD risk by the factor 2-4. The
PTSD risk was highest among combat units serving in Kunduz (Odds Ratio: 6.6). Only one in two subjects with
PTSD did receive any professional help. Conclusions: Deployment is associated with a high degree of stressful and
traumatic events and an increase of PTSD risk by the factor 2-4. 300 cases per 10.000 soldiers return with PTSD,
the cumulative total number of subjects with PTSD since the beginning of German deployments may thus reach
several thousands. Every one of two PTSD cases remains untreated (about 45% undetected cases). There is also a
substantial increase of other deployment-related mental disorders.
Wittchen H.-U. & Schönfeld S., Kirschbaum C., Thurau C., Trautmann S., Steudte, S., M., Hauffa, R., Zimmermann, P., 2012. Traumatic experiences and posttraumatic stress
disorder in soldiers following deployment abroad: How big is the hidden problem? Deutsches Ärzteblatt International 109(35-36), 559-568.
P6.2. Rates of mental disorders among German soldiers deployed to Afghanistan: Increased risk of PTSD or
of mental disorders in general?
Background: Controversy exists regarding the prevalence of military mission-related PTSD and other mental disorders among
deployed soldiers. Methods: Based on a random stratified sample of n=1599 German soldiers (response rate (RR) 93%,
n=1483), we assessed subjects 12 months after deployment to Afghanistan and compared findings to controls of n=932 never
deployed soldiers (RR: 95%, n=889). Interviews were conducted by trained non-military clinical interviewers using the DSM-IVTRComposite International Diagnostic Interview (CIDI-military). Outcome measures were 12-month prevalence and incidence of
PTSD, anxiety, depressive, substance use disorders and other DSM-IV-TR mental disorders. Results: Deployed soldiers reported
high rates of combat-related and other traumatic events. Compared to controls they had a higher 12-month incidence (OR: 4.3)
and prevalence (OR: 2.4) of PTSD, anxiety (OR: 3.6; 1.4), and alcohol use disorders (OR: 3.5, 1.9). They also had higher rates of
multiple diagnoses (MR: 1.74) and higher anxiety distress scores. Incident PTSD and other mental disorders were best predicted
by prior lifetime mental disorders. Conclusions: German soldiers deployed to Afghanistan are at increased risk of traumatic
events and of mental disorders including PTSD as compared to never-deployed soldiers. The risk for other mental disorders subsequent to traumatic events such as anxiety, somatoform, and alcohol use disorders was substantially larger than the risk for PTSD.
Prior mental disorders were found to be the strongest predictor of 12-month mental disorders and suggest that pre-mission psychopathological screening might be crucial to reduce mission-related mental health risks.
Figure: 12-months prevalence and incidence of PTSD in deployed and never deployed soldiers (controls)
Trautmann, S., Schönfeld, S., Behrendt, S., Höfler, M., Zimmermann, P., Wittchen, H.-U., 2014. Substance use and substance use disorders in recently deployed and never
deployed soldiers. Drug and Alcohol Dependence 134, 128-135.
Trautmann, S., Schönfeld, S., Höfler, M., Heinrich, A., Hauffa, R., Zimmermann, P., Wittchen, H.-U., 2013. Posttraumatische Belastungsstörungen nach Auslandseinsätzen
deutscher Soldaten. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 56 (7). 930-940.
Wittchen, H.-U. & Schönfeld, S., Kirschbaum, C., Trautmann, S., Thurau, C., Siegert, J., Höfler, M., Hauffa, R., Zimmermann, P., 2013. Rates of mental disorders among German soldiers deployed to Afghanistan: Increased risk of PTSD or of mental disorders in general? Depression and Anxiety 2(1).
96
Wittchen, H.-U. & Schönfeld, S., Kirschbaum, C., Trautmann, S., Thurau, C., Siegert, J., Höfler, M., Hauffa, R., Zimmermann, P., 2013. Rates of Mental Disorders Among German Soldiers Deployed to Afghanistan: Increased Risk of PTSD or of Mental Disorders In General? Depression and Anxiety 2(1).
Wittchen H.-U. & Schönfeld S., Thurau C., Trautmann, S., Galle, M., Mark, K., Hauffa, R., Zimmermann, P., Schaefer, J., Steudte, S., Siegert, J., Höfler, M., Kirschbaum, C.,
2012. Prevalence, incidence and determinants of PTSD and other mental disorders: design and methods of the PID-PTSD+³ study. International Journal of Methods in
Psychiatric Research 12(2), 98-116.
Wittchen H.-U. & Schönfeld S., Kirschbaum C., Thurau C., Trautmann S., Steudte, S., M., Hauffa, R., Zimmermann, P., 2012. Traumatic experiences and posttraumatic stress
disorder in soldiers following deployment abroad: How big is the hidden problem? Deutsches Ärzteblatt International 109(35-36), 559-568.
Zimmermann, P., Höfler, M., Schönfeld, S., Trautmann, S., Hauffa, R., Kowalski, J., & Wittchen, H.-U. (in press). Einsatzerlebnisse und einsatzbedingte psychische Erkrankungen deutscher Soldaten - empirische Struktur und prädiktive Wertigkeit traumatischer Stressoren. Zeitschrift für Klinische Psychologie und Psychoherapie.
P6.3. Topic area: Sleeping problems among deployed German soldiers
(Dissertation Project Anke Heinrich, Supervisors: Prof. Hans-Ulrich Wittchen, Dr. Susanne Knappe)
Sleeping problems among deployed and never deployed soldiers
Objective: Irrespective of clinical significance of disturbed sleep for health, well-being, morbidity and productivity at
work, validated data on the prevalence of sleeping problems in soldiers of the German Armed Forces are lacking.
Method: N=1 483 soldiers were assessed 12 months after return from deployment with the Pittsburgh Sleep
Quality Index (PSQI) and compared to N=889 non-deployed soldiers. The presence of mental disorders according
to the DSM-IV was verified using a standardized clinical interview (CIDI). Result: 40% of soldiers suffered from
disturbed sleep though no differences were observed between both subsamples. The risk for sleeping problems
however was increased if soldiers experienced numerous combat experiences. Furthermore, sleeping problems
were related to traumatic experiences during combat as well as to mental disorders occurring for the first time
after the deployment. Conclusion: It might be presumed that deployment is associated with an increased risk for
sleeping problems only in interaction with combat or traumatic experiences and does not lead to an accumulation of
sleeping problems per se.
Heinrich, A., Knappe, S., Trautman, S., Schönfeld, S., Hauffa, R. & Wittchen, H.-U. (submitted). Schlafprobleme bei Soldaten mit und ohne Auslandseinsatz. Zeitschrift für
Klinische Psychologie und Psychotherapie.
Heinrich, A., Knappe, S., Trautman, S., Schönfeld, S., Hauffa, R. & Wittchen, H.-U. (2014). Wie häufig leiden Soldaten mit und ohne Auslandseinsatz an Schlafproblemen?
Ergebnisse der PID-PTSD+3-Studie. (Poster) DGPPN, 26. – 29.11. 2014 (Berlin).
P6.4. Mit welchen psychischen Störungen sind Schlafprobleme bei Soldaten der Bundeswehr mit
Auslandseinsätzen assoziiert?
Hintergrund: Schlafstörungen und psychische Störungen treten häufig auch bei Soldaten auf. Gerade im militärischen Kontext gelten Schlafstörungen vor dem Einsatz als Prädiktor für posttraumatische Belastungsstörung
(PTBS) und für affektive Störungen nach dem Einsatz, beziehungsweise als Mediator zwischen belastenden
Einsatzereignissen und psychischen Störungen. Offen ist jedoch noch die Frage, ob dies ein überzufälliger Befund
ist, da Schlafstörungen z.B im Diagnostischen und Statistischen Manual psychischer Störungen (DSM-IV-TR) auch
als Kriteriumsmerkmale für diese psychischen Störungen genannt werden Es soll daher untersucht werden, ob
Schlafstörungen ausschließlich mit Affektiven Störungen, der PTBS und der Generalisierten Angststörung assoziiert sind, oder ob es darüber hinaus Assoziationen auch zu anderen psychischen Störungen gibt. Methoden:
Grundlage dieser Arbeit ist die Querschnittstudie der PID-PTSD+3-Studie an 1483 Soldaten des 20. und 21. ISAFKontingentes, die 12 Monate nach Ende ihres Einsatzes in Afghanistan standardisiert mittels des Pittsburgh Sleep
Quality Index (PSQI) untersucht wurden. Psychische Störungen (nach DSM-IV-TR) wurden mittels eines standardisierten klinischen Interviews (CIDI) erhoben. Die Soldaten wurden in drei Gruppen unterschieden: ohne inzidente
psychische Störungen, inzidente mit Schlaf assoziierte psychische Störungen (affektive Störungen, PTBS, generalisierte Angststörung) und andere inzidente psychische Störungen. Zur repräsentativen Auswertung wurde eine
Gewichtung hinsichtlich Alter, Geschlecht, Dienstgrad und Truppenart vorgenommen. Es wurden multinomiale logistische Regressionen zur Bestimmung der Zusammenhänge zwischen Schlafstörungen und psychischen Störungen
berechnet. Ergebnisse: Insgesamt litten 40.5% der Soldaten an Schlafstörungen. 21.4% berichteten mindestens
eine psychische Erkrankung in den letzten 12 Monaten, 8.0% mindestens eine inzidente psychische Störung. Der
Anteil der Soldaten mit einer psychischen Erkrankung war deutlich höher unter Soldaten mit Schlafstörungen,
sowohl bei den 12-Monatsdiagnosen als auch bei den 12-Monatsinzidenzen (34.5% vs. 12.4%, p < 0.001 bzw.
14.2% vs. 3.9%, p< 0.001). Unter den Soldaten mit einer Schlafstörung war das Risiko für eine inzidente mit Schlaf
assoziierte psychische Störung um das bis zu achtfache erhöht (OR: 8.9; 95% KI: 3.0 – 26.1; p< 0.001). Auch an
anderen inzidenten psychischen Störungen zu leiden war unter den Soldaten mit Schlafstörungen signifikant erhöht
97
(OR: 3.4; 95% KI: 2.0 – 5.6; p< 0.001). Im Hinblick auf die Wahrscheinlichkeit an mit Schlaf assoziierten psychischen Störungen oder an anderen psychischen Störungen zu leiden, konnte bei Soldaten mit Schlafstörungen
jedoch kein Unterschied beobachtet werden. Schlussfolgerungen: Am stärksten ist der Zusammenhang von
Schlafstörungen und psychische Störungen, die mit Schlaf assoziiert sind; doch auch bei anderen psychischen
Störungen liegen Schlafstörungen häufig komorbid vor. Eine Erfassung von Schlafstörungen unabhängig von anderen psychischen Beschwerden erscheint gerade im militärischen Kontext außerordentlich bedeutsam. Eine gezielte
und frühzeitige Behandlung von Schlafstörungen könnte betroffene Soldaten entlasten und gegebenenfalls zur einer
Verminderung oder gar Verhinderung anderer psychopathologischer Beschwerden führen.
Heinrich, A., Knappe, S., Trautman, S., Schönfeld, S., Hauffa, R. & Wittchen, H.-U. (submitted). Mit welchen psychischen Störungen sind Schlafprobleme bei Soldaten der
Bundeswehr mit Auslandseinsätzen assoziiert?.
Heinrich, A., Knappe, S., Trautman, S., Schönfeld, S., Hauffa, R. & Wittchen, H.-U. (submitted). Mit welchen psychischen Störungen sind Schlafprobleme bei Soldaten der
Bundeswehr mit Auslandseinsätzen assoziiert? Paper presented at the DGSM, 04.-06. 12. 2014 (Köln).
P6.5. Topic area: Substance use and substance use disorders in the context of military deployment
(Dissertation Project Sebastian Trautmann, Supervisors: Wittchen, Schönfeld, Behrendt)
Substance use and substance use disorders in recently deployed and never deployed soldiers
Background: Military studies investigating the prevalence of substance use (SU) and substance use disorders
(SUD) and the relation between SU and mental disorders often lack a comprehensive assessment of SU, SUD and
mental disorders and comparable groups of deployed and non-deployed personnel. There is also limited data regarding SU and SUD in the German military to date. Methods: Cross-sectional examination of n=1483 soldiers recently
deployed in Afghanistan and 889 never deployed soldiers using a fully-standardized diagnostic interview (MI-CIDI)
including a comprehensive substance section. Results: Across both groups, 12-months prevalence of DSM-IV alcohol use disorders was 3.1%, 36.9% reported binge drinking, 13.9% heavy drinking, 1.3% illegal drug use. 55.1%
were regular smokers, 10.9% nicotine dependent. Although recently deployed soldiers revealed slightly higher rates
in some measures, there were no significant differences to the never deployed regarding SU und SUD except that
recently deployed soldiers smoked more cigarettes per day. The association of SU with mental mental disorders
was substantially different though, revealing significant associations between SU and mental disorders only among
recently deployed soldiers. Conclusions: We do not find remarkable differences in the prevalence of SU and SUD
between recently deployed and never deployed soldiers. Especially binge drinking and regular smoking were prevalent across both samples indicating needs for improved interventions. The finding that SU and mental disorders
are only associated in recently deployed soldiers might have implications for improved screening and prevention
and suggests that deployment might promote different pathways and mechanisms involved in the evolution SU and
mental disorders.
Trautmann, S., Schönfeld, S., Behrendt, S., Höfler, M., Zimmermann, P., Wittchen, H.-U., (2014). Substance use and substance use disorders in recently deployed and never
deployed soldiers. Drug and Alcohol Dependence 134, 128-135.
P6.6. Associations between lifetime PTSD symptoms and current substance use disorders using a five-factor
model of PTSD
This paper aimed to extend the existing knowledge on the association between PTSD symptoms, alcohol use disorders (AUD) and nicotine dependence (ND) by distinguishing between anxious and dysphoric arousal PTSD symptoms and by considering the contribution of additional comorbid disorders. Data stem from a cross-sectional study
in a stratified, representative sample of 1483 recently deployed soldiers using standardized diagnostic interviews.
All lifetime PTSD-symptom clusters were associated with current AUD and ND in crude models except that anxious
arousal was not related to AUD. Associations were reduced in magnitude when controlling for comorbidity. Current
ND was related to the occurrence of any anxious arousal and to the number of re-experiencing symptoms above
the contribution of other symptoms clusters and comorbidity. Occurrence of any anxious arousal symptoms was
also related to a decreased risk for current AUD. In conclusion, associations between PTSD symptoms and SUD
may be partially attributable to additional comorbidity. Findings also yield further evidence for a role of emotional
numbing and re-experiencing symptoms in the comorbidity between PTSD and nicotine dependence and for a distinction between dysphoric and anxious arousal PTSD symptoms.
Trautmann, S., Schönfeld, S., Behrendt, S., Schäfer, J., Höfler, M., Zimmermann, P., Wittchen, H.-U., (submitted). Associations between lifetime PTSD symptoms and current
substance use disorders using a five-factor model of PTSD. Journal of anxiety disorders.
98
P6.7. Stress exposure and the risk for the onset of alcohol use disorders and nicotine dependence: The role
of prior internalizing disorders
Objective: This prospective study aimed to investigate whether prior internalizing disorders (PID) moderate the
relationship between stress exposure (SE) and the onset of alcohol use disorders (AUD) and nicotine dependence
(ND). Methods: 358 male soldiers were examined directly before and 12 months after return from deployment
using standardized interviews. Combat experiences, concerns about family disruptions, difficult living and working
environment were assessed as different aspects of SE. Diagnoses of PID (mood disorders (PMD), anxiety disorders
(PAD)) and substance use disorders were defined according to the DSM-IV-TR. Results: PMD (OR=11.5 (1.9-68.6),
p=0.007) and the number of PID diagnoses (OR=2.9 (1.2-7.0), p=0.021) were related to a stronger association between concerns about family disruptions and the risk of AUD onset. The number of PID diagnoses was also related
to a stronger association between difficult living and working environment and the risk of AUD onset (OR=1.8
(1.1-3.2), p=0.032). With regard to ND, the presence of a PMD (OR=0.4 (0.2-0.9), p=0.023) and the number of PID
diagnoses (OR=0.6 (0.4-0.9), p=0.026) were related to a weaker association between difficult living and working
environment and the risk of ND onset. Conclusions: PID might be related to an increased risk for the onset of AUD
but not ND following SE. This effect is probably restricted to PMD, comorbid PID and specific aspects of SE. The
identification of critical constellations of PID and SE might be a promising target for future research and could contribute the development of preventive measures to reduce the risk of AUD following SE.
Trautmann, S., Schönfeld, S., Behrendt, S., Heinrich, A., Höfler, M., Siegel, S., Zimmermann, P., Wittchen, H.-U., (submitted). Stress exposure and the risk for the onset of
alcohol use disorders and nicotine dependence: The role of prior internalizing disorders. Addictive Behaviors.
Predictors of changes in daily alcohol consumption in the aftermath of military deployment
Background: Several studies have documented factors related to increases in alcohol consumption in the context
of stressful experiences. However, little is known about predictors of different courses of alcohol use in this context. This study aims to investigate diverse predictors and correlates of increase and decrease of average daily alcohol consumption (aDAC) in the aftermath of military deployment taking into account a variety of potentially relevant
factors. Methods: N=358 soldiers were examined before (T1) and 12 months after return from deployment (T2)
using standardized interviews. Change in aDAC was categorized into decreased (n=72), stable (n=215) and increased (n=71) aDAC. Results: Overall, aDAC did not change significantly between T1 and T2 (median change=0.0g,
IQR=11.3g). Compared to stable aDAC, increase was characterized by a lower proportion of high-educated individuals (OR:0.3 (0.1-0.7), p=0.008), lower rank (OR:2.0 (1.0-4.1), p=0.050), and less acceptance by trend (MR:0.97
(0.93-1.00), p=0.053). Correlates of increased aDAC were less social support (MR: 0.84 (0.71-0.99), p=0.043),
more sleeping problems (MR:1.15 (1.00-1.31), p=0.045) and more negative post-event cognitions following deployment (MR:2.32 (1.28-4.21), p=0.006). Decrease in aDAC was predicted by lower PTSD symptom severity before
deployment (MR: 0.34 (0.16-0.72), p=0.005) and less childhood emotional neglect (MR:0.78 (0.60-1.00), p=0.050).
Conclusions: Increase and decrease in alcohol use after stressful experiences might have differential risk factors
and correlates. Findings might stimulate future research that could result in improved measures to prevent increases as well as in interventions that could foster decreases in alcohol consumption in the context of stressful experiences.
Trautmann, S., Schönfeld, S., Behrendt, S., Heinrich, A., Höfler, M., Siegel, S., Zimmermann, P., Wittchen, H.-U., submitted. Predictors of changes in daily alcohol consumption in the aftermath of military deployment. Drug and Alcohol Dependence.
P6.8. Topic area: Attentional processes and trauma-related psychopathology.
(Dissertation Project Judith Schäfer, Supervisors: Wittchen, Schönfeld)
The Interaction of Trauma Dose, Attentional Bias and Emotion Regulation Predicts Depressiveness
Trauma is a risk factor for the development of depression. Attentional biases are seen as important factors in the
etiology and maintenance of depression as part of the emotion regulation process and are supposed to confer
vulnerability for psychopathological processes following trauma. This study examines whether pre-traumatic attentional biases and emotion regulation predict a differential association between trauma and subsequent depressive
symptoms. Data are part of a longitudinal study investigating mental health and its determinants among German
99
soldiers before and after deployment using standardized diagnostic interviews, questionnaires and cognitive tasks.
Prior to deployment soldiers participated in a dot probe task with happy, threat and neutral stimuli. Analyses are
based on a sample of 249 deployed soldiers with complete data for the present analysis. Regression analyses
revealed that the number of traumatic events during the follow-up period predicted depressive symptoms at followup. Neither attentional bias to happy nor to threat stimuli was found to predict a differential association between
trauma exposure and depressive symptoms. However, the interaction of attentional bias to happy stimuli, trauma
and emotion regulation predicted depressive symptoms. In particular, when emotion regulation abilities were high
attentional bias predicted a weaker association between trauma exposure and depressive symptoms. When emotion regulation abilities were low attentional bias predicted a stronger association between trauma and depressive
symptoms. No such evidence was found for attentional biases to threat. These results suggest that attentional bias
to positive stimuli in combination with emotion regulation abilities may contribute to depressive symptoms subsequent trauma.
Schäfer, J., Höfler, M., Trautmann, S., Wittchen, H.-U., Zimmermann, P., Schönfeld, S. (in preparation). The Interaction of Trauma Dose, Attentional Bias and Emotion Regulation Predicts Depressiveness.
P6.9. Resilience in traumatized German soldiers: Attentional control predicts a differential association between resilience and attentional vigilance to threat
Attentional processes have been suggested to confer vulnerability for mental disorders after trauma exposure
(Cisler et al., 2011) and might therefore also be associated with resilience. Research is lacking on associations between attentional biases (AB) to happy and threat-related stimuli, attentional control (AC) and resilience. Data stem
from the follow-up assessment of a longitudinal study program investigating mental health and its determinants in
German soldiers deployed in Afghanistan with standardized diagnostic interviews (Wittchen et al., 2012). A subsample of n=161 completed a dot probe task of Sipos, Bar-Haim, Abend, Adler and Bliese (2013) for assessing AB to
threatening and positive stimuli and questionnaires about resilience and AC. Attentional control was positively associated with resilience. AB to happy and threat-related stimuli were not associated with resilience. AC was related to
a differential association between resilience and AB to threat. No such associations were found for AB to positive
stimuli. The results suggest that AC promotes the protective effect of resilience against AB to threat. Theoretical
and practical implications will be discussed.
Schäfer, J., Wittchen, H.-U., Höfler, M., Zimmermann, P., Schönfeld, S. (in preparation). Attentional control predicts a differential association between resilience and attentional vigilance to threat.
P7. Mental Disorders in the elderly: Relationship to impairment, functioning (ICF) and service utilisation
(MentDis_ICF65+)
PI: Prof. Uwe Koch, Prof. Martin Härter; Site director Dresden: Prof. Hans-Ulrich Wittchen; Funding: EU: Call
(part) identifier: FP7-HEALTH-2007-B; Duration: 10/2008 – 10/2012; Collaborations: Dr. Ralf Krappa, Dr. Stephan
Winters, Dr. Sylke Andreas (Universitätsklinikum Hamburg-Eppendorf), Giacomo Ciriago, Prof. Patrizio Bianchi, Prof.
Valeria Ruggiero, Prof. Enrico Granieri, Prof. Luuigi Grassi (Universita Degli Studi di Ferrara), Vanessa Cameron,
Prof. Sue Bailey, Dr. Paul Lelliot (Royal College of Psychiatrists), Francisco Lopez Garcia, Prof. Carmen Acebal
Sarabia, Javier Torres, Dr. Manuel Munoz (Universidad Complutense de Madrid), Philippe Spiess, Prof. Panteleimon
Giannakopolous, Dr. Alessandra Canuto (Les Hopitaux Universitaires de Geneve), Dr. Arik Tzukert, Dr. Menachem
Katz, Prof. Arieh Y. Shalev (Hadassah Medical Organisation), Matthias Winker, Hannes Lehmann, Sven Kreigenfeld,
Prof. Dr. Hans-Ulrich Wittchen (TU Dresden)
Background: The EU currently lacks reliable data on the prevalence and incidence of mental disorders in older
people. Despite the availability of several national and international epidemiological studies, the size and burden of
mental disorders in the elderly remain unclear due to various reasons. Therefore, the aims of the MentDis_ICF65+
study are (1) to adapt existing assessment instruments, and (2) to collect data on the prevalence, the incidence, and
the natural course and prognosis of mental disorders in the elderly. Method/Design: Using a cross-sectional and
prospective longitudinal design, this multicenter study from six European countries and associated states (Germany,
Great Britain, Israel, Italy, Spain, and Switzerland) is based on age-stratified, random samples of elderly people
living in the community. The study program consists of three phases: (1) a methodological phase devoted primarily
to the adaptation of age- and gender-specific assessment tools for older people (e.g., the Composite International
Diagnostic Interview, CIDI) as well as psychometric evaluations including translation, back translation; (2) a baseline
community study in all participating countries to assess the lifetime, 12 month and 1 month prevalence and comor-
100
bidity of mental disorders, including prior course, quality of life, health care utilization and helpseeking, impairments
and participation and, (3) a 12 month follow-up of all baseline participants to monitor course and outcome as well
as examine predictors. Discussion: The study is an essential step forward towards the further development and
improvement of harmonised instruments for the assessment of mental disorders as well as the evaluation of activity impairment and participation in older adults. This study will also facilitate the comparison of cross-cultural results.
These results will have bearing on mental health care in the EU and will offer a starting point for necessary structural changes to be initiated for mental health care policy at the level of mental health care politics.
Andreas, S., Härter, M., Volkert, J., Hausberg, M., Sehner, S., Wegscheider, K., Rabung, S., Ausin, B., Canuto, A., Da Ronch, C., Grassi, L., Hershkovitz, Y., Lelliott, P.,
Munoz, M., Quirk, A., Rotenstein, O., Santos-Olmo, A. B., Shalev, A. Y., Siegert, J., Weber, K., Wittchen, H.-U., Koch, U., & Schulz, H. (2013). The MentDis_ICF65+ study
protocol: Prevalence, 1-year incidence and symptom severity of mental disorders in the elderly and their relationship to impairment, functioning (ICF) and service utilisation. BMC Psychiatry, 13(62).
Wittchen, H.-U., Strehle, J., Gerschler, A., Höfler, M., Volkert, J., Hausberg, M., Härter, M., Schulz, H., Canuto, A., Crawford, M., Grassi, L., Munoz, M., Shalev, A., &
Andreas, S. (in press). Measuring Symptoms and Diagnosing Mental Disorders in the Elderly Community: The Test-Retest Reliability of the CIDI65+. International Journal
of Methods in Psychiatric Research.
P8. Other Epidemiologic Contributions
P8.1. Threshold and subthreshold generalized anxiety disorder among US adolescents: prevalence, sociodemographic, and clinical characteristics (M. Burstein, K. Beesdo-Baum, J.-P. He, K. R. Merikangas)
Background: Threshold and subthreshold forms of generalized anxiety disorder (GAD) are highly prevalent and
impairing conditions among adults. However, there are few general population studies that have examined these
conditions during the early life course. The primary objectives of this study were to: (1) examine the prevalence, and
sociodemographic and clinical characteristics of threshold and subthreshold forms of GAD in a nationally representative sample of US youth; and (2) test differences in sociodemographic and clinical characteristics between threshold
and subthreshold forms of the disorder. Method: The National Comorbidity Survey-Adolescent Supplement is a
nationally representative face-to-face survey of 10 123 adolescents 13 to 18 years of age in the continental USA.
Results: Approximately 3% of adolescents met criteria for threshold GAD. Reducing the required duration from 6
months to 3 months resulted in a 65.7% increase in prevalence (5.0%); further relaxing the uncontrollability criterion
led to an additional 20.7% increase in prevalence (6.1%). Adolescents with all forms of GAD displayed a recurrent
clinical course marked by substantial impairment and co-morbidity with other psychiatric disorders. There were few
significant differences in sociodemographic and clinical characteristics between threshold and subthreshold cases
of GAD. Results also revealed age-related differences in the associated symptoms and clinical course of GAD.
Conclusions: Findings demonstrate the clinical significance of subthreshold forms of GAD among adolescent youth,
highlighting the continuous nature of the GAD construct. Age-related differences in the associated symptoms and
clinical course of GAD provide further support for criteria that capture variation in clinical features across development.
Burstein, M., Beesdo-Baum, K., He, J.-P., & Merikangas, K. R. (2014). Threshold and subthreshold generalized anxiety disorder among US adolescents: prevalence, sociodemographic and clinical characteristics. Psychological Medicine.
P8.2. The latent structure and comorbidity patterns of generalized anxiety disorders and major depressive
disorders: A national study (C. Blanco, J. M. Rubio, M. Wall, R. Secades-Villa, K. Beesdo-Baum, S. Wang)
Background: There is controversy on whether generalized anxiety disorder (GAD) and major depressive disorder
(MDD) constitute the same or separate disorders. This study sought to examine the factor structure of the DSM-IV
diagnostic criteria of GAD and MDD and the patterns of comorbidity associated with both disorders. Methods: Data
were drawn from the National Epidemiological Survey on Alcohol and Related conditions (NESARC), a representative sample of the adult general population in the United States (N = 43,093). Sociodemographic and psychiatric
comorbidity correlates of GAD, MDD, and co-occurring GAD-MDD were obtained. Exploratory and confirmatory factor analyses of the DSM-IV diagnostic criteria for GAD and MDD were conducted, followed by a Multiple Indicators
Multiple Causes (MIMIC) model to examine the invariance of the model across several sociodemographic covariates. Results: A bifactor model with one general factor underlying all the MDD and GAD diagnostic criteria and another factor with large loadings only for the GAD criteria best represented the latent structure. This model showed
excellent fit indices (CFI = 1.00, TLI = 1.00, RMSEA < 0.02), and a high degree of invariance across sociodemogra101
phic covariates. The comorbidity patterns of individuals with MDD only (n = 4,885), GAD only (n = 947) and GADMDD (n = 810) were clearly distinguishable. Conclusions: The latent structure of the diagnostic criteria of MDD
and GAD and their comorbidity patterns suggests that GAD and MDD are closely related but different nosological
entities, with distinct latent structures, clinical manifestations, and patterns of comorbidity.
Blanco, C., Rubio, J. M., Wall, M., Secades-Villa, R., Beesdo-Baum, K., & Wang, S. (2014). The latent structure and comorbidity patterns of generalized anxiety disorder and
major depression disorder: A national study. Depression and Anxiety, 31(3), 214-222.
P8.3. Developmental epidemiology of anxiety disorders (K. Beesdo-Baum & S. Knappe)
Anxiety disorders are frequent and early-emerging conditions associated with considerable developmental, psychosocial, and psychopathologic complications. Early anxiety syndromes may remit spontaneously, but the vast majority
of children and adolescents with an anxiety disorder suffer from either the same condition or other mental disorders
throughout their life. Potential risk factors for the development of anxiety disorders have been identified, such as
parental psychopathology, behaviorally inhibited temperament, and early life adversity. Effective treatments exist for
anxiety disorders and related conditions, but the size of the problem cannot be resolved through treatment interventions alone; better strategies need to be identified for improved prevention and early intervention.
Beesdo-Baum, K., & Knappe, S. (2012). Developmental epidemiology of anxiety disorders. Child and Adolescent Psychiatric Clinics of North America, 21(3), 457-478.
Beesdo-Baum, K., & Wittchen, H.-U. (in press). Epidemiology of mental illness. In J. D. Wright (Ed.), International Encyclopedia of the Social & Behavioral Sciences (2nd ed.):
Elsevier.
Further Contributions
Beesdo-Baum, K. (2012). Vulnerability and resilience in the development of anxiety: Epidemiology. European Neuropsychopharmacology, S118 - S119.
Beesdo-Baum, K., & Knappe, S. (2012). Epidemiologie: Häufigkeit, Verlauf, Komorbidität. [Epidemiology: Prevalence, course, comorbidity]. In R. Rupprecht & M. Kellner (Eds.),
Angststörungen – Klinik, Forschung, Therapie. [Anxiety Disorders - Clinic, Research, Treatment] (pp. 64-90). Stuttgart: Kohlhammer.
Beesdo-Baum, K., & Knappe, S. (2014). Epidemiology and natural course. In P. Emmelkamp & T. Ehring (Eds.), The Wiley Handbook of Anxiety Disorders (Vol. 1, pp. 26-46):
John Wiley & Sons; Ltd.
Goodwin, R., Beesdo-Baum, K., Knappe, S., & Stein, D. J. (2014). Life course epidemiology of anxiety disorders In K. C. Koenen, S. Rudenstine, E. Susser & S. Galea (Eds.), A
Life Course Approach to Mental Disorders (pp. 97-110). Oxford: Oxford University Press.
Hund, B., Reuter, K., Jacobi, F., Siegert, J., Wittchen, H.-U., Härter, M., Mehnert, A. (2013). Adaptation des Composite International Diagnostic Interview (CIDI) zur Erfassung
komorbider psychischer Störungen in der Onkologie: das CIDI-O. Psychother Psych Med (PPMP).
Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. U. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and
mood disorders in the United States. International Journal of Methods in Psychiatric Research, 21(3), 169-184.
Then, F.S., Luck, T., Jacobi, F., Berger, K., Weyerer, S., Grabe, H.J., Busch, M.A., Wagner, M., Riedel, O.Heller, S. (2013). Assessment of mild cognitve Impairment and
dementia in epidemiologic studies: An overview on the current state of research in Germany. Psychiatrische Praxis, 40(4), 183-191.
102
AG 2 EXPERIMENTAL CLINICAL PSYCHOLOGY AND NEUROIMAGING
U. LÜKEN, K. BEESDO-BAUM & M. MÜHLHAN
PD Dr. Ulrike Lüken, Prof. Dr. Katja Beesdo-Baum & Dr. Markus Mühlhan
This work group has is embedded in a collaborative context encompassing several local work groups (Prof. Dr.
Thomas Goschke, Dept. of Psychology; Prof. Dr. Michael Smolka, Prof. Dr. Michael Bauer, Dept. of Psychiatry
and Psychotherapy; and many other groups) as well as extramural cooperations (Prof. Dr. Tilo Kircher, Dept. of
Psychiatry and Psychotherapy, University Hospital Marburg, Prof. Dr. Andreas Ströhle, Dept. of Psychiatry and
Psychotherapy, Campus Charité Mitte, Prof. Dr. Alfons Hamm, Ernst Moritz Arndt Universität Greifswald, Daniel
S. Pine, M.D., National Institutes of Mental Health). Research activities of this work group focus on experimental
and neuroimaging methods to study normal and dysfunctional processes in subclinical and clinical populations with
anxiety and related conditions as well as their neural plasticity following psychological treatment. The group also
aims at the identification of new treatment targets that might be instrumental in improving cognitive-behavioral
treatments and an understanding why they work.
Cooperation partner
Dr.Daniel S.Pine (NIMH,USA)
visiting in Dresden as speaker
for the
„Buhlerkolloquium“
in july 2013 with
Prof.Dr.Katja Beesdo-Baum
Research focus: Panic Disorder with Agoraphobia
P3. Therapygenetics and genetic imaging in panic disorder with agoraphobia
PI’s: Prof. Tilo Kircher (fMRI project; Dept. of Psychiatry and Psychotherapy, University Hospital Marburg and Prof.
Jürgen Deckert (genetic project; Dept. of Psychiatry, Psychosomatics and Psychotherapy, University Hospital
Würzburg)
Site Director: Dr. Ulrike Lüken; Funding: Federal Ministry of Education and Research, national research network
„Panic-Net“
Duration: First funding period: 05/2007 - 09/2009; second funding period: 01/2010 – 12/2012
Background: Within the last decade, functional magnetic resonance imaging (fMRI) has greatly contributed to our
basic understanding of the neural underpinnings of normal and pathological fear. Linking fMRI in a multilevel strategy (e.g. genomic imaging) with clinical treatment studies may moreover help to develop its potential for translational psychotherapy research. Methods: Based on fMRI data from the national research initiative “panic-net” we
investigated the neural substrates of Panic Disorder and Agoraphobia (PD/AG) in relation to treatment response
following exposure-based cognitive-behavioural therapy. Genetic markers of treatment response and biobehavioral correlates were further investigated. Results: Genetic polymorphisms of the serotonin system were found
to be associated with treatment response across different response levels. Carriers of the Monoaminooxidase-A
(MAO-A) high-activity allele showed significantly reduced treatment response, elevated autonomic arousal during
a behavioral avoidance test and altered neural processing of safety cues. Neither the Serotonin receptor 1A gene
(HTR1A) nor the 5HTT-LPR polymorphism were associated with treatment response, but risk allele carriers showed enhanced avoidance behavior (HTR1A) and decreased functional connectivity between the anterior cingulate
cortex and the amygdala, a circuit previously implicated in emotional regulation and fear extinction. Conclusion:
103
Therapygenetics and genomic imaging analyses demonstrated genetic modulation across different response levels,
including neurofunctional activation, autonomic arousal, defensive behaviors, and treatment response. Results translate evidence from animal studies to humans and suggest a central role of these genetic variants in differentiating
subgroups of patients with PD/AG.
Reif, A., Richter, J., Straube, B., Höfler, M., Lueken, U., Gloster, A. T., Weber, H., Domschke, K., Fehm, L., Ströhle, A., Jansen, A., Gerlach, A., Pyka, M., Reinhardt, I., Konrad, C., Wittmann, A., Pfleiderer, B., Alpers, G. W., Pauli, P., Arolt, V., Wittchen. H.-U., Hamm, A., Kircher, T. & Deckert, J. (2013). MAOA and mechanisms of panic disorder revisited: from bench to molecular psychotherapy. Molecular Psychiatry, 19, 122-128.
P1. Neuronal plasticity following cognitive-behavioral therapy in patients with panic disorder with agoraphobia: A multicenter 3 Tesla study using fMRI
PI: Prof. Tilo Kircher (Dept. of Psychiatry and Psychotherapy, University Hospital Marburg); Site Director: Dr. Ulrike Lüken
Funding: Federal Ministry of Education and Research, national research network „Panic-Net“; Duration:First funding
period: 05/2007 - 09/2009; second funding period: 01/2010 – 12/2012
Background: Neurobiological alterations in patients with panic disorder and agoraphobia (PD/AG) and changes during psychotherapy still await further clarification. Although several studies report differential activation patterns in
cortical-subscortical structures in PD/AG patients, neuroplastic changes relating to psychotherapeutic interventions
remain largely unknown. In cooperation with a clinical trial, the present study aimed to investigate alterations in
brain activation patterns in PD/AG patients and their modification during psychotherapy. In order to gain a sufficient
statistical power, patient data were pooled using a multicenter strategy. Specific neuropsychological paradigms
have been developed that tap on brain functions associated with fear regulation (e.g., classical fear conditioning, the
processing of intero- vs. exteroceptive stimuli, and the perception of panic relevant visual stimuli). Results from this
integrated neurobiological and psychotherapeutic approach will contribute to a better understanding of this disorder
and further clarify potential mechanisms of action in cognitive-behavioural therapy (CBT). Methods: Eighty-nine
patients with PD/AG and n = 90 healthy controls have been assessed before and after CBT using fMRI. Differences
in brain activation and connectivity pattern between groups and time points were analysed. Results regarding altered brain activation patterns have been furthermore evaluated within the scope of psychophysiological, genetic,
and clinical parameters. Results: Results showed comparable drop-out rates, but moderately impared data quality
especially in high claustrophobic PD/AG patients. Preliminary analyses indicated enhanced brain activation in PD/AG
patients during classical fear conditioning in the left dorso-lateral prefrontal cortex (dlPFC) and midbrain periaqueductal gray. In patients, activation of the left dlPFC and regions of the “fear network” (amygdalae, insulae, anterior
cingulate cortex; ACC) attenuated after CBT. Patients further demonstrated increased connectivity between the
dlPFC and fear circuitry structures which remained stable during CBT (Figure 1). Conclusion: The feasibility of largescale fMRI studies on PD/AG patients could be proved. Findings demonstrate altered brain activation during fear
conditioning which can be seen as a key pathological mechanism for the development and maintenance of PD/AG.
Findings contribute to a better understanding of how neurofunctional predispositions modulate treatment response
and enlarge our knowledge about the pathways by which successful treatments are conveyed.
Figure 1: Left figure: Interaction of activation for group (P/C), time point (t1/t2), and stimulus type (conditioned stimulus [CS] /CS–) during early
acquisition (A1). Right figure: Group difference (P>C) in the connectivity of the left inferior frontal gyrus (IFG). Connectivity was analyzed across the
whole time course of the conditioning paradigm. The activation cluster of the left IFG (Figure 1) served as the seed region. Higher functional connectivity in patients between the left IFG and the bilateral amygdalae (Amy.), the hippocampi (Hipp.), the anterior cingulate cortex (ACC), and the medial
and lateral prefrontal cortex (PFC; fear network) was observed. The bar graph illustrates the correlation coefficients for the correlation between the
left IFG and the right amygdala. Error bars refer to the standard error of the mean (Figure adapted from Kircher et al., 2013).
104
Kircher, T., Arolt, V., Jansen, A., Pyka, M., Reinhardt, I., Kellermann, T., Konrad, C., Lueken, U., Gloster, A. T., Gerlach, A. L., Ströhle, A., Wittmann, A., Pfleiderer, B., Wittchen, H. U., Straube, B. (2013). Effect of cognitive behavioural therapy on neural correlates of fear conditioning in panic disorder. Biological Psychiatry, 73, 93-101.
Lueken, U., Straube, B., Konrad, C. Wittchen, H.-U., Ströhle, A., Wittmann, A., Pfleiderer, B., Uhlmann, C., Arolt, V., Jansen, A., Kircher, T. (2013). Neural substrates of treatment response to cognitive behavioral therapy in panic disorder with agoraphobia. American Journal of Psychiatry, 170, 1345-1355.
Lueken, U.*, Straube, B.*, Reinhardt, I., Maslowski, N. I., Wittchen, H.-U., Ströhle, A., Wittmann, A., Pfleiderer, B., Konrad, C., Ewert, A., Uhlmann, C., Arolt, V., Jansen, A. &
Kircher, T. (2014). Altered top-down and bottom-up processing of fear conditioning in panic disorder with agoraphobia. Psychological Medicine, 44, 381-394. *shared first
authorship
Straube, B., Lueken, U., Jansen, A., Konrad, K., Gloster, A. T., Gerlach, A. L., Ströhle, A., Wittmann, A., Pfleiderer, B., Gauggel, S., Wittchen, H.-U., Arolt, V. & Kircher, T.
(2014). Neural correlates of procedural variants in cognitive behavioral therapy: A randomized, controlled multicentre fMRI study. Psychotherapy and Psychosomatics, 83,
222-233.
Lueken, U., Muehlhan, M., Wittchen, H.-U., Kellermann, T., Reinhardt, I., Konrad, C., Lang, T., Wittmann, A., Ströhle, A., Gerlach, A. L., Ewert, A., & Kircher, T. (2011). (Don’t)
panic in the scanner! How panic patients with agoraphobia experience a functional magnetic resonance imaging session. European Neuropsychopharmacology, 21, 516525.
Wittmann, A., Schlagenhauf, F., Guhn, A., Lueken, U., Stoy, M., Bermpohl, F., Fydrich, T., Pfleiderer, B., Bruhn, H., Gerlach, A. L., Kircher, T., Straube, B., Wittchen, H.-U.,
Arolt, V., Heinz, A. & Ströhle, A. (2014). Anticipating agoraphobic situations: the neural correlates of panic disorder with agoraphobia. Psychological Medicine, 7, 1-12.
P2. Neuroimaging markers of treatment response to cognitive-behavioral therapy in panic disorder with
agoraphobia
PI: Prof. Tilo Kircher (Dept. of Psychiatry and Psychotherapy, University Hospital Marburg); Site Director: Dr. Ulrike Lüken
Funding: Federal Ministry of Education and Research, national research network „Panic-Net“; Duration:First funding
period: 05/2007 - 09/2009; Second funding period: 01/2010 – 12/2012
Background: Although exposure-based cognitive behavioral therapy (CBT) is an effective treatment option for panic
disorder with agoraphobia (PD/AG), a substantial proportion of patients does not fully respond. Characterizing prognostic features of treatment response towards exposure-based CBT would inform expert decisions on patient stratification a priori. Evidence suggests that PD/AG is characterized by dysfunctional safety signal processing. Using
fear conditioning as a neurofunctional probe, we investigated neural baseline characteristics associated with treatment outcome in PD/AG patients. Methods: Neural correlates of fear conditioning and extinction were measured
using functional magnetic resonance imaging (fMRI) before a manualized CBT program focussing on behavioural
exposure in 49 medication-free patients with a primary diagnosis of PD/AG. Treatment response was defined as
exceeding 50 % reduction in Hamilton Anxiety Scale scores. Response groups were compared regarding baseline
neurofunctional differences in fear conditioning and functional connectivity in fear circuits associated with emotional
regulation 8e.g. anterior cingulate-amygdala circuit). Supplementing these group analyses we conducted multivariate pattern recognition analyses using supervised machine learning (Gaussian Process Classifiers; GPC) to predict
treatment response of individual patients using leave-one-out cross-validation (LOOCV). Results: Prior to treatment,
non-response was characterized by enhanced activation of the right pregenual ACC, hippocampus, and amygdala in
response to a safety signal. Responders showed an inhibitory functional coupling between the ACC and amygdala
Figure 2: Left figure: Differences are as indicated by the interaction effect of group-by-CS (conditioned stimulus) during the extinction phase (error
bars indicate the standard error of the mean). Estimated beta values from the pregenual anterior cingulate cortex (ACC), amygdala, and hippocampus
cluster show that the effect is driven by enhanced activation toward the CS– (conditioned stimulus not followed by the unconditioned stimulus, safety
signal) during the extinction phase in nonresponders but not in respondersRight figure: Group differences in functional connectivity between the ACC
and the amygdala. Connectivity was analyzed across the entire time course of the conditioning paradigm. The activation cluster of the ACC served as
the seed region. Results are presented using a region-of-interest approach for the amygdala (p,0.05, family-wise-error corrected). Responders and nonresponders differed in functional connectivity between these two regions, with responders showing a negative coupling between the ACC and the amygdala (error bars indicate the standard error of the means). L=left; R=right. *p < 0.05. **p < 0.01. ***p < 0.001. Adapted from Lueken et al. (2013).
105
(Figure 2). Using GPC, 82% of patients were correctly classified as responders or non-responders based on fMRI
data. Conclusion: The present study identified brain activation patterns associated with treatment response in PD/
AG. Altered safety signal processing and ACC - amygdala coupling could indicate individual differences among PD/
AG patients determining the effectiveness of exposure-based CBT and associated neuroplastic changes. Findings
point to brain networks by which successful CBT treatment in PD/AG is mediated. Predicting treatment response to
CBT based on functional neuroimaging data in PD/AG is possible with high accuracy on a single-subject level. This
novel machine learning approach brings personalized medicine within reach, directly supporting clinical decisions for
the selection of treatment options.
Lueken, U., Hahn, T., Straube, B., Wittchen, H.-U., Konrad, C., Ströhle, A., Wittmann, A., Pfleiderer, B., Arolt, V., Reif, A. & Kircher, T. (2014). Response prediction in panic disorder with agoraphobia using fMRI based pattern classification. Poster, 20th Meeting of the Organization for Human brain Mapping (OHBM), June 08-12, 2014, Hamburg.
Lueken, U., Straube, B., Konrad, C. Wittchen, H.-U., Ströhle, A., Wittmann, A., Pfleiderer, B., Uhlmann, C., Arolt, V., Jansen, A., Kircher, T. (2013). Neural substrates of treatment response to cognitive behavioral therapy in panic disorder with agoraphobia. American Journal of Psychiatry, 170, 1345-1355.
P5. Neural structures, functioning and connectivity in Generalized Anxiety Disorder and interaction with
neuroendocrine systems: a systematic review (Hilbert, K., Lueken, U., Beesdo-Baum, K.)
Background: Research on the neurobiological basis of Generalized Anxiety Disorder (GAD) has considerably
expanded in recent years. However, many studies investigated different domains and used different methods and
paradigms. Therefore, this review aims to integrate the findings to date and to identify the core correlates of neurobiological underpinnings of GAD discovered so far. Methods: We conducted a systematic review of original papers
investigating neural correlates, connectivity, or structural changes as well as reporting changes in the serotonergic
system, noradrenergic system and cortisol levels in DSM-IV-defined GAD samples until December 2013. Results:
Studies have identified abnormal amygdala and prefrontal cortex activation in patients and decreased functional connectivity between these areas. Furthermore, studies showed increased gray matter volume and decreased structural connectivity between these structures. Neuroendocrine findings are less consistent, but increased reactivity of
the noradrenergic system and perpetuations in the cortisol secretion have been reported. Limitations: Only studies
on DSM-IV defined Generalized Anxiety Disorder which employed a group comparison were included. Conclusion:
Current research suggests a distinct set of neurobiological alterations in Generalized Anxiety Disorder. However,
future research on the interaction between these structures and systems and on the specificity of these findings in
relation to other mental disorders is urgently needed.
Hilbert, K., Lueken, U., Beesdo-Baum, K. (2014). Neural structures, functioning and connectivity in generalized anxiety disorder and interaction with neuroendocrine systems:
A systematic review. Journal of Affective Disorders, 158, 114-126.
P6. Neural und endocrine emotion- und stress regulation in generalized anxiety disorder
PI: Prof. Katja Beesdo-Baum; Funding: Internal grant funding, Dept. of Psychology, TU Dresden Duration: 10/2008 –
10/2013; Cooperations: Dr. Ulrike Lüken, Dr. Markus Mühlhan, Institute of Clinical Psychology and Psychotherapy;
Dipl.-Psych. Elisabeth Klumbies and Dr. Susann Schmiedgen, Institute of Biological Psychology; Dr. Daniel S. Pine,
Section on Development and Affective Neuroscience, National Institute of Mental Health, National Institutes of
Health, Bethesda, USA
Background and aims: Knowledge on the neural, autonomic and endocrine functions in patients with Generalized
Anxiety Disorder (GAD) is insufficient and inconsistent. In particular, no studies exist that examined these functions
in the same sample of patients with GAD. Additionally, there is considerable symptom overlap and comorbidity with
Major Depression (MD). Therefore, the specificity of the results to date is not clear and the possible influence of
concomitant depression has not been evaluated. Aim of this basic, experimental project is to examine the emotionand stress regulation in patients with GAD compared to patients with MD and healthy controls (HC). Based on the
literature and prior own research, we expect a dissociation of various systems in GAD. Particularly, we expect that
patients with GAD show a reduced endocrine stress response but an increased autonomic and neural activity in
structures moderating the emotion- and stress regulation (particularly the amygdala). Method: Pilot study examining
the following functions in subjects with DSM-IV GAD, DSM-IV MD and matched healthy control subjects: (1) the
psychological, endocrine and autonomic stress reaction to a psychosocial stressor, (2) the basal endocrine stress
level, (3) the psychological, endocrine, autonomic and neural stress response to the examination situation in the
MRI-Scanner, (4) the neural function of emotion- and stress regulation, and (5) the neural and autonomic function
during fear conditioning. The following tests/paradigms are used: (a) an established standardized laboratory stress
test – the Trier Social Stress Test (TSST), (b) the selection of salivary cortisol to examine the cortisol day profile,
106
(c) a rating of subjective well-being and the collection of salivary cortisol to examine the cortisol and alpha-amylase
level prior to, during and after the fMRI assessment, (d) an established paradigm used during fMRI that systematically varies emotion and attention focus (Faces-Paradigm), and (e) a fear-conditioning paradigm used during fMRI.
Current Status: Data collection in this pilot study and feasibility study has been completed. Complete fMRI data
sets are available for 64 subjects (N=24 healthy controls, N=24 GAD of which N=16 had comorbid depression,
and N=14 MD without GAD). The study procedure has shown feasibility. Data analyses have been conducted to
provide pilot data for a DFG-grant application, which has resulted in funding (see below). Further analyses are now
conducted to prepare publications. Preliminary Results: Preliminary analyses of the neural function of emotionand stress regulation showed elevated emotional processing in both clinical groups compared to the HC during
presentation of aversive emotional stimuli with increased activation mainly in prefrontal and temporal areas and the
hippocampus for GAD patients and increased activation mainly in prefrontal and orbitofrontal areas and the nucleus
caudatus for MD patients, but only elevated emotional processing during presentation of positive emotional stimuli
in the MD group, with increased activation mainly in the prefrontal cortex, anterior cingulate cortex and temporal
areas. Additionally, these preliminary results showed an additional effect of the attentional focus during the stimuli
presentation: when attention was directed towards the subjective emotional processing, depressed patients showed increased activation in the prefrontal cortex and anterior cingulate cortex compared to both GAD patients and
HC. Vice versa, when attention was directed away from the subjective emotional processing, patients with GAD
showed increased activation, mainly in the prefrontal cortex, anterior cingulate cortex and other areas in the temporal and parietal cortex compared to both MD patients and HC. When inspecting structural alterations in these
groups, increased grey matter volumes were found in the amygdala, putamen, hippocampus and superior temporal
pole in GAD patients compared to HC and in the putamen in MD patients compared to HC. However, HC showed
increased grey matter volume in the PFC compared to both disorder groups. Conclusion: GAD and MD patients
reveal partly different structural and functional neural alterations supporting distinct disorder categories.
Hilbert, K., Lueken, U. & Beesdo-Baum, K. (2013). Neural correlates of generalised anxiety disorder without comorbid depression: preliminary data from a functional MRI
study. European Neuropsychopharmacology, 23(Suppl. 1), 86.
Hilbert, K., Lueken, U. & Beesdo-Baum, K. (2013, 07.-10.03.). Differential prefrontal cortex activation characterizes generalized anxiety disorder without depression. Poster
presented at the 2013 ECNP Workshop on Neuropsychopharmacology for Young Scientists in Europe, Nice (France).
P7. Differential neuro-biological correlates of emotion- and stress regulation in Generalized Anxiety Disorder
compared to Major Depression and Social Phobia
PI: Prof. Katja Beesdo-Baum; Funding: German Research Foundation (DFG); Duration: 10/2013 – 10/2016
Cooperations: Dr. Ulrike Lüken, Dr. Markus Mühlhan, Dipl.-Psych. Kevin Hilbert, Institute of Clinical Psychology and
Psychotherapy; Dipl.-Psych. Elisabeth Klumbies and Dr. Susann Schmiedgen, Institute of Biological Psychology; Dr.
Daniel S. Pine, Section on Development and Affective Neuroscience, National Institute of Mental Health, National
Institutes of Health, Bethesda, USA
Background and aims: The aetiology and pathogenesis of Generalized Anxiety Disorder (GAD) remains poorly
understood. Neurobiological findings are particularly scarce, inconsistent and mostly disregarding of common symptom overlap and comorbidities. Functional neuroimaging studies point to exaggerated activation in the amygdala
and associated neural structures of the ‘fear circuitry network’ in subjects with GAD compared to healthy controls.
However, neuroimaging studies on Major Depression (MD) or Social Phobia (SP) frequently report similar activation
patterns. Therefore, the specificity of the neuroimaging results is not clear. Moreover, the amygdala is viewed as an
important link in the formation of the stress response. Additionally, the few available studies on possible dysfunctions of the stress system in GAD suggest an elevated sympathetic reactivity and hyperactivation of the hypothalamic-pituitary-adrenal axis (HPAA), which leads to the release of cortisol, but partly a reduced endocrine stress reactivity has been reported as well. These indications for a dissociation of different stress systems may possibly be a
result of a reprogrammed HPAA in GAD. However, it remains unclear in how far previous results are mediated by
comorbid anxiety disorders as SP or by concomitant depression, for which altered HPAA-activity has been reliably
shown. This basic research and quasi-experimental case-control-study aims to investigate the neural as well as the
endocrine and autonomic correlates of emotion and stress processing in subjects with GAD without MD/SP, SP without GAS/MD, MD without anxiety disorder and healthy controls. Results are expected to contribute to an improved
characterization and understanding of the neurobiologic correlates of GAD differentiated from MD on the one and
SP on the other side with implications for diagnosis, classification and treatment. Method: The following functions
are examined in subjects with DSM-5 GAD, MD and SP and matched healthy control subjects: (1) the psychological,
endocrine, autonomic and neural stress response to the examination situation in the MRI-Scanner, (2) the psychological, endocrine and autonomic stress reaction to a psychosocial stressor, (3) the basal endocrine stress level, (4)
the neural function of emotion regulation under different states of attention, (5) the neural and autonomic function
107
during fear conditioning, (6) the neural function of anticipation and perception of stimuli under varying degrees of
uncertainty and ambiguity, and (7) underlying connectivity during resting-state. The following tests/paradigms are
used: (a) an established standardized laboratory stress test – the Trier Social Stress Test (TSST), (b) the selection
of salivary cortisol to examine the cortisol day profile on two subsequent days, (c) the investigation of hair cortisol
levels, (d) a rating of subjective well-being and the collection of salivary cortisol to examine the cortisol and alphaamylase level prior to, during and after the fMRI assessment, (e) an established paradigm used during fMRI that
systematically varies emotion and attention focus (Faces-Paradigm), and (f) a fear-conditioning paradigm used during
fMRI, (g) a paradigm that systematically varies the certainty of a cue indicating the valence of the next stimulus
during anticipation and the ambivalence of the subsequent stimulus during perception and (h) a resting-state scan.
Current Status: Complete fMRI data sets are available for 20 subjects (N=5 healthy controls, N=4 GAD, N=8 MD,
N=3 SP).
P8. The specificity of neural correlates of generalized anxiety disorder: differentiation from related disorders
and prediction of diagnosis using neuroimaging data (Doctoral thesis project; PI Kevin Hilbert)
Background and aims: Generalized Anxiety Disorder (GAD) is a chronic condition characterized in DSM-IV by
excessive and uncontrollable worry and anxiety (apprehensive expectation) about a variety of events and situations,
accompanied by physical symptoms such as restlessness, muscle tension, irritability, and difficulties concentrating
or sleeping (American Psychiatric Association, 2013). In recent years, research on the neurobiological basis of GAD
has considerably expanded and abnormal activation in the amygdala and prefrontal cortex, as well as alterations
in volume and connectivity of these structures have been reported in patients. However, many of these studies
yielded inconsistent results; and studies investigating the neural correlates of fear conditioning and extinction are
lacking completely for GAD, making the investigation of these processes a priority for future research. Additionally,
most neuroimaging studies so far investigated comorbid samples of GAD patients, thus raising the question
whether the neural correlates reported are specifically related to GAD or influenced by comorbidities. Therefore,
there is an urgent need for studies comparing non-comorbid GAD samples directly to other disorders. Deeper
knowledge on the specificity of the neural correlates of GAD and related disorders is also potentially useful for the
future diagnosis of GAD: recently, there is increasing interest in predicting the diagnosis of an individual subject
using brain imaging data, and first prove-of-concept studies demonstrated encouraging success for a range of disorder, e.g. specific phobia (Lueken et al., in press) or schizophrenia and bipolar disorder (Schnack et al., 2014). As
GAD is a highly under- and misdiagnosed disorder and often comorbid, neuroimaging data might be used to improve diagnostic decisions in the future. Overall, this dissertation thesis aims to (1) summarize and integrate existing
findings on the neural substrates of GAD to date, (2) investigate the commonalities and differences in neural correlates of GAD compared to Major Depression (MD) for structural and functional data, and (3) successfully predict the
diagnostic status of a subject based on structural volumetric data.
Methods: Objective (1) was pursued by systematically reviewing the existing literature on neural substrates of
GAD (see publication). Regarding objective (2), functional brain imaging data from an emotional processing paradigm under attention modulation is being compared between GAD patients, MD patients and healthy controls (HC).
Additionally, structural gray and white matter volume data is being analysed as well. These data is furthermore used
to predict the diagnostic status of individual subjects for (3) using Gaussian Process Classifiers.
Current Status: Aims (2) and (3) are being pursued at the moment. Complete fMRI data sets are available for 64
subjects (N=24 healthy controls, N=24 GAD of which N=16 had comorbid depression, and N=14 MD without GAD)
for these analyses. Regarding (1), the following core findings could be obtained: Studies on the neurobiological
basis of GAD have reported consistent results, with perturbations in amygdala and prefrontal cortex activation as
well as increased volume and decreased connectivity between these structures, and heterogeneous results, especially regarding neuroendocrinological findings on serotonin and cortisol. Still, a working model of emotional processing can be deducted from the data, focusing on a relationship between amygdala hyperactivity, subsequent hyperarousal and cortisol-serotonin interactions during emotional processing in the disorder. Based on these findings,
depression and other anxiety disorders can be differentiated from GAD on a neural level, but evidence from direct
comparisons is overall lacking.
Hilbert, K., Lueken, U., Beesdo-Baum, K. (2014). Neural structures, functioning and connectivity in Generalized Anxiety Disorder and interaction with neuroendocrine systems:
A systematic review. Journal of Affective Disorders, 158, 114-126.
108
Research focus: Specific Phobia
P9. Commonalities and differences in fear circuities in subtypes of Specific Phobia
PI: Dr. Ulrike Lüken; Funding: Internal grant funding, Dept. of Psychology, TU Dresden; Cooperations: R. Evens, K.
Hilbert, J. Hoyer, N.I. Maslowksi, Y. Stankevich, V. Stolyar; Duration: 10/2008 - 12/2013
Background: Specific phobia of the animal subtype has been employed as a model disorder exploring the neurocircuitry of anxiety disorders, but evidence is lacking whether the detected neural response pattern accounts for all
animal subtypes, nor across other phobia subtypes. The present study aimed at directly comparing two subtypes
of specific phobia: snake phobia (SP) representing the animal, and dental phobia (DP) representing the bloodinjection-injury subtype. Methods: Using functional magnetic resonance imaging (fMRI), brain activation and skin
conductance was measured during phobogenic video stimulation in 12 DP, 12 SP, and 17 healthy controls. Results:
For SP, the previously described activation of fear circuitry structures encompassing the insula, anterior cingulate
cortex and thalamus could be replicated and was furthermore associated with autonomic arousal. In contrast, DP
showed circumscribed activation of the prefrontal and orbitofrontal cortex (PFC/OFC) when directly compared to SP,
being dissociated from autonomic arousal. Conclusion: Results provide preliminary evidence for the idea that snake
and dental phobia are characterized by distinct underlying neural systems during sustained emotional processing
with evaluation processes in DP being controlled by orbitofrontal areas, whereas phobogenic reactions in SP are primarily guided by limbic and paralimbic structures. Findings support the current diagnostic classification conventions,
separating distinct subtypes in DSM-IV-TR. They highlight that caution might be warranted though for generalizing
findings derived from animal phobia to other phobic and anxiety disorders. If replicated, results could contribute to a
better understanding of underlying neurobiological mechanisms of specific phobia and their respective classification.
Figure 3: Direct comparison between the two phobia subtypes; results present neural activation patterns specific for dental phobics (DP) when
compared to snake phobics (SP) and vice versa. Upper line: functional activation patterns; middle line: differences in beta values extracted from the
peak voxels; lower line: scatterplots showing the relationship between neural activity and autonomic reactivity. Please note that an exclusive mask
was applied for activation that was unspecific for phobia using the respective contrast in healthy controls (p<0.05, FDR correction; max. cluster size
15 contiguous voxels). L: left; R: right; and AMP.NS.SCR: mean sum amplitude of non-stimulus specific skin conductance reactions (adopted from
Lueken et al., 2011a).
Lueken, U., Hilbert, K., Wittchen, H.-U., Reif, A. & Hahn, T. (2014). Diagnostic classification of specific phobia subtypes using structural MRI data: a machine learning
approach. Journal of Neural Transmission.
Lueken, U., Hilbert, K., Stolyar, V., Maslowski, N. I., Beesdo-Baum, K. & Wittchen, H.-U. (2013). Neural substrates of defensive reactivity in two subtypes of specific phobia.
Social Cognitive Affective Neuroscience.
Lueken, U., Kruschwitz, J. D., Muehlhan, M., Siegert, J., Hoyer, J., & Wittchen, H.-U. (2011). How specific is specific phobia? Different neural response patterns in two subtypes of specific phobia. Neuroimage,56, 363-372.
Lueken, U., Siegert, J., Hoyer, J., Gloster, A.T. & Wittchen, H.-U (2011). Symptom provocation in dental anxiety using cross-phobic video stimulation. European Journal of
Oral Sciences,119, 61-68.
109
P10. Fear processing in Dental Phobia during crossmodal symptom provocation: an fMRI study
PI: Dr. Ulrike Lüken; Funding: Internal grant funding, Dept. of Psychology, TU Dresden; Cooperations: R. Evens, K.
Hilbert, J. Hoyer, N.I. Maslowksi, Y. Stankevich, V. Stolyar; Duration: 10/2008 - 12/2013
Background: inconsistent research is available for dental phobia.These findings might partly relate to the fact that,
typically, visual stimuli were employed. The current study aimed to investigate the influence of stimulus modality on
neural fear processing in dental phobia. Methods: Thirteen dental phobics (DP) and thirteen healthy controls (HC)
attended a block-design functional magnetic resonance imaging (fMRI) symptom provocation paradigm encompassing both visual and auditory stimuli. Drill sounds and matched neutral sinus tones served as auditory stimuli and
dentist scenes and matched neutral videos as visual stimuli. Results: Group comparisons showed increased activation in the insula, anterior cingulate cortex, orbitofrontal cortex, and thalamus in DP compared to HC during auditory
but not visual stimulation. On the contrary, no differential autonomic reactions were observed in DP. Conclusion:
Present results are largely comparable to brain areas identified in animal phobia, but also point towards a potential
downregulation of autonomic outflow by neural fear circuits in this disorder. Findings enlarge our knowledge about
neural correlates of dental phobia and may help to understand the neural underpinnings of the clinical and physiological characteristics of the disorder.
Evens, R., Hilbert, K., Maslowski, N. I., Wittchen, H.-U. & Lueken, U. (2014, 08.-12.06.). The neural substrates of visual vs. auditory symptom provocation in dental phobia: a
crossmodal comparison study. Poster, 20th Meeting of the Organization for Human brain Mapping (OHBM), Hamburg.
Hilbert, K., Evens, R., Maslowski, N. I., Wittchen, H.-U., Lueken, U. (2014). Fear processing in dental phobia during crossmodal symptom provocation: an fMRI study. BioMed
Research International.
Research focus: neural substrates of interoception
P11. Neural substrates of interoception in the anxiety sensitivity endophenotype
PI: Dr. Ulrike Lüken; Funding: pending (DFG); Duration: piloting in 01/2011 - 03/2014; Cooperations: Dipl.-Psych.
Nina Maslowski (TU Dresden), Prof. Dr. Alfons Hamm (Greifswald), Dipl-Psych. Katharina Holtz (Greifswald)
Background: Interoceptive dysfunction has been regarded as an important factor for the development and maintenance of anxiety disorders, particularly panic disorder (PD). The insular cortex and adjacent structures such as the
anterior cingulate cortex or the inferior frontal operculum have been proposed as key structures for interoceptive
processing with altered functionality in anxiety prone subjects and anxiety disorders. Interoceptive exposure is a
key treatment component of many cognitive-behavioral therapy (CBT) programs targeting PD. Repeated confrontation with interoceptive cues induces a gradual reinterpretation of this sensory information in patients.The precise
mechanisms of action - including their neural basis - by which this specific intervention may unfold its effects, are
still unknown. The aim of the present study is to combine basic and clinical approaches in order to unravel neural
pathways focussing on interoceptive processing. Methods: First, we will investigate neural substrates of interoception employing a set of fMRI tasks that specifically address different interoceptive modalities (touch, respiration,
cardiovascular). Second, introducing a training component to an analogue sample of PD (highly anxiety sensitive
subjects), we will investigate the neurobiological pathways by which an interoceptive training may unfold its effects
on a neural level. Training units and fMRI tasks are closely matched, thus providing a valid behavioural probe of
those interoceptive processes to be targeted by the training. Results will help to further bridge the gap between
basic and applied research on anxiety and may offer the potential to better understand the mechanisms of action
underlying one core component of CBT programs in PD and how psychological treatments may change the brain.
Preliminary results: We piloted a novel a cue-exposure paradigm encompassing exteroceptive stimuli of interoceptive modalities (auditory heartbeat stimuli. Brain activity was measured with fMRI during cue-exposure in 36
subjects. Autonomic markers (skin conductance) and subjective measures of state and trait anxiety were assessed.
Stimulation with heartbeat stimuli triggered activation in cortical and subcortical areas commonly associated with
the processing of interoceptive information, including bilateral insular cortices, the inferior frontal operculum, and
the middle frontal gyrus. A psychophysiological interaction analysis indicated a functional connectivity between the
middle frontal gyrus (seed region) and bilateral insular cortices, the left amygdala and the supplementary motor
area. Reactivity towards the physical threat cue in the right anterior insular cortex was positively associated with
autonomic arousal.
Conclusion: The present findings indicate that exposure to physical threat cues induced activity in areas of the
interoception network as well as changes in psychophysiological arousal and subjective emotional experience, indicating that interoceptive processing was initiated by this physical threat cue. Since this approach constitutes a promising method for studying interoception in the fMRI environment, clinical application in anxiety prone populations
should be addressed by future studies.
110
Figure 4: A (upper line): Brain activation during physical threat cue-exposure in frontal (a), insular/ inferior frontal opercular (b) and parietal (c) regions as revealed by a second-level random effects analysis (full factorial design with factors “stimulus type” and “frequency”; contrast: H50+H100
> T50+T100), region-of-interest-analysis. Depicted brain activation is significant with p < 0.05 (FDR correction applied), cluster size > 10 contiguous
voxels. a = Activation in the middle frontal gyrus and inferior frontal gyrus triangularis, crosshairs at [42, 39, 3]; b = Activation in the inferior frontal
operculum and insula, crosshairs at [42, 15, 33]; c = Activation in the inferior parietal gyrus, crosshairs at [42, -48, 39]. B (lower line): PPI analysis.
The seed region in the middle frontal gyrus showed enhanced effective connectivity with the left and right insular cortices, the amygdala and the
SMA. Brain activation is overlayed on an averaged high-resolution T1-weighted anatomical image of all n = 36 subjects, color-coded for t-values. R =
right hemisphere.
Maslowski, N. I., Lange, S., Kragen, K., Ebser, N. & Lueken, U. (2014, 08.-12.06.). Inferior frontal opercular activation during the anticipation of loaded breathing is associated
with subjective feelings of dyspnea. (Poster) 20th Meeting of the Organization for Human brain Mapping (OHBM), Hamburg.
Maslowski, N., Huber, A., Westphal, D., Witchen, H.-U., & Lueken, U. (2012, 13.-17.10). Neural correlates of inspiratory breathing restriction: an fMRI pilot study. (poster).
25nd Congress of the European College in Neuropsychopharmacology (ECNP), Vienna (Austria), European Neuropsychopharmacology, 22(Suppl.2), S203-S204.
Maslowski, N., Wittchen, H.-U., & Lueken U. (2012, 13.-17.10.). Symptom provocation works for studying the interoception network: brain activation during interoceptive cueexposure. Poster, 25nd Congress of the European College in Neuropsychopharmacology, Vienna (Austria), European Neuropsychopharmacology, 22(Suppl.2), S203.
Maslowski, N. & Lueken, U. (2011, 26.-30.06.). Listen to your heart
Research focus: physiological confounders of neuroimaging investigations
P12. Confounders of neuroimaging investigations: the scanner as a Stressor
PI: Dr. Markus Mühlhan; Funding: Haushalt, Open Access publication Fond of the TU-Dresden and the German
Research Foundation (DFG); Duration: 01/2008 - 06/2014; Cooperations: Prof. Dr. Clemens Kirschbaum, Chair
of Biopsychology, Department of Psychology; Prof. Dr. Michael N. Smolka, Section of Systems Neuroscience,
Department of Psychiatry and Psychotherapy, Faculty of Medicine Carl Gustav Carus
Background: It has been repeatedly shown that functional magnetic resonance imaging (fMRI) triggers distress
and neuroendocrine response systems. Prior studies have revealed that sympathetic arousal increases, particularly
at the beginning of the examination. Against this background it appears likely that those stress reactions during the
scanning procedure may influence task performance and neural correlates. However, the question how sympathetic
arousal elicited by the scanningprocedure itself may act as a potential confounder of fMRI data remains unresolved
111
today. Methods: Thirty-seven scanner naive healthy subjects performed a simple cued target detection task. Levels
of salivary alpha amylase (sAA), as a biomarker for sympathetic activity, were assessed in samples obtained at
several time points during the lab visit.
Results: SAA increased two times, immediately prior to scanning and at the end of the scanning procedure. Neural
activation related to motor preparation and timing as well as task performance was positively correlated with the
first increase. Furthermore, the first sAA increase was associated with task induced deactivation (TID) in frontal and parietal regions. However, these effects were restricted to the first part of the experiment. Conclusion:
Consequently, this bias of scanner related sympathetic activation should be considered in future fMRI investigations. It is of particular importance for pharmacological investigations studying adrenergic agents and thecomparison
of groups with different stress vulnerabilities like patients and controls or adolescents and adults.
Figure 5: Conjunction of the main effect of the task in run 1 and percentage sAA increase immediately prior to scanning. Left: coronal and
axial slices of an anatomical spatially normalized mean image of all subjects. Colour blobs indicate regions that are activated by the task and
influenced by percentage salivary alpha-amylase (sAA) increase. Right:
Scatter plots and coefficient of determination R2. SMA: supplementary
motorarea; Lent. Ncll.: lentiform nuclei.
Figure 6: Conjunction of the task induced deactivation (TID) in run 1 and
percentage sAA increase immediately prior to scanning. Left: upper and
lower figures represent sagittal and coronal slices of an anatomical spatially normalized mean image of all subjects. The middle figure represents a
dorsal view of a smoothed standard rendered brain. Colour blobs indicate
regions that are deactivated during the task and influenced by relative salivary alpha-amylase (sAA) increase. Right: scatter plots and coefficient of
determination R2. SFG: superior frontal gyrus; MFG: medial frontal gyrus,
Ang. Gy: angular gyri.
Muehlhan, M., Lueken, U., Siegert, J., Wittchen, H.-U., Smolka, M.N., & Kirschbaum, C. (2013). Enhanced sympathetic arousal in response to fMRI scanning correlates with
task induced activations and deactivations. PLOS ONE 8 (8), e72576
Muehlhan, M., Lueken, U., Wittchen, H.-U., Smolka, M.N., & Kirschbaum, C (2012, 10.-14.10.). Sympathetic stress reactions in response to fMRI scanning altered performance and neural activation pattern of interest. Annual Meeting of the Organization for Human Brain Mapping, Beijing (poster)
Lueken, U., Muehlhan, M., Evens, R., Wittchen, H.-U., & Kirschbaum, C. (2012). Within and between session changes in subjective and neuroendocrine stress parameters
during magnetic resonance imaging: a controlled scanner training study. Psychoneuroendocrinology.
Muehlhan, M., Lueken, U., Wittchen, H.-U. & Kirschbaum, C. (2011). The scanner as a stressor: Evidence from subjective and neuroendocrine stress parameters in the time
course of an functional magnetic resonance imaging session. International Journal of Psychophysiology, 79, 118-126.
Lueken, U., Muehlhan, M., Wittchen, H.-U. & Kirschbaum, C. (2009, 21.-24.09.). How do subjects experience an fMRI session? Concordance between subjective and neuroendocrine stress indicators. Poster, 49th Annual Meeting of the Society for Psychophysiological Research (SPR), Berlin.Psychophysiology, 46 (Suppl. 1), S37.
Muehlhan, M., Lueken, U., Smolka, M. N. & Kirschbaum, C. (2009). Are your runs comparable? Differences in subjective and neuroendocrine stress indicators in the course of
an fMRI session. Poster, 49th Annual Meeting of the Society for Psychophysiological Research (SPR), Berlin (Germany), Oct. 21 - 24, 2009. Psychophysiology, 46 (Suppl.
1), S37.
Muehlhan, M., Lueken, U., Wittchen, H.-U. & Kirschbaum, C. (2009, 25.-29-11.). MRT als Stressor: Subjektive und neuroendokrine Veränderungen im Verlauf einer fMRTUntersuchung. Poster & Jahrestagung der Deutschen Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde (DGPPN), Berlin.2009. In F. Schneider & M.
Grözinger (Hrsg.), Abstractbuch zum DGPPN Kongress 2009 (S.283). Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde e.V.
P13. Confounders of neuroimaging investigations: The effect of body posture
PI: Dr. Markus Mühlhan, Dr. Sebastian Zaunseder; Funding: intramural research funding of the Department of
Psychology, TU-Dresden; Open Access publication Fond of the TU-Dresden and the German Research Foundation
(DFG); Duration: 06/2013 - 06/2014 Dr. Michael Marxen, Section of Systems Neuroscience, Department of
Psychiatry and Psychotherapy, Faculty of Medicine Carl Gustav Carus; Prof. Dr. Hagen Malberg, Dr. Sebastian
Zaunseder, Department of Electrical and Computer Engineering, Institute of Biomedical Engineering, Technische
Universität Dresden, Dresden, Germany
112
Background: Nearly all functional magnetic resonance imaging (fMRI) studies are conducted in the supine body
posture, which has been discussed as a potential confounder of such examinations. The literature suggests
that cognitive functions, such as problem solving or perception, differ between supine and upright postures.
However,the effect of posture on many cognitive functions is still unknown. Therefore, the aim of the present study
was to investigate the effects of body posture (supine vs. sitting) on one of the most frequently used paradigms in
the cognitive sciences: the N-back working memory paradigm. Methods: Twenty-two subjects were investigated
in a randomized within-subject design. Subjects performed the N-back task on two consecutive days in either the
supine or the upright posture. Subjective sleep quality and chronic stress were recorded as covariates. Furthermore,
changes in mood dimensions and heart rate variability (HRV) were assessed during the experiment. Results:Results
indicate that the quality of sleep strongly affects reaction times when subjects performed a working memory task
in a supine posture.These effects, however,could not be observed in the sitting position. Conclusion: The findings
can be explained by HRV parameters that indicated differences in autonomic regulation in the upright vs. the supine
posture.The finding is of particular relevance for fMRI group comparisons when group differences in sleep quality
cannot be ruled out.
Figure 7: Behavioral data. (A) Reaction times (RTs) during both work load conditions and postures. Error bars indicate SEM. (B)
Scatter plots and coefficients of determination (R2). Displayed is the relationship between sleep quality (PSQI total score) and
reaction times (RTs) in the supine and the upright posture. ***p < 0.001.
Figure 8: Profile plots of the time and frequency domain HRV parameters over the four blocks. Error bars indicate SEM. TP, total
power; LF, power in low frequency range; HF, power in high frequency range; nu, normalized units. Pairwise comparisons indicate
significant differences between groups: *p < 0.05; **p < 0.01; ***p < 0.001.
Muehlhan, M., Marxen, M., Landsiedel, J., Malberg, H., Zaunseder, S. (2014). The effect of body posture on cognitive performance: a question of sleep quality. Frontiers in
Human Neuroscience. 8:171.
113
Research focus: experimental psychopathology
P14: Experimental psychopathology and research in basic processes of clinical psychological interventions
PI: Dr. Sabine Schönfeld; Funding: internal; Duration: 07/2009 - 12/2011; Extramural Cooperations: Abteilung
klinische Psychologie und Psychotherapie Universität Bielefeld, University of Oxford (Warneford Hospital),
Universitätsklinikum Lübeck, Universität Amsterdam, Universitätsklinik Bonn, Yair Bar-Haim, Tel Aviv University,
Henrik Walter, Bonn
Background: The investigation of dysfunctional cognitive and emotional processes helps us to understand the etiology and maintenance of clinical psychological disorders. Here, experimental methods allow us to study the causal
relationship between basic mechanisms (that might also occur across disorders), which then can lead to the development of specifically tailored interventions, with the focus on PTSD and GAD. Aim: Experimental clinical psychological research with the focus on etiology, maintenance and intervention of disorders. A series of experiments was
designed to test the aetiology of intrusions as well as their disorder specific characteristics. Amongst others, we
investigated the role of trauma encoding conditions in the interplay between posttraumatic intrusions and dissociation, and compared different types of intrusions with self report data. Based on previous results regarding attention
(such as cognitive control or interference) and autobiographical memory deficits in PTSD and GAD we developed
and tested specific trainings aimed at the reduction of intrusions and other PTSD (and GAD) symptoms. In the near
future some of the cognitive and emotional processes will be investigated in a prospective design. Other studies
have focused on emotion regulation deficits in GAD. Next steps: Continuing this approach, within a disorder specific but also a transdiagnostic framework, and in analogue as well a clinical populations, and using mostly experimental methods we will investigate aetiological, maintaining as well as functional mechanism in clinical psychological
conditions. Association with other Projects/AGs: The studies regarding emotion regulation in PTSD and GAD will
be embedded in the SFB Goschke (Co-investigators Thomas Goschke, Alexander Strobel, Henrik Walter, Bonn). The
role of cognitive factors in the development of PTSD symptoms will also be addressed in the study psychological
health in German soldiers after foreign deployment (Judith Schäfer). Process variables with therapeutic interventions will be assessed in close cooperation with the PTSD clinic in our outpatient unit (IAP, Co-investigator Jürgen
Hoyer). Overarching themes and goal of the experiments: One aspect underlying most experimental studies in
this group is the investigation of the association between the function and development of intrusions and transdiagnostic (vs specific) and cognitive and emotional avoidance in anxiety disorders and PTSD.
Ehring, T., Zetsche, U., Weidacker, K., Wahl, K., Schönfeld, S. & Ehlers, A. (2011) The perseverative thinking questionnaire (PTQ): Validation of a content-independent measure of repetitive negative thinking, Journal of Behavior Therapy and Experimental Psychiatry.42, 225-232.
Schönfeld, S., & Renneberg, B. (2012). Introduction to the special issue on autobiographical memory and psychopathology. Journal of Behavior Therapy and Experimental
Psychiatry, 43(Suppl. 1), 1-3.
114
AG 3 MATERNAL AND INFANT’S HEALTH
J. MARTINI & H.-U. WITTCHEN
Dr. Julia Martini & Prof. Dr. Hans-Ulrich Wittchen
Overview
This work group is currently working on the following lines of research:
P1. Maternal anxiety and depression in relation to infant development (MARI Study):
Examination of
1. risk factors and course patterns of anxiety and depressive
disorders during peripartum period,
2. correlates of peripartum anxiety and depressive disorders and
3. the relation of maternal peripartum DSM-IV anxiety and depressive
disorders and infant development.
P2. Mental and physical health in premature infants and their parents
P3. Mental and physical health in parents of chronically ill children
P1. Maternal anxiety and depression in relation to infant development (MARI Study)
PI: Dr. Julia Martini, Prof. Dr. Hans-Ulrich Wittchen
Core staff members: Eva Asselmann, Yvonne Hansche, Dr. Michael Höfler, Julia Niehoff, Johanna Petzoldt, Jens Strehle, Gesine Wieder, Susanne Winkel, and Julia Wittich; Consultants: Prof. Dr. Katja Beesdo-Baum,
Prof. Dr. Franziska Einsle, and Dr. Susanne Knappe; Funding: Lundbeck
Institute Skodsborg (Denmark), Gesellschaft der Freunde und Förderer
TU Dresden, Fellowship Stiftung der Deutschen Wirtschaft) (J. Petzoldt);
duration: 01/2009 – ongoing; Cooperations: Prof. C. Kirschbaum (TU
Dresden), Prof. M. Steiner (University of Toronto, USA), Prof. Claudio N.
Soares (McMaster University, Hamilton, Canada), Dr. Corinna Reck (Universitätsklinikum Heidelberg), PD Dr. Katja Petrowksy (Universitätsklinik
Dresden)
Maternal anxiety disorders prior to conception, psychopathology during pregnancy and early infants’ development: A prospective-longitudinal study (J. Martini, J. Wittich, J. Petzoldt, S. Winkel, F. Einsle, J. Siegert, M.
Höfler, K. Beesdo-Baum & H.-U. Wittchen)
Family-genetic studies suggest that anxiety disorders run in families and that mechanisms of familial transmission
might act as early as during pregnancy. The aims of the Maternal Anxiety in Relation to Infant Development (MARI)
Study are to prospectively investigate the course of pregnancy in women with and without anxiety disorders prior
to conception from early pregnancy to postpartum focussing on (a) maternal psychopathology, (b) maternal perinatal
health, and (c) offspring outcomes that are supposed to be early indicators/ antecedents for later anxiety disorders.
