Biomedical subjects

Tanja Michael

Publications and source records attributed to Tanja Michael.

10 recordsLinked to original sources

PubMed2007

Rumination in posttraumatic stress disorder.

Recent studies have shown that rumination is a powerful predictor of persistent posttraumatic stress disorder (PTSD). However, to date, the mechanisms by which rumination maintains PTSD symptoms are little understood. Two studies of assault survivors, a cross-sectional (N = 81) and a 6-month prospective longitudinal study (N = 73), examined several facets of ruminative thinking to establish which aspects of rumination provide the link to PTSD. The current investigation showed that rumination is not only used as a strategy to cope with intrusive memories but it also triggers such memories. Certain characteristics of rumination, such as compulsion to continue ruminating, occurrence of unproductive thoughts, and "why" and "what if" type questions, as well as negative emotions before and after rumination, were significantly associated with PTSD, concurrently and prospectively. These characteristics explained significantly more variance in PTSD severity than the mere presence of rumination, thereby indicating that not all ways of ruminative thinking are equally maladaptive.

Adult↗

PubMed2007

A randomized comparison of cognitive behavioral therapy and behavioral weight loss treatment for overweight individuals with binge eating disorder.

OBJECTIVES: The aim of this study was to determine the efficacy of cognitive-behavioral therapy (CBT) and behavioral weight loss treatment (BWLT) for overweight patients with binge eating disorder (BED). METHOD: Eighty obese patients meeting criteria of BED according to DSM-IV-TR were randomly assigned to either CBT or BWLT consisting of 16 weekly treatments and 6 monthly follow-up sessions. Binge eating, general psychopathology, and body mass index (BMI) were assessed before, during, and after treatment, and at 12-month follow-up. RESULTS: At posttreatment results favored CBT as the more effective treatment. Analysis of the course of treatments pointed to a faster improvement of binge eating in CBT based on the number of self-reported weekly binges, but faster reduction of BMI in BWLT. At 12-month follow-up, no substantial differences between the two treatment conditions existed. CONCLUSION: CBT was somewhat more efficacious than BWLT in treating binge eating but this superior effect was barely maintained in the long term. Further research into cost effectiveness is needed to assess which treatment should be considered the treatment of choice.

Adult↗

PubMed2006

Subtypes of social phobia: are they of any use?

This study investigated the existence of DSM-IV social phobia subtype models in the community. Data came from the Dresden Predictor Study of a representative sample of 1877 German women (aged 18-24 years) who completed a diagnostic interview and filled out various self-report questionnaires. The number of feared social situations was distributed continuously without a clear-cut for delineation of subtypes and significantly increased functional impairment, comorbidity, subjective need for psychotherapy, seeking psychotherapeutic help and dysfunctional attitudes, and decreased social support and mental health. Subtype models based on the number (1, 2-4 and >4) and type ('formal speaking fear' versus 'other fears') of social fear did not have extra value above the continuum model of social phobia. The heterogeneity within social phobia has to be seen as a continuum of severity of social phobia, with a greater number of feared situations associated with more functional, social and psychological disability.

Adolescent↗

PubMed2006

Reduced heart rate responding to trauma reliving in trauma survivors with PTSD: correlates and consequences.

The authors investigated whether heart rate (HR) responses to voluntary recall of trauma memories (a) are related to posttraumatic stress disorder (PTSD), and (b) predict recovery 6 months later. Sixty-two assault survivors completed a recall task modeled on imaginal reliving in the initial weeks postassault. Possible cognitive modulators of HR responsivity were assessed; dissociation, rumination, trauma memory disorganization. Individuals with PTSD showed a reduced HR response to reliving compared to those without PTSD, but reported greater distress. Notably, higher HR response but not self-reported distress during reliving predicted greater symptom reduction at follow-up in participants with PTSD. Engagement in rumination was the only cognitive factor that predicted lower HR response. The data are in contrast to studies using trauma reminders to trigger memories, which have found greater physiological reactivity in PTSD. The authors' observations are consistent with models of PTSD that highlight differences between cued or stimulus-driven retrieval and intentional trauma recall, and with E. B. Foa and M. J. Kozak's (1986) hypothesis that full activation of trauma memories facilitates emotional processing.

Adolescent↗

PubMed2006

Enhanced perceptual priming for neutral stimuli in a traumatic context: A pathway to intrusive memories?

Clinical observations suggest that re-experiencing symptoms are triggered by stimuli that are perceptually similar to those present shortly before the trauma or its worst moments. Two experiments investigated the possible role of perceptual priming in this phenomenon. Volunteers (N = 28, N = 62) watched a series of "traumatic" and neutral picture stories, and completed blurred object identification (priming) and recognition memory tasks. Neutral objects that immediately preceded the "traumatic" stories were more strongly primed, but not better recognised, than objects from neutral stories. Enhanced priming predicted subsequent re-experiencing symptoms. The results support the role of perceptual priming in re-experiencing.

Adolescent↗

PubMed2006

Identifying anxiety states using broad sampling and advanced processing of peripheral physiological information.

