Biomedical subjects

Birgit Kröner-Herwig

Publications and source records attributed to Birgit Kröner-Herwig.

4 recordsLinked to original sources

PubMed2005

Are migraineurs hypersensitive? A test of the stimulus processing disorder hypothesis.

The concept of hypersensitivity in migraineurs was advanced mainly on the basis of studies on information processing in which increased amplitudes and reduced habituation in cortical evoked and event related potentials were found in migraine sufferers. The present investigation examined whether migraineurs exhibit hypersensitivity within three different experimental paradigms and various non electrocortical response parameters. Samples of 24 migraine, 19 tension-type headache sufferers, and 24 normal controls were compared regarding their subjective estimation of intensity and discomfort due to visual and acoustical stimuli. Subjects also participated in an experiment using the eyeblink startle response paradigm. In a last experimental task the Stroop test was applied. The trait variables emotionality, arousal, and extraversion were also measured. None of the experimental tasks revealed the predicted hypersensitivity of migraineurs in relation to the control samples. The series of experiments was conducted a second time with half of the participants in order to replicate the findings. The conclusions remained the same. The results of earlier studies on cortical processing can not be interpreted as demonstrating general hypersensitivity in the sense of a dispositional trait in migraine afflicted individuals irrespective of the involved response system.

Acoustic Stimulation↗

PubMed2004

Treating chronic tinnitus: comparison of cognitive-behavioural and habituation-based treatments.

Using a randomized control group trial the long-term efficacy of a habituation-based treatment as conceived by Jastreboff, and a cognitive-behavioural tinnitus coping training were compared. An educational intervention was administered as a control condition. Both treatments were conducted in a group format (habituation-based treatment, 5 sessions; tinnitus coping training, 11 sessions). Educational intervention was delivered in a single group session. Patients were categorized according to their level of disability due to tinnitus (low, high), age and gender and then randomly allocated to the treatment conditions (habituation-based treatment, n = 30; tinnitus coping training, n = 27; educational intervention, n = 20). Data assessment included follow-ups of up to 21 months. Several outcome variables including disability due to tinnitus were assessed either by questionnaire or diary. Findings reveal highly significant improvements in both tinnitus coping training and habituation-based treatment in comparison with the control group. While tinnitus coping training and habituation-based treatment do not differ significantly in reduction of tinnitus disability, improvement in general well-being and adaptive behaviour is greater in tinnitus coping training than habituation-based treatment. The decrease in disability remains stable throughout the last follow-up in both treatment conditions.

Adaptation, Psychological↗

PubMed2004

Therapist rotation--a new element in the outpatient treatment of alcoholism.

For nine years, the so-called "therapist rotation" has been a central part of OLITA, the Outpatient Longterm Intensive Therapy for Alcoholics. Thus far, the participation of several equally responsible therapists in the treatment of a patient has rarely been seen as a specific therapeutic approach. The present article analyzes the therapist rotation from a theoretical and clinical perspective. Articles concerned with the therapeutic alliance in the treatment of substance use disorders are reviewed. Furthermore, the literature on multiple psychotherapy, which may be seen as the precedent of the therapist rotation is surveyed. Based on the efficacy of multiple psychotherapy and the importance of the therapeutic alliance in the treatment of substance use disorders, the present work discusses the therapist rotation as an essential factor for the success of OLITA. It considers both potential advantages and disadvantages for patients and therapists and tries to identify conditions under which this approach appears to promote therapeutic interactions. Finally, the implementation of therapist rotation into OLITA is described, including the theoretical background of the program itself and the treatment procedure. New areas of application for the therapist rotation are discussed.

Alcoholism↗

PubMedDate not supplied

Substantial decrease of psychiatric comorbidity in chronic alcoholics upon integrated outpatient treatment - results of a prospective study.

It is far from clear how comorbidity changes during alcoholism treatment. This study investigates: (1) the course of comorbid Axis I disorders in chronic alcoholics over 2 years of controlled abstinence in the outpatient long-term intensive therapy for alcoholics (OLITA) and (2) the effect of comorbid Axis I and II disorders in this group of patients on subsequent drinking outcome over a four-year follow-up. This prospective treatment study evaluates psychiatric variables of 89 severely affected chronic alcohol dependent patients on admission (t(1)), month 6 (t(2)), 12 (t(3)) and 24 (t(4)). Drinking outcomes have been analyzed from 1998 to 2002. On admission, 61.8% of the patients met criteria for a comorbid Axis I disorder, 63.2% for a comorbid personality disorder. Axis I disorders remit from t(1) (59.0% ill), t(2) (38.5%), t(3) (28.2%) to t(4) (12.8%) (p < 0.0001). Anxiety disorders remit more slowly from t(1) (43.6%) to t(3) (20.5%, p = 0.0086), whereas mood disorders remit early between t(1) (23.1%) and t(2) (5.1%, p = 0.0387) with a slight transient increase at t(3) (10.3%). During the four-year follow-up, the cumulative probability of not having relapsed amounts to 0.59. Two predictors have a strong negative impact on abstinence probability: number of inpatient detoxifications (p = 0.0013) and personality disorders (p = 0.0106). The present study demonstrates a striking remission of comorbid Axis I disorders upon abstinence during comprehensive long-term outpatient alcoholism treatment. The presence of an Axis II rather than an Axis I disorder on admission strongly predicts drinking outcome over a four-year follow-up.

Adult↗