The MARI Study is a prospective-longitudinal study program with seven waves of assessment: T1 (baseline: week
10 to 12 of gestation), T2 (week 22 to 24 of gestation), T3 (week 35 to 37 of gestation), T4 (10 days postpartum),
T5 (2 months postpartum), T6 (4 months postpartum), and T7 (16 months postpartum). Overall, N =306 pregnant
women were enrolled during early pregnancy (T1) and allocated to one of the following initial diagnostic groups:
no AD: no anxiety nor depressive disorder prior to pregnancy (N =109), pure D: pure depressive disorder(s) prior to
pregnancy (N =48), pure A: pure anxiety disorder(s) prior to pregnancy (N =84), and comorbid AD: comorbid anxiety
and depressive disorders prior to pregnancy (N =65). Overall, N =284 mothers could be retained until T6 (retention
rate: 92.8 %) and N =274 until T7 (retention rate: 89.5 %).
Clinical and psychosocial measures were used including a standardized diagnostic interview (CIDI-V) with dimensional scales and standardized observation paradigms (mother-infant-relationship, infant temperament and neuropsychological development). Dimensional anxiety and depression liability indices were developed to reflect the severity
of anxiety and depressive disorders prior to pregnancy and to ease longitudinal modelling.
Findings from this study will contribute to improved knowledge about the natural course of anxiety disorders during
transition to parenthood and associated outcomes that are assumed to be early indicators of later psychopathology
in the offspring. Results are expected to provide new insights into mechanisms of familial transmission and clues
for targeted prevention and early intervention.
115
Martini, J., Wittich, J., Petzoldt, J., Winkel, S., Einsle, F., Siegert, J., Höfler, M., Beesdo-Baum, K. & Wittchen, H.-U. (2013). Maternal anxiety disorders prior to conception,
psychopathology during pregnancy and early infants’ development: A prospective-longitudinal study. Archives of Women’s Mental Health, 16, 549-560.
Design of the MARI Study
Note: T1: week 10 to 12 of gestation, T2: week 22 to 24 of gestation, T3: week 35 to 37 of gestation, T4: 10 days postpartum, T5: 2 months postpartum, T6: 4 months postpartum, T7: 16 months postpartum, initial diagnostic groups: no AD (reference): no anxiety nor depressive disorder prior
to pregnancy, pure D: pure depressive disorder(s) prior to pregnancy; pure A: pure anxiety disorder(s) prior to pregnancy; comorbid AD: comorbid
anxiety and depressive disorders prior to pregnancy. Diagnoses with an onset 4 weeks prior to baseline interview (around the time when pregnancy
is confirmed by a pregnancy test or by a gynaecologist) were not incorporated in the initial diagnostic groups.
P1.1. Risk factors and course patterns of anxiety and depressive disorders during peripartum period
Risk factors and course patterns of anxiety and depressive disorders during pregnancy and after delivery: A
prospective longitudinal study (J. Martini, J. Petzoldt; F. Einsle, K. Beesdo-Baum, M. Höfler & H.-U. Wittchen)
Background: Peripartum anxiety and depressive disorders are associated with adverse consequences for mother
and child. Thus, it is important to examine risk factors, correlates and course patterns of anxiety and depressive
disorders during pregnancy and after delivery. Methods: In the prospective-longitudinal Maternal Anxiety in Relation
to Infant Development (MARI) Study, n=306 expectant mothers were recruited from gynaecological outpatient
settings in Germany and completed up to seven waves of assessment from early pregnancy until 16 months postpartum. Anxiety and depressive disorders and potential risk factors/ correlates were assessed with the Composite
International Diagnostic Interview for Women (CIDI-V) and additional questionnaires. Results: Although peripartum
anxiety and depressive disorders appeared to be persistent in some women, others reported major changes with
heterogeneous courses and shifts between diagnoses and contents. There was a considerable amount of incident
disorders. Strongest predictors for peripartum anxiety and depressive disorders were anxiety and depressive disorders prior to pregnancy, but psychosocial (e.g. maternal education), individual (e.g. low self-esteem), and interpersonal (e.g. partnership satisfaction, social support) factors were also related. Limitation: Knowing the aims of the
study, some participants may have been more encouraged to report particular symptoms, but if so, this points to
the importance of a comprehensive assessment in perinatal care. Conclusion: Peripartum time is a sensitive period
for a considerable incidence or persistence/ recurrence of anxiety and depressive disorders albeit the course may
be rather heterogeneous. Interventional studies are needed to examine whether an alteration of associated factors
could help to prevent peripartum anxiety and depressive disorders.
Martini, J., Petzoldt, J., Einsle, F., Beesdo-Baum, K., Höfler, K. & Wittchen, H.-U. (submitted). Risk factors and course patterns of anxiety and depressive disorders during
pregnancy and after delivery: A prospective longitudinal study.
Martini, J., Petzoldt, J., Wittich, J., & Wittchen, H.-U. (2013). Course of DSM-IV social anxiety disorders during pregnancy and postpartum. European Neuropsychopharmacology: The Journal of the European College of Neuropsychopharmacology, 23, S517.
Petzoldt, J., Martini, J. & Wittchen, H.-U. (2013, 27.-30.11.) Verlauf von Angst- und depressiven Störungen in der Peripartalzeit und exzessives Säuglingsschreien: Eine
prospektiv-longitudinale Studie. Talk at the „DGPPN Kongress, Berlin, Germany.
Martini, J., Wittich, J. & Knappe, S. (2013) „Der Apfel fällt nicht weit vom Stamm“: Von der familiären Übertragung psychischer Störungen (The apple never falls far from the
tree: Familial transmission of mental disorders). In Reichert, J. & Rüdiger M. Psychologie in der Neonatologie: Psychologisch-sozialmedizinische Versorgung von Familien
Frühgeborener. Göttingen: Hogrefe.
116
P1.1. Risk factors and course patterns of anxiety and depressive disorders during peripartum period
Risk factors and course patterns of anxiety and depressive disorders during pregnancy and after delivery: A
prospective longitudinal study (J. Martini, J. Petzoldt; F. Einsle, K. Beesdo-Baum, M. Höfler & H.-U. Wittchen)
Background: Peripartum anxiety and depressive disorders are associated with adverse consequences for mother
and child. Thus, it is important to examine risk factors, correlates and course patterns of anxiety and depressive
disorders during pregnancy and after delivery. Methods: In the prospective-longitudinal Maternal Anxiety in Relation
to Infant Development (MARI) Study, n=306 expectant mothers were recruited from gynaecological outpatient
settings in Germany and completed up to seven waves of assessment from early pregnancy until 16 months postpartum. Anxiety and depressive disorders and potential risk factors/ correlates were assessed with the Composite
International Diagnostic Interview for Women (CIDI-V) and additional questionnaires. Results: Although peripartum
anxiety and depressive disorders appeared to be persistent in some women, others reported major changes with
heterogeneous courses and shifts between diagnoses and contents. There was a considerable amount of incident
disorders. Strongest predictors for peripartum anxiety and depressive disorders were anxiety and depressive disorders prior to pregnancy, but psychosocial (e.g. maternal education), individual (e.g. low self-esteem), and interpersonal (e.g. partnership satisfaction, social support) factors were also related. Limitation: Knowing the aims of the
study, some participants may have been more encouraged to report particular symptoms, but if so, this points to
the importance of a comprehensive assessment in perinatal care. Conclusion: Peripartum time is a sensitive period
for a considerable incidence or persistence/ recurrence of anxiety and depressive disorders albeit the course may
be rather heterogeneous. Interventional studies are needed to examine whether an alteration of associated factors
could help to prevent peripartum anxiety and depressive disorders.
Martini, J., Petzoldt, J., Einsle, F., Beesdo-Baum, K., Höfler, K. & Wittchen, H.-U. (submitted). Risk factors and course patterns of anxiety and depressive disorders during
pregnancy and after delivery: A prospective longitudinal study.
Martini, J., Petzoldt, J., Wittich, J., & Wittchen, H.-U. (2013). Course of DSM-IV social anxiety disorders during pregnancy and postpartum. European Neuropsychopharmacology: The Journal of the European College of Neuropsychopharmacology, 23, S517.
Petzoldt, J., Martini, J. & Wittchen, H.-U. (2013, 27.-30.11.) Verlauf von Angst- und depressiven Störungen in der Peripartalzeit und exzessives Säuglingsschreien: Eine
prospektiv-longitudinale Studie. Talk at the „DGPPN Kongress, Berlin, Germany.
Martini, J., Wittich, J. & Knappe, S. (2013) „Der Apfel fällt nicht weit vom Stamm“: Von der familiären Übertragung psychischer Störungen (The apple never falls far from the
tree: Familial transmission of mental disorders). In Reichert, J. & Rüdiger M. Psychologie in der Neonatologie: Psychologisch-sozialmedizinische Versorgung von Familien
Frühgeborener. Göttingen: Hogrefe.
P1.2. Correlates of peripartum anxiety and depressive disorders
Peripartum changes in partnership quality in women with and without anxiety and depressive disorders
prior to pregnancy: A prospective-longitudinal study (E. Asselmann, J. Petzoldt, H.-U. Wittchen & J. Martini)
Aims: To prospectively investigate peripartum changes in partnership characteristics in women with and without
anxiety and depressive disorders prior to pregnancy. Methods: The MARI (Maternal Anxiety in Relation to Infant
Development, 01/2009-09/2012) Study is a prospective-longitudinal study of expectant mothers recruited from
gynecological outpatient settings. N=306 women completed up to 7 assessments from early pregnancy to 16
months postpartum. Lifetime DSM-IV-TR anxiety and depressive disorders were assessed at baseline using the
CIDI-V (Martini et al., 2009). Partnership characteristics were assessed during pregnancy, 4 and 16 month postpartum using the Partnership Questionnaire (Hahlweg, 1996). Linear regressions were used to test associations
between diagnostic status prior to pregnancy and pre-/postpartum partnership characteristics. Results: Women
with comorbid anxiety and depression prior to pregnancy reported less tenderness during pregnancy as well as less
postpartum tenderness, satisfaction, and overall partnership quality compared to women with neither anxiety nor
depression. From pre- to postpartum, women with comorbid anxiety and depression reported a lower decrease in
communication and a higher increase in quarrelling, while women with pure depression reported a higher increase
in quarreling and a higher decline in overall partnership quality compared to women with no anxiety nor depression
prior to pregnancy. Most of these associations were attenuated to non-significance when adjusting for peripartum
anxiety and depressive disorders.
Conclusion: Findings suggest that especially women with pure depression and comorbid depression prior to pregnancy are at risk for unfavorable peripartum partnership characteristics and might thus profit from targeted interventions to successfully adjust to the new family situation.
Asselmann, E., Petzoldt, J., Wittchen, H.-U. & Martini., J. (in prep). Peripartum changes in partnership quality in women with and without lifetime anxiety and depressive disorders prior to pregnancy: A prospective-longitudinal study.
117
Associations of anxiety, depressive disorders and body weight with hypertension during pregnancy (S.
Winkel, F. Einsle, L. Pieper, M. Höfler, H.-U. Wittchen & J. Martini)
Purpose: To prospectively examine the relationships between maternal DSM-IV-TR anxiety disorders, depressive
disorders and body mass index (BMI) with arterial hypertension and blood pressure during pregnancy. Methods: In
the Maternal Anxiety in Relation to Infant Development (MARI) study, N=306 women were enrolled in early pregnancy and repeatedly assessed during peripartum period. With the Composite International Diagnostic Interview
for Women (CIDI-V) DSM-IV-TR anxiety and depressive disorders prior to pregnancy were assessed and four initial
diagnostic groups were determined (no AD: no anxiety nor depressive disorder prior to pregnancy, pure D: pure
depressive disorder(s) prior to pregnancy; pure A: pure anxiety disorder(s) prior to pregnancy; comorbid AD: comorbid anxiety and depressive disorders prior to pregnancy). Also the CIDI-V was used to assess anxiety/ depression
liability and body mass index (BMI) during early pregnancy. Blood pressure measurements were derived from
medical records. Arterial hypertension during pregnancy was defined by at least two blood pressure values >= 140
mmHg systolic and/or 90 mmHg diastolic. N=283 women with at least four documented blood pressure measurements during pregnancy were included in the analyses. Results: In this sample, N=47 women (16.6%) were
identified with arterial hypertension during pregnancy. Women with comorbid AD (compared to no AD) were at
higher risk for hypertension (OR=2.3, 95%CI=1.0-5.3) and had a significant higher blood pressure (systolic: ß=3.0,
95%CI=0.2-5.8; diastolic: ß=2.3, 95%CI=0.2-4.4). Anxiety liability was also associated with an increased risk of
hypertension (OR=1.1, 95%CI=1.0-1.2) and a higher systolic blood pressure (ß=0.4, 95%CI=0.0-0.8). The interaction model revealed that the OR for the association between pure A (reference: no AD) and hypertension increases
by 1.5 per unit increase in BMI (ORIT=1.5, 95%CI=1.1-2.0) and the OR for comorbid AD (reference: no AD) and
hypertension increases by 1.3 per unit increase in BMI (ORIT=1.3, 95%CI=1.0-1.7).
Conclusion: Especially obese pregnant women with a lifetime history of anxiety and depressive disorders should
be informed about their heightened risk of hypertension and should be provided with strategies for prevention such
as regular blood pressure measurements at home, changes in diet and physical activity.
Winkel, S., Einsle, S., Pieper, L., Höfler, M., Wittchen, H.-U. & Martini, J. (accepted) Associations of anxiety, depressive disorders and body weight with hypertension during
pregnancy.
Premenstrual symptoms are associated with psychological and physical symptoms in early pregnancy (S.
Winkel, F. Einsle, H.-U. Wittchen & J. Martini)
The reproductive life of women is characterised by a number of distinct reproductive events and phases (e.g. premenstrual phase, peripartum, perimenopause). The hormonal transitions during these phases are often associated
with both psychological and physical symptoms. Associations between these reproductive phases have been
shown by numerous studies. However, the relationship between symptoms during the premenstrual phase and
during early pregnancy has received little attention thus far, although early pregnancy is a time of dramatic hormonal
as well as physical adaptation.
Findings are based on a prospective longitudinal study with N=306 pregnant women (MARI study). Three hundred
five women that had menstrual bleeding in the year before pregnancy rated the severity of psychological and physical symptoms during premenstrual phases in the year preceding pregnancy. Besides this, they rated the severity
of the same symptoms during early pregnancy (weeks 10 to 12 of gestation). The overall severity of premenstrual
symptoms was significantly associated with the overall severity of early pregnancy symptoms (b=0.4, 95%CI: 0.3–
0.5; p<0.001). The overall severity of early pregnancy symptoms was best predicted by the severity of premenstrual
irritability. The best predictor for a particular symptom in early pregnancy mostly was the corresponding premenstrual symptom. The associations between premenstrual and early pregnancy symptoms support the reproductive
hormone sensitivity hypothesis that some women are prone to repeatedly experience specific psychological and
physical symptoms during different reproductive phases. The findings further imply that the nature of symptoms
might be rather consistent between different reproductive phases.
Winkel, S., Einsle, F., Wittchen, H.-U. & Martini, J. (2013) Premenstrual symptoms are associated with psychological and physical symptoms in early pregnancy. Archives of
Women‘s Mental Health, 16(2), 109-115.
Martini, J., Winkel, S. & Einsle, F. (2014) Menstruelle Zyklusstörungen, Prämenstruelles Syndrom und Prämenstruelle Dysphorische Störung. In J. Bitzer & H.-W. Hoefert
(Eds) Psychologie in der Gynäkologie. Pabst Science Publ.
Martini, J., & Einsle, F. (accepted) Prämenstruelles Syndrom und Prämenstruelle Dysphorische Störung (Premenstrual Syndrome and Premenstrual Dysphoric Disorder). In E.
Brähler & H.-W. Hoefert (Eds.) Lexikon der Modernen Krankheiten. Medizinisch Wissenschaftliche Verlagsgesellschaft.
Martini, J. (accepted) Reproduktiver Subtyp der Depression (Reproductive subtype of depression). In E. Brähler & H.-W. Hoefert (Eds.) Lexikon der Modernen Krankheiten.
Medizinisch Wissenschaftliche Verlagsgesellschaft.
118
The association of maternal mental disorders and physical complaints during peripartal time and early
infant development (L. Krause, J. Martini & F. Einsle)
Background: Infant‘s neonatal and childhood development is essential for later adult health and disease (Hodgson
& Coe, 2006). Searching for prenatal predictors of infant development, maternal mental disorders during peripartum period gained increased attention. However, predictors have been assessed in quite different ways, using
measurements of anxiety, depression and distress, as well as manifest DSM-IV anxiety and depressive disorders
(e.g. Beydoun & Saftlas, 2008; Da Costa et al., 2000; Field et al., 2004, 2010; Wang & Chen, 2010). The majority of
studies were restricted to a limited number of neonatal outcomes (e.g. birth weight, gestational age, APGAR score,
neonatal malformations) and only few studies (Beijers et al., 2010; Nielsen et al., 2011; Punamäki et al., 2006) investigated associations of maternal mental disorders and infant‘s diseases, such as digestive and feeding disorders
and respiratory as well as skin diseases during the first years of life.
Aims: Thus, the course of maternal mental disorders during peripartum period was assessed with questionnaire
measurements on anxiety, depression and distress (DASS, Martini et al., 2009) and standardized interviews on
DSM-IV anxiety and depressive disorders in women (CIDI-V, Martini et al., 2009). Infant‘s health during the first four
months was examined based on maternal reports on infant’s health (e.g. digestive and feeding disorders, respiratory and skin diseases) and consultation rates of paediatrician. Moreover, a variety of potential mediators/ moderators,
e.g. maternal parity, maternal age, pregnancy complications and neonatal outcomes derived from medical records
were considered. Based on these data the analyses to investigate the relation between maternal mental disorders
and physical complaints during peripartal time and infant‘s diseases are in preparation and will be provided soon.
Krause, L., Martini, J. & Einsle, F. (in prep). The association of maternal mental disorders and physical complaints during peripartal time and early infant development.
P1.3. The relation of maternal peripartum DSM-IV anxiety and depressive disorders and infant development
Maternal anxiety and depressive disorders predict infant crying, feeding and sleeping disorders (J. Petzoldt,
H.-U. Wittchen; F. Einsle & J. Martini)
Background: Maternal depression has been associated with excessive infant crying, feeding and sleeping disorders, but the specificity of maternal depression as compared to maternal anxiety remains unclear and manifest disorders prior to pregnancy have been widely neglected. In this study, we simultaneously examine maternal anxiety
and depressive disorders prior to, during and after pregnancy within one prospective-longitudinal study to predict
later excessive infant crying, feeding and sleeping disorders. Methods: In the Maternal Anxiety in Relation to Infant
Development (MARI) Study n=306 primiparous and multiparous women were repeatedly interviewed from early
pregnancy until 16 months postpartum with the Composite International Diagnostic Interview for Women (CIDI-V)
to assess DSM-IV anxiety and depressive disorders. Information on excessive infant crying, feeding and sleeping
disorders was obtained from n=286 mothers during postpartum period via questionnaire and interview (Baby-DIPS).
Results: Excessive crying (10.1%), feeding (36.4%) and sleeping disorders (12.2%) were common. When considering all three time frames, namely prior to, during and after pregnancy, maternal anxiety disorders consistently
predicted excessive crying and feeding disorders especially in primiparous mothers, whereas maternal depressive
disorders predicted sleeping disorders irrespective of parity. Conclusions: Primiparous and anxious mothers may be
more prone to anxious misinterpretations of crying and feeding situations and a subsequent escalation of motherinfant interactions. The relation between maternal depressive and infant sleeping disorders may be better explained
by other mechanism e.g. a transmission of unsettled maternal sleep to the fetus during pregnancy. Maternal anxiety and depression prior to pregnancy require more attention in research and clinical practice.
Petzoldt, J., Wittchen, H.-U., Einsle, F. & Martini, J. (submitted). Maternal anxiety and depressive disorders predict infant crying, feeding and sleeping disorders.
Petzoldt, J. & Martini, J. (in press). Regulationsstörungen der frühen Kindheit (Regulatory disorders in early infancy). In E. Brähler & H.-W. Hoefert (Eds.) Lexikon der Modernen Krankheiten. Medizinisch Wissenschaftliche Verlagsgesellschaft.
Petzoldt,J., Wittchen, H.-U. & Martini, J. (2014, 26.-29.11.). Zusammenhänge zwischen mütterlichen Angst- und depressiven Störungen mit frühkindlichen Schlafstörungen.
Talk at the “DGPPN Kongress 2014”, Berlin.
Petzoldt, J., Martini, J. & Wittchen, H.-U. (2014, 10.-12.09.) Maternal anxiety and depressive disorders prior to pregnancy predict infant insomnia disorder. Talk at the “International Marcé Society Biennial Meeting 2014”, Swansea (Great Britain).
Petzoldt, J., Wittchen, H.-U., Wittich, J., & Martini, J. (2013). Perinatal maternal DSM-IV anxiety and depressive disorders and regulatory disorders in the offspring. European
Neuropsychopharmacology: The Journal of the European College of Neuropsychopharmacology, 23, S584-S585.
Ortel, D. (2014) Ein- und Durchschlafstörungen bei 16-monatigen Kleinkindern in Abhängigkeit vom Geburtsrang. Unveröffentlichte Bachelorarbeit. Technische Universität
Dresden.
119
Maternal anxiety disorders predict excessive infant crying: A prospective longitudinal study (J. Petzoldt, H.-U.
Wittchen, J. Wittich, F. Einsle, M. Höfler & J. Martini)
Purpose: To prospectively examine relations between maternal DSM-IV-TR anxiety and depressive disorders and
excessive infant crying. Methods: Based on the prospective longitudinal Maternal Anxiety in Relation to Infant
Development Study, n=306 expectant mothers were enrolled during early pregnancy and repeatedly interviewed
until 16 months post partum. Lifetime and prospective information on maternal anxiety and depressive disorders
was assessed via standardised diagnostic interviews (Composite International Diagnostic Interview for Women).
Excessive crying (crying for ≥3 h per day on ≥3 days per week for ≥3 weeks) was assessed via Baby-DIPS. During
the first 16 months after delivery, n=286 mother-infant dyads were available and included in the analyses. Results:
Excessive crying was reported by n=29 mothers (10.1%). Infants of mothers with anxiety disorders prior to pregnancy were at higher risk for excessive crying than infants of mothers without any anxiety disorder prior to pregnancy (OR=2.54, 95% CI 1.11 to 5.78, p=0.027). Risk was even increased when considering additionally incident
anxiety disorders until delivery (OR=3.02, 95% CI 1.25 to 7.32, p=0.014) and until 16 months postpartum (OR=2.87,
95% CI 1.13 to 7.28, p=0.027). Associations remained stable when adjusting for sociodemographic and perinatal
covariates. Maternal depressive disorders prior to pregnancy were not significantly associated with excessive crying
in this sample. Implications: Maternal lifetime and incident anxiety disorders revealed to be a robust predictor for
excessive crying. Thus, early identification and monitoring of women with anxiety disorders is important to identify
mother-infant dyads at risk for excessive crying.
Petzoldt, J., Wittchen, H. U., Wittich, J., Einsle, F., Hofler, M., & Martini, J. (2014). Maternal anxiety disorders predict excessive infant crying: a prospective longitudinal study.
Archives of Disease in Childhood, 99(9), 800-806.
Petzoldt, J., Martini, J. & Wittchen, H.-U. (2014, 07.-09.07.) Excessive infant crying in relation to maternal DSM-IV anxiety and depressive disorders in a prospective-longitudinal study. Talk at the “12th International Infant Cry Research Workshop”, Coventry (Great Britain).
Kästner, S. (2013) Geschlechtsunterschiede im Schreiverhalten von Säuglingen. Unveröffentlichte Bachelorarbeit, Technische Universität Dresden.
Niedzielski, J. (2013) Unterschiede im Schreiverhalten bei viermonatigen Säuglingen in Abhängigkeit vom Geburtsrang. Unveröffentlichte Bachelorarbeit, Technische Universität Dresden.
Maternal mental disorders before, during and after pregnancy and infant reactivity (J. Martini, J. Petzoldt, N.N.)
Background: A number of studies show associations between maternal DSM-IV anxiety and depressive disorders
with offspring temperament (e.g. Behavioural Inhibition), which is assumed to predict later mental disorders in children. Behavioural Inhibition refers to a temperamental tendency of children to consistently react to unfamiliar situations with initial fear, distress and avoidance. Infant Reactivity might be an early predictor of Behavioural Inhibition
(Kagan & Snidman 1991).Aims: To prospectively examine the associations between maternal lifetime DSM-IV anxiety and depressive disorders and perceived maternal distress during pregnancy and Infant Reactivity. Methods: The
current analysis focuses on the data of a subsample of the MARI Study. N = 199 women reported lifetime status of
DSM-IV anxiety and depressive disorder and were followed up during pregnancy (10.-12., 22.-24. and 35.-37. week
of pregnancy) and after delivery (16 weeks after delivery) using a standardized diagnostic interview (CIDI-V, Martini
et al., 2009) and questionnaires (DASS-P, Martini et al., 2009). Infant Reactivity was assessed 16 weeks after delivery by direct laboratory observation using Kagan’s standardized observation paradigm and coding-procedure (Kagan &
Snidman, 1991). Results: In comparison to infants of mothers without lifetime diagnosis of anxiety and/ or depressive disorder, infants of mothers with lifetime depressive disorder had lower cry-scores (OR=0.32, 95%CI 0.130.76, p<.05) and infants of mothers with co-morbid anxiety and depression tended to be more often highly reactive
(OR=3.81, 95%CI 0.98-14.78, p=.05). Maternal perceived mental distress after birth, but not during pregnancy, was
associated with higher infant cry-scores (Beta=.05, KI 0.00-0.11, p<.05). Discussion: Results suggest a link between
maternal lifetime anxiety and depressive disorders as well as maternal perceived distress and infant temperament.
Thus, the familial transmission of internalising mental disorders might be moderated/ mediated by temperamental
factors that are assumed to be early predictors of mental disorders in the offspring.
Martini, J. (2012, 14.-16.06.). Mütterliche psychische Auffälligkeiten vor, während und nach der Schwangerschaft und frühkindliche Reaktivität. Invited talk at the Symposium
„Psychische Erkrankungen in der Schwangerschaft: Risiken und Chancen.“ (Chair: J. Junge-Hoffmeister). VI. Symposium der Marcé Gesellschaft für Peripartale Psychische Erkrankungen e.V., Wiesloch.
120
P2. Mental and physical health in premature infants and their partners
Self-confident parents and secure and robust babies – Optimizing the education and assistance of parents
with premature infants
PI: Prof. Dr. Anja Strobel, Dr. Julia Martini; Staff: Heidi Thyzel, Franziska Lauke, Cäcilia Luong
Funding: Junior Professorship of Process-Orientated Assessment (Jun.-Prof. A. Strobel), Friends and Sponsors
(Gesellschaft der Freunde und Förderer) TU Dresden, Klinik und Poliklinik für Kinder- und Jugendmedizin,
Universitätsklinikums Dresden and Verein „Bild hilft Kindern“ e.V.; Duration: 2009 – 2013; Cooperations: Prof. Dr.
Mario Rüdiger & PD. Dr. Jörg Reichert (Universitätsklinikum, TU Dresden), Dr. Hans Hammer & Hans Proquitté
(Charité - Universitätsmedizin Berlin), Prof. Dr. Ulrich Thome (Universitätsklinikum Leipzig)
Parents of premature infants often worry about the health of their infant and possible consequences of prematurity for later development (Wolke et al., 2001). If hospitalization of the newborn is required, this is a challenging
situation for the parents, who often feel helpless and uncertain regarding the parental care (Singer et al., 1996).
Postpartum period per se is a vulnerable time for the incidence of mental disorders in parents and premature delivery might exacerbate this situation and psychopathological symptoms might occur more often (Carter et al., 2005).
For this reason, perinatal care centers often offer support services, but systematic research on the efficacy and
effectiveness of these programs is rare.
This project is established as a multicenter study. The aim of this study is a formative evaluation of different intervention-programs of three perinatal centers in Germany (Universitätsklinikum Dresden, Universitätsklinikum Leipzig,
Charité - Universitätsmedizin Berlin) with the following milestones: (1) Description, (2) Explication, (3) Proof of
Effectiveness, (4) Evaluation, (5) Optimization of Feedback and (6) Setting of Standards.
In order to improve the support services in perinatal centers in Germany, this project will provide comprehensive
field manuals and also data to compare different intervention-programs. The effectiveness of these interventionprograms will be evaluated in regard to incident psychopathological symptoms (DASS-P, Martini et al., 2009) and
maternal mental disorders (CIDI-V, Martini et al., 2009) as well as maternal self-efficacy, mother-child-relationship
and a comprehensive assessment about medical data, including days of hospitalization and a range of medical complications. Publications are currently in preparation and will be provided soon.
Martini, J., Wittich, J. & Knappe, S. (2013) „Der Apfel fällt nicht weit vom Stamm“: Von der familiären Übertragung psychischer Störungen. In J. Reichert, M. Rüdiger (Hrsg.)
Psychologie in der Neonatologie: Psychologisch-sozialmedizinische Versorgung von Familien Frühgeborener. Göttingen. Hogrefe.
Luong, C. (2012) Zusammenhänge zwischen der psychischen Gesundheit und Persönlichkeitsfaktoren der Mütter von Frühgeborenen und ihrer Besuchshäufigkeit auf der
Neonatologie. Unveröffentlichte Diplomarbeit, Technische Universität Dresden.
Crying, feeding and sleeping problems: A comparison of term and preterm infants (J. Petzoldt, P. Hinner, N.N.)
Background: Mothers of preterm infants often face special demands during the first weeks after discharge from a
hospital when adjusting to the new family situation. In these days regulation problems like excessive crying, feeding
or sleeping problems can develop and increase maternal distress. Former investigations have shown that regulation
problems in general are more prevalent in preterm infants (Mara et al. 2010, Pierrehumbert at al. 2003, Schmid et
al. 2009) with significant higher rates of feeding problems (Schmid et al. 2009, Cierpka 2012). Aims: Mothers of
preterm infants from a university hospital in Dresden were investigated approx. three weeks after discharge from
the hospital and matched with mothers of term infants from the regional-epidemiological sample of the MARI Study
(Martini et al. 2013). All examined mothers provided information on their infants crying, feeding and sleeping behaviors (online or paper-pencil questionnaire and interview format). This paper is still in preparation. Upcoming analyses
will compare rates, characteristics and maternal burden of regulation problems during infancy in term and preterm
infants. Results of these analyses are intended to a) improve our understanding of the relation between prematurity
and regulation problems and b) identify potential needs for support of mothers of premature infants after discharge
from the hospital.
Hinner, P., Hennig, J., Petzoldt, J., Reichert, J,, Rüdiger, M. (2014,09.06.) The role of preterm behavioral demands for maternal adaptation after discharge from hospital.
Poster presented at the “12th International Infant Cry Research Workshop, Coventry (Great Britain).
121
P3. Mental and physical health in parents of chronically ill children
Fear of Progression in parents of children with cancer
PI: Dr. Julia Martini, Dr. F. Schepper; Staff: Katharina Abel; Funding: Elternhilfe für krebskranke Kinder Leipzig e.V.,
Fellowship of the José Carreras Leukämie-Stiftung (K. Abel); Duration: 05/2013 - ongoing; Cooperations: Prof. Dr. H.
Christiansen, Prof. Dr. A. Mehnert (Universitätsklinikum Leipzig), Prof. Dr. P. Herschbach (Klinikum rechts der Isar
der TU München), Verbundprojekt für Geschwister (Leipzig, Jena, Berlin, Erfurt/ Suhl, Halle, Dresden, Chemnitz,
Magdeburg)
Fear of Progression in parents of children with cancer: Adaptation of the Fear of Progression Questionnaire
and correlates (F. Schepper, K. Abel, H. Christiansen, J. Martini)
Background: Fear of Progression (FoP), the fear of further disease progression, is one of the most common psychological strains of chronically ill patients and can also be found in healthy partners of cancer patients. As primary
caregivers, parents of children with cancer are likely to develop distinct fears related to their child’s disease that
may persist even after primary medical treatment. Aims: To assess FoP in parents of children with cancer using
an adapted version of the FoP questionnaire (Herschbach et al., 2005) to investigate relationships between FoP in
parents of children with cancer and disease and treatment-related issues, the child’s current medical condition and
parents’ quality of life. Method: The short form of the FoP Questionnaire was adapted by rephrasing the items for
the parental perspective. To test the questionnaire 76 parents (51 mothers, 25 fathers) whose children were in parttime inpatient oncological treatment or follow-up care and who had agreed to participate in psycho-social assistance
at either Elternhilfe krebskranker Kinder Leipzig e.V. or Sonnentrahl e.V. Dresden were surveyed. Time since diagnosis was between 2 weeks and 20 years (mean = 3.9 years). Results: The FoP questionnaire for parents of children with cancer is a short questionnaire with adequate psychometric properties (e.g. Crobach’s α = .90). FoP scores
were highest in parents with a child in part-time inpatient oncological treatment. Parents with a child in follow-up
care exhibited mid-range FoP scores. Significant correlations with FoP were found for the child’s current medical
condition (r = .35), time since diagnosis (r = -.30), parents’ capacity to cope with disease related fears (r = -.45) and
parents’ quality of life (r = -.55).
Conclusion: Based on the FoP questionnaire for parents, clinicians should seek to identify those parents with
increased FoP-scores during inpatient treatment and during follow-up care. Psycho-social treatment should focus on
parents’ disease-related coping strategies and psycho-educative counselling to reduce FoP.
Schepper, F., Abel, K., Christiansen, H., Martini, J. (in prep) Fear of Progression in parents of children with cancer: Adaptation of the Fear of Progression Questionnaire and
correlates.
Abel, K., Schepper, F., Martini, J. (2013, 20.-22.11.) Ausprägung der Progredienzangst bei Eltern krebskranker Kinder. Talk at the 12. Jahrestagung der Arbeitsgemeinschaft
für Psychoonkologie (PSO): Brücken verbinden!?-Sektorale Vernetzung in der Psychoonkologie, Dresden.
Abel, K. (2014) Ausprägung der Progredienzangst bei Eltern krebskranker Kinder. Unveröffentlichte Diplomarbeit, Technische Universität Dresden.
122
AG 4 ROAMER - A ROADMAP FOR MENTAL HEALTH AND WELL BEING
H.-U. WITTCHEN & S. KNAPPE
AG 4 ROAMER
A Roadmap for Mental Health and Well-Being Research in Europe
Prof. Dr. Hans-Ulrich Wittchen & Dr. Susanne Knappe
Overview
On the regional level, Europe has one of the highest levels of resources for mental health care. Despite this, the
high burden and impact of mental disorders in Europe is expected to rise. “ROAdmap for MEntal health Research”
(ROAMER) is designed to develop a comprehensive, consensus-based roadmap to promote and integrate mental
health and well-being research in Europe. Research advances and innovations are to be devoted to decreasing the
burden of mental disorders and increasing the mental health and well-being of Europeans. ROAMER will combine a
neutral, fact-based methodology with extensive stakeholder involvement in consultation and dissemination. During
the kick-off phase, the methodology (including comprehensive EU-wide indicators to assess the current state of
the art, gaps and advances) and the desired situation (scoping and objectives) will be finalised. The ROAMER project has been initiated and funded by the European Commission (FP7 - HEALTH.2011.3.3-4), aimed to develop an
effective and widely accepted Roadmap on the promotion and integration of mental health and wellbeing research
in Europe for the next 10-15 years. The project was started in October 2011 and will be developed by the end of
2014. The main objectives of the project are
1. To develop an accurate picture of the state-of-art in mental health and wellbeing research in Europe
2. To analyse gaps and salient advances, to establish research priorities and infrastructure and capacity requirements of mental health and wellbeing research in Europe
3. The wide involvement of Europe’s leading scientists in the mental health field in a collective endeavour to
prioritise mental health and wellbeing research
4. Full engagement with key non-academic stakeholders in mental health and wellbeing research, including
funders, policy makers, professionals, end users, carers and family members
5. To help to close the gap between science and society
6. To inform the public about mental health and wellbeing research and launch the definitive roadmap.
Figure 5 AG ROAMER: project components
123
P1. Psychological research and treatments – state of the art and advances needed
PI: Professor Dr. Hans-Ulrich Wittchen (Workpackage 5, Psychological Research and Treatments)
Staff: Dr. Susanne Knappe, Dr. Sarah Forberger; Funding: EU: Call (part) identifier: FP7 - HEALTH.2011.3.3-4;
Duration: 01/2012 – 10/2014. Project partners: Prof Joseph Maria Haro Abad (project coordinator; CIBERSAM), Dr.
Carla Obradors (project manager; CIBERSAM), Prof. José Luis Ayuso (CIBERSAM); Prof. Til Wykes, Prof. Graham
Thornicroft, Prof. Gunter Schumann (King’s College London), Prof. Marion Leboyer (FondaMental), Dr. Jacques
Demotes (INSERM), Prof. Jim van Os, Prof. Don Linszen (Maastricht University Medical Centre), Dr. Dave McDaid
(London School of Economics), Prof. A. Meyer-Lindenberg (Central Institute of Mental Health), Prof. Kristian
Wahlbeck (Nordic School of Public Health), Prof. Mario Maj (University of Naples), Prof. Istvan Bittér (Semmelweis
University Budapest), Prof. Shôn Lewis (University of Manchester), Prof. Trevor W. Robbins (Cambridge
University);Collaborators for WP 5: Prof. Wolfgang Lutz (Universität Trier), Prof. Dr. Dr. Uwe Koch (UKE Hamburg),
Prof. Ilse Kryspin-Exner (Universität Wien), Prof Herta Flor (Universität Heidelberg), Prof. Arne Holte (Nordic School
of Public Health), Prof. Francesco Colom (Institute of Neurosciences Barcelona), Prof. Daniel David (Romania),
Prof Tim Dalgleish (Cambridge University), Prof. Arnoud Arntz (Maastricht University), Prof. Giovanni A. Fava
(University Institute of Neurosciences
Psychological treatments and interventions comprise a large group of methods and approaches to address the
needs of patients and groups of patients with mental disorders or mental health problems, as well as their networks
of support (e.g. partner and family) as it applies to prevention, treatment and rehabilitation. Psychological treatments
and intervention range from highly sophisticated psychotherapy, delivered by specialised psychotherapists, to the
application of specific behavioral technique s as part of a broader treatment plan (e.g. psychoeducation or motivational interviewing). The effectiveness of strictly psychological treatments is well established by randomised clinical
trials of variants of Cognitive Behavioral Therapy (CBT) in the areas of anxiety, depressive, somatoform and stressrelated disorders (e.g. PTSD), the eating disorders and personality disorders, where such methods are typically
regarded as first - line treatments. They are also established as core elements in the treatment of substance use
disorders and most childhood and adolescent neurodevelopmental disorders and conditions (e.g. ADHD). For the
group of psychodynamic and psychoanalytic methods similar strong evidence is lacking.
There are however a number of gaps such as the general lack of understanding about the basic mechanisms of
behavior or the mediators of interventions, a fundamental lack in understanding behavior change in the specific
context of CBT, a lack of knowledge about the situation of research on psychological treatments and interventions
in Europe. In fact – and despite some coordinated EU - efforts in this domain - there is even a profound lack of
knowledge about the degree to which psychological treatments are applied in the EU countries, where and what
kind of research and service delivery programs are in place and how they integrated into the wider network of
mental health care infrastructure. As a result of this situation, Europe lacks even the most basic prerequisites for an
evidence - based mental health research policy. Two scientific workshops were held in May/June 2012 in Dresden
in the Institute of Clinical Psychology and Psychotherapy and in March 2013 in the Kings College of Psychiatry in
London in collaboration with the ROAMER workpackage 4. Consensus was derived on conceptional issues and
fields of interest for the workpackage 5, namely (i) basic mechanisms of behaviour, (ii) mechanisms of behaviour
change, (iii) psychological factors and mechanisms involved in the onset and the progression of mental disorders,
(iv) the research on psychological interventions and treatments in Europe with regard to basic research, clinical
research and service delivery. Position papers to reflect the current state of the art, advances in the last years but
also gaps and needs are currently drafted by distinguished experts in the respective field.
Haro, J.M., Ayuso-Mateos, J. L., Bitter, I., Demotes, J., Marion Leboyer, M., Lewis, S. W., Linszen, D., Maj, M., McDaid, D., Meyer-Lindberg, A., Robbins, T. W., Schumann,
G., Thornicroft, G:, van der Feltz-Cornelis, C., van Os, J., Wahlbeck, K., Wittchen, H.-U., Wykes, T., Arango, C., Bickenbach, J., Brunn, M., Cammarata, P., Evans-Lacko,
S., Finocchiaro, C., Fiorillo, A., Forsman, A., Hazo, J. B., Knappe, S., Kuepper, R., Luciano, M., Miret, M., Obradors-Tarragó, C., Pagano, G., Papp, S., Walker-Tilley, T. The
ROAMER Consortium (2014). ROAMER: A Roadmap for mental health research in Europe. International Journal of Methods in Psychiatric Research 23 (Suppl. 1), 1-14
Emmelkamp, P.M.G., David, D., Beckers, T., Muris, P., Cuijpers, P., Lutz, W., Andersson, G., Araya, R., Banos Rivera, R. M., Barkham, M., Berking, M., Berger, T., Botella, C.,
Carlbring, P., Colom, F., Essau, C., Hermans, D., Hofmann, S. G., Knappe, S., Ollendick, T. H., Raes, F., Rief, W., Riper, H., van der Oord, S., Vervliet, B. (2014). Advancing Psychotherapy and Evidence –Based Psychological Interventions. International Journal of Methods in Psychiatric Research 23 (Suppl. 1), 58-91.
Fava, G. A., Tossani, E., Bech, P., Berrocal, C., Chouinard, G., Csillag, C., Wittchen, H.-U., & Rief, W. (2014). Emerging clinical trends and perspectives on comorbid patterns
of mental disorders in research. International Journal of Methods in Psychiatric Research, 23(1), 92-101.
Goschke, T. (2014). Dysfunctions of decision-making and cognitive control as transdiagnostic mechanisms of mental disorders: advances, gaps, and needs in current
research. International Journal of Methods in Psychiatric Research, 23(S1), 41-57.
Wittchen, H.-U., Knappe, S., Andersson, G., Araya, R., Banos Rivera, R. M., Barkham, M., Bech, P., Beckers, T., Berger, T. Berking, M., Berrocal, C., Botella, C., Carlbring, P.,
Chouinard, G., Colom, F., Csillag, C., Cujipers, P., David, D., Emmelkamp, P. M. G., Essau, C. A., Fava, G. A., Goschke, T., Hermans, D., Hofmann, S.G., Lutz, W., Muris,
P., Ollendick, T. H., Raes, F., Rief, W., Riper, H., Tossani, E., van der, Oord, S., Vervliet, B., Haro, J. M., Schumann, G. (2014) The need for a behavioural science focus in
research on mental health and mental disorders. International Journal of Methods in Psychiatric Research 23 (Suppl. 1), 28-40.
Wittchen, H.-U., Knappe, S., Schumann, G. (2014) The psychological perspective on mental health and mental disorder research: Introduction to the ROAMER work package
5 consensus document. International Journal of Methods in Psychiatric Research 23 (Suppl. 1), 15-27.
124
P2. Public mental health research in Europe: A systematic mapping for the ROAMER Project
Background: As part of the ROAMER (Roadmap for Mental Health Research in Europe) Project, which aims to create an integrated European roadmap for mental health research, we set out to map the hitherto unmapped territory
of public mental health research in Europe. Methods: Five electronic databases (CINAHL, Health Management,
Medline, PsycINFO, Social Services Abstracts) were used for identifying public mental health research articles
published between January 2007 and April 2012. The number of publications for each European country in five
research domains (i.e. mental health epidemiology, mental health promotion, mental disorder prevention, mental
health policy and mental health services) was analysed by population size and Gross Domestic Product (GDP) and
mean impact factors were compared. Results: 8 143 unique publications were identified. Epidemiology research
dominates public mental health research, while promotion, prevention and policy research are scarce. Mental health
promotion is the fastest growing research area. Older adults are underrepresented. Publications per capita were
highest in the Northwestern Europe, and a similar trend was found also when adjusting the number of publications
by GDP. The most widely cited research origins from Italy, Switzerland, United Kingdom, the Nordic countries, the
Netherlands, Greece and France. Conclusion: In Europe, public mental health research is currently a matter of the
affluent Northern and Western European countries, and major efforts will be needed to support and promote public
mental health research in South and East Europe. In spite of a smaller public mental health research output, some
Mediterranean countries produce highly cited public mental health research.
Forsman, A. K., Wahlbeck, K., Aarø, L. A., Alonso, J., Barry, M. M., Brunn, M., Cattan, M., de Girolamo, G., Eberhard-Gran, M., Evans-Lacko, S., Fiorillo, A., Hansson, L., Haro,
J. M., Hazo, J.-B., Hegerl, U., Katschnig, H., Knappe, S., Luciano, M., Miret, M., Nordentoft, M., Obradors-Tarragó, C., Pilgrim, D., Ruud, T., Salize, H.-J., Stewart-Brown,
S. L., Tómasson, K., van der Feltz-Cornelis, C. M., Ventus, D. B. J., Vuori, J., Värnik, A., also on behalf of the ROAMER Consortium (subm.) Research priorities of public
mental health in Europe: Recommendations of the ROAMER project. European Journal of Public Health.
The state of the art in European research on reducing social exclusion and stigma related to mental health:
A systematic mapping of the literature
Stigma and social exclusion related to mental health are of substantial public health importance for Europe. As
part of ROAMER (ROAdmap for MEntal health Research in Europe), we used systematic mapping techniques to
describe the current state of research on stigma and social exclusion across Europe. Findings demonstrate growing
interest in this field between 2007 and 2012. Most studies were descriptive (60%), focused on adults of working
age (60%) and were performed in Northwest Europe - primarily in the UK (32%), Finland (8%), Sweden (8%) and
Germany (7%). In terms of mental health characteristics, the largest proportion of studies investigated general mental health (20%), common mental disorders (16%), schizophrenia (16%) or depression (14%). There is a paucity of
research looking at mechanisms to reduce stigma and promote social inclusion, or at factors that might promote
resilience or protect against stigma/social exclusion across the life course. Evidence is also limited in relation to
evaluations of interventions. Increasing incentives for cross-country research collaborations, especially with new EU
Member States and collaboration across European professional organizations and disciplines, could improve understanding of the range of underpinning social and cultural factors which promote inclusion or contribute toward lower
levels of stigma, especially during times of hardship.
Evans-Lacko, S., Courtin, E., Fiorillo, A., Knapp, M., Luciano, M., Park, A.-L., Brunn, M.,Byford, S., Chevreul, K., Forsman, A., Gulacsi, L., Haro, J. M., Kennelly, B., Knappe, S.,
Lai, T., Lasalvia, A., Miret, M., O’Sullivan, C., Obradors-Tarragó, C., Rüsch, N., Sartorius, N., Švab, V., van Weeghel, J., Van Audenhove, C., Wahlbeck, K., Zlati, A., also
on behalf of the ROAMER Consortium, McDaid, D., Thornicroft, G. (in press). The state of the art in European research on reducing social exclusion and stigma related to
mental health: a systematic mapping of the literature. European Psychiatry.
P3. Clinical research task force – Delphi Survey
Project partners: Prof. Christina M. van der Feltz-Cornelis (PI), Prof. Jim van Os, Dr. Susanne Knappe, Prof. Gunter
Schumann,, Prof. Eduard Vieta, Prof. H.-U. Wittchen, Prof. Shon W. Lewis, Dr. Iman Elfeddali, Prof. K. Wahlbeck,
Prof. D. Linszen, Dr. R. Kuepper, BA Sc. R. Wendel
Clinical research is of particular importance for mental disorders, particularly because of the low validity of animal
models, and because of the sub-optimal definition and stratification of diseases. Testing diagnostic and treatment
strategies in humans is therefore critical. The complexity of treatment strategies associating medicines, psychotherapy and medical devices also requires clinical trials supporting evidence-based medical practice. Specific
methodological issues have to be addressed, including commonly agreed outcome measures. Clinical research on
mental health therefore represents a highly multidisciplinary activity, and for this reason the cross-WP task force on
125
clinical research was established in ROAMER. The objective of the Clinical Research Task Force will be to identify
important new developments in Clinical Research regarding mental disorders, what would be new horizons for innovative research, and what are gaps to be addressed in future research. An important area is related to the “how”
of research, in terms of methodological innovation, quality assurance and prevention of poor research. A two stage
Delphi -survey was designed by the Roamer Clinical Research Task Force that was specifically formed for this purpose and is led by Prof. Christina van der Feltz-Cornelis. The list of items was sent for comments to the WP leaders
and approved by the ROAMER Scientific Advisory Board and by the Coordinator. From this list the survey was devised (SK, CFC) and input was provided by a member of the scientific advisory Board on how to conduct surveys and
how to interpret the results (HP). The Delphi-survey aims to gain insight into challenges/gaps and advances (among
others policies) in clinical research in the field of mental health and wellbeing.
Towards Horizon 2020: challenges and advances for clinical mental health research – outcome of an expert survey
Background: The size and increasing burden of disease due to mental disorders in Europe poses substantial challenges to its population and to the health policy of the European Union. This warrants a specific research agenda
concerning clinical mental health research as one of the cornerstones of sustainable mental health research and
health policy in Europe. The aim of this research was to identify the top priorities needed to address the main challenges in clinical research for mental disorders.
Methods: The research was conducted as an expert survey and expert panel discussion during a scientific workshop.
Results: Eighty-nine experts in clinical research and representing most European countries participated in this survey. Identified top priorities were the need for new intervention studies, understanding the diagnostic and therapeutic implications of mechanisms of disease, and research in the field of somatic-psychiatric comorbidity. The “subjectivity gap” between basic neuroscience research and clinical reality for patients with mental disorders is considered
the main challenge in psychiatric research, suggesting that a shift in research paradigms is required. Conclusion:
Innovations in clinical mental health research should bridge the gap between mechanisms underlying novel therapeutic interventions and the patient experience of mental disorder and, if present, somatic comorbidity. Clinical mental
health research is relatively underfunded and should receive specific attention in Horizon 2020 funding programs.
van der Feltz, C. M., van Os, J., Knappe, S., Schumann, G., Vieta, E., Wittchen, H.-U., Lewis, S. W., Elfeddali, I., Wahlbeck, K., Linszen, D., Obradors-Tarragó, C., Haro, J.
M., also on behalf of the ROAMER consortium (2014) Towards Horizon 2020: Challenges and advances for clinical mental health research. Outcome of an expert survey.
Neuropsychiatric Research and Treatment, 10, 1057-1068.
Wendel, R. (2013). Gaps and advances in clinical research pertaining to methodological issues: A taxonomy of findings from a Delphi-survey. Bachelor Thesis. Universität
Potsdam.
Horizon 2020 priorities in clinical mental health research: results of a consensus-based ROAMER expert survey
Within the ROAMER project, that aims to provide a Roadmap for Mental Health Research in Europe, a two-stage
Delphi survey among 86 European experts was conducted in order to identify research priorities in clinical mental
health research. Consensus-based analyses indicated that expert consensus existed with regard to the importance
of three challenges in the field of clinical mental health research: 1. the development of new, safe and effective
interventions for mental disorders; 2. understanding the mechanisms of disease in order to be able to develop such
new interventions and 3. which outcomes to use for clinical mental health research evaluation. Proposed actions
involved increasing the utilization of tailored approaches (personalized medicine); developing blended eHealth/
mHealth decision aids/guidance tools that help the clinician to choose between various treatment modalities; developing specific treatments in order to better target comorbidity; and (further) development of biological and psychopharmacological interventions. The experts indicated that addressing these priorities will result in increased efficacy
and impact across Europe, with a high probability of success given that Europe has important strengths such as
skilled academics and a long research history. Finally, the experts stressed the importance of creating funding and
coordinated networking as essential action needed in order to target the variety of challenges in clinical mental
health research.
Iman Elfeddali, I., van der Feltz-Cornelis, C. M., van Os, J., Knappe, S.,. Schumann, G., Vieta, E:, Wittchen, H.-U., Lewis, S. W., Wahlbeck, K., Linszen, D., Obradors-Tarragó,
C., Haro, J. M., also on behalf of the ROAMER consortium (submitted). Horizon 2020 priorities in clinical mental health research: results of a consensus-based ROAMER
expert survey. Special Issue on Mental Health Care in the International Journal of Environmental Research and Public Health
126
AG 5 NEUROPSYCHOLOGY
O. RIEDEL & U. LÜKEN
AG 5 Neuropsychology
Dr. Oliver Riedel und PD Dr. Ulrike Lüken
Overview
Our work group focuses on four main areas of interest – all of which are joint projects with neurology:
a) the epidemiology of Parkinson’s Disease with dementia (GEPAD-study) and
b) it’s continuation projects, the DEMPARK-study and the LANDSCAPE study
c) neuropsychological effects of deep brain stimulation of the subthalamic nucelaus in advanced Parkinson’s
disease (DBS-REWARD)
d) Regulation of cognitive and affective flexibility via fronto-striatal networks (FLEXI-PD)
Our workgroup is participating in the Collaborative Research Centre “Volition and cognitive control: mechanisms,
modulators, and dysfunctions” (SFB 940). Future research directions will be stimulated by increased needs for
neuropsychological competence as part of the neuroimaging research at the Neuroimaging Center and upcoming
research initiatives in the field of the linkage between neuropsychological development and psychopathology in
young and old age. The group maintains important close collaborations with leading researchers and research units
as for instance Prof. Dr. G. Deuschl (Kiel), Prof. Dr. R. Dodel (Marburg), Dr. J. Koy (Luxembourg), Prof. Dr. S.-C. Li
(Dresden), Prof. Dr. W. Oertel (Marburg), Prof. Dr. H. Reichmann (Dresden), Prof. Dr. T. E. Schläpfer (Bonn), Prof.
Dr. A. Storch (Dresden) & PD Dr. M. Wolz (Dresden).
P1. GEPAD (German Study on Epidemiology of Parkinson´s Disease with Dementia)
PI: Prof. Hans-Ulrich Wittchen, Prof. Richard Dodel; Staff: Dipl.- Psych. O. Riedel, Dipl. Math. J. Klotsche, Dr. A.
Spottke
Funding: Novartis Pharma GmbH, Nürnberg (study completed in 2009); Cooperations: Neurologische Klinik,
Friedrich- Wilhelms- Universtät (Bonn), Klinik und Poliklinik für Neurologie, Universitätsklinikum C. G. Carus
(Dresden); Kompetenznetz Parkinson (Marburg) sowie die Mitglieder des GEPAD steering committee: Prof. Deuschl
(Kiel), Prof. Förstl (München), Prof. Henn (Mannheim), Prof. Heuser (Berlin), Prof. Oertel (Marburg), Prof. Reichmann
(Dresden), Prof. Riederer (Würzburg) und Prof. Trenkwalder (Göttingen)
Hintergrund: Nicht-motorischen Symptomen (NMS) bei der Parkinson Krankheit (Parkinson’s Disease, PD) kommt
eine zunehmende diagnostische und therapeutische Bedeutung zu. Dies betrifft insbesondere demenzielle und
depressive Syndrome. Das Wissen über ihre Häufigkeiten und Komorbiditätsmuster bei ambulant versorgten
Patienten ist jedoch begrenzt, da bisherige Daten hauptsächlich von hochselegierten Populationen gewonnen wurden.
Ziele: Ermittlung der Häufigkeit von NMS bei PD Patienten, die im niedergelassenen Facharztsektor betreut werden, stratifiziert nach Alter, Geschlecht, Dauer und Schweregrad der PD. Methoden: GEPAD ist eine bundesweite
epidemiologische Querschnittsstudie. Eine repräsentative Stichprobe von 315 Neurologen wurde gebeten, an
einem Stichtag im Erhebungszeitraum (September/Oktober 2005) bis zu fünf PD-Patienten klinisch zu beurteilen.
Die Beurteilung umfasste die Schwere der PD (Hoehn & Yahr, UPDRS), den Einsatz von Skalen für neuropsychiatrische Syndrome (MMSE, Clock Drawing Test CDT, MADRS), sowie in einer Subpopulation das parkinsonspezifische Demenzscreening PANDA. Zusätzlich wurde das Vorliegen einer Demenz nach DSM-IV Kriterien beurteilt. Es
wurden insgesamt 1.449 PD-Patienten untersucht.
Ergebnisse: In der Gesamtstichprobe hatten 71% aller PD-Patienten mindestens ein NMS. Die geschätzten
Häufigkeiten (Range) betrugen bei der Depression 25% (13.2–47.9%), bei der Demenz 28.1% (12.2–59.4%) und
12.7% (3.1–40.9%) zeigten psychotische Symptome. Weitere häufige Komplikationen waren Schlafstörungen (49%)
und Angststörungen (20%). Depression war mit dem Geschlecht, nicht jedoch mit dem Lebensalter assoziiert. Die
Demenzrate stieg signifikant mit zunehmendem Lebensalter an. Beide Störungen und ihre Koinzidenz wurden stark
von der Schwere der PD getrieben.
Diskussion: Nicht-motorische Symptome erwiesen sich in unserer umfassenden und repräsentativen Stichprobe
mit über 40% als sehr häufig. Ambulant versorgte PD Patienten haben ein erhöhtes Risiko für viele neuropsychiatrische Störungen, das - mit Ausnahme der Demenz - bei fortschreitender PD, nicht jedoch mit zunehmenden
Lebensalter, ansteigt. Die Ergebnisse geben wertvolle ätiopathogenetische Hinweise und verdeutlich auch die
enormen diagnostisch-therapeutischen Herausforderungen wider, mit denen niedergelassene Neurologen bei der
ambulanten Betreuung von PD Patienten konfrontiert sind.
Riedel, O., Klotsche, J., Spottke, A., Deuschl, G., Foerstl, H., Henn, F., Heuser, I., Oertel, W., Reichmann, H., Riederer, P., Trenkwalder, C., Dodel, R., & Wittchen, H.-U..
(2008). Cognitive impairment in 873 patients with idiopathic Parkinson‘s disease: Results from the German study on epidemiology of Parkinson‘s disease with de-mentia
(GEPAD). Journal of Neurology, 255: 255-264.
Riedel, O., Klotsche, J., Spottke, A., Deuschl, G., Foerstl, H., Henn, F., Heuser, I., Oertel, W. H., Reichmann, H., Riederer, P., Trenkwalder, C., Dodel, R., & Wittchen, H.-U.
(2010). Frequency of dementia, depression and other neuropsychiatric symptoms in 1,449 outpatients with Parkionson’s Disease. Journal of Neurology, 257, 1072-1083.
127
P1. GEPAD (German Study on Epidemiology of Parkinson´s Disease with Dementia)
Background: Non-motor symptoms (NMS) in Parkinson’s disease (PD) are of growing diagnostic and therapeutic
importance, especially dementia and depression syndromes. Little is known about their frequency and comorbidity
patterns in PD outpatients as previous data have been primarily derived from highly selected clinical populations.
Aims: Provision of prevalence estimates of non-motor comorbidities in PD in the outpatient care sector, stratified
by age, sex, duration and stage of disease.
Methods: We have conducted a national study in the outpatient care sector to provide a fuller characterization of
the frequency of dementia, depression, and other NMS in PD outpatients. We also examined associations with biosocial and neurological variables. A nationwide representative sample of 1,449 PD outpatients was examined with a
standardized clinical interview. PD severity was rated with the Hoehn & Yahr (HY) scale and the Unified Parkinson’s
Disease Rating Scale. Depression was measured with the Montgomery-Asberg Depression Rating Scale. Cognitive
impairment and dementia were assessed with the Mini-Mental State Exam and according to diagnostic criteria.
Logistic regression analyses were used to investigate associations.
Results: At least one NMS occurred in 71% of all patients with PD. The estimated prevalences (ranges) by age
group and HY-stage were: depression, 25% (13.2–47.9%); dementia, 28.1% (12.2–59.4%); and psychotic syndromes, 12.7% (3.1–40.9%). Other frequent complications were sleep disturbances (49%) and anxiety (20%).
Depression was associated with gender but not with age. Dementia was associated with age. The rates and comorbidity of depression and dementia were driven by PD severty.
Conclusion: NMS were highly prevalent in our comprehensive patient sample, largely representative of management problems occurring in an outpatient setting. PD outpatients are at an increased risk for all neuropsychiatric
conditions, increasing with PD severity but not with age or age of onset (except dementia), revealing challenging
symptom patterns.
Figure 1: Prevalence of dementia (DSMIV) and depression (MADRS>14) among
patients with Parkinson´s Disease in the
GEPAD study (N=1,449).
P2. Depression bei Parkinson-Erkrankungen (GEPAD)
Hintergrund: Depressive Störungen sind eine häufige Begleiterscheinung bei der Parkinson-Krankheit (Parkinson’s
Disease, PD). Die epidemiologischen Kenntnisse über ihre Häufigkeit und Erscheinungsformen sind jedoch bislang
nur unzureichend. Es fehlen insbesondere Daten über die Prävalenz depressiver Erkrankungen bei PD Patienten
mit und ohne Demenz, die im niedergelassenen Versorgungssektor betreut werden. Ziele: Schätzung des altersund geschlechtsspezifischen Depressionsrisikos bei dementen und nicht-dementen PD-Patienten im ambulanten
Versorgungssektor sowie die Exploration möglicher Symptommuster. Methoden: GEPAD ist eine bundesweite,
repräsentative Querschnittsstudie an n=1,449 PD-Patienten, die von n=315 Fachärzten für Neurologie an einem
Stichtag klinisch untersucht wurden. Die Einschätzung einer depressiven Störung erfolgte über die Montgomery
Asberg Depression Rating Scale (MADRS ≥14). Die Schwere der Parkinsonerkrankung wurde mit der Hoehn
&Yahr-Skala und der Unified Parkinson’s Disease Rating Scale (UPDRS) eingestuft. Die Diagnose einer Demenz
erfolgte anhand der entsprechenden DSM-IV-Kriterien. Ergebnisse: Depression trat bei 25.2% aller Patienten auf
(95% KI: 22.8-27.5). Darüber hinaus erfüllten 8.4% aller Patienten zwar nicht das Depressionskriterium (MADRSScore unter 14), wurden jedoch zum Zeitpunkt der Erhebung mit Antidepressiva behandelt, was eine korrigierte
Depressionsprävalenz von 33.6% nahelegt. Sowohl bei Männern als auch bei Frauen war die Wahrscheinlichkeit
128
einer Depression mit zunehmender Schwere der PD um das 2- bis 4fache erhöht. Unter nicht-dementen Patienten
wurden die höchsten Raten bei Frauen in der HY-Stufe IV und V gefunden (53.7%, 95% KI: 37.7-69.6). Patienten
mit Demenz hatten eine höhere Wahrscheinlichkeit für eine Depression (bis zu 76.2%, 95% KI: 60.5-87.9). Das
Depressionsprofil dementer und nicht-dementer Patienten zeigte keine strukturellen Unterschiede, es zeigten
sich jedoch durchweg höhere Scores auf den Subskalen. Die Wahrscheinlichkeit einer Depression war weder
mit dem Lebensalter, noch mit der PD-Krankheitsdauer, noch mit dem Erkrankungsalter assoziiert. Diskussion:
Die Depressionsraten sind bereits bei jüngeren PD-Patienten und in frühen Stadien der Erkrankung drastisch
erhöht. Dies unterstreicht die Notwendigkeit einer gründlichen Untersuchung neuer PD-Patienten auf depressive
Störungen. Das Depressionsrisiko ist eng mit der Schwere der PD und demenziellen Begleiterkrankungen verbunden, nicht jedoch mit dem Lebensalter, Erkrankungsalter oder der Dauer der PD. Die Daten legen nahe, dass
depressive Störungen mehr als ein bloßes Demoralisationssyndrom darstellen.
Riedel, O., Klotsche, J., Spottke, A., Deuschl, G., Foerstl, H., Henn, F., Heuser, I., Oertel, W., Reichmann, H., Riederer, P., Trenkwalder, C., Dodel, R., & Witt-chen, H.-U..
(2008). Cognitive impairment in 873 patients with idiopathic Parkinson‘s disease: Results from the German study on epidemiology of Parkinson‘s disease with dementia
(GEPAD). Journal of Neurology, 255: 255-264.
Riedel, O., Klotsche, J., Spottke, A., Deuschl, G., Foerstl, H., Henn, F., Heuser, I., Oertel, W. H., Reichmann, H., Riederer, P., Trenkwalder, C., Dodel, R., & Witt-chen, H.-U.
(2010). Frequency of dementia, depression and other neuropsychiatric symptoms in 1,449 outpatients with Parkionson’s Disease. Journal of Neurology, 257, 1072-1083.
P2. Depression in Parkinson’s disease (GEPAD)
Background: Parkinson’s Disease (PD) is often accompanied by depression. However, the epidemiological description of forms, frequencies and patterns is still understudied and little is known about the frequency of depressive
disorders in PD patients who seek the outpatient care sector and the contribution of coexisting dementia. Aims:
To examine the age- and gender-specific risk of depression in demented and non-demented subjects, its symptom
structure, and associated clinical factors in a nationwide random sample of n=1,449 PD outpatients. Methods:
GEPAD is a nationwide, epidemiological and cross-sectional study. A representative sample of n=315 office-based
neurologist totally assessed n=1,449 PD outpatients with and without dementia on a single study day. Depression
ratings were based on a clinical assessment including the clinical Montgomery-Asberg Depression Rating Scale
(MADRS>14). PD-severity was rated according to Hoehn &Yahr and the Unified Parkinson’s Disease Rating Scale.
Diagnosis of dementia was based on DSM-IV criteria. Results: Depression occurred in 25.2% (CI: 22.8-27.5) of patients. Additionally, 8.4% of patients did not exceed the MADRS cut-off but were currently being treated with antidep-ressants, suggesting a corrected total prevalence of 33.6%. Females were more likely depressive than males
(29.3% vs. 22.4%). In both genders, depression risk was elevated 2-4-fold depending on HY-stage. Overall, highest
rates in non-demented patients were found in females at stages IV-V (53.7%, CI: 37.7-69.6). Demented patients
were more likely to feature depression than non-demented (up to 76.2%, 95% CI: 60.5-87.9). Depression symptom
profiles for demented PD patients (as compared to non-demented) revealed no structural differences but consistently higher symptom scores. Neither age at onset of PD nor duration of disease were significantly linked with
depression. Conclusions: Depression rates are already substantially elevated at early PD stages, emphasizing the
need for a thorough examination of mood disorders in all PD patients. Depression is associ-ated with PD-severity
and dementia but not with age, age at onset of PD or disease duration. It is probably not merely a demoralisation
syndrome and is largely statistically independent of dementia.
Figure 2: Associations between
depression (MADRS>14) and
selected variables in demented
and non-demented patients in the
GEPAD study (N=1,449).
129
P3. Depression und Pflegebedürftigkeit bei Parkinson-Patienten (GEPAD)
Hintergrund: Die Parkinson-Krankheit (Parkinson’s Disease, PD) wird häufig durch neuropsychiatrische Komplikationen erschwert, welche die Pflegebedürftigkeit zusätzlich zu den motorischen Einschränkungen erhöhen. Die
Interaktion zwischen Depression, kognitiven Beeinträchtigungen, neurologischen Symptomen und der Pflegebedürftigkeit sind jedoch bislang noch nicht ausreichend untersucht. Methodik: Es wurden GEPAD bundesweit
n=1,449 PD-Patienten von n=315 Fachärzten für Neurologie klinisch untersucht. Die Einschätzung einer depressiven Störung erfolgte über die Montgomery Asberg Depression Rating Scale (MADRS ≥14). Die Schwere der
Parkinsonerkrankung wurde mit der Hoehn &Yahr-Skala und der Unified Parkinson’s Disease Rating Scale (UPDRS)
erfasst. Die Diagnose einer Demenz erfolgte anhand der entsprechenden DSM-IV-Kriterien. Für jeden Patienten
wurde das Vorliegen einer Pflegebedürftigkeit nach dem SGB XI dokumentiert. Ergebnisse: Pflegebedürftigkeit
lag bei 18.3% aller Patienten vor. Insgesamt hatten 13.9% eine Demenz, 18.8% erfüllten die Studienkriterien
für eine Major Depression und 14.3% hatten beide Störungen gleichzeitig. Regressionsanalysen zeigten, dass
das Lebensalter, die Dauer der PD sowie ihr Schweregrad in allen drei Subgruppen die Wahr-scheinlichkeit für eine
Pflegebedürftigkeit substantiell erhöht. Die stärksten Effekte zeigten sich bei Patienten, die an einer Depression ohne
Demenz litten. Depressive Patienten, die mit Antidepressiva behandelt wurden, hatten immer noch einen höheren
MADRS-Gesamtscore und waren motorisch schwerer durch die PD beeinträchtigt als unbehandelte Patienten; sie waren
jedoch nicht häufiger pflegebedürftig als Patienten ohne Depression. Diskussion: Pflegebedürftigkeit tritt häufig bei
PD-Patienten auf. Sie wird besonders bei Patienten mit Depression maßgeblich durch das Lebensalter der Patienten
sowie durch die Dauer und Schwere der Erkrankung determiniert. Eine erfolgreiche Behandlung der depressiven
Erkrankung geht mit einer geringeren Wahrscheinlichkeit für Pflegebedürftigkeit einher.
Reijnders J, Ehrt U, Weber W, Aarsland D & Leentjens A.(2008). A systematic review of prevalence studies of depression in Parkinson‘s disease. Movement Disorder, 2. 183-9.
Riedel, O., Dodel, R., Deuschl, G., Klotsche, J., Förstl, H., Heuser, I., Oertel, W., Reichmann, H., Riederer, P., Trenkwalder, C. & Wittchen, H.-U. (2012). Depression and caredependency in Parkinson’s Disease: Results from a nationwide study of 1,449 outpatients. Parkinsonism and Related Disorders, 18, 596-601.
P3. Depression and care-dependency in Parkinson’s Disease (GEPAD)
Background: Parkinson’s disease (PD) is frequently compounded by neuropsychiatric complications, increasing disability. The combined effect of motor and mental status on care-dependency in PD outpatients is not well characterized.
Methods: We conducted a cross-sectional study of 1,449 PD outpatients. The assessment comprised the Montgomery-Asberg Depression Rating Scale (MADRS) and the diagnostic criteria for dementia. PD severity and treatment complications were rated using Hoehn &Yahr staging and the Unified Parkinson’s Disease Rating Scale
(UPDRS) IV. The acknowledged level of care-dependency was documented. Results: Care-dependency was present
in 18.3% of all patients. A total of 13.9% had dementia, 18.8% had depression, and 14.3% had both. Regression
analyses revealed increasing effects of age, PD duration, and PD severity on care-dependency in all three mentaldisorder subgroups with the strongest effects in patients with depression only. Depressed patients with antidepressive treatment still had significantly higher PD severity, higher MADRS and UPDRS-IV scores but were not
more likely to be care-dependent than non-depressed patients. Conclusion: Care-dependency occurs frequently in
PD and is substantially driven by age, PD duration, and PD severity in patients with depression only. Treatment of
depression goes along with lower rates of care-dependency.
Figure 3: Impact of age,PD duration and PD severity on care-dependency in patients with depression and/or dementia, est mated
by a stepwise regression analysis by first entering age (step 1), then adding duration of PD (step 2) and PD severity (step 3).
130
P4. GEPAD - Sensitivität und Spezifität des “Parkinson Neuropsychometric Dementia Assessment” (PANDA)
Hintergrund: Störungen der kognitiven Funktionen treten bei Patienten mit idiopathischem Parkinson-Syndrom
(IPS) häufig auf, werden bei Routineuntersuchungen trotz ihrer Alltagsrelevanz jedoch oft nicht erfasst. Ziel
war es, die Sensitivität des für Parkinsonpatienten entwickelten kognitiven Screeninginstruments Parkinson
Neuropsychometric Dementia Assessment (PANDA) an einer von der Normierungsstudie unabhängigen Patientenpopulation zu überprüfen und mit der des Mini-Mental-Status-Tests (MMST) zu vergleichen. Methode: Datensätze
mit PANDA- und MMST-Werten von 304 IPS-Patienten aus der “GEPAD-Studie”, die im Expertenurteil durch
Neurologen als kognitiv unbeeinträchtigt (PD, n=221, mittleres Alter: 68.9, SD=8.3 Jahre) oder dement (PDD,
n=84, 72.7, SD=5.8 Jahre) eingestuft worden waren, wurden analysiert und mit denen der Kontrollgruppe (KG) der
PANDA-Normierungsstudie (n=108, 60.3 SD=9.9 Jahre) verglichen. Ergebnisse: Sowohl beim PANDA als auch
beim MMST schnitten in einer nach Alter und Bildung kontrollierten multivariaten Varianzanalyse mit post-hoc-Vergleichen die PDD-Patienten schlechter ab als die PD-Gruppe und die KG (p<0.001). Die PD-Patienten unterschieden
sich nicht von der KG. Die Spezifität und Sensitivität (KG versus PDD) des PANDA lagen bei 91% bzw. 86%, die
des MMST bei 98% bzw. 55%. 27% der PD-Patienten hatten einen PANDA-Wert unterhalb des Cut-Off-Wertes
für Beeinträchtigung, wiesen in einer Subtest-analyse aber auch Wortgenerierungsdefizite auf. Im MMST lagen
nur 2% dieser Patienten unterhalb des Cut-Off-Wertes für Beeinträchtigung. Schlussfolgerung: Mit seiner hohen
Sensitivität und Spezifität stellt der einfach und schnell durchzuführende PANDA ein geeignetes Instrument dar, um
eine Demenz bei Parkinsonpatienten im ambulanten Versorgungssektor erfassen zu können; die Sensitivität liegt
deutlich höher als die des MMST. Auch kognitive Beeinträchtigungen der Patienten, die laut Expertenurteil nicht das
Ausmaß einer Demenz erreichen, werden mit dem PANDA abgebildet.
Kalbe E, Calabrese P, Kohn N, Hilker R, Riedel O, Wittchen H. -U., et al. (2008). Screening for cognitive deficits in parkinson‘s disease with the Parkinson Neuropsycho-metric
Dementia Assessment (PANDA) instrument. Parkinsonism and Related Disorders, 14, 93-101.
Kalbe E, Riedel O, Kohn N, Dodel R, Calabrese P, & Kessler J. (2007). Sensitivität und Spezifität des „Parkinson Neuropsychometric Dementia Assessment“ (PANDA): Ergebnisse der GEPAD-Studie. Aktuelle Neurologie, 34, 140-146.
P4. GEPAD - Sensitivity and Specifity of the “Parkinson Neuropsychometric Dementia Assessment”
(PANDA)
Introduction: Cognitive dysfunctions and dementia frequently occur in patients with idiopathic Parkinson´s disease
(PD) but are often underestimated in daily routine diagnosis. We examined the sensitivity of the new cognitive
screening tool Parkinson Neuropsychometric Dementia Assessment (PANDA) in a patient population that was
independent of the tool´s normative study and compared it to the sensitivity of the Folstein’s Mini Mental State
Examination (MMSE). Methods: PANDA and MMSE scores of 304 PD patients taken from the German large-scale
“GEPAD” study on the epidemiology of PD with dementia were analysed and compared with those of the control
group (CG) from the PANDA normative study (n=108, mean age 60.3, SD=9.9). The patients were classified as
either having no cognitive impairment (PD, n=221, mean age: 68.9, SD=8.3 years) or dementia (PDD, n=84, mean
age 72.7, SD=5.8 years) based on a neurologists´ expert rating. Results: In a multivariate analysis of variance controlled for age and education followed by post-hoc tests for multiple comparisons the PPD patients were impaired
both in the PANDA and the MMSE compared to the CG and the PD group (p<0.001). The PD group did not differ
significantly from the CG in either test. The specificity and sensitivity (CG versus PDD) of the PANDA were 91%
and 86%, respectively, and 98% and 55% for the MMSE. 27% of the non-demented PD patients scored below the
cut-off score for cognitive dysfunction in the PANDA and in fact were impaired in the word generation task according to a subtest analysis. In the MMSE only 2% of the PD patients were classified to have cognitive impairment.
Conclusion: With its high specificity and sensitivity, the PANDA is an efficient tool to detect dementia in PD patients in an outpatient setting, and its sensitivity is higher than that of the MMSE. Mild cognitive dysfunctions which
do not reach the level of dementia according to an expert rating can be detected with the PANDA
P5. GEPAD – Validität des Clock Drawing Test (CDT) bei Parkinson-Patienten mit und ohne Depression
Hintergrund: Der Verwendung schnell durchführbarer und sprachfreier Demenzscreenings kommt eine wachsende Bedeutung zu. Ein bekanntes Beispiel für ein solches Instrument ist der „Clock Drawing Test“ (CDT). Trotz
seiner weiten Verbreitung bei unterschiedlichen Patientenpopulationen wurde die Güte des CDT jedoch bislang
noch nie in einer repräsentativen Stichprobe mit Parkinson-Patienten evaluiert. Methodik: In einer querschnittlichen
Studie wurden 1.449 Patienten mit der Parkinson-Krankheit von niedergelassenen Neurologen untersucht. In dieser
Untersuchung wurde neben der Dokumentation des neurologischen Status auch das Vorliegen von Demenz und
131
Depression nach den diagnostischen DSM-IV-Kriterien geprüft. Darüber hinaus wurde mit jedem Patienten der CDT
durchgeführt. Ergebnisse: Der CDT zeigte bei 42,7% aller Patienten eine kognitive Beeinträchtigung an. Insgesamt
lagen die Sensitivität und die Spezifität des CDT bei 70,7% bzw. 68,9%. Der positive prädiktive Wert und der negative prädiktive Wert betrugen jeweils 48% und 85,3%. Bei Vorliegen einer Depression wurde die Spezifität signifikant auf 55,8% gesenkt (71,3% bei nicht-depressiven Parkinson-Patienten, P < 0.001). Ein Einfluss der motorischen
Beeinträchtigungen auf die Klassifikationsgüte des CDT konnte nicht nachgewiesen werden.
Diskussion: Die ermittelten Klassifikationsleistungen entsprechen den Ergebnissen früherer Studien, die an
Patientenpopulationen mit anderen chronischen Erkrankungen durchgeführt wurden. Unsere Daten belegen, dass
der CDT ebenfalls bei Patienten mit der Parkinson-Krankheit ein gut einsetzbares Demenzscreening ist, wobei die
Ergebnisse bei zusätzlich depressiven Patienten mit entsprechender Vorsicht interpretiert werden müssen.
Riedel, O., Klotsche, J., Förstl, H. & Wittchen, H.-U. (2013). Clock Drawing Test – is it useful for dementia screening in patients having Parkinson’s Disease with and without
depression? Journal of Geriatric Psychiatry and Neurology, 26. 151-157.
P5. GEPAD – Validity and feasibility of the Clock Drawing Test (CDT) in PD outpatients with and without
depression
Background: Despite the wide use of Clock Drawing Tests (CDTs) for screening cognitive impairment, their use
in patients having Parkinson’s disease (PD) with dementia has not been systematically investigated until date.
Methods: In this cross-sectional study, neurological and neuropsychiatric statuses of 1,449 PD outpatients with and
without dementia were comprehensively assessed. Results: The CDT revealed cognitive impairment in 42.7% of
the 1,383 patients whose drawings were available. Overall, CDT sensitivity and specificity were 70.7% and 68.9%,
respectively. The positive and negative predictive values were 48.0% and 85.3%, respectively. In patients with
depression, CDT specificity dropped significantly to 55.8% (71.3% in non-depressed patients, P < 0.001). Classification
performance was not impacted by motor symptoms. Discussion: The estimated classification performances and predictive values correspond to those previously reported for non-PD populations. Our results indicate that CDT is a suitable screening instrument in PD patients, but test results from depressed patients warrant careful consideration.
P6. DEMPARK/LANDSCAPE – Demenz bei der Parkinson Erkrankung: Eine längsschnittliche Kohortenstudie
PI: Prof. Richard Dodel; Co-PI: Prof. H.-U. Wittchen, Prof. W. Oertel, Prof. A. Storch; Funding: Novartis Pharma
GmbH/International Parkinson Fonds; Duration: 2009 - 2014
Hintergrund: Demenz und kognitive Beeinträchtigungen sind häufige und hochgradig beeinträchtigende Symptome
der Parkinson-Krankheit (Parkinson’s Disease, PD), die bei bis zu 78% aller Patienten im Krankheitsverlauf auftreten können. Allerdings ist bislang weitgehend unklar, wie häufig sich zunächst milde kognitive Beeinträchtigungen
zu dem Vollbild einer Demenz verändern und durch welche Faktoren diese Übergänge mediiert werden. Die
DEMPARK-Studie möchte diese und ähnliche Fragen beantworten. Hierzu werden sowohl PD Patienten ohne kognitive Einschränkungen (n=250), als auch Patienten mit milden kognitiven Störungen (n=200) und Demenz (n=250)
umfassend untersucht. Dabei wird eine Vielzahl von unterschiedliche Korrelaten erhoben, einschließlich des neuropsychologischen Status, Bildgebungsbefunde sowie Liquor-, Blut- und Genanalysen der Patienten. Im Rahmen der
LANDSCAPE-Studie wird zusätzlich eine Patientenkohorte mit der Lewy-Körper-Demenz (LBD, n=120) eingeschlossen und längsschnittlich verfolgt. Methodik: DEMPARK ist eine multizentrische Studie mit insgesamt neun nationalen Studienzentren (Aachen, Bonn, Dresden, Frankfurt, Kassel, Kiel, Marburg, Tübingen und Köln). Die Erhebung
der Patienteninformationen wird dabei auf die Studienzentren aufgeteilt – in Abhängigkeit von deren Spezialisierung
technischen Ressourcen (z. B. wird die Bildgebung in Dresden, Bonn und Frankfurt durchgeführt, während die
Liquoranalyse nur von Kassel vorgenommen wird). Der Aufbau der Patientenstichprobe und die neuropsychologische Testung wird hingegen an allen Studienzentren realisiert. Die hierfür zusammengestellte Testbatterie
umfasst validierte und gebräuchliche Instrumente zur Einschätzung des PD-Status (Hoehn&Yahr-staging, UPDRSSkala, umfassende Anamnese), die Erfassung der kognitiven Fähigkeiten (z. B. MMSE, PANDA, CERAD, WMS-R)
sowie depressiver Störungen und krankheitsbezogener Lebensqualität (Geriatrische Depressionsskala und PDQ-39).
Die Testung der exekutiven Funktionen erfolgt mit ausgewählten Verfahren wie z. B. dem Stroop Test, dem modifizierten Card Sorting Test (mCST), und der Brief Test of Attention (BTA)-Skala. Alle Patienten werden bei Einschluss
in die Studie umfassend evaluiert. Follow-Ups werden nach 6 und 12 Monaten erfolgen. Aktueller Stand: Die
Studienzentren haben im September 2009 ihre Arbeit aufgenommen und im Frühjahr 2014 den Einschluss der
Patienten zum 36-Monats-Follow-Up weitgehend abgeschlossen. Gegenwärtig werden die Daten der Baseline, des
6-Monats-Follow-Up sowie des 12-Monats-Follow-Ups ausgewertet. Zur Zeit werden die Follow-Up-Messungen
durchgeführt.
132
Balzer-Geldsetzer, M., Braga da Costa, A., Kronenbürger, M., Schulz, J., Röske, S., Spottke, A., Wüllner, U., Klockgether, T., Storch, A., Schneider, C., Riedel, O., Wittchen,
H.-U., Seifried, C., Hilker, R., Schmidt, N., Witt, K., Deuschl, G., Mollenhauer, B., Trenkwalder, C., Liepelt-Scarfone, I., Berg, D., Gasser, T., Kalbe, E., Bodden, M., Oertel,
W. & Dodel, R. (2011). Parkinson’s Disease and dementia: A longitudinal study. (DEMPARK). Neuroepidemiology, 37, 168-176.