Advances in biosignal acquisition and processing have provided an effective window to the complex peripheral physiology related to human emotions. Numerous cardiovascular measures have been used for assessing the activity of the sympathetic and parasympathetic branches of the autonomic nervous system. More recently, respiratory parameters have shown promise for the assessment of anxiety. Current theoretical accounts of anxiety recommend a broad assessment of anxiety responses involving measures from the physiological, behavioral and verbal-cognitive domain. However, practical and statistical considerations put restrictions on the number of dependent variables used in studies on emotion. In a laboratory experiment we assessed a large number of psychophysiological parameters to identify their relative utility for differentiating between a neutral (quiet sitting) and an anxious state induced by threat of shock. High effect sizes were found in all psychophysiological systems with electrodermal and behavioral responses demonstrating the highest, and respiratory and cardiovascular responses yielding medium and small effect sizes. A linear combination of the six most powerful variables was highly significant in distinguishing the neutral from the anxious state and resulted in 83.3% correct classification. Results demonstrate the necessity to include measures from multiple response domains for an adequate assessment of anxiety states. Furthermore, our results point to the significance of respiratory parameters in anxiety assessment.

Adult↗

PubMed2005

Enhanced priming for trauma-related material in posttraumatic stress disorder.

Intrusive reexperiencing in posttraumatic stress disorder (PTSD) has been linked to perceptual priming for trauma-related material. A prospective longitudinal study (N = 69) investigated perceptual priming for trauma-related, general threat, and neutral words in assault survivors with and without PTSD, using a new version of the word-stem completion task. Survivors with PTSD showed enhanced priming for trauma-related words. Furthermore, priming for trauma-related words measured soon after the trauma was associated with subsequent PTSD severity at 3, 6, and 9 months. The enhanced priming effect was specific to trauma-related words. Enhanced perceptual priming for traumatic material appears to be one of the cognitive processes operating in PTSD.

Adolescent↗

PubMed2004

Intrusive re-experiencing in post-traumatic stress disorder: phenomenology, theory, and therapy.

The article describes features of trauma memories in post-traumatic stress disorder (PTSD), including characteristics of unintentional re-experiencing symptoms and intentional recall of trauma narratives. Reexperiencing symptoms are usually sensory impressions and emotional responses from the trauma that appear to lack a time perspective and a context. The vast majority of intrusive memories can be interpreted as re-experiencing of warning signals, i.e., stimuli that signalled the onset of the trauma or of moments when the meaning of the event changed for the worse. Triggers of re-experiencing symptoms include stimuli that have perceptual similarity to cues accompanying the traumatic event. Intentional recall of the trauma in PTSD may be characterised by confusion about temporal order, and difficulty in accessing important details, both of which contribute to problematic appraisals. Recall tends to be disjointed. When patients with PTSD deliberately recall the worst moments of the trauma, they often do not access other relevant (usually subsequent) information that would correct impressions/predictions made at the time. A theoretical analysis of re-experiencing symptoms and their triggers is offered, and implications for treatment are discussed. These include the need to actively incorporate updating information ("I know now ...") into the worst moments of the trauma memory, and to train patients to discriminate between the stimuli that were present during the trauma ("then") and the innocuous triggers of re-experiencing symptoms ("now").

Cognition↗

PubMed2004

Age of traumatisation as a predictor of post-traumatic stress disorder or major depression in young women.

BACKGROUND: Findings in developmental psychopathology suggest that traumatisation in childhood may increase the risk of both post-traumatic stress disorder (PTSD) and major depressive disorder, whereas traumatisation in adolescence is more likely to lead to elevated PTSD risk. AIMS: To estimate the impact of traumatisation in childhood or adolescence in a community sample. METHOD: A representative sample of 1966 young women from Dresden aged 18-45 years were interviewed for occurrence of traumatic events and the onset of PTSD and major depression. The sample was subdivided into a childhood trauma group (trauma up to age 12 years) and an adolescent trauma group (trauma from age 13 years). RESULTS: A quarter of all participants reported traumatic events meeting the DSM AI criterion. In the childhood group conditional risks for PTSD and major depressive disorder were 17.0% and 23.3%, respectively, compared with risks of 13.3% and 6.5%, respectively, in the adolescent group. In 29% of those with PTSD, major depression was also present. CONCLUSIONS: The risk of developing major depressive disorder after traumatisation in childhood is approximately equal to the risk of developing PTSD. After age 13 years, the risk of PTSD is greater than the risk of major depression after traumatisation.

Adolescent↗

PubMed2003

Posttraumatic stress disorder following assault: the role of cognitive processing, trauma memory, and appraisals.

Two studies of assault victims examined the roles of (a) disorganized trauma memories in the development of posttraumatic stress disorder (PTSD), (b) peritraumatic cognitive processing in the development of problematic memories and PTSD, and (c) ongoing dissociation and negative appraisals of memories in maintaining symptomatology. In the cross-sectional study (n = 81), comparisons of current, past, and no-PTSD groups suggested that peritraumatic cognitive processing is related to the development of disorganized memories and PTSD. Ongoing dissociation and negative appraisals served to maintain PTSD symptoms. The prospective study (n = 73) replicated these findings longitudinally. Cognitive and memory assessments completed within 12-weeks postassault predicted 6-month symptoms. Assault severity measures explained 22% of symptom variance; measures of cognitive processing, memory disorganization, and appraisals increased prediction accuracy to 71%.

Adult↗