P6. Dementia in Parkinson’s Disease (Cohort study)
Background: Dementia and cognitive impairment are both highly disabling non-motor symptoms of Parkinson’s
disease (PD), and occur in up to 78% of all patients during the course of the disease. Little is known, however,
about the rates of transition from mild cognitive impairment (MCI) to dementia and its associated factors. The
DEMPARK study addresses these and related questions by assessing cognitively unimpaired PD patients (n=250)
as well as PD patients with dementia (n=250) or MCI (n=200). The assessment comprises different methods including neuropsychological testing, functional imaging (fMRI), liquor and genetic analyses. As part of the LANDSCAPE
study, an additional cohort of patients with Dementia with Lewy Bodies (DLB, n=120) will be enrolled and monitored longitudinally. Methods: DEMPARK is a multicenter study, consisting of nine national study centres (Aachen,
Bonn, Dresden, Frankfurt, Kassel, Kiel, Marburg, Tübingen and Köln). The study tasks are allocated to different
centres, depending on their field of expertise and technical requirements (e.g. the conduction of fMRI is limited to
Dresden, Bonn and Frankfurt, while CSF analysis will be done by Kassel only). The constitution of the study sample
as well as the neuropsychological testing is conducted by every study centre. The test battery comprises of various
standardized and acknowledged instruments for estimating the PD status (Hoehn & Yahr staging, UPDRS evaluation, anamnesis) as well as cognition (eg. MMSE, PANDA, CERAD, WMS-R), mood status and quality of life (PDQ-39,
Geriatric Depression scale). The level of executive functioning will be assessed by the use of selected measures,
such as the Stroop test, the modified Card Sorting Test (mCST) and the Brief Test of Attention (BTA). All patients
will be crosssectionally examined at the time of inclusion. Follow Ups are planned after 6 and 12 months. Current
status: The study has started in September 2009 with enrolment of the patients. In spring 2014, all patients were
included in the 36-months-follow-up. Currently, the data obtained from the baseline as well as from the 6- and
12-months-follow-up are being analysed and prepared for publication.
P7. DBS-REWARD: Effekte der Tiefen Hirnstimulation des Nucleus subthalamicus auf das Belohnungssystem
bei Patienten mit fortgeschrittener Parkinsonerkrankung
PI: PD Ulrike Lüken; Staff: Dipl.-Psych. O. Riedel; Dipl.-Psych. S. Rietzel; Dipl.-Psych. Y. Stankevich, Dipl.-Psych. R.
Evens
Funding: DFG; Duration: 08/2010 – 03/2013; Cooperations: Prof. Dr. Thomas Goschke (Dept. of Psychology,
Faculty of Sci-ence; TU Dresden); Prof. Dr. Alexander Storch (Dept. of Neurology, Medical Faculty Carl Gustav
Carus, TU Dresden); PD Dr. Martin Wolz (Dept. of Neurology, Elblandklinikum Meissen); Dr. Jan Koy (Service de
Neurochirurgie, Centre Hospitalier de Luxembourg); Prof. Dr. Thomas E. Schläpfer (Dept. of Psychiatry, University
Hospital Bonn)
Hintergrund: Die Tiefe Hirnstimulation (THS) des Nucleus subthalamicus (STN) ist eine Methode zur Behandlung
der motorischen Kardinalsymptome bei fortgeschrittener Parkinsonerkrankung. Bislang wurde dem STN überwiegend eine motorische Funktion innerhalb der basalganglionären Regelkreise zugesprochen. Diese Sichtweise
einer reinen Relaisstation ist jedoch unzureichend. Neuere Arbeiten zeigen, dass diese Hirnstruktur nicht nur
für die Modulation rein motorischer Funktionen, sondern darüber hinaus für kognitiv-affektive Funktionen relevant ist. Gegenstand des Forschungsprojekts war die Untersuchung des Einflusses der THS des STN auf das
Belohnungssystem. Methode: THS behandelte Parkinsonpatienten (THS, n=33, mittleres Alter: 66, SD=6 Jahre)
wurden in zwei Stimulationsbedingungen (THS-on vs. THS-off) mittels einer Reihe experimentalpsychologischer
Paradigmen untersucht. Zum einen wurde der Einfluss der Stimulation auf unterschiedliche Funktionen des
Belohnungssystems wie der Fähigkeit zum Belohnungsaufschub, dem Erwerb von adaptiven Spielstrategien und
der Evaluation des hedonischen Werts einer Belohnung untersucht, zum anderen wurden eine Reihe von exekutiven Funktionen getestet. Referenzwerte wurden an einer nach Alter und Geschlecht parallelisierten gesunden
Kontrollgruppe (KG, n=34, mittleres Alter=65, SD=6 Jahre), sowie an einer klinischen Kontrollstichprobe von
Parkinsonpatienten, die nicht mit THS behandelt werden (nonTHS, n=33, mittleres Alter=65, SD=8 Jahre), gewonnen. Ergebnisse: Im Vergleich zu beiden Kontrollgruppen wiesen THS-Patienten nicht nur schlechtere exekutive
Leistungen, sondern auch eine stärke depressive und apathische Symptomatik auf. Dabei erklärten Apathie-, aber
nicht Depressionssymptome Leistungsunterschiede in der Interferenzanfälligkeit zwischen den Gruppen. Eine
verschlechterte Leistung im Stroop-Test im THS-off konnte durch einen Anstieg an Zustandsängstlichkeit erklärt
werden. Bezüglich des Belohnungssystems zeigten THS-Patienten gegenüber der KG eine geringere Fähigkeit
zum Belohnungsaufschub (Fig. 4a). Beide Patientengruppen zeigten eine erhöhte Evaluation des hedonischen133
Werts gegenüber der KG (Fig.4b). Während es keine Gruppenunterschiede in der Entwicklung einer adaptiven
Spielstrategie gab, zeigte sich ein Stimulationseffekt mit einer größeren Anzahl risikoreicher Entscheidungen
unter THS (s. Fig. 4c). Keine weiteren Stimulationseffekte wurden beobachtet. Diskussion: Sowohl akute Stimmungsveränderungen, als auch neuropsychiatrische Symptome können sich auf kognitive Funktionen bei der
Parkinsonerkrankung auswirken und sollten daher bei der Interpretation von Leistungsveränderungen berücksichtigt werden. Bezüglich der Stimulationseffekte auf das Belohnungssystem deuten unsere Ergebnisse auf diskrete
Veränderungen im Bereich der Belohnungs- und Bestrafungssensitivität hin.
Evens, R., Stankevich, Y., Dshemuchadse, M., Storch, A., Wolz, M., Reichmann, H., Schlaepfer, T., Goschke, T., & Lueken, U. (submitted). The impact of subthalamic deep
brain stimulation on reward processing in Parkinson’s disease.
Lueken, U., Stankevich, Y., Goschke, T., Schläpfer, T., Koy, J., Reichmann, H., Storch, A. & Wolz, M. (2014). Einfluss der Tiefen Hirnstimulation des Nucleus subthalami-cus
auf exekutive Funktionen bei Patienten mit idiopathischem Parkinsonsyndrom unter Berücksichtigung von Apathie, Depressivität und Stimmung. Fortschritte der Neurologie – Psychiatrie, 82, 386-393.
Stankevich, Y., Evens, R., Goschke, T., Reichmann, H., Storch, A., Lueken, U. (2013). The effects of deep brain stimulation of the subthalamic nucleus on reward process-ing
in Parkinson’s disease. (poster). Donders Discussions, Oct 31 – Nov 1, 2013, Nimwegen (Netherlands).
Lueken, U., Rietzel, S., Wolz, M., Storch, A., Hertel, F. & Goschke, T. (2011) Executive task performance under deep brain stimulation revisited: The modulating influence of
stimulation side, trait and state affect in idiopathic Parkinson’s syndrome. (lecture), 7. Jahrestagung der Deutschen Gesellschaft für Neuromodulation (DGNM), No-vember
25-26, 2011, Aachen (Germany).
Rietzel, S., Lueken, U., Wolz, M., Storch, A. & Goschke, T. (2011) DBS-Reward: Reward processing under deep brain stimulation of nucleus subthalamicus in patients with
Parkinson‘s Disease. (lecture), 7. Jahrestagung der Deutschen Gesellschaft für Neuromodulation (DGNM), November 25-26, 2011, Aachen (Germany).
Lueken, U., Wolz, U., Koy, J., Storch, A., Riedel, O., Wittchen, H.-U., Dshemuchadse, M. & Goschke, T. (2009). Beyond motor control: Does deep brain stimulation of the
subthalamic nucleus alter reward processing in patients with Parkinson’s disease? (poster), XVIII WFN World Congress on Parkinson‘s Disease and Related Dis-orders,
Dec. 13-16, 2009. Journal of Parkinsonism and Related Disorders (in press). (Funded by a travel grant of the XVIII WFN World Congress on Parkinson’s Dis-ease and Related Disorders and the Melvin Yahr International Parkinson’s Disease Foundation)
Lueken, U., Koy, J., Wolz, M., Riedel, O., Rietzel, S. & Goschke, T. (2008). Effects of subthalamic deep brain stimulation on reward processing in patients with Parkinson’s
disease. (poster), 6th International Congress on Mental Dysfunctions & Other Non-Motor features in Parkinson’s disease, Oct. 16 -19, 2008, Dresden (Germany).
Lueken, U., Schwarz, M., Hertel, F., Schweiger, E., & Wittling, W. (2008). Impaired performance on the Wisconsin Card Sorting Test under left- when compared to right-sided
deep brain stimulation of the subthalamic nucleus in patients with Parkinson‘s disease. Journal of Neurology, 255, 1940-1948.
P7. Effects of subthalamic deep brain stimulation on reward processing in patients with Parkinson’s Disease
Introduction: Deep brain stimulation (DBS) has become an effective treatment option for managing severe
Parkinson‘s disease (PD). However, evidence is accumulating that DBS of target sites like the subthalamic nucleus (STN) can result in unintended behavioral effects that lie beyond motor control. Neurophysiological studies on
hyperdirect cortisolsubthalamic pathways sup-port the notion that the STN may be a relevant key structure for
fast-forward inhibitory control. In patients, recent studies report changes in cognitive, especially executive task
performance following treatment. In addition, there are also some reports about neuropsychiatric disturbances
such as (hypo-)mania, hypersexuality, pathological gambling, or substance abuse. Assuming a common underlying
dysfunction behind these multifaceted disturbances, we aimed to investigate impulsivity and reward processing in
these patients employing a comprehensive experimental assessment of neuropsychiatric, executive, and rewardrelated functions. We hypothesized that DBS of the STN alters specific aspects of behavioral impulsivity and reward
evaluation. Moreover, the relationship between altered reward processing and behavioral changes was evaluated.
Methods: Using a post-operative stimulation-on/-off design, a sample of PD patients that were treated with DBS
of the STN (PD-DBS, n=33, mean age: 66, SD=6 years) was investigated using an elaborate assessment protocol
that encompassed several neuropsychological tests, neuropsychiatric questionnaires, and experimental paradigms
tapping on reward processing and impulsivity (e.g.; Intertemporal Choice, Iowa Gambling Task, task switching, psychophysics of reward). Matched healthy volunteers (HC, n=34, mean age = 65, SD = 6 years) and clinical controls
of patients with Parkinson’s disease without DBS (PD-nonDBS, n=33, mean age = 65, SD = 8 years) were studied
for reference data in this aged patient group. Results: DBS-patients did not only show poorer performance in tasks
on executive functions, but also increased depressive and apathetic symptoms compared to both control groups.
Apathetic, but not depressive symptoms explained differences in susceptibility to interference between the groups.
A poorer performance in the Stroop-task during DBS-off (Fig. 4) could be explained by an increased state anxiety
(Fig. 5). During reward processing PD-DBS displayed an increased delay discounting compared to HC. Both patient
groups showed an increased hedonic tone compared to HC. While there were no group differences in the Iowa
Gambling Task, there was a stimulation effect with more risky choices under DBS-on (Fig. 6). No further stimulation effects were observed. Conclusion: Both changes in state affect and neuropsychiatric symptoms can have an
effect on cognitive functions in patients with Parkinson’s disease and therefore should be considered interpreting
potential changes in performance. Furthermore, regarding stimulation effects on reward processing, our results
point towards discrete changes in the area of reward and punishment sensitivity.
134
Figure 4: Disease and stimulation effects
in three different reward tasks. A: Intertemporal choice task showing disease,
but not stimulation effects; B: hedonic
value task showing disease, but no stimu-lation effects; C: Iowa Gambling Task
showing disease and stimulation effects.
PD: Parkinson’s disease; DBS: deep brain
stimulation; HC: healthy controls; on:
DBS-on; off: DBS-off; *p < 0.05; **p <
0.01
A
B
C
P8. fronto-striatale Dysregulation kognitiver und motivationaler Flexibilität bei der Parkinsonerkrankung
(FLEXI-PD; SFB 940, Projekt C4)
PI’s: Dr. Ulrike Lüken, Dr. Oliver Riedel, Prof. Alexander Storch; Staff: Dipl.-Psych. Y. Stankevich, Dipl.-Psych. R.
Evens, Dr. M. Fauser; Funding: DFG; Duration: 07/2012 – 06/2016; Cooperations: Prof. Dr. Thomas Goschke (Chair
of General Psychology, Dept. of Psychology, Faculty of Science; TU Dresden); Prof. Shu-Chen Li (Chair of Livespan
Developmental Neuroscience, Dept. of Psychology, Faculty of Science; TU Dresden)
Hintergrund: Im Rahmen des SFB 940 “Volition and cognitive control: mechanisms, modulators, and dysfunctions”
widmet sich dieses Projekt der Rolle frontostriataler Schleifensysteme bei der Balance von Flexibilität und Stabilität
in kognitiven (regelbasierten) als auch motivationalen (belohnungsbasierten) Prozessen. Die Parkinsonerkrankung
wird dabei als eine Modellstörung begriffen, die sich durch einen progressiven Abbau dopaminerger Innervation
des frontostriatalen Schleifensystems auszeichnet. Dabei sind dorsale, mit kognitiver Flexibilität assoziierte
Funktionsbereiche zu Erkrankungsbeginn stärker betroffen, als ventrale, mit belohnungsverhalten assoziierte
Bereiche, so dass zu Krankheitsbeginn eine Dissoziation der betroffenen Funktionen angenommen wird. Es wird
angenommen, dass neuropsychiatrische Symptome von Impulsivität und Depression, die das Erkrankungsbild häufig begleiten, Ausdruck einer zusätzlich gestörten Balance dorsaler und ventraler striataler Schleifensysteme sind.
Methodik: Ausgehend von der Annahme, dass Krankheitsstadium und komorbide neuropsychiatrische Symptome
eine veränderte Balance der frontostriatalen Schleifensysteme reflektieren, werden wir mittels eines prospektivlongitudinalen Studiendesigns Parkinsonpatienten in den frühen Krankheitsstadien (Hoehn & Yahr I-II) zu zwei
Messzeitpunkten (Baseline, 24-Monats Follow-Up) hinsichtlich ihrer neuralen Substrate der kognitiven und motivationalen Flexibilität untersuchen. Patienten durchlaufen pro Messzeitpunkt zwei pharmakologische fMRT-Untersuchungen, bei der die dopaminerge Medikation modifiziert wird (on, off). Zusätzlich werden Patienten hinsichtlich
neuropsychiatrischer Symptome stratifiziert. Aktueller Stand: Nach Bewilligung des SFB im Mai 2012 befinden wir
uns in Endphase der ersten Erhebungswelle (Fig. 7), die Ende Juli 2014 abgeschlossen sein wird.
135
Figure 7: Paticipant flow chart for patients (left) and healthy controls (right) for study inclusion.
Evens, R., Stankevich, Y., Riedel, O., Storch, A. & Lueken, U. (2013, 31.10.-01.11.). Neural activation patterns of motivational flexibility during a reversal learning task. (poster),
Donders Discussions, Radboud University Nijmegen (Netherlands)
P8. Fronto-striatal dysregulation of cognitive and motivational flexibility (SFB 940, project C4)
Background: Within the collaborative research centre (CRC), mechanisms and brain systems mediating volitional
control are elucidated, and in particular, the balance between flexibility and stability (shielding-shifting dilemma).
Focusing on frontostriatal brain systems project C4 will investigate the balance between stability and flexibility in
both “hot” (e.g. reward and punishment related) motivational and “cold” (e.g. explicit rulebased) cognitive control processes, assuming a dynamic interplay between ventral, limbic-striatal and dorsal, fronto-striatal circuits.
Dopaminergic functions follow an inverted U-shaped function such that different dopamine baseline levels can
either optimize or overdose functions associated with dorsal and ventral striatal circuits. Parkinson’s disease (PD)
is characterized by neurodegenerative processes primarily affecting the nigrostriatal dopaminergic projections and
changing dopamine levels over time. Of note, dopamine depletion follows an asymmetric spatiotemporal progression with the dorsal striatal circuits being initially affected, while only later progressing to ventral parts of the
striatum. PD probably represents one of the best available human models for fronto-striatal dysfunctions, also differentiating between dorsal and ventral components in the course of disease. Further, neuropsychiatric symptoms
(depression, impulsivity) which are frequent sequelae of PD can, on a neural level, be understood as reflecting an
altered balance of dorsal and ventral striatal functionality. Methods: In project C4 we use PD as a model disorder
to test the hypothesis that shielding and shifting of motivational and cognitive goals is altered by dopamine depletion. Extending previous research the following research questions will be targeted: a) We will stratify patients
according to symptoms of depression and impulsivity to study influences of altered trait affectivity; b) we will
employ paradigms simultaneously addressing dorsal (cognitive flexibility) and ventral (motivational flexibility) striatal
functions, allowing for testing interaction effects within one sample; c) we will conduct a prospective longitudinal
design in order to study intraindividual changes in the functional balance between dorsal and ventral striatal circuits
in the course of the disease and under medication-on and -off conditions. Using a modified set- switching paradigm we will also ex-ploratory test the effects of phasic positive affect induction on cognitive flexibility in PD patients under medication on and off conditions. Starting with a sample of mild PD (Hoehn & Yahr I-II), patients will
be followed-up after two years. Established behavioral tasks that have been proven to be feasible in PD patients
will provide a basis for comparisons between previous stud-ies and new data using a multilevel approach including
pharmacological functional magnetic resonance imaging (fMRI). Results are expected to make an important contribution to better understand the neural underpinnings of volitional control, focusing on fronto-striatal circuit (dys-)
functions and relevant modulators such as neuropsychiatric symptoms and disease duration.
Current status: Following the positive approval of the CRC in May 2012, we are now in the final phase of data
collection of the first assessment period (fig. 7 and 8) that will be finished end of July 2014.
136
P9. Dopaminerge Modulation des hippocampal vs. striatal- modulierten räumlichen Lernens bei
Parkinsonpatienten (SFB 940 Projekt C4)
Hintergrund: Bisherige Studien zu den nicht-motorischen Effekten der Parkinsonerkrankung und dopaminerger Medikation untersuchten primär kognitiv-affektive Defizite, die mit frontostriatalen Dysfunktionen
assoziiert sind. Dem gegenüber sind striatohippocampale Defizite im räumlichen Lernen bisher weniger gut
untersucht. Beim räumlichen Lernen nehmen der Hippocampus und das Striatum unterschiedliche Funktionen
ein. Die Degeneration dopaminerger Zellen im Mittelhirn als pathophysiologisches Korrelat des idiopathischen Parkinsonsyndroms könnte sich daher differenziell auf die Modulation des räumlichen Lernens durch
den Hippocampus vs. das Striatum auswirken. Methoden: Wir entwickelten eine Aufgabe zum räumlichen
Lernen, die mit Hilfe Virtueller Realität (VR) dargeboten wird. Studien an verschiedenen Altersgruppen bestätigten, dass es zu einer schlechteren Leistung speziell bei Hippocampusbasierten Lernprozessen im höheren
Lebensalter kommt (Schunck et al., 2013). Da es im höheren Lebensalter ebenfalls zu einem (vergleichsweise
geringeren) Abbau dopaminerger Zellen kommt, übertrugen wir diese Befunde auf die Modellerkrankung des
Parkinsonsyndroms und untersuchten Erkrankungs- und Medikationseffekte (ON, OFF) auf das räumliche Lernen.
Ergebnisse: Erste Analysen zeigten einen signifikanten Effekt der Medikation mit besseren Leistungen im
medikamentösen ON. Weiterhin zeigten Patienten spezifische Defizite im hippocampus-basierten vs. striatelen
räumlichen Lernen. Ein Trend bezüglich differenzieller Medikationseffekte auf striatal moduliertes Lernen war
ebenfalls beobachtbar (Fig. 8). Diskussion: Die Ergebnisse implizieren, dass dopaminerge Medikation sich positiv
auf das räumliche Lernen bei Parkinsonpatienten auswirkt, wobei die Leistungen der Patienten im OFF vergleichbar waren zu denen einer altergematchten Kontrollgruppe. Die neurofunktionellen Grundlagen des räumlichen
Lernens sollen in einer fMRT Studie weiter untersucht werden.
Thurm, F., Schuck, N. W., Fauser, M., Lueken, U., Storch, A. & Li, S.-C. (2014, 23.-26.07.). Dopaminergic modulation of hippocampal and striatal aspects of spatial learning and memory in Parkinsonism. 36th annual meeting of the Cognitive Science Society, Quebec (Canada).
Schuck, N.W., Doeller, C.F., Schjeide,B.-M.M., Schröder, J., Frensch, P.A., Bertram, L., & Li, S.-C. (2013). Aging and KIBRA polymorphism affect spatial memory processes in a virtual navigation task. Hippocampus, 23, 919-930.
P9. Dopaminergic modulation of hippocampal and striatal aspects of spatial learning in Parkinson’s
disease (SFB 940 project C4)
Background: In light of the involvement of the frontal-striatal pathway in reward processing and adaptive behavioral control, research on non-motor symptoms of Parkinson’s disease (PD) and effects of PD medication has
mostly focused on cognitive impairments that can be attributed to dopamine deficiency of the frontal-striatal loop.
A rarely investigated, if not entirely over-looked, aspect in current research on cognitive dysfunctions of PD is the
potential interactions between striatal dopamine degeneration and hippocampal-dependent functions. Of specific
interest, the hippocampus and striatum play different roles in spatial learning and memory. Midbrain dopamine
degeneration may thus affect the relative contributions of the hippocampus and striatum on spatial learning in
PD patients. Methods: Using a virtual reality (VR) spatial navigation task, a recent study showed impaired performance of older compared to younger adults, particularly in hippocampus-dependent boundary processing
(Schuck et al., 2013). Normal aging is accompanied by a global but less severe dopaminergic loss compared to
PD, these results hint towards navigation deficits in PD patients as well. Here we used a VR-spatial navigation
task to investigate PD patients’ spatial navigation performance and effects of dopamine treatment by assessing
PD patients’ navigation performance ON and OFF medication. Results: Preliminary analysis revealed an apparent
effect of medication, with patients performing better under medication. PD patients showed worse spatial navigation in the boundary (hippocampus-dependent) condition compared to the location cue (striatum-dependent)
condition (Figure 8). There was a trend towards a stronger medication effect in the location cue condition, which
is presumably STR-dependent. Conclusion: The data suggest that dopaminergic medication facilitates spatial
memory in PD. PD patients OFF medication do not perform particularly worse than age-matched healthy controls.
A follow-up fMRI study investigating different activation patterns in HC and STR during spatial navigation might
provide further insights with respect to the reported results.
137
Figure 8: Medication effects on spatial learning in PD patients compared to healthy controls. PD: Parkinson’s disease;
HC: healthy controls.
138
AG 6 ADDICTION RESEARCH UNIT
G. BÜHRINGER & S. BEHRENDT
AG 6 Addiction Research Unit
Prof. Dr. Gerhard Bühringer & Dr. Silke Behrendt
Introduction:
This work group is a cooperative initiative of senior researchers to synergistically combine their expertise and the
knowledge of collaborating colleagues for the study of complex research questions.
The research program on substance use disorders has been expended considerably in the last years, covering a
broad area of basic research fields. Moreover, non-substance related use disorders (e.g. gambling disorders respectively pathological gambling) have become an integral part of the topics of work, with an increasing interest in the
understanding of underlying mechanisms involved in the development of disorders as well as of communalities and
differences between substance-related and “behavioral“ disorders. Several large new projects were funded recently by the DFG (on impaired cognitive control and impaired learning as possible core factors for the development of
addictive disorders) and by the EU (on addictions as challenges for the cohesion and functioning of modern societies). Many of the following research projects are part of university-based, regional or European research networks.
Overall scientific topics are (1) the description and analysis of processes and factors (mediators and moderators) in the
context of onset, course, reduction and remission of substance use, and substance use and non-substance use disorders and (2) the analysis and development of options to modify such disorders, both on an individual (e.g. treatment)
and societal level (e.g. health policy or taxation). Research projects are structured according to the following areas:
(1) Epidemiological studies on the aetiology of substance use, gambling, and related disorders.
(2) Impaired cognitive control and learning as core aetiopathological factors for the development of addictive
behaviors.
(3) Development and evaluation of therapeutic programs and treatment service systems.
(4) Analysis of societal influence factors and intervention strategies in the field of addictive behaviors.
Further information and all previous publications on this program can be found on the Addiction Research Unit webpage: http://www.psychologie.tu-dresden.de/i2/klinische/index.html
Research Area 1 Epidemiological studies on the aetiology of substance use, gambling and related disorders
P1. Characteristics of developmentally early alcohol use disorder symptom reports: a prospective-longitudinal community study (Behrendt, S., Bühringer, G., Perkonigg, A., Lieb, R., Beesdo-Baum, K.)
Background: Symptoms of DSM-IV alcohol use disorders (alcohol abuse and dependence; AUD) occur as early as
in adolescence and early adulthood. Relatively little is known from longitudinal epidemiological studies on characteristics of AUD symptomatology in this age group. Aims: We aim to investigate single AUD symptoms taking into
account prevalence rates, symptom counts, and stability. We also aim to identify positive predictive values (PPVs)
of single AUD symptoms for a full diagnosis of alcohol dependence cross-sectionally at each assessment wave.
Methods: N=2,039 community subjects (baseline age 14 – 24 years) from Metropolitan Munich, Germany, participated in a baseline assessment and two follow-up assessments about four and ten years after baseline. Single AUD
symptoms, craving, and full AUD diagnoses were assessed with the DSM-IV/M-CIDI.
25
20
Per
cent
ages
17,03
15
12,0
9,36
10
6,92
4,78
5
1,1
0
1,1
4,46
2,00
0,42
0,22
T0
Interpersonal
Hazardous situation
Legal problems
Obligations
Tolerance
Withdrawal
Lost control
Intended control
Much time spent
Activities
Problem
Figure 1: DSM-IV Alcohol use
disorder symptoms among
adolescents and young adults
in the general population (lifetime prevalence)
139
Results: Tolerance and much time were most and role obligations and withdrawal least frequent over the assessment waves. Between 47.2 and 55.1% of subjects with DSM-IV-AUDS reported only one symptom. PPV for DSMIV-AD only exceeded 70% for activities, problem, withdrawal, and desired control. The lowest PPV showed for
tolerance and hazardous use. AUDS report compared to non-report was associated with elevated drinking frequency
and amounts for most of the AUDS. Stability rates of baseline AUDS at four-year and ten-year follow-up did not
raise above 36.4% for any symptom.
Conclusions: The overall pattern of most/least frequent AUDS reported in adolescence and early adulthood
resembles findings in older adults. This finding does not suggest a developmentally specific symptom pattern in
adolescence and early adulthood. Moderate AUDS-stability and considerable remission rates may indicate that
AUDS in this age group are transient for a considerable proportion of subjects. However, the associations with elevated consumption indicate that AUDS reports early in life need to be taken seriously in prevention and intervention.
Behrendt S, Buehringer G, Perkonigg A, Lieb R, & Beesdo-Baum K. (2013). Characteristics of developmentally early alcohol use disorder symptom reports: A prospectivelongitudinal community study. Drug and Alcohol Dependence.131:308-15.
P2. Relevance of the psychosocial network for the development of pathological gambling (pilot study)
PI: Prof. Gerhard Bühringer; Staff: Dipl.-Psych. M. Neumann, Dipl.Psych. A. Pixa; Duration: 01/2011 – 12/2014;
Funding: bwin party services (unrestricted grant)
Background: There is a lack of knowledge on the relevance of the psychosocial network for the early recognition
and termination of gambling disorders / pathological gambling. Objectives: The pilot study aims to analyse and
compile potential risk and protective factors in the psychosocial network of gambling subjects, as a basis for future
comprehensive field studies.
Methods: (1) literature review, (2) explorative in depth clinical interviews with pathological gamblers (N = 24; conducted in 01/2012) and gamblers at risk for pathological gambling (N=10; planned for 08/2014) and (3) small-scale
cross sectional studies to analyse the potential of the psychosocial network to early recognize and modify disordered gambling without professional treatment.
Research Area 2
Impaired cognitive control and impaired learning as core aetio-pathological factors for substance use and
gambling disorders
P3. Impulsivity and cognitive control in pathological gambling
PI: Prof. Gerhard Bühringer, Prof. Thomas Goschke; Staff: Dipl.-Psych. A. Kräplin; Duration: 02/2009 - 12/2011,
ongoing data analyses; Funding: internal resources
Background: Pathological gambling (PG) has been characterized by heightened impulsivity, which may be indicative
for a dysfunctional balance between motivational and valuation-related, as well as cognitive control-related brain networks. However, the understanding of the multiple underlying processes of impulsivity in PG unfortunately remains
unclear, as most studies have not considered the multidimensional nature of impulsivity. Aims: The present studies
were conducted to assess which specific patterns of impulsivity can be found 1) in PG compared to healthy control
individuals (HCs) and 2) in PG compared to other impulsivity-related mental disorders. This would clarify the role of
the different impulsivity dimensions in PG and facilitate conclusions regarding the dissociable underlying mechanisms. Design: In two cross-sectional studies individuals with PG (≥5 DSM-IV criteria) were compared with HCs,
individuals with alcohol dependence (AD) and individuals with Gilles de la Tourette syndrome (GTS). The studies
applied a broad assessment battery of different behavioral and self-report measures acquiring the four dimensions
response, choice and attentional impulsivity, as well as sensation seeking.
Results: 1) PG is associated with a specific impulsivity profile compared to HCs, which is characterized by increased response and choice impulsivity whereas attention impulsivity and sensation seeking are comparable. 2)
Heightened scores in impulsivity are not disorder-specific for PG compared to AD and GTS. PG is only specifically
related to increased choice impulsivity compared to GTS. Conclusion: Dysfunctions in inhibition-related and valuation-related brain networks may be a core characteristic of PG resulting in lower inhibitory control in responses and
a changed valuation of outcomes in choices. However, those alterations are not disorder-specific for PG supporting
the importance to development mechanism-targeted rather than disorder-specific intervention strategies. In addition to well implemented control strategies in therapy, computer-aided neurocognitive trainings may be effective to
enhance unconscious processes.
140
Kräplin, A., Bühringer, G., Oosterlaan, J., van den Brink, W., Goschke, T. & Goudriaan, A. E. (in press). Dimensions and disorder specificity of impulsivity in pathological gambling. Addictive Behaviors.
Kräplin, A., Dshemuchadse, M., Behrendt, S., Scherbaum, S., Goschke, T., & Bühringer, G. (2014). Dysfunctional decision-making in pathological gambling: Pattern specificity
and the role of impulsivity. Psychiatry Research, 215(3), 675–682.
P4. Addiction as disorder of volition: Impaired cognitive control functions in nicotine dependence and
pathological gambling
PI: Prof. Thomas Goschke, Prof. Gerhard Bühringer; Staff: Dipl.-Psych. A. Kräplin, Dr. R. Mayer; Duration: 04/2011 03/2014, ongoing data analyses; Funding: DFG
Background: Recent studies demonstrated associations between addictive behaviors and impaired cognitive control functions. Furthermore, research has indicated that cognitive control can be decomposed into a set of distinct
control mechanisms. However, the patterns and specificity of cognitive control impairments in different addictive
behaviors remain unclear.
Aims: Central issues are to clarify (1) which patterns of cognitive control functions are associated with nicotine
dependence (ND) and pathological gambling (PG), (2) whether cognitive control functions are generally disturbed
or only in an addiction-related context, and (3) how reliable measures of cognitive control are. Methods: In the
first experiment three groups were examined using a set of eight experimental paradigms assessing different
facets of cognitive control (inhibition, goal maintenance, anticipation of future outcomes and conflict monitoring).
These groups are two disorder groups, either with ND (n=41) or PG (n=26) according DSM-IV, and one group of
healthy controls (n=52). In the second experiment one group with ND (n=29) and a healthy control group (n=30)
were assessed with four of the paradigms from experiment one using either neutral or smoking-related pictures as
preceding cues. Results: Currently, we have results for experiment one: ND shows specifically impaired inhibition
functions while the other facets of cognitive control do not differ between the ND group and the control group.
Regarding disorder-specificity, the ND and PG groups differed significantly in the facet anticipation of future outcomes. For experiment two we expect that the ND group will show poorer performance in cognitive control functions
if the smoking-related cues precede the tasks. Conclusions: (1) Impairments in inhibitory control seem to play an
important role in ND while other cognitive control functions are intact. Moreover, a lower inhibitory control is a shared
characteristic of ND with PG, whereas individuals with PG specifically display further alterations in the valuation of
short- and long-term outcomes. It can be concluded that lowered inhibitory control may be a core characteristic of different addictive behaviors and could be a cross-disorder mechanism to be targeted in therapies. In contrast, changed
valuation systems may be specific for PG. Further analyses regarding aim (2) and (3) are currently performed.
Kräplin A., Mayer, R. , Goschke, T. & Bühringer, G.. (2013, 18.-21.09.). Kognitive Kontrollfunktionen bei Nikotinabhängigkeit: Generelles Defizit oder spezifische Muster?
Poster auf dem Deutschen Suchtkongress 2013,Bonn.
Kräplin, A., Mayer, R., Bühringer, G. & Goschke, T..(2013, 10.-12.03.). Cognitive control functions in pathological gambling: General or specific impairments? Poster on the 1st
International Conference on Behavioral Addictions. Budapest.
Bühringer, G., Kräplin, A., & Behrendt, S. (2012). Universal characteristics and consequences of the addiction syndrome. In: H. J. Shaffer (Ed.), APA Addiction Syndrome
Handbook (pp. 291-316). Washington, D. C.: APA Books.
P5. Volitional dysfunction in self-control failures and addictive behaviors
Pl: Prof. Gerhard Bühringer, Prof. Thomas Goschke, Prof. Michael Smolka, Prof. Hans-Ulrich Wittchen; Mitarbeiter:
Dipl.-Psych. A. Kräplin, Dr. K.-M. Krönke, Dipl.-Psych. M. Wolff, Dr. S. Behrendt; Funding: Collaborative Research
Centre (CRC) 940; Laufzeit: 07/2012 – 06/2016
Theory: Failures of self-control are sources of a wide range of harmful behaviors in everyday life and a core characteristic of several clinical conditions. Evident examples are substance use disorders and “behavioral addictions”
like pathological gambling. Aims: To examine whether (1) impairments of cognitive control are associated with
non-clinical everyday self-control failures and pattern and severity of addictive disorders, (2) commonalities and differences exist in pattern, frequency and severity of cognitive control impairments between the subgroups of addictive disorders, (3) patterns of neural activity and volitional dysfunctions are associated with everyday self-control
failures and addictive disorders and (4) cognitive control impairments and/or associated patterns of brain activity at
baseline are predictive for pattern and severity of addictive disorders two years later. Method: In the first funding
phase the project will combine complementary expertise in addiction research (Bühringer), epidemiology (Wittchen),
experimental cognitive psychology (Goschke) and functional neuroimaging (Smolka). We will examine data from: (1)
the core cognitive control task battery of the Collaborative Research Centre (CRC) 940, (2) clinical assessments, (3)
experience sampling on the pattern of daily self-control and (4) fMRI-based neural correlates at baseline as well as
their predictive relevance for addictive state changes at follow-up two years later. 300 subjects with subclinical and
141
clinical forms of (A) “behavioral addictions”, (B) substance use disorders, and (C) controls will be tested (for an overview of methods see Fig. 2). Expected results: By combining behavioral measure of cognitive control with neuroimaging, clinical assessment, and experience sampling in the same sample of participants, we expect the project
to deepen our understanding of mechanisms underlying volitional dysfunctions, as well as to reveal communalities
and differences between daily self-control failures, substance use disorders and behavioral addictions. Importantly,
our project will yield unique evidence about the predictive validity of behavioral tasks for non-pathological everyday
self-control failures as well as clinically relevant addictive behaviors. Depending on the outcome, we plan to launch
an appropriately powered prospective-longitudinal community study to examine to what degree cognitive control
impairments predict the onset and course of addictive disorders.
Figure 2: Schematic levels of data collection and experimental setup in the sub-project „Volitional dysfunction in selfcontrol failures and addictive behaviors“ of the Collaborative
Research Centre (CRC) 940.
P6. Learning and habitization as predictors of the development and maintenance of alcoholism
PI and coordination: Prof. Hans-Ulrich Wittchen, Prof. Andreas Heinz; Funding: DFG: Research Group FOR 1617
Duration: 04/2012 - 03/2015; Cooperation: Bernstein Center for Computational Neuroscience (Prof. Dr. John-Dylan
Haynes), Charité Berlin (Prof. Dr. Felix Bermpohl, Dr. Ralph Buchert, Dr. Eva Friedel, Prof. Dr. Rainer Hellweg, Dr.
Daniel Schad, Prof. Dr. Philipp Sterzer, Prof. Dr. Henrik Walter), ETH Zürich (Dr. Quentin Huys), Max-Plank Institute
for Human Cognitive and Brain Science (Dr. Florian Schlagenhauf), Technische Universität Dresden (Prof. Dr.
Michael Smolka), Universität Potsdam (Prof. Dr. Dr. Michael Rapp), Universitätsklinikum Carl Gustav Carus Dresden
(Prof. Dr. Dr. Michael Bauer, Dr. Andrea Kobiella, PD Dr. Ulrich Zimmermann), Universitätsklinikum HamburgEppendorf (Prof. Dr. Jürgen Gallinat), University College London (Prof. Peter Dayan, Prof. Ray Dolan) .
Background and Aims: Alcohol dependence is characterised by failures of choice. People drink despite severe
negative consequences; other pleasures are hardly rewarding to them. A crucial unanswered question is the genesis of such choice anomalies. For instance, both insensitivity to negative consequences and inability to respond to
rewards unrelated to drugs could give rise to maladaptive behaviors. The question we address in this work is the
role learning mechanisms per se play in the aetiology of alcohol addiction. Our approach rests on computational
characterisations of learning mechanisms that have been highly successful in teasing apart separate neurobiological
contributions by structures thought to be involved in the development and maintenance of addiction. At a first level,
we combine multimodal imaging techniques with computational measurements of behavioral changes consequent
on rewards and punishments. We assess computationally and neurobiologically distinct and well circumscribed learning mechanisms. Our focus is mainly on the acquisition of Pavlovian values for stimuli; on the effects of Pavlovian
predictions on other types of choices; and on the habitization of behavior. The multimodal imaging techniques allow
both the localisation and neurochemical identification of learning mechanisms in addictive behaviors. At a second
level, we acknowledge the abstract nature of reinforcement learning techniques: a century of animal literature
has taught us that rewards are not just rewards and that conditioned responses are highly sensitive to the precise
nature of both unconditioned and conditioned stimuli. We thus compare learning mechanisms in scenarios involving
stimuli that are either relevant or irrelevant to the addictive behavior. This involves 1) learning about cues typically
predictive of drugs; and 2) learning in the presence of the drug.
142
Our long-term aim is to further improve treatment and prevention of alcohol addiction. Four factors ensure maximal clinical impact: First, we examine these associations at a neurobiological and behavioral level in prospective
investigations of (1) a representative at-risk population of young adults and (2) in a group of alcohol-dependent
patients, both in a cross-sectional manner and in a longitudinal design aiming at the prediction of the emergence
and recurrence of addictive behavior. Second, based on a comprehensive cross-sectional and longitudinal neuropsychological and psychopathological characterization of subjects/patients, we link the neurobiological findings on
learning mechanisms to specific cognitive, affective and behavioral dysfunctions and learning under the influence of
alcohol. Third, we explore and test which of these dysfunctions and mechanisms are promising novel targets for
interventions, resulting in the development and testing of specific pharmacological interventions for the targeted (in
terms of specific individual profiles of dysfunctions) treatment of alcohol dependence in a junior group. Fourth, all
our work is flanked by multivariate pattern analyses which may help to refine both patient profiles for therapeutic
interventions and neurobiological and neurochemical findings. Finally, the group and work plan is carefully titrated to
ensure cross-fertilization between these approaches. We hope that this marks a major step towards individualized
prevention and therapy of alcoholism.
DFG-Research Group FOR 1617 “Learning & habitization as predictors of the development & maintenance of
alcoholism” Z-Project Coordination and administration
Pl: Prof. Hans-Ulrich Wittchen, Prof. Andreas Heinz; Co-PI: Prof. Gerhard Bühringer; Staff: Dipl.-Psych. S. Paul, Dipl.Psych. L.Scholl; Funding: DFG; Duration: 04/2012 - 03/2015; Cooperation: Charité Berlin (Prof. Dr. Andreas Heinz),
see above
The Z-project ensures main service functions implied in the research group. The project will take care of administrative issues e.g. overall including financial administration of funds, coordination of work groups and allocation of
resources, flow and time lines. It ensures consistent sampling and recruitment of subjects, patients and controls,
avoiding systematic selection. It provides a comprehensive, standardized and as far as possible coherent/identical
clinical, diagnostic and phenotypic assessment of constructs and domains across all work packages, including overall quality assurance and the establishment of an electronic data base throughout the project. Finally, the Z-project
advises and coordinates statistical analyses and modelling of data across centers in preparation for integrated analyses (latent constructs) beyond the single project tasks and coordination/ integration of the specific work packages
amongst each other. The single projects are interrelated and critically dependent on each other. Thus, coordination
and integration tasks of the Z-project are continuous tasks throughout the project. This project helps to conduct
integrative analyses across groups of projects to answer the main research questions of this proposal.
Figure 3: Components
of the DFG-Research
Group FOR 1617
“Learning & habitization as predictors of
the development &
maintenance of alcoholism”
143
The Z project will ensure main service functions implied in the research group. The project will take care of administrative issues e.g. overall including financial administration of funds, coordination of work groups and allocation
of resources, flow and time lines. It will ensure consistent sampling and recruitment of subjects, patients and
controls, avoiding systematic selection. It will provide a comprehensive, standardized and as far as possible coherent/identical clinical, diagnostic and phenotypic assessment of constructs and domains across all work packages,
including overall quality assurance and the establishment of an electronic data base throughout the project.
Finally, the Z-project will advise and coordinate statistical analyses and modelling of data across centers in preparation for integrated analyses (latent constructs) beyond the single project tasks and coordination/ integration of
the specific work packages amongst each other. The single projects are interrelated and critically dependent on
each other. Thus, coordination and integration tasks of the Z-project are continuous tasks throughout the project.
This project will help to conduct integrative analyses across groups of projects to answer the main research questions of this proposal.
DFG FOR: First results: Pavlovian-to-Instrumental-Transfer effects in the Nucleus Accumbens relate to
relapse in alcohol addiction
Garbusow, M., Schad, D. J., Sebold, M., Friedel, E., Bernhardt., N., Koch, S.P., Steinacher, B., Kathmann, N.,
Geurts, D.E., Sommer, C., Müller, D.K., Nebe, S., Wittchen, H.-U., Zimmermann, U.S., Smolka, M.N., Rapp, M.A.,
Huys, Q.J.M., Schlagenhauf, F., Heinz, A.
In detoxified alcohol-dependent patients, positive affect can promote relapse, hypothetically by promoting
approach behavior, while negative affect may particularly inhibit approach behavior. However, to date the mechanisms by which contextual stimuli promote relapse has not been elucidated in detail, and one hypothesis is that
such stimuli directly indicate the motivation to drink via associated brain regions like the ventral striatum and
thus promote alcohol seeking, intake and relapse. Pavlovian-to-Instrumental-Transfer (PIT) may be one of those
behavioral phenomena contributing to relapse, because it directly assesses the influence of Pavlovian conditioned
(contextual) cues on instrumental behavior (e.g. alcohol seeking and intake). We used a PIT paradigm during
functional magnetic resonance imaging to examine the effects of classically conditioned Pavlovian stimuli on
instrumental choices in 31 patients suffering from alcohol use disorder (AUD) and 24 matched healthy controls.
Patients were followed-up over a period of three months. We observed that 1) there was a significant behavioral PIT effect for all participants, which was more pronounced in alcohol dependent patients; 2) PIT significantly
modulated Blood Oxygen Level Dependent (BOLD) signal in the nucleus accumbens (NAcc); only in relapsers and
3) NAcc PIT activation was associated with, and predictive of, critical outcomes (amount of alcohol intake and
relapse) in AUD patients. These observations show for the first time that PIT BOLD signals, as a measure of the
influence of Pavlovian cues on instrumental behavior predict alcohol intake and relapse in alcohol addiction.
P7. Complex time-based prospective memory in DSM-V tobacco use disorder
PI: Dr. Silke Behrendt; Staff: none; Duration: 04/2012 - 01/2013, ongoing data analyses; Funding: Project initiation
grant by the Department of Psychology at Technische Universität Dresden
Background: There is evidence or impaired cognitive control functions in substance use disorders (SUD).
However, there is a lack of studies on complex prospective memory (PM) in SUD that separately investigate PM
components that require cognitive control (planning, initiation, different aspects of execution). This is an important research gap, because PM may play a role in the onset and course of SUD. Objective: We aimed to investigate the performance of young adults with DSM-V tobacco use disorder (TUD) and healthy controls (HC) in different phases of complex PM. Methods: N=43 community subjects aged 18 - 35 years completed the modified Six
Elements Test which includes planning, retention, initiation and execution of a time-based complex PM-task (with
delay phases and distractor activities). Subjects with TUD were current daily smokers. They fulfilled at least two
DSM-V TUD criteria (mean: 3.9). Results: No significant group differences showed in task planning errors and
timely task initiation. No group differences were found in rule adherence and completeness during task conduction (execution). However, in the actual conduction of the task, TUD showed significantly more deviations (Coef.
0.48; p=0.002) from their originally remembered plans than HC. Conclusion: In a short-term, time- and laboratory-based complex PM-task, no general impairments in PM-phases that require cognitive control as planning,
initiation, and execution were found in young adults with relatively mild TUD. Future research might investigate,
whether a greater risk of deviation from originally remembered plans in TUD could play a role in smoking progression and cessation.
Behrendt S, Kliegel M, Kräplin A. & Bühringer G. (in prep.) Performance of smokers with DSM-V tobacco use disorder in time-based complex prospective memory.
144
Research Area 3
Development and evaluation of therapeutic programs and treatment service system
P8. Efficacy of a targeted cognitive-behavioral treatment program for cannabis use disorders (CANDIS I)
PI: Dr. Eva Hoch, Prof. Hans-Ulrich Wittchen, Prof. Gerhard Bühringer; Staff: Dip.-Psych. J. Henker, Dipl.-Psych.
A. Pixa, Dipl.-Psych. R. Noack, Dipl.-Psych. H. Rohrbacher; Funding: Federal Ministry for Education and Research
(BMBF); Duration: 11/2004 – 10/2007, ongoing data analyses
Aims: To examine the efficacy, 3- and 6-month follow-up effects of a psychological treatment for older adolescents
and adults with DSM-IV cannabis use disorders. The program was tailored to the needs of this patient population.
Methods: A randomized controlled clinical trial of 122 patients aged 16 to 44 years with DSM-IV cannabis
dependence as the main substance use diagnosis was conducted. Patients were randomly assigned to either Active
Treatment (AT, n=90) or a Delayed Treatment Control group (DTC, n=32). Treatment consisted of 10 sessions of
therapy, detailed in a strictly enforced manual. Assessments were conducted at baseline, during each therapy session, at post treatment and at follow-up assessments at 3 and 6 months. Results: The treatment retention rate was
88%. Abstinence was achieved in 49% of AT patients and in 13% of those in DTC (p<0.001; intend-to-treat (ITT) analysis). Further, AT patients improved significantly (p<0.001) in the frequency of cannabis use per week, addiction severity, number of disability days, and overall level of psychopathology. Program effects were maintained over a 3-month
(abstinence rate: 51%) and 6-month follow-up (45%) period. Conclusion: The treatment program is effective in obtaining abstinence as well as reducing cannabis use and improves the associated social and mental health burden.
P9: Implementation of the program „CANDIS – targeted treatment for cannabis disorders“ in German outpatient treatment facilities (CANDIS II)
Pl: Dr. Eva Hoch, Co-PI: Prof. Hans-Ulrich Wittchen, Prof. Gerhard Bühringer; Staff: Dipl.-Psych. K. Dittmer, Dipl.Psych. A. Rühlmann, Dipl.-Psych. A. Pixa; Funding: Federal Ministry of Health (BMG); Duration: 11/2007 – 11/2009,
ongoing data analyses
Background: The cognitive-behavioral treatment program “CANDIS” was evaluated successfully and received
approval from patients and study therapists (see Project 7). Aims: 1) To transfer the CANDIS-treatment program
into routine care testing its effectiveness under real-life treatment conditions of established outpatient drug treatment facilities, 2) to evaluate chances and possible barriers of the transfer and 3) to develop and pilot-test a group
version of the CANDIS treatment manual.
Methods: In order to evaluate the implementation of the CANDIS program a four-step multicentered randomized
controlled evaluation study was conducted in a nationwide sample of 11 outpatient treatment facilities. Adolescents
(aged 16 years and above) and adults with problematic cannabis use were randomly assigned to an active treatment
condition (standardized treatment, ST; n=385) or to a delayed treatment control group (DTC; n=130). Subjects of
the DTC group entered treatment after a waiting period of 8 weeks. The one-on-one treatment was manualized
and consisted of motivational enhancement therapy (MET), cognitive-behavioral therapy (CBT), and a psychosocial
problem solving training. After treatment completion three and six months follow-up assessments were conducted.
To determine chances and possible barriers of the program transfer into practice, study therapists were consulted
prior, during and after the study. At the same time a new group version of CANDIS treatment was developed and
pilot tested. First Results: N=438 out of 662 screened patients said that they were interested in participating in the
study (66%). N=255 subjects entered treatment, n=130 subjects were randomized to the DTC group before. The
study sample was predominantly male (86.8%), on average 26.3 years of age (range: 16 - 63 years) and from all
social classes. The average age of cannabis use onset was 15.1 years (range: 8-45 years), the average age of first
regular cannabis use was 18.7 years (range: 10-55 years). 86.8% of the study sample met the lifetime diagnostic
criteria of cannabis dependence, 12.2% of cannabis abuse. Patients were heavy cannabis users with an average of
20.9 cannabis units in the past 7 days. LOCF-analysis illustrates that in the active treatment condition abstinence
rates were significantly higher than in the DTC group (ST: 53.3%; DTC: 25.4%; p-value ≤ 0.001). Among completers (n=166) the abstinence rate was 63.9%. The following barriers were listed most frequently by study therapists
(n=22): 1) difficulty to follow manualized treatment under limited time, a heavy work load, and when seeing patients
with complex problems, 2) colleagues have prejudices towards manualized therapy and 3) insufficient co-operation
with regional services. Conclusions: The CANDIS program can be transferred and applied successfully in the
German outpatient drug treatment system. Further statistical analyses are needed to show which group of patients’
benefits most from the short term intervention and which group might need more intensive treatment.
Hoch, E., Bühringer, G., Pixa, A., Dittmer, K., Henker, J., Seifert, A., & Wittchen, H.-U. (2013). Candis treatment program for cannabis use disorders: Findings from a randomized multi-site translational trial. Drug and Alcohol Dependence, 1(134), 185-193.
145
P10. PREMOS – Predictors, Moderators and Outcomes of Substitution Treatment for opioid dependence in
Germany
Pl: Prof. Hans-Ulrich Wittchen, Prof. Gerhard Bühringer, Prof. Jürgen Rehm; Staff: Dipl.-Psych. A. Träder, Dipl.Psych. L. Revollar Paredes, Dipl.-Psych. K. Mark, Dipl.-Math. J. Siegert; Funding: Federal Ministry of Health (BMG)
Duration: 11/2007 - 10/2010, ongoing data analyses; Cooperations: Prof. Scherbaum (Klinik für Psychiatrie
und Psychotherapie, Essen), Prof. Soyka (Privatklinik Meiringen, Schweiz), Dr. med. Backmund (Städtisches
Krankenhaus Schwabing, München), Dr. med. Gölz,(Praxiszentrum Kaiserdamm, Berlin), Prof. Kraus (Medizinischen
Klinik II. Kreiskliniken Altötting-Burghausen), Prof. Tretter (Bezirkskrankenhaus München-Haar), PD Dr. Schäfer
(Klinik für Psychiatrie und Psychotherapie, Kliniken-Essen-Mitte)
Aims: The overarching goal of PREMOS was the evaluation of long-term effects of opioid substitution treatment in
routine care in Germany as well as the data-based delineation of suggestions for optimisation and adaption of treatment to patient characteristics and needs. Predictors of stable and positive treatment outcomes will be identified.
Methods: A nationwide representative, clinical-epidemiological cohort of substitution patients (N=2,284) (t1,
Baseline) from 223 facilities. Subjects were followed-up over six years and three follow-up waves (12 month:
t2; RR: 91%, 56 month: t3, cRR: 71.1%; 69 month: t4, cRR: 90.9%). At each wave, facilities and subjects were
assessed with standardized instruments to determine course and outcome of treatment, medical and psychopathological aspects. Additional investigations addressed the specific situation of female patients and the development
of a definition of “stable abstinence”. Data were weighted with regard to (e.g.) facility size and response rate.
Results: Retention was very good (71.4 - 91%) with complete data for the six-year course available for N=1,624
subjects. Additional 470 subjects provided information on course and outcome. 131 cases of deceased patients
were documented. At t3, 70% of the baseline sample was still in substitution treatment (retention), 47% were in
temporary stable substitution, 8% had completed the treatment as planned or were temporarily abstinent.
According to conservatives estimates, the proportion of positive courses is 55%. About 8% had passed away, 13%
had an instable treatment course, 3% were incarcerated or in inpatient treatment. A maximum of 30% can be rated
as disadvantageous courses. Secondary outcomes include a relatively stable high mental and physical morbidity and
an improvement of social integration and low criminality over the assessment waves. Conclusions: With its longitudinal design and representative sample, PREMOS provides a good basis for the evaluation of the effects of substitution treatment in routine care in Germany. (1) Subjects with opioid dependence have multiple chronic health conditions. (2) They have a stable and extended need for continuous treatment. (3) Longterm substitution treatment is
effective, the main aims of treatment (e.g. retention, survival) are reached (4) Stable abstinence was relatively rare
(<4%); criteria for treatment termination are not well-adapted to the course of the disorder. (5) The guidelines for
concomitant drug use and for psychosocial counselling need improved adaption to patients’ needs and treatment
settings. (6) Provision of care is lacking for severe mental disorders and for female patients with children in the
post-partum period. (7) No uniform models of prediction could be determined. Suggestions for targeted treatment
optimisation for longterm substitution treatment have been delineated.
Hessel F, Pfeiffer-Gerschel T. & Reimer J. (2014). The quality of care in substitution treatment for opiate dependency: A reflection of the results of the PREMOS-Study.
Suchttherapie,. 15(2), 84-90.
Soyka, M., Träder, A., Klotsche, J., Haberthür, A., Bühringer, G., Rehm, J., & Wittchen, H.-U. (2012). Criminal behavior in opioid-dependent patients before and during maintenance therapy: 6-year follow-up of a nationally representative cohort sample. Journal of Forensic Sciences, 57(6), 1524-1530.
P11. Treatment of substance use disorders in outpatient psychotherapy
PI: Dr. Silke Behrendt; Funding: internal resources; Duration: 01/2012 - 12/2012
Background: The revision of the psychotherapy guidelines in Germany in 2011 lead to broadened options for treating substance use disorders (SUD) in outpatient psychotherapy (OP). Aim: We aimed to address the following questions: how frequently are SUDs treated in OP? What opinions do psychotherapists (PT) hold concerning the new
treatment possibilities?
Methods: Private practice PTs in five states in East Germany were asked to participate in a postal survey. The
frequency of OP for patients with SUD, e.g. harmful use and abuse of as well as dependence on psychotropic substances according to DSM-IV-TR and ICD-10, by private practice PTs as well as their attitude towards the treatment
of patients with these diagnoses were investigated. Results: The response rate was N= 229 out of N=1,382 (16.6
%). Among respondents 94.3 % had treated at least one patient with SUD (4-week prevalence including nicotine
dependence). These rates varied between 3.1 % and 26.6 % depending on the substance and diagnosis (SUD
as primary reason for treatment; see Figure 4). The highest rates of strong affirmation for OP for SUD of approximately 20% were found for disorders related to legal substances (alcohol, tobacco and medication, see Figure 5).
Conclusion: Most PTs treated at least one patient with SUD in OP. However, this type of treatment offer should be
146
further extended. Conducting such treatment should be supported by (e.g.) therapist training. Information about the
options of treating SUD in OP should be further disseminated.
Behrendt S, Bühringer G. & Hoyer J. (2014) Ambulante Psychotherapie der Substanzstörungen. Erweiterte Möglichkeiten nach Änderung der Psychotherapierichtlinie 2011.
Psychotherapeut, 59, 310-316.
P12. Project Elderly: Motivational Enhancement Therapy and Community Reinforcement Approach For
Treating Alcohol Problems in the Elderly – an international multicenter study
PIs: Prof. Gerhard Bühringer, Dr. Silke Behrendt (site coordinator Dresden); Staff: Dipl.-Psych. A. Kohlmann
Funding: Lundbeck; Duration: 01/2013 - 12/2017
Background: Western societies are aging rapidly. There is epidemiological evidence for increasing rates of problematic alcohol consumption patterns and alcohol use disorders in elderly individuals to date. Also, the respective
rates in nursing homes for the elderly are considerable. In contrast to this situation, there is a lack of specifically
tailored interventions for alcohol use disorders in the elderly. Usage of outpatient treatment offers in Germany
(drug counselling services) by the elderly is low. Established models and infrastructure for an effective cooperation
between the service system for substance use disorders and institutions for the elderly are lacking. Methods: An
international multicenter study. N=1,000 subjects aged >= 60 years with DSM-V alcohol use disorders will receive
outpatient treatment at four different study sites (Dresden and Munich, Germany; Albuquerque, USA; Odense,
Denmark). Participants are randomly assigned to either a short (four sessions) or a long (12 sessions) version of
treatment. The short version consists of Motivational Enhancement Therapy (MET), the long version of MET (sessions 1-4) and interventions based on the Community Reinforcement Approach (CRA) (sessions 5-12).
Expected results: We hypothesise that patients in the MET-condition will show a clinically significant improvement
of their drinking pattern between onset, end of treatment, and 6- and 12-month follow-up. A good clinical outcome
is defined as abstinence or controlled use (i.e. Blood Alcohol Content <= 0.5‰). We further hypothesise that patients randomly assigned to the MET + CRA condition will show a clinically better improvement of their drinking pattern between onset, end of treatment and 6- and 12-month follow-up compared to subjects in the MET condition.
P13. Dissertation Project “The importance of resources for the treatment of alcohol use disorders in older adults”
PhD candidate: Anne Kohlmann; Supervisors: Prof. G. Bühringer, Dr. Behrendt; Duration: 01/2014 – 12/2016
Background: Western societies have been characterized as „aging“ because the proportion of adults aged 65
years and older has increased substantially relative to other age groups. Simultaneously, rates of problematic
alcohol consumption and alcohol dependence among older people have increased. Therefore, research about
the effectiveness of treatment of alcohol use disorders in older adults is of special interest. Resource activation is a primary principle of change in psychotherapy. On the other hand, a considerable number of studies
have shown that the availability of resources is changing during life. However, little is known about the effect
of available resources on psychotherapy for alcohol use disorders in older adults.
Aim: In the context of the “Elderly-Study”, the importance of the availability of resources for the treatment of
alcohol use disorders in older adults will be investigated. The main research question is, whether the availability of resources can serve as decision guidance for the allocation of specific aspects (length, content) of alcohol use disorder treatment to elderly patients.
Methods: A population of 1000 participants (age ≥60 years) with alcohol use disorders according to DSM-V
will be randomly assigned to either Motivational Enhancement therapy (MET) for four sessions or MET followed by Community Reinforcement Approach (CRA) for 12 sessions in total. The availability of different kinds
of resources (personal action resources, social and material resources, meaning resources) will be measured
via questionnaires (e.g. “Personal Happiness Form”, “WHO Quality of Life”, “Form-90”). The associations
between treatment outcome and the availability of resources will be assessed and will be compared between
MET alone and MET/CRA. Expected results: We expect insights in the importance of resources for the feasibility and effectivity of treatment of alcohol use disorders in older adults. We expect that the availability of
resources in general, the availability of special kinds of resources as well as the treatment condition is associated with treatment outcome. All participants are expected to benefit from MET as well as from MET/CRA.
Participants with a high level of resources are expected to profit more from MET than participants with a low
level of resources. Participants with a low level of resources are expected to profit more from MET/CRA than
from MET alone.
147
Research Area 4
Analysis of societal influence factors and intervention of strategies in the field of addictive behaviors
P14 – 19. Addictions and Lifestyles in Contemporary Europe - Reframing Addictions Project (ALICE-RAP)
PI: Prof. Jürgen Rehm, Prof. Gerhard Bühringer; Staff: Dr. S. Behrendt, Dr. S. Forberger, Dipl.-Psych. M. Neumann,
Dipl.-Psych. Ch. Probst; Funding: European Commission; Duration: 04/2011 – 03/2016
ALICE RAP is a Europe wide project of 107 researchers and 71 research institutions from 25 European countries to
analyse the place and challenges of addictions and lifestyles to the cohesion, organization and functioning of contemporary European society. Through integrated multidisciplinary research, a wide range of factors will be studied
through a foresight approach to inform a redesign of effective addictions governance (for further information see:
www.alicerap.eu).
P14. Work area 2/ Work package 5 – Counting addiction (Prof. Jürgen Rehm)
Objectives: WP 5 will give an epidemiological overview of addictions related to alcohol, tobacco, illegal drug use,
gambling, and gaming for 31 countries. The following estimates will be undertaken by country, sex and age: prevalence of dependence, incidence of dependence, prevalence of abuse (DSM)/harmful use (ICD) and mortality, years
of life lost and burden of disease attributable to addiction and to substance use.
Methods: The revised DISMOD III tool will be used to systematically integrate all epidemiological exposure
data available from different countries. Epidemiological data will be combined with risk relation data to estimate
substance-attributable mortality, years of life lost due to mortality and disability, and burden of disease due to
addiction and substance use based on methods developed by the ongoing Comparative Risk Assessment of the
Global Disease Burden study. Data will be systematically gathered from 31 countries by local experts via systematic
assessment. Data will include but not be limited to unpublished data from governmental surveys or data in local
data-banks that are accessible from government websites or relevant departments.
P15. Work area 3/Work packages 7-9 – Determinants of addiction (Prof. Gerhard Bühringer)
Objectives: Each work package (WP) has four main objectives: 1. to develop agreed definitions for transitions
focused in the respective WP, that is WP 7: risky use and risky gambling, WP 8 harmful substance use and harmful
gambling (including substance use disorders according to DSM IV and ICD 10) and WP 9: reductions in harmful substance use and gambling; 2. to synthesise evidence held in each discipline about the predictors of each transition;
3. to produce a synthesis report as an up-to-date comprehensive review on the determinants of the respective transition from a multidisciplinary perspective and 4. to develop multidisciplinary logic models that can form the basis
for future research.
Methods: The work within the WPs has been structured into tasks. These include a start-up meeting at which the
team agreed on terms and methods and an expert paper about the determinants of each transition in each of the
partners’ disciplines. These papers provided an overview on identified determinants of each transition within particular disciplines. Where possible, determinants for different age groups were considered. Assisted by the partners,
a postdoctoral researcher used the expert papers and the findings from expert meetings and skype conferences to
generate a final synthesis report and logic models and a logic model report. Additionally, in collaboration with WP5,
evidence for quantitative transition probabilities for the transition from risky substance use/gambling to harmful
substance use/gambling will be identified. The results are used to explore implications for the EU addiction research
and policy.
Contribution of the institute: Prof. Bühringer is scientific leader of work package 8. Beyond this, Prof. Dr.
Bühringer and associated staff produce expert papers from psychology for each work package and contributed to
each synthesis report and logic models via discussion in expert meetings, comments and feedback on the reports
and writing parts of the report (implications for future research).
Bühringer, B., Braun, B., Kräplin, K., Neumann. M & Sleczka, P. (2013) Gambling: two sides of the same coin: recreational activity and public health problem. AR Policy Paper
2. ALICE RAP Policy Paper Series. http://www.alicerap.eu/resources/documents/catview/1-alice-rap-project-documents/19-policy-paper-series.html
Planned Publication
• Synthesis reports and logic models reports are delivered to the EU and will be made available on www.alicerap.eu soon
• “Reflections on interdisciplinary working within Alice Rap” Gell et al.
• In preparation: book on determinants of addiction in the OUP book series
148
P16. Work area 4/ Work package 10 – Revenues, profits and participants (sub-study on prison interviews)
(Prof. Jürgen Rehm, Prof. Gerhard Bühringer)
Objectives: Work package 10 has four main objectives: 1. to calculate retail expenditures on addictive goods (illicit
drugs, gambling, alcohol and tobacco) in Member States and estimate what share of these markets are attributable
to those who are addicted; 2. to improve understanding of suppliers in the illicit drug trade, 3. to improve understanding of the costs and profits associated with the illegal drug trade, and 4. to improve understanding of public-sector
corruption in the provision of addictive substances. Methods: The estimation of illicit drug markets will build on
RAND, Europe’s recent report for the EC. For gambling a framework for understanding how revenues are generated from addicts in the gambling industry will be developed. Using expenditure surveys and gambling prevalence
surveys in the UK, this work will provide quantitative estimates of one Member State to illustrate how the model
could be used for all Member States with relevant data. For alcohol and tobacco, LSE and RAND will systematically
review studies which analyze expenditure information and quantity consumed in Member States. These demandside estimates will be compared with information about EU production, exports, and imports and incorporate
information about unrecorded alcohol consumption. Given the hidden nature of illicit markets, a major contribution
will be to conduct prison-based interviews with convicted drug dealers at all levels of the supply-chain in Germany,
Slovenia, and Italy. At TU Dresden the prison based interviews for Germany were conducted.
Report will be 2014
P17. Work area 5 / Work package 13.1 – Theoretical overview of governance views (Prof. Dr. Gerhard
Bühringer)
Objectives: This part of work package 13 will be achieved through in depth and systematic reviews of the published literature on governance views and as they apply to governance of addictions. An historical perspective (and
thus linking with WP1.1) will be taken, using the laboratory of Europe to look at different governance views.
Stakeholders´ perspectives will be captured through three expert meetings and colloquia ensuring a very wide
range of representatives and capturing some of the broader related governance issues including trade, control,
commerce, agriculture, health, international bodies, and users. Topics for inclusion in the publication will include:
Introduction to governance and governance of addictions; History of governance of addictions (Europe and global); Conceptual models for governance approaches, Application of concepts to differing governance views across
Europe, Governance and health: a public good; Trade and governance; Private sector governance; Civil society and
governance; Partnerships and governance; Governance of illegal issues; Governance of communications and the
Internet; and What do we learn from an analysis of the governance view. Methods: Book publication with chapter
authors, edited by Peter Anderson, Gerhard Bühringer, and Jean Collins.
P18. Dissertation project “Predictors of the course of cannabis use and cannabis use disorders”
PhD candidate: Maria Neumann; Supervisors: Prof. G. Bühringer, Dr. S. Behrendt
Background: Cannabis is the most widely used illegal substance worldwide. However, cannabis use (CU) remains
unproblematic for many consumers and only a small percentage progresses to regular use or develops a cannabis
use disorder (CUD). While cannabis use onset is well researched, little attention has been on predictors associated with the course of CU and CUD after CU onset. In particular, natural remission from CUD without formal help
occurs frequently but predictors have not been researched so far. Objectives: The aim of the thesis is to 1. summarise existing knowledge on predictors of the natural course of CU and CUD after onset and 2. to examine whether
these risk factors also are associated with reduced remission rates in CUD treatment, specifically, to understand
the role of co-morbid disorders and poly-substance use in the treatment of CUD. Eventually, the risk of externalising
disorders on the development of problematic CU will be quantified.
Methods: A systematic literature review of predictors of the natural course of CU and CUD in epidemiological, prospective-longitudinal studies, followed by identification of treatment outcome predictors in a clinical study (analysis
of the CANDIS II data set). If applicable, a meta-analysis for the quantification of the association between externalizing
behaviors and disorders and CU/CUD will be conducted. Expected results: Insight is expected into the current knowledge on predictors of the course of CU and CUD in the general population and on existing research gaps in this area.
Moreover, insight is expected on putative influential factors (i.e. barriers for treatment success) in overall successful
short-term outpatient treatments for CUD. In addition, quantification of the association between externalizing behaviors and disorders and CU/CUD will lend further insight into the role of this important factor in CU/CUD development.
149
P19. Work area 3 / Work packages 7-9 – Transition probabilities between different stages of substance use
PI: Prof. Jürgen Rehm; Funding: Alice Rap; Duration: 04/2013 - 02/2016
Objectives: Substance use disorders are usually preceded by a history of use initiation, periods of low-risk use, and
risky patterns of use. Aim of the study was to contribute to our understanding of transition probabilities (TPs) between such patterns of use and respective influential factors. Methods: Panel data from three waves assessing a
sample of German adolescents and young adults (N=3,021 at baseline) were used to calculate annual TPs for nicotine and alcohol use, taking a few important covariates into account. Use states were abstinence, use, risky use (for
alcohol only), and harmful use and as covariates we considered age, gender, socioeconomic status (for alcohol only)
and mental comorbidity. Age- and gender-specific TPs were used to simulate the prevalence of drinking states over
the ages 14 to 30. For alcohol a four-state Markov model was fit and annual TPs and hazard ratios (HRs) were calculated based on that. Results: For nicotine the TPs were highest (≥80%) for staying in one state. TPs for going back
to abstinence or use were higher in younger age groups (13-17) and very low in older age groups (>17, <10%).
In older age groups (>17) TPs for becoming a user or harmful user were very low (<5%). For alcohol the highest
TPs (≥70%) were found for staying in one state (abstinence, use, risky use) and for transitioning from harmful use
to use. Lowest TPs were found between abstinence and risky or harmful use and between risky and harmful use
(≤6%). Gender was found to influence transitions between abstinence and use, socioeconomic status was found to
influence transitions between use and risky or harmful use. With one exception TPs decreased with increasing age.
Conclusion: The results indicate that transitions between abstinence and use seem to be more strongly influenced
by environmental factors (as e.g. gender) while transitions related to risky patterns of use seem to be more strongly
influenced by individual and intra-individual factors (as e.g. socioeconomic status or comorbidity).
P20. Dissertation project “Socioeconomic profiles of alcohol-attributable harm in South Africa – Towards a
science based decision making in health policy for inclusive growth”
PhD candidate: Charlotte Probst; Supervisors: Prof. J. Rehm, Prof. Ch. Parry, Prof. H.-U. Wittchen
Objectives: In South Africa a decline in life-expectancy at birth was observed in the past decade, with alcohol being
the leading risk factor for burden of disease and risky patterns of use are widely spread. For high income countries
it has been shown that alcohol-attributable harm is not equally distributed in societies; people with low socioeconomic status mostly suffer greater harm than their wealthier or more educated counterparts. Hence, accurate prevention of alcohol-attributable harm requires: 1. Knowledge on the societal distribution of alcohol-attributable harm. 2.
Knowledge on cost-effective preventive measures eligible to precisely reach groups at highest risk and outcomes
with the greatest burden. Methods: Alcohol-attributable fractions will be calculated by socioeconomic status, age,
and gender. These alcohol-attributable fractions will then be applied to mortality data or disability adjusted life years.
In a second step the effects of alcohol policies on the socioeconomic gap will be evaluated using systematic literature reviews and meta-analyses. Last a model will be generated to predict the optimal political strategy to reduce
alcohol-attributable harm in those groups at highest risk.
150
AG 7 BEHAVIORAL MEDICINE
H.-U. WITTCHEN & L. PIEPER
AG 7 Behavioral Health and Behavioral Medicine
Workgroup PI: Prof. Dr. Hans-Ulrich Wittchen & Dr. Lars Pieper
Overview: The Behavioral health and behavioural medicine workgroup focusses on the complex interaction between behavioral factors and the physical and/or mental health of people using epidemiological designs in various
research fields. Recent core work packages are:
- Completion of a nationwide study on severe allergic asthma (SAP Needs)
- Completion of a research program with several projects in Multiple Sclerosis and Alzheimer Dementia, all
focusing on caregiver burden (IDEA)
- Completion of a project focusing on the frequency of the renocardiac syndrome in specialized care (CaRe
survey)
- Implementation of a project focusing on Alcohol use disorders in primary and specialized care (APC Study)
- Continued publication work of the prospective-longitudinal landmark DETECT program, extending the analyses to a range of new topics, including emphasis on cardio-metabolic and cardiovascular risk factors and
markers
- As a cooperation partner of the Department of Biological Psychology, TU Dresden, we perform a large-scale
epidemiological study of the biological and psychological risk factors for burnout disease (ROB study).
P7.1. Collaborative Contributions
P7.1.1. Four-week prevalence of mental disorders in patients with cancer across major tumor entities.
(Mehnert A, Brähler, E., Faller, H., Härter,M., Keller, M., Schulz, H., Wegscheider, K., Weis, J., Böhncke, A., Hund,
B., Reuter, K., Richard, M., Sehner, S., Sommerfeldt, S., Szalai, C., Wittchen, H.-U., Koch, U.)
Purpose: To provide the 4-week prevalence estimates of mental disorders in cancer populations. Patients and
Methods: We enrolled adult patients with cancer from in- and outpatient care facilities, using a proportional stratified random sample based on the nationwide cancer incidence in Germany. Patients who scored 9 or above on
the Patient Health Questionnaire (PHQ-9) were administered to the standardized computer-assisted Composite
International Diagnostic Interview for mental disorders adapted for cancer patients (CIDI-O). A random sample of those with
a PHQ-9 score that was less than 9 were selected for a CIDI-O. Results: A total of 5,889 patients were identified, which
led to 4,020 participants (a 68.3% response rate); of those, 2,141 patients were interviewed. The 4-week total prevalence
for any mental disorder was 31.8% (95% CI, 29.8% to 33.8%); this included any anxiety disorder (11.5%; 95% CI, 10.2%
to 12.9%), any adjustment disorder (11.1%; 95% CI, 9.7% to 12.4%), any mood disorder (6.5%; 95% CI, 5.5% to 7.5%),
any somatoform/conversion disorder (5.3%; 95% CI, 4.3% to 6.2%), nicotine dependence (4.5%; 95% CI, 3.6% to 5.4%),
alcohol abuse/dependence (0.3%; 95% CI, 0.1% to 0.6%), any mental disorder resulting from general medical condition
(2.3%; 95% CI, 1.7% to 2.9%), and any eating disorder (0%). The highest prevalence for any mental disorder was found
in patients with breast cancer (41.6%; 95% CI, 36.8% to 46.4%), followed by patients with head and neck cancer (40.8%;
95% CI, 28.5% to 53.0%). The lowest prevalence was found in patients with pancreatic cancer (20.3%; 95% CI, 8.9% to
31.6%) and stomach/esophagus cancers (21.2%; 95% CI, 12.8% to 29.6%). Conclusion: Our findings provide evidence
for the strong need for psycho-oncological interventions.
Mehnert, A., Brähler, E., Faller, H., Härter, M., Keller, M., Schulz, H., Wegscheider, K., Weis, J., Boehncke, A., Hund, B., Reuter, K., Richard, M., Sehner, S., Sommerfeldt,
S., Szalai, C., Wittchen, H.-U., & Koch, U. (2014). Four-week prevalence of mental disorders in cancer patients across major tumor entities Journal of Clinical Oncology.
P7.1.2. Visceral, subcutaneous abdominal adiposity and liver fat content distribution in normal glucose
tolerance, impaired fasting glucose and/or impaired glucose tolerance (Borel, A.-L., Nazare, J.-A., Smith, J.,
Aschner, P., Barter, P., van Gaa L., Tan, C. Eng, Wittchen, H.-U., Matsuzawa,Y., Kadowaki, T., Ross, R., BrulleWohlhueter,C., Alméras, N., Haffner, S. M., Balkau, B., Després, J. P. for the INSPIRE ME IAA investigators)
Objectives: To examine the specific distribution of liver fat content, visceral and subcutaneous adiposity in normal
glucose tolerance (NGT/NGT), isolated impaired fasting glucose (iIFG), isolated impaired glucose tolerance (iIGT)
and combined conditions (IFG+IGT), as well as with newly diagnosed type 2 diabetes (nT2D). Design: Multicenter,
international observational study: cross-sectional analysis. Subjects: Two thousand five hundred and fifteen patients (50.0% women, 54.5% non-Caucasian) without previously known diabetes were recruited from 29 countries.
Abdominal fat distribution was measured by computed tomography (CT). Liver fat was estimated using the CT-liver
mean attenuation. Results: Compared with NGT/NGT patients, increased visceral adiposity was found in iIFG, iIGT,
151
IFG+IGT and nT2D; estimated liver fat progressively increased across these conditions. A one-s.d. increase in visceral adiposity was associated with an increased risk of having iIFG (men: odds ratio (OR) 1.41 (95% confidence interval (CI) 1.15–1.74), women: OR 1.62 (1.29–2.04)), iIGT (men: OR 1.59 (1.15–2.01), women: OR 1.30 (0.96–1.76)),
IFG+IGT (men: OR 1.64 (1.27–2.13), women: OR 1.83 (1.36–2.48)) and nT2D (men: OR 1.80(1.35–2.42), women:
OR 1.73 (1.25–2.41)). A one-s.d. increase in estimated liver fat was associated with iIGT (men: OR1.46 (1.12–1.90),
women: OR 1.81 (1.41–2.35)), IFG+IGT (men: OR 1.42 (1.14–1.77), women: OR 1.74 (1.35–2.26)) and nT2D (men:
OR 1.77(1.40–2.27), women: OR 2.38 (1.81–3.18)). Subcutaneous abdominal adipose tissue showed an inverse relationship with nT2D in women (OR 0.63 (0.45–0.88)). CONCLUSIONS: Liver fat was associated with iIGT but not with
iIFG, whereas visceral adiposity was associated with both. Liver fat and visceral adiposity were associated with nT2D,
whereas subcutaneous adiposity showed an inverse relationship with nT2D in women.
Borel, A.-L., Nazare, J.-A., Smith, J., Aschner, P., Barter, P., van Gaal, L., Tan, C. E., Wittchen, H.-U., Matsuzawa, Y., Kadowaki, T., Ross, R., Brulle-Wohlhueter, C., Alméras,
N., Haffner, S. M., Balkau, B., Després, J.-P., & for the INSPIRE ME IAA investigators. (2014). Visceral, subcutaneous abdominal adiposity and liver fat content distribution
in normal glucose tolerance, imaired fasting glucose and/or impaired glucose tolrerance. International Journal of obesity.
P7.1.3. Testosterone, sex hormone-binding globulin and the metabolic syndrome in men: an individual participant data meta-analysis of observational studies. (Brand, J. S., Rovers, M. M., Yeap, B. B., Schneider, H. J.,
Tuomainen, T. P., Haring, R., Corona, G., Onat, A., Maggio, M., Bouchard, C., Tong, P. C., Chen, R. Y., Akishita, M.,
Gietema, J. A., Gannagé-Yared, M. H., Undén, A. L, Hautanen, A., Goncharov, N. P., Kumanov, P., Chubb, S. A.,
Almeida, O. P., Wittchen, H.-U., Klotsche, J., Wallaschofski, H., Völzke, H., Kauhanen, J., Salonen, J. T., Ferrucci, L.,
van der Schouw, Y. T.)
Backround: Low total testosterone (TT) and sex hormone-binding globulin (SHBG) concentrations have been associated with the metabolic syndrome (MetS) in men, but the reported strength of association varies considerably.
Objectives: We aimed to investigate whether associations differ across specific subgroups (according to age and
body mass index (BMI)) and individual MetS components. Data Sources: Two previously published meta-analyses
including an updated systematic search in PubMed and EMBASE. STUDY ELIGIBILITY CRITERIA: Cross-sectional
or prospective observational studies with data on TT and/or SHBG concentrations in combination with MetS in men.
Methods: We conducted an individual participant data meta-analysis of 20 observational studies. Mixed effects
models were used to assess cross-sectional and prospective associations of TT, SHBG and free testosterone (FT)
with MetS and its individual components. Multivariable adjusted odds ratios (ORs) and hazard ratios (HRs) were
calculated and effect modification by age and BMI was studied. Results: Men with low concentrations of TT, SHBG
or FT were more likely to have prevalent MetS (ORs per quartile decrease were 1.69 (95% CI 1.60-1.77), 1.73
(95% CI 1.62-1.85) and 1.46 (95% CI 1.36-1.57) for TT, SHBG and FT, respectively) and incident MetS (HRs per
quartile decrease were 1.25 (95% CI 1.16-1.36), 1.44 (95% 1.30-1.60) and 1.14 (95% 1.01-1.28) for TT, SHBG and FT,
respectively). Overall, the magnitude of associations was largest in non-overweight men and varied across individual
components: stronger associations were observed with hypertriglyceridemia, abdominal obesity and hyperglycaemia
and associations were weakest for hypertension. Conclusion: Associations of testosterone and SHBG with MetS vary
according to BMI and individual MetS components. These findings provide further insights into the pathophysiological
mechanisms linking low testosterone and SHBG concentrations to cardiometabolic risk.
Brand, J. S., Rovers, M. M., Yeap, B. B., Schneider, H. J., Tuomainen, T.-P., Haring, R., Corona, G., Onat, A., Maggio, M., Bouchard, C., Tong, P. C. Y., Chen, R. Y. T., Akishita, M., Gietema, J. A., Gannage-Yared, M.-H., Unden, A.-L., Hautanen, A., Goncharov, N. P., Kumanov, P., Chubb, P. S. A., Almeida, O. P., Wittchen, H.-U., Klotsche,
J., Wallaschofski, H., Volzke, H., Kauhanen, J., Salonen, J. T., Ferrucci, L., & van der Schouw, Y. T. (2014). Testosterone, sex hormone-binding globulin and the metabolic
syndrome in men: an individual participant data meta-analysis of observational studies. PlOS ONE, 9(7), e100409.
P7.2. Severe Allergic Asthma: Prevalence and Current Treatment Needs (SAP-NEEDS)
PI: Prof. Hans-Ulrich Wittchen; Staff: Dipl.-Psych. M. C. Dekoj, Dr. O. Riedel, Dipl.-Stat. J. Klotsche; Funding:
Novartis Pharma GmbH, Nürnberg; Duration: 12/2007 – 07/2010; Cooperations: Dr. Brehler (Münster), Dr. Hellmann
(Bundesverband der Pneumologen, Augsburg), Dr. Kardos (Deutsche Atemwegsliga e. V., Frankfurt), Prof. Nowak
(München), Prof. Rabe (NL-Leiden), Prof. Rychlik (Burscheid), Prof. Ritz (TX-Dallas), Prof. Schultze-Werninghaus
(Bochum). Prof. Wahn (Berlin), Prof. Wort (Fürth), Prof. Zielen (Frankfurt)
Background: Allergic Asthma (AA) is a common disease with estimated prevalence rates between 2.0-11.9 % in
European communities. Its most severe form (SAA) is characterized by reduced disease control and insufficient
responsiveness to standard therapy. It is currently unknown how frequent SAA is in routine care, what proportion
are adequately treated and controlled and to what degree there are unmet needs in terms of asthma control, treat152
ment and quality of life. Aims: (1) To estimate the prevalence, determinants and correlates of the allergic asthma
of all stages of severity with particular focus on severe asthma. (2) To describe treatment patterns and degree of
asthma control(3). To assess patients mental health status, associated disability and quality of life (4) To identify the
degree of met and unmet needs. Method: SAP-NEEDs is a 3-stage national, cross-sectional, epidemiologic study
in a nationally representative sample of over 200 pulmonary specialists, respectively a random sample of over 1000
patients. In stage 1 (5/2008) doctors were sampled and requested to describe all their AA patients. Stage 2 consists
of random selection of about 5 patients, all of which undergo a comprehensive standardized clinical appraisal by
their physician, supplemented by a patient self-report questionnaire including established scales to assess asthma
related parameters and psychosocial parameters. Stage 3 consists of a prospective-longitudinal 6-months follow-up
in a smaller subsample (see below). Results & Conclusion: In the following abstracts study results will be presented and discussed.
Sap-Needs-Design: 3-stage nationwide epidemiology design
Study population prestudy:
Office-based specialist (e.g. pulmonologists) (n=966)
Feb./March 2008
Up to 15 contacts
Point prevalence study I (681 settings)
(RR: 70,5%), N=13 466 patients of which n=3 608
were diagnosed as having allergic asthma
April-May 2008
Random selection of settings
Patient Assessment
Up to 15 contacts
Main study II (148 settings)
Stratified random sample (N=570, RR: 67.2%) of patients with
Allergic Asthma
June-Nov. 2008
Prospective-longitudinal
follow-up (6 months)
Severe asthma follow-up cohort N: 312)
3 assessments bi-monthly, for cohort study: n=53 new onset
Omlizumab patients versus 53 matched controls with SAA
July 08 – August 2009
Distribution of settings by states
(N=681)
Bayern
83 (12,19 %)
Baden-Württembg 74 (10,87 %)
Hessen
48 (7,05 %)
Saarland
14 (2,16%)
Rheinland-Pfalz 24 (3,52%)
NRW
161 (23,64 %)
Niedersachsen
66 (9,69 %)
Schleswig-Holst. 18 (2,64%)
Bremen
11 (1,62 %)
Hamburg
17 (2,5 %)
Berlin
39 (5,73 %)
Sachsen
31 (4,55%)
Sachsen-Anhalt 27 (3,96%)
Meckl.-Vorpom.
37 (5,43%)
Thüringen
9 (1,32%)
Brandenburg
22 (3,23%)
Reasons for non-participation of settings
Time constraints (vacation)
Too much work
No studies generally
Other reasons
Case pyment too low
Ethical reasons
76,8%
42,5%
29,1%
15,8%
4,6%
1,4%
Figure: Design of the SapNeeds Study
P7.2.1. Die Prävalenz des schweren allergischen Asthmas in der Versorgung: Eine bundesweite epidemiologische Studie (H.-U. Wittchen, M. C. Dekoj, J. Klotsche, R. Brehler, R. Buhl, A. Hellmann, P. Kardos, D. Nowak, K.
Rabe, R., T. Ritz, G. Schultze-Werninghaus, U. Wahn, H. Worth, S. Zielen, O. Riedel)
Hintergrund: Bisherige Schätzungen über die Häufigkeit des allergischen Asthmas (AA) aus Allgemeinbevölkerungsstudien zeigen national wie auch international eine beträchtliche Schwankungsbreite von 2 – 11,9%. Die
Unsicherheit epidemiologischer Schätzungen erscheint besonders ausgeprägt für das schwere allergische Asthma
(SAA). Schätzungen für den deutschsprachigen Raum gehen von ca. 200.000 behandelten SAA Betroffenen aus.
Ungeklärt ist bislang, wie häufig SAA in der niedergelassenen fachärztlichen Routine vorkommt. Methoden: Im
Rahmen der SAP-NEEDs Studie, einer mehrstufigen bundesweiten klinisch-epidemiologischen StichtagsprävalenzStudie im niedergelassenen fachärztlichen (n= 681) Versorgungssektor Deutschlands wurden in der ersten Studienphase die Behandlungsdiagnosen von n=13.466 Patienten standardisiert erhoben. Eingeschlossen wurden
alle Patienten, die am variabel gewählten Stichtag in einem variablen Zeitintervall (Stunde bis zu einem halben
Tag) im Zeitraum Mai bis Juli 2008 ihren Arzt aufsuchten. Primäre Zieldiagnosen waren „allergisches Asthma“,
„andere Asthmaformen“ die mit ausgewählten Patienteninformationen (Alter, Geschlecht, Therapie) nach den der
Stufeneinteilung der Nationalen Versorgungsleitlinien Asthma (NVL Asthma) kodiert wurden. Zusätzlich wurden ausgewählte Merkmale (Fachrichtung, Leitlinienorientierung) der Untersuchungszentren erhoben. Zusätzlich sollten für
einen vordefinierten Studienstichtag die aktuell behandelten Patienten mit AA gelistet und grob charakterisiert werden (u. a. Alter, Geschlecht, Medikationsstatus). Auf Grundlage der geschichteten Stichprobenziehung wurden die
Häufigkeit des allergischen Asthma nach der NVL Asthma berechnet und mit 95% Konfidenzintervallen, getrennt für
Männer und Frauen nach Alterstufe auf die Grundgesamtheit aller Patienten geschätzt. Ergebnisse: 26,8% (95%
CI: 25.9-27.6%) aller Behandlungsfälle in der fachärztlichen pneumologischen Versorgung wurden als „allergisches
Asthma“ diagnostiziert. Nach dem NVL-Stufenschema wurden von allen allergischen Asthmapatienten 21,0% auf
Stufe I, 39,4% auf Stufe II und 27,8% auf Stufe III klassifiziert. Als SAA (Stufe IV) wurden 11,9% aller AA Patienten
eingestuft. Die Behandlungsprävalenz des SAA wies bei einem leichten Überwiegen der Männer (13,0 vs. 11,2%
bei Frauen) einen stetigen alterskorrelierten Anstieg von 9,5% bei den 16-32-jährigen Männern auf 20% bei der älte153
sten Gruppe (51+Jahre) bzw. von 5,8% auf 19% bei den Frauen auf. Auf die volljährige Durchschnittsbevölkerung
Deutschlands hochgerechnet ergibt sich eine Gesamtschätzung von 345.100 bis 404.600 SAA Patienten (95%
KI). Die überwiegende Mehrheit aller AA und SAA Patienten (69,0%) wird mit einer Kombination von inhalativen
Corticosteroiden und Beta2-Sympathomimetika behandelt, der Anteil Omalizumab Behandelter wird unter den SAA
Fällen auf 15-19% geschätzt. Diskussion: In Übereinstimmung mit früheren Befunden ergibt sich mit fast einem
Viertel aller Patienten eine überaus hohe Prävalenz des AA in der fachärztlichen Versorgung. Die Rate des SAA und
unter Annahme, dass alle SAA Patienten in Behandlung stehen, wird mit über 345.000 Fällen deutlich höher als
frühere Hochrechnungen eingeschätzt. Die erhobenen Behandlungsindikatoren für die Routineversorgung sind in
Übereinstimmung mit den Leitlinien.
P7.2.2. Controlled and uncontrolled allergic asthma in routine respiratory specialist care – A clinical epidemiological study in Germany (P. Kardos, H.-U. Wittchen, S. Mühlig, T. Ritz, R. Buhl, K. F. Rabe, J, Klotsche, O. Riedel)
Background: Studies in the last decade revealed high rates of poorly treated and poorly controlled asthma in the
community. Extending these findings we describe the more recent situation in specialist respiratory care as the
most frequent source of treatment provision using comprehensive clinical and patient assessments and exploring
predictors for poor control.
Methods: This is a German cross-sectional, clinical epidemiological study in a nationally representative stratified
treatment prevalence sample of N=572 outpatients diagnosed with allergic asthma (AA; females 58.2%, aged
47.5±16.3 (16-81 years). Treating physicians completed standardized clinical assessments (lung function, laboratory,
clinical findings, severity, illness and treatment history, asthma control (GINA)), supplemented by patients self-report
measures (EQ5-D, AQLQ, ACT) and mental health module (CIDI-SF). Results: 65.4% of patients were rated (GINA)
as controlled, 30.3% partially controlled, and 4.4% uncontrolled; the patient-rated ACT revealed lower rates of control (19.9% controlled, 44.2% partial, 35.8% uncontrolled, Kappa: 0.2) Consistent with findings of clinical measures,
controlled asthma was highest among patients with pre-treatment stage I severity (83.6%) and decreased by pretreatment severity (stage IV patients: 29.3%). Poorer control was associated with pre-treatment severity, nocturnal
attacks, diminished adherence and comorbid anxiety/depression. Patients received complex multiple drug and nondrug interventions, largely consistent with guidelines. Degree of asthma control was associated with improved and
even normalized quality of life findings. Conclusion: In this representative sample of long-term treated AA patients
in specialist respiratory care we find better control rates and better adherence to guidelines as previous studies.
Despite remarkable differences between clinicians vs patients-rated control ratings even the initially most severe
stage IV patients (12.9% of patients) revealed remarkable control rates and close to normal quality of life. Intensified
treatment (e.g. omalizumab) was associated with improved control. Poorer control was associated with higher initial
severity, diminished adherence, comorbid anxiety/depression and old age. Limitation: Findings apply to AA patients
in respiratory specialist care sector which is likely to treat the more severely affected patients. Thus, findings cannot
be generalized to the general population, other treatment settings or asthma types.
P7.2.3. Omalizumab vs. “usual care”: Results from a naturalistic longitudinal study in routine care (H.-U.
Wittchen, S. Mühlig, J. Klotsche, R. Buhl, P. Kardos, T. Ritz, O. Riedel)
Background: It is unclear how far the superior efficacy of omalizumab, established in randomized controlled clinical trials of
patients with severe allergic asthma (SAA) also translates into routine practice and when compared to matched controls.
Methods: New-onset omalizumab treated patients with SAA (OT, n=53) were compared to a matched control
group of usual care patients (UC, n=53). Treatment and procedures were naturalistic. Subsequent to a baseline
assessment, patients were followed-up over at least 6 months with at least two follow-up assessments. Primary
clinical outcomes were the number of asthma attacks, persistence of asthma symptoms and degree of control
(Asthma Control Test, GINA). Secondary outcome criteria were quality of life (EQ-5D) and number of medications.
For each outcome we compared within-group effects from baseline to 6-month follow up as well as between group
effects. Results: OT-patients showed significant improvements in number (effect size, ES=.03) and frequency
(ES=.04) of asthma attacks as well as asthma control (ES=.09), whereas controls revealed no significant improvements in these measures. Further improvements in the OT group were found for “perceived control always” (ACT,
p=.006), no impairment (ACT, p=.02), reduction of sickness days (p=.002) and number of medications needed
(p=.001). Conclusions: Substantial beneficial effects of omalizumab, similar to those observed in controlled trials
and post marketing studies, were confirmed particularly with regard to reduction of asthma attacks, persistence of
symptoms, asthma control and reduction of concomitant asthma medications. This study provides a tougher test
and generalizable evidence for the effectiveness of omalizumab in routine care.
154
Wittchen, H.-U., Mühlig, S., Klotsche, J., Buhl, R., Kardos, P., Ritz, T. & Riedel, O. (2012). Omalizumab vs. „usual care“: Results from a naturalistic longitudinal study in routine care. International Archives of Allergy and Immunology, 159: 83-93.
Kardos, P., Wittchen, H.-U., Mühlig, S., Ritz, T., Buhl, R., Rabe, K., Klotsche, J. & Riedel, O. (2011). Controlled and uncontrolled allergic asthma in routine respiratory specialist
care – A clinical epidemiological study in Germany. Current Medical Research & Opinion, 29, 1835-1847.
P7.2.4. Asthma Triggers in Respiratory Specialty Care Patients: Associations with Psychopathology, Quality
of Life, and Asthma Control (Thomas Ritz, Hans-Ulrich Wittchen, Jens Klotsche, Stephan Mühlig & Oliver Riedel
for the sap-NEEDs study group)
Background: Patients’ perceptions of asthma triggers are important in diagnosis and treatment of the disease.
However, associations of trigger perceptions with asthma outcomes have received little attention. In studying these
associations, controlling for effects of anxiety and depression is important because of their known influence on patients’ health reports.
Methods: Asthma patients (N=453) from a nationally representative sample of respiratory specialty care practices
were administered questionnaires on asthma triggers, asthma-specific and general quality of life, and asthma
control. Clinically significant anxiety and depression were determined from responses to psychiatric interview and
screening questionnaires using established algorithms. Physicians recorded number of exacerbations and emergency treatments in the prior year, spirometric lung function, and allergy test results. Hierarchical multiple regressions
examined associations between reported trigger factors, anxiety and depression, and general health and asthma
outcomes. Results: Patients of all asthma severity levels were well represented in the study sample. Anxiety and
depression were associated with more frequent non-allergic, in particular psychological, triggers. Controlling for
demographics, asthma severity, anxiety, and depression, asthma triggers, in particular non-allergic triggers, explained
substantial portions of variance in asthma control and quality of life, with up to 32.5% explained in asthma-specific
quality of life. Exacerbations and emergency treatments were consistently associated with psychological triggers.
Spirometric lung function was largely unrelated to reported asthma triggers. Conclusion: Patients’ perception of
asthma triggers are important determinants of asthma outcomes. Reports of non-allergic triggers, in particular psychological triggers, can alert health care professional to patients at risk for suboptimal asthma management outcomes.
P7.3. IDEA – Improving Alzheimer Dementia Treatment: Epidemiological Assessment of Doctors’, Patients’
and Caregivers’ Unmet Needs and Barriers
PI: Prof. Hans-Ulrich Wittchen; Staff: Dipl.-Psych. A. Emmrich, Dipl.-Stat. J. Klotsche, Dipl.-Psych. B. Kotlarski,
Dr. O. Riedel; Funding: Novartis Pharma GmbH, Nürnberg; Duration: 11/2008 – 12/2010; Cooperations: Deutsche
Alzheimer Gesellschaft e. V:, Gabriela Zander-Schneider, Wolfgang Schneider (Alzheimer-Selbsthilfe e. V., Köln),
Dr. Hoffmann (Malteser-Krankenhaus St- Hildegardis, Köln) sowie die Mitglieder des Steering Committees:
Prof. Deuschl (Christian-Albrechts-Universität Kiel ), Prof. Dodel (Philipps-Universität Marburg), Prof. Falkai
(Universitätsmedizin Göttingen), Prof. Förstl (Technische Universität München), Prof. Hüll (Universitätsklinikum
Freiburg), Prof. Maier (Universitätsklinikum Bonn), Prof. Reichmann (Universitätsklinikum Dresden), Prof. Teipel
(Universitätsklinikum Rostock)
P7.3.1. The psychopathological burden of outpatiens with Alzheimer’s Dementia and their caregivers (A.
Emmrich, O. Riedel, H.-U. Wittchen)
Introduction: Little is known about the impact of neuropsychiatric symptoms in Alzheimer´s Dementia (AD) patients and the associated psychopathological burden for their caregivers (CG) in familial care. Aims: 1) Describing the
familial care situation of patients with mild or moderate AD. 2) Exploring the impact of neuropsychiatric symptoms
in patients with AD on caregiver burden. Methods: Nationwide random sample of N=500 AD-outpatients and their
CG. Patients were assessed by their office-based physicians. CG filled out a questionnaire and subsequently were
interviewed by the research team (N=221). Patients’ neuropsychiatric symptoms were assessed by a standardized clinical appraisal (physician). The caregiver interview included the Neuropsychiatric Inventory, the Depression
Screening Questionnaire and the Anxiety Screening Questionnaire. Results: According to the physician’s 91.6%
and according to CG 95.7% of patients revealed clinically significant neuropsychiatric symptoms. CGs rated a higher
mean number of syndromes (4,5 vs. 3,2 (physicians); p<.001). CG most frequently rated patients’ apathy (66.4%)
and depression (61.9%); physicians depression (54.3%) and irritability (44.2%). Among CGs, depressive symptoms
were present in 42.7%, GAD symptoms in 16.7%. Depressive symptoms were more frequent in females (OR=2.9)
and offspring (OR=2.0), while GAD symptoms were elevated only in females (OR=8.0). Both complications were
155
inversely associated with CG age (>71 vs. <55 years, OR=0.3). Patients’ apathy and depression were associated
with CGs’ depressive symptoms; patients’ apathy and irritability with GAD symptoms in CG. Conclusions: Findings
underline an exceedingly high burden of depressive spectrum symptoms in early stages, which seem to significantly increase family care burden and contribute to increased psychopathology burden in the caregivers.
P7.3.2. Alzheimer’s Disease: effects of transdermal vs. oral medication on caregiver burden (O. Riedel, A.
Emmrich, J. Klotsche, R. Dodel, H. Förstl, W. Maier, H. Reichmann)
Background: Transdermal and oral anti-dementia treatments in Alzheimer patients might also be associated with
reductions in the substantial burden of caregivers. We evaluated whether transdermal application of acetylcholine
esterase inhibitors (ChE-I) is associated with reduced caregiver burden as compared to the oral administration or
untreated patients. Methods: Cross-sectional naturalistic cohort study of n=403 unselected patients sampled in
routine out-patient neurological care. Three matched groups: A: no treatment, B: oral, C: transdermal treatment.
Assessments included a standardized clinical documentation by the physician, burden questionnaires and a standardized caregiver interview. Results: Transdermal and oral treatment reduced the caregiver burden in most measures.
Transdermal treatment was superior with regard to a) reduced administration time (p<.001), b) a lower rate of administration problems (p=.031), c) reduced burden in activities of daily living (p=.008) and d) reduced anxiety burden
(OR=0.25, 95% CI: .05-.99). Caregivers in the transdermal group, however, did not have a significantly better quality
of life regarding mental/physical health or a consistently more favorable profile of functional burden. Physicians’ and
caregivers’ ratings on patients’ improvements were not associated (kappa 0.01-0.06). Conclusion: The transdermal
administration revealed some beneficial effects with regard to a reduced time burden and lower problem rates in treatment administration, also associated with improved activities in daily living of the caregiver. They do not translate into
a better “generic quality of life” of the caregiver. In appreciating potential differences on caregiver burden in the future, the substantially different perceptions and rating habits of physicians and caregivers need to be considered.
Riedel, O., Emmrich, A., Klotsche, J., Dodel, R., Förstl, H., Maier, W., Reichmann, H., & Wittchen, H.-U. (2012). Alzheimer’s disease: Differences of transdermal vs oral treatment on caregiving time. Dementia and Geriatric Cognitive Disorders Extra, 2(1), 468-480.
P7.4. Anxiety increases pressure: studies in the area of tension between anxiety and blood pressure as well
as anxiety disorders and hypertension
P7.4.1. The long term effect of anxiety on blood pressure (F. Einsle, J. Klotsche, L. Pieper, S. Rabung, H.-U. Wittchen)
Background: Studies focusing on the long-term effect of anxiety on blood pressure show heterogeneous results:
Markovitz et al. (1991) reported that anxiety increases systolic but not diastolic blood pressure. In contrast, Hildrum
et al. (2008) showed that anxiety leads to a decrease of both blood pressure parameters over time. Most studies
found no association between anxiety and blood pressure (e.g. Räikkönen et al., 2001; Shinn et al., 2001; Sparrow
et al., 1982). One possible reason for the heterogeneous results might be that anxiety wasn’t defined specifically
enough. Another reason may be different definitions of blood pressure outcomes. But most importantly, other influencing parameters like BMI, age and gender were mostly not taken into account. Aims: To clarify the association between anxiety and blood pressure, data of the Detect Study (described below) was used. Therefore, different anxiety
measurements (e.g. the subscales phobic anxiety and interactional problems of the HEALTH questionnaire; Rabung
et al., 2009) should be analysed. To avoid the other points of criticism in our study, blood pressure will be defined
as systolic and diastolic value (mmHg) measured by general practitioners as well as the presence of a hypertensive
disease. Furthermore, including influencing variables in regression analyses should help to clarify the association between anxiety and blood pressure.
P7.4.2. Isolated Clinical Hypertension – Clinical Significance, Psychological and Psychophysiological correlates
Pl: Prof. Franziska. Einsle, Prof. Katja Beesdo-Baum; Staff: Dipl.-Psych. A. Schilling, Dipl.-Psych. N. Meissner, Dipl.Psych. J. Schneider, M. Geiger, L. Haas, F. Schlichthaar, Dr. D. Langer, Dr. A. Sennewald, Dr. P. Muckermann, Dr.
C. Groß; Funding: Anreizmittel des Universitätsklinikums Carl Gustav Carus der Technischen Universität Dresden;
Duration: 01/2005 – 03/2008, ongoing data analysis; Cooperations: Prof. Dr. J. Hoyer (intern), Prof. Dr. P. Joraschky
(Universitätsklinikum Dresden, Klinik und Poliklinik für Psychotherapie und Psychosomatik)
Background: Isolated Clinical Hypertension (ICH) is defined as a persistently elevated blood pressure in the presence of a physician that does not occur when measured outside the doctor’s office. Despite the high prevalence
(10-30%) of ICH there is only little attention given to this condition. ICH may progress to definite sustained hyper156
tension in 50-70% of patients. Patients with ICH are at higher risk for organ damages and mortality. At this stage,
specific treatments for ICH do not exist which is primarily due to the small knowledge regarding the aetiology of
this condition. Psychological factors may play a role in the etiology of ICH but surveys assessing this question are
rare. Aim: Aims of this study are to determine the clinical relevance of ICH and to examine psychological (e.g.
health, social, phobic anxiety; personality characteristics) and psychophysiological (heart rate variability) correlates of
this condition. Based on the results, the main goal is to approach possible non-invasive treatments for patients with
ICH. Methods: Patients with ICH (N=65), permanent hypertension (N=130), and normal blood pressure (N=104)
were recruited, e.g. by primary care physicians. Definition of patient groups was based on the WHO-guidelines for
the classification of blood pressures. A large psychological assessment battery was applied including questionnaires
measuring social anxiety (SAS, SPS), health related worries (PSWQ), control over anxiety (AKF), general anxiety
(HADS-anxiety scale) anger (STAXI), type D (DS 14), hypochondrias (IAS); Intolerance of Uncertainty; Behavioral
Inhibition (RSRI). A subsample of N=60 patients participated in a standardized stress-test. Heart rate variability was
operationalized by the Low and High Frequency Ratio (LF/HF) as well as RMSSD. Results: Patients with ICH more
frequently than persons with normal blood pressure reported social phobia, higher anxiety levels in social interaction
(SIAS) and trait-anger (STAXI). Patients with hypertension compared to subjects with normal blood pressure more
frequently report higher trait anger and overall higher anxiety levels. ICH did not differ from hypertension in any of
the assessed disorders and constructs. In the stress test, patients with ICH (N=10), normal blood pressure (N=15)
and hypertension (N=15) were compared. Patients with ICH show increased LF/HF-proportions and decreased
RMSSD-scores in all stress situations, as well as decreased RMSSD-scores in all relaxation situations. A significant
effect occurs for the reaction on social stress. Patients with ICH have an increased sympathetic nervous system
reaction as compared to individuals with normal blood pressure or hypertension. Conclusions: Findings suggest a
link between ICH and social anxiety as well as response to stress, particularly social stress. For some patients with
ICH, the social interacting situation with a doctor may influence the psycho-physiological reaction (blood pressure).
The management of social stress might be a therapeutic target for patients with ICH.
Muckermann P. (2012): Psychische Korrelate des Weißkitteleffekts - Eine Untersuchung zu Ärger, Depressivität und Depression, Typ - D und Unsicherheitsintoleranz. Dissertation at the Faculty of Medicine „Carl Gustav Carus“, TU Dresden.
Schlichthaar F. (2012): Bedeutung von Ärger und Persönlichkeitseigenschaften bei isolierter klinischer Hypertonie. Dissertation at the Faculty of Medicine „Carl Gustav
Carus“, TU Dresden.
Einsle, F; Langer, D; Bergmann A; Beesdo-Baum, K (2012, 03.). Versorgungssituation von Patienten mit Isolierter Klinischer Hypertonie (Poster). Deutscher Kongress für Psychosomatische Medizin und Psychotherapie, München.
P7.4.3. Quality of life as well as anxiety and depression in patients with pulmonary hypertension:
Correlations with functional and hemodynamic parameters
Pl: Dr. Michael Halank (UKD); Staff: Prof. F. Einsle, Dipl.-Psych. G. Wieder; Funding: Pfizer; Duration: 2006 – 2008,
ongoing data analysis; Cooperation: Dr. Stephanie Christoph (UKD), Prof. Volker Köllner (Saarbrücken)
Objectives: Pulmonary hypertension (PH) is defined by a resting mean pulmonary artery pressure (PAPm) ≥ 25
mmHg and has a poor prognosis untreated. A restricted quality of life as well as anxiety and depression are common in patients with pulmonary hypertension (PH). However, it is unclear how these constructs are correlated with
patients´ functional status and other somatic variables. Methods: Therefore, 85 patients with pulmonary arterial
hypertension and inoperable chronic thromboembolic pulmonary hypertension (mean age: M = 58 years, SD = 11
years, 59 % women) were assessed by the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression. For judgement of quality of life (QoL), Short Form 36 General Health Survey (SF-36), St. George’s Respiratory
Questionnaire (SGRQ) and McNew Quality of Life after Myocardial Infarction questionnaire (McNew) were used.
Besides correlations with World Health Organisation (WHO) - functional class (FC) and the six-minute walk test,
associations with peak oxygen uptake (peak VO2 – spiroergometry) and hemodynamic data (right heart catheter)
were analysed. Results: Quality of life was impaired in patients with PH. We demonstrated that peak VO2 was
independently associated with physical subscales in SF-36, St. George`s and McNew questionnaires. In multivariate
analyses, hemodynamic parameters and 6-MWD did not display significant independent associations with physical
scores in the 3 questionnaires. Furthermore, anxiety revealed a significant independent association with the activity
score (St. George) and physical score (MacNew). 16 patients (18.8 %) were classified as clinically significant for
anxiety, 29 patients (34.1 %) as clinically significant for depression. In a multivariate regression analysis, variance
in anxiety was explained by age, six-minute walk distance, and WHO-FC. Age, six-minute walk distance as well as
mean pulmonary arterial pressure and mixed venous oxygen saturation were included in the model as independent
variables explaining variance of depression. Conclusion: The number of clinically significant anxious and depressed
patients as well as the amount of quality of life was similar to other studies. Anxiety and depression are associated
with functional status while only depression shows correlations with hemodynamic variables. The results underline
the importance of anxiety and depression in patients with PH and the necessity of an adequate treatment.
157
Einsle, F., Halank, M., Christoph, S., Breme,r H., Ewert, R., Wilkens, H., Meye,r J., Seyfarth, H.J., Kolditz, M., Höffken, G., Köllner, V. (submitted). Peak oxygen uptake
reflects best physical quality of life in patients with pulmonary arterial hypertension and or CTEPH * equal for first authorship.
Einsle, .F, Christoph, S., Dannemann, S., Wieder, G., Ewert, R., Meyer, J., Bremer, H., Seyfarth, H.J., Klose, H., Martini, J., Wilkens, H., Halank, M., Köllner, V., (submitted).
Anxiety and depression in patients with pulmonary hypertension: correlations with functional and hemodynamic parameters, *equal for senior authorship.
Christoph, S., Einsle, F., Halank, M., Bremer, H., Ewer,t R., Wilkens, H., Meyer, J., Seyfarth, H.J., Dannemann S., Klose, H., Köllner, V. (submitted). Impact of anxiety and
depression on the exercise capacity in patients with pulmonary hypertension.
P7.5. Alcohol dependence in primary and specialist care in Europe (APC)
PI: Prof. Jürgen Rehm, Prof. Hans-Ulrich Wittchen; Staff: Dr. L. Pieper, Dipl.-Psych. J. Manthey, Dipl.-Psych. C.
Probst; Funding: Lundbeck; Duration: 07/2012 – 04/2014; Steering Committee: T. Gual (Barcelona), M. Wojnar (Warsaw)
Background: Alcohol dependence (AD) is severely undertreated in the EU with overall estimates of less than 10%
of people with this condition receiving treatment within the same year (Alonso et al., 2004; Rehm et al., 2012).
Main objective: Create an in depth understanding of the alcohol dependent population in primary and specialist
care in 10 EU countries to get a better understanding of the met and unmet medical needs in the population.
Sampling and procedure: A personal interview-based investigation among 18-64 year old clients in primary health
care facilities as well as settings for specialist care for alcohol use disorders will be conducted with the following
steps (steps 1-4 for primary care; steps 5-6 for specialist care institutions). Main expected outcomes: The patient
population will be segmented according to diagnosis and treatment status with respect to AD and alcohol use disorders: Undiagnosed clients with AD (defined by fulfilling the criteria for AD within the last year using the CIDI, but no
indication of present of past alcohol dependence from the PCP); Diagnosed with AD but not in treatment (defined by
fulfilling the criteria for AD within the last year using the CIDI, and a diagnoses from the PCP for the same time period);
Diagnosed with and treated for AD (defined as fulfilling the criteria for AD within the last year and being treated, either by
the PCP or upon referral of the PCP). For AUD (alcohol use disorders), the same groups will be constructed. In addition
to the main outcomes based on the classification above, there will be a sensitivity analyses with the patient populations
being segmented based on the suggested DSM 5 criteria for alcohol use disorders. Other outcomes are: (1) determinants for treatment seeking for treatment seeking (facilitators and barriers); (2) predictors for not seeking treatment, even
when there is a need; (3) potential role for alternative treatment regimens on treatment seeking processes.
P7.5.1. Alcohol dependence and treatment utilization in Europe – a representative cross-sectional study in primary care (Jürgen Rehm (Toronto, Dresden), Allaman Allamani (Firenze), Roberto Della Vedova (Monza), Zsuzsanna Elekes
(Budapest), Andrzej Jakubczyk (Warsaw), Inga Landsmane (Riga), Jakob Manthey (Dresden), José Moreno- España
(Barcelona), Lars Pieper (Dresden), Charlotte Probst (Dresden), Sigita Snikere (Riga), Pierluigi Struzzo (Monfalcone), Fabio
Voller (Firenze), Hans-Ulrich Wittchen (Dresden), Antoni Gual (Barcelona), Marcin Wojnar (Warsaw))
Purpose: Alcohol use disorders (AUDs), especially alcohol dependence (AD) causes marked mortality and burden of
disease in Europe. However, the treatment rate is low. Primary care could play a key role in reducing alcohol-attributable harm by screening, brief interventions and treatment including treatment referral. This study investigates identification and treatment of AUDs in European primary care settings. Methods: 13,003 General Practitioners (GPs)
assessments and 9,098 interviews (joint number of interviewed patients with GP assessment: 8,476) were collected in six European countries. AUDs, co-morbidities and health service utilization were assessed by the GP, and
independently via the Composite International Diagnostic Interview (for AUDs including AD) and other structured
interviews. Weighted regression analyses were used to compare the impact of influencing variables. Results: 8.7%
(95% confidence interval (CI): 8.1 to 9.3%; male: 14.6%, 95% CI: 13.4 to 15.7%; female: 4.8%, 95% CI: 4.2 to
5.3%) of the patients qualified for AD within the past year. They showed markedly higher rates of mental and somatic co-morbidity and disability compared to patients without AD. 20.4% (95% CI: 17.6 to 23.3%) of patients with AD in
the past year received professional interventions; 68.1% (95% CI: 60.9 to 75.3%) of those received formal treatment.
Conclusion: ADs were prevalent and associated with considerable co-morbidity. Despite recognition, interventions for
AUDs in primary care are rare. The environment should be changed to allow such interventions in the future.
Rehm J., Allamani A., Della Vedova R., Elekes Z., Jakubczyk A., Landsmane I., Manthey J., Moreno- España J., Pieper L., Probst C., Snikere S., Struzzo P., Voller F., Wittchen H.-U.,
Gual A., Wojnar M. (in press) Alcohol dependence and treatment utilization in Europe – a representative cross-sectional study in primary care. Annals of Family Medicine.
P7.5.2. Alcohol dependence in primary care in Europe (APC) study: Design, instruments and patient
characteristics (Jakob Manthey (Dresden), Antoni Gual (Barcelona), Andrzej Jakubczyk (Warsaw), Lars Pieper
(Dresden), Charlotte Probst (Dresden), Pierluigi Struzzo (Monfalcone), Marcis Trapencieris (Riga), Marcin Wojnar
(Warsaw), Jürgen Rehm (Dresden, Toronto))
158
The Alcohol dependence in primary care in Europe (APC) study is a large scale epidemiological study in primary care
in six European countries (Germany, Hungary, Italy, Latvia, Poland, and Spain) which examines (a) the prevalence
of alcohol dependence and alcohol use disorders (AUDs), (b) the recognition of general practitioners (GPs) and the
proportion of patients receiving professional treatment, and (c) patients characteristics that are linked to recognition
and treatment provision. The present paper aims to describe in great detail the design, methods and sample of the
APC study. In all study regions, 13,003 primary care patients (aged 18 to 64) were assessed by participating GPs
(N=358, refusal rate: 56.4%), of whom 8,476 (refusal rate: 17.8%) were interviewed. The GP questionnaire comprised sociodemographics, main health risk factors, health problems, reason for medical visit, and questions on alcohol
use and AUDs of the patient. The patient interview consisted of sociodemographics, questions about risk factors,
and validated instruments for functioning and disability, mental distress and health service utilization. Consumption
and AUDs were assessed via the CIDI (Composite International Diagnostic Interview). Data from this study will provide, in unprecedented detail, an insight into AUDs and alcohol related burden in routine primary care in Europe.
Manthey J., Gual A., Jakubczyk A., Pieper L., Probst C., Struzzo P., Trapencieris M., Wojnar M., & Rehm J. (in press) Alcohol dependence in primary care in Europe (APC)
study: Design, instruments and patient characteristics. Annals of Family Medicine.
P7.6. Cardiorenal syndromes (CRS): A Clinical-Epidemiological Survey of Prevalence, Treatment and Care of
Patients with Chronic Kidney Disease (CaRe-Survey)
PI: Prof. Hans-Ulrich Wittchen; Staff: Dr. L. Pieper, Dipl.-Psych. K. Langer, Dr. J. Klotsche, Dr. O. Riedel, Dr. M.
Höfler; Funding: Abbott Deutschland GmbH; Duration: 04/2011 – 06/2013; Steering Committee: Prof. C. Wanner
(Würzburg), Dr. C. Haufe (Erfurt), Prof. C. Hugo (Dresden), Prof. C. Barth (Neu-Isenburg), Prof. A.M. Zeiher
(Frankfurt), Dr. D. Leistner (Frankfurt), Dr. Rump (Düsseldorf)
The terms cardiorenal and renocardiac syndromes (CRS) describe an increasingly recognized syndrome cluster of great
clinical relevance. Still lacking a consistent or well-accepted definition for the vast array of interrelated derangements,
and to stress the well-established bidirectional pathophysiological nature of heart-kidney interactions, several authors
have suggested to differentiate 5 subtypes that reflect the pathophysiology, the time-frame, and the nature of concomitant cardiac and renal dysfunction. CRS can be generally defined as a pathophysiologic disorder of the heart and
kidneys whereby acute or chronic dysfunction of one organ may induce acute or chronic dysfunction of the other.
The study puts emphasis and focus on Type 4 CRS and described in a nationally representative sample of nephrological and internal medicine (dialysis) settings the frequency of CRS by using standardized assessment forms, to what
degree physicians are aware of this typology and diagnosis, take into account specific diagnostic criteria and methods
to recognize and diagnose heart disease in patients with chronic kidney disease. We also examined the use of biomarkers that can contribute to an early diagnosis of CRS and assess to what degree timely therapeutic intervention for
heart disease are applied. The study provided much needed data on the prevalence of heart disease in patients with
chronic kidney disease and might result in the derivation of clinicians screening tools that can help physicians to characterize groups of patients, increase the awareness and ability to initiate appropriate treatment more often. Further,
the study contributed more generally to an accurate selection and stratification of the population under investigation.
Wittchen, H.-U., Pieper, L., Haufe, C., Hugo, C., Zeiher, A.M., & Wanner, C. (in prep) Frequency and treatment of chronic heart disease in patients with chronic kidney disease: Results of the CaRe study.
P7.7. Multiple Sclerosis Patients and their Caregivers Psychopathological and General Burden of Disease MS Caregiver Burden
PI: Prof. H.-U. Wittchen, Prof. T. Ziemssen; Staff: Dr. L. Pieper, Dipl.-Psych. C. Thurau, Dr. J. Klotsche, Dr. S. Kern,
Dr. O. Riedel; Funding: Novartis Deutschland GmbH; Duration: 05/2009 – 03/2011
Neuropsychiatric syndromes and disorders occur frequently within the treatment of Multiple Sclerosis (MS) and
aggravate the course of disease. Despite the fact that these variables further impact patients’ social and familiar
resources, they remain understudied in MS-research. Against this background, the aim of the “Multiple Sclerosis
Patients and their Caregivers Psychopathological and General Burden of Disease” study (MS Caregiver Burden),
was to investigate the needs for treatment of MS patients and their caregivers (“significant others”). Specifically,
the goals were to: (1) Describe the prevalence and forms of neuropsychiatric syndromes in patients by patterns
and stages of MS. (2) Describe the impact and burden of MS symptoms and neuropsychiatric complications on the
caregiver/partner. (3) Determine how frequently the caregiver is affected by mental disorders. (4) Assess patients
159
and caregivers met and unmet needs for intervention. The study was conducted in Dresden (MS-Centrum, Prof.
Ziemssen). The main investigation includes patients aged 18-55 with documented MS (RRMS, SPMS, PPMS, CIS).
Furthermore, the patients suffering from MS had a caregiver who was also willing to participate. The attending physician completed a standardized clinical and neurological assessment documenting patients’ symptoms and other
relevant aspects of their disease. The MS patients and their caregivers were assessed independently from each
other in face-to-face interviews by clinical trained interviewers. The interview included domains of psychiatric disorders on the basis of the Structured Clinical Diagnostic Interview for DSM-IV-TR (SKID), neuropsychiatric symptomatology, and treatment modalities. In addition to the SKID, the patients answered specific questionnaires regarding
the dimensional characteristic of selected aspects (e.g. quality of life). Finally, the patient and the caregiver have
provided information allowing determining the degree of met and unmet needs in relation to treatment and care.
Wittchen, H.-U., Pieper, L., Klotsche, J., Thurau, K., & Ziemssen, T. (in prep) Häufigkeit psychischer Störungen bei MS-Patienten und ihren Angehörigen: Ergebnisse der MSCaregiver-Burden Studie.
P7.8. DETECT (Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of
Treatment): An overview
PI: Prof. H.-U. Wittchen, Dr. L.Pieper; Staff: Dr. J. Klotsche, Dr. T. Eichler, , Dr. H. Glaesmer, E. Katze, Dipl.-Psych.
A. Bayer; Funding: Pfizer GmbH; Duration: 09/2002 – 08/2008; Steering Committee: Prof. Dr. H. Lehnert (Coventry/
Lübeck), Prof. Dr. G. K. Stalla (München), Prof. Dr. M. A. Zeiher (Frankfurt); Advisory Board: Prof. Dr. W. März (Graz/
Heidelberg), Prof. Dr. S. Silber (München), Prof. Dr. Dr. U. Koch (Hamburg), Prof. Dr. D. Pittrow (München/Dresden),
Prof. Dr. M. Wehling (Mannheim), Dr. D. Leistner (Frankfurt), Dr. H.J. Schneider (München), Dr. C. Sievers (München)
P7.8.1. Prognostic value of NT-pro-BNP and hs-CRP for risk stratification in primary care: results from the
population-based DETECT study (D. M. Leistner (Frankfurt), J. Klotsche (Berlin), L. Pieper (Dresden), S. Palm
(Frankfurt), G. K. Stalla (München), H.Lehnert (Lübeck), S. Silber (München), W. März (Heidelberg), H.-U. Wittchen
(Dresden), A. M. Zeiher (Frankfurt))
Background: There is continuous debate to the use of biomarkers in the general practitioners office and to what
degree the established biomarkers N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and high-sensitive
C-reactive protein (hs-CRP) might contribute to improved prediction of incident cardiovascular events. Objective:
To evaluate the utility and 5-year predictive value of a single measurement of NT-pro-BNP and hs-CRP for incident
cardiovascular events, and its added value beyond the contribution of conventional risk factors in primary care.
Methods: Five year prospective longitudinal clinical epidemiological study in a nationwide sample of 4,775 primary care subjects (mean age 55.8 years, 62 % women) without coronary artery disease at baseline. Main outcome
measures were incident major cardiovascular events and all-cause death. Results: During the 5 years of follow-up,
188 subjects (3.9 %) died or experienced a first major cardiovascular event. The addition of NT-pro-BNP, but not of hsCRP to a prediction model with established cardiovascular risk factors improved the prediction of major cardiovascular
events (increase in C statistic by 0.009; p = .008), and was associated with a significant improvement in net reclassification improvement (NRI = 23.6 %; p = 0.003). Conclusion: In a primary care setting, one single measurement of
NT-pro-BNP, but not of hs-CRP significantly improves the prediction of incident cardiovascular events.
Leistner, D., Klotsche, J., Pieper, L., Palm, S., Stalla, G. K., Lehnert, H., Silber, S., März, W., Wittchen, H.-U., & Zeiher, A. (2013). Prognostic value of NT-pro-BNP and hs-CRP
for risk stratification in primary care: Results from the population-based DETECT study. Clinical Research in Cardiology, 104(4), 259-268.
P7.8.2. Improved prediction of all-cause mortality by a combination of serum total testosterone and insulinlike growth factor I in adult men (N. Friedrich (Greifswald), H. J. Schneider (München), R. Haring (Greifswald), M.
Nauck (Greifswald), H. Völzke (Greifswald),H. K. Kroemer (Greifswald),M. Dörr (Greifswald),J. Klotsche (Berlin),C.
Jung-Sievers (München), D. Pittrow (München), H. Lehnert (Lübeck), W. März (Heidelberg), L. Pieper (Dresden),
H.-U. Wittchen (Dresden), H.Wallaschofski (Greifswald), G. K. Stalla (München))
Objective: Lower levels of anabolic hormones in older age are well documented. Several studies suggested that
low insulin-like growth factor I (IGF-I) or testosterone levels were related to increased mortality. The aim of the
present study was to investigate the combined influence of low IGF-I and low testosterone on all-cause mortality in
men. Methods and results: From two German prospective cohort studies, the DETECT study and SHIP, 3942 men
were available for analyses. During 21,838 person-years of follow-up, 8.4% (n = 330) of men died. Cox model analyses with age as timescale and adjusted for potential confounders revealed that men with levels below the 10th
160
percentile of at least one hormone [hazard ratio (HR) 1.38 (95% confidence-interval (CI) 1.06–1.78), p = 0.02] and
two hormones [HR 2.88 (95% CI 1.32–6.29), p < 0.01] showed a higher risk of all-cause mortality compared to men
with non-low hormones. The associations became non-significant by using the 20th percentile as cut-off showing
that the specificity increased with lower cut-offs for decreased hormone levels. The inclusion of both IGF-I and total
testosterone in a mortality prediction model with common risk factors resulted in a significant integrated discrimination improvement of 0.5% (95% CI 0.3–0.7%, p = 0.03). Conclusions: Our results prove that multiple anabolic deficiencies have a higher impact on mortality than a single anabolic deficiency and suggest that assessment of more
than one anabolic hormone as a biomarker improve the prediction of all-cause mortality.
Friedrich, N., Schneider, H., Haring, R., Nauck, M., Völzke, H., Kroemer, H. K., Dörr, M., Klotsche, J., Jung-Sievers, C., Pittrow, D., Lehnert, H., März, W., Pieper, L., Wittchen,
H.-U., Wallaschofski, H., & Stalla, G. K. (2012). Improved prediction of all-cause mortality by a combination of serum total testosterone and insulin-like growth factor I in
adult men. Steroids, 77(1-2), 52-58.
P7.8.3. Binary regression: Total gain in positive and negative predictive values (J. Klotsche (Berlin), D. Ferger
(Dresden), D. Leistner (Frankfurt), L. Pieper (Dresden), A. M. Zeiher (Frankfurt), H.-U. Wittchen (Dresden), J. Rehm
(Toronto, Dresden)
Models that predict disease incidence or disease recurrence are attractive for clinicians as well as for patients. The
usefulness of a risk prediction model is linked to the two questions whether the observed outcome is confirmed by
the prediction and whether the risk prediction is accurate in predicting the future outcome, respectively. The first
phrasing of the question is linked to considering sensitivity and specificity and the latter to the positive and negative
predictive values. We present the measures of standardized total gain in positive and negative predictive values
dealing with the performance or accuracy of the prediction model for a binary outcome. Both measures provide a
useful tool for assessing the performance or accuracy of a set of predictor variables for the prediction of a binary
outcome. This concept is a tool for evaluating the optimal prediction model in future research.
Klotsche, J., Ferger, D., Leistner, D., Pieper, L., Zeiher, A.M., Wittchen, H.-U.,& Rehm, J. (2012). Binary regression: Total gain in positive and negative predictive values. Biometrical Journal 54(6), 808-823.
P7.8.4. Changes in the Prevalence, Treatment and Control of Hypertension in Germany? A ClinicalEpidemiological Study of 50.000 Primary Care Patients (A. M. Labeit (Mannheim), J. Klotsche (Berlin), L.Pieper
(Dresden), D. Pittrow (München), F. Einsle (Dresden), G. K. Stalla (München), H.Lehnert (Lübeck), S. Silber
(München), A. M. Zeiher (Frankfurt), W. März (Heidelberg), M. Wehling (Mannheim), H.-U. Wittchen (Dresden))
Introduction: Medical societies have developed guidelines for the detection, treatment and control of hypertension (HTN). Our analysis assessed the extent to which such guidelines were implemented in Germany in 2003 and
2001. Methods: Using standardized clinical diagnostic and treatment appraisal forms, blood pressure levels and
patient questionnaires for 55,518 participants from the cross-sectional Targets and Essential Data for Commitment
of Treatment (DETECT) study (2003) were analysed. Physician’s diagnosis of hypertension (HTNdoc) was defined as
coding hypertension in the clinical appraisal questionnaire. Alternative definitions used were physician’s diagnosis
or the patient’s self-reported diagnosis of hypertension (HTNdoc,pat), physician’s or patient’s self-reported diagnosis or a BP measurement with a systolic BP>140 mmHg and/or a diastolic BP>90 (HTNdoc,pat,bp) and diagnosis
according to the National Health and Nutrition Examination Survey (HTNNHANES). The results were compared with
the similar German HYDRA study to examine whether changes had occurred in diagnosis, treatment and adequate
blood pressure control (BP below 140/90 mmHg) since 2001. Factors associated with pharmacotherapy and controls were determined. Results: The overall prevalence rate for hypertension was 35.5% according to HTNdoc and
56.0% according to NHANES criteria. Among those defined by NHANES criteria, treatment and control rates were
56.0% and 20.3% in 2003, and these rates had improved from 55.3% and 18.0% in 2001. Significant predictors of
receiving antihypertensive medication were: increasing age, female sex, obesity, previous myocardial infarction and
the prevalence of comorbid conditions such as coronary heart disease (CHD), hyperlipidemia and diabetes mellitus
(DM). Significant positive predictors of adequate blood pressure control were CHD and antihypertensive medication.
Inadequate control was associated with increasing age, male sex and obesity. Conclusions: Rates of treated and
controlled hypertension according to NHANES criteria in DETECT remained low between 2001 and 2003, although
there was some minor improvement.
Labeit, A., Klotsche, J., Pieper, L., Pittrow, D., Einsle, F., Stalla, G. K., Lehnert, H., Silber, S., Zeiher, A. M., März, W., Wehling, M., & Wittchen, H.-U. (2012). Changes in the
prevalence, treatment and control of hypertension in Germany? A clinical-epidemiological examination of 50.000 primary care patients. PLoS ONE, 7(12).
161
P7.8.5. Circulating Troponin As Measured by a Sensitive Assay for Cardiovascular Risk Assessment in Primary
Prevention (D. M. Leistner (Frankfurt), J. Klotsche (Berlin), L.Pieper (Dresden), G.K. Stalla (München), H. Lehnert (Lübeck),
S. Silber (München), W. März (Heidelberg), H.-U. Wittchen (Dresden), A. M. Zeiher (Frankfurt), for the DETECT Study Group)
Background: Measuring circulating cardiac troponin using novel sensitive assays has revealed that even minute
elevations are associated with increased mortality in patients with coronary artery disease or even in the general
population. Less well defined, however, is the incremental value of measuring circulating cardiac troponin I (cTnI)
by a sensitive assay for risk assessment in primary prevention. Methods: We measured circulating concentrations
of cTnI, N-terminal pro–B-type natriuretic peptide (NtproBNP), and high-sensitivity C-reactive protein (hsCRP) in
5388 individuals free of known cardiovascular disease recruited into the DETECT study, a prospective longitudinal
population-based cohort study. We determined the prognostic implications for incident major adverse cardiovascular events (MACE) during 5 years of follow-up. Results: Circulating cTnI was detectable in 19% of the subjects.
Increased cTnI concentrations were associated with established risk factors for atherosclerosis and demonstrated
a graded relationship with all-cause mortality and incident MACE during 5-year follow-up. A single measurement
of cTnI significantly improved risk prediction over established risk factors, and also added prognostic information,
when adjusted for serum concentrations of NtproBNP and hsCRP. Conclusions: Minute increases in cTnI are associated with increased mortality and incident MACE in a large primary prevention cohort and, thus, identify contributors to cardiovascular risk not fully captured by traditional risk factor assessment.
Leistner, D. M., Klotsche, J., Pieper, L., Stalla, G. K., Lehnert, H., Silber, S., März, W., Wittchen, H.-U., Zeiher, A. M., & for the DETECT Study Group. (2012). Circulating troponin as measured by a sensitive assay for cardiovascular risk assessment in primary prevention Clinical Chemistry 58(1), 200-208.
P7.9. Psychological and Biological Risk Factors of Burnout (ROB)
PI: Prof. Dr. Clemens Kirschbaum, Dr. Lars Pieper; Staff: Prof. A. Buske-Kirschbaum, Prof. Dr. J. Schmitt, Dr. R.t
Miller, Dipl.-Psych. R. Hoffmann; Funding: Support-the-best Pool (TU Dresden); Duration: 01/2014 - ongoing
Research shows that psychological stress at work effects on the physical and mental health. Reports of health insurance and the stress-report 2012 illustrate the need to address stress at the workplace, as they reported an increase of work-related stress and mental disability days. According to findings of the World Health Organization (WHO)
stress can be considered as one of the major health problems of our time. The pathological consequences of chronic stress include a syndrome, which is characterized by emotional, physical and cognitive exhaustion, cynicism and
reduced performance – the burnout syndrome. Many years of research has led to a more or less clear picture of the
symptoms of burnout. However, no precise statements about the psychological and biological conditions of origin
of the disease can be drawn. Therefore, in this project psychological and biological risk factors of burnout should be
explored in order to identify risk groups and develop effective prevention and intervention measures. This project
will also generate current epidemiological information on burnout in Germany and German-speaking countries. For
this purpose approximately 10,000
volunteers should be recruited to
answer different questionnaires to
the burnout topic and associated
factors in an online survey. To
identify risk structures data should
be collected longitudinally in this
study in contrast to the majority of
previous studies. The first followup survey should take place about
a year after the baseline survey. In
addition to the questionnaire study
a blood collection and analysis
should be carried out in a subgroup
of 500 subjects in order to determine exploratory biomarkers for
burnout.
Figure: Online screening platform of
the ROB study
162
AG 8 EATING DISORDERS
C. JACOBI
AG 8 Essstörungen/Eating Disorders
Prof. Dr. Corinna Jacobi
Overview:
In collaboration with Prof. Dr. Hans-Ulrich Wittchen, our department represents one of the sites involved in the
EC network ”The Integrated Neurobiology of Food Intake, Addiction and Stress (NeuroFAST)”. Our own substudy
“Interrelations between eating and substance use disorders” examines common and specific risk factors of both
disorders, and their associations with other mental disorders. In the past year, age and gender-specific prevalence and
incidence rates as well as their comorbidities were examined on the categorical and on the symptom level that will
now be supplemented by longitudinal associations between risk factors and subsequent symptoms and syndromes as
well as the examination of common and specific risk factors for eating disorders and substance use disorders.
Suported by the SANS foundation (Schweizerische Anorexia nervosa Stiftung) we developed and tested early interventions for girls at risk for anorexia nervosa using the parent-oriented prevention program “E@T“. The program
builds upon a family-based treatment for adolescents with anorexia nervosa and targets risk factors and early symptoms of anorexia nervosa before the onset of a full syndrome.
Aiming at the prevention of subclinical eating disorders of the bulimic subtype, the existing Internet-based program
“Student Bodies+” was adapted for subclinical eating disorders of the restricting subtype (women at risk for anorexia nervosa). In 2012, we started a randomized controlled trial aiming at reducing risk factors for anorexia nervosa
in young women age 18 and above (“Internet-based prevention for women at risk for anorexia nervosa”; funded by
the Else Kröner-Fresenius-Stiftung). While enrolment of participants has just been completed, follow-ups are still
pending. Final results on the efficacy of this indicated preventive intervention program will be available by fall 2015.
Within the Federal Psychotherapy Research Program (BMBF), our study “Internet-based relapse prevention for
eating disorders after inpatient treatment for bulimia nervosa” as part of the ”Eating Disorders Diagnostic and
Treatment Network (EDNET)” was terminated. The network consisted of four multicenter, randomized controlled
psychotherapy studies and supplementary basic research projects.
P1. Internet-gestützte Nachsorge für Frauen mit schwerwiegender und chronischer Bulimia nervosa (IN@)
Teilprojekt des „Eating Disorder Diagnostic and Treatment Network (EDNET)“; PI: Prof. Corinna Jacobi
Staff: Dipl.-Psych. I. Beintner, Dipl.-Psych. E. Fittig, Dipl.-Psych. K. Möbius; Funding: Bundesministerium für Bildung
und Forschung (BMBF); Duration: 10/05 – 10/13; Cooperations: C. Barr Taylor, Stanford University School of Medicine
Auch nach erfolgreicher Behandlung sind die Rückfallraten bei der Bulimia nervosa (BN) hoch. Ein leicht zugängliches Nachsorgeprogramm könnte dabei helfen, Rückfälle zu reduzieren. Ausgehend von der hohen Akzeptanz und
Wirksamkeit Internet-gestützter Präventionsangebote haben wir ein Internet-gestütztes Nachsorgeprogramm (IN@)
für Frauen mit BN entwickelt, die eine stationäre Behandlung erfolgreich abgeschlossen haben. Die Intervention
dauert 9 Monate und besteht aus 11 Sitzungen mit psychoedukativem Material sowie Selbstbeobachtungs- und
163
verhaltensbezogenen Aufgaben. Teilnehmerinnen werden per Email oder Live-Chat durch eine Psychologische
Psychotherapeutin mit Erfahrung in der Behandlung von Essstörungen angeleitet.
Zwischen Ende 2007 und Februar 2012 wurden 253 Frauen mit BN (DSM-IV) im Anschluss an eine stationäre
Behandlung zufällig der Internet-gestützten Intervention (IN@+TAU) oder einer (TAUonly) zugeteilt. Die Frauen
wurden in 13 psychosomatischen Kliniken in Deutschland rekrutiert und konnten an der Studie teilnehmen, wenn
sie bulimische Kernsymptome im Rahmen der stationären Behandlung um mindestens 50% reduziert hatten.
Die Teilnehmerinnen durchliefen standardisierte Diagnostik vor der Randomisierung, nach Ende der 9-monatigen
Intervention sowie zum anschließenden 9-Monats-Follow-up. Hauptzielkriterium war die Abstinenz von Essanfällen
und kompensatorischen Verhaltensweisen nach Abschluss der Intervention. Sekundäre Zielkriterien waren die
Häufigkeiten von Essanfällen und kompensatorischen Maßnahmen sowie essstörungsbezogene Kognitionen und
Einstellungen. Die Mehrheit der teilnehmenden Frauen (>80%) unterzog sich im Interventionszeitraum irgendeiner
weiteren psychiatrischen oder psychotherapeutischen Behandlung. Zwischen den Studienbedingungen gab es diesbezüglich keine Unterschiede. Die Beteiligung am Nachsorgeprogramm war moderat; 45% der Teilnehmerinnen in
der IN@+TAU Gruppe öffneten mehr als ein Viertel der Programmseiten und nahmen an der Datenerhebung nach
Abschluss der Intervention teil.
Hinsichtlich der Abstinenzraten nach Abschluss der Nachsorge-Intervention und zum Follow-up konnten keine
Unterschiede zwischen den Studienbedingungen nachgewiesen werden. Zum Ende der Intervention und zum
Follow-up war IN@+TAU mit einer geringeren Häufigkeit selbstinduzierten Erbrechens verbunden.
Untersucht wurden außerdem Mediatoren und Moderatoren der Wirksamkeit psychotherapeutischer Behandlung.
Für Patientinnen, die bei Entlassung aus der Klinik noch Restsymptomatik berichten, erhöht IN@+TAU die Wahrscheinlichkeit, bei Abschluss der Nachsorge-Intervention und zum Follow-up noch Abstinenz zu erreichen.
Insgesamt sind die Effekte der Online-Intervention IN@, aber auch der von den Patientinnen in Anspruch genommenen weiteren psychiatrischen oder psychotherapeutischen Behandlungen, wenig Anlass zu Optimismus.
Allerdings handelt es sich hier um eine hinsichtlich der Schwere und Chronizität der Erkrankung mit anderen
Studienergebnissen schlecht vergleichbare Stichprobe. Immerhin scheint die Online-Intervention die Prognose der
Patientinnen zu verbessern, die im Rahmen der stationären Behandlung keine Abstinenz von Essanfällen und kompensatorischen Verhaltensweisen erreichen.
Internet-based Aftercare for Women With Severe and Chronic Bulimia Nervosa (IN@)
Relapse is common in bulimia nervosa. Encouraged by the effectiveness of online eating disorders prevention programs,
we developed a 9-month guided, cognitive-behavioral, online aftercare program (IN@) to improve the maintenance of
treatment gains following inpatient treatment.
253 women with bulimia nervosa recruited from psychosomatic hospitals in Germany were randomized to IN@ in addition to treatment as usual (IN@+TAU) or to TAU only. The primary outcome was abstinence from binge eating and compensatory behaviors in the past 2 months before post-intervention. Secondary outcomes were abstinence at 9-month
follow-up (FU), frequency of binge eating and purging, and changes in eating pathology at post-intervention and FU.
Participation with IN@ was moderate. Most women (>80%) had received psychiatric or psychotherapeutic treatment
during the intervention period, with no differences between IN@+TAU and TAU only. Abstinence rates and frequencies of binge eating did not differ between the groups at post-intervention or FU. IN@+TAU was associated with fewer
vomiting episodes (d = .30) at post-intervention and FU.
Moderators and mediators of treatment effects in psychotherapeutic eating disorder treatments were investigated.
Women who reported residual core BN symptoms at hospital discharge were more likely to achieve abstinence at
post-intervention and follow-up if they had access to IN@.
Overall, effects of the Internet-intervention are moderate and the amount of TAU was large in both groups. However,
given the severity and chronicity of the included sample, results are difficult to compare with results from other trials.
Jacobi C, Beintner I, Fittig E, Möbius K (2014) Internet-gestützte Nachsorge für Frauen mit schwerwiegender und chronischer Bulimia nervosa (IN@). 4. Wissenschaftlicher
Kongress der Deutschen Gesellschaft für Essstörungen; Deutsche Gesellschaft für Essstörungen e.V. (DGESS); Leipzig.
Beintner I, Jacobi C, Fittig E, Möbius K (2013). Internet-based Aftercare (IN@) for Women with Severe and Chronic Bulimia nervosa Following Inpatient Treatment. 2nd Scientific Meeting of the European Society for Research on Internet Interventions (ESRII); Linköping.
Jacobi C, Beintner I, Fittig E, Möbius K (2013). Internet-based Aftercare (IN@) for Women with Severe and Chronic Bulimia nervosa Following Inpatient Treatment. 6th Scientific Meeting of the International Society for Research on Internet Interventions (ISRII); Chicago.
Jacobi C, Beintner I ,Fittig E, Möbius K (2012). Internet-gestützte Nachsorge für Bulimia nervosa (IN@) im Anschluss an stationäre Behandlung: Patientencharakteristika und
Wirksamkeit stationärer Behandlung. 3. Wissenschaftlicher Kongress der Deutschen Gesell-schaft für Essstörungen e.V. (DGESS); Hannover.
Beintner I & Jacobi C (2011). Internetgestützte Nachsorge bei Bulimia nervosa. Psychotherapeut. 56 (6), 516-521.
Beintner I, Fittig E, Jacobi C (2009). IN@ - Internet-gestützte Nachsorge bei Bulimia nervosa. 60. Arbeitstagung des Deutschen Kollegirojektreums für Psychosomatische
Medizin, Mainz.
Beintner I, Jacobi C, Fittig E & Kampisiou C (2007).Internetgestützte Nachsorge bei Bulimia nervosa nach stationärer Behandlung. 1. Jahrestagung der DGESS, Prien.
164
P2. Früherkennung und Frühintervention bei Anorexia nervosa
PI: Prof. Dr. Corinna Jacobi; Staff: Dipl.-Psych. U. Völker, Dipl.-Psych. R. Richter; Funding: Schweizerische Anorexia
Nervosa Stiftung (SANS); Duration: 09/2008 - 05/2014; Cooperations: C. B. Taylor, J. Lock, Megan Jones (Stanford
University School of Medicine)
Hintergrund: Bisherige Untersuchungen zeigen, dass Internet-gestützte präventive Interventionen insbesondere
bei jungen Frauen, die bereits ein erhöhtes Risiko für die Entwicklung einer Essstörung aufweisen, in der Reduktion
bedeutsamer Risikofaktoren wirksam sind. Im Längsschnitt konnte gezeigt werden, dass diese Art der Intervention
auch die Inzidenz für bulimische Essstörungen und Binge-Eating-Störung in Hochrisikogruppen senkt. Es fehlen
allerdings entsprechende Studien für Anorexia nervosa (AN), ebenso fehlen spezifischer auf die Risikofaktoren dieser schwerwiegenden Essstörung zugeschnittene präventive Maßnahmen.
Zielsetzungen: Die wesentlichen Zielsetzungen der geplanten Studie bestehen 1) in der Identifikation psychologischer und biologischer Risikofaktoren und
Korrelate bei jungen Mädchen mit erhöhtem
Risiko der Entwicklung einer AN und 2) der
Entwicklung von Methoden zur Frühintervention
für diese Risikogruppe. Die entwickelte elternbasierte, präventive Online-Intervention soll
zentrale Symptome der AN reduzieren oder normalisieren bzw. die Inzidenzen von vollständig
ausgeprägter oder subklinischer Anorexie zum
Follow-up um 50% senken.
Methode: Mehrstufiges Vorgehen:
1) Screening und Identifikation von
Hochrisikoprobandinnen im Alter von 11-17
Jahren anhand ausgewählter Risikofaktoren
und erster Symptome für AN. 2) Entwicklung
eines 6-wöchigen, familienorientierten Internetgestützten Präventionsprogramms („E@T”)
für Mädchen und junge Frauen mit erhöhtem
Risiko für AN. 3) Randomisierte kontrollierte
Studie zum Vergleich der familienorientierten,
Internet-gestützten Intervention und einer Kontrollgruppe ohne Intervention. Vergleich der Outcome-Maße zum
Post-Zeitpunkt und zum 1-Jahres Follow-up.
Primäre Outcome-Maße: AN-Symptome (Gewichtsnormalisierung, Normalisierung von EDE-Figur- und Gewichtssorgen, EDE-Zügelung des Essverhaltens, Normalisierung körperlicher Aktivität zur Gewichtsreduktion). Sekundäre
Outcome-Maße: Vollständige oder subklinische AN-Diagnosen, EDI-Schlankheitsstreben, EDI-Unzufriedenheit mit
dem Körper, Selbstwertgefühl, Depressivität.
Ergebnisse: Nach Abschluss zweier Pilotstudien und umfangreichen Vorbereitungen begann im Herbst 2010 die
Rekrutierung für die Hauptstudie. Bis Ende 2012 wurden in 86 Mittelschulen und Gymnasien in Dresden und näherem Umland 12.377 Screening-Fragebögen verteilt, von denen N=4.416 zurückliefen, was einer Rücklaufquote
von 35,7 % entspricht. Insgesamt 12% der erreichten Stichprobe (N=475) erfüllten die vorab definierten Risikomerkmale. 65 Familien konnten davon bis zum Studienende randomisiert werden. Am Ende der Intervention (post)
waren noch Daten von 43 Eltern und Kindern, zum 1-Jahres Follow-up von 26 Eltern und Kindern verfügbar (dropout-Raten 55,8% in der Interventions- und 64,5% in der Kontrollgruppe). In Anbetracht der gerade erst abgeschlossenen letzten Follow-up-Untersuchungen können derzeit nur prä-post-Ergebnisse berichtet werden.
Adhärenz und Zufriedenheit: Im Mittel öffneten die Eltern der Interventionsgruppe 28%
der Seiten des Pro-gramms (Median=16%),
öffneten im Mittel 2,7 Sitzungen (Median= 2,0;
Range 0-6) und loggten sich im Mittel 3,4 Mal in
das Programm ein (Median = 3,0; Range: 0-11).
Im Durchschnitt wurde das Programm von den
teilnehmenden Eltern mit der Schulnote „gut“
bewertet (M = 2,20; SD = 0,94; Range: 1-5).
Abbildung: Nutzung des E@T-Programms durch
die Eltern der Interventionsgruppe
165
Prä-post-Ergebnisse: Im Vergleich des Selbstberichts der Mädchen der Interventions- und Kontrollgruppe fand sich
hinsichtlich der Veränderung der Risikomerkmale lediglich ein Trend in Bezug auf exzessives Sporttreiben im Sinne
einer Zunahme des exzessiven Sporttreibens in der Interventionsgruppe und hinsichtlich der Veränderung der
Skalenwerte ein Trend auf der EDI-Skala Bulimie im Sinne einer Verbesserung von Gedanken und Verhaltensweisen
bezogen auf Essanfälle ebenfalls in der Interventionsgruppe (mittlere Effektstärken). Im Elternbericht gab es einen
Ergebnisse:
– per protocol sample signifikanten
Unterschied
in der EDE-Skala
Restraint
zwischen
der Elternbericht
Interventions- und
der Kontollgruppe i.S. einer
Ergebnisse:
Selbstbericht
Mädchen
- per protocol
sample Verbesserung des gezügelten Essens der Töchter der Interventionsgruppe.
# of days past 4 weeks
Exzessiver Sport
EDI-2
Bulimie
d = .54, p= .036
post
mean score
mean score
baseline
EDE Restraint
d = .46, p= .055
d = -.73, p= .084
baseline
E@T
Kontrollgruppe
post
E@T
Kontrollgruppe
baseline
post
Insgesamt weisen die geringe Teilnahmebereitschaft der Eltern und die hohen Drop-out-Raten im Verlauf der
relativ kurzen Intervention sowie der Follow-up-Erhebungen auf eine hohe Verleugnung der Ernsthaftigkeit der
Risikomerkmale der Töchter hin. Zusätzlich scheint es sich bei den Drop-outs bereits zur Baseline eher um stärker
belastete Kinder (hinsichtlich gestörter Einstellungen zu Figur und Gewicht) zu handeln. Die noch vorläufigen präpost-Ergebnisse weisen auf eine leichte Verbesserung ausgewählter Einstellungen zum gestörten Essverhalten hin,
die endgültigen Follow-up-Ergebnisse bleiben noch abzuwarten.
Völker, U., Jacobi, C., Pfütze, H., Lock, J.D., & Taylor, C.B. (2010). Early Detection and Intervention of Anorexia Nervosa: Two Pilot Studies. Poster presented at the 16th
Annual Meeting of the Eating Disorders Research Society (EDRS), Boston(USA).
Völker, U., Jacobi, C., Pfütze, H., Lock, J.D., & Taylor, C.B. (2010). Früherkennung und Prävention von Anorexia nervosa: Zwei Pilotstudien. Poster präsentiert auf dem 28.
Symposium der Fachgruppe Klinische Psychologie und Psychotherapie der Deutschen Gesellschaft für Psychologie (DGPS), Mainz.
Völker, U., Jacobi, C., Jones, M., Lock, J., & Taylor, C.B. (2011). Early Detection and Intervention of Anorexia Nervosa. Vortrag auf der International Conference on Eating Disorders der Academy for Eating Disorders (AED). Miami(USA).
Völker, U., Jacobi, C., Möbius, K., Richter, R., Jones, M., Taylor, C.B., & Lock, J. (2012). Indizierte familienbasierte Prävention von Anorexia nervosa. Vortrag auf dem 3. Wissenschaftlichen Kongress der Deutschen Gesellschaft für Essstörungen (DGESS), Hannover.
Jones, M., Völker, U., Lock, J., Taylor, C.B., & Jacobi, C. (2012). Family-Based Early Intervention for Anorexia Nervosa. European Eating Disorders Review, 20(3), e137-43.
Völker, U., Jacobi, C., Jones, M., Lock, J., & Taylor, C.B. (2013). Potential risk factors and early symptoms of anorexia nervosa: Prevalence in 11-16 year old girls. Advances in
Eating Disorders: Theory, Research and Practice.
Jacobi, C., Völker, U., Möbius, K., Richter, R., Jones, M., Taylor, C.B., & Lock, J. (2013). Early Detection and Intervention of Anorexia Nervosa: Discouraging (?) Results of a Randomized Controlled Efficacy Trial. Vortrag auf dem 2nd European Meeting for the European Society for Research on Internet Interventions (ESRII), Linköping (Sweden).
Völker, U., Jacobi, C., Möbius, K., Richter, R., Jones, M., Taylor, C.B., & Lock, J. (2013). Früherkennung und Prävention von Anorexia nervosa: Entmutigende (?) Ergebnisse
einer Randomisierten Kontrollierten Studie. Vortrag auf dem 4. Wissenschaftlichen Kongress der Deutschen Gesellschaft für Essstörungen e.V.(DGESS), Leipzig.
Early detection and intervention of anorexia nervosa
Background: Previous studies demonstrated the effectiveness of Internet-based preventive interventions in reducing potent risk factors for eating disorders, especially in young women at already higher risk. Few longitudinal
studies have also shown that the incidence of full-syndrome bulimic or binge eating disorders can be reduced in
such high-risk groups. However, studies demonstrating the same effect on syndromes of anorexia nervosa (AN) are
still lacking as are preventive interventions specifically targeting risk factors of this severe eating disorder. Aims:
The aims of this study are 1) to identify psychological and biological risk factors and correlates in adolescent girls at
risk for anorexia nervosa and 2) to develop methods for intervention in this high-risk group. The intervention should
reduce or normalize core symptoms of AN or reduce the incidence of subclinical or full-syndrome AN by 50%
within the follow-up period. Method: Multi-stage procedure: 1) Screening and identification of high-risk subjects
aged 11-17 years on the basis of selected risk factors and/or early symptoms of AN. 2) Development of a familyoriented, 6-week, Internet-based prevention program (“E@T“) for adolescent girls at risk for AN. 3) Randomized
controlled trial comparing the family-oriented, Internet-based intervention with a control group without intervention.
Comparison of outcomes at post-treatment and 1-year follow-up. Primary outcomes are AN symptoms (weight
normalization, normalization of EDE weight and shape concerns, EDE restraint, normalization of driven exercise).
Secondary outcomes are full or partial AN diagnoses, EDI drive for thinness, EDI body dissatisfaction, self-esteem,
166
and depression. Results: After completion of two pilot studies and extensive preparatory work recruitment for the
main study started in fall 2010. 12.377 screening questionnaires were handed out in 86 schools in Dresden and
in surrounding areas up to 12/2011. Of these, 4.416 questionnaires were returned (=35%). Overall, 12% (N=475)
of the children of responding parents fulfilled our predefined risk criteria. Until study termination, 65 families were
randomized to the intervention or the control group. At post-intervention, 43 parents and daughters filled out postassessments, at 1-year follow up, data from 26 parents and daughters were available (drop-out rates 55.8% in
the intervention and 64.5% in the control group). Since the last follow-up assessments have just been completed
recently, currently only pre-post results can be reported. Adherence and acceptance: On average, parents of the
intervention group opened 28% of program pages (median: 16%), 2.7 numbers of sessions (median: 2, range: 0-6)
and logged on to the program 3.4 times on average (median: 3.0; range: 0-11). Overall, the program was evaluated
as “good” on a scale from “1” (very good) to “6” (very poor; M=2.2; SD=0.94; range: 1-5). Pre-post results: There
was a trend on daughters’ self-report of risk criteria regarding driven exercise with a slight increase of driven exercise in the intervention group compared to the control
group. Regarding disturbed eating attitudes and behaviors, daughters reported a significant decrease in attitudes and behaviors related to bulimic episodes (mean
effect sizes). Parents on the other hand, reported a
significant decrease in EDE-Restraint eating with an
improvement of restrained eating for the children of
the intervention group. Generally, the low participation
rate and high drop-out rates during the relatively short
intervention as well as until follow-up assessments
demonstrate the high denial or parents of the seriousness of their daughters’ risk factors. Additionally
worrisome is that daughters of drop-outs are already
more severely disturbed in terms of eating attitudes
and behaviors at baseline. Although the pre-post results
show slight improvements in selected attitudes of
disturbed eating, follow-up results are still pending.
P3. Internet-gestützte Prävention und Frühintervention für junge Frauen mit erhöhtem Risiko der
Entwicklung einer Anorexia nervosa
PI: Prof. Dr. Corinna Jacobi; Staff: Dipl.-Psych. Paula von Bloh, M. Sc. Klin. Psych. Nadine Eiterich; Funding: Else KrönerFresenius-Stiftung; Duration: 11/2012-11/2015; Cooperations: C. B. Taylor (Stanford University School of Medicine)
Hintergrund und Ziele: Im Rahmen der Pilotstudie zum Internet-gestützten Präventionsprogramm „Student
167
Bodies-AN“ konnten Risikofaktoren für Essstörungen sowie spezifische Symptome gestörten Essverhaltens
(restriktives Essverhalten, niedriger BMI) und assoziierte Psychopathologie reduziert werden; die assoziierte
Psychopathologie verbesserte sich deutlich. Die Prä-Post- sowie Prä-Follow-up (FU)-Effektstärken liegen überwiegend im mittleren bis großen Bereich. Weiterhin sind die Ergebnisse zu Akzeptanz und Adhärenz als sehr gut zu
bewerten. Ziel der jetzt laufenden randomisierten kontrollierten Studie ist die Evaluation des Programms für junge
Frauen mit erhöhtem Risiko der Entwicklung einer Anorexia nervosa (AN).
Methode: Innerhalb des RCTs wurden junge Frauen mit erhöhtem Risiko für AN auf zwei verschiedenen Wegen
rekrutiert: 1. Rekrutierung innerhalb von Lehrveranstaltungen verschiedener Bildungseinrichtungen in Deutschland
(Dresden, Halle und Leipzig), 2. Teilnehmerwerbung über den Einbezug öffentlicher Medien (z.B. Poster, Flyer,
Mitgliedermagazine von Krankenkassen). Die Erhebung der Hauptoutcomes erfolgt jeweils vor und nach der
Intervention sowie zum 6- und 12-Monats- FU. Abhängige Variablen sind die Veränderung zentraler essstörungsrelevanter Variablen im Prä-Post- bzw. Prä-FU-Vergleich.
Ergebnisse: 4652 Frauen wurden gescreent, davon erfüllten 864 (18.6 %) die Einschlusskriterien und 166 (1.9 %)
konnten bisher in die Studie aufgenommen werden. Die Rekrutierung konnte im Juli 2014 abgeschlossen werden.
Die FU-Ergebnisse liegen voraussichtlich im Herbst 2015 vor.
Internet-based prevention and early intervention for women at risk for anorexia nervosa
PI: Prof. Dr. Corinna Jacobi
Background and aims: In a pilot study to evaluate the Internet-based prevention program “Student Bodies-AN”
core attitudes and subthreshold symptoms of disordered eating (restrictive eating, low BMI) were significantly reduced between pre- and post-intervention as well as between pre-intervention and 6-month-follow-up (FU) with mostly
medium to large effects. In addition, associated psychopathology improved considerably. Acceptance of and adherence to the program were good. The aim of the current randomized controlled trial is to assess the efficacy of the
program for women at risk for anorexia nervosa.
Method: Participants were recruited through two different recruitment strategies: 1. The study was announced
in seminars and lectures at different institutions of education in Germany (Dresden, Halle, and Leipzig), 2. The
study was announced through different media (e.g., posters, flyers, health insurance membership magazines).
Assessments take place at pre- and post-intervention, and 6- and 12-month-FU. Dependent measures are changes
in core eating disorder-related variables.
Results: 4652 women were screened and 864 (18.6 %) met the inclusion criteria. Of these, 166 (1.9 %) were
enrolled in the randomized controlled trial. The recruitment has been terminated in July 2014. FU-results will be
available by fall 2015.
P4. The Integrated Neurobiology of Food Intake, Addiction, and Stress (NeuroFAST), Arbeitspaket:
“Interrelations between eating disorders and substance use disorders”.
PIs: Prof. Dr. Corinna Jacobi, Prof. Dr. Hans-Ulrich Wittchen; Staff: Dipl.-Psych. Martin Paul; Funding: European
Commission (EC); Duration: 01/2010 - 03/2015; Cooperations: J. Hebebrand (Universität Duisburg-Essen)
Hintergrund: NeuroFAST ist ein multidisziplinäres Projekt, an dem zwölf europäische Forschungseinrichtungen
aus sieben Ländern beteiligt sind. Das Hauptziel besteht darin, die neurobiologischen Grundlagen von Substanzmissbrauch und -abhängigkeit zu erforschen und in diesem Zusammenhang zu prüfen, ob diese Mechanismen
auch beim Essen bestimmter Nahrungsmittel oder bei Personen mit gestörtem Essverhalten eine Rolle spielen.
Der Zusammenhang zwischen gestörtem Essverhalten bzw. Essstörungen und Substanzmissbrauch bzw. -abhängigkeit ist sowohl durch längsschnittliche wie auch querschnittliche (Komorbiditäts-) und Familienstudien dokumentiert: Erhöhter Alkoholkonsum hat sich als Risikofaktor für die Entwicklung von Bulimia nervosa erwiesen,
Substanz- und Essstörungen sind häufige komorbide Störungen und Substanzstörungen treten gehäuft in den
Familien Essgestörter im Vergleich zu gesunden Kontrollgruppen auf. Allerdings weisen insbesondere die bisherigen
Risikofaktorenstudien eine Reihe von ernsthaften Einschränkungen auf. Die Stichproben sind häufig zu klein für die
Identifikation von Risikofaktoren für vollsyndromale Essstörungen und es ist unklar, ob die Risikofaktoren für vollsyndromale Störungen identisch mit denen für subklinische Störungen oder gestörtem Essverhalten sind. Darüber
hinaus bedürfen viele Faktoren einer Replikation und weder die Interaktion zwischen den Faktoren noch deren
Spezifität für Essstörungen haben bislang Berücksichtigung gefunden, da keine anderen Outcomes eingeschlossen
waren. Schließlich sind familiale und genetische Assoziationen und Interaktionen selten untersucht worden. Im
Rahmen von NeuroFAST sollen diese Lücken geschlossen werden.
Ziele: Die übergeordneten Ziele sind die Untersuchung der Zusammenhänge zwischen (i) Essverhalten,
Essstörungen und (ii) Psychopathologie und Substanzstörungen bzw. -missbrauch. Unter Verwendung eines
Kontinuum-Ansatzes wollen wir im Einzelnen
168
1) die altersbezogenen Häufigkeiten eines breiten Spektrums von Essverhaltensweisen (von einzelnen
Symptomen wie Essanfällen, Diäthalten über subklinischen Syndromen bis zu voll ausgebildeten Störungen
und deren Überlappung) untersuchen,
2) die Zusammenhänge zwischen diesen Verhaltensweisen mit Substanzstörungen, Angststörungen und affektiven Störungen untersuchen, und
3) familiengenetische und umweltbezogene Risikofaktoren hinsichtlich ihres Auftretens, zeitlichen Verlaufsmusters
und ihrer Entwicklungspfade, sowie ihrer Interaktionen mit anderen Faktoren (z.B. Stress) untersuchen.
Methode: Die genannten Zusammenhänge werden anhand einer großen, populationsbasierten, prospektiv-longitudinalen Studie mit 4 Erhebungswellen bei Jugendlichen und jungen Erwachsenen überprüft. Die EDSP (Early
Developmental Stages of Psychopathology)-Studie liefert kategoriale und dimensionale Daten über die Inzidenz
von Symptomen und Syndromen von Essstörungen, Substanzstörungen und anderen psychischen Störungen. Die
Stichprobe beinhaltet 3.021 Teilnehmer im Alter von 14-24 Jahren zu Baseline (T0). Die Daten wurden von 19952005 über 10 Jahre erhoben. Es gibt insgesamt 3 Follow-up-Erhebungen (T1, T2, T3), ein Modul zur Erfassung
familiärer Faktoren und eine direkte Befragung der Eltern zu T1 und T3. Die Studie verfügt über ausreichend Power
zur Hypothesentestung und statistischen Modellierung der dimensionalen und kategorialen Zusammenhänge. Die
Zusammenhänge zwischen den kumulativen Inzidenzen von Essstörungen und Substanzstörungen bzw. anderen
psychischen Störungen sollen anhand von Odds Ratios und logistischen Regressionen korrigiert nach Alter und
Geschlecht untersucht werden. Cox Regressionen mit Hazard Ratios werden zur Untersuchung der Unterschiede
in den Risikofaktoren spezifischer anderer psychischer Störungen verwendet. Zur Identifikation von potentiellen
Risikofaktoren und ihrer Interaktionen werden die Methoden von Kraemer et al. (1997; 2002) zugrunde gelegt.
Erste Ergebnisse: Bisher wurden die altersund geschlechtsspezifischen Prävalenzen (12-Monate und Lebenszeit),
sowie die kumulierten Lebenszeitinzidenzen auf Störungsebene zu den verschiedenen Erhebungszeitpunkten ermittelt. In unserer Stichprobe liegt die Wahrscheinlichkeit bis zum Alter von 34 Jahren alkoholabhängig zu werden bei
11% (Nikotinabhängigkeit: 28.5%). Für Essstörungen liegt die Wahrscheinlichkeit mit 4.7% niedriger.
Weiterhin wurden die Zusammenhänge zwischen den einzelnen Störungsbildern beleuchtet. So konnten wir z. B.
herausfinden, dass das Risiko, eine Substanzstörung zu entwickeln, bei essgestörten Patientinnen zwei- bis dreifach
erhöht ist. Vor allem Patientinnen mit einer Bulimie-Diagnose sind häufig davon betroffen.
Die querschnittliche Betrachtung von Komorbiditätsmustern anhand von 12-Monatsprävalenzen ergab unterschiedliche
Ergebnisse für Anorexia Nervosa (AN) und Bulimia Nervosa (BN): Signifikante Zusammenhänge für Substanzstörungen
konnten nur für BN gefunden werden, während depressive Störungen einen solchen Zusammenhang nur mit AN
aufwiesen. Demgegenüber wurden für Angststörungen signifikante Komorbidiäten sowohl mit AN als auch mit
BN gefunden. Die längsschnittliche Betrachtung der Daten ergab bedeutsame Zusammenhänge für AN und BN
mit allen diagnostischen Gruppen der depressiven-, Angst- und Substanzstörungen bezogen auf kumulative
Lebenszeitinzidenzen bis zu einem maximalen Alter von 34 Jahren. Unterschiede zwischen AN und BN konnten weiterhin für das chronologische Auftreten von komorbiden Ess- und Substanzstörungen gefunden werden: Während eine AN-Erkrankung mehrheitlich nach dem Vorliegen einer Substanzstörung einsetzte, ging eine
Erkrankung an BN dem Einsetzen einer Substanzstörung in den meisten Fällen voraus. Weiterhin wurden etwas
größere Stabilitätsraten für AN als für BN sowie für Essstörungen auf klinischem- als auf subklinischem oder symptomatischem Niveau gefunden. Im Bereich der Substanzstörungen wies Nikotinabhängigkeit die größte Stabilität
auf, zudem waren hier Stabilitätsraten für jüngere Studienteilnehmer am größten. Das Risiko, nach Remission einer
Essstörung an Missbrauch oder Abhängigkeit von illegalen Drogen oder einer depressiven Störung zu erkranken war
für Personen mit initialer Essstörungsdiagnose im Vergleich zu Personen ohne Essstörung signifikant erhöht. Unter
Personen mit remittierter Substanzstörung konnte kein erhöhtes Risiko für eine inzidente Essstörung gefunden
werden, allerdings wiesen Personen mit initialer Nikotinabhängigkeit ein erhöhtes Risiko für inzidente depressive
Störungen sowie Personen mit irgendeiner remittierten Substanzstörung ein erhöhtes Risiko für die Entwicklung
einer Angststörung auf.
Ausblick: Im weiteren Verlauf des Projekts sollen potenzielle gemeinsame und spezifische Risikofaktoren für Essund Substanzstörungen identifiziert werden. Im Rahmen einer Kooperation mit dem Universitätsklinikum DuisburgEssen werden deren Befunde zu gestörtem Essverhalten und Substanzmissbrauch bei kinder- und jugendpsychiatrischen Patienten mit denen unserer repräsentativen, populationsbasierten Studie verglichen.
The Integrated Neurobiology of Food Intake, Addiction, and Stress (NeuroFAST), work package:
“Interrelations between eating disorders and substance use disorders”.
Background: NeuroFAST is a multidisciplinary EC-founded project with twelve participating research institutes from
seven countries. The major aim is to explore basic neurobiological mechanisms of substance abuse and addiction
and to examine whether these mechanisms are involved while consuming certain food (e.g. chocolate) and thereby in people with disordered eating behavior. The association between disordered eating/eating disorders and
169
substance abuse/substance abuse disorders is supported by longitudinal, cross-sectional (comorbidity) and family
history studies: Alcohol use has been shown to be a risk factor for the development of bulimia nervosa, substance
use disorders and eating disorders are often comorbid, and families of patients with eating disorders have shown to
have higher rates of substance abuse than normal controls.
Previous studies of risk factors for eating disorders do however have serious limitations, i.e., they were too small
for meaningful risk factor detection of full-syndrome clinical disorders, and it is not clear whether the risk factors for
full syndromes are the same as for partial/subclinical syndromes and for dysfunctional eating behavior. Many risk
factors were only found in one study, replication studies are lacking, interactions between risk factors over time
to onset of the disorder have hardly been considered, and the specificity of many factors has not been addressed,
because the studies did not include outcomes other than eating disorders. Finally, familial and genetic associations
and interactions with other factors have seldom been considered. In NeuroFAST, we will rectify these omissions.
Aims: The overall aims of this substudy are to examine the relationships between (i) eating, and a broad range of
eating disorders and (ii) psychopathology and substance use and substance use disorders. Using a comprehensive
continuum approach, we will:
1) provide evidence about the age-related frequency of a wide range of eating behaviour dysfunctions, from
single symptoms (bingeing) and phenomena (diets) to syndromes of subthreshold and full-syndrome eating
disorders and their overlap.
2) examine the association of these with substance use disorders, anxiety and mood disorders.
3) model family genetic and environmental risk factors for their occurrence, temporal patterns and trajectories, to
better understand their development and interactions with each other as well as with other (e.g. stress) factors.
Method: We will test this interrelationship in a large population-based prospective-longitudinal (4 waves) study of
adolescents and young adults. The EDSP (Early Developmental Stages of Psychopathology) study provides categorical and dimensional data on incident symptoms and syndromes of eating disorders, incident substance use
and disorders and other mental disorders. The sample includes 3,021 participants aged 14 to 24 years at baseline
(T0). Data were collected up to 10 years from 1995 to 2005. The study includes 3 follow-up surveys (T1, T2, T3),
a family history component (T1, T2, T3), and direct information from parents assessed at T1 and T3. The study
is well powered for testing hypotheses and statistical modelling of associations dimensionally (full data set) and
categorically (diagnostic cohorts). Associations between the cumulative incidences of either eating- or substance
use disorders with other mental disorders will be assessed by odds ratios from logistic regressions while adjusting
for sex and age. Cox regressions with hazard ratios will be used to assess differences in the risk of specific other
mental disorders between those with and without eating disorders, and between those with and without substance
use disorders. The model for the identification of potential risk factors and their interactions follows methodological and statistical recommendations by Kraemer et al. (1997; 2002). First results: So far, age and gender specific
prevalence rates (12 months and lifetime) as well as cumulated lifetime incidences on the categorical level were
calculated for all points of measurement. The probability to be diagnosed with alcohol dependence up to the age of
34 was about 11% (nicotine dependence: 28.5%). The probability for any eating disorders was clearly lower (4.7%).
We also found a two- to threefold risk for developing a substance use disorder in patients with eating disorders.
The association is especially strong for bulimia nervosa. Considering cross-sectional 12-month associations, different comorbidity patterns were found for anorexia nervosa (AN) and bulimia nervosa (BN). Significant associations
were only found between substance use disorders (SUDs) and BN and depressive disorders and AN. Anxiety disorders, however, were associated with both AN and BN. In longitudinal analyses, a different profile emerged: AN and
BN both were significantly associated with the diagnostic groups of substance use disorders, depressive disorders
and anxiety disorders based on cumulative lifetime incidence up to the age of 34 years. With regard to the temporal
associations between eating disorders (EDs) and SUDs, we also found different patterns for AN and BN: Whereas
AN most frequently had its onset following an SUD based on lifetime comorbidity, BN most likely occurred before
an SUD. The examination of stability rates for EDs revealed that AN tended to show slightly higher stability than
BN and that the stability of threshold EDs was greater than the stability of subthreshold or symptomatic forms of
EDs. For SUDs, stability rates were highest for nicotine dependence; higher rates were also obtained for younger
participants in our sample and full recovery from an SUD also occurred more frequently in older participants with an
initial SUD. Examining syndrome shifts between EDs and SUDs and from EDs and SUDs to other diagnoses after
the remission of the initial disorder, we observed an elevated risk for incident dependence or abuse of illicit drugs
other than cannabis and for incident depressive disorders in individuals diagnosed with some form of an ED at baseline compared to participants without an ED. Whereas no increased risk for incident EDs was found for participants
with an SUD at baseline, elevated risks were found for incident anxiety disorders within all subtypes of SUD and for
incident depressive disorders within individuals with nicotine dependence at baseline. Outlook: Over the course of the
study, a main aim is to identify potential shared and specific risk factors. In cooperation with the University Hospital
Duisburg-Essen (Child and Adolescent Psychiatry) data of patients with eating disorders and substance use disorders
will be compared with the results from our representative, community based study.
170
AG 9 CLINICAL RESEARCH
J. HOYER & K. BEESDO-BAUM
AG 9 Clinical Research
Prof. Dr. Jürgen Hoyer & Prof. Dr. Katja Beesdo-Baum
Die klinische, patientennahe Forschung am Institut für Klinische Psychologie und Psychotherapie zielt auf die
Entwicklung und Validierung klinisch-diagnostischer Instrumente auf allen Ebenen des Verhaltens ab, beinhaltet
Studien zur klinisch-psychologischen Grundlagenforschung einschließlich der Methoden der experimentellen
Psychopathologie, bildgebender Verfahren, psychophysiologischer und biopsychologischer Verfahren und entwickelt und überprüft neue psychotherapeutische Anwendungs- und Settingvarianten sowohl im Rahmen randomisiert-kontrollierter wie auch naturalistischer Psychotherapiestudien. Die Frage nach der Objektivierung der wesentlichen Wirkmechanismen psychotherapeutischer Interventionen und nach der bestmöglichen Passung für den
individuellen Patienten steht dabei im Vordergrund der Forschungsbemühungen.
Das Institut für Klinische Psychologie und Psychotherapie zählt seit etlichen Jahren auch durch die Gründung und
die Vernetzung mit bundes- und europaweiten Forschungsverbünden zu den forschungsstärksten klinisch-psychologischen Einrichtungen nicht nur in Deutschland. Wichtige Schwerpunkte sind dabei insbesondere Angststörungen
und affektive Störungen, aber auch Essstörungen und Substanzstörungen. Studien zu den Themen- oder
Methodenbereichen diagnostische Verfahren, Neuroimaging, Essstörungen und Substanzstörungen werden nicht in
diesem Kapitel, sondern in anderen Abschnitten dieses Berichts dargestellt.
Projektübersicht
PI
P1 Hans-Ulrich Wittchen
P2 Hans-Ulrich Wittchen
P3 Hans-Ulrich Wittchen/
Franziska Einsle P4 Jürgen Hoyer
P5 Jürgen Hoyer
P6 Jürgen Hoyer
P7 Jürgen Hoyer/
Clemens Kirschbaum
P8 Jürgen Hoyer
P9 Samia Härtling
P10 Katja Beesdo-Baum
P11 Katja Beesdo-Baum
P12 Tobias Stalder/
Susann Schmiedgen P13 Jürgen Hoyer
P14 Jürgen Hoyer/
Nadine Furka P15 Andrew Gloster/
Jürgen Hoyer
P16 Samia Härtling/ Franziska Einsle
P17 Jürgen Hoyer/
Sara Jahnke P18 Jürgen Hoyer/
MIKADO network a Including sub-projects
Project title
PROTECT-AD: Providing Tools for Effective Care and
Research network
Treatment of Anxiety Disorders (AD): Outcomes,
Mediators and Moderators of Enhanced Extinction Learninga
PANIC-NETa
Research network
Partnership communication and therapist-patient Open trial
communication in panic disorder with agoraphobia
Short-term psychodynamic psychotherapy (STPP) and
Research network
cognitive-behavioral therapy (CBT) in social phobia – a randomized controlled multicenter study
Patient characteristics predicting attrition and outcome in Research network
CBT for social phobia: Results from a large multicenter trial Transfer of manualized CBT for social phobia into clinical Implementation study
practice (SOPHOPRAX)
RCT
Dissociative symptoms in social phobia during a RCT stressful social performance situation
Task Concentration Training vs. Cognitive Behavioral Therapy: RCT A randomized controlled trial for social anxiety disorder with fear of blushing
GAD-Ambulanz
Open trial
The Role of Pre-treatment Depression for Psychotherapy RCT Outcome in Generalized Anxiety Disorder
Steroid-Hormonlevel im Haar bei Posttraumatischer Open trial
Belastungsstörung: Untersuchung langfristiger endokriner Veränderungen im Therapieverlauf
Behavioral activation for depression in groups
Open trial
Gruppentherapie zur Verhaltensaktivierung bei Depressionen - Open trial
Konzeption einer therapie-unterstützenden App
Everyday experiences and mood changes
Observational clinical study
Risiken und Nebenwirkungen von Psychotherapie
Effectiveness study
Sexual abuse of children and adolescents: Aetiology, dunkelfeld research and the consequences for victimsa
Social anxiety and loneliness in social and sexual online communication with strangers – an international study
Research network
Internet study
171
P1. PROTECT-AD
For this project description see section AG 11.
P2. PANICNET: Improving the Treatment of Panic Disorder with Agoraphobia: A Multicenter Randomized
Controlled Therapy Study to Facilitate Understanding of the Mechanisms of Action in Exposure Therapy
PI: Prof. Dr. Hans-Ulrich Wittchen, Dr. Andrew Gloster, Prof. Dr. Franziska Einsle, Prof. Dr. Katja Beesdo-Baum
Staff: Christine Fröhlich, Dorte Westphal, Simone Heinze, Michael Höfler, Christina Hauke, Irina Lydmirskya,
Cornelia Wolf, Angela Emmrich, Josephine Tesch, Katrin Hummel, Christiane Kämpfe
Duration 2nd Funding phase: 10/09 – 03/13
Cognitive behavioral therapy (CBT) is efficacious for panic disorder with agoraphobia (PD/A). Nevertheless, the
active ingredients of treatment and the mechanisms through which CBT achieves its effects remain largely unknown. The mechanisms of action in CBT (MAC) study was established to investigate these questions in 369 patients diagnosed with PD/A. The MAC study utilized a multi-center, randomized controlled design, with two active
treatment conditions in which the administration of exposure was varied, and a wait-list control group. The special
feature of MAC is the way in which imbedded experimental, psychophysiological, and neurobiological paradigms
were included to elucidate therapeutic and psychopathological processes. This paper describes the aims and goals
of the MAC study and the methods utilized to achieve them. All aspects of the research design (e.g., assessments,
treatment, experimental procedures) were implemented so as to facilitate the detection of active therapeutic components, and the mediators and moderators of therapeutic change. To this end, clinical, behavioral, physiological,
experimental, and genetic data were collected.
Panic-net PUBLICATIONS 07/2012-10/2014
Cammin, S., Helbig-Lang, S., Lang, T., Fehm, L., Gloster, A. T., Wittchen, H.-U., Gerlach, A. L., Stroehle, A., Deckert, J., Kircher, T., Hamm, A. O., Alpers, G. W., & Arolt, V.
(2013). Specificity of homework compliance effects on treatment outcome in CBT: Evidence from a controlled trial on panic disorder and agoraphobia. J Clin Psychol,
69(6), 616-629.
Emmrich, A., Beesdo-Baum, K., Gloster, A. T., Knappe, S., Höfler, M., Arolt, V., Deckert, J., Gerlach, A. L., Hamm, A. O., Kircher, T., Lang, T., Richter, J., Ströhle, A., Zwanzger, P., & Wittchen, H.-U. (2012). Depression does not affect the treatment outcome of CBT for panic and agoraphobia: results from a multicenter randomized trial. Psychother Psychosom, 81(3), 161-172.
Gloster, A. T., Hauke, C., Höfler, M., Einsle, F., Fydrich, T., Hamm, A. O., Ströhle, A., & Wittchen, H.-U. (2013). Long-term stability of cognitive behavioral therapy effects for
panic disorder with agoraphobia: A two-year follow-up study. Behaviour Research and Therapy.
Gloster, A. T., Klotsche, J., Gerlach, A., Hamm, A., Ströhle, A., Gauggel, S., Kircher, T., Alpers, G. W., Deckert, J., & Wittchen, H. U. (2013). Timing matters: Change Depends
on the Stage of Treatment in Cognitive Behavioral Therapy for Panic Disorder With Agoraphobia. J Consult Clin Psychol, 82, 141-153.
Gloster, A. T., Wittchen, H.-U., Einsle, F., Höfler, M., Lang, T., Helbig-Lang, S., Fydrich, T., Fehm, L., Hamm, A. O., Richter, J., Alpers, G. W., Gerlach, G., Ströhle, A., Kircher,
T., Deckert, J., Zwanzger, P. & Arolt, V. (2009). Mechanism of Action in CBT (MAC): Methods of a Multi-Center Randomized Controlled Trial in 369 Patients with Panic
Disorder and Agoraphobia European Archives of Psychiatry and Clinical Neuroscience, 259(Suppl 2), 155-166.
Hauke, C., Gloster, A. T., Gerlach, A. L., Richter, J., Kircher, T., Fehm, L., Stoy, M., Lang, T., Klotsche, J., Einsle, F., Deckert, J., & Wittchen, H.-U. (2014). Standardized Treatment Manuals: Does Adherence matter? Sensoria: A Journal of Mind, Brain & Culture.
Helbig-Lang, S., Lang, T., Petermann, F., & Hoyer, J. (2012). Anticipatory anxiety as a function of panic attacks and panic-related self-efficacy: An ambulatory assessment
study in panic disorder. Behav Cogn Psychother, 40(5), 590-604.
Hoyer, J., & Gloster, A. T. (2013). Psychologische Flexibilität messen: Der Fragebogen zu Akzeptanz und Handeln Verhaltenstherapie, 23(1), 42-44.
Kämpfe, C., Gloster, A. T., Wittchen, H.-U., Helbig-Lang, S., Lang, T., Gerlach, A. L., Richter, J., Alpers, G. W., Fehm, L., Kircher, T., Hamm, A. O., Ströhle, A., & Deckert, J.
(2012). Experiential avoidance and anxiety sensitivity in patients with panic disorder and agoraphobia: Do both constructs measure the same? Int J Clin Health Psychol,
12(1), 5-22.
Kircher, T., Arolt, V., Jansen, A., Pyka, M., Reinhardt, I., Kellermann, T., Konrad, C., Lueken, U., Gloster, A. T., Gerlach, A. L., Ströhle, A., Wittmann, A., Pfleiderer, B., Wittchen, H.-U., & Straube, B. (2013). Effect of cognitive-behavioral therapy on neural correlates of fear conditioning in panic disorder. Biol Psychiatry, 73(1), 93-101.
Lang, T., Helbig-Lang, S., Gloster, A., Richter, J., Hamm, A. O., Fehm, L., Fydrich, T., Gerlach, A. L., Ströhle, A., Alpers, G. W., Gauggel, S., Kircher, T., Deckert, J., Höfler,
M., Arolt, V., & Wittchen, H.-U. (2012). Effekte therapeutenbegleiteter vs. patientengeleiteter Expositionsdurchführung bei Panikstörung und Agoraphobie. Zeitschrift für
Klinische Psychologie und Psychotherapie 41(2), 114-124.
Lueken, U., Hilbert, K., Stolyar, V., Maslowski, N. I., Beesdo-Baum, K., & Wittchen, H.-U. (2013). Neural substrates of defensive reactivity in two subtypes of specific phobia.
Social Cognitive & Affective Neuroscience.
Lueken, U., Straube, B., Jansen, A., Maslowski, N. I., Ströhle, A., Wittmann, A., Pfleiderer, B., Uhlmann, C., Reif, A., & Kircher, T. (2012). Neural correlates of fear conditioning in panic disorder with agoraphobia. Eur Neuropsychopharmacol, 22(Suppl. 2), 367.
Lueken, U., Straube, B., Konrad, C., Wittchen, H.-U., Ströhle, A., Wittmann, A., Pfleiderer, B., Uhlmann, C., Arolt, V., Jansen, A., & Kircher, T. (2013). Neural substrates of
treatment response to cognitive-behavioral therapy in panic disorder with agoraphobia. Am J Psychiatry.
Lueken, U., Straube, B., Maslowski, N. I., Wittchen, H.-U., Ströhle, A., Wittmann, A., Pfleiderer, B., Konrad, C., Uhlmann, C., & Kircher, T. (2012). What happens in the brain
after successful vs. non-successful CBT treatment? A multicenter fMRI study on panic disorder with agoraphobia (abstract/poster). Eur Neuropsychopharmacol, 22(Suppl.
2), 366-367.
Lueken*, U., Straube*, B., Reinhardt, I., Maslowski, N. I., Wittchen, H.-U., Ströhle, A., Pfleiderer, B., Konrad, C., Ewert, A., Uhlmann, C., Arolt, V., Jansen, A., Kircher, T., &
*shared first authorship. (2013). Altered top-down and bottom-up processing of fear conditioning in panic disorder with agoraphobia. Psychol Med, pp 1-14.
Quast, C., Reif, A., Brückl, T., Pfister, H., Weber, H., Mattheisen, M., Cichon, S., Lang, T., Hamm, A., Fehm, L., Ströhle, A., Arolt, V., Domschke, K., Kircher, T., Wittchen,
H.-U., Pauli, P., Gerlach, A. L., Alpers, G. W., Deckert, J., Rupprecht, R., Binder, E. B., & Erhardt, A. (2014). Gender - specific association of variants in the AKR1C1 gene
with dimensional anxiety in patients with panic disorder: Additional evidence for the importance of neurosteroids in anxiety? . Depression and Anxiety.
172
Reif, A., Richter, J., Straube, B., Höfler, M., Lueken, U., Gloster, A. T., Weber, H., Domschke, K., Fehm, L., Ströhle, A., Jansen, A., Gerlach, A. L., Pyka, M., Reinhardt, I., Konrad, C., Wittmann, A., Pfleiderer, B., Alpers, G. W., Pauli, P., Lang, T., Arolt, V., Wittchen, H.-U., Hamm, A. O., Kircher, T., & Deckert, J. (2013). MAOA and mechanisms
of panic disorder revisited: From bench to molecular psychotherapy. Mol Psychiatry.
Richter, J., Hamm, A. O., Pane-Farre, C. A., Gerlach, A. L., Gloster, A. T., Wittchen, H.-U., Lang, T., Alpers, G. W., Helbig-Lang, S., Deckert, J., Fydrich, T., Fehm, L., Ströhle,
A., Kircher, T., & Arolt, V. (2012). Dynamics of defensive reactivity in patients with panic disorder and agoraphobia: Implications for the etiology of panic disorder. Biol
Psychiatry, 72(6), 512-520.
Weber, H., Scholz, C. J., Domschke, K., Baumann, C., Klauke, B., Jacob, C. P., Maier, W., Fritze, J., Bandelow, B., Zwanzger, P. M., Lang, T., Fehm, L., Ströhle, A., Hamm, A.
O., Gerlach, A. L., Alpers, G. W., Kircher, T., Wittchen, H.-U., Arolt, V., Pauli, P., Deckert, J., & Reif, A. (2012). Gender differences in associations of glutamate decarboxylase 1 gene (GAD1) variants with panic disorder. PLoS One, 7(5), e37651.
Wittmann, A., Schlagenhauf, F., Guhn, A., Lueken, U., Gaehlsdorf, C., Stoy, M., Bermpohl, F., Fydrich, T., Pfleiderer, B., Bruhn, H., Gerlach, A. L., Kircher, T., Straube, B., Wittchen, H.-U., Arolt, V., Heinz, A., & Ströhle, A. (2014). Anticipating agoraphobic situations: The neural correlates of panic disorder with agoraphobia. Psychological Medicine.
Panic-Net Subprojects
P2.1. The long-term (24 months) follow-up course and outcome of PD/AG treated with CBT: Long-term
effects, stability, failures and insufficient response
PI: Dr. Andrew Gloster; Staff: Dr. Michael Höfler, Dipl.-Psych. Christina Hauke, Dipl.-Psych. Simone Heinze, Dipl.Psych. Irina Lyudmirskaya, Dipl.-Psych. Cornelia Wolf & Dipl.-Psych. Christiane Kämpfe
Objective: Cognitive-behavioral therapy (CBT) aims to help patients establish new behaviors that will be maintained
and adapted to the demands of new situations. The long-term outcomes are therefore crucial in testing the durability of CBT.
Method: A two-year follow-up assessment was undertaken on a subsample of n = 146 PD/AG patients from a multicenter randomized controlled trial. Treatment consisted of two variations of CBT: exposure in situ in the presence
of the therapist (T+) or on their own following therapist preparation (T-). Results: Both variations of CBT had high
response rates and, overall, maintained the level of symptomatology observed at post-treatment with high levels
of clinical significance. Effect sizes 24 months following treatment were somewhat lower than at the 6-month
follow up. Once patients reached responder status, they generally tended to remain responders at subsequent
assessments. Differences were observed for patients that obtained additional treatment during the follow-up period. Expert opinion and subjective appraisal of treatment outcome differed. No robust baseline predictors of 2-year
outcome were observed. Conclusion: Most patients maintain clinically meaningful changes two years following
treatment across multiple outcome measures. Approximately 1/3 of patients continued to experience meaningful
residual problems.
Gloster, A. T., Hauke, C., Hofler, M., Einsle, F., Fydrich, T., Hamm, A., Sthrohle, A., & Wittchen, H.-U. (2013). Long-term stability of cognitive behavioral therapy effects for
panic disorder with agoraphobia: A two-year follow-up study. Behaviour research and therapy, 51(12), 830-839.
P2.2. What to do when treatment fails: Acceptance and Commitment Therapy (ACT)
PI: Dr. Andrew Gloster; Staff: Dr. Michael Höfler, Dipl.-Psych. Christina Hauke, Dipl.-Psych. Simone Heinze, Dipl.Psych. Irina Lyudmirskaya, Dipl.-Psych. Cornelia Wolf & Dipl.-Psych. Christiane Kämpfe
Patients with no or only partial response, with relapse following treatment, and those who drop out of treatment
(typically considered treatment failures) is drastically under-studied (Pollack et al., 2008). It is of obvious importance
to not only understand the reasons for treatment failures, but also to study possible solutions. Furthermore, the failure to offer help and interventions to those patients identified as obvious treatment failures raises ethical concerns.
Treatment refusal was of particular concern in the original trial and in exposure treatments in general. Typically, heuristics of questionable scientific value are applied that focus on ideographic factors believed to be of particular relevance for a given patient. In light of the intense dose administered in the first funding phase, it is unlikely that more
of the same techniques will improve outcomes. Nevertheless, the overall success rate of exposure-based therapy
suggests that additional interventions should be based in learning theory. Recent theoretical models have focused
on the exploration of how to generate non-threat related associations in patients that enhance inhibitory regulation
of fear, panic and agoraphobic avoidance. In this context, Acceptance and Commitment Therapy (ACT), a variation
of CBT, is a logical choice in that the therapy also promotes exposure, but under a very different context.
Therefore, this subproject: 1) developed a modified ACT treatment manual adapted to the needs of patients with
PD/AG that failed to adequately benefit from a previous CBT intervention; 2) determined the malleability of patients
that failed to respond to CBT by using an additional ACT intervention. This information was then used to implement
a randomized controlled trial for these patients. In addition to patients from the original study, patients who met criteria for adequate prior treatment were recruited. To date, n = 41 patients have been enrolled in the study.
Data derived from this study will be used to a) determine the effect of the add-on ACT intervention by comparing the
173
primary and secondary outcomes to patients not receiving this additional intervention; and b) explore characteristics of
patients that profiting from this add-on intervention and compare them to those that responded to the CBT intervention. Preliminary evidence from studies on psychological flexibility and experiential avoidance, both central concepts in
ACT, lend support to the importance of this approach to helping these patients, as evidenced in the following articles.
Gloster AT, Hummel KV, Lyudmirskaya I, Hauke T, Sonntag R F (in press) Aspects of Exposure Therapy in Acceptance and Commitment Therapy. In P. Neudeck & H.-U.
Wittchen (Eds.). Exposure Therapy: Rethinking the Model - Refining the Method. Berlin: Springer.
Kaempfe, C., Gloster, A., Wittchen, H.-U., Helbig-Lang, S., Lang, T., Gerlach, A. L., Richter, J., Alpers, G. W., Fehm, L., Kircher, T., Hamm, A. O., Ströhle, A., & Deckert, J.
(2012). Experiential avoidance and anxiety sensitivity in patients with panic disorder and agoraphobia: Do both constructs measure the same? International Journal of
Clinical and Health Psychology, 12(1), 5-22.
P2.3. The influence of physical activity (before in-vivo exposure) upon behavioral therapy success for panic
disorder and agoraphobia
Pl: Prof. Ströhle (Charitè Berlin); Prof. Wittchen; Staff: Dr. Franziska Einsle; Dipl.-Psych. Christine Fröhlich; Dipl.Psych. Gesine Wieder; Dipl.-Psych. Dorte Westphal; Dr. Andrew Gloster
Background & Aims: Exposure therapy is the treatment of choice for panic disorder and agoraphobia.
Nevertheless, there is still the need for improvements in this generally well-received therapy method. Therefore,
additional therapeutic procedures improving clinical effectiveness are needed. One of those is physical endurance
training.
Having shown the clinical effectiveness of endurance training in panic disorder (Broocks et al., 1998), it remains
an open question whether physical exercise can further reduce panic symptoms above the effects of exposure
treatment, and which mechanisms of action are involved thereby. The change of the brain-derived neurotophic
factor (BDNF), associated with exercise, may be an important process. BDNF has been associated with fear conditioning, depression, anxiety and the impact of antidepressants (Liu et al. 2004; Martinowich et al., 2007; Groves,
2007; Duman and Monteggia 2006; Sen et al. 2008). In a study of Ströhle et al. (2010), 30 minutes of endurance
activity (70% VO2max) in patients with panic disorder led to a clear increase and therefore almost a normalization
of severely reduced BDNF concentrations. Furthermore, cognitive processes (Lautenschlager et al., 2008) are also
possible mechanisms of action. Method: 54 patients (of whom 30 are from Dresden) with panic disorder and agoraphobia will be treated with a therapy manual evaluated in the context of the MAC study (Gloster et al., 2011;
Lang et al., 2011). For physical activation, 27 patients of the test group conduct an additional 30-minute endurance
training (70% VO2max, treadmill) directly before in-vivo exposure, whereas the other 27 patients of the control
group conduct the training with 30% VO2max. Before and after the training blood samples are taken in both groups
to determine BDNF and patients were asked about their thoughts during the training. Therapy success is measured
with different diagnostic anxiety symptoms questionnaires which were administered before, during, and after therapy, as well as at follow-up. As reference group, the 301 already treated patients of the MAC study of the first
funding period are used.
174
P2.4. The effect of type, severity and combinations of comorbid conditions on treatment outcome and process
Pl: Prof. Dr. Katja Beesdo-Baum; Staff: Dipl.-Psych. Angela Emmrich, Dr. Franziska Einsle; Dipl.-Psych. Gesine
Wieder; Dr. Andrew Gloster, Dipl.-Psych. Josephine Tesch
P2.4.1. Depression Does Not Affect the Treatment Outcome of CBT for Panic and Agoraphobia: Results from
a Multicenter Randomized Trial
Background: Controversy surrounds the questions whether co-occurring depression has negative effects on
cognitivebehavioral therapy (CBT) outcomes in patients with panic disorder (PD) and agoraphobia (AG) and whether
treatment for PD and AG (PD/AG) also reduces depressive symptomatology. Methods: Post-hoc analyses of randomized clinical trial data of 369 outpatients with primary PD/AG (DSM-IV-TR criteria) treated with a 12-session
manualized CBT (n = 301) and a waitlist control group (n = 68). Patients with comorbid depression (DSM-IV-TR
major depression, dysthymia, or both: 43.2% CBT, 42.7% controls) were compared to patients without depression regarding anxiety and depression outcomes (Clinical Global Impression Scale [CGI], Hamilton Anxiety Rating
Scale [HAM-A], number of panic attacks, Mobility Inventory [MI], Panic and Agoraphobia Scale, Beck Depression
Inventory) at post-treatment and follow-up (categorical). Further, the role of severity of depressive symptoms on
anxiety/ depression outcome measures was examined (dimensional).
Results: Comorbid depression did not have a significant overall effect on anxiety outcomes at post-treatment
and follow-up, except for slightly diminished post-treatment effect sizes for clinician-rated CGI (p = 0.03) and
HAM-A (p =0.008) when adjusting for baseline anxiety severity. In the dimensional model, higher baseline depression scores were associated with lower effect sizes at post-treatment (except for MI), but not at follow-up (except for
HAM-A). Depressive symptoms improved irrespective of the presence of depression. Conclusions: Exposure-based
CBT for primary PD/AG effectively reduces anxiety and depressive symptoms, irrespective of comorbid depression
or depressive symptomatology.
Emmrich, A., Beesdo-Baum, K., Gloster, A. T., Knappe, S., Hofler, M., Arolt, V., Deckert, J., Gerlach, A. L., Hamm, A., Kircher, T., Lang, T., Richter, J., Strohle, A., Zwanzger,
P., & Wittchen, H. U. (2012). Depression Does Not Affect the Treatment Outcome of CBT for Panic and Agoraphobia: Results from a Multicenter Randomized Trial. Psychotherapy and Psychosomatics, 81(3), 161-172.
P2.4.21 Associations of post-treatment depression with long-term outcome in CBT-treated patients with primary panic disorder and agoraphobia
Introduction: Treatment effects of cognitive behavioral therapy (CBT) for panic disorder with agoraphobia (PD/
AG) are maintained over the long-term in most but not all patients. This paper examines whether post-treatment
depression contributes to adverse long-term outcome in CBT-treated patients with primary PD/AG. Methods: N
= 102 PD/AG patients with (n = 23) and without (n = 79) depressive disorders at 6-month follow-up (FU-6) were
re-assessed 24 months (FU-24) after having completed a standardized CBT for PD/AG and two booster sessions
prior to FU-6. Regression analyses examined whether depression diagnoses (DSM-IV-TR major depression and/
or dysthymia) and dimensional depressive symptomatology (Beck Depression Inventory, BDI-II) assessed at FU-6
predict change in panic/anxiety measures
(Hamilton Anxiety Scale [HAMA], Clinical
Global Impression Scale [CGI], number of
panic attacks, Mobility Inventory [MI], Panic
and Agoraphobia Scale) between FU-6 and
FU-24. Results: Depression diagnosis at
FU-6 was not associated with changes
in outcome measures between FU-6 and
FU-24. Self-reported depressive symptoms
(BDI-II) at FU-6 were associated with signiFigure 2. Percentage of patients who were categorized as non-responders at FU-24. Odds Ratios
(OR) are reported (with 95% CI in parentheses)
for the association of FU-6 depression diagnosis
with non-response status at FU-24 (adjusted for
the FU-6 value of the respective anxiety outcome
and for MI-Unaccompanied and age at FU-6).
175
ficant worsening between FU-6 and FU-24 on clinician-rated measures (HAMA, CGI) in the total group and the nondepressed subgroup. In the depressed subgroup, depressive symptoms were associated with worsening in CGI
and increase in avoidance behavior (MI).
Limitations: Small sample size of patients with FU-6 depression to detect effects of depression diagnoses on longterm panic/anxiety outcome. Conclusions: Depressive disorders have no malignant effect on long-term outcome of
CBT for PD/AG. Residual depressive symptoms, however, should be carefully monitored since they could have an
adverse impact on the severity of panic symptoms and might promote re-emerging avoidance behavior.
Tesch, J., Wittchen, H.-U., Emmrich, A., Lueken, U., Einsle, F., Hoefler, M., Hamm, A., Fydrich, T., Ströhle, A., Gloste, A. T., & Beesdo-Baum, K. (submitted). Associations of
post-treatment depression with long-term outcome in CBT-treated patients with primary panic disorder and agoraphobia. Journal of Affective Disorders.
P2.4.3. Smoking does not adversely affect Outcome of Exposure Therapy in Panic Disorder and Agoraphobia
Background: Smoking is more prevalent among patients with panic disorder and agoraphobia (PD/AG) than in the
general population. We examined whether smoking and nicotine dependence (ND) affects therapy outcome in PD/
AG patients treated with an exposure-based cognitive behavioural therapy (CBT) and vice versa CBT effects on
smoking and ND.
Methods: Post-hoc analyses of baseline, post and 6-months follow-up data from a multi-centre randomised, controlled clinical trial with primary PD/AG patients treated with 12-session manualized CBT (n=301) were conducted.
In this sample, smoking-status was divided into up-to-baseline never-smokers (n=85), non-ND-smokers (n=68),
ND-smokers (n=83) and former-smokers (n=65). Results: PD/AG patients with ND had more severe psychological
symptoms before CBT than never-smokers. Smoking-status was not associated with pre-post-CBT-changes in severity of psychopathology. PD/AG patients being former-smokers did not relapse during CBT. PD/AG patients being
ND-smokers did not change their nicotine consumption in spite of a response to CBT for PD/AG.
Figure: Interdependency effect (time *
group) between Nicotine Consumption
and 6-months Follow-up HAMA-Response
Status for ND-Smokers
Conclusions: In conclusion, ND neither predicted a lower effectiveness of CBT for PD/AG, nor effective CBT for
PD/AG affected nicotine consumption. Because of long-term smoking-related health risks and associations between
ND and panic symptom severity, smoking cessation programmes as additional modules of CBT for smoking patients should be considered.
Baer, I., Wieder, G., Beesdo-Baum, K., Höfler, M., Behrendt, S., Lüken, U., Riemenschneider, H., Bergmann, A., Gerlach, A. L., Lang, T., Hamm, A. O., Ströhle, A., Fydrich, T.,
Kircher, T., Alpers, G. W., Deckert, J., Arolt, V., Wittchen, H.-U. & Einsle, F. (submitted). Smoking does not adversely affect Outcome of Exposure Therapy in Panic Disorder and Agoraphobia. Behaviour Research and Therapy.
P2.4.4. Baseline Predictors for Short- and Long-Term Outcome of CBT for Panic Disorder with Agoraphobia
Background: The current study aims to examine a range of demographic, clinical, and attitudinal variables for treatment outcome of CBT for PD/AG independently and in multiple models. Given that most prior research focused on
immediate treatment response or medium-term follow- up and few studies examined predictors for longer term outcomes, we will examine outcomes two years after treatment in addition to immediate treatment response. In addition,
beyond definitions for treatment response, we will include a measure of overall quality of life as outcome indicator.
Method: Post-hoc analyses of data from a multicenter randomized controlled trial, in which 301 outpatients with
176
primary PD/AG were treated using standardized CBT. A range of demographic, clinical, and attitudinal variables
assessed at pre-treatment were analyzed as putative predictors for treatment response on Hamilton Anxiety Scale,
Clinical Global Impression, number of panic attacks, agoraphobic avoidance (Mobility Inventory), and overall panic/
agoraphobia symptomatology (Panic Agoraphobia Scale) at post-treatment and 24-month Follow-up. Results:
Sociodemographic variables did not systematically predict immediate treatment response and long-term outcome.
Several initial symptom and illness as well as treatment characteristics were, however, associated with shortand long-term treatment outcome. When considering all significant univariate predictors for the various outcome
measures in multiple regression analyses, consistently MI emerged as a significant predictor for immediate treatment outcome, with higher agoraphobic avoidance predicting more unfavourable outcome. The other most strongest predictors varied by outcome (low HAMA and comorbid specific phobia for HAMA-Response, higher number
of panic attack symptoms and “Therapy will help me” for MI-Response; middle social class, lower BDI-scores,
higher health related quality of life scores and “I will continue the therapy” for higher levels of quality of life at posttreatment). Regarding long-term outcome, multiple models revealed the two PAS-subscales (agoraphobic avoidance
and health worries) as predictors for HAMA outcomes, the patients’ belief to continue therapy after the first session
as predictor for MI-outcome, and HAMA, quality of life and the patients’ belief after the first session to continue
therapy to predict long-term outcome with regard to quality of life.
Conclusion: Clinical and attitudinal variables may be usefull predictors for short- and long-term outcome of CBT for
PD/AG with potential implications for treatment planning.
Beesdo-Baum, K., Emmrich, A., Höfler, M., Lüken, U., Einsle, F., Gloster, A., et al., & Wittchen, H.-U., (in prep.). Baseline Predictors for Short- and Long-Term Outcome of
CBT for Panic Disorder with Agoraphobia.
P2.5. The relevance of interoceptive exposure within the treatment of panic disorder and agoraphobia
Pl: Dipl.-Psych. Dorte Westphal, Dr. Franziska Einsle; Cooperations: Prof. Dr. Alexander L. Gerlach (Lehrstuhl für
Klinische Psychologie und Psychotherapie); Dipl.-Psych. Thomas Lang (Institutsleitung C.D.S. Bremen)
Background: Interoceptive exposure is an effective component of confrontation therapy for panic disorder and
agoraphobia (Barlow et al., 2000; Goldstein & Chambless, 1978). Still, there is few empirical evidence regarding its
mechanisms of action. Schmidt & Trakowski (2004) and Antony et al. (2005) could show that especially hyperventilation, breathing through a straw, spinning, pressing down the tongue, and running on the spot can cause anxiety
and symptoms. Beyond that, there is interesting work aiming to identify a dimensional structure of physical symptoms occurring within panic attacks. Those studies are based on data of patients having a panic disorder which
was determined through structured diagnostics (e.g. Meuret et al., 2006, Andor et al., 2008). Most results support
a respiratory and a vestibular dimension. The existence of an additional cardio-vascular factor needs clarification.
Aims: This project investigates mechanisms of action within interoceptive exposure in the context of a manualised
exposure therapy. Besides the analysis of the effectiveness of interoceptive exposure and its relevance for the
course of therapy, the symptom dimensions in interoceptive exercises found by Andor et al. (2008) shall be validated and examined for their impact upon interoceptive exposure. Furthermore, influencing factors on the effectiveness of interoceptive exposure, especially patients´ physical and health factors (e.g. smoking status, weight, physical activity) as well as their anxiety sensitivity, shall be determined. Methods: Data was collected in the PANICNET
multicenter study (Gloster et al., 2009) funded by the BMBF. Information about interoceptive exposure of the 301
patients having a manualized exposure therapy for panic disorder and agoraphobia (Lang et al., 2011) is analysed.
Patients performed the interoceptive exposure in the 4th and 5th meeting together with their therapist. He documented the reported physical symptoms, severity of the symptoms and the induced anxiety and its similarity to
panic symptoms (each on scale 1 to 10) over all 9 exercises. The three exercises which caused most anxiety were
assigned as homework between the two meetings.
At present, data is entered. The data will be analysed afterwards towards the factor structure found by Andor et
al. (2008). Furthermore, an examination of the results of interoceptive exposure over the course of time and of a
relationship with the success of manualized exposure therapy (e.g. number of drop-outs, correlation with overall
effectiveness of the treatment) is planned. Eventually, the relevance of baseline data (e.g. smoking status, extent of
anxiety sensitivity) for interoceptive exposure shall be investigated.
P3. Partnership communication and therapist-patient communication in panic disorder with agoraphobia
(Dissertation Project: G. Wieder; Supervisor: H.-U. Wittchen, F. Einsle)
The major aim of this dissertation project is to investigate communication processes in patients having panic disorder with agoraphobia with (a) their therapist and (b) their significant other.
177
Background: The effectiveness of exposure therapy for panic disorder with agoraphobia is well established. Still, its
core mechanisms are unclear. In a number of studies communicative style between therapist and patient (e.g. criticism, complimentary) proved to be a factor that modulated therapy success. However, research was conducted with
mostly subjective investigation methods and mainly focussed on the therapist and only marginally on the patient.
A further research aim, as every patient is part of a system, is to investigate partnership communication more indepth as former studies suggest a positive association between supportive communication and symptom reduction. Specifically, its specificity compared to other anxiety disorders shall be examined. Methods: The dissertation
project is divided into two strains: In project (a) N = 60 patients of a BMBF funded multicenter randomized trial are
assessed regarding their voice fundamental frequency (f0) as an objective voice marker of emotional arousal in therapy communication (thought experiment session). F0 will be linked to therapy outcome defined as drop-out vs. therapy completer. Project (b) investigates partnership communication using two questionnaires (measuring partnership
quality and satisfaction and communication during couple conflict) in the Outpatient Clinic for Psychotherapy of the
Technische Universitaet Dresden with patients having panic disorder and agoraphobia, generalized anxiety disorder
and social phobia respectively. Patients are to fill out the questionnaires before therapy to avoid bias through therapy communication. Current status: Data collection in project (a) began in February 2013 and is nearly completed.
First results are expected in autumn 2014. Data collection in project (b) began in March 2013 and is currently in
progress. At present, N = 8 patients with panic disorder and agoraphobia, N = 11 patients with generalized anxiety
disorder, and N = 10 patients with social phobia could be included. First results are expected in spring 2015.
Wieder, G. (2013). Wodurch Paarinteraktion bei Patienten mit Panikstörung und Agoraphobie gekennzeichnet ist – Implikationen für die therapeutische Praxis. Psychotherapeutenjournal, 1, 49-53
P4. Psychodynamische Kurzzeittherapie (STPP) und kognitive Verhaltenstherapie (CBT) bei sozialer Phobie –
eine randomisierte, kontrollierte und multizentrische Studie
PI: Prof. Dipl.-Psych. Dr. Falk Leichsenring (Universität Gießen); Leiter des
Zentrums Dresden (CBT): Prof. Dr. Jürgen Hoyer; Staff: Dipl. Psych. Franziska Gebler Funding: Bundesministerium für Bildung und Forschung (BMBF);
Duration: 01/2007 - 4/2013, further analyses ongoing; Cooperations: Universities of Bochum/Dortmund (Prof. Dr. S. Herpertz, Prof. Dr. U. Willutzki),
Frankfurt (Prof. Dr. U. Stangier), Jena (Prof. Dr. B. Strauß), and Mainz (PD
Dr. J. Wiltink, Prof. Dr. W. Hiller). Controlled-trials.com/ISRCTN53517394
webpage: www.sopho-net.de
Hintergrund: Soziale Phobie ist eine der häufigsten psychischen Störungen im Kindes- und Erwachsenenalter.
Sie zeichnet sich durch einen frühen Beginn, einen oft chronischen Verlauf und schwerwiegende psychosoziale
Beeinträchtigungen aus. Obwohl kognitive Verhaltenstherapie (CBT) eine effektive Therapiemethode für die soziale
Phobie ist, sind die Responder-Raten von 50% noch nicht ausreichend. Sie könnten durch eine längere und intensivere Behandlung gesteigert werden. Eine in der Behandlung der sozialen Phobie ebenfalls häufig eingesetzte
Therapieform ist die psychodynamische Kurzzeittherapie (STPP). Letztere wurde in der Behandlung der Sozialen
Phobie weltweit erst einmal geprüft. Der Forschungsverbund zur Psychotherapie der Sozialen Phobie (sopho-net)
ist ein Zusammenschluss verschiedener Universitätseinrichtungen in Jena/ Erfurt, Bochum, Dortmund, Dresden,
Göttingen, Leipzig und Mainz. Die hier vorgestellte Studie innerhalb des sopho-net ist die erste und bisher einzige,
welche diese beiden Therapiemethoden, jeweils mit manual-orientiertem Vorgehen, miteinander verglichen hat. Sie ist
zugleich eine der größten und (angesichts der durch das KKS Heidelberg durchgeführten externen Qualitätskontrolle)
methodisch besten Psychotherapievergleichsstudien überhaupt. Eine weitere Stärke der Studie ist das Vorliegen von
24-Monats-Follow-Up-Untersuchungen, welche die längerfristige Stabilität der therapeutischen Veränderungen objektivierbar machen. Ziel: Es sollte untersucht werden, inwiefern die manualisierte CBT der manualisierten STPP bezüglich
der Symptomreduktion und die STPP der CBT in Bezug auf Verbesserungen des Selbstbildes und der interpersonellen
Beziehungen überlegen ist. Methode: Hypothesen und Design der Studie wurden in Leichsenring, Hoyer et al. (2009)
detailliert dargestellt. Insgesamt wurden N = 494 Patienten mit sozialer Phobie rekrutiert. N = 209 Patienten schlossen
die CBT-Behandlung, N = 207 Patienten die STPP Behandlung ab. Die in Dresden untersuchte Stichprobe umfasste
109 Patienten im Alter von 18 bis 70 Jahren, 54 davon sind gemäß Studienprotokoll an der Institutsambulanz
und Tagesklinik für Psychotherapie (IAP) behandelt worden (erreichte Planquote: 111%). Ergebnisse: In beiden
Behandlungsformen wurde die sozial-phobische Symptomatik gegenüber der unbehandelten Wartegruppe hoch
bedeutsam reduziert wurde. CBT war dabei der STPP überlegen: Die Remissionsraten lagen bei 36% (CBT) vs. 26%
(STPP), die Responseraten bei 60% (CBT) bzw. 52% (STPP). Diskussion: CBT und erstmals auch STPP bewährten
sich als effektive Behandlungsformen der Sozialen Phobie, aber CBT erreichte bei einer größeren Zahl von Patienten
klinisch bedeutsame Verbesserungen.
178
Short-term psychodynamic psychotherapy (STPP) and cognitive-behavioral therapy (CBT) in social phobia –
a randomized controlled multicenter study
Background: Social Phobia is one of the most prevalent mental disorders both in children and adults. SP is characterized by an early onset, a chronic course, severe psychosocial impairment and high socio-economic costs.
Although CBT is beneficial for SP, the rates of treatment responders are not yet sufficient (about 50%). Response
rates may be improved by a longer and more intensive treatment. Next to CBT, STPP is also frequently used to
treat SP. Only one RCT of STPP exists worldwide.
The Social Phobia Psychotherapy Research Network (sopho-net) is a cooperation of different universities of Jena/
Erfurt, Bochum, Dortmund, Dresden, Göttingen, Leipzig and Mainz. This trial within sopho-net is the first and only
study comparing these two manual-guided methods of psychotherapy in SP. The study is also one of the largest
and most rigorously conducted direct comparisons of psychotherapy methods world-wide. One of the methodological strengths of the study is the fact that 24-month-follow-up analyses were run which makes the stability of
the therapeutic change testable. Aims: The study tested whether manualized CBT is superior to manualized STPP
concerning symptoms of SP, whereas manualized STPP was expected to be superior concerning improvements in
self-image and interpersonal relations. In addition, it was possible to develop innovative psychometric and healtheconomic assessments based on the large sample recruited and diagnosed within the study network (Sonntag et
al., 2013; Stuhldreher et al., 2014; von Consbruch et al. 2013). Method: Effects of STPP and CBT were studied
with the same methods, thus allowing for direct comparison of data. A total of N = 494 Patienten with social phobia
were included in the study. N = 209 patients completed CBT-treatment, N = 207 patients STPP. The sample for
Dresden included 109 patients at the age of 18 – 70 years. Of these, 54 were treated at the Institutsambulanz und
Tagesklinik für Psychotherapie (IAP). Results: Both treatments were superior to the WL with regard to response
and remission (p<0.001). Remission and response rates were 36% and 60%, respectively, for CBT, and 26%/52%
for STPP. CBT was superior to PDT for all outcome measures (p<0.02) except the reduction of co-morbid depression. Rates of response and remission were stable or tended to increase for both treatments over the 24-month
follow-up period. For both CBT and psychodynamic therapy, response rates were approximately 70% by the 2-year
follow-up. Remission rates were nearly 40% for both treatment conditions. Conclusion: Both CBT and PDT were
efficacious in treating SAD, but the rates of those with significant clinical improvements at post treatment were
higher for CBT. The improvements were shown to be successfully maintained over the 24-month follow-up period
with favourable response rates of about 70% in both treatment conditions.
Leichsenring, F., Hoyer, J. et mult. al. (2009). The Social Phobia Psychotherapy Research Network. The first multicenter randomized controlled trial of psychotherapy for social
phobia: Rationale, methods and patient characteristics. Psychotherapy and Psychosomatics, 78, 35-41.
Leichsenring, F., Salzer S., Beutel, M., Herpertz, St., Hiller, W., Hoyer, J., Huesing, D., Joraschky, P., Nolting, B., Poehlmann, K., Ritter, V., Stangier U., Strauss, B., Stuhldreher N., Tefikow S., Teismann T., Willutzki, U., Wiltink, J., & Leibing E. (2013). Psychodynamic versus cognitive therapy of social anxiety disorder: A multi-center randomized controlled trial. American Journal of Psychiatry, 170, 159-167.
Leichsenring, F., Salzer, S., Beutel, M. E., Herpertz, S., Hiller, W., Hoyer, J., Hüsing, J., Joraschky, P., Nolting, B., Pöhlmann, K., Ritter, V., Stangier, U., Strauss, B., Tefikow,
S., Teismann, T., Willutzki, U., Wiltink, J., & Leibing, E. (2014). Long-term outcome of psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder.
The American journal of psychiatry, 171, 1074-1082
Sonntag, M., Konnopka, A., Leichsenring, F., Salzer, S, Beutel, M.E., Herpertz, S., Hiller, W., Hoyer, J., Joraschky, P., Nolting, B., Poehlmann, K., Stangier U., Strauß, B., Willutzki, U., Wiltink, J., Leibing, E. & König, H.H. (2013). Reliability, validity and responsiveness of the EQ-5D in assessing and valuing health status in patients with social
phobia. Health and Quality of Life Outcomes, 11, 215.
Stuhldreher N., Leibing E., Leichsenring, F., Beutel, M., Herpertz, St., Hiller, W., Hoyer, J., Konnopka, A., Poehlmann, K., Salzer S., Stangier U., Strauss, B., Willutzki, U., Wiltink, J., & Koenig, H.-H. (2014). The costs of social anxiety disorder: the role of symptom severity and comorbidities. Journal of Affective Disorders, 165, 87–94.
von Consbruch, K., Flückiger, C., Stangier, U., Beutel, M., Herpertz, S., Hoyer, J., Leibing, E., Leichsenring, F., Strauß, B., Willutzki, U. & Wiltink, J. (2013). WIFA-k: Ein neues
Messinstrument zur zeitökonomischen Erfassung allgemeiner Wirkfaktoren der Psychotherapie. Psychotherapie Psychosomatik, Medizinische Psychologie; 63, 286-289.
P5. Patient characteristics predicting attrition and outcome in CBT for social phobia: Results from a large
multicenter trial
PI: Prof. Dr. Jürgen Hoyer; Staff: Stephan Sarnowsky, B.A.; Funding: Bundesministerium für Bildung und Forschung
(BMBF) Duration: 01/2007 - 3/2013; further analyses ongoing; Cooperations: Universities of Bochum (Prof. Dr. U.
Willutzki), Frankfurt (Prof. Dr. U. Stangier), Göttingen (Prof. Dr. E. Leibing), Mainz (Prof. Dr. W. Hiller, Dr. J. Wiltink).
Background: We examined the role of baseline patient characteristics as predictors of outcome (end-state functioning, response, and remission) and attrition for cognitive therapy (CT) in social anxiety disorder (SAD). Also patient
characteristics that have rarely been examined previously (e.g., personality, self-esteem, shame, attachment style,
interpersonal problems) were analyzed. Method: Data came from the CT arm of a multi-center RCT with N = 244
patients having DSM-IV SAD. CT was conducted according to the manual by Clark and Wells. Severity of SAD was
assessed at baseline and end of treatment with the Liebowitz Social Anxiety Scale (LSAS). Multiple linear regression analyses and logistic regression analyses were applied.
179
Results: Up to 37% of the post-treatment variance (post-treatment LSAS score) could be explained by all pretreatment variables combined. Symptom severity (baseline LSAS) was consistently negatively associated with endstate functioning and remission, but not with response. Number of comorbid diagnoses was negatively associated
with end-state functioning and response, but not with remission. Self-esteem was positively associated with higher
end-state functioning and more shame negatively with response. Attrition could not be significantly predicted.
Conclusions: The results indicate that the initial probability for treatment success mainly depends on severity of
disorder and comorbid conditions while other psychological variables are of minor importance, at least on a nomothetic level. This stands in contrast with efforts to arrive at an empirical based foundation for differential indication
and argues to search for potent moderators of therapeutic change rather on the process level.
Hoyer, J., Wiltink, J., Hiller, W., Leibing, E., Miller, R., Poehlmann, K., Salzer, S., Sarnowsky, S, Stangier, U., Strauß, B. & Willutzki, U. (submitted). Patient variables predicting
attrition, symptom reduction and end-state functioning in cognitive therapy of social phobia. Clinical Psychology & Psychotherapy.
P6. Transfer of manualized CBT for social phobia into clinical practice (SOPHOPRAX)
PI: Prof. Dr. Jürgen Hoyer; Staff: Dipl.- Psych. Manuela Möser, Stephan Sarnowsky, B.A.; Funding: Bundesministerium
für Bildung und Forschung (BMBF) (01GV1001); Duration: 10/2010 - 03/2015; Cooperations: Universities of
Frankfurt (Prof. Dr. U. Stangier) and Göttingen (Prof. Dr. E. Leibing) and Mainz (Prof. Dr. M. Beutel, Dr. J. Wiltink);
Koordinationszentrum für Klinische Studien (KKS) Dresden; Trial Registration: ClinicalTrials. gov Identifier: NCT01388231
Background: Though cognitive-behavioral therapy (CBT) is generally known to be efficacious in the treatment of
social phobia, little is known about the efficacy of manualized treatments in the less structured setting of routine
clinical practice (Phase IV of psychotherapy research). The present study (SOPHO-PRAX) represents a continuation
of a multi-centre randomized clinical trial project (SOPHO-NET, Leichsenring et al., 2013, see above) evaluating the
efficacy of CBT versus short-term psychodynamic psychotherapy (STPP) in the treatment of social phobia. In this
naturalistic study, we investigated a) how successful experienced licensed psychotherapists treat patients with
social anxiety disorder; and b) whether an additional training in the manual by Clark and Wells (German: Stangier,
Clark, & Ehlers, 2006) leads to relatively better results. Methods/Design: Forty-nine experienced cognitive-behavioural psychotherapists collaborating with the German university centres Dresden, Frankfurt, and Göttingen, who
had no previous experiences with the above mentioned manual, were randomized into two conditions: one group
undergoing training in the Clark-Wells manual (mCT group), the other receiving no such specialized training (CBT
group). A total of 166 patients with social phobia were included in the study, diagnosed with the Structured Clinical
Interview for Mental Disorders (SKID) at the study centres, and quasi-randomised to either mCT or CBT therapists.
Social anxiety was assessed with the Liebowitz Social Anxiety Scale (LSAS) before and after up to 25 treatment
sessions. Results: First analyses (Hoyer et al., 2014) show favourable overall results with large ES on the LSAS of
d = 1.77 for study completers and a tendency toward higher efficacy in the mCT group. Discussion: The novelty of
the present CBT trial lies in the advantage of combining the elements of randomized-controlled trials and naturalistic
studies. It will directly inform about the incremental effects of procedures established in a controlled clinical trial
into practice. Study results may be of great relevance to health care policy, health insurance companies and the
statutory boards of psychotherapists. They may serve to improve quality of treatment, and shorten the timeframe
Trial sites
Treatment
post
Dresden
nz
6 months
Frankfurt
Göttingen
Training in manualized
CBT
CBT 25 + 5 sessions
(manualized)
No specific training
CBT 25 + 5 sessions
(treatment as usual)
Randomization
of 49 therapists
167 patients with Social Phobia
Figure 1: Intervention scheme (SOPHOPRAX)
180
Follow-up
12 months
between the development and widespread use of effective methods, thereby reducing health cost expenditures.
The design of SOPHO-PRAX aims to further a faster and more widespread distribution of effective treatments.
The results of this study will not only inform about the degree to which the new methods lead to an improvement
of treatment course and outcome, but also about whether the effects of routine psychotherapeutic treatment are
comparable to those of the controlled, strictly manualized treatments of the SOPHO-NET study.
±Crawcour, S., Ginzburg, D., Leibing, E., Stangier, U., Wiltink, J. & Hoyer, J. (2012). Transfer of manualized CBT for social phobia into clinical practice (SOPHOPRAX): a study
protocol for a cluster-randomized controlled trial. Trials, 13, 70.
Hoyer, J., Crawcour, S., Ginzburg, D., Möser. M., Leibing, E. & Stangier, U. (2014, 05.). Transfer eines manualisierten Behandlungsprogramms für Soziale Phobie in die Praxis:
Eine versorgungsnahe, randomisierte und kontrollierte Studie. Vortrag auf dem 32. Symposium für Klinische Psychologie und Psychotherapie der DGPs in Braunschweig.
Leichsenring, F., Salzer S., Beutel, M., Herpertz, St., Hiller, W., Hoyer, J., Huesing, D., Joraschky, P., Nolting, B., Poehlmann, K., Ritter, V., Stangier U., Strauss, B., Stuhldreher N., Tefikow S., Teismann T., Willutzki, U., Wiltink, J., & Leibing E. (2013). Psychodynamic versus cognitive therapy of social anxiety disorder: A multi-center randomized controlled trial. American Journal of Psychiatry, 170, 159-167.
P7. Prädiktoren, Konsequenzen und Veränderbarkeit der psychoneuroendokrinologischen Stressantwort bei
der Sozialen Phobie
Pl: Prof. Dr. Jürgen Hoyer, Co-PI: Prof. Dr. Clemens Kirschbaum; Staff: Dipl. Psych. David Bräuer; Dipl. Psych.
Elisabeth Klumbies; Funding: Haushaltsmittel, DFG HO 1900/6-1, Ethikvotum EK137062007; Duration: 04/2009
– 07/2013, further analyses ongoing; Cooperations: Prof. Dr. Alexander Strobel, Institut für Differenzielle und
Persönlichkeitspsychologie der TU-Dresden.
In der Studie sollen in einer standardisierten sozialen Stresssituation (Trierer Sozial Stress Test, TSST) subjektive
und endokrinologische Reaktionsparameter bei Patienten mit Sozialer Phobie systematisch untersucht werden.
Hierzu soll der TSST vor und im Anschluss an eine manualisierte Psychotherapie mit Patienten und einer gesunden
Kontrollgruppe durchgeführt werden. Darüber hinaus werden durch wiederholte Untersuchung einer TherapieWartekontrollgruppe mögliche Habituationseffekte kontrolliert. Die Studie verfolgt die Ziele, (a) die der Sozialen
Phobie zugrunde liegenden psychobiologischen Mechanismen besser zu beschreiben, (b) psychoneuroendokrinologische Subgruppen der Sozialen Phobie u.a. im Hinblick auf die Therapieresponsivität zu identifizieren, (c)
Vorschläge zur spezifischeren Diagnostik und selektiven Therapieindikation bei der Sozialen Phobie zu liefern und
(d) die Veränderungssensitivität endokrinologischer Parameter nach einer erfolgreichen (vs. nicht erfolgreichen)
Therapie zu untersuchen. Erste Analysen zeigen, dass weniger die objektive Stressreaktion (mit Ausnahme der
Phase vor dem Experiment) die Patienten mit Sozialer Phobie von Gesunden unterscheidet als die subjektive
Stressreaktion und die ihr folgenden, negativen Bewertungen (Klumbies et al., 2014).
Using a stressful standardized social scenario (Trier Social Stress Test, TSST), this study aims at an systematic examination of the subjective and endocrine responses in patients with social phobia after confronting a socially stressful situation. The TSST will be conducted before and after a manualized psychotherapy and also one year after the
first assessment. Healthy controls and patients from a waitlist will be also tested, e.g., in order to control for habituation effects. The study will help a) to describe psychobiological mechanisms underlying social phobia, b) to identify
subgroups of social phobia which may respond differentially to treatment, c) to make proposals for more specific
diagnostic procedures and improved selective indication, and d) to inform about the change sensitivity of selected
endocrine parameters after (successful vs. unsuccessful) treatment.
First results suggest that the excessive self-reported stress in SP is not reflected by a respective biological stress
response. Patients with SP apparently show neither an extreme form of focused fear reactivity nor excessive defensive impairment (Klumbies et al., 2014).
Klumbies, E., Bräuer, D., Hoyer, J., & Kirschbaum, C. (2014). The reaction to social stress in social phobia: Discordance between physiological and subjective parameters. Plos
one, 9(8), e105670.
Ziegler, C., Dannlowski, U., Bräuer, D., Stevens, S., Laeger, I., Wittmann, H., Kugel., H., Heindel, W., Dobel., C, Hurlemann, R., Reif, A., Lesch, K.-P, Kirschbaum, C., Arolt,
V., Gerlach, A., Hoyer, J., Deckert, J. , Zwanzger, P. & Domschke, K. (in prep.). Oxytocin receptor gene methylation – Converging multi-level evidence for a role in social anxiety.
P8. Dissociative symptoms in social phobia during a stressful social performance situation
PI: Prof. Dr. Jürgen Hoyer, Co-PI: Prof. Dr. Clemens Kirschbaum; Staff: Dipl.- Psych. David Bräuer, Dipl. Psych.
Elisabeth Klumbies, Dipl. Psych. Tabea Schweden, cand. psych. Paul Wersch; Funding: Bundesministerium für
Bildung und Forschung (BMBF); Duration: 01/2007 - 07/2013; further analyses ongoing.
181
Background: Theoretical models of social phobia assume that intense social stress can provoke dissociative symptoms in social phobia and that these symptoms contribute to the maintenance of disorder. The present study – a
sub-study of the SOPHOSAT project –aims at investigating how frequent and intense dissociative symptoms are in
reliably diagnosed patients with social phobia as compared to healthy controls. Furthermore, we explored a broad
range of correlates of dissociative symptoms. More particularly, we expected dissociative symptoms to be positively correlated with safety behaviours and subsequent post-event processing. Method: N = 54 patients reliably
diagnosed with social phobia as well as N = 30 age and sex-matched controls were examined before, in, and after
a standardized social performance situation (Trier Social Stress Test, TSST). An adapted version of the Cambridge
Depersonalisation Scale was used to assess dissociative symptoms during TSST. Social anxiety, depression, personality, participants’ subjective appraisal of the situation, safety behaviours, post-event processing and diverse physiological stress parameters (ACTH, cortisol, heart rate, heart rate variability) were also assessed.
Results: .Dissociative symptoms, especially feelings of being different, were clearly more pronounced in social phobia patients than in controls (d = 1.14). Dissociative symptoms were most closely associated with social anxiety and
post-event processing.
Discussion: The results favour the view that the majority of social phobia patients suffer from dissociative symptoms. The role of these symptoms in the maintenance of social anxiety should be more thoroughly explored and
conceptualized. Further research should test the hypothesis that fear of dissociation specifically explains prolonged
processing and pertinent avoidance of social situations. In addition, we plan to develop treatment modules for
those, who specifically fear dissociative symptoms during social performance situations such as oral exams.
Hoyer, J., Bräuer, D., Crawcour, S., Klumbies, E. & Kirschbaum, C. (2013). Depersonalisation/derealisation during acute social stress in social phobia. Journal of Anxiety Disorders, 27.
Figure: Typical scenario during the Trier Social
Stress Test (TSST)
P9. Die Behandlung der Erythrophobie mittels verhaltenstherapeutischer Kurzzeitgruppentherapie
Pl: Prof. Dr. Jürgen Hoyer; Staff: Dr. Samia Chaker, Dipl. Psych. Anke Heinrich; Funding: DFG; Study duration:
01/2007 – 9/2012; detailed analyses ongoing.
Die Angst zu erröten und von anderen dafür negativ bewertet zu werden ist eine häufige Befürchtung im Rahmen
sozialer Ängste. In einer randomisierten kontrollierten Therapiestudie haben wir geprüft, ob die verhaltenstherapeutische Standardbehandlung nach Clark und Wells (1995) erfolgreich auf die Erythrophobie angewendet werden kann. Weiterhin haben wir untersucht, ob die Standardbehandlung vergleichbare Effektstärken erzielt wie
das Aufmerksamkeitstraining, ein verhaltenstherapeutisches Programm, welches spezifisch für die Veränderung
des bei Erythrophobie dysfunktionalen Aufmerksamkeitsfokus, entwickelt wurde. Als Besonderheit haben wir
die Behandlung dabei als Gruppentherapie (bis zu 12 Personen) und als Kurzzeittherapie (2 Wochenenden à
10,5 Stunden Nettotherapiezeit) konzipiert. Zusätzlich haben wir errötungsbezogene Aufmerksamkeitsbias bei
Erythrophobie im Kontrast zu anderen sozialen Ängsten und gesunden Kontrollpersonen untersucht. N = 82
Personen konnten in die Studie eingeschlossen werden, von denen zur 12-Monats-Katamnese vollständige
Datensätze von n = 54 Personen vorlagen. Mittels multipler Imputation konnten die Datensätze von n = 72
Personen vollständig geschätzt werden und bilden die Datengrundlage für alle Berechnungen.
Beide aktiven Therapiebedingungen waren der Wartekontrollgruppe in Bezug auf die Reduktion der sozialphobischen und errötungsängstlichen Symptomatik signifikant überlegen. Das Aufgabenkonzentrationstraining (AKT)
und die kognitiv-verhaltenstherapeutische Standardtherapie (KVT) unterschieden sich nicht in Bezug auf die
Reduktion der sozialphobischen und errötungsängstlichen Symptomatik. Auch durch eine Kombination beider
Interventionsstrategien (AKT-KVT vs. KVT-AKT) ergab sich kein Vorteil für eine der beiden Kombinationen. Die
Ergebnisse blieben über die Zeiträume von 6- und 12 Monaten nach Behandlungsende stabil. Insgesamt konnten durch die intensive Kurzzeitbehandlung Responseraten von bis zu 69% und Remissionsraten von bis zu 71%
erreicht werden. Die Akzeptanz der Kurzzeitintervention in der Gruppe war sehr groß und Effektstärken und
182
Responseraten liegen in einem Bereich, der auch durch andere Studien erreicht wurde. Besonders hervorhebenswert ist die Effizienz der Kurzzeitgruppentherapie, denn die Ergebnisse wurden durch eine Interventionsdauer von
zwei Wochenenden in Gruppen von bis zu zwölf Teilnehmern bei zwei Therapeuten erreicht. Die Datenauswertung
der experimentellen Daten zu den Aufmerksamkeitsbias dauert aktuell noch an.
Task Concentration Training vs. Cognitive Behavioral Therapy: A randomized controlled trial for social anxiety disorder with fear of blushing.
Objective: To examine the efficacy of different short-time group therapy modalities for social anxiety disorder with
fear of blushing. Task Concentration Training (TCT) and cognitive-behavioral therapy according to Clark and Wells
(CBT) were compared. Methods: Eighty-two individuals meeting criteria for social anxiety disorder with the fear
of blushing as primary concern were randomly assigned to wait-list or active condition. Group treatment consisted
of two therapy weekends with either TCT on the first weekend plus CBT on the second or CBT first plus TCT.
Reduction in fear of blushing and a Social Phobia Composite consisting of various validated self- and expert rating
scales was defined as primary outcome criterion. There were 6- and 12-month follow-up-assessments. Results:
TCT and CBT were both superior to wait-list and equally effective after the first therapy weekend. Adding the
second weekend led to further improvement and high response rates. No differences were found between the
sequences TCT-CBT and CBT-TCT. At the 6- and 12-month follow-up, effects remained stable for the TCT-CBT
condition while further improvement was found for the CBT-TCT sequence based on within-group analyses. At the
6-month follow-up, remission rates in completers as established by diagnostic status were between 69 and 73%.
Conclusions: TCT and CBT according to Clark and Wells are both highly effective in treating SAD with fear of
blushing. Both treatments can be meaningfully combined leading to further and stable improvement.
Chaker, S. (2011). Die Behandlung der Erythrophobie mittel verhaltenstherapeutischer Kurzzeittherapie. Unveröffentlichte Dissertationsschrift. Technische Universität Dresden.
Chaker, S., Haustein, E., Hoyer, J. & Davidson, J.R. (2011). Brief Social Phobia Scale – German version BSPS-G. Ein Interview zur Erfassung sozialer Ängste unter Einbeziehung von Körpersymptomen. Verhaltenstherapie, 21, 194-197.
Chaker, S., Heinrich, A., Klotsche, J. & Hoyer, J. (submitted). Task Concentration Training vs. Cognitive Behavior Therapy: A randomized controlled trial for social anxiety disorder with fear of blushing. Clinical Psychology and Psychotherapy.
Chaker, S., Hofmann S.G. & Hoyer, J. (2010). Can a one-weekend group therapy reduce fear of blushing? Results from an open trial. Anxiety, Stress & Coping, 23, 303-318.
Härtling, S., Bögels, S., Klotsche, J. & Hoyer, J. (2013). Psychometrische Eigenschaften des Fragebogens zur Errötungsangst (FEA). Diagnostica, 59, 142-153.
P10. Die Behandlung der Generalisierten Angststörung im Rahmen einer Spezialambulanz
Pl: Dr. Katja Beesdo-Baum (PI) & Prof. Dr. Jürgen Hoyer (Co-PI); Staff: Thekla Bensmann, Sabrina Heidrich, Esther
Lochmann, Silke Behrendt, Christian Probst, Christin Thurau, Juliane Schlapphof, Ulrike Lüken, Susanne Baumbach,
Franziska Einsle, Kristin Anacker, Katrin Hummel, Stephan Crawcour, Florian Harder, Sara Jahnke, Anne Müller,
Miriam Jendrusch (Wolf), Susanne Knappe, Theresa Rische, Manuela Einert, Susann Steudte, Miriam Wolf, Nina
Maslowski, Maria Leckscheidt, Christiane Kämpfe, Charis Sura; Funding: Haushalt; Duration: 08/2005 - ongoing;
Cooperation: Institutsambulanz für Psychotherapie der TU Dresden
Hintergrund: Für die Behandlung der Generalisierten Angststörung (GAS) liegen unterschiedliche psychologische
Behandlungsansätze vor. In kontrollierten Studien an Patienten mit hoch restriktiven Einschlußkriterien konnte die
Wirksamkeit dieser Ansätze bzw. auch einzelner Module nachgewiesen werden. Inwieweit diese Ergebnisse auch
bei nicht-ausgelesenen GAS-Patienten mit ausgeprägter Komorbidität Bestand haben ist unklar. Ziel: Im Rahmen
einer Spezialambulanz Generalisierte Angststörung erhalten Patienten mit GAS eine optimierte psychologische
Behandlung, deren Effektivität geprüft werden soll. Darüber hinaus werden differentielle Indikationsentscheidungen
der Therapeuten zum Einsatz spezifischer Behandlungsmodule (Konfrontation in sensu, Konfrontation in vivo,
Angewandte Entspannung, (Meta-)Kognitive Verfahren, Problemlösetraining, Bearbeitung interpersoneller
Probleme, usw.) untersucht. Methode: Nicht-randomisierte, offene, klinische Studie mit Patienten, die sich in der
Institutsambulanz für Psychotherapie der TU Dresden anmelden, die diagnostischen Kriterien einer GAS erfüllen
und einer Behandlung im Rahmen der Spezialambulanz Generalisierte Angststörung einwilligen. Das Vorhandensein
komorbider Störungen, welche häufig bei Patienten mit GAS bestehen, stellt keinen Ausschlussgrund dar. Alle
Therapien werden im Bereich der Status- und Prozessdiagnostik mit spezifischen, für die Beschreibung therapeutischer Verläufe bei der GAS besonders geeigneten Verfahren dokumentiert (u.a. Penn State Worry Questionnaire,
Metakognitionsfragebogen, Intolerance of Uncertainty Scale). Erste Ergebnisse: Insgesamt wurden bisher 194
Patienten mit GAS in die Spezialambulanz Generalisierte Angststörung aufgenommen. Gegenwärtig werden
29 Patienten von 15 spezialisierten und speziell supervidierten Therapeutinnen behandelt. Im Rahmen einer
Diplomarbeit wurden die Daten von 93 Patienten ausgewertet. In der Therapiegruppe zeigten sich deutliche
Verbesserungen für die Hauptsymptomatik und assoziierte Symptombereiche, während die Wartekontrollgruppe
183
keine bedeutsamen Veränderungen erlebte. Für den Vergleich der Angstreduktion zwischen Therapiegruppe und
Wartekontrollgruppe ergaben sich in den Erhebungsinstrumenten Effektstärken zwischen 0,41 und 0,94. Die
Verbesserungen blieben zur 6-Monatskatamnese stabil oder es zeigten sich weitere Symptomrückgänge.
Diskussion: Die aufgezeigte Wirksamkeit der KVT unter Routinebedingungen ist kurz und langfristig mit der aus
randomisiert-kontrollierten Therapiestudien vergleichbar.
Tabelle: Veränderungen (MD) während der Behandlung (prä vs. post) und Vergleich der Veränderungen zwischen den Gruppen (LOCF)
Treatment of Generalized Anxiety Disorder in a Specialized Outpatient Clinic
Background: Randomized controlled studies with highly selected patient samples proved efficacy of psychological
treatment programs and treatment modules for Generalized Anxiety Disorder (GAD). However, it remains unclear
whether these results can also be found for unselected GAD patients with comorbid disorders.
Aim: The aim is to provide optimized treatment for patients with GAD within our GAD-Outpatient Clinic and to evaluate the efficacy of this treatment. Furthermore, therapist’s decisions about the differential indication of treatment
modules (e.g. worry exposure, in vivo exposure, applied relaxation, (meta-) cognitive therapy, problem solving training, targeting of interpersonal problems) will be evaluated. Method: Non-randomized, open clinical trial with patients seeking treatment in our Outpatient Clinic at the Institute of Clinical Psychology and Psychotherapy, meeting
diagnostic criteria for GAD and giving informed consent regarding treatment in our GAD Clinic. Comorbidity with
other disorders is not an exclusion criterion. All therapies are monitored with disorder specific questionnaires (e.g.
Penn State Worry Questionnaire, Meta-Cognition Questionnaire, and Intolerance of Uncertainty Scale). Preliminary
Results: 194 patients were included for treatment in the specialized GAD outpatient clinic. Currently, 29 patients
receive specialized treatment by 15 well supervised therapists. In the context of a diploma thesis data from 93 patients were examined. The treatment groups showed significant improvements in primary and secondary outcome
measures whereas the waitlist control group did not reveal changes in psychopathological symptom constellations. The comparison between treatment and waitlist control group revealed effect sizes between 0.41 and 0.94.
Improvements remained stable or further increased at 6-month follow-up. Discussion: Psychotherapeutic treatment
in the GAD outpatient clinic is comparatively effective as treatments in randomized controlled treatment studies.
webpage: http://www.psychologie.tu-dresden.de/i2/klinische/therapie/GAD_2012/index.html
Schmidt-Zerbst, C. (2013). Wirksamkeit kognitiver Verhaltenstherapie für die Generalisierte Angststörung unter Routinebedingungen in einer Hochschulambulanz (Supervision:
Beesdo-Baum). Diplomarbeit, TU Dresden.
P11.The Role of Pre-treatment Depression for Psychotherapy Outcome in Generalized Anxiety Disorder
(K. Beesdo-Baum, L. Horster, M. Höfler, E.S. Becker & J. Hoyer)
Background: Previous studies revealed equivocal results whether pre-treatment depression (measured categorical
or dimensional) has negative effects on cognitive behavioral therapy (CBT) anxiety outcome in patients with genera184
lized anxiety disorder (GAD). As most studies used a heterogeneous set of interventions it remains unclear whether
patients with depression benefit similarly well as non-depressed patients from specific single component treatments for GAD. Additionally, the role of pre-treatment depression on depression outcome after CBT for GAD has
not been examined in prior research. Therefore, this study aimed (1) to examine the moderating effect of depression at pre-treatment (defined categorically and dimensionally) on anxiety and depression therapy outcomes in CBT
for GAD and (2) to test whether there are differences in susceptibility to depression between two employed standalone interventions, namely worry exposure (WE) and applied relaxation (AR). Methods: This is a secondary analysis
of randomized clinical trial data of 57 outpatients with primary DSM-IV GAD (n = 19 with and n = 38 without comorbid major depressive disorder, MDD) who completed a 15-session manualized treatment for GAD with either WE or
AR. Regression analyses (linear and logistic) were conducted to examine associations between pre-treatment depression (categorical: MDD; dimensional: Beck Depression Inventory, BDI; Hamilton Depression Rating Scale, HAMD) and
post-treatment/12-month follow-up anxiety (Hamilton Anxiety Rating Scale, HAMA; State-Trait Anxiety Inventory – Trait
version, STAI-T; Anxiety subscale of the Brief Symptom Inventory, BSI-ANX; Penn State Worry Questionnaire, PSWQ;
Beliefs about subjective danger and uncontrollability of worry measured by Metacognition Questionnaire, MCQ II;
White Bear Suppression Inventory, WBSI) and depression outcomes (Depression subscale of the BSI, BSI-DEP; BDI;
HAMD). Therapy outcome was operationalized by (1) standardized change between post-treatment (or 12-month
follow-up) and pre-treatment (Cohen’s d, dimensional) and (2) end-state functioning (categorical). Interaction terms
were used to test for a differential role of pre-treatment depression in therapy efficacy for WE vs. AR. Results: In the
pooled sample, comorbid MDD was no significant predictor for any anxiety outcome variable. While higher BDI-scores
predicted smaller effect sizes only in thought suppression (WBSI) at post-treatment, greater HAMD-scores were related to less improvement in several anxiety outcome variables at both post-treatment (BSI-ANX, WBSI, MCQ II) and
12-month follow-up (BSI-ANX, PSWQ, WBSI, MCQ II). Neither categorical nor dimensional measures of depression
predicted anxiety end-state functioning. Regarding depression outcome, greater dimensional depression at pre-treatment was associated with more improvement but less chance to achieve high end-state functioning at post-treatment.
However, the greater improvement within patients with greater pre-treatment depressive symptomatology might be
mostly due to statistical arteifacts as regression towards the mean. At 12-month follow-up, only BDI-scores were still
associated with more improvement in one measure for depressive symptomatology (BSI-DEP) while no depression
measure predicted high end-state functioning in depression. Tested interaction effects for type of treatment (WE vs.
AR) revealed no significant differences. Conclusion: Findings indicate that behavioral therapy for GAD effectively
reduces both anxiety and depression symptoms irrespective of comorbid depression or depressive symptomatology
(measured via self-report, BDI). Different possibilities for the discrepancy of the prediction with HAMD are plausible,
but further research is needed to draw a final conclusion. The lack of evidence for interaction effects with intervention
type suggests that both WE and AE are similarly robust to alleviate both anxiety and depression symptoms in GAD
patients with depression.
Post-treatment minus BL
HAMA
FU-12 minus BL
Patients
with
comorbid
MDDc
(n = 19)
Patients
without
comorbid
MDDc
(n = 38)
Between-group
comparison,
ESDd (95% CI)
-1.32 (.28)
-1.45 (.15)
.13 (-.50 to .77)
p
Patients
with
comorbid
MDDc
(n = 19)
Patients
without
comorbid
MDDc
(n = 38)
Between-group
comparison,
ESDd (95% CI)
p
.684
-
-
-
-
STAIT
-.78 (.28)
-.99 (.18)
.21 (-.47 to .89)
.543
-
-
-
-
BSI-ANX
-.58 (.14)
-.67 (.13)
.09 (-.28 to .45)
.642
-.65 (.20)
-.69 (.13)
.04 (-.42 to .51)
.853
PSWQ
-.89 (.19)
-.70 (.13)
-.18 (-.62 to .25)
.409
-1.18 (.24)
-.87 (.15)
-.31 (-.88 to .26)
.284
WBSI
-.90 (.17)
-.80 (.18)
-.10 (-.39 to .59)
.686
-1.19 (.31)
-1.22 (.21)
.03 (-.70 to .76)
.935
MCQ II
-.92 (.19)
-.75(.11)
-.16 (-.59 to .26)
.449
-1.32 (.24)
-1.07 (.13)
-.25 (-.80 to .29)
.365
Table. Anxiety outcome in GAD patients with and without comorbid MDD
Note. a Numbers represent predicted values evaluated at means of predictors (with standard error of prediction in parentheses); c 12-month prevalence for MDD at pre-treatment; d effect size difference calculated from linear regression, > 0 means that concurrent depression is related to less
improvement. Table. Anxiety outcome in GAD patients with and without comorbid MDD
Beesdo-Baum, K., Horster, L., Höfler, M., Becker, E. S. & Hoyer, J. Hoyer (in prep.). The Role of Pre-treatment Depression for Psychotherapy Outcome in Generalized Anxiety
Disorder . J Anxiety Disorders
Horster, L. (2014). The role of pre-treatment depression for psychotherapy outcome in Generalized Anxiety Disorder (Supervision: Beesdo-Baum). Diplomarbeit (psychology
diploma thesis), TU Dresden.
185
P12. Steroid-Hormonlevel im Haar bei Posttraumatischer Belastungsstörung: Untersuchung langfristiger
endokriner Veränderungen im Therapieverlauf
PI: Dr. Tobias Stalder, Prof. Dr. Jürgen Hoyer, Dr. Susann Schmiedgen; Staff: Dipl. Psych. Susann Lange; Funding:
DFG Duration: 1.07.2013 - 31.7.2016
In den vergangenen Jahrzehnten konnten Veränderungen stressadaptiver Mechanismen, vermittelt über die Hypothalamus-Hypophysen-Nebennierenrinden-Achse (HHNA) und deren Endprodukt Cortisol, mit der Pathophysiologie und
Therapie der Posttraumatischen Belastungsstörung (PTBS) in Verbindung gebracht werden. Die bisherige Forschung auf
diesem Gebiet lieferte allerdings häufig inkonsistente Befunde, was insbesondere auf methodische Limitationen in der
Erfassung langfristiger Steroidkonzentrationen zurückzuführen ist. Die Methode der Cortisolbestimmung im Haar liefert
erstmals ein valides Maß der kumulativen Hormonausschüttung über Zeiträume von mehreren Monaten und bietet somit
wichtige, neue Perspektiven für die biopsychologische Erforschung der PTBS.
Ziel des vorgestellten Forschungsvorhabens ist es, die Haarcortisolbestimmung erstmals im Rahmen einer kontrollierten PTSD-Therapiestudie mit eingeschachtelter Querschnittserhebung einzusetzen. Hierbei soll zu Studienbeginn ein
Vergleich von PTBS Patienten mit (i) einer gesunden, nicht-traumatisierten Kontrollgruppe sowie mit (ii) gesunden traumatisierten Kontrollpersonen ohne PTBS Diagnose erfolgen. Erste Ergebnisse zeigen einen verminderten Haarcortisollevel
sowohl bei PTSB-Patienten als auch bei Traumatisierten ohne PTBS (vgl. Abb. 1). Weiterhin sollen in einem Prä-PostKontrollgruppendesign mit drei Messzeitpunkten intraindividuelle Veränderungen kumulativer Haarsteroidlevel von PTBS
Patienten im Verlauf einer kognitiven Verhaltenstherapie (im Vergleich zu gematchten Kontrollpersonen) untersucht werden. Die Ergebnisse des Forschungsvorhabens können wichtige Erkenntnisse zu endokrinen Korrelaten der PTBS liefern
und über die Möglichkeit der Therapieevaluation anhand von langfristigen Steroidhormonspiegeln informieren.
Mean hair cortisol concentration (pg/mg)
25
20
PTSD patients (n = 25)
Traumatized controls (n = 25)
Non-traumatized controls (n = 28)
15
∗
∗
∗
∗
10
5
0
Segment 1
Segment 2
Figure 1:Mean (± SEM) hair cortisol concentrations of PTSD patients,
traumatized (TC) and non-traumatized (NTC) healthy controls. Note:
segment 1 represents the hair segment closest to the scalp.
(aus steudte et al., 2013)
Steudte-Schmiedgen, S., Kirschbaum, C., Gao, W., Alexander, N., Schönfeld, S., Hoyer, J., & Stalder, T. (2014). Are facets of PTSD symptomatology differentially related to
hair cortisol concentrations? Response to Wang et al. . Biological Psychiatry.
Steudte-Schmiedgen, S., Stalder, T., Kirschbaum, C., Weber, F., Hoyer, J., & Plessow, F. (in press). Trauma exposure is associated with increased context-dependent adjustments of cognitive control in patients with posttraumatic stress disorder and healthy controls. Cognitive, Affective, & Behavioral Neuroscience.
Steudte, S., Kirschbaum, C., Gao, W., Alexander, N., Schönfeld, S., Hoyer, J., & Stalder, T. (2013). Hair cortisol as a biomarker of traumatization in healthy individuals and
posttraumatic stress disorder patients. Biological Psychiatry 74, 639-646.
P13. Verhaltensaktivierende Methoden in der Depressionsbehandlung
Pl: Prof. Dr. Jürgen Hoyer; Staff: Dipl. Psych. Esther Lochmann; Funding: Haushalt; Duration: 01/2012 - 03/2016
Cooperation: University of Basel, Switzerland (Dr. Andrew T. Gloster)
Verhaltensaktivierende Methoden gehören zu den wirksamsten psychotherapeutischen Optionen bei der
Behandlung der Depression. Sie sind gut aus einem verhaltenstheoretischen Verständnis der Depression abzuleiten und wurden in den letzten Jahren von Autoren wie Dimidjian oder Martell so verfeinert, dass ihre Erprobung
und Weiterentwicklung aussichtsreich erscheint. Gleichzeitig werden sie im deutschen Sprachraum kaum oder
nur in Verbindung mit weiteren kognitiven Interventionen eingesetzt, sodass der relative Beitrag der verhaltensaktivierenden Methoden zum Gesamterfolg der Therapie nicht erkennbar wird. Aufgrund der starken Betonung von
(einfachen) Verhaltensänderungen und der besonderen Rolle, die soziale Verstärkung dabei spielt, erscheint uns der
Ansatz gut in einem Gruppenformat einsetzbar. Deshalb soll in dem derzeit beginnenden Projekt erprobt werden,
ob sich bei Patienten mit unipolarer leichter bis mittelgradiger Depression, die sich auf einer Warteliste für eine
186
Einzel-Psychotherapie befinden, mit einer auf 8 Sitzungen begrenzten Gruppentherapie eine signifikante Besserung
der Depression erreichen lässt, die entweder den schnelleren Erfolg der Einzeltherapie begünstigt oder diese sogar
überflüssig macht. Erste Ergebnisse sind ermutigend (Furka & Hoyer, 2014). Das zugrundeliegende Manual wird
2016 in Buchform erscheinen (Hoyer & Furka, in Vorb.).
Behavioral Activation for Depression
Behavioral Actication (BA) is among the most efficacious methods for the treatment of unipolar depression. The
method is rooted in the behaviour-analytic understanding of depression put forward by Lewinsohn. It has experienced a “comeback” after the seminal study by Jacobson et al (1996) showing that BA alone is as effective as
other more established methods, namely cognitive-behaviour therapy as described by Aaron Beck. BA is not well
received in German speaking countries where the cognitive component of CBT is often specifically emphasized in
spite of the empirical evidence for the additional use of this component not being established.
Given that many patients with depression remain untreated for many months and considering the essential role
of social reinforcement in behavioral approaches, we decided to develop a manual for BA treatment groups which
is restricted to 8 sessions and addresses mildly to moderately depressed patients. First data show encouraging
results with completer ES of d around .8 (Furka & Hoyer, 2014). The manual for the group treatment will be published as a book in 2016 (Hoyer & Furka, 2016).
Furka, N. & Hoyer, J. (2014, 05.).Verhaltensaktivierung bei Depression: Erste Ergebnisse zu einem Gruppenprogramm. Poster auf dem 32. Symposium für Klinische Psychologie und Psychotherapie der DGPs in Braunschweig.
Hoyer, J. & Furka, N. (in Vorb.). Verhaltensaktivierung. Weinheim: Beltz.
Hoyer, J. & Lochmann, E. (2012). Verhaltensaktivierende Methoden in der Depressionsbehandlung: Ein Gruppenprogramm. Unveröffentlichtes Behandlungsmanual. Technische Universität Dresden
Lochmann, E. & Hoyer, J. (2013). Verhaltensaktivierung bei Depression: Aktuelle Anwendungs- und Settingvarianten. Psychotherapie im Dialog, 3, 57-60.
Abbildung 1: Prinzipien der Verhaltensaktivierung (aus Martell, Dimidjian & Herman-Dunn, 2010 [Guilford
Press]; deutsch: Hoyer & Lochmann,
2012)
P14. Gruppentherapie zur Verhaltensaktivierung bei Depressionen - Konzeption einer therapie-unterstützenden App
Pl: Prof. Dr. Jürgen Hoyer; Staff: Dipl. Psych. Nadine Furka; Funding: Internal; Duration: 07/2014 - 03/2016
Cooperation: Dipl. Psych. R. Kroymann (Freie Praxis Dresden)
Seit Mai 2012 haben ca. 50 Patienten die unter P11 beschriebene Gruppentherapie zur Verhaltensaktivierung
bei Depressionen absolviert. Erste Ergebnisse dieser Pilotierungsphase zeigen einen signifikanten Anstieg in der
Verhaltensaktivierung der Patienten sowie einen damit einhergehenden Rückgang der depressiven Symptomatik
über den Therapieverlauf. Ca. 50% der Patienten erreichen zu Therapieende einen Depressionswert im subklinischen Bereich (BDI II < 11; Furka & Hoyer, 2014). Des Weiteren bestätigen erste Patientenrückmeldungen
die subjektiv empfundene Nützlichkeit und Akzeptanz der Gruppentherapie, liefern aber zugleich auch wichtige Hinweise zur Optimierung des therapeutischen Erfolgs. So berichten Patienten beispielsweise, das Ausfüllen ihrer Stimmungsprotokolle zu vergessen oder über Befindlichkeiten die Paper und Pencil Version der
Stimmungsprotokolle in bestimmten sozialen und beruflichen Kontexten zu nutzen. Da die Protokollierung von
187
Stimmung und Aktivitäten sowie die Planung von Aktivitäten ein zentraler Bestandteil verhaltensaktivierender Interventionen ist, soll auf die beschriebenen Probleme mit der Konzeption einer therapiebegleitenden App reagiert
werden. Darüber hinaus soll die therapiebegleitende App den Transfer und die Generalisierung von in der Therapie
vermittelten Inhalten und Fertigkeiten in den Alltag sicherstellen und auch dieses sehr grundsätzliche Hindernis einer
erfolgreichen Psychotherapie angehen. Die geplante App sieht nicht nur die Smartphone-gestützte Protokollierung
von Stimmung und Aktivität vor, sondern auch deren anschauliche Visualisierung, die es den Patienten erleichtern soll
Kontingenzen zwischen dem eigenem Verhalten und der eigenen Stimmung zu erfassen (siehe Abbildung 1). Mittels
stündlichem Signalton und Aufforderung zur Eingabe von Stimmung und Aktivität soll dem Aspekt des Vergessens
entgegengewirkt werden. Weitere Funktionen der App sollen u.a. eine Erinnerungsfunktion an geplante Aktivitäten, im
Sinne eines werte-orientierten Prompting (siehe Abbildung 2), umfassen sowie die komprimierte Form psychoedukativer Inhalte und Bewältigungsstrategien, die während der Gruppentherapie vermittelt werden.
Restaurant mit Ehemann
Abbildung 1. Verlauf der Stimmung über den Tag.
Mittels eines beweglichen Cursors kann die Stimmungskurve abgetastet werden, wobei am jeweiligen
Standpunkt des Cursors eine Anzeige der durchgeführten Aktivität erfolgt.
Erinnerung:
Ich bin in 1h zum
Abendessen verabredet
und sollte 30min fŸ r
Kleider-wahl und Makeup einplanen.
Werte-orientierter
Prompt:
Die Verabredung ist mir
wichtig, weil mir viel
daran liegt schš ne Dinge
mit meinem Mann zu
unternehmen und die
Beziehung zu pflegen.
Abbildung 2. Beispiel für Erinnerungs
nachricht(werteorientiertes Prompting)
Furka, N. & Hoyer, J. (2014, Mai).Verhaltensaktivierung bei Depression: Erste Ergebnisse zu einem Gruppenprogramm. Poster auf dem 32. Symposium für Klinische Psychologie und Psychotherapie der DGPs in Braunschweig.
P15. Everyday experiences and mood changes
Pl: Dr. Andrew T. Gloster (University of Basel)/Prof. Dr. Jürgen Hoyer; Staff: Dipl. Psych. Nadine Furka; Funding: Haushalt,
University of Basel ; Duration: 07/2014 - 06/2016; Cooperation: University of Basel, Switzerland (Dr. Andrew T. Gloster)
Background: Self-report questionnaires are ubiquitously utilized, seldom with an awareness of inherent biases. As a
result, erroneous conclusions may be made about the nature of a patient’s problems and psychopathology in general.
Although multiple lines of research have shown that humans are inaccurate in reporting and rely on multiple heuristics,
the impact of these effects on our understanding of clinical symptomatology has generally been neglected. This is
especially critical in clinical studies, where the dominance of two data points (i.e., pre-treatment and post-treatment)
preclude all information about the fluctuation of symptomatology and course of change. As such, the rich variability of
dynamic expression of patient symptomatology over time is lost, crucial information about the maintaining factors of
psychopathology is obfuscated, and theories of psychopathology remain incomplete.
By assessing these clinical and healthy control samples, we will be able to test a wide range of negative affect (i.e.,
from healthy controls to extreme cases of MDD and SP) and can determine whether effects are consistent across
emotions of anxiety and depression. We will also test whether people’s most salient and recent events are most
influential on the retrospective recall (i.e., peak-end rule). To our knowledge, this study would be the first to examine these issues in these diverse samples and the first to test across clinical and non-clinical populations and their
respective emotions. Finally, we will test which patient/ participant characteristics influence the magnitude of the
memory-experience gap (e.g., are greater gaps associated with more fluctuation of symptoms, severity, overall experiential avoidance, etc.). Method: This research will use ecological momentary assessment (EMA), a new assessment
method that captures data close to the time of occurrence in participants own environment, as a means to obtain data
that is less biased in patients with mental disorders and participants without any mental disorder (n=117). The patient
groups will consist of individuals diagnosed with social phobia (n = 48) and major depression (n=117), both of which
are prevalent in outpatient treatment centers. Importantly, the inclusion of an anxiety disorder, a mood disorder, and
participants without any disorder allows for testing of the generalizability of our previous findings.
188
Screening
Time1
In Lab
(Day1)
Time 2
In Lab
(Day 8)
EMA
(Days 8-15)
Time 3
In Lab
(Day 15)
The study is a quasi-experimental, 2-week longitudinal observation study
In gathering such information, we have two overarching aims. First, we aim to determine the degree of accuracy
in recall of symptomatology and explore which heuristics (e.g., recency and saliency bias) interfere with accurate
reporting. In particular, participants’ EMA data will be compared with their retrospective recall and examined for
recall inaccuracies and overestimation of symptom covariation. Moreover, in an exploratory approach, we want to
investigate in the interaction of symptom fluctuation with biological markers of stress- and sleep regulation.
Hoyer, J. & Gloster, A.T. (2013). Psychologische Flexibilität messen: Der Fragebogen zu Akzeptanz und Handeln. Verhaltenstherapie, 23, 42-44
P16. Risiken und Nebenwirkungen von Psychotherapie
PI: Dr. Samia Härtling, Prof. Dr. Franziska Einsle; Staff: Anne Kasper, Christine Willrodt, Helene Vilsmeier, Tino
Franzke, Anne Dschietzig; Kooperationspartner: Prof. Dr. Bernhard Strauß, Universitätsklinikum Jena, Prof. Dr.
Michael Linden, Charité Universitätsmedizin Berlin; Funding: Haushalt ; Duration: seit 01/2013
Die Wirksamkeit von Psychotherapie gilt heute als belegt. Demgegenüber steht die Erforschung von unerwünschten Therapieeffekten, Nebenwirkungen oder Therapieschäden erst am Anfang. Dies zeigt sich unter anderem darin,
dass einheitliche Definitionen fehlen und weltweit kaum Studien zu diesen Themen vorliegen. Die Arbeitsgruppe
Risiken und Nebenwirkungen von Psychotherapie möchte Häufigkeit, Art, Verlauf und Konsequenzen von unerwünschte Therapiefolgen und Nebenwirkungen von Psychotherapie untersuchen und langfristig präventive Strategien zur Minimierung dieser Effekte entwickeln. Bevor dies in größerem Rahmen sinnvoll möglich ist, werden in
mehreren kleineren Arbeitspaketen die nötigen Arbeitsschritte in Bezug auf definitorische Klarheit, Auswahl und
ggf. Erstellung geeigneter Erhebungsinstrumente, Fallzahlschätzungen, Teilnehmerrekrutierung etc. durchgeführt.
In einem ersten Arbeitsschritt wurde nach Sichtung der Literatur erste Definitionen von unterwünschten
Ereignissen, negativen Therapiewirkungen und Nebenwirkung erstellt (siehe Abb. 1).
In einem zweiten Arbeitsschritt wurden verschiedene Fragebögen zur Selbsteinschätzung eingesetzt, um deren
Praxistauglichkeit, Gütekriterien und Vergleichbarkeit zu bestimmen, sowie erste inhaltliche Anhaltspunkte für
Häufigkeit unerwünschter Ereignisse, negativer Therapiewirkungen und deren Korrelate zu bekommen. Die Untersuchung dieser Aspekte erfolgte an einer Gelegenheitsstichprobe von ambulanten Verhaltenstherapiepatienten
(N = 70) der Dresdner Hochschulambulanz. Als Erhebungsinstrumente wurden das Inventar zur Erfassung negativer Effekte von Psychotherapie (INEP; Ladwig, Rief, & Nestoriuc, eingereicht), die Skala therapeutische Allianz
– Revised (Brockmann et al., 2011) sowie Informationen aus den Patientenakten verwendet. 84 % der Patienten
berichteten mindestens einen unerwünschten Effekt (Range: kein (16% der Patienten) bis 13 (3 % der Patienten)
unerwünschte Therapieeffekte). Mehr unerwünschte Therapieeffekte im Bereich Symptomatik und Stigmatisierung
fanden sich bei Patienten mit ambulanter Vorbehandlung, während mehr unerwünschte Effekte im Bereich Beruf
bei stationärer Vorbehandlung vorlagen. Die Anzahl an Behandlungsdiagnosen war assoziiert mit unerwünschten
Therapieeffekten im Bereich Beruf. Es zeigten sich allerdings keine Zusammenhänge zwischen der Einschätzung
der Beeinträchtigung durch die Therapeuten (CGI, GAF) zu Therapiebeginn und einem vermehrten Vorliegen unerwünschter Therapieeffekte. Für die durch den Patienten eingeschätzte therapeutische Beziehung und das Vorliegen
unerwünschter Therapieeffekte zeigte sich eine negative Assoziation. Hinsichtlich der zeitbezogenen Variablen erga189
ben sich bei Therapiemenge, -frequenz und beantragter Therapiedauer keine Assoziationen. Für die Regelmäßigkeit
zeigte sich, dass unregelmäßigere Therapien mit mehr unerwünschten Effekten im Bereich Freunde/Familie einhergingen.
In einem dritten Arbeitsschritt wurde mit einer Teilstichprobe von N = 23 Patienten zusätzlich ein Interview zur
Checkliste Unwanted Effects to Adverse Treatment Reactions (UE-ATR; Linden, 2012; Patienten-Interviewversion
von Einsle, Härtling, & Linden, 2013) eingesetzt. Dieses Interview enthält Einschätzungen der Patienten und des
Interviewers und kann somit sowohl als Selbstbeurteilungsinstrument als auch als Fremdbeurteilungsinstrument
angesehen werden. Die Selbstaussagen der teilnehmenden Patienten in Fragebogen und Interview wurden in
einem ersten Auswertungsschritt miteinander verglichen. Es ergab sich ein weitgehend übereinstimmendes Bild,
welches sich in großen positiven Korrelationen zwischen beiden Messinstrumenten zeigte. Weitere Auswertungen
zu spezifischen Unterschieden zwischen beiden Erhebungsinstrumenten sowie zum Vergleich zwischen der
Selbsteinschätzung der Patienten und der Fremdeinschätzung der Interviewer werden in den nächsten Monaten
durchgeführt. Die Häufigkeit unerwünschter Ereignisse, sowie das Vorliegen negativer Therapiewirkungen
im Rahmen dieser verhaltenstherapeutischen Gelegenheitsstichprobe unterstreicht die Wichtigkeit dieses
Forschungsgebiets, insbesondere vor dem Hintergrund der Rechte des Patienten nach informierter Einwilligung in
die Therapie. Die berichteten Assoziationen untermauern die Vielschichtigkeit des Themas und die Notwendigkeit
weiterführender längsschnittlicher Untersuchungen, für die in den nächsten Jahren ein weiterführendes Funding
angestrebt wird.
Einsle, F., Kasper, A., Willrodt, Ch., Hoyer, J. & Härtling, S. (2013, 11.). Unerwünschte Ereignisse während ambulanter Psychotherapie: Assoziationen mit Patienten- und Therapievariablen. Vortrag auf dem 41. DGPPN Kongress 2012 in Berlin.
P17. Sexual abuse of children and adolescents: Aetiology, dunkelfeld research and the consequences for victims
Currently, there is only few data on sexual abuse and its consequences for the victims in Germany, especially for
non-reported sexual abuse, the so-called “Dunkelfeld”. The MIKADO multi-centre project has been funded in 2011
by the German Federal Ministry of Family, Elderly, Women and Youth. The project covers frequency of sexual relative to other forms of abuse, offences via internet, consequences of sexual abuse for the victims, the prevalence
of pedophilic interest, etiological hypotheses for pedophilic interest and the interaction of hands-on delinquency and
use of child pornography. The research project was implemented by a collaboration of five national and international
research groups. The main goals are to generate more specific and detailed data on child sexual abuse in Germany
and to develop suggestions for primary as well as secondary prevention. The Dresden group within MIKADO especially focused on the previously neglected topic of the stigmatization and social discrimination of people with pedophilia (as opposed to child abusers!). The staff has made theoretical, methodological, and empirical contributions to
the previously neglected field of stigma research regarding people with pedophilia. This work group closely collaborates with other MiKADO members, based mainly in Bonn (Alexander Schmidt), Köln (Prof. Roland Imhoff), and
Turku (Finland, Katarina Alanko). The MiKADO project ends in September, 2014.
Research questions involved:
a) How prevalent are stigmatizing attitudes towards people with pedophilia?
b) How does stigma affect people with pedophilia and their sexual behavior?
c) Is it possible to reduce stigma towards people with pedophilia among psychotherapist in training?
d) How can people with pedophilia be reached for research purposes outside of clinical or forensic institutions?
P17.1. Literature Review on Stigmatization Against People with Pedophilia
Background: Stigmatization restricts people’s opportunities in life and has severe consequences on mental
health and psychological well-being. This article focuses on stigmatization research on pedophilia. Methods:
Based on an extensive literature search, it reviews studies that have empirically determined lay theories, stereotypes, prejudices, and discrimination against people with pedophilia, as well as the effect of stigma on this group.
Results: The review reveals a scarcity of empirical studies on the subject (11). While the majority of studies give
at least an indication that stigma against people with pedophilia is highly prevalent, we also identified severe
methodological limitations and a lack of a unifying and systematic research agenda. Conclusion: We discuss the
need for more theory-driven, rigorous, and representative empirical studies and propose perspectives and requirements for the scientific study of stigma against people with pedophilia.
Jahnke, S., & Hoyer, J. (2013). Stigmatization of people with pedophilia: A blind spot in stigma research? International Journal of Sexual Health, 25(3), 169 – 184.
190
P17.2. Assessing Public Stigma among People with Pedophilia
Background: Despite productive research on stigma and its impact on people’s lives in the past twenty years, stigmatization of people with pedophilia has received little attention. Methods: We conducted two surveys estimating
public stigma and determining predictors of social distance from this group. In both studies, pedophilia was defined
as a “dominant sexual interest in children”; the survey was comprised of items measuring agreement with stereotypes, emotions, and social distance (among others). Responses were compared with identical items referring to
either people who abuse alcohol (Study 1), sexual sadists or people with antisocial tendencies (Study 2). Study 1
was conducted in two German cities (N = 854) and Study 2 sampled 201 English-speaking online participants.
Results: Both studies revealed that nearly all reactions to people with pedophilia were more negative than those to
the other groups, including social distance. Fourteen percent (Study 1) and 28% (Study 2) of the participants agreed
that people with pedophilia should better be dead, even if they never had committed criminal acts. The strongest
predictors of social distance towards people with pedophilia were affective reactions to this group (anger and, inversely associated, pity) and the political attitude of right-wing authoritarianism (Study 1). Results strongly indicate that
people with pedophilia are a stigmatized group who risk being the target of fierce discrimination.
Figure1: Agreement
(in percent) to Social
Distance items relating
to noffending people
with pedophilia or
nonoffending alcohol
abusers among a nonprobabilistic sample
from Dresden and
Stuttgart (N = 854)
Conclusion: We discuss this particular form of stigmatization with respect to social isolation of persons with pedophilia and indirect negative consequences for child abuse prevention.
Jahnke, S., Imhoff, R., & Hoyer, J. (2014). Stigmatization of people with pedophilia: Two comparative surveys. Archives of Sexual Behavior.
P17.3. Assessing Consequences of Stigma against People with Pedophilia
Background: Despite many years of research on the adverse consequences of stereotyping and discrimination for
many stigmatized groups, little is known about how stigma affects people with pedophilia. In this article, we present
a model, termed Framework for the Effects of Stigma Against People with Pedophilia (FESAP) that outlines how
stigma against people with pedophilia might negatively affect cognitive, emotional and social areas of functioning
and the motivation to pursue therapy, all of which may ultimately contribute to an increased risk of sexual offending. Methods: We tested our assumptions in an online survey among self-identified German-speaking people
with pedophilia (N = 104). In line with our hypotheses, stigma (assessed as perceived social distance and fear of
discovery) predicted higher scores on the Brief Symptom Inventory-53, the UCLA Loneliness Scale, the Emotion
Subscale of the Coping Inventory for Stressful Situations, and the Fear of Negative Evaluation-5 scale, as well as lower
scores on the Rosenberg Self-Esteem Scale. Results: Contrary to our predictions, perceived stigmatization was not
linked to self-efficacy related to control of sexual urges towards children, scores on the Bumby Molest Scale and motivation to seek treatment. Results were controlled for the effects of age, educational level, social desirability, and type
of pedophilia (exclusive or nonexclusive). Conclusion: We critically evaluate the empirical contribution of the presented model to stigma and child sex offending research, including a discussion of the results in light of the potential
indirect effects that public stigma may have on risk factors for sexual offenses.
Jahnke, S., Schmidt, A., Geradt, M., & Hoyer, J. (submitted). Consequences of stigma against people with pedophilia: A new perspective on pedophilia and child sexual abuse
prevention. Archives of Sexual Behavior.
191
P17.4. Testing a Stigma Reduction Program among Psychotherapists in Training
Background: Offering counseling and psychotherapy to patients with pedophilia is considered an essential part of
sexual abuse prevention by many experts in the field. Yet, professionals’ willingness to offer treatment might be
compromised by stigmatizing attitudes towards these patients. Methods: In the present study, we developed and
tested a 10-minute online intervention (including educational material and a video about a person with pedophilia) to
reduce stigma and increase motivation to work with this particular patient group. Psychotherapists in training were
either assigned to the anti-stigma intervention group (n = 68) or the control group (n = 69) that received information
about violence-free parenting. Results: In the anti-stigma condition, agreement with the stereotypes controllability
and dangerousness, anger, reduced pity and social distance diminished significantly after the intervention, compared
to the control group, while motivation to work with this group remained unchanged. The effects persisted, though
slightly reduced in size, for perceived controllability, anger and social distance at follow-up. Conclusion: Our results
suggest that stigmatizing attitudes, negative affective responses and social distance regarding people with pedophilia
among psychotherapists in training can be positively influenced by a low-cost intervention. Practical implications of
these findings for high quality health care and child sexual abuse prevention are discussed.
Jahnke, S., Philipp, K. & Hoyer, J. (in press). Stigmatizing attitudes towards people with pedophilia and their malleability among psychotherapists in training. Child Abuse & Neglect.
P18. Social anxiety and loneliness in social and sexual online communication with strangers – an international study
Pl: MIKADO (Prof. Dr. Michael Osterheider, Regensburg)
& Prof. Dr. Jürgen Hoyer ; Staff: Dipl. Psych. Anja Schulz;
Funding: BMFSFJ ; Duration: 10/2010-09/2014; Cooperation: Universities of Regensburg, Bonn, and Hamburg and
Åbo Akademi University, Turku, Finland.
Background: The Internet provides young persons with many possibilities, but simultaneously increases exposure
to risks such as being sexually approached by strangers, also referred to as online sexual solicitation. As-of-yet,
there are many questions regarding the frequency, characteristics and risk factors of solicitation perpetrators that
cannot be answered based on samples of (potential) victims or apprehended offenders that were investigated todate. Understanding these factors is of cardinal importance when considering effective treatment, risk assessment
and prevention procedures. Specifically, the validity of the implicit assumption that the same risk factors apply for
both offender populations, when applying procedures developed for offline offenders to online offenders, is yet
unclear. This thesis aims to answer the following questions: How frequently do adult Internet users engage in
online sexual solicitation behaviors against children and adolescents? What are the characteristics of these perpetrators compared to those who interact sexually with adults only? To what extent do risk factors that have been identified in other sexual offending behaviors against children, particularly loneliness and social anxiety, also play a role
in solicitation offenders? Reviewing the empirical literature, there is an opportunity for a methodological approach
focusing on adults to obtain self-reports of their experiences of having solicited someone online. Using an online
survey among N = 2828 adult users of Finnish, German and Swedish websites (e.g. social networks, chat rooms,
forums, blogs), the frequency and characteristics of online sexual solicitation perpetrators are assessed in the context where these behaviors occur. Thus, the thesis aims to expand the scope of empirical investigation to novel
information sources and aid to the understanding of solicitation processes. Methods: This study examined the
role of social anxiety, self-perceived loneliness and problematic Internet use as risk factors for online solicitation of
minors. Within a larger convenience sample of adult Internet users from Germany, Finland and Sweden (N = 2828),
the responses of those who communicated online with strangers about sex (n = 741) were specifically analyzed.
Results: As expected, online sexual solicitation of minors was associated with social anxiety, self-perceived loneliness and self-regulation deficits concerning Internet in the online perpetrators. Interestingly, loneliness was specifically pronounced for those who communicated with children, whereas social anxiety and problematic Internet use
were specific for those communicating with adolescents. Discussion: These results suggest that characteristics
associated with offline child sexual abusers and child pornography users can be generalized to online solicitation
offenders.
Schulz, A., Bergen, & Hoyer, J.(submitted). Social anxiety and loneliness in adults who solicit minors online. Sex Abuse.
192
AG 10 DIAGNOSTIC ISSUES AND PSYCHOMETRICS
H.-U. WITTCHEN, K. BEESDO-BAUM, S. KNAPPE & J. HOYER
Prof. Dr. Hans-Ulrich Wittchen, Prof. Dr. Katja Beesdo-Baum, Dr. Susanne Knappe & Prof. Dr. Jürgen Hoyer
Overview: This work group has started its research program in 2009. In the context of the revisions of the diagnostic classification systems for mental disorders, the DSM and the ICD, the workgroup members participated
in a series of systematic literature reviews for the DSM-5 Anxiety Disorder Work Group and began to examine
specific questions related to diagnostic issues and psychometrics using available and newly collected data sets. A
major contribution of the workgroup has been the development and psychometric evaluation of the German of the
dimensional anxiety scales for DSM-5. Upon publication of DSM-5 in 2013, and the finalizing of the German translation, the workgroup now focuses on the adaptation of diagnostic instruments (such as the DIA-X/CIDI) to assess
DSM-5 mental disorders. The work group closely collaborates with other local groups (e.g., AG - Epidemiology and
AG - clinical research) and with extramural groups (Michelle G. Craske, UCLA; Ron Kessler, Harvard). Core research
questions of the work group have been:
a) How can the diagnostic criteria of mental disorders, particularly anxiety disorders, be improved in future diagnostic schemes?
b) Are dimensional measures suitable to supplement categorical diagnoses?
c) How can diagnostic processes be optimized?
P1. Separation anxiety disorder in adults: Possible changes in DSM-V (Bögels, S., Knappe, S. & Clark, L. A.)
Background: Unlike other DSM-IV anxiety disorders, separation anxiety disorder (SAD) has been considered a disorder that typically begins in childhood, and could be diagnosed only in adults “if onset is before 18.” Moreover,
SAD is the only DSM-IV anxiety disorder placed under “Disorders Usually First Diagnosed in Infancy, Childhood, or
Adolescence” whereas most anxiety disorders typically start – and are diagnosed – in childhood. Therefore, adult
SAD may have been under-recognized and under-diagnosed. Methods: A literature review was carried out on behalf
of the Anxiety, Obsessive–Compulsive Spectrum, Posttraumatic, and Dissociative Disorders DSM-5 workgroup to
explore the evidence for SAD in adulthood, focusing on potentially relevant clinical characteristics and risk factors.
Results: The review revealed that SAD in adulthood is prevalent, often comorbid and debilitating. The DSM-IV ageof-onset criterion was not supported as a substantial portion of adults report first onset in adulthood. Research on
putative risk factors is limited to childhood SAD: SAD runs in families, albeit patterns of familial aggregation and
heritability estimates indicate low specificity. Tentative evidence for biomarkers and biased cognitive processes
exists, again pointing to moderate SAD-specificity only. Conclusions: Further research on the epidemiology, etiology, and treatment of ASAD, using DSM-5 criteria, is needed, and particularly prospective-longitudinal studies to
understand the developmental trajectories of separation anxiety disorder from childhood to adulthood.
Bögels, S. M., Knappe, S., & Clark, L. A. (2013). Separation anxiety disorder in adults in DSM-5. Clinical Psychology Review, 33, 663–674.
P2. A dimensional approach to measuring anxiety for DSM-5 (LeBeau, R.T., Glenn, D.E., Hanover, L., BeesdoBaum, K., Wittchen, H.-U., & Craske, M.G.)
Background: In preparation for DSM-5’s planned inclusion of dimensional assessments of psychopathology as a
complement to traditional categorical diagnoses, we developed brief self-rated scales for anxiety disorders that
are consistent in content and structure. In the present paper, we discuss the creation of the scales and examine
their psychometric properties and clinical sensitivity. Methods: Phase One assessed psychometric properties of
the initial versions of the scales in a large non-clinical sample (n = 702). Phase Two assessed the psychometric
properties of revised versions of the scales, including test–retest reliability, in a non-clinical sample (n = 57). Phase
Three examined the scales’ psychometric properties and relationship with clinician ratings of disorder severity in a
clinical sample (n = 48). Results: The scales demonstrated internal consistency (a = 0.85–0.92), convergent validity
(rs=0.39–0.69), and test–retest reliability in the non-clinical samples (ICC = 0.51–0.81). In the clinical sample, the
scales demonstrated significantly higher total scores than in the non-clinical sample (Cohen’s d=0.72–1.50) and
moderate to high correlations with clinician ratings of disorder severity (r = 0.43–0.82). Conclusions: Although further evaluation and refinement of the scales (particularly the specific phobia and agoraphobia scales) is needed, the
results provide preliminary support for the use of these scales in DSM-5 and thus take an important step toward the
integration of standardized dimensional measurement into the diagnosis of anxiety disorders.
LeBeau, R. T., Glenn, D. E., Hanover, L. N., Beesdo-Baum, K., Wittchen, H.-U., & Craske, M. G. (2012). A dimensional approach to measuring anxiety for DSM-5. International
Journal of Methods in Psychiatric Research, 21(4), 258-272.
193
P3. Psychometric properties of the dimensional anxiety scales for DSM-5 in an unselected sample of
German treatment seeking patients. (Beesdo-Baum, K., Knappe, S., Klotsche, J., Craske, M.G., LeBeau, R.T.,
Hoyer, J., Strobel, A., Pieper, L. & Wittchen, H.-U.)
Background: Dimensional assessments are planned to be included as supplements to categorical diagnoses in
DSM-V. The aim of this study was to examine the unidimensionality, reliability, validity, and clinical sensitivity of
brief selfrated scales for specific anxiety disorders in an unselected German sample of consecutive attendees to a
psychological clinic. These scales use a common template to assess core constructs of fear and anxiety. Methods:
Dimensional scales for social anxiety disorder, specific phobia, agoraphobia, panic disorder, and generalized anxiety disorder were administered along with established scales to 102 adults seeking treatment for mental health
problems at a German university outpatient clinic for psychotherapy. The computer-assisted clinical version of the
Munich-Composite International Diagnostic Interview was used to assess mental disorders according to DSM-IV criteria. Dimensionality and scale reliability were examined using confirmatory factor analyses. Convergent and discriminant validity were examined by testing differences in the size of correlations between each dimensional anxiety
scale and each of the previously validated scales. Each dimensional scale’s ability to correctly differentiate between
individuals with versus without an anxiety diagnosis was examined via the area under the curve. Results: Analyses
revealed unidimensionality for each scale, high reliability, and convergent and discriminant validity. Classification performance was good to excellent for all scales except for specific phobia.
Table: Comparison of dimensional scale values among patients with vs. without the corresponding DSM-IV anxiety disorder and
classification performance of the dimensional scales (N = 102)
Conclusions: The application of the dimensional anxiety scales may be an effective way to screen for specific anxiety disorders and to supplement categorical diagnoses in DSM-V, although further evaluation and refinement of the
scales (particularly the specific phobia scale) is needed.
Beesdo-Baum, K., Klotsche, J., Knappe, S., Craske, M. G., LeBeau, R. T., Hoyer, J., Strobel, A., Pieper, L., & Wittchen, H.-U. (2012). Psychometric properties of the dimensional anxiety scales for DSM-5 in an unselected sample of German treatment seeking patients. Depression and Anxiety, 29, 1014-1024.
P4. Dimensional anxiety scales for DSM-5: Sensitivity to clinical severity (S. Knappe, J. Klotsche, A. Strobel,
R.T. LeBeau, M.G. Craske, H.-U. Wittchen, K. Beesdo-Baum)
Background: Psychometric properties and clinical sensitivity of brief self-rated dimensional scales to supplement
categorical diagnoses of anxiety disorders in the DSM-5 were recently demonstrated in a German treatment seeking sample of adults. The present study aims to demonstrate sensitivity of these scales to clinical severity levels.
Methods: The dimensional scales were administered to 102 adults at a university outpatient clinic for psychotherapy. Diagnostic status was assessed using the Munich-Composite International Diagnostic Interview. To establish
a wide range of clinical severity, we considered subthreshold (n = 83) and threshold anxiety disorders (n = 49,
including Social Phobia, Specific Phobia, Agoraphobia, Panic Disorder, and Generalized Anxiety Disorder). Results:
Individuals with either subthreshold or threshold anxiety disorder scored higher on all dimensional scales relative to
194
individuals without anxiety. In addition, individuals with a threshold anxiety disorder scored higher on the dimensional
scales than individuals with a subthreshold anxiety disorder (except for specific phobia). Disorder-related impairment
ratings, global functioning assessments and number of panic attacks were associated with higher scores on dimensional scales. Findings were largely unaffected by the number of anxiety disorders and comorbid depressive disorders.
Conclusion: The self-rated dimensional anxiety scales demonstrated sensitivity to clinical severity, and a cut-off
based on additional assessment of impairment and distress may assist in the discrimination between subthreshold
and threshold anxiety disorders. Findings suggest further research in various populations to test the utility of the
scales for use in DSM-5.
Knappe, S., Klotsche, J., Strobel, A., LeBeau, R. T., Craske, M. G., Wittchen, H.-U., & Beesdo-Baum, K. (2013). Dimensional anxiety scales for DSM-5: Sensitivity to clinical
severity. European Psychiatry, 28, 448–456.
P5. Test–retest reliability and sensitivity to change of the dimensional anxiety scales for DSM-5 (S. Knappe, J.
Klotsche, F. Heyde, S. Hiob, J. Hoyer, A. Strobel, J. Siegert, R.T. LeBeau, M.G. Craske, H.-U. Wittchen, K. Beesdo-Baum)
Background: Psychometric properties and clinical sensitivity of brief self-rated dimensional scales to supplement
categorical diagnoses of anxiety disorders in the DSM-5 were recently demonstrated in a German treatment seeking sample of adults. The present study aims to demonstrate sensitivity of these scales to clinical severity levels.
Methods: The dimensional scales were administered to 102 adults at a university outpatient clinic for psychotherapy. Diagnostic status was assessed using the Munich-Composite International Diagnostic Interview. To establish a
wide range of clinical severity, we considered subthreshold (n = 83) and threshold anxiety disorders (n = 49, including
Social Phobia, Specific Phobia, Agoraphobia, Panic Disorder, and Generalized Anxiety Disorder). Results: Individuals
with either subthreshold or threshold anxiety disorder scored higher on all dimensional scales relative to individuals
without anxiety. In addition, individuals with a threshold anxiety disorder scored higher on the dimensional scales than
individuals with a subthreshold anxiety disorder (except for specific phobia). Disorder-related impairment ratings, global functioning assessments and number of panic attacks were associated with higher scores on dimensional scales.
Findings were largely unaffected by the number of anxiety disorders and comorbid depressive disorders.
Conclusion: The self-rated dimensional anxiety scales demonstrated sensitivity to clinical severity, and a cut-off based
on additional assessment of impairment and distress may assist in the discrimination between subthreshold and
threshold anxiety disorders. Findings suggest further research in various populations to test the utility of the scales for
use in DSM-5.
Knappe, S., Klotsche, J., Heyde, F., Hiob, S., Hoyer, J., Strobel, A., Siegert, J., LeBeau, R. T., Craske, M. G., Wittchen, H.-U., & Beesdo-Baum, K. (2013). Test-retest reliability
and sensitivity to change of the dimensional anxiety scales for DSM-5. CNS Spectrums.
Hiob, S. (2013). The dimensional anxiety scales for DSM-5: Sensitivity to change in a clinical sample (Supervision: Beesdo-Baum/Knappe). Diplomarbeit (psychology diploma
thesis), TU Dresden.
Heyde, F. (2013). Psychometric properties of the dimensional anxiety scale for DSM-5 in a non-clinical student sample (Supervision: Knappe/Beesdo-Baum). Diplomarbeit
(psychology diploma thesis), TU Dresden.
P6. Psychometric Properties of the 1-Week Dimensional Anxiety Scales for DSM-5 in a Non-Clinical Student
Sample (K. Beesdo-Baum, H.-U. Wittchen, M.G. Craske, J. Hoyer, S. Jurkschat, A. El Hadad & S. Knappe)
Background and objectives: The American Psychiatric Association has published the Diagnostic and Statistical
Manual of Mental Disorders, Fifth Edition (DSM-5; [1]) with supplemented dimensional measures for different
psychiatric disorders. The DSM-5 Anxiety, OC Spectrum, Posttraumatic and Dissociative Disorder Workgroup
developed brief self-rating dimensional anxiety scales, for which good psychometric properties and classification
performance were demonstrated for the 4-week version in previous studies [2, 3]. The objective of this study is to
examine dimensionality, convergent and discriminant validity and classification performance of the German oneweek version of the dimensional anxiety scales in a large, convenience, non-clinical, student sample. Methods:
The one-week version of the German dimensional cross-cutting anxiety scale as well as dimensional anxiety scales
for social anxiety disorder, specific phobia, agoraphobia, panic disorder, generalized anxiety disorder and separation
anxiety disorder, together with a range of previously validated measures, were given to 251 university students via
online-survey. To determine unidimensionality confirmatory factor analyses were conducted. Internal consistency
(reliability) was determined with Cronbach’s alpha. To examine convergent and discriminant validity, differences of
correlation coefficients between each dimensional scale and the previously validated measures were tested. To
examine the classification performance of the dimensional scales the area under the curve (AUC) was calculated.
Test-retest reliability was examined using Intraclass Correlational Coefficients (ICCs) between the total score on
each of the disorder-specific dimensional scales and the Cross-D at Time 1 with the total score on each scale at
195
Time 2 (approx. 10 days later; N=149). Results: For all dimensional scales unidimensionality and high internal consistency (α = .81 to α = .89) were demonstrated. High correlations were found for all dimensional anxiety scales with their
corresponding measures (r =. 59 to r = .73) except for specific phobia (r = .31), and most correlation coefficients for the
corresponding measures were significantly higher than the correlation coefficients of the non-corresponding measures
(P´s < .05). All correlations between the dimensional anxiety scales and scales assessing theoretically distinct domains of
anxiety (depression, psychoticism, paranoid ideation) were low to moderate and significantly lower than the correlations
between the corresponding anxiety measures. The ability of each of the dimensional anxiety scales to differentiate between individuals with and without an indication for an anxiety disorder was sufficient to good (AUC = .71 to .89) except
for generalized anxiety disorder (AUC = .64). With exception of panic disorder (ICC = .59), strong test-retest reliability for
the dimensional anxiety scales (ICC = .79 to .93) and the Cross-D (ICC = .96) could be demonstrated. Conclusions: The
results for the one-week version of the German dimensional anxiety scales for DSM-5 in a non-clinical student sample
largely confirm findings of previous studies examining the four-week version. Good psychometric properties and sufficient to good classification performance were demonstrated. For the first time the psychometric properties of the separation anxiety disorder scale were examined, which emerged to be equally good compared to the other dimensional anxiety
scales. Further evaluation however is still needed, especially in clinical samples.
Beesdo-Baum, K., Wittchen, H.-U., Craske, M.G., Hoyer, J., Jurkschat, S., A. El Hadad & Knappe, S. (in press). Psychometric Properties of the 1-Week Dimensional Anxiety
Scales for DSM-5 in a Non-Clinical Student Sample. (Abstract). European Neuropsychopharmacology.
Jurkschat, S. (2014). Psychometric properties of the revised dimensional anxiety scales for DSM-5 in a non-clinical student sample (Supervision: Beesdo-Baum). Diplomarbeit
(psychology diploma thesis), TU Dresden.
P7. Limited psychometric properties of the DSM-5 dimensional assessment scales for OCD and PTSD
Background: A set of disorder specific dimensional anxiety scales was introduced in the DSM-5 to map the frequency, intensity and clinical characteristics of anxiety disorders. All scales follow the same template. Their psychometric properties and clinical utility were demonstrated for social anxiety disorder, specific phobia, agoraphobia,
panic disorder and generalized anxiety disorder in clinical and non-clinical samples. Of note, dimensional scales
were also introduced for repetitive and obsessive compulsive behaviors (obsessive-compulsive disorder, OCD-D,
adapted from the Florida Obsessive-Compulsive Inventory) and posttraumatic stress disorder (PTSD-D, based on
the National Stressful Events Survey PTSD Short Scale). Psychometric properties and clinical utility of the DSM-5
dimensional assessments for OCD and PTSD remain yet to be determined. Aims: To examine concurrent and
divergent validity, as well as reliability, and sensitivity to change of the DSM-5 dimensional scales for OCD and
PTSD in a sample of treatment seeking adults from a German outpatient center. Methods: The German versions of the DSM-5 dimensional scales for OCD and PTSD were administered to 102 outpatients (10 and 20 cases
with threshold and subthreshold OCD; 9 and 11 cases with threshold and subthreshold PTSD) of whom 55 were
followed-up 1 year later. DSM-IV diagnostic status was determined by the DIA-X/M-CIDI; cases with one diagnostic
criterion of B-E missing were coded as subthreshold cases. Mean differences and t-Scores between non-cases,
subthreshold and threshold cases were calculated. Convergent and discriminant validity was analyzed with Pearson
correlations between the global stress index and the ‘obsessions’ subscale of the Brief Symptom Index for the
PTSD and OCD dimensional scales, respectively. The test for correlated correlation coefficients was used for
comparing the correlation coefficients for these conceptually similar measures to conceptually different measures
derived from a range of previously validated instruments. Internal consistency (reliability) was determined with
Cronbach’s alpha. At follow-up, the self-rating Clinical Global Impression-Improvement scale (CGI-I) was applied to
assess symptom change. Results: For the DSM-5 dimensional scale for OCD, but not for PTSD, mean differences
emerged between non-cases, subthreshold and threshold cases. Concurrent validity was only established for the
OCD scale. Discriminant validity was not observed because correlations with non-corresponding scales were similar
to correlations with corresponding scales. Reliability of the scales was 0.94 for OCD and 0.91 for PTSD dimensional
scales. For both scales and for threshold and at least subthreshold conditions, pre-post differences were unrelated
to scores in dimensional scales, indicating lack of sensitivity to change. Conclusions: Both the DSM-5 dimensional
scales for OCD and PTSD scales revealed high internal consistency as well as correlations with conceptually similar
measures such as BSI subscales and indices. Concurrent and discriminant validity was however lower as compared
to the other dimensional anxiety scales. Also, sensitivity to change was not observed which may be attributed to
limited sample size, small case numbers and adaption of the scales’ instruction for German patients. Further testing
and evaluation of the psychometric properties for the DSM-5 dimensional scales for OCD and PTSD are needed in
larger non-clinical and clinical samples.
Knappe, S., Mark, T., Hoyer, J., Craske, M. G., Wittchen, H.-U. & Beesdo-Baum, K. (2014). Limited psychometric properties of the DSM-5 dimensional assessment scales for
OCD and PTSD. Poster presented at the 27th Congress of the European College of Neuropsychopharmacology, Berlin, Germany, October 18-21, 2014.
196
P8. Development of a measure for the behavioral symptoms of Generalized Anxiety Disorder (L. Krause & K.
Beesdo-Baum)
Background: Although some pathogenetic models and psychotherapeutic treatments indicate the importance of
dysfunctional coping behaviors in Generalized Anxiety Disorder (GAD), these have been insufficiently addressed in
prior research. In fact, the proposal to include behavioral symptoms as defining feature of GAD in DSM-V has failed
due to lack of empirical data. This may be due to the fact, that to date there exists no valid measure to determine
the behavioral symptoms in GAD. The consideration of such a measure may improve the understanding of this
burdensome mental disorder and thus allow for improved recognition, diagnosis, and treatment. Therefore, the aim
of this study was to develop an instrument that measures the behavioral symptoms of GAD. Methods: In a multistage process the items of the measure were developed. After item generation (Stage I) and further analysis of
content validity (Stage II), the item refinement with exploratory factor analysis (Stage III) was conducted. To initially
ensure content validity, stage I involved the exploration of clinical literature and research for domains of the questionnaire, following interviews with 22 GAD – experts used for the construction of the items. The content validity
was further analyzed using expert ratings in stage II. In the last phase of the developing process, the initial factor
structure of the measure was determined in a sample of 150 university students. In addition, construct validity was
examined by calculating correlations between the resulting subscales and worry as well as intolerance of uncertainty and controlling them for depression. Finally, cut-off scores for each subscale and the total scale were determined
using receiver operator characteristics (ROC) curves. Results: Exploratory Factor analysis (Principal component
analysis, PCA) revealed the five factors: (1) safety behavior, (2) behavioral avoidance, (3) reassurance seeking, (4)
procrastination, and (5) cognitive avoidance. For the resulting subscales good internal consistencies (Cronbach’s α)
as well as good construct validity were shown. Finally, high worriers were found to have significantly higher sum
scores on the five subscales and the total scale than the group of low and medium worriers. Conclusion: The
measure for the behavioral symptoms of GAD is a promising self-report instrument that comprises five internally
consistent dimensions. The overall results imply that the behavioral symptoms may be important constructs that are
associated to pathological worry. Further work is required to confirm factor structure, further validate the measure
and test the specificity to GAD.
Table: Comparison of means among low/medium and high worrier and classification performance of the five behavioral subscales
Krause, L. (2013). Development of a measure for the behavioral symptoms of Generalized Anxiety Disorder (Supervision: Beesdo-Baum). Diplomarbeit (psychology diploma
thesis), TU Dresden.
P9. Angststörungen im DSM-5. Ein Überblick über Änderungen in Struktur und Inhalt. (H.-U. Wittchen, I.
Heinig & K. Beesdo-Baum)
Hintergrund und Fragestellung: Die DSM-5 Arbeitsgruppe „Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic,
and Dissociative Disorders“ befasste sich mit der Rekonzeptualisierung aller Angstassoziierten Störungen. Ergebnisse:
Basierend auf systematischen Literaturanalysen, der Reanalyse vorhandener Daten sowie der Bewertung der
Ergebnisse vor dem Hintergrund der DSM-5-Prinzipien wurde das Störungsspektrum in separate Kategorien für die
197
„klassischen Angststörungen“, Trauma- und Belastungsbezogenen Störungen, Zwangsstörungen und Verwandte
Störungen sowie Dissoziativen Störungen gegliedert. Unter den „klassischen Angststörungen“ werden nun auch
der Selektive Mutismus und die Störung mit Trennungsangst gruppiert. Eine wesentliche Änderung im DSM-5
gegenüber dem DSM-IV betrifft die vereinfachte Klassifikation der Panikstörung und der Agoraphobie, welche nunmehr separat kodiert werden; ihre Überlappung wird als komorbide Doppeldiagnose ausgewiesen. Diskussion:
Die Angststörungskriterien wurden insgesamt hinsichtlich Inhalt und Reihenfolge sowie deren Anwendbarkeit auf
alle Alters-, Geschlechts- und Kulturgruppen hin vereinheitlicht. Zudem wurden diagnosenspezifische und diagnosenübergreifende dimensionale Angstskalen entwickelt, welche die kategoriale Diagnostik insbesondere bei der
Beurteilung des Schweregrades und des Therapieverlaufs ergänzen können.
Wittchen, H. U., Heinig, I., & Beesdo-Baum, K. (2014). Angststörungen im DSM-5. Ein Überblick über Änderungen in Struktur und Inhalt. Nervenarzt, 8, 548–555.
P10. Measuring Symptoms and Diagnosing Mental Disorders in the Elderly Community: The TestRetest Reliability of the CIDI65+ (H.-U. Wittchen, J. Strehle, A. Gerschler, J. Volkert, M.C. Dehoust, S. Sehner,
K. Wegscheider, B Ausìn, A. Canuto, M. Crawford, C. Da Ronch, L. Grassi, Y. Hershkovitz, M. Munoz, A. Quirk, O.
Rotenstein, A.B. Santos-Olmo, A. Shalev, K. Weber, H. Schulz, M. Härter, & S. Andreas)
Prevalence findings for the Elderly are artifactually low, most likely due to insufficient consideration of age-related
cognitive abilities in diagnostic interviews. Aims: (1) To describe the rationale for the development of an age-adapted Composite International Diagnostic Interview (CIDI65+) for use in a European project (MentDis_ICF65+). (2) To
examine its test-retest reliability. Methods: Based on substantive pilot work the CIDI standard questions were shortened, broken down into shorter subsets and combined with sensitization questions and dimensional measures.
Test-retest (T-RT) was determined in N=68 subjects aged 60-79 years via 2 independent examinations by clinical
interviewers using kappa (sensitivity, specificity) for categorical and intraclass-coefficients (ICC) for dimensional
measures. Results: T-RT reliability was good for any mental disorder (k:.63), major depression (k: .55), anxiety (k:
.62, range: .30-.78), substance (k=.77, range: k:.71-.82), obsessive- compulsive disorder (k:1.00) and most core symptoms/syndromes (k range: .48-1.00). Agreement for some disorders (i.e: somatoform/pain) attenuated, partly due
to time lapse effects. ICC for age of onset, recency, quantity, frequency and duration questions ranged between k:
.60 - .90. Dimensional agreement measures were not consistently higher. Conclusion: The age-adapted CIDI65+
is reliable for assessing most mental disorders, distress, impairment and time-related information in the Elderly,
prompting the need to examine validity.
Wittchen, H.-U., Strehle, J., Gerschler, A., Höfler, M., Volkert, J., Hausberg, M., Härter, M., Schulz, H., Canuto, A., Crawford, M., Grassi, L., Munoz, M., Shalev, A., & Andreas, S. (in press).
Measuring Symptoms and Diagnosing Mental Disorders in the Elderly Community: The Test-Retest Reliability of the CIDI65+. International Journal of Methods in Psychiatric Research.
P11. Überprüfung der psychometrischen Eigenschaften der deutschen OASIS-Skala (OASIS-D) im
Hausarztsektor
Local PI: Susanne Knappe (Dresden); Local staff: cand. Psych. Fabian Rottstädt, cand. Psych. Charlotte Bauer,
BA Sc. Theresa Ollmann; Funding: intern, household; Duration: 05/2014 –8/2014; Project partners: Prof. Franziska
Einsle (SRH Fachhochschule für Gesundheit, Gera), Prof. Jochen Gensichen (Institut für Allgemeinmedizin,
Universitätsklinikums Jena)
Angststörungen sind häufig (ca. 14% der deutschen Bevölkerung, Jacobi et al., 2004), gehen mit einer Vielzahl
an gesundheitlichen bzw. sozialen Beeinträchtigungen einher und haben langfristig unbehandelt eine ungünstige
Prognose. Hausärzten kommt in ihrer Funktion als Schnittstelle in der Versorgung eine besondere Bedeutung
bei der Früherkennung von Angststörungen zu, wobei viele Patienten mit Angststörungen ausschließlich hausärztlich behandelt werden. Während es für die Depression inzwischen gut evaluierte Screeninginstrumente zur
Früherkennung gibt, fehlt dies für den Bereich der Angststörung. Ziel dieser hausärztlichen Setting stattfindenden
Fragebogenstudie ist daher die Testung der psychometrischen Eigenschaften der deutschsprachigen Papier-Bleistift
Version der Overall Anxiety Severity and Impairment Scale (OASIS-D; Original: Norman et al. 2006) in einer zufälligen
Stichprobe von Allgemeinarztpatienten, die an einem ausgewählten Stichtag die Praxis ihres Hausarztes aufsuchen.
Ziel ist die Überprüfung der internen Konsistenz (Reliabilität), konvergenten und diskriminanten Validität, Spezifität und
Sensitivität sowie Bestimmung der Re-Testreliabilität und der Erkennensraten des Instrumentes.
Rottstädt, F. (2014). Sexuelle Funktionsstörungen bei Patienten mit Angststörungen – Eine Untersuchung hausärztlichen Setting. (Diplomarbeit), Technische Universität Dresden
Bauer, C. (2014). Patientenpräferenzen bei der Diagnostik psychischer Beschwerden im hausärztlichen Setting. (Diplomarbeit), Technische Universität Dresden
198
P12. Clinical Assessment of Anxiety Disorders
Anxiety disorders as currently defined in diagnostic classificatory systems of DSMIV/ DSM-5 (American Psychiatric
Association, 2000, 2013) and ICD-10 (World Health Organization, 1992) are early, frequent, and highly comorbid
conditions of psychopathology that mostly follow a waxing and waning though persistent course (Beesdo, Knappe,
& Pine, 2009). Anxiety disorders are often comorbid among themselves as well as with other mental and somatic
conditions and serve as a risk factor for more severe illness such as depression. Thus, it is important to recognize
and treat anxiety disorders in a variety of clinical settings.
Knappe, S. & Hoyer, J. (2014). Clinical assessment of anxiety disorders. In P.M.G. Emmelkamp & T. Ehring (Eds.), The Wiley Handbook of Anxiety Disorders. Volume II. Clinical Assessment & Treatment (p. 645-691). Wiley-Blackwell.
P13. Strategies and challenges for improving the diagnostics of anxiety disorders
Susanne Knappe, Habilitation thesis; Duration: 01/2014 – 10/2014; Funding: Maria Reiche Habilitationsstipendium, TU Dresden
For decades, classification taxonomies provided presumably explicit diagnostic criteria for categorizing normal and
pathological conditions. Categorical diagnoses have been criticized, however, as some epidemiological studies provided substantial reasons for altering diagnostic thresholds. In clinical practice, valid case identification is further complicated by the frequent co-morbidity among disorders and the dimensional nature of underlying clinical phenomena.
Latest revisions of classificatory systems have thus incorporated dimensional assessments in order to better capture the frequency and intensity of syndromes. Driven also by notable arguments from a more biomedical research
perspective, an alternative classificatory system was recently developed.
The thesis is focused on anxiety disorders as a prominent disorder category, and spans from traditional diagnostic
approaches to current and putative future classificatory systems. The aims are (1) to review ‘traditional’ diagnostic
approaches in order to delineate an algorithm of diagnostic processes in clinical practice, (2) to use prospective
longitudinal data from a community sample to examine how epidemiological study findings can inform subtyping
of anxiety disorders and hierarchical diagnostic algorithms, (3) to determine based on their psychometric properties
whether dimensional anxiety scales supplement categorical diagnoses, and (4) to explore an alternative classificatory approach based on the Research Domain Criteria with regard to its merits and limitations for the diagnostic
process and for clinical psychology.
P14. Structured clinical interviews for sexual dysfunctions in women and men according to DSM-5
PI: Jürgen Hoyer; Local staff: Dipl. Psych. Katharina Schierz, cand.psych. Sabrina Ziebell, cand.psych. Paul Wersch
Funding: internal, household; Duration: 04/2014 - 03/2016; Project partners: Dr. Eva Frank-Noyon (Private Practice
Frankfurt), Dr. Regina Steil and Dipl. Psych. Pia Bornefeld-Ettmann (Goethe University Frankfurt), Prof. Dr. Peer
Briken (Department Chair of the Institute for Sex Research and Forensic Psychiatry, University of Hamburg)
Although sexual dysfunctions are highly frequent in the general population and especially in clinical samples, standardized interviews that could raise the reliability and validity of diagnoses in this field are still to be developed. Expanding
previous work in close collaboration with renowned experts, our group has developed the “Structured Interview for
Sexual Dysfunction (SISEX)” based on DSM-5 definitions. In the absence of a commonly accepted gold standard for
the diagnosis of sexual dysfunctions, the present study aims at examining the criterion validity of the SISEX using
ratings of videotaped role plays. SISEX-trained diagnosticians will interview role players who adopted patient profiles
that systematically cover the DSM-5 criteria of sexual dysfunction. These videotaped role plays are to be rated by independent diagnosticians in order to eventually compute the predictive accuracy of the diverse SISEX sections as well as
the inter-rater reliability.
The male version of the SISEX is in preparation. Clinical studies validating both versions of the interview are planned.
Hoyer, J., Bornefeld-Ettmann, P. & Frank-Noyon, E. (2014). Strukturiertes Interview für sexuelle Funktionsstörungen nach DSM 5. Version für Frauen. Teil A Handanweisung.
Unveröffentlichtes Manuskript. Institut für Psychologie, Technische Universität Dresden.
Hoyer, J. & Frank-Noyon, E. (2014). Strukturiertes Interview für sexuelle Funktionsstörungen nach DSM 5. Version für Frauen. Teil B Interview. Unveröffentlichtes Manuskript.
Institut für Psychologie, Technische Universität Dresden.
Schierz, K. & Hoyer, J. (in prep.). Structured Interview for Sexual Dysfunction – female version (SISEX-F): A study into its criterion validity.
Ziebell, S. (in prep., 2014). Kriteriumsvalidität eines strukturierten Interviews zu sexuellen Funktionsstörungen bei Frauen: Eine Untersuchung anhand videografierter Rollenspiele. Unveröffentlichte Diplomarbeit, TU Dresden.
199
AG 11 PSYCHOTHERAPIE- UND INTERVENTIONSFORSCHUNG
H.-U. WITTCHEN & J. HOYER
AG 11 Psychotherapie- und Interventionsforschung
Prof. Dr. Hans-Ulrich Wittchen & Prof. Dr. Jürgen Hoyer
Zusammenfassung: Das Projekt PROTECT-AD wurde im Februar 2014 vom Bundesministerium für Bildung und
Forschung zur Förderung empfohlen (Bewilligung wird Ende 2014 erwartet). Seitdem wird das Projekt unter der Leitung
von Prof. Dr. Hans-Ulrich Wittchen von unserer Arbeitsgruppe auf den Weg gebracht. PROTECT-AD ist ein multizentrisches Projekt, das von Mitarbeitern des Instituts (Projektkoordination: Dipl.-Psych. Ingmar Heinig und M.Sc. Linda van
den Berg) gemeinsam mit Kollegen aus sechs weiteren Studienzentren getragen wird: der Klinik für Psychiatrie und
Psychotherapie der WWU Münster (Prof. Dr. Volker Arolt), dem Forschungs- und Behandlungszentrum für Psychische
Störungen der RU Bochum (Prof. Dr. Silvia Schneider), dem Institut für Psychologie der Ernst-Moritz-Arndt Universität
Greifswald (Prof. Dr. Alfons Hamm), der Klinik für Psychiatrie und Psychotherapie der Philipps-University Marburg (Prof.
Dr. Tilo Kircher), der Klinik für Psychiatrie, Psychosomatik und Psychotherapie der JMU Würzburg (Prof. Dr. Jürgen
Deckert), und der Klinik für Psychiatrie und Psychotherapie der Charité Universitätsmedizin Berlin (Prof. Dr. Andreas
Ströhle). Die Forschungsaktivitäten des Projekts zielen auf subjektive, behaviorale, physiologische, neuronale und (epi)
genetische Korrelate des Extinktionslernens bei Angststörungen. Im Projekt wird ein translationaler Forschungsansatz
verfolgt, der schlussendlich zu einer verbesserten therapeutischen Versorgung mit expositionsbasierten Therapien führen
soll, dem zum jetzigen Zeitpunkt effektivsten Behandlungsverfahren für Angststörungen.
Overview: Our project PROTECT-AD (Providing Tools for Effective Care and Treatment of Anxiety Disorders (AD):
Outcomes, Mediators and Moderators of Enhanced Extinction Learning) was backed by the BMBF in February 2014
(final approval expected in the end of 2014). Since then, our work group started launching the project under the direction
of Prof. Dr. Wittchen. PROTECT-AD is a multicenter project, carried out not by members of the Institute (project coordinators Ingmar Heinig and Linda van den Berg) and the corresponding outpatient clinic (Prof. Dr. Hoyer) in collaboration
with 6 associated study centers: the Department of Psychiatry and Psychotherapy at WWU Münster (Prof. Dr. Arolt),
the Mental Health Research and Treatment Center at RU Bochum (Prof. Dr. Schneider), the Institute of Psychology
at Ernst-Moritz-Arndt University in Greifswald (Prof. Dr. Hamm), the Department of Psychiatry and Psychotherapy at
Philipps-University in Marburg (Prof. Dr. Kircher), the Department of Psychiatry, Psychosomatics and Psychotherapy JMU
Würzburg (Prof. Dr. Deckert), and the Department of Psychiatry and Psychotherapy at Charité Berlin (Prof. Dr. Ströhle).
Research activities in our work group focus on subjective, behavioral, physiological, neural and (epi)genetic indices of
extinction learning in AD patients. By implementing a translational approach, we ultimately aim to improve the provision
of exposure-based therapy, the currently most effective 1st line treatment for AD.
With final approval, we expect a total funding of about 5.3 million EUR over a study duration of four years.
Figure 1. Structure of
the consortium.
200
P1. RCT 1: Optimizing extinction using intensified psychological interventions for adult anxiety disorders
PI: Prof. Dr. Hans-Ulrich Wittchen, Dresden
Background: Novel preclinical research evidence suggests extinction learning as the core mechanism of action of
exposure-based therapies and provides according strategies to improve the effectiveness of treatment by optimized
extinction. A translational research agenda is suggested to examine whether enhanced extinction learning components derived from preclinical research, applied within an intensified exposure-based treatment, improves outcomes.
Methods: In a multicenter randomized clinical trial we test in n=700 patients with primary AD based on a transdiagnostic treatment manual whether intensified psychological interventions based on augmented extinction learning
(IPI) result in faster, stronger and more persistent outcomes on subjective, clinical and behavioral indices as compared to an, otherwise identical, standard research treatment without explicit enhanced extinction (TAU). Different
ADs with and without comorbidity (e.g. Depression) are included. Mechanistic subprojects (P3-P5) are embedded to
investigate physiological, neural and (epi)genetic correlates of enhanced extinction learning. Last, moderators of outcome (i.e. type of diagnosis, comorbidity) are examined. Results/Discussion: We hypothesize that the enhanced
extinction elements of IPI will result in (a) higher effect sizes, faster recovery, and (b) more pronounced changes in
an array of systems, including elements of extinction learning and in objective behavioural measures assessed in
intersession exposure trials.
Figure 1. Preliminary
design of P1.
P2. RCT 2: Differential impact of parental participation on intensified exposure-based psychological interventions in anxiety disorders in children
PI: Prof. Dr. Silvia Schneider, Bochum; Co-PI: Prof. Dr. Jürgen Margraf, Bochum
Background: The goal of the present trial is to improve our understanding of a disorder-specific use of parental
participation in psychological treatment of childhood anxiety disorders. In sharp contrast to adult anxiety disorders,
childhood anxiety disorders are under-researched in spite of their high prevalence, strong continuity into adulthood
and powerful prediction of adult disorders. However, effective treatments share exposure interventions and thus
extinction learning as a core ingredient. Basic research indicates that suboptimal conditions for extinction learning
and context conditioning with the parents as powerful context variable could explain poorer extinction learning and
higher return of fear in children. Methods: Parallel to P1, we will administer high doses of extinction trials (with
versus without parental participation) in n=400 children with Separation AD, Specific Phobia and/or Social AD to
examine the disorder-specific efficacy of parental participation. Mechanistic subprojects (P3-P5) are embedded to
investigate physiological, neural and (epi)genetic correlates of enhanced extinction learning in children. Results/
Discussion: We expect that for separation anxiety disorder, but not for specific phobia and social anxiety disorder,
parent inclusion decreases return of fear and yields more lasting treatment effects via optimizing extinction learning.
The present study will answer this question adequately and has the goal to generate evidence-based recommendations for clinical guidelines. The proposed study will disseminate effective treatments and build new centers for
the treatment of childhood anxiety disorders and thus improve psychotherapy services in Germany for the most
common mental disorders in childhood. It is expected that early successful treatment will not only reduce burden in
children and their families but may also prevent the development of mental disorders in later life.
201
P3. Subproject - Behavioral and psychophysiological markers of extinction learning and outcome
PI: Prof. Dr. Alfons Hamm, Greifswald
Background: Extinction learning is considered to be the core mechanism of action of exposure therapy. The aim of
this subproject is to investigate extinction learning in the laboratory using a multi-level approach (cognitive, autonomic,
and motor reflexes) in a group of child and adult patients with AD, and to relate the findings in the laboratory to clinical
outcome data after exposure therapy. It is administered within P1 and P2. Methods: (1) A delayed extinction paradigm
with adult patients prior to and after exposure therapy. In this paradigm patients learn on day one that one of two cues
is associated with a painful event. On the second day patients these cues are presented again but the patient will
make the experience that the aversive consequence will not occur. Expectancy ratings will be assessed during each
trial together with autonomic arousal and startle reflex modulation. After extinction, aversive painful stimuli will be presented again and reinstatement of fear to the will be assessed. (2) The VR-context conditioning paradigm in children.
Different context conditions will be presented in virtual reality and aversive experiences will be made in one context
but not in the other. Afterwards extinction learning will be induced during which individual enter the different contexts
but no aversive experiences will be made. Again expectancy ratings of the probability of the occurrence of an aversive
event will be assessed together with autonomic arousal startle reflex potentiation and avoidance behavior. Results/
Discussion: We hypothesize that extinction learning per se as well as extinction learning of contextual fear is impaired
in adult and child AD prior to therapy and will improve to a greater degree after IPI than TAU.
P4. Subproject - Neural response and fear circuitry related to extinction learning and outcome
PI: Prof. Dr. Carsten Konrad, Marburg; Co-PI: Prof. Dr. Tilo Kircher, Marburg
Background: This is the first study investigating extinction learning and reinstatement before and after ET using
identical fear extinction paradigms (as P3) with fMRI. In previous work, we showed sustained amygdala activation
and reduced ACC involvement during extinction in subjects with high trait anxiety. Reinstatement is based on activation of learned associations and impaired in patients with hippocampal lesions. Now we examine (only in adults,
P1) the neural correlates of fear extinction, reinstatement and emotion processing focusing on amygdala, (para-) hippocampal and anterior cingulate cortex function and relate neural activations to response patterns in P3. Methods:
Adult P1 patients will undergo fear extinction in the MRI scanner before and after exposure-based therapy using
functional Magnetic Resonance Imaging (fMRI). All eligible patients and 100 healthy controls will be investigated
before and after treatment. Maximizing synergies between P3 and P4, we will use an identical fear conditioning
and extinction task. While subjects will undergo fear conditioning in P3 on the 1st day, extinction and a reinstatement test will be assessed in a 3T MRI scanner on the 2nd day (including autonomic markers of conditioning and
expectancy ratings), thus allowing for consolidation of fear memories. Amygdala reactivity will be tested by an emotional face-matching paradigm 9. T1w and DTI anatomical scans will be assessed for normalization and explorative
morphometric analysis. Results/Discussion: Brain regions of interest will be amygdala, (para-) hippocampal and
anterior cingulate cortex. We hypothesize that (1) impaired extinction learning and exaggerated emotion processing
in AD as compared to healthy controls relies on sustained amygdala and reduced anterior cingulate cortex activation, while enhanced reinstatement is related to (para-) hippocampal function; (2) that augmented extinction learning
in IPI is associated with stronger reduction in amygdala activation and enhanced ACC activation as compared to
TAU, providing indirect evidence for neural mediating processes.
P5. Subproject - (Epi)genetic effects related to extinction learning and outcome
PI: Prof. Dr. Jürgen Deckert, Würzburg; Co-PI: Prof. Dr. Dr. Katharina Domschke, Würzburg
Background: AD and components of fear conditioning are largely genetically determined. Several risk genes of
anxiety and particularly extinction have been identified, with some of them also driving response to treatment.
Pilot studies imply epigenetic mechanisms such as DNA methylation in the pathogenesis of anxiety. In this subproject, for the first time the role of DNA methylation in the pathogenesis, as predictors of therapy response and as
potential correlates of extinction elements in psychological interventions of anxiety disorders will be investigated
accompanying P1 and P2. Methods: All patients will be analyzed for DNA variation/methylation in candidate genes
of anxiety/extinction (COMT, MAO-A, 5-HTT, BDNF, CNR1, N PSR1) and on an epigenome-wide level. EDTA blood
for (epi)genetic analyses will be taken at the same time of the day at baseline, post and at follow-up after 6 months
to evaluate long-term effects. DNA methylation will be determined after DNA extraction from whole blood and
bisulfite conversion. Results/Discussion: The identification of (epi)genetic markers - intertwined with psychophysiological and neural network markers (P3/4) - in the etiology, course and comorbidity of anxiety disorders may aid
202
in developing resilience increasing preventive measures in high-risk groups. Additionally, the definition of epigenetic
signatures as a core mechanism of action of fear extinction in exposure-based interventions and thereby an objective, reliable biomarker of treatment outcome is hoped to contribute to the development of a more targeted, personalized treatment of anxiety disorders based on epigenetic information.
P7. Transfer of exposure-based interventions into the routine provider system
PI: Prof. Dr. Jürgen Hoyer, Dresden
Background: Exposure-based interventions are often applied with insufficient intensity/ adherence in routine care.
Though multiple barriers have been suggested to account for this failure, systematic research is largely lacking.
The proposed transfer program will involve all major stakeholders (i.e., patients, providers, chambers, insurances)
to improve transfer of state-of-the-art exposure-based interventions into the routine provider system via a stepwise
translational effort. Methods: The first phase will be used for preparation and translation of surveys, development
of instruments, and the clarification of SOPs and ethical approval. In the second phase the first provider survey will
take place, including its analysis, discussion, and the development of possible actions to improve professional provision of exposure-based interventions. These actions will be implemented in the third phase, for example in terms of
trainings and information events. The fourth phase will consist of a second extended survey to analyze used transfer actions. Results/Discussion: The ultimate goal is to raise awareness for more effective treatment options, to
promote the more appropriate use of exposure-based interventions and associated tools, particularly in children and
underserved high-risk groups. We will test the impact of 1) to 3) by repeated surveys in two regions: a) the region
of the East German chamber (Ostdeutsche Psychotherapeutenkammer, OPK), where we will implement this program, and b) in the North Rhine-Westfalia region, where no such activity will be launched.
Neudeck, P. & Wittchen, H.-U. (2012). Exposure therapy. Rethinking the model – refining the method (Eds.). New York: Springer.
Wittchen, H.-U. & Gloster, A. T. (2009). Anxiety disorders. Psychiatr Clin North Am (eds.), 32.
203
PUBLIKATIONEN/PUBLICATIONS
Publikationen
Publications
205
Im Berichtszeitraum vom 07/2012 - 10/2014 (Stand 31.10.2014) wurden von den Institutsmitarbeitern rund 300 Artikel
sowie 45 Bücher und Buchbeiträge verfasst.
Auflistung der Impact Faktoren (5-years Science Edition) der Peer Review Zeitschriften, in denen im
Berichtszeitraum publiziert wurde (eine Auswahl).
Peer Review
Impact
Faktor
Lancet
39,3154
Science
34,4631
BMJ case reports
17,215
2
American Journal of Psychiatry
15,062
2
Archives of General Psychiatry (JAMA Psychiatry)
14,396
1
Molecular Psychiatry
14,196
1
Biological Psychiatry
10,347
3
Clinical Psychology Review
9,860
2
Neuropsychopharmacology
8,5181
International Journal of Epidemiology
8,000
3
Clinical Chemistry
7,869
1
British Journal of Psychiatry
7,815
1
Psychotherapy and Psychosomatics
7,024
1
Neuroimage
6,9561
Epidemiology
6,8941
Psychological Medicine
6,491
6
Social Cognitive & Affective Neuroscience
6,447
1
Pediatrics
6,1121
Psychoneuroendocrinology
6,0692
Journal of Clinical Psychiatry
5,847
2
International Journal of Cancer
5,497
1
Addiction
5,32719
Pain Physician
5,303
1
Acta Psychiatrica Scandinavica
5,080
1
Depression and Anxiety
4,820
5
International Journal of Behavioral Nutrition and Physical Activity
4,807
1
European Neuropsychopharmacology
4,736
5
Behavior Research and Therapy 4,564
6
Journal of Psychiatric Research
4,460
2
Clinical and Experimental Allergy
4,337
1
Journal of Affective Disorders
4,167
3
PLOS ONE
4,015
6
Drug and Alcohol Dependence
3,836
7
Alcoholism: Clinical and Experimental Research
3,614
2
European Psychiatry
3,516
2
American Journal of Medical Genetics Part B Neuropsychiatric Genetics
3,419
1
International Journal of Methods in Psychiatric Research
3,388
13
International Journal of Eating Disorders
3,384
2
Archives of Sexual Behavior
3,280
1
206
Anzahl der
Publikationen
Peer Review Papers
In press
Asselmann, E., & Beesdo-Baum, K. Predictors of the course of anxiety disorders in adolescents and young adults. Current Psychiatry Reports.
Asselmann, E., Wittchen, H.-U., Lieb, R., Höfler, M., & Beesdo-Baum,
K. Does low coping effiacy mediate the association between
negative life events life events and incident psychopathology?
A prospective-longitudinal community study in adolescents and
young adults. Epidemiologiy and Psychiatric Sciences.
Allgulander, C, Baldwin, D. S., Gastó, C., Pirkola, S., Wittchen, H.-U.,
Atkinson, G., Haswell, H. & Prieto, R.. Enhancing the identification of patients with generalized anxiety disorder: a multi-centre
European study.
Behrendt, S., Bühringer, G., & Hoyer, J. Behandlung von
Substanzstörungen in der ambulanten Psychotherapie nach
Änderung der Psychotherapierichtlinie 2011.
Boral, J.-A., Brulle-Wohlhueter, C., Balkau, B., Wittchen, H.-U. Haffner,
S.M., Lemieux, I., Desprès, J.-P. & Almeras, N. Usefulness of
Measuring Both Body Mass Index and Waist Circumference for
the Estimation of Visceral Adiposity and Related Cardiometabolic
Risk Profile (From the INSPIRE ME IAA Study). American
Journal of Cardiology.
Braun, B., Ludwig, M., Sleczka, P., Bühringer, G., & Kraus, L. Gamblers
seeking treatment: Who does and who doesn’t? Journal of
Behavior Addictions.
Elfeddali, I., van der Feltz-Cornelis, C. M., van Os, J., Knappe, S.,
Schumann, G., Vieta, E., Wittchen, H.-U., Lewis, S. W.,
Wahlbeck, K., Linszen, D., Obradors-Tarragó, C., Haro, J. M., &
on behalf of the ROAMER consortium. Horizon 2020 priorities
in clinical mental health research: results of a consensus-based
ROAMER expert survey International Journal of Environmental
Research and Public Health.
Garbusow, M. Schad, D. J., Sebold, M., Friedel, E., Bernhardt, N., Koch,
S. P., Steinacher, B., Kathmann, N., Geurts, D. E., Sommer, C.,
Müller, D. K. Nebe, S., Wittchen, H.-U., Paul, S., Zimmermann,
U. S., Smolka, M. N., Rapp, M. A., Huys, Q. J. M., Schlagenhauf,
F. & Heinz, A. Pavlovian-to-instrumental-transfer effects in the
nucleus accumbens relate to relapse in alcohol addication.
Hahn, T., Kircher, T., Straube, B., Wittchen, H.-U., Konrad, C., Ströhle,
A., Wittmann, A., Pfleiderer, B., Reif, A., Arolt, V. & Lueken, U.
Predicting treatment response to cognitive-behavioral therapy in
panic disorder with agoraphobia by integrating local neural information. JAMA Psychiatry.
Hoyer, J., Wiltink, J., Hiller, W., Leibing, E., Miller, R., Salzer, S.,
Sarnowsky, S., Stangier, U., Strauß, B., & Willutzki, U. Baseline
patient characteristics predicting outcome and attrition in cognitive therapy for social phobia: Results from a large multicentre
trial. Clinical Psychology & Psychotherapy.
Kass, A. E., Trockel, M., Safer, D. L., Sinton, M., Cunning, D., Rizk,
M. T., Genkin, B. H., Weisman, H. L., Bailey, J. O., Jacobi, C.,
Wilfley, D. E., Taylor, C. B. Internet-based preventive intervention for reducing eating disorder risk: A randomized controlled
trial comparing guided with unguided self-help. Behaviour
Research and Therapy.
Kowalski, J. T., Jacobi, F., Trautmann, S., Schönfeld, S., Thurau, C.,
Höfler, M., Siegel, S., Wittchen, H.-U., & Zimmermann, P.
Bewertung und Inanspruchnahme der psychosozialen Versorgung
von Soldaten nach Auslandseinsatz. Trauma und Gewalt.
Kühn, S., Brick, T., Wittchen, H.-U., Paul, S., Smolka, M., Sterzer, P.,
Walter, H., Heinz, A. & Gallinat, J. Traces of life: How stressful
life events impact hippocampal grey matter volume and its relation to depressivity.
Lieb, R., Miché, M., Gloster, A., Beesdo-Baum, K., Meyer, A. &
Wittchen, H.-U. JAMA Archives.
Jacobi, F., & Groß, J. Prevalence of mental disorders, health-related quality of life, and service utilization across the adult life span. Die
Psychiatrie, 4.
Jacobi, F., & Barnikol. Das Problem diagnostischer Schwellen für die
Abschätzung von Prävalenz und Behandlungsbedarf psychischer
Störungen. Der Nervenarzt.
Rehm, J., Allamani, A., Vedova, R. D., Elekes, Z., Jakubczyk, A.,
Landsmane, I., Manthey, J., Moreno-España, J., Pieper, L.,
Probst, C., Snikere, S., Struzzo, P., Voller, F., Wittchen, H.-U.,
Gual, A., & Wojnar, M. Do general practitioners recognize alcohol dependence? A large cross-sectional study in six European
countries. Annals of Family Medicine.
Steudte-Schmiedgen, S., Stalder, T., Kirschbaum, C., Weber, F., Hoyer,
J., & Plessow, F. Trauma exposure is associated with increased
context-dependent adjustments of cognitive control in patients
with posttraumatic stress disorder and healthy controls.
Cognitive, Affective and Behavioral Neuroscience.
Straube, B., Reif, A., Richter, J., Lueken, U., Weber, H., Arolt, V.,
Jansen, A., Zwanzger, P. M., Domschke, K., Pauli, P., Konrad,
C., Gerlach, A. L., Lang, T., Fydrich, T., Alpers, G. W., Stroehle,
A., Wittmann, A., Pfleiderer, B., Wittchen, H.-U., Hamm, A.,
Deckert, J. & Kircher, T. The functional -1019C/G HTR1A polymorphism and mechanisms of fear. Translational Psychiatry.
Völker, U., Jacobi, C., Trockel, M. & Taylor, C.B. Moderators and
Mediators of Outcome in Internet-based Indicated Prevention for
Eating Disorders. Behaviour Research and Therapy.
2014
Armbruster, D., Pieper, L., Klotsche, J., & Hoyer, J. (2014). Predictions
get tougher in older individuals: A longitudinal study of optimism, pessimism and depression. Social psychiatry and psychiatric epidemiology.
Asbridge, M., Mann, R., Cusimano, M. D., Tallon, J. M., Pauley, C., &
Rehm, J. (2014). Cycling-related crash risk and the role of cannabis and alcohol: A case-crossover study. Preventive medicine.
Aspen, V., Weisman, H., Vannucci, H., Nafiz, N., Gredysa, D., E. Kass,
A.E., Trockel, M., Jacobi, C., Wilfley, D.E. & Taylor, C.B. (2014).
Psychiatric co-morbidity in women presenting across the continuum of disordered eating. Eating Behaviors.
Asselmann, E., Knappe, S., Wittchen, H.-U., Lieb, R., Höfler, M., &
Beesdo-Baum, K. (2014). Stability of recalled parental rearing
behavior in a community sample of adolescents and young
adults. Journal of Research on Adolescence.
Asselmann, E., Wittchen, H.-U., Lieb, R., & Beesdo-Baum, K. (2014).
The role of behavioral inhibition and parenting for an unfavorable emotional trauma response and PTSD. Acta Psychiatrica
Scandinavica.
Asselmann, E., Wittchen, H.-U., Lieb, R. & Beesdo-Baum, K. (2014).
The role of the mother-child-relationship for anxiety and depressive disorders - Results from a prospective-longitudinal study in
adolescents and their mothers. European Child and Adolescent
Psychiatry.
Asselmann, E., Pane’-Farre’, C., Isensee, B., Wittchen, H.-U., Lieb, R.,
Höfler, M., & Beesdo-Baum, K. (2014). Characteristics of initial
fearful spells and their associations with DSM-IV panic attacks
and panic disorder in adolescents and young adults from the
community. Journal of Affective Disorders, 165, 95-102.
K. (2014). Associations of fearful spells and panic attacks with
incident anxiety, depressive, and substance use disorders: A
10-year prospective-longitudinal community study of adolescents
and young adults. Journal of Psychiatric Research, 55, 8-14.
Asselmann, E., Wittchen, H.-U., Lieb, R., Höfler, M., & Beesdo-Baum, K.
(2014). Does helpseeking alter the risk for incident psychopathology in adolescents and young adults with and without fearfull spells
or panic attacks? Findings from a 10-year prospective-longitudinal
community study. Journal of Affective Disorders, 169, 221-227.
K. (2014). Danger and loss events and the incidence of anxiety
and depressive disorders: A prospective-longitudinal community
study of adolescents and young adults. Psychological Medicine.
Baldwin, D. S., Andrerson, I. M., Nutt, D. J., Allgulander, C., Bandelow,
B., den Boer, J. A., Christmas, D. M., Davies, S., Fineberg, N.,
Lidbetter, N., Malizia, A., McCrone, P., Nabarro, D., O’Neill, C.,
Scott, J., van der Wee, N., & Wittchen, H.-U. (2014). Evidence-
207
based pharmacological treatment of anxiety disorders, post-traumatic
stress disorder and obsessive-compulsive disorder: A revision of the
2005 guidelines from the Brithish Association Psychopharmacolgy.
Journal of Psychopharmacology, 28(5), 403-439.
Behrendt, S., Bühringer, G., & Hoyer, J. (2014). Ambulante
Psychotherpie der Substanzstörungen. Psychotherapeut.
Beintner, I., Jacobi, C., & Schmidt, U. H. (2014). Participation and outcome in manualized self-help for bulimia nervosa and binge eating disorder - A systematic review and metaregression analysis.
Clinical Psychology Review, 34(2), 158-176.
Beintner, I., Jacobi, C., & Taylor, C. B. (2014). Participant adherence to
the Internet-based prevention Program Student Bodies™ for eating disorders - a review. Internet Interventions, 1(1), 26-32.
Borel, A.-L., Nazare, J.-A., Smith, J., Aschner, P., Barter, P., van Gaal, L.,
Tan, C. E., Wittchen, H.-U., Matsuzawa, Y., Kadowaki, T., Ross,
R., Brulle-Wohlhueter, C., Alméras, N., Haffner, S. M., Balkau,
B., Després, J.-P. & for the INSPIRE ME IAA investigators. (2014).
Visceral, subcutaneous abdominal adiposity and liver fat content
distribution in normal glucose tolerance, imaired fasting glucose
and/or impaired glucose tolrerance. International journal of obesity.
Brand, J. S., Rovers, M. M., Yeap, B. B., Schneider, H. J., Tuomainen,
T.-P., Haring, R., Corona, G., Onat, A., Maggio, M., Bouchard,
C., Tong, P. C. Y., Chen, R. Y. T., Akishita, M., Gietema, J. A.,
Gannage-Yared, M.-H., Unden, A.-L., Hautanen, A., Goncharov,
N. P., Kumanov, P., Chubb, P. S. A., Almeida, O. P., Wittchen,
H.-U., Klotsche, J., Wallaschofski, H., Volzke, H., Kauhanen,
J., Salonen, J. T., Ferrucci, L., & van der Schouw, Y. T. (2014).
Testosterone, sex hormone-binding globulin and the metabolic
syndrome in men: an individual participant data meta-analysis of
observational studies. PLOS ONE 9(7), e100409.
Burstein, M., Beesdo-Baum, K., He, J.-P., & Merikangas, K. R. (2014).
Threshold and subthreshold generalized anxiety disorder among
US adolescents: Prevalence, sociodemographic, and clinical
characteristics. Psychological Medicine, 1-12.
Diers, K., Weber, F., Brocke, B., Strobel, A., & Schönfeld, S. (2014).
Instructions matter: A comparison of baseline conditions for
cognitive emotion regulation paradigms. Frontiers in Psychology,
5, 347/341-311.
Elfeddali, I., van der Feltz-Cornelis, C. M., van Os, J., Knappe, S., Vieta,
E., Wittchen, H.-U., Obradors-Tarragó, C. & Haro, J. M. (2014).
Horizon 2020 priorities in clinical mental health research: results of
a consensus-based ROAMER expert survey. International Journal
of Environmental Research and Public Health, 11, 10915-10939.
Emmelkamp, P. M. G., David, D., Beckers, T., Muris, P., Cuijpers,
P., Lutz, W., Andersson, G., Araya, R., Banos Rivera, R. M.,
Barkham, M., Berking, M., Berger, T., Botella, C., Carlbring, P.,
Colom, F., Essau, C., Hermans, D., Hofmann, S. G., Knappe, S.,
Ollendick, T. H., Raes, F., Rief, W., Riper, H., van der Oord, S.,
& Vervliet, B. (2014). Advancing psychotherapy and evidence
– based psychological interventions. International Journal of
Methods in Psychiatric Research, 23(1), 58-91.
Evans-Lacko, S., Courtin, E., Fiorillo, A., Knapp, M., Luciano, M., Park,
A.-L., Brunn, M., Byford, S., Chevreul, K., Forsman, A., Gulacsi,
L., Haro, J. M., Kennelly, B., Knappe, S., Lai, T., Lasalvia, A.,
Miret, M., O’Sullivan, C., Obradors-Tarragó, C., Rüsch, N.,
Sartorius, N., Švab, V., van Weeghel, J., van Audenhove, C.,
Wahlbeck, K., Zlati, A., ROAMER Consortium, McDaid, D., &
Thornicroft*, G. (2014). The state of the art in European research
on reducing social exclusion and stigma related to mental health:
A systematic mapping of the literature. European Psychiatry.
Fava, G. A., Tossani, E., Bech, P., Berrocal, C., Chouinard, G., Csillag,
C., Wittchen, H.-U., & Rief, W. (2014). Emerging clinical trends
and perspectives on comorbid patterns of mental disorders
in research. International Journal of Methods in Psychiatric
Research, 23(1), 92-101.
Fischer, B., Jones, W., & Rehm, J. (2014). Trends and changes in
prescription opioid analgesic dispensing in Canada 2005-2012:
An update with a focus on recent interventions. BMC Health
Service Research, 14(1), 90.
Fischer, B., Keates, A., Bühringer, G., Reimer, J., & Rehm, J. (2014).
Considering prescription opioid-related harms in the population:
208
Response to commentaries. Addiction, 109(2), 186-188.
Francois, C., Laramee, P., Rahhali, N., Chalem, Y., Aballea, S., Millier,
A., Bineau, S., Toumi, M., & Rehm, J. (2014). A predictive microsimulation model to estimate the clinical relevance of reducing
alcohol consumption in alcohol dependence. European addiction
research, 20(6), 269-284.
Goschke, T. (2014). Dysfunctions of decision-making and cognitive control as transdiagnostic mechanisms of mental disorders: advances, gaps, and needs in current research. International Journal of
Methods in Psychiatric Research, 23(Suppl.1), 41-57.
Hägele, C., Schlagenhauf, F., Rapp, M., Sterzer, P., Beck, A., Bermpohl,
F., Stoy, M., Ströhle, A., Wittchen, H.-U., Dolan, R. J., &
Heinz, A. (2014). Dimensional psychiatry: Reward dysfunction and depressive mood across psychiatric disorders.
Psychopharmacology.
Haro, J. M., Ayuso-Mateos, J. L., Bitter, I., Demotes-Mainard, J.,
Leboyer, M., Lewis, S. W., Linszen, D., Maj, M., McDaid,
D., Meyer-Lindenberg, A., Robbins, T. W., Schumann, G.,
Thornicroft, G., van der Feltz-Cornelis, C., van Os, J., Wahlbeck,
K., Wittchen, H.-U., Wykes, T., Arango, C., Bickenbach, J.,
Brunn, M., Cammarata, P., Evans-Lacko, S., Finocchiaro, C.,
Fiorillo, A., Forsman, A. K., Hazo, J. B., Knappe, S., Kuepper, R.,
Luciano, M., Miret, M., Obradors-Tarragó, C., Pagano, G., Papp,
S., & Walker-Tilley, T. (2014). ROAMER: A roadmap for mental
health research in Europe. International Journal of Methods in
Psychiatric Reasearch, 23(Suppl.1), 1-14.
Härtling, S. (2014). Editorial. Psychotherapeutenjournal, 2, 119.
Hildebrandt, A., Behrendt, S., & Hoyer, J. (2014). Treatment outcome
in substance use disorder patients with and without comorbid posttraumatic stress disorder: A systematic review.
Psychotherapy Research.
Hilbert, K., Evens, R., Maslowski, N. I., Wittchen, H.-U., & Lueken, U.
(2014). Fear processing in dental phobia during crossmodal symptom provocation: An fMRI study. BioMed Research International.
Hilbert, K., Lueken, U., & Beesdo-Baum, K. (2014). Neural structures,
functioning and connectivity in generalized anxiety disorder and
interaction with neuroendocri-nologic systems: A systematic
review. Journal of Affective Disorders, 158, 114-126.
Höfler, M., & Hoyer, J. (2014). Population size matters: bias in conventional meta-analysis. International Journal of Social Research
Methodology, 17, 585-597.
Jacobi, F., Höfler, M., Siegert, J., Mack, S., Gerschler, A., Scholl, L.,
Busch, M. A., Hapke, U., Maske, U., Seiffert, I., Gaebel, W.,
Maier, W., Wagner, M., Zielasek, J., & Wittchen, H.-U. (2014).
Twelve-month prevalence, comorbidity and correlates of mental
disorders in Germany: The mental health module of the German
health interview and examination survey for adults (DEGS1-MH).
International Journal of Methods in Psychiatric Research.
Jacobi, F., Höfler, M., Strehle, J., Mack, S., Gerschler, A., Scholl, L.,
Busch, M. A., Maske, U., Hapke, U., Gaebel, W., Maier, W.,
Wagner, M., Zielasek, J., & Wittchen, H.-U. (2014). Psychische
Störungen in der Allgemeinbevölkerung. Studie zur Gesundheit
Erwachsener in Deutschland und ihr Zusatzmodul Psychische
Gesundheit (DEGS1-MH). Nervenarzt, 85(1), 77-87.
Jahnke, S., Imhoff, R., & Hoyer, J. (2014). Stigmatization of people with
pedophilia: Two comparative surveys. Archives of Sexual Behavior.
Jahnke, S., Philipp, K., & Hoyer, J. (2014). Stigmatizing attitudes
towards people with pedophilia and their malleability among psychotherapists in training. Child Abuse & Neglect.
Klumbies, E., Bräuer, D., Hoyer, J., & Kirschbaum, C. (2014). The reaction to social stress in social phobia: Discordance between physiological and subjective parameters. PLOS ONE, 9(8), e105670.
Kontis, V., Mathers, C. D., Rehm, J., Stevens, G. A., Shield, K. D.,
Bonita, R., Riley, L. M., Poznyak, V., Beaglehole, R., & Ezzati,
M. (2014). Contribution of six risk factors to achieving the 25x25
non-communicable disease mortality reduction target: a modelling study. Lancet.
Kräplin, A., Bühringer, G., Oosterlaan, J., van den Brink, W., Goschke,
T., & Goudriaan, A. E. (2014). Dimensions and disorder specificity of impulsivity in pathological gambling. Addictive Behaviors,
39(11), 1646-1651.
Kräplin, A., Dshemuchadse, M., Behrendt, S., Scherbaum, S., Goschke,
T., & Bühringer, G. (2014). Dysfunctional decision-making in
pathological gambling: Pattern specificity and the role of impulsivity. Psychiatry Research, 215(3), 675-682.
Lachenmeier, D. W., Kanteres, F., & Rehm, J. (2014). Alcoholic beverage strength discrimination by taste may have an upper threshold. Alcohol Clin Exp Res, 38(9), 2460-2467.
Lachenmeier, D. W., Monakhova, Y. B., & Rehm, J. (2014). Influence
of unrecorded alcohol consumption on liver cirrhosis mortality.
World Journal of Gastroenterology, 20(23), 7217-7222.
Lange, S., Shield, K. D., Koren, G., Rehm, J., & Popova, S. (2014). A
comparison of the prevalence of prenatal alcohol exposure
obtained via maternal self-reports versus meconium testing: A
systematic literature review and meta-analysis. BMC Pregnancy
Childbirth, 14(1), 127.
Laramee, P., Brodtkorb, T.-H., Rahhali, N., Knight, C., Barbosa, C.,
Francois, C., Toumi, M., Daeppen, J.-B., & Rehm, J. (2014). The
cost-effectiveness and public health benefit of nalmefene added
to psychosocial support for the reduction of alcohol consumption in alcohol-dependent patients with high/very high drinking
risk levels: A markov model. BMJ Open, 4(9), e005376.
Leichsenring, F., Salzer, S., Beutel, M. E., Herpertz, S., Hiller, W., Hoyer,
J., Hüsing, J., Joraschky, P., Nolting, B., Pöhlmann, K., Ritter,
V., Stangier, U., Strauss, B., Tefikow, S., Teismann, T., Willutzki,
U., Wiltink, J., & Leibing, E. (2014). Long-term outcome of psychodynamic therapy and cognitive-behavioral therapy in social
anxiety disorder. The American journal of psychiatry, 171(10),
pp. 1074–1082.
Lev-Ran, S., Florentin, I., Feingold, D., & Rehm, J. (2014). Individuals
receiving specialized treatment for drug and alcohol dependence
and gambling disorder in Israel - characteristics and implications
for prevalence estimates. Substance Abuse.
Lueken, U., Hilbert, K., Reif, A., & Hahn, T. (2014). Diagnostic classification of specific phobia subtypes using structural MRI data: A
machine learning approach. Journal of Neural Transmission.
Lueken, U., Stankevich, Y., Goschke, T., Schläpfer, T. E., Koy, J.,
Reichmann, H., Storch, A., & Wolz, M. (2014). Einfluss der
Tiefen Hirnstimulation des Nucleus subthalamicus auf exekutive
Funktionen bei Patienten mit idiopathischem Parkinsonsyndrom
unter Be-rücksichtigung von Apathie, Depressivität und
Stimmung. Fortschritte der Neurologie-Psychiatrie, 82, 386-393.
Lueken, U., Straube, B., Wittchen, H.-U., Konrad, C., Ströhle, A.,
Wittmann, A., Pfleiderer, B., Arolt, V., Kircher, T., Deckert, J.,
& Reif, A. (2014). Therapygenetics: Anterior cingulate cortex amygdala coupling is associated with 5-HTTLPR and treatment
response in panic disorder with agoraphobia. Journal of Neural
Transmission.
Lueken*, U., Straube*, B., Reinhardt, I., Maslowski, N. I., Wittchen,
H.-U., Ströhle, A., Pfleiderer, B., Konrad, C., Ewert, A., Uhlmann,
C., Arolt, V., Jansen, A., Kircher, T. (*shared first authorship).
(2014). Altered top-down and bottom-up processing of fear
conditioning in panic disorder with agoraphobia. Psychological
Medicine, 44(2), 381-394.
Mack, S., Jacobi, F., Gerschler, A., Strehle, J., Höfler, M., Busch, M.,
Hapke, U., Seiffert, I., Gaebel, W., Zielasek, J., Maier, W., &
Wittchen, H.-U. (2014). Self-reported utilization of mental health
services in the adult German population - evidence for unmet
needs? Results of the DEGS1-Mental Health Module (DEGS1MH). International Journal of Methods in Psychiatric Research.
Marmet, S., Rehm, J., Gmel, G., Frick, H., & Gmel, G. (2014). Alcoholattributable mortality in Switzerland in 2011 - age-specific causes
of death and impact of heavy versus non-heavy drinking. Swiss
medical weekly, 144, w13947.
Mehnert, A., Brähler, E., Faller, H., Härter, M., Keller, M., Schulz, H.,
Wegscheider, K., Weis, J., Boehncke, A., Hund, B., Reuter, K.,
Richard, M., Sehner, S., Sommerfeldt, S., Szalai, C., Wittchen,
H.-U., & Koch, U. (2014). Four-week prevalence of mental disorders in cancer patients across major tumor entities Journal of
Clinical Oncology.
Möser, M., Peikert, G., Guthke, T., Hannich, H.-J., Jacobi, F.,
Mrazek, A., Rosendahl, W., & Hoyer, J. (2014). Vertiefende
Qualifikationen und Spezialisierungen bei approbierten Psycho-
logischen Psychotherapeuten in den Neuen Bundesländern.
Verhaltenstherapie und psychosoziale Praxis, 46, 152-161.
Muehlhan, M., Marxen, M., Landsiedel, J., Mahlberg, H., & Zaunseder,
S. (2014). The effect of body posture on cognitive performance: A
question of sleep quality. Frontiers in Human Neuroscience, 8(171).
Musiat, P., Moritz, S., Jacobi, C., & Schmidt, U. (2014). Association
Splitting - A Feasibility pilot of a novel technique to reduce
weight and shape related cognitions in people with high levels
of weight and shape concerns. Eating and weight disorders,
19(2), 153-158.
Nutt, D. J., & Rehm, J. (2014). Doing it by numbers: A simple
approach to reducing the harms of alcohol. Journal of
Psychopharmacology, 28(1), 3-7.
Parry, C. D., Morojele, N. K., Myers, B. J., Kekwaletswe, C. T., Manda,
S. O., Sorsdahl, K., Ramjee, G., Hahn, J. A., Rehm, J., & Shuper,
P. A. (2014). Efficacy of an alcohol-focused intervention for
improving adherence to antiretroviral therapy (ART) and HIV
treatment outcomes - a randomised controlled trial protocol.
BMC infectious diseases, 14(1), 500.
Petzoldt, J., Wittchen, H.-U., Wittich, J., Einsle, F., Höfler, M., & Martini,
J. (2014). Maternal anxiety disorders predict excessive infant
crying: A prospective-longitudinal study. Archives of Disease in
Childhood.
Popova, S., Lange, S., Burd, L., & Rehm, J. (2014). Canadian children
and youth in care: The cost of fetal alcohol spectrum disorder.
Child & youth care forum, 43, 83-96.
Probst, C., Roerecke, M., Behrendt, S., & Rehm, J. (2014).
Socioeconomic differences in alcohol-attributable mortality compared with all-cause mortality: A systematic review and metaanalysis. International journal of epidemiology, 43(3), 1314-1327.
Probst, C., Roerecke, M., Behrendt, S., & Rehm, J. (2014). Gender
differences in socioeconomic inequality of alcohol-attributable
mortality: A systematic review and meta-analysis. Drug and
Alcohol Review.
Quast, C., Reif, A., Brückl, T., Pfister, H., Weber, H., Mattheisen, M.,
Cichon, S., Lang, T., Hamm, A., Fehm, L., Ströhle, A., Arolt, V.,
Domschke, K., Kircher, T., Wittchen, H.-U., Pauli, P., Gerlach,
A. L., Alpers, G. W., Deckert, J., Rupprecht, R., Binder, E. B.,
& Erhardt, A. (2014). Gender - specific association of variants
in the AKR1C1 gene with dimensional anxiety in patients with
panic disorder: Additional evidence for the importance of neurosteroids in anxiety? Depression and Anxiety.
Rehm, J. (2014). Russia: Lessons for alcohol epidemiology and alcohol
policy. Lancet, 383(9927), 1441-1442.
Rehm, J. (2014). Editorial: Re-examining the theory about the collectivity
of changes in alcohol consumption. Addiction.
Rehm, J., Dawson, D., Frick, U., Gmel, G., Roerecke, M., Shield, K. D.,
& Grant, B. (2014). Burden of disease associated with alcohol
use disorders in the united states. Alcoholism, Clinical and
Experimental Research, 38(4), 1068-1077.
Rehm, J., Kailasapillai, S., Larsen, E., Rehm, M. X., Samokhvalov, A.
V., Shield, K. D., Roerecke, M., & Lachenmeier, D. W. (2014).
A systematic review of the epidemiology of unrecorded alcohol
consumption and the chemical composition of unrecorded alcohol. Addiction, 109(6), 880-893.
Rehm, J., Rehm, M. X., Gmel, G., & Frick, U. (2014). Forschung
und klinische Praxis - Grenzen und Möglichkeiten einer
Praxisverbesserung durch Forschungsergebnisse. Sucht, 60(2),
127-129.
Rehm, J., Rehm, M. X., Gmel, G., & Frick, U. (2014). Wie vermindern
wir alkoholbedingte Krankheitslast. Sucht, 60(2), 115-116.
Rehm, J., Rehm, M. X., Shield, K. D., Gmel, G., Frick, U., & Mann,
K. (2014). Reduzierung alkoholbedingter Mortalität durch
Behandlung der Alkoholabhängigkeit Sucht, 60(2), 93-105.
Riedel, O., Klotsche, J., Wittchen, H.-U., & for the GEPAD study group.
(2014). Motor impairment, depression, dementia: Which forms
the impression of disease severity in Parkinson’s Disease?
Parkinsonism & Related Disorders.
Roerecke, M., & Rehm, J. (2014). Cause-specific mortality risk in alcohol
use disorder treatment patients: A systematic review and metaanalysis. International Journal of Epidemiology, 43(3), 906-919.
209
Samokhvalov, A. V., & Rehm, J. (2014). Premature mortality in patients
with epilepsy. Lancet, 383(9916), 511.
Shield, K. D., Parry, C. D., & Rehm, J. (2014). Chronic diseases and conditions related to alcohol use. Alcohol Research, 35(2).
Steudte-Schmiedgen, S., Kirschbaum, C., Gao, W., Alexander, N.,
Schönfeld, S., Hoyer, J., & Stalder, T. (2014). Are facets of PTSD
symptomatology differentially related to hair cortisol concentrations? Response to Wang et al.. Biological Psychiatry.
Steudte-Schmiedgen, S., Kirschbaum, C., Gao, W., Alexander, N.,
Schönfeld, S., Hoyer, J., & Stalder, T. (2014). Reply to: Linking
hair cortisol levels to phenotypic heterogeneity of posttraumatic stress symptoms in highly traumatized chinese women.
Biological Psychiatry.
Stölzel, F., Seidel, N., Uhmann, S., Baumann, M., Berth, H., Hoyer, J., &
Ehninger, G. (2014). Be smart about cancer! A school-based program
covering cancer-related risk behavior. BMC Public Health, 14, 392.
Straube, B., Lueken, U., Jansen, A., Konrad, C., Gloster, A. T., Gerlach,
A. L., Ströhle, A., Wittmann, A., Pfleiderer, B., Gauggel, S.,
Wittchen, H.-U., Arolt, V., & Kircher, T. (2014). Neural correlates
of procedural variants in cognitive-behavioral therapy: A randomized, controlled multicenter fMRI study. Psychotherapy and
Psychosomatics, 83(4), 222-233.
Stuhldreher, N., Leibing, E., Leichsenring, F., Beutel, M. E., Herpertz,
S., Hoyer, J., Konnopka, A., Salzer, S., Strauss, B., Wiltink, J.,
& König, H.-H. (2014). The costs of social anxiety disorder: The
role of symptom severity and comorbidities. Journal of Affective
Disorders, 165, 87-94.
Trautmann, S., Schäfer, J. & Zimmermann, P. (2014). Das Risiko
erneuter Auslandseinsätze bei Soldaten mit einsatzbezogener
Posttraumatischer Belstungsstörung. Verhaltenstherapie und
Psychosoziale Praxis, 46(3), 748-758.
van der Feltz-Cornelis, C. M., van Os, J., Knappe, S., Schumann, G.,
Vieta, E., Wittchen, H.-U., Lewis, S. W., Elfeddali, I., Wahlbeck,
K., Linszen, D., Obradors-Tarragó, C., & Haro, J. M. (2014).
Towards Horizon 2020: Challenges and advances for clinical mental health research - Outcome of an expert survey.
Neuropsychiatric Disease and Treatment, 1057-1068.
Weckesser, L. J., Plessow, F., Pilhatsch, M., Muehlhan, M.,
Kirschbaum, C., & Miller, R. (2014). Do venepuncture procedures induce cortisol responses? A review, study, and synthesis
for stress research. Psychoneuroendocrinology, 46, 88-99.
Wittchen, H.-U. (2014). Editorial. International Journal of Methods in
Psychiatric Research, 23(S1), v-vi.
Wittchen, H.-U., Strehle, J., Gerschler, A., Volkert, J., Dehoust, M. C.,
Sehner, S., Wegscheider, K., Ausìn, B., Canuto, A., Crawford,
M., Da Ronch, C., Grassi, L., Hershkovitz, Y., Munoz, M., Quirk,
A., Rotenstein, O., Santos-Olmo, A. B., Shalev, A. Y., Weber, K.,
Schulz, H., Härter, M., & Andreas, S. (2014). Measuring symptoms and diagnosing mental disorders in the elderly community:
The test-retest reliability of the CIDI65+. International Journal of
Methods in Psychiatric Research.
Wittchen, H.-U., Heinig, I., & Beesdo-Baum, K. (2014). Angststörungen
im DSM-5: Ein Überblick über Änderungen in Struktur und Inhalt.
Nervenarzt, 85(5), 548-552.
Wittchen, H.-U., Knappe, S., Andersson, G., Araya, R., Banos Rivera, R.
M., Barkham, M., Bech, P., Beckers, T., Berger, T., Berking, M.,
Berrocal, C., Botella, C., Carlbring, P., Chouinard, G., Colom, F.,
Csillag, C., Cuijpers, P., David, D., Emmelkamp, P. M. G., Essau,
C. A., Fava, G. A., Goschke, T., Hermans, D., Hofmann, S. G.,
Lutz, W., Muris, P., Ollendick, T. H., Raes, F., Rief, W., Riper,
H., Tossani, E., van der Oord, S., Vervliet, B., Haro, J. M., &
Schumann, G. (2014). The need for a behavioural science focus
in research on mental health and mental disorders. International
Journal of Methods in Psychiatric Reasearch, 23(Suppl.1), 28-40.
Wittchen, H.-U., Knappe, S., & Schumann, G. (2014). The psychological perspective on mental health and mental disorder research: introduction
to the ROAMER work package 5 consensus document. International
Journal of Methods in Psychiatric Research, 23(Suppl.1), 15-27.
Wittmann, A., Schlagenhauf, F., Guhn, A., Lueken, U., Gaehlsdorf, C.,
Stoy, M., Bermpohl, F., Fydrich, T., Pfleiderer, B., Bruhn, H.,
Gerlach, A. L., Kircher, T., Straube, B., Wittchen, H.-U., Arolt, V.,
210
Heinz, A., & Ströhle, A. (2014). Anticipating agoraphobic situations: The neural correlates of panic disorder with agoraphobia.
Psychological Medicine, 1-7.
Zimmermann, K., Görgens, H., Bräuer, D., Einsle, F., Noack, B., von
Kannen, S., Grossmann, M., Hoyer, J., Strobel, A., Köllner, V.,
Weidner, K., Ziegler, A., Hemmelmann, C., & Schackert, H. K.
(2014). Analysis of gastrin-releasing peptide gene and gastrinreleasing peptide receptor gene in patients with agoraphobia.
Psychiatric Genetics.
Zimmermann, P., Höfler, M., Schönfeld, S., Trautmann, S., Hauffa,
R., Kowalski, J., & Wittchen, H.-U. (2014). Einsatzerlebnisse
und einsatzbedingte psychische Erkrankungen deutscher
Soldaten - empirische Struktur und prädiktive Wertigkeit traumatischer Stressoren. Zeitschrift für Klinische Psychologie und
Psychoherapie, 43(3), 180 – 191.
2013
Andreas, S., Härter, M., Volkert, J., Hausberg, M., Sehner, S.,
Wegscheider, K., Rabung, S., Ausin, B., Canuto, A., Da Ronch,
C., Grassi, L., Hershkovitz, Y., Lelliott, P., Munoz, M., Quirk, A.,
Rotenstein, O., Santos-Olmo, A. B., Shalev, A. Y., Siegert, J.,
Weber, K., Wittchen, H.-U., Koch, U., & Schulz, H. (2013). The
MentDis_ICF65+ study protocol: Prevalence, 1-year incidence
and symptom severity of mental disorders in the elderly and
their relationship to impairment, func-tioning (ICF) and service
utilisation. BMC Psychiatry, 13(62).
Asbridge, M., Mann, R., Cusimano, M. D., Trayling, C., Roerecke, M.,
Tallon, J. M., Whipp, A., & Rehm, J. (2013). Cannabis and traffic collision risk: findings from a case-crossover study of injured
drivers presenting to emergency departments. International
Journal of Public Health, 59(2), 395-404.
Bandelow, B., Boerner, R. J., Kasper, S., Linden, M., Wittchen, H.-U., &
Möller, H.-J. (2013). Generalisierten Angststörung: Diagnose und
Therapie. Deutsches Ärzteblatt International, 110(17), 300-310.
Bandelow, B., Boerner, R. J., Kasper, S., Linden, M., Wittchen, H.-U., &
Möller, H.-J. (2013). Regular muscle activity reply: Correspondence.
Deutsches Ärzteblatt International, 110(37), 610-611.
Behrendt, S., Bühringer, G., Perkonigg, A., Lieb, R., & Beesdo-Baum, K.
(2013). Characteristics of developmentally early alcohol use disorder symptom reports: A prospective-longitudinal community
study. Drug and Alcohol Dependence, 131(3), 308-315.
Bergmann, M. M., Rehm, J., Klipstein-Grobusch, K., Boeing, H.,
Schutze, M., Drogan, D., Overvad, K., Tjonneland, A., Halkjaer,
J., Fagherazzi, G., Boutron-Ruault, M.-C., Clavel-Chapelon,
F., Teucher, B., Kaaks, R., Trichopoulou, A., Benetou, V.,
Trichopoulos, D., Palli, D., Pala, V., Tumino, R., Vineis, P.,
Beulens, J. W., Redondo, M. L., Duell, E. J., Molina-Montes, E.,
Navarro, C., Barricarte, A., Arriola, L., Allen, N. E., Crowe, F. L.,
Khaw, K.-T., Wareham, N., Romaguera, D., Wark, P. A., Romieu,
I., Nunes, L., Riboli, E., & Ferrari, P. (2013). The association of
pattern of lifetime alcohol use and cause of death in the european prospective investigation into cancer and nutrition (EPIC)
study. International Journal of Epidemiology, 42(6), 1772-1790.
Blanco, C., Rubio, J. M., Wall, M., Secades-Villa, R., Beesdo-Baum, K.,
& Wang, S. (2013). The latent structure and comorbidity patterns
of generalized anxiety disorder and major depressive disorder: A
national study. Depression and Anxiety, 31(3), 214-222.
Bögels, S., Knappe, S., & Clark, L. A. (2013). Separation anxiety disorder
in adults in DSM-5. Clinical Psychology Review, 33(5), 663-674.
Brand, R., Wolff, W., & Hoyer, J. (2013). Psychological symptoms
and chronic mood in representative samples of elite studentathletes, deselected student-athletes and comparison students.
School Mental Health, 5(3), 166-174.
Bräuer, D., Görgens, H., Einsle, F., Zimmermann, K., Noack, B., von
Kannen, S., Hoyer, J., Strobel, A., Weidner, K., Jatzwauk, M.,
Ziegler, A., Hemmelmann, C., Köllner, V., & Schackert, H. K.
(2013). Analysis of stathmin gene variation in patients with
panic disorder and agoraphobia. Psychiatric Genetics, 23(1),
43-44.
Braun, B., Ludwig, M., Kraus, L., Kroher, M., & Bühringer, G. (2013).
Ambulante Suchthilfe für pathologische Glücksspieler in
Bayern: Passung zwischen Behandlungsbedarf und -angebot.
Suchttherapie, 14(1), 37-45.
Cammin-Nowak, S., Helbig-Lang, S., Lang, T., Gloster, A. T., Fehm, L.,
Gerlach, A. L., Ströhle, A., Deckert, J., Kircher, T., Hamm, A.,
Alpers, G. W., Arolt, V., & Wittchen, H.-U. (2013). Specificity of
homework compliance effects on treatment outcome in CBT:
Evidence from a controlled trial on panic disorder and agoraphobia. Journal of Clinical Psychology, 69(6), 616-629.
Dayalu, V., Teulings, H.-L., Bowers, A., Crawcour, S., & Saltuklaroglu, T.
(2013). Manual disfluency in drawing while producing and listening
to disfluent speech. Human Movement Science, 32(4), 677-690.
Einsle, F. (2013). Was wir über Angststörungen wissen und deshalb tun
sollten. Rausch, 2(3), 195-204.
Fischer, B., Ialomiteanu, A., Boak, A., Adlaf, E., Rehm, J., & Mann, R. E.
(2013). Prevalence and key covariates of non-medical prescription
opioid use among the general secondary student and adult populations in Ontario, Canada. Drug and Alcohol Review, 32(3), 276-287.
Fischer, B., Ialomiteanu, A., Kurdyak, P., Mann, R. E., & Rehm, J.
(2013). Reductions in non-medical prescription opioid use among
adults in Ontario, Canada: are recent policy interventions working? Substance Abuse Treatment, Prevention and Policy, 8(1), 7.
Fischer, B., Jones, W., Urbanoski, K., Skinner, R., & Rehm, J. (2013).
Correlations between prescription opioid analgesic dispensing
levels and related mortality and morbidity in Ontario, Canada,
2005-2011. Drug and Alcohol Review, 33(1), 19-26.
Fischer, B., Keates, A., Bühringer, G., Reimer, J., & Rehm, J. (2013).
Non-medical use of prescription opioids and prescription opioidrelated harms: why so markedly higher in North America compared to the rest of the world? Addiction, 109, 177-181.
Flynn, A., Tremblay, P. F., Rehm, J., & Wells, S. (2013). A modified
random walk door-to-door recruitment strategy for collecting
social and biological data relating to mental health, substance
use/addictions and violence problems in a Canadian community.
International Journal of Alcohol and Drug Research, 2(2), 8-16.
Giesbrecht, N., Spagg, J. C., Pemjean, A., Marquez, J., Khenti, A.,
Rehm, J., & Minoletti, A. (2013). A national alcohol strategy for
Chile: Rationale, development, content and status of implementation North America. International Journal of Alcohol and Drug
Research, 17-29.
Gloster, A. T., Hauke, C., Höfler, M., Einsle, F., Fydrich, T., Hamm, A.,
Ströhle, A., & Wittchen, H.-U. (2013). Long-term stability of
cognitive behavioral therapy effects for panic disorder with agoraphobia: A two-year follow-up study. Behaviour Research and
Therapy, 51(12), 830-839.
Gloster, A. T., Klotsche, J., Gerlach, A. L., Hamm, A., Ströhle, A.,
Gauggel, S., Kircher, T., Alpers, G. W., Deckert, J., & Wittchen,
H.-U. (2013). Timing matters: Mediators of outcomes in cognitive behavioral therapy for panic disorder with agoraphobia
depend on stage of treatment. Journal of Consulting and Clinical
Psychology, 62(1), 141-153.
Gmel, G., Shield, K. D., Kehoe-Chan, T., & Rehm, J. (2013). The effects
of capping the alcohol consumption distribution and relative
risk functions on the estimated number of deaths attributable
to alcohol consumption in the European Union in 2004. BMC
Medical Research Methodology, 13(1), 24.
Goldberg, D. P., Wittchen, H.-U., Zimmermann, P., Pfister, H., &
Beesdo-Baum, K. (2013). Anxious and non-anxious forms of
major depression: familial, personality and symptom characteristics. Psychological Medicine, 1-12.
Goldner, E. M., Lusted, A., Roerecke, M., Rehm, J., & Fischer, B.
(2013). Prevalence of Axis-1 psychiatric (with focus on depression and anxiety) disorder and symptomatology among nonmedical prescription opioid users in substance use treatment:
Systematic review and meta-analyses. Addictive Behaviors,
39(3), 520-531.
Goodwin, R. D., Perkonigg, A., Höfler, M., & Wittchen, H.-U. (2013).
Mental disorders and smoking trajectories: A 10-year prospective study among adolescents and young adults in the community. Drug and Alcohol Dependence, 1(130), 1-3.
Goodwin, R. D., Talley, N. J., Hotopf, M., Cowles, R. A., Galea, S., & Jacobi,
F. (2013). A link between physician-diagnosed ulcer and anxiety disorders among adults. Annals of Epidemiology, 23(4), 189-192.
Grigoriadis, S., Vonderporten, E. H., Mamisashvili, L., Roerecke, M.,
Rehm, J., Dennis, C.-L., Koren, G., Steiner, M., Mousmanis,
P., Cheung, A., & Ross, L. E. (2013). Antidepressant exposure
during pregnancy and congenital malformations: is there an
association? a systematic review and meta-analysis of the best
evidence. Journal of Clinical Psychiatry, 74(4), e293-308.
Halank, M., Einsle, F., Lehmann, S., Bremer, H., Ewert, R., Wilkens,
H., Meyer, J. F., Grünig, E., Seyfarth, H.-J., Kolditz, M., Wieder, G.,
Höffken, G., & Köllner, V. (2013). Exercise capacity affects quality of
life in patients with pulmonary hypertension. Lung, 191(4), 337-343.
Härtling, S., Bögels, S. M., Klotsche, J., & Hoyer, J. (2013).
Psychometrische Eigenschaften des Fragebogens zur
Errötungsangst (FEA). Diagnostica, 59(3), 142-153.
Härtling, S., Cooper, R., Uebele, C., & Dauer, S. (2013). Erröten
– ein psychologisches Phänomen? Überblick über den
Forschungsstand. Report Psychologie, 38(2), 58-66.
Hoch, E., Bühringer, G., Pixa, A., Dittmer, K., Henker, J., Seifert, A., &
Wittchen, H.-U. (2013). Candis treatment program for cannabis
use disorders: Findings from a randomized multi-site translational trial. Drug and Alcohol Dependence, 1(134), 185-193.
Hoyer, J. (2013). Sexuelle Funktionsstörungen und ambulante
Psychotherapie. Psychotherapeut, 58, 371-378.
Hoyer, J., Bräuer, D., Crawcour, S., Klumbies, E., & Kirschbaum, C.
(2013). Depersonalization/derealisation during acute social stress
in social phobia. Journal of Anxiety Disorders, 27(2), 178-187.
Hoyer, J., & Gloster, A. (2013). Psychologische Flexibilität messen: Der
Fragebogen zu Akzeptanz und Handeln II. Verhaltenstherapie,
23(1), 42-44.
Hoyer, J., & Plag, J. (2013). Generalisierte Angststörung. Psychiatrie
und Psychotherapie Up2date, 89-104.
Hund, B., Reuter, K., Jacobi, F., Siegert, J., Wittchen, H.-U., Härter, M.,
& Mehnert, A. (2013). Adaptation des Composite International
Diagnostic Interview (CIDI) zur Erfassung komorbider psychischer Störungen in der Onkologie: das CIDI-O. Psychotherapie Psychosomatik - Medizinische Psychologie, 64(03/04), 101-107.
Jacobi, F., Mack, S., Gerschler, A., Scholl, L., Bürkner, A., Preiß, S.,
Spitzer, K., Busch, M. A., Hapke, U., Gaebel, W., Maier, W.,
Wagner, M., Höfler, M., & Wittchen, H.-U. (2013). The design and
methods of the mental health module in the German Health Interview
and Examination Survey for Adults (DEGS1-MH). International Journal
of Methods in Psychiatric Research, 22(2), 83-99.
Jacobi, F., Maier, W., & Heinz, A. (2013). Diagnostic and statistical manual for mental misorders: Hilfestellung zur Indikation. Deutsches
Ärzteblatt, 12, 547-549.
Jahnke, S., & Hoyer, J. (2013). Stigmatization of people with pedophilia:
A blind spot in stigma research. International Journal of Sexual
Health, 25, 169-184.
Kerr, W. C., Greenfield, T. K., Ye, Y., Bond, J., & Rehm, J. (2013). Letter
to the editor. Addiction, 108(11), 2029-2030.
Kircher, T., Arolt, V., Jansen, A., Pyka, M., Reinhardt, I., Kellermann, T.,
Konrad, C., Lueken, U., Gloster, A., Gerlach, A. L., Ströhle, A.,
Wittmann, A., Pfleiderer, B., Wittchen, H.-U., & Straube, B. (2013).
Effect of cognitive-behavioural therapy on neural correlates of fear
conditioning in panic disorder. Biological Psychiatry, 1(73), 93-101.
Knappe, S., & Beesdo-Baum, K. (2013). Rezensionen: Chronische
Depression. Zeitschrift für Klinische Psychologie und
Psychotherapie, 42(2), 138-139.
Knappe, S., Klotsche, J., Heyde, F., Hiob, S., Siegert, J., Hoyer, J.,
Strobel, A., LeBeau, R. T., Craske, M. G., Wittchen, H.-U., &
Beesdo-Baum, K. (2013). Test-retest reliability and sensitivity
to change of the dimensional anxiety scales for DSM-5. CNS
Spectrums, 19(3), 256-267.
Knappe, S., Klotsche, J., Strobel, A., LeBeau, R. T., Craske, M. G.,
Wittchen, H.-U., & Beesdo-Baum, K. (2013). Dimensional anxiety scales for DSM-5: Sensitivity to clinical severity. European
Psychiatry, 28, 448-456.
Knappe, S., Müller, N., & Härtling, S. (2013). Der Einbezug von Eltern
in die ambulante Kinder- und Jugendpsychotherapie: Status Quo,
211
Nutzen und Barrieren aus Sicht niedergelassener Psychotherapeuten
in Sachsen. Psychotherapeutenjournal 3, 248-254.
Koch, S., & Wittchen, H.-U. (2013). 5 Fragen an…Prof. Dr. Hans-Ulrich
Wittchen. Report Psychologie.
Kruschwitz, J. D., Lueken, U., Wold, A., Walter, H., & Paulus, M. (2013).
High thrill and adventure seeking is associated with reduced
interoceptive sensitivity: Evidence for an altered sex-specific
homeostatic processing in high-sensation seekers. European
Journal of Personality, 28, 472-481.
Lachenmeier, D. W., Godelmann, R., Witt, B., Riedel, K., & Rehm, J.
(2013). Can resveratrol in wine protect against the carcinogenicity of ethanol? A probabilistic dose-response assessment.
International Journal of Cancer, 134(1), 144-153.
Lachenmeier, D. W., Monakhova, Y. B., Markova, M., Kuballa, T., &
Rehm, J. (2013). What happens if people start drinking mouthwash as surrogate alcohol? A quantitative risk assessment. Food
and Chemical Toxicology, 51, 173-178.
Lachenmeier, D. W., Monakhova, Y. B., Rehm, J., Kuballa, T., & Straub,
I. (2013). Occurrence of carcinogenic aldehydes in alcoholic
beverages from Asia. International Journal of Alcohol and Drug
Research, 2(2), 31-36.
Lachenmeier, D. W., & Rehm, J. (2013). What is the main source of human
exposure to higher alcohols and is there a link to immunotoxicity?
Immunopharmacology and Immunotoxicology, 35(3), 451-453.
Lange, S., Shield, K. D., Rehm, J., & Popova, S. (2013). Prevalence of
fetal alcohol spectrum disorders in child care settings: A metaanalysis. Pediatrics, 132(4), e980-995.
Leichsenring, F., Simone, S., Beutel, M. E., Herpertz, S., Hiller, W.,
Hoyer, J., Hüsing, J. D., Joraschky, P., Nolting, B., Pöhlmann,
K., Ritter, V., Ulrich, S., Strauss, B., Nina, S., Susan, T., Tobias,
T., Willutzki, U., Wiltink, J., & Leibing, E. (2013). Psychodynamic
therapy and cognitive-behavioral therapy in social anxiety disorder: A multicenter randomized controlled trial. American Journal
of Psychiatry, 170(7), 759-767.
Leistner, D., Klotsche, J., Pieper, L., Palm, S., Stalla, G. K., Lehnert,
H., Silber, S., März, W., Wittchen, H.-U., & Zeiher, A. (2013).
Prognostic value of NT-pro-BNP and hs-CRP for risk stratification in primary care: results from the population-based DETECT
study. Clinical Research in Cardiology, 104(4), 259-268.
Lima, M. C. P., Kerr-Correa, F., & Rehm, J. (2013). Alcohol consumption pattern and Coronary Heart Disease risk in Metropolitan
Sao Paulo: analyses of GENACIS Project. Revista Brasileira de
Epidemiologia, 16(1), 49-57.
Jacobi, F., & Kessler-Scheil, S. (2013). Epidemiologie psychischer
Störungen. Zur Frage der Häufigkeit und Krankheitslast psychischer Störungen in unserer Gesellschaft. Continuing-MedicalEducation (CME) Beitrag. Psychotherapeut 2, 191-206.
Lochmann, E., & Hoyer, J. (2013). Verhaltensaktivierung bei Depression: Aktuelle
Anwendungs- und Settingvarianten. Psychotherapie im Dialog, 3, 57-60.
Lueken, U., Hilbert, K., Stolyar, V., Maslowski, N. I., Beesdo-Baum, K., &
Wittchen, H.-U. (2013). Neural substrates of defensive reactivity
in two subtypes of specific phobia. Social Cognitive & Affective
Neuroscience, 11, 1668-1675.
Lueken, U., Straube, B., Konrad, C., Wittchen, H.-U., Ströhle, A.,
Wittmann, A., Pfleiderer, B., Uhlmann, C., Arolt, V., Jansen, A.,
& Kircher, T. (2013). Neural substrates of treatment response to
cognitive-behavioral therapy in panic disorder with agoraphobia.
American Journal of Psychiatry, 170(11), 1345-1355.
Lusted, A., Roerecke, M., Goldner, E., Rehm, J., & Fischer, B. (2013).
Prevalence of pain among nonmedical prescription opioid users
in substance use treatment populations: Systematic review and
meta-analyses. Pain Physician, 16(6), e671-684.
Martini, J., Petzoldt, J., Wittich, J., & Wittchen, H.-U. (2013). Course of
DSM-IV social anxiety disorders during pregnancy and postpartum. European Neuropsychopharmacology, 23, 517
Martini*, J., Wittich*, J., Petzoldt, J., Winkel, S., Einsle, F., Siegert, J.,
Höfler, M., Beesdo-Baum, K., Wittchen, H.-U., (*shared first
authorship). (2013). Maternal anxiety disorders prior to conception, psychopathology during pregnancy and early infants’ development: a prospective-longitudinal study. Archives of Women’s
Mental Health, 16(6), 549-560.
212
Muehlhan, M., Lueken, U., Siegert, J., Wittchen, H.-U., Smolka, M.,
& Kirschbaum, C. (2013). Enhanced sympathetic arousal in
response to fMRI scanning correlates with taskinduced activations and deactivations. PLOS ONE, 8, e72576.
Neufeld, M., & Rehm, J. (2013). Alcohol consumption and mortality in Russia
since 2000: Are there any changes following the alcohol policy
changes starting in 2006? Alcohol and alcoholism, 48(2), 222-230.
Ohlmer, R., Jacobi, C., & Taylor, C. B. (2013). Preventing symptom
progression in women at risk for AN: Results of a pilot study.
European Eating Disorders Review, 21(4), 323-329.
Petzoldt, J., Wittchen, H.-U., Wittich, J., & Martini, J. (2013).
Perinatal maternal DSM-IV anxiety and depressive disorders and regulatory disorders in the offspring. European
Neuropsychopharmacology, 23, 584-585
Popova, S., Lange, S., Burd, L., Chudley, A. E., Clarren, S. K., & Rehm,
J. (2013). Cost of fetal alcohol spectrum disorder diagnosis in
Canada. PLOS ONE, 8(4), e60434.
Popova, S., Lange, S., Burd, L., Urbanoski, K., & Rehm, J. (2013). Cost
of specialized addiction treatment of clients with fetal alcohol
spectrum disorder in Canada. BMC Public Health, 13(1), 570.
Popova, S., Yaltonskaya, A., Yaltonsky, V., Kolpakov, Y., Abrosimov, I.,
Pervakov, K., Tanner, V., & Rehm, J. (2013). What research is
being done on prenatal alcohol exposure and fetal alcohol spectrum disorders in the russian research community? Alcohol and
Alcoholism, 49(1), 84-95.
Rehm, J. (2013). The role of the comparison group in epidemiology and
general limitations. Addiction, 108(12), 2058-2059.
Rehm, J., Anderson, P., Gual, A., Kraus, L., Marmet, S., Nutt, D.
J., Room, R., Samokhvalov, A. V., Scafato, E., Shield, K. D.,
Trapencieris, M., Wiers, R. W., & Gmel, G. (2013). The tangible
common denominator of substance use disorders: A reply to
commentaries to Rehm et al.. (2013). Alcohol and Alcoholism,
49(1), 118-122.
Rehm, J., & Frick, U. (2013). Establishing disability weights from pairwise
comparisons for a US burden of disease study. International
Journal of Methods in Psychiatric research, 22(2), 144-154.
Rehm, J., & Lachenmeier, D. W. (2013). Unrecorded alcohol and lead
poisoning. The American Journal of Medicine, 126(12), e39.
Rehm, J., Marmet, S., Anderson, P., Gual, A., Kraus, L., Nutt, D., Room,
R., Samokhvalov, A. V., Scafato, E., Trapencieris, M., Wiers, R.
W., & Gmel, G. (2013). Defining substance use disorders: Do
we really need more than heavy use? Alcohol and Alcoholism,
48(6), 633-640.
Rehm, J., Rehm, M. X., Alho, H., Allamani, A., Aubin, H.-J., Bühringer,
G., Daeppen, J.-B., Frick, U., Gual, A., & Heather, N. (2013).
Alcohol dependence treatment in the EU: A literature search
and expert consultation about the availability and use of guidelines in all EU countries plus Iceland, Norway, and Switzerland.
International Journal of Alcohol and Drug Research, 2(2), 53-67.
Rehm, J., Rehm, M. X., Shield, K. D., Gmel, G., & Gual, A. (2013).
Alcohol consumption, alcohol dependence and related harms in
Spain, and the effect of treatment-based interventions on alcohol dependence. Adicciones, 25(1), 11-18.
Rehm, J., & Roerecke, M. (2013). Reduction of drinking in problem drinkers
and all-cause mortality. Alcohol and Alcoholism, 48(4), 509-513.
Rehm, J., Samokhvalov, A. V., & Shield, K. D. (2013). Global burden of
alcoholic liver diseases. Journal of Hepatology, 59(1), 160-168.
Rehm, J., & Shield, K. D. (2013). The impact of confounding and alcohol
consumption patterns on the calculated risks of alcohol-related
diseases. Addiction, 108(9), 1544-1545.
Reif, A., Richter, J., Straube, B., Höfler, M., Lueken, U., Gloster, A. T.,
Weber, H., Domschke, K., Fehm, L., Ströhle, A., Jansen, A.,
Gerlach, A. L., Pyka, M., Reinhardt, I., Konrad, C., Wittmann,
A., Pfleiderer, B., Alpers, G. W., Pauli, P., Lang, T., Arolt, V.,
Wittchen, H.-U., Hamm, A. O., Kircher, T., & Deckert, J. (2013).
MAOA and mechanisms of panic disorder revisited: From bench
to molecular psychotherapy. Molecular Psychiatry, 19(1), 122-128.
Reinecke, A., Hoyer, J., Rinck, M., & Becker, E. S. (2013). Cognitivebehavioural therapy reduces unwanted thought intrusions in
generalized anxiety disorder. Journal of Behavior Therapy and
Experimental Psychiatry, 44(1), 1-6.
Reinecke, A., Rinck, M., Becker, E. S., & Hoyer, J. (2013). Implicit bias
in generalized anxiety disorder resolves through cognitive-behavioral treatment and predicts the onset of treatment response.
Behaviour Research and Therapy, 51, 15-23.
Riedel, O., Dodel, R., Rohde, K., & Wittchen, H.-U. (2013). Depression
bei Morbus Parkinson: Epidemiologie und Therapie. Aktuelle
Neurologie, 40, 574-587.
Riedel, O., Klotsche, J., Förstl, H., Wittchen, H.-U., & for the GEPAD
Study Group. (2013). Clock drawing test: Is it useful for dementia screening patients having parkinson’s disease with and without depression? Journal of Geriatric Psychiatry and Neurology,
26(151), 151-157.
Riedel, O., Schneider, C., Klotsche, J., Reichmann, H., Storch, A., &
Wittchen, H.-U. (2013). Die Epidemiologie des idiopathischen
Parkinson-Syndroms und assoziierter Demenz und Depression in
Dresden. Fortschritte der Neurologie - Psychiatrie, 81, 81-87.
Rief, W., & Wittchen, H.-U. (2013). DSM-5 - Pro und Contra.
Verhaltenstherapie, 23(4), 280-286.
Roerecke, M., Gual, A., & Rehm, J. (2013). Reduction of alcohol consumption and subsequent mortality in alcohol use disorders:
Systematic review and meta-analyses. The Journal of Clinical
Psychiatry, 74(12), e1181-1189.
Roerecke, M., & Rehm, J. (2013). Alcohol use disorders and mortality: A
systematic review and meta-analysis. Addiction, 108(9), 1562-1578.
Roerecke, M., & Rehm, J. (2013). On the evidence of a cardioprotective
effect of alcohol consumption. Addiction, 108(2), 429-431.
Roerecke, M., & Rehm, J. (2013). What is best evidence in epidemiology? A reply to stockwell (2012). Addiction, 108(2), 427-428.
Rohde, K., Riedel, O., Lueken, U., Rietzel, S., Fauser, M., Ossig, C.,
Reichmann, H., & Storch, A. (2013). Impulsiv-zwanghafte
Verhaltensstörungen in einer deutschen Stichprobe ambulant
versorgter Parkinson-Patienten. Fortschritte der Neurologie Psychiatrie, 81(09), 503-510.
Ross, L. E., Grigoriadis, S., Mamisashvili, L., Vonderporten, E. H., Roerecke,
M., Rehm, J., Dennis, C.-L., Koren, G., Steiner, M., Mousmanis, P.,
& Cheung, A. (2013). Selected pregnancy and delivery outcomes
after exposure to antidepressant medication: A systematic review
and meta-analysis. JAMA Psychiatry, 70(4), 436-443.
Samokhvalov, A. V., Gamaleddin, I., Sproule, B., & Rehm, J. (2013).
Naltrexone may block euphoria-like placebo effect. BMJ Case
Reports, 2013.
Samokhvalov, A. V., Paton-Gay, L. C., Balchand, K., & Rehm, J. (2013).
Phenibut dependence. BMJ Case Reports, 2013.
Samokhvalov, A. V., Selby, P., Bondy, S. J., Chaiton, M., Ialomiteanu, A.,
Mann, R., & Rehm, J. (2013). Smokers who seek help in specialized cessation clinics: How special are they compared to smokers
in general population? Journal of Smoking Cessation, pp1-9.
Schober, I., Renwick, B., de Jong, H., Kenyon, M., Sharpe, H., Jacobi, C.,
& Schmidt, U. (2013). Threat-related attentional bias in anorexia
nervosa. International Journal of Eating Disorders, 47(2), 168-173.
Schumann, G., Binder, E. B., Holte, A., de Kloet, R. E., Oedegaard, K.
J., Robbins, T. W., Walker-Tilley, T. R., Bitter, I., Brown, V. J.,
Buitelaar, J., Ciccocioppo, R., Cools, R., Escera, C., Fleischhacker,
W., Flor, H., Frith, C. D., Heinz, A., Johnsen, E., Kirschbaum,
C., Klingberg, T., Lesch, K.-P., Lewis, S., Maier, W., Mann, K.,
Martinot, J.-L., Meyer-Lindenberg, A., Müller, C. P., Müller, W. E.,
Nutt, D. J., Persico, A., Perugi, G., Pessiglione, M., Preuss, U. W.,
Roiser, J., Rossini, P. M., Rybakowski, J. K., Sandi, C., Stephan,
K. E., Undurraga, J., Vieta, E., an der Wee, N., Wykes, T., Haro, J.
M., & Wittchen, H.-U. (2013). Stratified medicine for mental disorders. Neuropsychopharmacology, 24(1), 5-50.
Shield, K. D., Gmel, G., Kehoe-Chan, T., Dawson, D. A., Grant, B. F., &
Rehm, J. (2013). Mortality and potential years of life lost attributable to alcohol consumption by race and sex in the United
States in 2005. PLOS ONE, 8(1), e51923.
Shield, K. D., Ialomiteanu, A., Fischer, B., & Rehm, J. (2013). Assessing
the prevalence of non-medical prescription opioid use in the
Canadian general adult population: evidence of large variation
depending on survey questions used. BMC Psychiatry, 13, 6.
Shield, K. D., Jones, W., Rehm, J., & Fischer, B. (2013). Use and nonmedical use of prescription opioid analgesics in the general
population of Canada and correlations with dispensing levels in
2009. Pain Research & Management, 18(2), 69-74.
Shield, K. D., Rehm, J., Gmel, G., Rehm, M. X., & Allamani, A. (2013).
Alcohol consumption, alcohol dependence, and related mortality in Italy in 2004: Effects of treatment-based interventions on
alcohol dependence. Substance Abuse Treatment, Prevention,
and Policy, 8(1), 21.
Shield, K. D., Rehm, J., Rehm, M. X., Gmel, G., & Aubin, H.-J. (2013).
Alcohol consumption, alcohol dependence and related harms in
France: Increasing public health by increasing the availability of
treatment for alcohol dependence. Addiction.
Shield, K. D., Rylett, M., Gmel, G., Gmel, G., Kehoe-Chan, T., & Rehm,
J. (2013). Global alcohol exposure estimates by country, territory and region for 2005 - a contribution to the comparative
risk assessment for the 2010 global burden of disease study.
Addiction, 108(5), 912-922.
Shield, K. D., Samokhvalov, A. V., & Rehm, J. (2013). Global burden of
tuberculosis and lower respiratory infections attributable to alcohol consumption in 2004. International Journal of Alcohol and
Drug Research, 2(1), 1925-7066.
Shield, K. D., Shuper, P. A., Gmel, G., & Rehm, J. (2013). Global burden of
HIV/AIDS in 2004 resulting from non-adherence to medication regimes
and alcohol-attributable non-adherence to medication regimes.
International Journal of Alcohol and Drug Research, 2(1) 19-44.
Shuper, P. A., Joharchi, N., & Rehm, J. (2013). Personality as a predictor
of unprotected sexual behavior among people living with HIV/
AIDS: A systematic review. AIDS and Behavior., 18(2), 398-410.
Sonntag, M., Konnopka, A., Leichsenring, F., Salzer, S., Beutel, M. E.,
Herpertz, S., Hiller, W., Hoyer, J., Joraschky, P., Nolting, B.,
Pöhlmann, K., Stangier, U., Strauss, B., Willutzki, U., Wiltink,
J., Leibing, E., & König, H.-H. (2013). Reliability, validity and
responsiveness of the EQ-5D in assessing and valuing health
status in patients with social phobia. Health and Quality of Life
Outcomes 11(1), 215.
Sornpaisarn, B., Shield, K. D., Cohen, J., Schwartz, R., & Rehm, J.
(2013). Elasticity of alcohol consumption, alcohol-related harms,
and drinking initiation in low- and middle-income countries: a
systematic review and meta-analysis. International Journal of
Alcohol and Drug Research, 2(1), 45-58.
Steudte, S., Kirschbaum, C., Gao, W., Alexander, N., Schonfeld, S.,
Hoyer, J., & Stalder, T. (2013). Hair cortisol as a biomarker of
traumatization in healthy individuals and posttraumatic stress
disorder patients. Biological Psychiatry, 74(9), 639-649.
Tomenson, B., Essau, C., Jacobi, F., Ladwig, K. H., Leiknes, K. A.,
Lieb, R., Meinlschmidt, G., McBeth, J., Rosmalen, J., Rief, W.,
Sumathipala, A., Creed, F., & EURASMUS Population Based
Study Group. (2013). Total somatic symptom score as a predictor of health outcome in somatic symptom disorders. The British
Journal of Psychiatry, 203, 373-380.
Trautmann, S., Schönfeld, S., Behrendt, S., Höfler, M., Zimmermann, P.,
& Wittchen, H.-U. (2013). Substance use and substance use disorders in recently deployed and never deployed soldiers. Drug
and Alcohol Dependence, 1(134), 128-135.
Trautmann, S., Schönfeld, S., Höfler, M., Heinrich, A., Hauffa, R.,
Zimmermann, P., & Wittchen, H.-U. (2013). Posttraumatische
Belastungsstörungen nach Auslandseinsätzen deutscher
Soldaten - Steigt das Risiko mit der Einsatzdauer? Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 56,
930-940.
Völker, U., Jacobi, C., Jones, M., Lock, J., & Taylor, C.B. (2013).
Potential risk factors and early symptoms of anorexia nervosa:
Prevalence in 11-16 year old girls. Advances in Eating Disorders:
Theory, Research & Practice, 2(1), 19-30.
von Consbruch, K., Flückiger, C., Stangier, U., Beutel, M. E., Herpertz,
S., Hoyer, J., Leibing, E., Leichsenring, F., Salzer, S., Strauß,
B., & Wiltink, J. (2013). WIFA-k: Ein neues Messinstrument
zur zeitökonomischen Erfassung allgemeiner Wirkfaktoren
nach Grawe. Psychotherapie Psychosomatik, Medizinische
Psychologie, 63(7), 286-289.
Walter, S., Wendt, C., Böhnke, J., Crawcour, S., Tan, J.-W., Chan, A.,
Limbrecht, K., Gruss, S., & Traue, H. C. (2013). Transsituational
213
individual-specific biopsychological classification of emotions.
IEEE transactions on affective computing. Ergonomics, 43(4),
988-995.
Weidner, K., Bittner, A., Pirling, S., Galle, M., Junge-Hoffmeister, J.,
Einsle, F., & Stöbel-Richter, Y. (2013). Was hält Schwangere
gesund? Protektive Faktoren für Postpartale Depression.
Zeitschrift für Psychosomatische Medizin und Psychotherapie,
59, 391-407.
Whiteford, H. A., Degenhardt, L., Rehm, J., Baxter, A. J., Ferrari, A. J.,
Erskine, H. E., Charlson, F. J., Norman, R. E., Flaxman, A. D.,
Johns, N., Burstein, R., Murray, C. J. L., & Vos, T. (2013). Global
burden of disease attributable to mental and substance use disorders: findings from the global burden of disease study 2010.
Lancet, 382(9904), 1575-1586.
Wieder, G. (2013). Wodurch Paarinteraktion bei Patienten
mit Panikstörung und Agoraphobie gekennzeichnet ist - Implikationen für die therapeutische Praxis.
Psychotherapeutenjournal, 1, 49-53.
Winkel, S., Einsle, F., Wittchen, H.-U., & Martini, J. (2013). Premenstrual
symptoms are associated with psychological and physical symptoms in early pregnancy. Archives of Womens Mental Health,
16(2), 109-115.
Wittchen*, H.-U., Schönfeld*, S., Kirschbaum, C., Trautmann, S.,
Thurau, C., Siegert, J., Höfler, M., Hauffa, R., Zimmermann,
P.*shared first authorship. (2013). Rates of mental disorders
among german soldiers deployed to Afghanistan: Increased
risk of PTSD or of mental disorders in general? Depression and
Anxiety, 2(1), 1-7.
Ye, Y., Bond, J., Cherpitel, C. J., Stockwell, T., Macdonald, S., &
Rehm, J. (2013). Risk of injury due to alcohol: Evaluating potential bias using the case-crossover usual-frequency method.
Epidemiology, 24(2), 240-243.
2012
Beesdo-Baum, K., Klotsche, J., Knappe, S., Craske, M. G., LeBeau, R.
T., Hoyer, J., Strobel, A., Pieper, L., & Wittchen, H.-U. (2012).
Psychometric properties of the dimensional anxiety scales for
DSM-V in an unselected sample of german treatment seeking
patients. Depression and Anxiety, 29(12), 1014-1024.
Beesdo-Baum, K., & Knappe, S. (2012). Developmental epidemiology
of anxiety disorders. Child and Adolescent Psychiatric Clinics of
North America, 21(3), 457-478.
Behrendt, S., Beesdo-Baum, K., Höfler, M., Perkonigg, A., Bühringer,
G., Lieb, R., & Wittchen, H.-U. (2012). The relevance of age
at first alcohol and nicotine use for initiation of cannabis use
and progression to cannabis use disorders. Drug and Alcohol
Dependence, 123(1-3), 48-56.
Fischer, B., Lusted, A., Roerecke, M., Taylor, B., & Rehm, J. (2012).
The prevalence of mental health and pain symptoms in general
population samples reporting nonmedical use of prescription
opioids: A systematic review and meta-analysis. The Journal of
Pain, 13(11), 1029-1044.
Flam-Zalcman, R., Mann, R. E., Stoduto, G., Nochajski, T. H., Rush,
B. R., Koski-Jannes, A., A., Wickens, C. M., Thomas, R. K., &
Rehm, J. (2012). Evidence from regression-discontinuity analyses for beneficial effects of a criterion-based increase in alcohol
treatment. International Journal of Methods in Psychiatric
Research, 22(1), 59-70.
Goodwin, R. D., Beesdo-Baum, K., Martini, J., Knappe, S., Höfler, M.,
Behrendt, S., Lieb, R., & Wittchen, H.-U. (2012). Maternal nicotine dependence and prenatal smoking and their association
with mental disorders among offspring from the community
(abstract). Comprehensive Psychiatry, 54(1)e4.
Goodwin, R. D., Cowles, R. A., Galea, S., & Jacobi, F. (2012). Gastritis
and mental disorders. Journal of Psychiatric Research, 47(1),
128-132.
Goodwin, R. D., Galea, S., Perzanowski, M., & Jacobi, F. (2012).
Impact of allergy treatment on the association between aller-
214
gies and mood and anxiety in a population sample. Clinical &
Experimental Allergy, 42(12), 1765–1771.
Gustavsson, A., Svensson, M., Jacobi, F., Allgulander, C., Alonso, J.,
Beghi, E., Dodel, R., Ekman, M., Faravelli, C., Fratiglioni, L.,
Gannon, B., Jones, D. H., Jennum, P., Jordanova, A., Jonsson,
L., Karampampa, K., Knapp, M., Kobelt, G., Kurth, T., Lieb, R.,
Linde, M., Ljungcrantz, C., Maercker, A., Melin, B., Moscarelli,
M., Musayev, A., Norwood, F., Preisig, M., Pugliatti, M., Rehm,
J., Salvador-Carulla, L., Schlehofer, B., Simon, R., Steinhausen,
H.-C., Stovner, L. J., Vallat, J.-M., Van den Bergh, P., van Os, J.,
Vos, P. E., Xu, W., Wittchen, H.-U., Jonsson, B., Olesen, J., &
Grp, C. S. (2012). Corrigendum to “Cost of disorders of the brain
in Europe 2010” (vol 21, pg 718, 2011). [Correction]. European
Neuropsychopharmacology, 22(3), 237-238.
Jacobi, C., Völker, U., Trockel, T. M., & Taylor, C.B. (2012). Effects of an
Internet-based Intervention for Subthreshold Eating Disorders: A randomized controlled trial. Behavior Research and Therapy, 50, 93-99.
Jacobi, F. (2012). Der Hype um die kranke Seele. Gesundheit und
Gesellschaft, 5, 22 - 27.
Jacobi, F., Genz, A., & Schweer, R. (2012). Macht Arbeit psychisch
krank? Die Diskussion über die Zunahme psychischer Störungen
und die Rolle der Arbeit. Leistung und Lohn. Zeitschrift für
Arbeitswirtschaft, 518-521.
Jahnke, S. (2012). Buchrezension: Bründel, H. (2011) Sexuelle Gewalt
in schulischen Institutionen - Hintergrund, Analysen, Prävention.
Psychotherapeutenjournal, 11(4), 341.
Jones, M., Völker, U., Lock, J., Taylor, C.B., & Jacobi, C. (2012). Familybased intervention for anorexia nervosa. European Eating
Disorders Review.
Kerr, W. C., Greenfield, T. K., Ye, Y., Bond, J., & Rehm, J. (2012). Are
the 1976-1985 birth cohorts heavier drinkers? Age-period-cohort
analyses of the National Alcohol Surveys 1979-2010. Addiction,
108(6), 1038-1048.
Kerridge, B. T., Saha, T. D., Gmel, G., & Rehm, J. (2012). Taxometric
analysis of DSM-IV and DSM-5 alcohol use disorders. Drug and
Alcohol Dependence, 1(129), 60-69.
Kessler, R. C., Calabrese, J. R., Farley, P. A., Gruber, M. J., Jewell, M.
A., Katon, W., Keck, P. E. J., Nierenberg, A. A., Sampson, N.
A., Shear, M. K., Shillington, A. C., Stein, M. B., Thase, M. E.,
& Wittchen, H.-U. (2012). Composite International Diagnostic
Interview screening scales for DSM-IV anxiety and mood disorders. Psychological Medicine, 73(8), 1-13.
Kessler, R. C., Petukova, M., Sampson, N., Zaslavsky, A. M., &
Wittchen, H.-U. (2012). Twelve-month and lifetime prevalence
and lifetime morbid risk of anxiety and mood disorders in the
United States. International Journal of Methods in Psychiatric
Reasearch, 21(3), 169-184.
Klotsche, J., Ferger, D., Leistner, D. M., Pieper, L., Zeiher, A. M., Wittchen,
H.-U. & Rehm, J. (2012). Binary regression: Total gain in positive
and negative predictive value. Biometrical Journal, 54(6), 808-823.
Knappe, S., Beesdo-Baum, K., Nocon, A., & Wittchen, H.-U. (2012).
Re-examining the differential familial liability of agoraphobia and
panic disorder. Depression and Anxiety, 29(11), 931-938.
Kraus, L., Sassen, M., Kroher, M., Taqi, Z., & Bühringer, G. (2012).
Beitrag der Psychologischen Psychotherapeuten zur Behandlung
pathologischer Glücksspieler: Ergebnisse einer Pilotstudie in
Bayern. Psychotherapeutenjournal, 2, 152-156.
Kruschwitz, J. D., Simmons, A. N., Flagan, T., & Paulus, M. P. (2012).
Nothing to lose: processing blindness to potential losses drives
thrill and adventure seekers. Neuroimage, 59(3), 2850-2859.
Labeit, A., Klotsche, J., Pieper, L., Pittrow, D., Einsle, F., Stalla, G. K.,
Lehnert, H., Silber, S., Zeiher, A. M., März, W., Wehling, M., &
Wittchen, H.-U. (2012). Changes in the prevalence, treatment
and control of hypertension in Germany? A clinical-epidemiological examination of 50.000 primary care patients. PLOS ONE,
7(12) e52229.
Lachenmeier, D. W., & Rehm, J. (2012). Is there a relationship between
alcohol quality and health? Alcohol and Alcoholism, 48(1) 127129.
Lang, T., Helbig-Lang, S., Gloster, A., Richter, J., Hamm, A. O.,
Fehm, L., Fydrich, T., Gerlach, A. L., Ströhle, A., Alpers, G.
W., Gauggel, S., Kircher, T., Deckert, J., Höfler, M., Arolt, V.,
& Wittchen, H.-U. (2012). Effekte therapeutenbegleiteter vs.
patientengeleiteter Expositionsdurchführung bei Panikstörung
und Agoraphobie. Zeitschrift für Klinische Psychologie und
Psychotherapie, 41(2), 114-124.
LeBeau, R. T., Glenn, D., Hanover, L. N., Beesdo-Baum, K., Wittchen,
H.-U., & Craske, M. G. (2012). A dimensional approach to measuring anxiety for DSM-5. International Journal of Methods in
Psychiatric Reasearch, 21(4), 258–272.
Leistner, D., Klotsche, J., Pieper, L., Palm, S., Stalla, G. K., Lehnert,
H., Silber, S., März, W., Wittchen, H.-U., & Zeiher, A 2012).
Prognostic value of reported chest pain for cardiovascular risk
stratification in primary care. European Journal of Preventive
Cardiology 104(4), 259-268.
Leistner, D. M., Klotsche, J., Pieper, L., Stalla, G. K., Lehnert, H., Silber,
S., März, W., Wittchen, H.-U., Zeiher, A. M., & for the DETECT
Study Group. (2012). Circulating troponin as measured by a
sensitive assay for cardiovascular risk assessment in primary
prevention Clinical Chemistry,58(1), 200-208.
Study Group. (2012). Circulating troponin as measured by a sensitive assay for cardiovascular risk assessment in primary prevention. Acta Bioquimica Clinica Latinoamericana, 46(2), 293-302.
Study Group. (2012). The best next drug in the course of generalized anxiety disorders: The PN-GAD-algorithm. International
Journal of Psychiatry in Clinical Practice, 17(2), 78-89.
Leistner, D. M., Klotsche, J., Röxe, T., Fischer, A., Pieper, L., Stalla, G.
K., Lehnert, H., Silber, S., März, W., & Wittchen, H.-U. (2012).
Prognostic implications of circulating miRs as biomarkers in
cardiovascular primary prevention - results from the populationbased DETECT-study. Circulation, 126(21, Suppl.S), meeting
abstract16180.
Ludwig, M., Kräplin, A., Braun, B., & Kraus, L. (2012). Gambling experiences, problems, research and policy: gambling in Germany. Addiction,
108(9), 1554-1561.
Martin, G. W., & Rehm, J. (2012). The effectiveness of psychosocial modalities in the treatment of alcohol problems in adults: A review of the
evidence. Canadian Journal of Psychiatry, 57(6), 350-358.
Michalak, J., Zhang, X. C., & Jacobi, F. (2012). Vegetarian diet and mental disorders: Results from a representative community survey. International
Journal of Behavioral Nutrition and Physical Activity, 1(67).
Ohlmer, R., Jacobi, C., & Fittig, E. (2012). Diagnosing underweight in
adolescent girls: Should we rely on self-reported height and
weight? Eating Behaviors, 13(1), 1-4.
Ohlmer, R., Völker, U., & Jacobi, C. (2012). Essstörungen: Neue Wege
in der Prävention. Deutsches Ärzteblatt PP, 11(2), 80-81.
Osterheider, M., Banse, R., Briken, P., Goldbeck, L., Hoyer, J.,
Santtila, P., & Eisenbarth, H. (2012). Entstehungsbedingungen,
Risikofaktoren und Erklärungsmodelle für sexuelle Gewalt an
Kindern und Jugendlichen: Das MIKADO Projekt. Zeitschrift für
Sexualforschung, 25, 285-291.
Parry, C. D., Ferreira-Borges, C., Poznyak, V., Lönnroth, K., & Rehm, J.
(2012). The international study on alcohol and infectious diseases: Three priorities for research. Addiction, 108(1), 1-2.
Petrowski, K., Paul, S., Albani, C., & Brähler, E. (2012). Factor structure
and psychometric properties of the trier inventory for chronic
stress (TICS) in a representative German sample. BMC Medical
Research Methodology, 12(42)169.
Petrowski, K., Paul, S., Zenger, M., & Brähler, E. (2012). An ultra-short
screening version of the recalled parental rearing behavior (FEEUS) and its factor structure in a representative sample. BMC
Medical Research Methodology, 12(169).
Pieper, L., & Wittchen, H.-U. (2012). Depression und Diabetes. Eine
»Zufallsassoziation« zweier häufiger Volkskrankheiten oder eine ätiopathologisch relevante Beziehung? Tägliche Praxis, 53(3), 579-606.
Popova, S., Lange, S., Burd, L., & Rehm, J. (2012). Health care burden
and cost associated with fetal alcohol syndrome: Based on official canadian data. PLOS ONE, 7(8), e43024.
Popova, S., Patra, J., Sarnocinska-Hart, A., Gnam, W. H., Giesbrecht,
N., & Rehm, J. (2012). Cost of privatisation versus government
alcohol retailing systems: Canadian example. Drug and Alcohol
Review, 31(1), 4-12.
Rehm, J., & Hingson, R. (eds.). (2013). Measuring the Burden- Alcohol’s
evolving impact on individuals, families, and society. The Journal
of the National Institute on Alcohol Abuse and Alcoholism, 35.
Rehm, J., & Pollock, B. G. (2012). Why do we need yet another journal?
International Journal of Alcohol and Drug Research, 1(1).
Rehm, J., Shield, K. D., Gmel, G., Rehm, M. X., & Frick, U. (2012).
Modelling the impact of alcohol dependence on mortality burden
and the effect of available treatment interventions in the European
Union. European Neuropsychopharmacology, 23(2), 89-97.
Rehm, J., Shield, K. D., Joharchi, N., & Shuper, P. A. (2012). Alcohol
consumption and the intention to engage in unprotected sex:
systematic review and meta-analysis of experimental studies.
Addiction, 107(1), 51-59.
Reif, A., Weber, H., Domschke, K., Klauke, B., Baumann, C., Jacob,
C.P., Ströhle, A., Gerlach, A.L., Alpers, G.W., Pauli, P., Hamm,
A., Kircher, T., Arolt, V., Wittchen, H.-U., Binder, E.B., Erhardt,
A. & Deckert, J. (2012). Meta-analysis argues for a femalespecific role of MAOA-uVNTR in panic disorder in four European
populations. American Journal of Medical Genetics Part B
Neuropsychiatric Genetics, 159, 786-793.
Leistner, D. M., Klotsche, J., Pieper, L., Stalla, G. K., Lehnert, H.,
Silber, S., März, W., Wittchen, H.-U., Zeiher, A. M., & for the
DETECT Study Group. (2012). Meta-analysis argues for a femalespecific role of MAOA-uVNTR in panic disorder in four european
populations. American Journal of Medical Genetics Part B
Neuropsychiatric Genetics, 159B(7), 786-793.
Riedel, O., Emmrich, A., Klotsche, J., Dodel, R., Förstl, H., Maier, W.,
Reichmann, H., & Wittchen, H.-U. 2012). Alzheimer’s disease:
Differences of transdermal vs oral treatment on caregiving time.
Dementia and Geriatric Cognitive Disorders Extra, 2(1), 468-480.
Riedel, O., & Wittchen, H.-U. (2012). Treatment of alzheimer’s disease: which effects on caregivers do we find? European
Neuropsychopharmacology, 22(Suppl.2), S388.
Roerecke, M., & Rehm, J. (2012). Alcohol intake revisited: risks and renefits. Current Atherosclerosis Reports, 14(6), 556-562.
Schober, I., Renwick, B., de Jong, H., Kenyon, M., Sharpe, H., Jacobi,
C., & Schmidt, U. (2013). Threat-Related Attentional Bias in
Anorexia Nervosa. International Journal of Eating Disorders,
47(2), 168-173.
Schönfeld, S., & Renneberg, B. (2012). Introduction to the special issue
on autobiographical memory and psychopathology. Journal of
Behavior Therapy and Experimental Psychiatry, 43(Suppl.1), 1-3.
Schwappach, D., Popova, S., Mohapatra, S., Patra, J., Godinho, A., &
Rehm, J. (2012). Strategies for evaluating the economic value
of drugs in alcohol dependence treatment. Drug and Alcohol
Dependence, 122(3), 165-173.
Sornpaisarn, B., Shield, K. D., & Rehm, J. (2012). Two-chosen-one taxation: examining its potential effectiveness to reduce drinking initiation and heavy alcohol consumption in low- to middle-income
countries. Addiction, 107(8), 1389-1390.
Soyka, M., Träder, A., Klotsche, J., Haberthür, A., Bühringer, G., Rehm,
J., & Wittchen, H.-U. (2012). Criminal behavior in opioid-dependent patients before and during maintenance therapy: 6-year
follow-up of a nationally representative cohort sample. Journal of
Forensic Sciences, 57(6), 1524-1530.
Taylor, B., & Rehm, J. (2012). The relationship between alcohol consumption and fatal motor vehicle injury: high risk at low alcohol levels.
Alcoholism: Clinical & Experimental Research, 36(10), 1827-1834.
Wittchen, H.-U. (2012). The burden of mood disorders. Science Online,
338(6103), 15.
Wittchen, H.-U. (2012). Editorial: International journal of methods in psychiatric research goes online. International Journal of Methods in
Psychiatric Research 21(1), 2-4.
Wittchen, H.-U., & Einsle, F. (2012). Depression, anxiety and somatic
complaints – is it all psychosomatic? Medicographia, 34(3),
307-Wittchen, H.-U., Härtling, S., Dukes, E., Morlock, R.,
Edelsberg, J., Oster, G., & Berger, A. (2012). Generalisierte
215
Angststörung in der primärärztlichen Versorgung: Eine Analyse
administrativ-epidemiologischer Daten zu Inanspruchnahme
und Versorgungsmerkmalen. MMW Fortschritte der Medizin,
154(Orginalien III), 77-84.
Wittchen, H.-U., Schönfeld, S., Kirschbaum, C., Thurau, C., Trautmann,
S., Steude, S., Klotsche, J., Höfler, M., Haufa, R., &
Zimmermann, P. 2012). Traumatische Ereignisse und posttraumatische Belastungsstörungen bei im Ausland eingesetzten
Soldaten: Wie hoch ist die Dunkelziffer? Deutsches Ärzteblatt
International, 109(35-36), 559-568.
Bücher und Buchbeiträge
In press
Beesdo-Baum, K., & Hilbert, K. Generalised anxiety disorder. In D. J.
Stein & B. Vythilingum (eds.), Gender and Anxiety Disorders
(2nd.): Springer.
Beesdo-Baum, K., & Wittchen, H.-U. Epidemiology of mental disorders.
In J. D. Wright (ed.), International encyclopedia of the social &
behavioral sciences (2nd.): Elsevier.
Behrendt, S. The role of age in the onset and further development
of cannabis use disorders. In V. Preedy (ed.), The Handbook
of Cannabis and Related Pathologies: Biology, Diagnosis,
Treatment, and Pharmacology: Academic Press.
Knappe, S., Sasagawa, S., & Creswell, C. Developmental epidemiology
of social anxiety and social phobia in adolescents. In Ranta, K.,
La Greca, A. M., Garcia-Lopez, L.-J., Marttunen, M., (eds). Social
anxiety and phobia in adolescents -development, Manifestation
and intervention strategies. Springer
Martini, J. Reproduktiver Subtyp der Depression (1 ed.). In Brähler,
E. & Höfert, H.-W. Lexikon der Modernen Krankheiten Berlin:
Medizinisch Wissenschaftliche Verlagsgesellschaft
Martini, J., & Einsle, F. Prämenstruelles Syndrom und Prämenstruelle
Dysphorische Störung (1 ed.). In Brähler, E. & Höfert, H.-W.
Lexikon der Modernen Krankheiten Berlin: Medizinisch
Wissenschaftliche Verlagsgesellschaft
Petzoldt, J., & Martini, J. Frühkindliche Regulationsstörungen (1 ed.). In
Brähler, E. & Höfert, H.-W. Lexikon der Modernen Krankheiten
Berlin: Medizinisch Wissenschaftliche Verlagsgesellschaft
Rehm, J., Probst, C., & Shield, K. D. Burden of disease: the epidemiological aspects of addiction. In N. el-Guebaly, G. Carrā & M.
Galanter (eds.), Textbook of Addiction Treatment: International
Perspectives. London: Springer.
Thom, J., & Jacobi, F. Häufigkeiten und epidemiologische Entwicklung
psychischer Störungen. In D. Windemuth (ed.), Psychische
Erkrankungen im Betrieb. Wiesbaden: Universum.
Wittchen, H.-U. Epidemiology of mental illness. In D. J. Stein & B.
Vythilingum (eds.), Gender and Anxiety Disorders (2nd.): Springer.
2014
Beesdo-Baum, K., & Knappe, S. (2014). Epidemiology and natural course
of anxiety disorders. In P. M. G. Emmelkamp & T. Ering (eds.),
The Wiley Handbook of Anxiety Disorders: Theory & Research
(1 ed., pp. 1440) Chichester: Wiley-Blackwell.
Goodwin, R., Beesdo-Baum, K., Knappe, S., & Stein, D. J. (2014). Life
course epidemiology of anxiety disorders In K. C. Koenen, S.
Rudenstine, E. Susser & S. Galea (Eds.), A Life Course Approach
to Mental Disorders (pp. 97-110). Oxford: Oxford University Press.
Hoyer, J., & Hoyer, J. (2014). Skala zur Erfassung kognitiver
Verzerrungen bei Missbrauchern (KV-M). In D. Richter, E.
Brähler & B. Strauß (eds.), Diagonistische Verfahren in der
Sexualwissenschaft. Göttingen: Hogrefe.
Hoyer, J., & Jahnke, S. (2014). KfS: Kurzfragebogen zu sexuellen
Funktionsstörungen. In D. Richter, E. Brähler & B. Strauß (eds.),
Diagnostische Verfahren in der Sexualwissenschaft (pp. 113116). Göttingen: Hogrefe.
Hoyer, J., Reitz, D., & Frank-Noyon, E. (2014). SISEX: Strukturiertes
Interview zu sexuellen Funktionsstörungen. In B. Strauß
216
& E. Brähler (eds.), Deutschsprachige Verfahren in der
Sexualwissenschaft. Göttingen: Hogrefe.
Knappe, S., & Hoyer, J. (2014). Clinical assessment of anxiety disorders.
In P. M. G. Emmelkamp & T. Ering (eds.), The Wiley Handbook
of Anxiety Disorders: Theory & Research (1 ed., Vol. 2, pp.
1441). Chichester, UK: Wiley Blackwell.
Martini, J., Winkel, S. & Einsle, F. (2014) Menstruelle Zyklusstörungen,
Prämenstruelles Syndrom und Prämenstruelle Dysphorische
Störung. In J. Bitzer & H.-W. Hoefert (eds) Psychologie in der
Gynäkologie: Pabst Science Publ.
Rehm, J., & Shield, K. D. (2014). Alcohol consumption. Lyon:
International Agency for Research on Cancer.
Von Tiling, J., Crawcour, S., & Hoyer, J. (eds.). (2014). Kognitive
Verhaltenstherapie des Stotterns. Stuttgart: Kohlhammer.
2013
Anderson, P., Casswell, S., Parry, C., & Rehm, J. (2013). Alcohol. In K.
Leppo, E. Ollila, S. Peña, M. Wismar & S. Cook (eds.), Health
in all policies: seizing opportunities, implementing policies.
Helsinki, Finland: Ministry of Social Affairs and Health.
Boyle, P., Boffetta, P., Lowenfels, A. B., Burns, H., Brawley, O.,
Zatonski, W., & Rehm, J. (eds.). (2013). Alcohol - Science, policy
and public health. Oxford: Oxford University Press.
Gmel, G., Labhart, F., Shield, K. D., Rylett, M., Lachenmeier, D. W.,
& Rehm, J. (2013). A global overview of alcohol consumpiton
patterns. In P. Boyle, P. Boffetta, A. B. Lowenfels, H. Burns, O.
Brawley, W. Zatonski & J. Rehm (eds.), Alcohol. Science, policy
and public health (pp. 115-124). Oxford: Oxford University Press.
Gmel, G., Shield, K. D., & Rehm, J. (2013). Tools for estimating alcohol consumption. In P. Boyle, P. Boffetta, A. B. Lowenfels,
H. Burns, O. Brawley, W. Zatonski & J. Rehm (eds.), Alcohol.
Science, policy and public health (pp. 107-114). Oxford: Oxford
University Press.
Hoch, E., Zimmermann, P., Henker, J., Rohrbacher, H., Noack, R.,
Bühringer, G., & Wittchen, H.-U. (2013). CANDIS Modulowy program terapii dla problemowych uzytkownikow preztworow konopi. Göttingen: Hogrefe & National Bureau for Drug Prevention.
Kleinert, J., Hoyer, J., & Raven, H. (2013). Zwanghaftes und external
reguliertes Sport- und Bewegungsverhalten. In H.-W. Hoefert &
C. Klotter (eds.), Gesundheitszwänge (pp. 383). Lengerich: Pabst.
Lachenmeier, D. W., Gmel, G., & Rehm, J. (2013). Unrecorded alcohol consumption. In P. Boyle, P. Boffetta, A. B. Lowenfels,
H. Burns, O. Brawley, W. Zatonski & J. Rehm (eds.), Alcohol.
Science, policy and public health (pp. 132-142). Oxford: Oxford
University Press.
Lau, J. Y. F., Hilbert, K., & Gregory, A. M. (2013). Anxiety and depression in young people: Developmental considerations. In P.
Graham & S. Reynolds (eds.), Cognitive behaviour therapy
for children and families - current trends (3.ed.) Cambridge:
Cambridge University Press.
Marmet, S., Gmel (sen.), G., Gmel (jun.), G., Frick, H., & Rehm, J. (es.).
(2013). Alcohol-attributable mortality in Switzerland between
1997 and 2011. Lausanne: Addiction Suisse.
Martini, J., Wittich, J., & Knappe, S. (2013). „Der Apfel fällt nicht
weit vom Stamm“: Von der familiären Übertragung psychischer Störungen In J. Reichert (ed.), Psychologie in der
Kinderheilkunde - Beiträge psychologischer Forschung und
Praxis für die Neonatologie (pp. 90-111). Göttingen: Hogrefe.
Phillips, K. A., Craske, M. G., Andrews, G. J., Bögels, S., Friedman,
M. J., Hollander, E., Lewis-Fernandez, R., Pynoos, R. S.,
Rauch, S. L., Simpson, B. H., Spiegel, D., Stein, D. J., Stein,
M. B., Ursano, R. J., & Wittchen, H.-U. (2013). Anxiety disorders In Diagnostic and statistical manual of mental disorders,
(DSM-5™) (5 ed., pp. 189-234). Arlington: American Psychiatric
Association.
Phillips, K. A., Craske, M. G., Andrews, G. J., Bögels, S., Friedman, M.
J., Hollander, E., Lewis-Fernandez, R., Pynoos, R. S., Rauch,
S. L., Simpson, B. H., Spiegel, D., Stein, D. J., Stein, M. B.,
Ursano, R. J., & Wittchen, H.-U. (2013). Dissociative disor-
ders. In Diagnostic and statistical manual of mental disorders,
(DSM-5™) (5 ed., pp. 291-308). Arlington: American Psychiatric
Association.
Ursano, R. J., & Wittchen, H.-U. (2013). Obsessive-compulsive
and related disorders In Diagnostic and statistical manual of
mental disorders, (DSM-5™) (5 ed., pp. 235-264). Arlington:
American Psychiatric Association.
Ursano, R. J., & Wittchen, H.-U. (2013). Trauma- and stressorrelated disorders. In Diagnostic and statistical manual of mental
disorders, (DSM-5™) (5 ed., pp. 265-290). Arlington: American
Psychiatric Association.
Rehm, J., Gmel, G., Rehm, M. X., Scafato, E., & Shield, K. D. (2013). What
can alcohol do to European societies? In P. Anderson, F. Braddick,
J. Reynolds & A. Gual (eds.), Alcohol policy in Europe: Evidence
from AMPHORA (2nd ed., pp. 4-16). The AMPHORA project.
Rehm, J., & shield, K. D. (2013). Key studies of alcohol and disease. In
P. Boyle, P. Boffetta, A. B. Lowenfels, H. Burns, O. Brawley, W.
Zatonski & J. Rehm (eds.), Alcohol. Science, policy and public
health (pp. 13-23). Oxford: Oxford University Press.
Samokhvalov, A. V., Shuper, P. A., & Rehm, J. (2013). Infectious
Disease. In P. Boyle, P. Boffetta, A. B. Lowenfels, H. Burns, O.
Brawley, W. Zatonski & J. Rehm (eds.), Alcohol. Science, policy
and public health (pp. 300-306). Oxford: Oxford University Press.
Shield, K. D., Rehm, J., & Monteiro, M. (2013). Alcohol consumption
and drinking patterns in the Americas Prevention of alcohol-related injuries in the Americas: From evidence to policy action (pp.
5-16). Washington, DC: Pan American Health Organization.
Shield, K. D., Rehm, J., & Monteiro, M. (2013). The burden of injuries
attributable to alcohol in the Americas. In C. J. Cherpitel, G.
Borges, N. Giesbrecht, M. Monteiro & T. Stockwell (eds.),
Prevention of alcohol-related injuries in the Americas: from
evidence to policy action (pp. 17-26). Washington, DC: Pan
American Health Organization.
Shield, K. D., Rylett, M. J., Gmel, G., & Rehm, J. (2013). Trends in alcohol consumption and alcohol-attributable mortality in the EU in
2010. In WHO Regional Office for Europe (eds.), Status report
on alcohol and health in 35 European countries 2013 (pp. 3-14).
Copenhagen: WHO Regional Office for Europe.
2012
Barth, J., Behrendt, S., & Jacobi, F. (2012). Psychische Störungen,
Sucht und Suizid. In M. Egger & O. Razum (eds.), Public Health
– Sozial- und Präventivmedizin kompakt (ed. 1, pp. 261-269).
Berlin, Boston: de Gruyter.
Bühringer, G., Kräplin, A., & Behrendt, S. (2012). Universal characteristics and consequences of the addiction syndrome (ed. 1).
Washington, D.C.: American Psychological Association.
Herzberg, P. Y., Franke, G. H., & Hoyer, J. (2012).
Persönlichkeitspsychologische Grundlagen. In E. Brähler &
B. Strauß (eds.), Enzyklopädie der Psychologie: Grundlagen
der Medizinischen Psychologie (8 ed., Vol. 1, pp. 227-250).
Göttingen: Hogrefe.
Hoyer, J., Franke, G. H., & Herzberg, P. Y. (2012). Persönlichkeit und
Krankheit. In E. Brähler & B. Strauß (eds.), Grundlagen der
Medizinischen Psychologie (Enzyklopädie für Psychologie) (8 ed.,
Vol. 1, pp. 201-226). Göttingen Hogrefe.
Jacobi, C., Jones, M., & Beintner, I. (2012). Prevention of Eating
Disorders in Children and Adolescents. In J. Lock (Ed.), The
Oxford Handbook of Child and Adolescent Eating Disorders:
Developmental Perspectives. Oxford University Press: N.Y.
Jacobi, F. (2012). Warum sind psychische Störungen Volkskrankheiten?
In: Vorstand des BDP (Hrsg.): Die großen Volkskrankheiten (pp.
16-24). Berlin: Deutscher Psychologen Verlag.
Auswahl an Vorträgen auf
Tagungen und Kongessen
2014
Beesdo-Baum, K., Mack, S., Jacobi, F., Strehle, J., Maske, U. E.,
Hapke, U., & Wittchen, H.-U. (2014, 21.-24.05.). Depression:
Prevalence, disease burden, service use and treatment barriers.
17th European Psychiatric Association (EPA) Epidemiology and
Social Psychiatry Section Meeting, Ulm.
Beesdo-Baum, K. (2014, 18.05.). DEGS Survey - Befunde zur Suizidalität.
3. Regionales Netzwerktreffen, EUREGENAS - European
Regions Enforcing Actions Against Depression, Dresden.
Beesdo-Baum, K. (2014, 22.10.). Separation anxiety disorder: findings from general population studies. ECNP Targeted Network
Meeting: Adult separation anxiety disorder: boundaries, causes
and potential treatments Berlin, Germany.
Beintner, I., Jacobi, C., Schmidt, U. (2014). Nutzung Manual-basierter
Selbsthilfe bei Bulimia nervosa und Binge Eating Störung. 4.
Wissenschaftlicher Kongress der Deutschen Gesellschaft für
Essstörungen e.V. (DGESS); Leipzig.
Bühringer, G. (2014, 14.10.). Suchterkennung: Maßnahmen und
Prävention. Lehrgang, Dezernat Personal, TU Dresden, Dresden.
Bühringer, G., & Neumann, M. (2014, 02.-04.09.). Reflections on DSM
5 and ICD 11. International Society of Addiction Journal Editors
(ISAJE) Annual Meeting, Chicago, US.
Bühringer, G. & Paul, S. (2014, 04.). Strukturierte Tabakentwöhnung.
11. Dresdner Gefäßtagung und Tagung der AG Angiologie
der Deutschen Gesellschaft für Kardiologie – Herz- und
Kreislaufforschung e.V., Dresden.
Höcker, A., Mühlhan, M., & Schäfer, A. (2014, 09.). Zusammenhänge
zwischen frühen Belastungen und der neuroendokrinen
Stressantwort bei Patienten mit Alkoholabhängigkeit Deutschen
Suchtkongress, Berlin.
Hoyer, J. (2014, 03). Wie erfolgreich sind niedergelassene
Psychologische PsychotherapeutInnen bei der Sozialen Phobie?
2. Ostdeutschen Psychotherapeutentag, Leipzig.
Hoyer, J., Bräuer, D., Wersch, P., Klumbies, E., & Kirschbaum, C. (2014,
03.). Depersonalisation symptoms during acute social stress:
predictors and consequences on the psychological and biological
level. Deutscher Psychosomatik Kongress, Berlin.
Hoyer, J., Crawcour, S., Ginzburg, D., Möser, M., Leibing, E., &
Stangier, U. (2014, 05.). Transfer eines manualisierten
Behandlungsprogramms für Soziale Phobie in die Praxis: Eine
versorgungsnahe, randomisierte und kontrollierte Studie. 32.
Symposium für Klinische Psychologie und Psychotherapie der
Deutschen Gesellschaft für Psychologie (DGPs) , Braunschweig.
Jacobi, C., Beintner, I., Fittig, E., Möbius, K. (2014). Internet-gestützte
Nachsorge für Frauen mit schwerwiegender und chronischer
Bulimia nervosa (IN@). 4. Wissenschaftlicher Kongress der
Deutschen Gesellschaft für Essstörungen e.V. (DGESS); Leipzig
Lueken, U. (2014). The Biology of Psychological Treatment of Fear.
International Master in Affective Neuroscience (ICANS Lecture).
2014 Summer Course on Fear, Anxiety, Obsessions & Trauma,
Florence, Italy.
Lueken, U. (2014). Genomic Imaging und Therapygenetics bei der
Panikstörung mit Agoraphobie. Jahreskongress der Deutschen
Gesellschaft für Biologische Psychiatrie (DGBP), Sept. 26-27,
2014, Aachen.
Lueken, U., Hahn, T., Straube, B., Konrad, C., Wittchen, H.-U., Ströhle,
A., Wittmann, A., Pfleiderer, B., Arolt, V., Jansen, A., Kircher,
T. (2014, 29.-30.05.). Prädiktion des Outcomes expositionsbasierter Verhaltenstherapie mit Hilfe neurofunktioneller
Marker bei Patienten mit Panikstörung und Agoraphobie. 32.
Symposium der Fachgruppe für Klinische Psychologie und
Psychotherapie der Deutschen Gesellschaft für Psychologie
(DGPs), Braunschweig.
Lueken, U., Hahn, T., Straube, B., Wittchen, H.-U., Wittmann, A.,
Ströhle, A., Pfleiderer, B., Arolt, V., Reif, A., & Kircher, T. (2014,
18.-21.10.). Neuroimaging effects of CBT on fear conditioning
in panic disorder. 27th Congress of the European College in
Neurpsychopharmacology (ECNP). Berlin.
217
Paul, S., Jünger, E., Wittchen, H.-U., Bühringer, G., Scholl, L.,
Sommer, C., DFG-Forschergruppe 1617, & Zimmermann,
U. S. (2014, 30.09.-02.10.). Der ist doch nicht zurechnungsfähig! - Der Einfluss intravenöser Alkoholgabe auf die
Angabe von Trinkverhalten, alkoholbedingten Problemen,
Trinkmotiven, Wirkungserwartungen uns suchtrelevanten
Tempramentsmerkmalen. Deutscher Suchtkongress, Berlin.
Petzoldt, J., Martini, J., & Wittchen, H.-U. (2014, 07.-09.07.). Excessive
infant crying in relation to maternal DSM-IV anxiety and
depressive disorders in a prospective-longitudinal study. 12th
International Infant Cry Research Workshop, Coventry, UK.
Schäfer, J., Wittchen, H.-U., Höfler, M., & Schönfeld, S. (2014, 10.13.09.). Attentional control moderates the relationship between
attentional vigilance to threat and symptoms of posttraumatic
stress disorder respectively self-reported resilience in traumatized German soldiers. EABCT Congress Den Haag, Netherlands.
Schönfeld, S., Schäfer, J., & Wittchen, H.-U. (2014, 10.-13.09.). The
role of cognitive perseverance in the prediction of posttraumatic symptoms following deployment related trauma. EABCT
Congress Den Haag, Netherlands.
Schönfeld, S., Schäfer, J., & Wittchen, H.-U. (2014, 10.-13.09.). Overgeneral
memory pre trauma as a vulnerability factor for current posttraumatic symptoms. EABCT Congress Den Haag, Netherlands.
Stangier, U., von Consbruch, K., Höfling, V., Lücke, P., Lin, J., Leibing,
E., Hoyer, J., Willutzki, U., Hiller, W., & Clark, D. M. (2014,
05.). Wirkmechanismen der kognitiven Therapie bei Sozialer
Angststörung. 32. Symposium für Klinische Psychologie und
Psychotherapie der DGPs, Braunschweig.
Trautmann, S., Trikojat, K., Schäfer, J., Strehle, J., Richter, J., &
Schönfeld, S. (2014, 29.-31.05.). Anstieg von alkoholbezogenen
Aufmerksamkeitsverzerrungen und Craving nach Erleben
eines Traumas. 32. Symposium der Fachgruppe für Klinische
Psychologie und Psychotherapie der Deutschen Gesellschaft für
Psychologie (DGPs), Braunschweig.
Wiltink, J., Beutel, M. E., Herpertz, S., Hoyer, J., Joraschky, P.,
Michal, M., Nolting, B., Pöhlmann, K., Salzer, S., Strauss, B.,
Leibing, E., & Leichsenring, F. (2014, 03.). Vorhersage des
Behandlungserfolgs in der psychodynamischen Kurzzeittherapie
der Sozialen Phobie durch Patientenmerkmale. Deutscher
Psychosomatik Kongress, Berlin.
2013
Abel, Schepper, & Martini, J. (2013, 20.-22.11.). Ausprägung
der Progredienzangst bei Eltern krebskranker Kinder. 12.
Jahrestagung der Arbeitsgemeinschaft für Psychoonkologie in
der Deutschen Krebsgesellschaft e.V. (PSO), Dresden.
Beintner, I., Jacobi, F., Fittig, E., Möbius, K. (2013). Internet-based aftercare (IN@) for women with severe and chronic bulimia nervosa
following inpatient treatment. 2nd Scientific Meeting of the
European Society for Research on Internet Interventions (ESRII);
Linköping, Sweden.
Beesdo-Baum, K., Lieb, R., & Wittchen, H.-U. (2013, 06.-09.04.). Age
at onset and adult outcomes of anxiety and/or depressive disorders. 21st European Congress of Psychiatry, Nice, France.
Einsle, F., Kasper, A., Willrodt, C., Hoyer, J., & Härtling, S. (2013, 11.).
Unerwünschte Ereignisse während ambulanter Psychotherapie:
Assoziationen mit Patienten- und Therapievariablen. 41. DGPPN
Kongress 2012, Berlin.
Hoyer, J. (2013). Psychische Störungsbilder nach schweren
Arbeitsunfällen und Berufskrankheiten: Möglichkeiten
und Grenzen von Psychotherapie. Erste Dresdner
Rehabilitationstage, DGUV Akademie, Dresden.
Hoyer, J. (2013, 05.). Was ist eine „gute Psychotherapie“ heute und
welche Versorgungsstrukturen braucht sie? Festveranstaltung
zu 10-jährigen Bestehen des Verbands universitärer
Ausbildungsinstitute, Trier.
Hoyer, J. (2013, 06.). Was ist gute Psychotherapie aus Sicht der (möglichen) Patienten? Fachtagung des Zentrums für Psychotherapie
(ZfP), Chemnitz.
218
Hoyer, J., Hummel, K., & Gloster, A. T. (2013, 05.). Valued living: Erklärt
es die Behandlungszufriedenheit besser als Symptomreduktion?
31. Symposium für Klinische Psychologie und Psychotherapie
der DGPs, Trier.
Jacobi, C., Beintner, I., Fittig, E., Möbius, K. (2013). Internet-based
aftercare (IN@) for women with severe and chronic bulimia
nervosa following iInpatient treatment. 6th Scientific Meeting of
the International Society for Research on Internet Interventions
(ISRII); Chicago, US.
Jahnke, S. (2013, 09.). Stigmatization of People with Pedophilia: Results
of a Survey in Two German Cities. Tagung der Fachgruppe
Rechtspsychologie in der Deutschen Gesellschaft für
Psychologie (DGPs), Universität Bonn.
Jahnke, S., Imhoff, R., & Hoyer, J. (2013). Stigmatization of people with
pedophilia: Results from a survey in Germany. 15. Tagung der
Fachgruppe Rechtspsychologie der Deutschen Gesellschaft für
Psychologie (DGPs) Bonn.
Lueken, U. (2013). Neural substrates of treatment response to cognitive
behavioral therapy in panic disor-der with agoraphobia. Symposium
des SFR TRR 58 „Fear, Anxiety, Anxiety Disorders”, Hamburg.
Lueken, U., Straube, B., Konrad, C., Wittchen, H.-U., Ströhle, A.,
Wittmann, A., Pfleiderer, B., Arolt, V., Jansen, A., & Kircher, T.
(2013). Therapieprädiktion bei Patienten mit Panikstörungen.
Jahrestagung der Deutschen Gesellschaft für Psychiatrie,
Psychotherapie und Nervenheilkunde (DGPPN), Berlin.
Parry, C., Shield, K. D., & Rehm, J. (2013, 03.-07.06.). The global burden
of alcohol: estimates of the Global Burden of Disease 2010
Study, shortcomings and future steps to improve these estimates. 39th Annual Alcohol Epidemiology Symposium of the
Kettil Bruun Society, Kampala, Uganda.
Petzoldt, J., Martini, J., & Wittchen, H.-U. (2013, 27.-30.11.). Verlauf von
Angst- und depressiven Störungen in der Peripartalzeit und exzessives Säuglingsschreien: eine prospektiv-longitudinale Studie.
Deutsche Gesellschaft für Psychiatrie, Psychotherapie und
Nervenheilkunde (DGPPN) Berlin.
Petzoldt, J., Martini, J., & Wittchen, H.-U. (2014, 10.-12.09.). Maternal anxiety
and depressive disorder prior to pregnancy predict infant insomnia
disorder. International Marcé Society Biennial Meeting, Swansea, UK.
Rehm, J. (2013, 15.11.). Alcohol and cancer - The global picture: from
epidemiological results to action. Toronto Cancer Prevention
Coalition meeting on “Cancer and alcohol: myths, evidence,
action and precautionary policies”, Toronto, Canada.
Rehm, J. (2013, 29.-31.10.). Alcohol as a risk factor for NCD and other
health harm. Global Health Conference, Seoul, Korea.
Rehm, J. (2013, 31.10.). Alcohol consumption and public health. Catholic
University of Korea, Seoul, Korea.
Rehm, J. (2013, 04.-05.11.). Alcohol dependence treatment guidelines
and practice in Europe. Nalmefene International Advisory Board
Meeting, Lisbon, Portugal.
Rehm, J. (2013, 06.-07.06.). Alcohol dependence treatment guidelines
and practice in Europe. The 7e Edition de l’ALBATROS, Congrès
International d’Addictologie, Paris, France.
Rehm, J. (2013, 18.-19.11.). Alcohol dependence treatment: comparative approaches. Norwegian Alkoholkonferansen (national alcohol
conference), Oslo, Norway.
Rehm, J. (2013, 13.06.). Alcohol in the European Union – consumption and attributable mortality. European Day of the 8th Global
Conference on Health Promotion, Helsinki, Finland.
Rehm, J. (2013, 25.04.). Alcohol in the European Union – consumption and harm. Discussion on alcohol consumption data. WHO
meeting of National Focal Points for Alcohol Policy in the WHO
European Region, Istanbul, Turkey.
Rehm, J. (2013, 29.01.-01.02.). Alcohol policy – international and national. CIHR Strategic Training Program in Public Health Policy at the
University Club, Toronto, Canada.
Rehm, J. (2013, 10.-11.03.). Burden and cost of alcohol, tobacco
and illegal drugs addictions in Europe. European College of
Neuropsychopharmacology Consultation Meeting, Nice, France.
Rehm, J. (2013, 09.-10.09.). Can economic research make a difference?
The example of alcohol treatment. International Conference on
Future challenges for addiction research, Zurich, Switzerland.
Rehm, J. (2013, 08.13.). The global burden of alcohol-attributable disease including harm to others. First National Roundtable on
Girls, Women and Alcohol, Toronto, Canada.
Rehm, J. (2013, 03.-05.04.). Global burden of disease and injury and
economic cost attributable to alcohol use and alcohol-use disorders. Alcohol Policy 16 Conference, Washington, US.
Rehm, J. (2013, 07.-10.05.). Impact of alcohol on society -alcohol
dependence and mortality. Global Addiction and Europad Joint
Conference, Pisa, Italy.
Rehm, J. (2013, 06.-07.06.). Nouvelles données épidemiologiques des
dommages liées à l’alcool. 7e Edition de l’ALBATROS, Congrès
International d’Addictologie, Paris, France.
Rehm, J. (2013, 21.02.). Prescription opioid abuse and dependence
- Lessons from a new form of drug addiction. Twenty First
Thomas James Okey Institute of Psychiatry, London, UK.
Rehm, J. (2013, 12.11.). Reframing addictions: heavy use over time.
ALICE RAP EU Policy Seminar, Brussels, Belgium.
Rehm, J. (2013, 23.-25.04.). Reframing addictions: Heavy use over time.
3rd Plenary Meeting of Alice Rap, Barcelona, Spain.
Rehm, J. (2013, 11.-12.02.). Taxation of alcoholic beverages from a public health perspective. WHO resource tool on alcohol pricing and
taxation policies Bangkok, Thailand.
Rehm, J. (2013, 08.-11.09.). Treatment decreases mortality in alcohol
dependent patients. 14th Congress of the European Society for
Biomedical Research on Alcoholism, Warsaw, Poland.
Rehm, J. (2013, 27.-28.02.). Vergessene Mehrheit – Suchtbehandlung
im Krankenhaus als „Sekundärbelastung“ - Was ist das
Problem? 7. Rhein-Main Zukunftskongress Krankenhaus und
Partner, Offenbach.
Rehm, J. (2013, 05.-09.10.). Why we need to prioritize addiction treatments. 26th European College of Neuropsychopharmacology
Congress, Barcelona, Spain.
Rehm, J., & Borges, G. (2013, 18.-20.03.). Estimates of disease burden attributable to alcohol use disorders. WHO Meeting of the
Technical Advisory Group on Alcohol Epidemiology, Geneva,
Switzerland.
Rehm, J., & Ezzati, M. (2013). Estimates of alcohol-attributable disease
burden generated in the GBD 2010 project. WHO Meeting of
the Technical Advisory Group on Alcohol Epidemiology.
Rehm, J., & Gual, A. (2013, 07.-08.11.). Alcohol treatment policy and the
AMPHORA project. Annual SSA Symposium, York, UK.
Rehm, J., & Parry, C. (2013, 18.-20.03.). Implications of recent developments in estimation of alcohol-attributable burden for WHO
activities related to monitoring alcohol consumption and alcoholrelated harm. WHO Meeting of the Technical Advisory Group on
Alcohol Epidemiology, Geneva, Switzerland.
Rehm, J., & Shield, K. D. (2013, 26.-27.04.). Alcohol in the European
Union – consumption and harm. Global Alcohol Policy
Symposium, Istanbul, Turkey.
Rehm, J., & Shield, K. D. (2013). Burden and cost of alcohol, tobacco
and illegal drugs globally and in Europe. Nordic-Baltic Alcohol
and Drug Policy Network (NordAN), Tallinn, Estonia.
Shield, K. D., & Rehm, J. (2013, 14.-15.02.). Revisiting alcohol-attributable problems. 7th National Alcohol Conference, Bangkok,
Thailand.
Westphal, D., Gerlach, A. L., Lang, T., Wittchen, H.-U., & Einsle,
F. (2013). Die Rolle der interozeptiven Exposition bei
der Behandlung der Panikstörung mit Agoraphobie. 8.
Workshopkongreß für Klinische Psychologie und Psychotherapie
der Deutschen Gesellschaft für Psychologie, Fachgruppe
Klinische Psychologie und Psychotherapie, Trier.
Wittchen, H.-U. (2013, 30.09.). Cost of disorders of the brain in Europe.
3rd World Parkinson Congress, Montreal, Canada.
Wittchen, H.-U. (2013, 19.09.). From early vulnerabilities over the
expression of anxiety and depressive disorders to targeted intervention. Lundbeck Institute Seminar, Skodsborg, Denmark.
2012
Beesdo-Baum, K., Becker, E. S., & Hoyer, J. (2012, 05.). Verhaltenskorrelate und Expositionstherapie bei der Generalisierten
Angststörung. 30. Symposium für Klinische Psychologie und
Psychotherapie der DGPs, Luxemburg.
Beesdo, K. (2012, 13.-17.10.). Vulnerability and resilience in the development of anxiety: Epidemiology. 25th Congress of the European
College of Neuropsychopharmacology (ECNP), Vienna, Austria.
Braun, B., Sassen, M., Kraus, L., & Bühringer, G. (2012, 05.). Gamblers
seeking treatment: Who does and who doesn´t? 15th
Conference of the European Association of Substance Abuse
Research (EASAR), Nijkerk, Netherlands.
Braun, B., Sassen, M., Kraus, L., & Bühringer, G. (2012, 10.).
Pathologische Glücksspieler: Wer sucht Hilfe, wer nicht?
Deutscher Suchtkongress 2012, Berlin.
Bühringer, G. (2012, 06.). Meilensteine der Suchtforschung und deren
Bedeutung für die Behandlungspraxis. 25. Kongress des
Fachverbandes Sucht e.V., Heidelberg.
Bühringer, G., Kraus, L., Höhne, B., Küfner, H., Künzel, J., & Ludwig,
M. (2012, 09.). Evaluation of the 5th amendment of the german
gambling ordinance. 9th European Conference on Gambling
Studies and Policy Issues, Loutraki, Greece.
Höcker, A., Muehlhan, M., Barnow, S., Stopsack, M., & Schäfer, I.
(2012, 24.-25.09.). Relationships between childhood abuse and
the neuroendocrine response to stress in individuals with substance abuse. 1st German health research meeting on behavioural disorders related to violence, neglect,maltreatment, and
abuse in childhood and adolescence, Günzgburg.
Hoyer, J. (2012, 30.03.). Prädiktoren für Therapieerfolg und
Therapieabbruch in der Verhaltenstherapie der Sozialen Phobie:
Ergebnisse der Sophonet-Studie. Deutscher Kongress für
Psychosomatische Medizin und Psychotherapie (DKPM) “Die
Zukunft der Psychosomatik”, München.
Hoyer, J. (2012, 06.). Fortbildungsangebote in Randgebieten der Psychotherapie: Welche sind wissenschaftlich begründbar? Expertentagung
der Ostdeutschen Psychotherapeutenkammer, Leipzig.
Hoyer, J. (2012, 11.). Handeln, wenn das Zeitfenster aufgeht: Flexible
Formate in der ambulanten Verhaltenstherapie. PsychosomatikKolloquiums der Klinik Carolabad, Chemnitz.
Hoyer, J. (2012, 10.). Orientierung im Netzwerk der Sorgen:
Psychotherapie bei der Generalisierten Angststörung.
Norddeutsche Psychotherapietage, Lübeck.
Hoyer, J. (2012, 07.). Sorgen, Emotionsvermeidung und Sorgenkonfrontation. Psychosomatische und Psychotherapeutische
Abteilung des Universitätsklinikums Erlangen-Nürnberg, Erlangen.
Hoyer, J., Bräuer, D., Klumbies, E., & Kirschbaum, C. (2012, 05.).
Dissoziative Symptome bei Sozialer Phobie. 30. Symposium für
Klinische Psychologie und Psychotherapie der DGPs, Luxemburg.
Hoyer, J., Hiller, W., Leibing, E., Stangier, U., & Willutzki, U. (2012,
03.). Wie erfolgreich ist Kognitive Verhaltenstherapie bei
Sozialer Phobie? Bewährung des Clark/Wells-Ansatzes in
einer Multicenter-Studie. 27. Deutsche Gesellschaft für
Verhaltenstherapie e. V.(DGVT) Kongress, Berlin.
Hoyer, J., Wiltink, J., Hiller, W., Leibing, E., Stangier, U., Willutzki, U. &
Leichsenring, F. (2012, 03.). Prädiktoren für Therapieerfolg und
Therapieabbruch in der Psychotherapie der Sozialen Phobie:
Ergebnisse der Sophonet-Studie. Psychotherapiekongress 2012
„Meilensteine in Forschung und Praxis“, Hannover.
Jacobi, F. (2012, 27.-29.09.). Treten psychischer Störungen häufiger
auf? 11. Deutscher Kongress für Versorgungsforschung & 4.
Nationaler Präventionskongress, Dresden.
Jacobi, F., Pehle, U., & Hoyer, J. (2012, 05.). Gründe therapeutischer
Misserfolge aus Patientensicht. 30. Symposium für Klinische
Psychologie und Psychotherapie der DGPs, Luxemburg.
Knappe, S., & Müller, N. (2012, 09.). Der Einbezug von Eltern in die
ambulante Kinder- und Jugendpsychotherapie. 48. Kongress der
Deutschen Gesellschaft für Psychologie.
Kraus, L., & Bühringer, G. (2012). Staatsvertrag zum Glücksspielwesen
in Deutschland. Auswirkungen der Öffnung des Internets.
Workshop „Evaluierung des Glücksspielstaatsvertrages”.
Staatsministerium des Innern, München.
219
Kräplin, A. (2012, 18.– 21.09). Cognitive control functions in pathological gamblers - Pilot data and further research 9th European
Conference on Gambling Studies and Policy Issues (EASG),
Loutraki, Greece.
Kräplin, A., & Bühringer, G. (2012, 12.). Glücksspielen: Kontrollaufgabe
des Staates oder Verantwortung des Einzelnen? Psychologie am
Samstag, Fachrichtung Psychologie, TU Dresden, Dresden.
Ludwig, M., Kraus, L., Braun, B., Müller, S., & Bühringer, G. (2012,
09.). Has gambling changed after major amendments of gambling regulations in Germany? A propensity score analysis. 9th
European Conference on Gambling Studies and Policy Issues,
Loutraki, Greece.
Muehlhan, M., Lueken, U., Evens, R., & Kirschbaum, C. (2012,
23.–27.09.). MRT als Stressor: Erfassung, Auswirkungen
und Reduktion von Stressreaktionen während funktioneller
Magnetresonanztomographie /fMRT. 48. Kongress der
Deutschen Gesellschaft für Psychologie (DGPs), Bielefeld.
Reif, A., Domschke, K., Straube, B., Richter, J., Wittchen, H.-U., Weber,
H., Höfler, M., Kircher, T., Hamm, A., & Deckert, J. (2012,
24.11.). Die Bedeutung des MAO-A Polymorphismus für die
Entstehung und Therapie von Angst. Deutsche Gesellschaft für
Psychiatrie, Psychotherapie und Nervenheilkunde (DGPPN), Berlin.
Richter, R. (2012, 17.-19.05). Enrollment and attendance in family-based
prevention programs. 30. Symposium Klinische Psychologie und
Psychotherapie, Luxemburg.
Schäfer, I., Barnow, S., Klein, M., Muehlhan, M., Scherbaum, N.,
Driessen, M., Thomasius, R., Sack, P.-M., Ravens-Sieberer, U.,
Härter, M., & Pawils, S. (2012, 24.-25.09.). Childhood Abuse
and Neglect as a cause and consequence of Substance Abuse
– understanding risksand improving Services (CANSAS). 1st
German health research meeting on behavioural disorders related to violence, neglect, maltreatment, and abuse in childhood
and adolescence, Günzburg.
Schäfer, I., Barnow, S., Klein, M., Muehlhan, M., Driessen, M.,
Scherbaum, N., Thomasius, R., Sack, P.-M., Ravens-Sieberer, U.,
Pawils, S., & Härter, M. (2012, 21.-24.11.). Suchterkrankungen
als Ursache und Folge früher Gewalt – der BMBF-Verbund
„CANSAS“. Deutsche Gesellschaft für Psychiatrie,
Schäfer, I., Muehlhan, M., Menger, H., Lüdecke, D., Bong, S., Haupt,
L., Marzok, M., Sehner, S., & Wiedemann, K. (2012, 08.-11.03.).
Auswirkung früher Traumatisierung auf die Cortisolsekretion
alkoholabhängiger Patienten unter psychosozialem Stress.
14. Jahrestagung der Deutschsprachige Gesellschaft für
Psychotraumatologie (DeGPT), Hamburg.
Straube, B., Reinhardt, I., Jansen, A., Lueken, U., Wittchen, H.-U.,
Wittmann, A., & Ströhle, A. (2012, 03.-05.05.). The effect of psychotherapy on fear conditioning in patients with panic disorder:
An fMRI multicenter study. 4th European Meeting on Human
Fear Conditioning, Rauischholzhausen.
Straube, B., Yang, Y., Sass, K., Ströhle, A., Lueken, U., Wittchen,
H.-U., Deckert, J., Arolt, V., Kircher, T., & Lotze, M. (2012,
23.11.). Semantisches Priming bei Patienten mit Panikstörung.
Symposium: Neurale Korrelate von kognitiven, emotionalen
und semantischen Prozessen bei Patienten mit Panikstörung
und Agoraphobie; Deutsche Gesellschaft für Psychiatrie,
Westphal, D., Gerlach, A. L., Lang, T., Wittchen, H.-U., & Einsle, F.
(2012, 16.11). Which exercise is the best to induce bodily
symptoms and anxiety during interoceptive exposure?: Results
from a multicenter clinical outcome study in patients with panic
disorder and agoraphobia. 14. Jahrestagung der Gesellschaft für
Angstforschung (GAF), Würzburg.
Wittchen, H.-U. (2012, 09.02.). Benefits and Costs of Psychotherapy.
Network for psychotherapeutic care in europe (NPCE) &
Bundespsychotherapeutenkammer (BPtK), Brüssel, Netherlands.
Wittchen, H.-U. (2012, 17.-18.08.). Comorbidity of depression and anxiety disorders. China Conference of Anxiety Disorders (CCAD), Jinan, China.
Wittchen, H.-U. (2012, 20.04.). Cost of brain disorders in europe.
Pfizersymposium “MAP 2012 the GAD Patient in Focus,
London, UK.
220
Wittchen, H.-U. (2012, 12.10.). Costs and burden of untreated depression in Europe. Conference “Depression in Latvia and Europe
- myths and reality”, Riga, Lettland.
Wittchen, H.-U. (2012, 20.03.). Early developmental stages of psychopathology (EDSP) study, a prospective longitudinal cohort community study. Pôle de Psychiatrie, Paris, France.
Wittchen, H.-U. (2012, 21.11.). Effekte der langfristigen Substitution
Opiatabhängiger - Ergebnisse der 6-Jahres-Verlaufsstudie
PREMOS. Symposium Landesärztekammer BadenWürttemberg, Stuttgart.
Wittchen, H.-U. (2012, 14.04.). The global burden of CNS disorders.
Lundbeck Symposium, Dublin, Ireland.
Wittchen, H.-U. (2012). Kognitive Verhaltenstherapie der Panikstörung:
Wirkung und Wirkmechanismen. Psychotherapiekongress
“Meilensteine der Forschung und Praxis” Hannover.
Wittchen, H.-U. (2012, 21.11.). Mental disorders in Europe - a review of
epidemiological studies. Deutsche Gesellschaft für Psychiatrie,
Psychotherapie und Nervenheilkunde (DGPPN), Symposium
“the Burden of mental disorders n Europe and the European
Mental Health Strategy”, Berlin.
Wittchen, H.-U. (2012, 14.11.). Reinventing Psychotherapy - Was wirkt
an einer CBT? Jahrestagung der ÖGPB, Vienna, Austria.
Wittchen, H.-U. (2012, 17.05.). The size and burden of mental disorders
in Europe. 14th Conference of the Israel Psychiatric Association
Tel-Aviv, Israel.
Wittchen, H.-U. (2012, 05.03.). Size and burden of mental disorders in
Europe: Update, insights and implications. 20th European Congress
of Psychiatry, ECNP-Symposium, Praha, Czech Republic.
Wittchen, H.-U. (2012, 05.03.). Size, burden and treatment of mental disorders in europe from a german perspective. European Congress
of Psychiatry, ECNP-Symposium, Praha, Czech Republic.
Wittchen, H.-U. (2012, 26.06.). Thoughts about strategies on mental
health and mental health research in europe. Lundbeck LINF
Faculty Meeting, Dunkeld, Scotland.
Wittchen, H.-U. (2012, 22.11.). Vorstellung der wichtigsten Daten
aus dem Zusatzmodul “Mental Health”. DGPPN Kongress,
Pressekonferenz “Wie krank sind die Deutschen? Vorstellung
des Deutschen Gesundheitssurveys”, Berlin.
Wittchen, H.-U. (2012, 22.11.). Wer behandelt GAD und wie?
Versorgungsrealität in Deutschland. DGPPN Kongress, PfizerSymposium „Psychiater, übernehmen Sie – Wann ist der
Facharzt bei GAD gefragt“, Berlin.
Wittchen, H.-U. (2012, 23.11.). Zur Häufigkeit psychischer Störungen in
der Bevölkerung 2012. Deutsche Gesellschaft für Psychiatrie,
Wittchen, H.-U., Bühringer, G., Rehm, J., & die PREMOS Gruppe. (2012,
20.04.). Effekte der langfristigen Substitution Opioidabhängiger:
Ergebnisse und Schlussfolgerungen der PREMOS Studie. CaSu
Fachtag Substitution, Frankfurt.
Wittchen, H.-U., & Jacobi, F. (2012, 14.06.). Was sind die häufigsten
psychischen Störungen in Deutschland? Erste Ergebnisse der
„Zusatzuntersuchung psychische Gesundheit“ (DEGS-MHS).
RKI-Symposium DEGS-Symposium: “Gemessen und gefragt –
die Gesundheit der Deutschen unter der Lupe”, Berlin.
Wittich, J. (2012, 14.-16.06.). Entwicklung eines Fragebogens zu
Erziehungseinstellungen im Säuglings- und Kleinkindalter. VI.
Symposium of the German Marcé-Society: Von der Versorgung
zur Forschung - Konzepte und Visionen, Wiesloch.
Wittich, J. (2012, 14.-16.06.). Fragebogen zu Erziehungseinstellungen
im Säuglings- und Kleinkindalter. VI. Symposium der Marcé
Gesellschaft für Peripartale Psychische Erkrankungen e.V.;
Symposium „Von der Forschung zur Versorgung.“, Wiesloch.
Wittmann, A., Schlagenhauf, F., Guhn, A., Lueken, U., Fydrich, T.,
Bermpohl, F., Fehm, L., Pfleiderer, B., Gerlach, A. L., Kircher,
T., Straube, B., Jansen, A., Wittchen, H.-U., Deckert, J., Arolt,
V., Zwanzger, P., & Ströhle, A. (2012, 21.-24.11.). Neuronale
Korrelate der Agoraphobie. Symposium: Neurale Korrelate
von kognitiven, emotionalen und semantischen Prozessen
bei Patienten mit Panikstörung vor und nach Psychotherapie;
Deutsche Gesellschaft für Psychiatrie, Psychotherapie und
Nervenheilkunde (DGPPN), Berlin.
Auswahl an Poster Präsentationen auf
Tagungen und Kongressen
2014
(2014, 17.-20.09.). Does help-seeking alter the risk for incident
psychopathology in adolescents and young adults with and
without fearful spells or panic attacks? Findings from a 10-year
prospective-longitudinal community study. 9. Jahrestagung der
Deutschen Gesellschaft für Epidemiologie (DGEpi), Ulm.
(2014, 21.-25.09.). Does low coping efficacy mediate the association between negative life events and incident psychopathology? A prospective-longitudinal community study of adolescents
and young adults. 49. Kongress der Deutschen Gesellschaft für
Psychologie (DGPs), Bochum.
Beesdo-Baum, K., Wittchen, H.-U., Craske, M. G., Hoyer, j., Jurkschat,
S., El Hadad, A., & Knappe, S. (2014, 18.-21.10.). Psychometric
properties of the 1-week dimensional anxiety scales for DSM-5
in a non-clinical student sample. 27th Congress of the European
College of Neuropsychopharmacology (ECNP) Berlin.
Evens, R., Hilbert, K., Maslowski, N. I., Wittchen, H.-U., & Lueken,
U. (2014, 08.-12.06.). The neural substrates of symptom
provocation in dental phobia: a crossmodal comparison study.
20th meeting of the Organization for Human Brain Mapping,
Hamburg.
Furka, N., & Hoyer, J. (2014, 29.-31.05.). Verhaltensaktivierung bei
Depression: Erste Ergebnisse zu einem Gruppenprogramm. 32.
DGPs, Braunschweig.
Gergei, I., Klotsche, J., Kleber, M. E., Pieper, L., Wittchen, H.-U.,
Krämer, B. K., Wanner, C., Mann, J. F. E., März, W., & Mondorf,
U. (2014, 06.-09.09). Prävalenz und Prognose Chronischer
Nierenerkrankungen in der Primärversorgung in Deutschland Ergebnisse der Diabetes Cardiovascular Risk-Evaluation: Targets
and Essential Data for Commitment of Treatment (DETECT)
– Studie. 6. Jahrestagung der Deutschen Gesellschaft für
Nephrologie, Berlin.
Hilbert, K., Nebe, S., Lueken, U., & Beesdo-Baum, K. (2014, 08.-12.06.).
Differential neural correlates of uncertainty and ambiguity processing in worriers: a preliminary analysis. 20th meeting of the
Organization for Human Brain Mapping, Hamburg.
Höcker, A., Mühlhan, M., Mollen, F., Holl, J., Wolff, S., Barnow, S.,
& Schäfer, I. (2014, 09.). The impact of childhood abuse and
neglect on cortisol awakening response in individuals with
alcohol dependence 3rd German health research meeting on
behavioral disorders related to violence, neglect, maltreatment,
and abuse in childhood and adolescence, Eichstätt.
Jahnke, S., & Hoyer, J. (2014, 05.). Stigmatisierung von Pädophilen:
Ergebnisse zweier vergleichender Befragungsstudien. 32.
DGPs, Braunschweig.
Jahnke, S., Philipp, K., & Hoyer, J. (2014, 06.). Challenging the stigma
towards people with pedophilia among psychotherapists in training *Best Student Poster Award. 40th Annual Meeting of the
International Academy of Sex Research, Dubrovnik, Croatia.
Knappe, S., Lieb, R., Wittchen, H.-U. & Beesdo-Baum, K. (2014, 05).
Externalizing, anxiety and depressive disorders: Co-morbidity,
prospective associations, correlates and risk factors in youth.
Section - meeting of the European Psychiatric Association (EPA),
Ulm/Neu-Ulm.
Knappe, S., Mark, T., Hoyer, J., Craske, M. G., Wittchen, H.-U., &
Beesdo-Baum, K. (2014, 18.-21.10.). Limited psychometric
properties of the DSM-5 dimensional assessment scales for
OCD and PTSD. 27th Congress of the European College of
Neuropsychopharmacology (ECNP) Berlin.
Lange, S., Lueken, U., & Maslowski, N. I. (2014, 18.-21.10.). High
anxiety sensitivity is associated with reduced resting
heart variability. 27th Congress of the European College in
Neurpsychopharmacology (ECNP), Berlin.
Lueken, U., Hahn, T., Straube, B., Wittchen, H.-U., Wittmann, A.,
Ströhle, A., Pfleiderer, B., Arolt, V., Reif, A., & Kircher, T. (2014,
18.-21.10.). Developing fMRI markers for individual response
prediction in panic disorder. 27th Congress of the European
College in Neurpsychopharmacology (ECNP), Berlin.
Lueken, U., Hahn, T., Straube, B., Wittchen, H.-U., Konrad, C., Ströhle,
A., Wittmann, A., Pfleiderer, B., Arolt, V., Reif, A., & Kircher,
T. (2014, 08.-12.06.). Response prediction in panic disor-der
with agoraphobia using fMRI based pattern classification. 20th
Meeting of the Organization for Human brain Mapping (OHBM),
Hamburg.
Maslowski, N. I., Lange, S., Kragen, K., Ebser, N., & Lueken, U. (2014,
08.-12.06.). Inferior frontal opercular activation during the anticipation of loaded breathing is associated with sub-jective feelings
of dyspnea. 20th Meeting of the Organization for Human brain
Mapping (OHBM), Hamburg.
Muehlhan, M., Wittchen, H.-U., & Alexander, N. (2014, 08.-12.06.).
Effects of trait anxiety on neural response to the attentional network test. Annual Meeting of the Organization for Human Brain
Mapping Annual Meeting, Hamburg.
Nebe, S., Krömer, N., Schad, D. J., Sebold, M., Garbusow, M., Scholl,
L., Paul, S., Walter, H., Schlagenhauf, F., Sterzer, P., Heinz,
A., Huys, Q. J. M., Rapp, M., & Smolka, M. N. (2014). Linking
impulsivity and habitual behavior to striatal activation. 20th Annual
Meeting of the Organization for Human Brain Mapping, Hamburg.
Paul, S., Bühringer, G. & Noack, R. (2014, 21.-25.09.). CannabisKonsummotive sind assoziiert mit DSM-5 Cannabis Use
Disorder. Entwicklung und diagnostische Überprüfung
des CANUM-G Motivfragebogens an einer deutschen
Studentenstichprobe 49. Kongress der Deutschen Gesellschaft
für Psychologen, Bochum.
Paul, S., Hoyer, J., Bühringer, G., Wittchen, H.-U., & Noack, R. (2012,
13.-17.10.). Cannabis use motives questionnaire: development,
factor structure and psychometric properties in a German university student sample 25th Congress of the European College in
Neuropsychopharmacology (ECNP), Vienna, Austria.
Schäfer, J., Pannasch, S., Richter, J., Höfler, M., & Schönfeld, S. (2014,
10.-13.09.). Peri-traumatic attentional bias to threat predicts posttraumatic intrusions depending on emotion dysregulation and
attentional control. EABCT Congress, Den Haag, Netherlands.
Schäfer, J., Schönfeld, S., & Wittchen, H.-U. (2014). Assoziationen
zwischen Resilienz und Aufmerksamkeitsverzerrungen bei
Soldaten der Bundeswehr kurz vor dem Auslandseinsatz.
16. Jahrestagung der Deutschsprachigen Gesellschaft für
Psychotraumatologie DeGPT.
Stankevich, Y., Evens, R., Riedel, O., Storch, A., & Lueken, U. (2014,
18.-21.10.). Behavioral and neural correlates of cognitiv control in
Parkinson’s disease. 27th Congress of the European College in
Neurpsychopharmacology (ECNP), Berlin.
Yang, Y., Wittmann, A., Lueken, U., Holtz, K., Herrmann, M., Sass, K.,
Jansen, A., Konrad, C., Ströhle, A., Pfleiderer, B., Hamm, A.,
Deckert, J., Arolt, V., Wittchen, H.-U., Kircher, T., & Straube, B.
(2014, 08.-12.06.). Semantic conditioning: Building fear associations by incidental pairing with fear related words. 20th Meeting
of the Organization for Human brain Mapping (OHBM), Hamburg.
2013
Abel, K., Schepper, F., Martini, J. (2013, 20.-22.11.). Ausprägung
der Progredienzangst bei Eltern krebskranker Kinder. 12.
Jahrestagung der Arbeitsgemeinschaft für Psychoonkologie
(PSO): Brücken verbinden!?-Sektorale Vernetzung in der
Psychoonkologie. Dresden.
Beesdo-Baum, K., Pine, D. S., Höfler, M., Lieb, R., & Wittchen, H.-U.
(2013, 22.-27.10.). What do child and adolescent psychiatric disorders predict? Prospective-longitudinal associations with adult
psychopathology. 60th Annual Meeting of the American Academy
of Child & Adolescent Psychiatry (AACAP), Orlando, US.
Beesdo-Baum, K., & Wittchen, H.-U. (2013, 07.-09.03.). Anxiety disorders as early stages of malignant psychopathological long-term
221
outcomes: results of the 10-years prospective EDSP study.
103rd Annual Meeting of the APPA, New York, US.
Behrendt, S., Hoyer, J., & Bühringer, G. (2013, 09.). Behandlung
von Patienten mit Substanzstörungen nach Änderung der
Psychotherapierichtlinie im Jahr 2011. Deutscher Suchtkongress
2013, Bonn.
Behrendt, S., Hoyer, J. & Bühringer, G. (2013, 05.). Behandlung
von Patienten mit Substanzstörungen durch niedergelassene Psychologische Psychotherapeuten nach Änderung der
Psychotherapierichtlinie im Jahr 2011. 31. Symposium für
Klinische Psychologie und Psychotherapie der DGPs, Trier.
Evens, R., Stankevich, Y., Riedel, O., Storch, A., & Lueken, U. (2013, 20.22.03.). Fronto-striatal dysregulation of motivational and cognitive
flexibility in Parkinson’s. Spring School SFB 940 CRC, Dresden.
Evens, R., Stankevich, Y., Riedel, O., Storch, A., & Lueken, U. (2013,
31.10.-01.11.). Neural activation patterns of motivational flexibility during a reversal learning task. Donders Discussions,
Radboud University Nijmegen, Netherlands.
Hilbert, K., & Beesdo-Baum, K. (2013, 20.-22.03.). Cognitive control
deficits and relationship to worry frequency and controllability:
Concept of a fMRI study. Spring School of the Collaborative
Research Centre Volition and Cognitive Control: Mechanisms,
Modulators, Dysfunctions (SFB 940), Dresden.
Hilbert, K., & Beesdo-Baum, K. (2013, 07.-10.03.). Differntial prefrontal
cortex activation characterizes generalized anxiety disorder without depression. ECNP workshop on Neuropsychopharmacology
for Young scientists, Nice, France.
Hilbert, K., Lueken, U., & Beesdo-Baum, K. (2013). Neural correlates of
generalized anxiety disorder without comorbid depression: preliminary data from a functional MRI study (abstract). European
Neuropsychopharmacology, 23, 86.
Hoyer, J., & Gloster, A. T. (2013, 09.). Valued living: Does it explain
treatment satisfaction better than mere symptom reduction?
SSP conference “crossing borders”, Basel, Swizerland.
Hoyer, J., & Möser, M. (2013, 05.). Alternative Medizin bei
Generalisierter Angststörung. 31. Symposium für Klinische
Psychologie und Psychotherapie der DGPs, Trier.
Jahnke, S. (2013, 05.). Pedophilia as stigma: An empirical survey of the
social perception of people with a sexual interest in children. 9th
Workshop Congress for Clinical Psychology and Psychotherapy,
Trier.
Jahnke, S. (2013, 08.). Stigmatization of People with Pedophilia: A
comparative survey in Germany. 39th Annual Meeting of the
International Academy of Sex Research, Chicago, US.
Jahnke, S., Imhoff, R., & Hoyer, J. (2013, 05.). Pädophilie als Stigma:
Eine empirische Untersuchung zur sozialen Wahrnehmung von
Menschen mit sexuellem Interesse für Kinder. 31. Symposium
für Klinische Psychologie und Psychotherapie der DGPs, Trier.
Jahnke, S., Imhoff, R., & Hoyer, J. (2013, 08.). Stigmatization of people
with pedophilia: A comparative survey in Germany. Meeting of
the International Academy of Sex Research, Chicago, US.
Knappe, S., Beesdo-Baum, K., Lieb, R., & Wittchen, H.-U. (2013, 04.).
Externalizing disorders and the risk for anxiety disorders in children and adolescents. 2nd Herrenhausen Conference, Hanover.
Kräplin, A., Mayer, R., Bühringer, G., & Goschke, T. (2013, 10.-12.03.).
Cognitive control functions in pathological gambling: General
or specific impairments? 1st International Conference on
Behavioral Addictions, Budapest, Hungary.
Kräplin, A., Mayer, R., Goschke, T., & Bühringer, G. (2013, 18.-23.09.).
Kognitive Kontrollfunktionen bei Nikotinabhängigkeit: Generelles
Defizit oder spezifische Muster? Deutscher Suchtkongress
2013, Bonn.
Martini, J., Petzoldt, J., Wittich, J., & Wittchen, H.-U. (2013, 05.-09.10.).
Course of DSM-IV social anxiety disorders during pregnancy
and postpartum. 26th Congress of the European College in
Neuropsychopharmacology (ECNP), Barcelona, Spain.
Paul, S., Rodehacke, S., & Krömer, N. B. (2013, 02.09.). Die deutsche
Version der Substance Use Risk Profile Scale (SURPS):
Psychometrische Validierung anhand von deutschen, englischen, irischen und französischen Jugendlichen. Deutscher
Suchtkongress, Bonn.
222
Petzoldt, J., Wittchen, H.-U., Wittich, J., & Martini, J. (2013, 05.-09.10.).
Perinatal maternal DSM-IV anxiety and depressive disorders
and regulatory disorders in the offspring. 26th Congress of
the European College in Neuropsychopharmacology (ECNP),
Barcelona, Spain.
Stankevich, Y., Evens, R., Goschke, T., Reichmann, H., Storch, A., &
Lueken, U. (2013, 31.10.-01.11.). The effects of deep brain
stimulation of the subthalamic nucleus on reward processing in
Parkinson’s disease. Radboud University Nijmegen, Netherlands.
Wiltink, J., Herpertz, S., Hoyer, J., Joraschky, P., Leibing, E.,
Leichsenring, F., Nolting, B., Pöhlmann, K., Strauss, B., &
Beutel, M. E. (2013, 06.). Do patient characteristics predict
outcome of short term psychodynamic psychotherapy for
Social Anxiety? 44th annual conference of the Society for
Psychotherapy Research, Brisbane, Australia.
Wittich, J., Strobel, A., Wittchen, H.-U. & Martini, J. (2013, 05.-09.10.).
Parenting in early childhood: structural and criterion validity of the parenting atitudes towards infants and toddlers
questionnaire. 26th Congress of the European College in
Neuropsychopharmacology (ECNP), Barcelona, Spain.
2013
Beesdo-Baum, K., Low, N. C. P., Knappe, S., Behrendt, S., Höfler,
M., Lieb, R., & Wittchen, H.-U. (2012). Age-specific cumulative lifetime Incidence risk for mental disorders as a function
of familial liability 25th Congress of the European College in
Beesdo-Baum, K., Pine, D. S., Lieb, R., & Wittchen, H.-U. (2012, 02.06.12.). Mental disorders in adolescence and young adulthood:
Homotypic and heterotypic longitudinal associations. American
College of Neuropsychopharmacology (ACNP) 51st Annual
Meeting Hollyswood, Florida, US.
Behrendt, S., Beedo-Baum, K., Höfler, M., Bühringer, G., & Wittchen,
H.-U. (2012, 13.-17.10.). The role of different mental disorders in mothers and fathers for offspring risk of substance
use disorders. 25th Congress of the European College in
Beintner, I., Schuster, K. & Jacobi, C. (2012). Tagesklinische Behandlung
von PatientInnen mit Essstörungen in einer Universitätsambulanz.
3. Wissenschaftlicher Kongress der Deutschen Gesellschaft für
Essstörungen e.V. (DGESS), Hannover.
Crawcour, S., Bräuer, D., Klumbies, E., Kirschbaum, C., & Hoyer, J.
(2012, 13.-17.10.). Depresonalisation/ derealisation symptoms
in social phobia versus controls during acute social stress. 25th
Congress of the European College in Neuropsychopharmacology
(ECNP), Vienna Austria.
Einsle, F., Wieder, G., Winkel, S., Wittich, J., Petzoldt, J., & Martini, J.
(2012, 17.-20.05.). Anxiety disorders before pregnancy – a risk
for a high blood pressure in early pregnancy? 2nd International
Congress on Cardiac Problems in Pregnancy (CPP), Berlin.
Emmrich, A., Beesdo-Baum, K., Gloster, A. T., Hauke, C., & Wittchen,
H.-U. (2012, 19.-21.04). Depressive symptomatology in
patients with primary panic disorder with agoraphobia and
exposure exercise completion between the therapy sessions.
Psychotherapiekongress, Hannover.
Emmrich, A., Beesdo-Baum, K., Gloster, A. T., Knappe, S., Höfler, M.,
Arolt, V., Deckert, J., Gerlach, A. L., Hamm, A., Kircher, T.,
Lang, T., Richter, J., Ströhle, A., Zwanzger, P., & Wittchen,
H.-U. (2012, 19.-21.04.). Depression does not affect the
treatment outcome of CBT for panic and agoraphobia.
Psychotherapiekongress, Hannover.
Emmrich, A., Beesdo-Baum, K., Gloster, A. T., Knappe, S., Höfler, M.,
Deckert, J., Gerlach, A. L., Lang, T., Richter, J., & Wittchen,
H.-U. (2012, 13.-17.10.). The role of depression in treatment
outcomes of a multicenter randomized trial CBT for panic disorder and agoraphobia. 25th Congress of the European College in
Emmrich, A., Beesdo-Baum, K., Gloster, A. T., & Wittchen, H.-U. (2012,
13.-17.10.). Depressive symptomatology in patients with primary
PUBLIKATIONEN/PUBLICATIONS±
panic disorder with agoraphobia and exposure exercise completion
between the treatment sessions. 25th Congress of the European
College in Neuropsychopharmacology (ECNP), Vienna, Austria.
Frommelt, A.-M., Forberger, S., Behrendt, S., Rehm, J., & Bühringer,
G. (2012, 27.-28.09.). Addictions and lifestyles in contemporary
Europe: reframing addictions project (ALICE-RAP). INEBRIA
Conference, Barcelona, Spian.
Heber, I., Kronenbürger, M., Balzer-Geldsetzer, M., & Riedel, O.
(2012, 26.-29.09.). Schützt der Parkinsontremor vor der
Parkinsondemenz? 85. Kongress der Deutschen Gesellschaft für
Neurologie, Hamburg.
Hoyer, J., Hiller, W., Stangier, U., Willutzki, U., Wiltink, J., & Leibing,
E. (2012, 09.). Predicting outcome in CBT for social phobia:
Results from a large multicenter trial. EABCT conference, Genf,
Switzerland.
Kirschner, H., Lueken, U., & Beesdo-Baum, K. (2012, 19.-23.09.).
Psychophysiological correlates of anticipatory anxiety and uncertainty in high- and low worriers: an experimental study. 52nd
Annual Meeting of the Society for Psychophysiological Research
(SPR), New Orleans, US.
Knappe, S., Beesdo-Baum, K., Klotsche, J., Strobel, A., Le Beau,
R. T., Craske, M. G., & Wittchen, H.-U. (2012, 13.-17.09.).
Psychometric Properties and Sensitivity to Clinical Severity of
the Dimensional Anxiety Scales for DSM-5. 25th Congress of
the European College in Neuropsychopharmacology (ECNP),
Vienna, Austria.
Lueken, U., Rietzel, S., Wolz, M., Storch, A., & Goschke, T. (2012,
19.06.). Subthalamic deep brain stimulation alters cognitive
flexibility and reward-based learning in Parkinson’s disease:
Reliminary results. MDS 16th International Congress of
Parkinson’s Disease and Movement Disorders, Dublin, Ireland.
Lueken, U., Straube, B., Jansen, A., Maslowski, N. I., Ströhle, A.,
Wittmann, A., Pfleiderer, B., Uhlmann, C., Reif, A., & Kircher,
T. (2012, 13.-17.10.). Neural correlates of fear conditioning in
panic disorder with agoraphobia. 25th Congress of the European
Lueken, U., Straube, B., Maslowski, N. I., Wittchen, H.-U., Ströhle, A.,
Wittmann, A., Pfleiderer, B., Konrad, C., Uhlmann, C., & Kircher,
T. (2012, 13.-17.10.). What happens in the brain after successful
vs. non-successful CBT treatment? A multicenter fMRI study on
panic disorder with agoraphobia. 25th Congress of the European
Maslowski, N. I., Huber, A., Westphal, D., Wittchen, H.-U., & Lueken,
U. (2012). Neural correlates of inspiratory breathing restriction:
An fMRI pilot study investigating anticipation and perception
of loaded breathing. 25th Congress of the European College in
Maslowski, N. I., Kube, J., Wittchen, H.-U., & Lueken, U. (2012, 21.24.11.). Neural substrates of fear conditioning and extinction
in panic disorder using a delayed extinction task. Jahrestagung
der Deutschen Gesellschaft für Psychiatrie, Psychotherapie und
Maslowski, N. I., Wittchen, H.-U., & Lueken, U. (2012, 13.-17.10.).
Symptom provocation works for studying the interoception network: brain activation during interoceptive cue-exposure. 25th
Congress of the European College in Neuropsychopharmacology
(ECNP), Vienna, Austria.
Möser, M., & Hoyer, J. (2012, 21.-24.11). Alternative und ergänzende
medizinische Ansätze bei der Generalisierten Angststörung: eine
Übersicht kontrollierter Studien. 41. Kongress der Deutschen
Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik
und Nervenheilkunde (DGPPN), Berlin.
Muehlhan, M., Lueken, U., Wittchen, H.-U., Smolka, M., & Kirschbaum,
C. (2012, 10.-14.06.). Sympathetic stress reactions in response
to fMRI scanning alters cognitive performance and neural
activation patterns of interest. 18th Annual Meeting of the
Organization for Human Brain Mapping, Beijing (China).
Petzoldt, J., Martini, J., & Wittich, J. (2012). Does maternal anxiety and
depression before and during pregnancy predict crying during
early infancy? European Neuropsychopharmacology, 22, S426.
Petzoldt, J., Martini, J. & Wittich, J. (2012, 01.-03.03.). Maternal psy-
chopathological symptoms during peripartal time as predictor for
crying behavior in infancy. International Congress on Knowledge
through Interaction: How Children Learn about Self, Others and
Objects, Heidelberg.
Pieper, L., Klotsche, J., Thurau, C., Ziemssen, T., & Wittchen, H.-U.
(2012). Anxiety and depression in patients with multiple scleriosis: results of the MS Cargiver Burden study. 25th Congress
of the European College in Neuropsychopharmacology (ECNP),
Vienna, Austria.
Riedel, O. (2012, 13.-17.10.). Treatment of Alzheimer disease: Wich
effects on cargivers do we find? 25th Congress of the European
Straube, B., Kellermann, T., Lueken, U., Reinhardt, I., Jansen, A.,
Wittchen, H.-U., Wittmann, A., Ströhle, A., Pfleiderer, B.,
Konrad, C., Arolt, V., & Kircher, T. (2012, 13.06.). The effect of
CBT on aversive conditioning: A multi-center fMRI study in panic
disorder. Human Brain Mapping (HBM), Beijing, China.
Wieder, G., Martini, J., Wittich, J., Winkel, S., Petzoldt, J., & Einsle,
F. (2012, 13.-17.10.). Blood pressure in early pregnancy mediates the association between maternal anxiety and pregnancy
complications. 25th Congress of the European College in
Winkel, S., Wittich, J., Petzoldt, J., & Martini, J. (2012, 21.-24.11.).
Leiden Frauen mit Angst- und depressiven Störungen vor
der Schwangerschaft unter mehr Schwangerschaftsübelkeit
und -erbrechen? 41. Kongress der Deutschen Gesellschaft
für Psychiatrie und Psychotherapie, Psychosomatik und
Wittchen, H.-U. (2012, 14.04.). The global burden of CNS disorders.
Lundbeck Symposium, Dublin, Ireland.
Wolff, W., Brand, R., & Hoyer, J. (2012, 05.). Sportspezifische
Stressoren als Risikofaktoren für psychische Störungen
bei jugendlichen Leistungssportlern. 44. Jahrestagung der
Arbeitsgemeinschaft Sportpsychologie, Kiel.
Yang, Y., Straube, B., Lueken, U., Wittchen, H.-U., Wittmann, A.,
Ströhle, A., & Pfleiderer, B. (2012, 10.-14.06.). Neural correlates
of semantic priming in panic disorder with agoraphobia using
panic related stimuli - preliminary results. Human Brain Mapping
(HBM), Beijing, China.
223
ÖFFENTLICHKEITSARBEIT/PUBLIC RELATIONS
Öffentlichkeitsarbeit
Public Relations
225
DatumTitel
23.09.2014
18.06.2014
22.05.2014
04.04.2014
03.04.2014
18.02.2014
17.02.2014
14.02.2014
10.02.2014
25.01.2014
15.01.2014
11.12.2013
10.12.2013
15.06.2013
04.06.2013
04.06.2013
18.05.2013
10.05.2013
10.05.2013
10.05.2013
10.05.2013
02.05.2013
28.03.2013
27.03.2013
18.02.2013
15.02.2013
13.02.2013
21.01.2013
04.01.2013
01.01.2013
01.12.2012
29.11.2012
12.10.2012
28.09.2012
20.09.2012
16.07.2012
18.06.2012
2014.10.10
Zeitung/Magazin
Warum Rauchen eine Sucht ist
Dresdner Neueste Nachrichten
Schnell weg von der Flasche
Sächsische Zeitung
Ein klares Votum für die Gruppentherapie
Dresdner Universitätsjournal
Keine Angst vorm Rotwerden
Stottern nach Herzenslust
Sächsische Zeitung
Bundesförderung für Dresdner Gesundheitsforschung
DNN
Dresdner an Forschungsnetz zu psychischen Erkrankungen beteilig
Freie Presse
Nägel knabbern und Nase bohren: Was tun gegen Ticks?
Familienleben
Arbeit für psychisch Erkrankte muss normal werden
Beste Absolventen ausgezeichnet
Viele deutsche Soldaten gehen psychisch krank in den Einsatz - Info Neurologie & Psychiatrie
Interview mit Hans-Ulrich Wittchen
Zwischen Mythos und Manual - Notwendigkeit der Kategorisierung
Report Psychotherapie
Soldaten sind nicht unverwundbar
Ein Drittel aller Erwachsenen in Deutschland leidet an einer psychischen Störung Pressemitteilung TU Dresden
Verhaltenstherapiewoche zwischen Wissenschaft und Praxis
Verhaltenstherapiewoche zwischen Wissenschaft und Praxis
Eine Bibel die die Welt entzweit
FAZ
Wenn die Angst vor dem Arzt krank macht
Kölner Stadt-Anzeiger
Frankfurter Rundschau
Berliner Zeitung
Kölnische Rundschau
Psychiatrists Not Crazy About The Revised Manual Of Mental Disorders
Worldcrunch
Dem Stress im Job erfolgreich Paroli bieten
Freie Presse
Immer mehr Sachsen wegen Psycho-Leiden krank
Sächsische Zeitung
Willkommen an Bord
Psychische Erkrankungen - Hohes Aufkommen, niedrige Behandlungsrate Deutsches Ärzteblatt
Neue Ordnung für die Seele
Apotheken Umschau
Wahnsinn wird normal
Spiegel
Psychotherapeutischer Behandlungsbedarf bei Drogenabhängigen
Subletter
Warum sollte die Psyche gesunder sein als der Rest des Körpers?
Psychologie Heute
Die Angst vor der Angst: Angst- und Panikstörung
Focus Gesundheit
Möglichst draußen reden
Stern
Keine Panik
CAZ Campus-Zeitung Dresden
Psychische Krankheiten sind Volkskrankheiten
BPTK
Therapie bei Angsterkrankungen
Dresdner Stadtteilzeitung
Abstinenz als Behandlungsziel?
Subletter
Vernachlässigte Kranke: Der Psychologe Hans-Ulrich Wittchen beklagt Focus
die falsche Behandlung seelischer Störungen
Broschüre: Alle Achtung vor dem Stress. Gütersloh (Autorin: Carola Kleinschmidt) Bertelsmann Stiftung
DatumTitel
TV/Radio/Internet
20.07.2014
„ELDERLY“-Studie
15.07.2014
Glücksspiel – Wenn aus Spiel erst wird
05.07.2014
Pédophilie: pourquoi la stigmatisation nést vraiment pas la solution
13.06.2014
Verantwortung endet nicht an der Landesgrenze
14.05.2014
Rien ne va plus - Spielsucht statt Spielspaß
15.04.2014
Rushhour des Lebens - Stress in der mittleren Lebensphase
31.03.2014
Spezifisches Behandlungskonzept gegen Angst vor dem Erröten
18.02.2014
Psychische Erkrankungen sollen besser erforscht werden
17.02.2014
Dresdner an Forschungsnetz zu psychischen Erkrankungen beteiligt
13.01.2014
Warum die Dresdner auf Therapie warten
15.11.2013
Journal Podcast: Highlights from the current issue of
The American Journal of Psychiatry
29.08.2013
Ophidiophobie - Die Angst vor Schlangen
10.05.2013
Iatrophobie - Wenn die Angst vor dem Arzt krank macht
10.05.2013
10.05.2013
10.05.2013
MDR – Sachsenspiegel kompakt
MDR 1 Radio – Dienstag direkt
LE PLUS Le nouvel observateur - Online
AD HOC NEWS
MDR – Exakt - Die Story
MDR Sachsenspiegel
TU Dresden online
Focus Online
Focus Online
Sächsische Zeitung - Online
PsychiatryOnline
226
MDR – Lexi TV
Berliner Zeitung Online
FR - Online
MZ - Web
Rundschau - Online
DatumTitel
TV/Radio/Internet
24.04.2013
25.03.2013
18.03.2013
19.01.2013
13.01.2013
27.12.2012
25.09.2012
SWR 2 WISSEN
Noch normal oder schon verrückt? Die Diagnose Bibel der
Psychiatrie erscheint neu
Schwerpunkt: Seelisch krank oder gesund? Die korrekte
Diagnose psychischer Erkrankungen
Wer definiert psychische Erkrankungen?
Alkoholkonsum in Russland: Tödliches Wässerchen
Wenn Angst das Leben beherrscht.
Festtage - Telefonseelsorger helfen bei Weihnachtsstress
Traumatisierte Bundeswehrsoldaten: Psychologen warnen
vor hoher Dunkelziffer
WDR 5
ZEIT - Forum Wissenschaft
Spiegel Online
Spiegel Online
Mitteldeutsche Zeitung - Online
Spiegel Online
Am 26. November 2013 wurden im Rahmen einer nationalen Pressekonferenz in Berlin die Hauptergebnisse
der „Dunkelzifferstudie“ gemeinsam mit PD Dr. Peter Zimmermann und PD Dr. Jens Kowalski, den Leitern
des Psychotraumazentrums des Bundeswehr-krankenhauses Berlin vorgestellt. Darauf folgte eine bundesweite
Berichterstattung mit mehr als 50 Medienbeiträgen zu den Ergebnissen dieser Studie. Die wichtigsten Medienbeiträge
sind in der folgenden Tabelle aufgeführt:
Datum
Titel: PTSD
Zeitung/TV/Radio/Internet
26.11.2013
27.11.2013
26.11.2013
27.11.2013
26.11.2013
26.11.2013
27.11.2013
27.11.2013
26.11.2013
26.11.2013
26.11.2013
26.11.2013
26.11.2013
26.11.2013
26.11.2013
26.11.2013
26.11.2013
26.11.2013
26.11.2013
27.11.2013
26.11.2013
27.11.2013
26.11.2013
27.11.2013
26.11.2013
27.11.2013
26.11.2013
26.11.2013
26.11.2013
27.11.2013
26.11.2013
26.11.2013
26.11.2013
26.11.2013
26.11.2013
27.11.2013
26.11.2013
26.11.2013
Bundeswehrstudie: Bei Soldaten bleiben traumatische Störungen meist unerkanntAbendzeitung München
Studie Bundeswehr
AFP
Tagesschau 20.00Uhr
ARD Tagesschau
Psychisch kranke Soldaten - Großes Schweigen
Ärzte Zeitung
Traumatische Belastung – Studie Bundeswehr
Bayerischer Rundfunk
Jeder fünfte Soldat geht mit psychischer Störung in den Einsatz
Berliner Morgenpost
Bundeswehr – Traumatisierte Soldaten häufig vorbelastet
Berliner Zeitung
Kommentar zur Bundeswehr - Schlaflos im Senegal
Berliner Zeitung
Psychische Erkrankungen bei Soldaten oft unerkannt
Bild
Traumatische Belastung - Studie Bundeswehr
BR
Sanitätsdienst: Bundeswehrstudie
Bundeswehr
Bundeswehrstudie zu psychischen Erkrankung bei Soldaten
Bundeswehr aktuell
Afghanistan Einsatz: Krank vom Krieg
Der Tagesspiegel
Psychische Erkrankungen von Soldaten
Die Freie Welt
Traumatisierte Soldaten fast immer unbehandelt
Die Welt
Studie zu psychischen Störungen – Viele Soldaten
FAZ
gehen vorbelastet in den Einsatz
Ängste, Depressionen, Alkohol, Soldaten oftmals vor
Focus Online
Auslandseinsatz psychisch krank
Trauma-Soldaten leiden unbemerkt
Frankfurter Neue Presse
Bundeswehr - Soldaten psychisch vorbelastet in den Krieg
Frankfurter Rundschau
Traumatische Störungen bei Soldaten oft unerkannt
Gesundtheitsstadt Berlin
Jeder fünfte Soldat geht mit psychischer Störung in den Einsatz
Handelsblatt
Bundeswehrsoldaten haben häufig Traumata
Handelsblatt
Bundeswehr: Traumatisierte Soldaten oft vorbelastet
Kölner Stadtanzeiger
Bundeswehr: „Ich war völlig ausgebrannt“
Kölner Stadtanzeiger
Dunkelzifferstudie Bundeswehr Kriege fressen auch bei Soldaten Seele auf Kriegsberichterstatter
Studie: Jeder fünfte Soldat geht mit psychischer Störung in den Einsatz Lausitzer Rundschau
Psychische Erkrankungen bei Soldaten unerkannt
MDR
Psychische Erkrankungen bei Soldaten unerkannt
MDR
Bundeswehr: Traumatische Störungen bei Soldaten meist unerkannt
Münchner Abendzeitung
Krank in den Krieg
Münchner Abendzeitung
Hohe Dunkelziffer bei psychischen Erkrankungen
N24
Studie: Nur jeder fünfte traumatisierte Bundeswehrsoldat sucht Hilfe
Neues aus Braunschweig
Soldaten leiden stärker als sie es je zugeben würden
Nordkurier
Die Folgen des Kriegsgrauens
Nordseezeitung
Soldaten verschweigen psychische Probleme
N-TV
Jeder fünfte Soldat ist traumatisiert N-TV
Jeder fünfte Soldat ist traumatisiert
N-TV Mediathek
Traumatische Störungen bei Soldaten meist unerkannt
RP Online
227
Datum
Titel: PTSD
26.11.2013
26.11.2013
26.11.2013
26.11.2013
27.11.2013
26.11.2013
27.11.2013
27.11.2013
26.11.2013
26.11.2013
26.11.2013
26.11.2013
26.11.2013
Viele Soldaten haben psychische Störungen
RP Online
Studie: Viel mehr Soldaten als vermutet leiden unter Traumata
Short News
Bundeswehrstudie: PTBS bleibt bei Soldaten oft unentdeckt
Spiegel Online
Studie zu Belastungsstörungen deutsche Soldaten psychisch vorbelastet Süddeutsche Zeitung
Traumatisierte Soldaten
Süddeutsche Zeitung
Bundeswehr schickt psychisch vorbelastete deutsche
T - Online
Soldaten in Auslandseinsatz
Studie: Jeder fünfte Soldat geht mit psychischer Störung in den Einsatz T - Online
Bundeswehrstudie: Leserbriefe
Tagesschau
Psychische Belastung von Soldaten
Taz
Studie: Fast 80 Prozent traumatisierter Soldaten bleiben unerkannt
WELT
Psychische Belastung deutscher Soldaten?
ZDF-Mediathek
Bundeswehr: Psychische Störung - Auslandseinsatzstudie
Zeit Online
Verteidigung: Jeder fünfte Soldat geht mit psychischer
Zeit Online
Störung in den Einsatz
228
Zeitung/TV/Radio/Internet
2
0
1
4
Chemnitzer Strasse 46
01187 Dresden
Chemnitzer Str. 46
01187 Dresden
15th birthday Status Report 2013/14
STATUS REPORT 2013/14 INSTITUTE OF CLINICAL PSYCHOLOGY AND PSYCHOTHERAPY
2
0
1
4
Status Report 2013/14
Institute of Clinical Psychology
and Psychotherapy

Statusbericht 2013-2014 - Fachrichtung Psychologie

Transcription

Similar documents

PersÃ¶nlichkeitsstÃ¶rungen - Klinische Psychologie Mainz

keywords 1985-1995 - Ciszterci Szent István Gimnázium

Kongress Essstörungen 2012

Folie 1

GMTTB Jahrestagung Bildgebung bei HWS Beschwerden

LBDG Command Car 1

MEISTER HANS HOYER

Leitmerkmalmethode Manuelle Arbeitsprozesse

Newsletter 2/2014 - Mari Bersama e. V.