Reduced gray matter volume in the left prefrontal, occipital, and temporal regions as predictors for posttraumatic stress disorder: a voxel-based morphometric study.

The concept of acute stress disorder (ASD) was introduced as a diagnostic entity to improve the identification of traumatized people who are likely to develop posttraumatic stress disorder (PTSD). Neuroanatomical models suggest that changes in the prefrontal cortex, amygdala, and hippocampus play a role in the development of PTSD. Using voxel-based morphometry, this study aimed to investigate the predictive power of gray matter volume (GMV) alterations for developing PTSD.

Negative schemata about the self and others and paranoid ideation in at-risk states and those with persisting positive symptoms.

Background: The objective of this study is to test the conflicting theories concerning the association of negative self and other schemata and paranoid ideation.

Methods: A risk-based approach, including risk stratification, is used to gain insight into the association of the negative self and other schemata that may be shared by individuals or differentiate between individuals at clinical high risk (CHR) for a first-episode psychosis and those with full-blown psychosis. The dataset includes a sample of individuals at CHR (n = 137) and a sample of individuals with persisting positive symptoms (PPS, n = 211).

Posterior and prefrontal contributions to the development posttraumatic stress disorder symptom severity: an fMRI study of symptom provocation in acute stress disorder.

Acute stress disorder (ASD) is predictive of the development of posttraumatic stress disorder (PTSD). In response to symptom provocation, the exposure to trauma-related pictures, ASD patients showed increased activation of the medial posterior areas of precuneus and posterior cingulate cortex as well as of superior prefrontal cortex in a previous study. The current study aimed at investigating which activated areas are predictive of the development of PTSD.

The effect of auditory and visual training on the mismatch negativity in schizophrenia.

Background: The mismatch negativity (MMN) is an electrophysiological index of early auditory attention and has repeatedly been suggested to be associated with cognitive functioning. Despite the frequently reported finding of reduced MMN amplitude in schizophrenia, up to now, studies assessing the impact of perceptual discrimination training aiming to improve MMN measures in schizophrenia patients are scarce.

Method: In the present study, the effect of auditory training (AUD, n=14) on the MMN was compared to that of visual-spatial training (VIS, n=14) and a treatment-as-usual (TAU, n=14) condition in schizophrenia patients.

Modality of fear cues affects acoustic startle potentiation but not heart-rate response in patients with dental phobia.

The acoustic startle response (SR) has consistently been shown to be enhanced by fear-arousing cross-modal background stimuli in phobics. Intra-modal fear-potentiation of acoustic SR was rarely investigated and generated inconsistent results. The present study compared the acoustic SR to phobia-related sounds with that to phobia-related pictures in 104 dental phobic patients and 22 controls.

The effect of cognitive training on evoked potentials in schizophrenia.

Electrophysiological indices are sensitive to cognitive dysfunction in schizophrenia but have rarely been used to assess benefits of cognitive remediation. Our aim was to evaluate the effect of specific cognitive training approaches on event-related potentials. Forty-six patients with schizophrenia underwent either auditory (AUD) or visuo-spatial (VIS) cognitive training or treatment-as-usual (TAU).

Posterior Midline Activation during Symptom Provocation in Acute Stress Disorder: An fMRI Study.

Functional imaging studies of patients with post-traumatic stress disorder showed wide-spread activation of midline cortical areas during symptom provocation, i.e., exposure to trauma-related cues.

Why do bad things happen to me? Attributional style, depressed mood, and persecutory delusions in patients with schizophrenia.

Theoretical models postulate an important role of attributional style (AS) in the formation and maintenance of persecutory delusions and other positive symptoms of schizophrenia. However, current research has gathered conflicting findings. In a cross-sectional design, patients with persistent positive symptoms of schizophrenia (n = 258) and healthy controls (n = 51) completed a revised version of the Internal, Personal and Situational Attributions Questionnaire (IPSAQ-R) and assessments of psychopathology.

Mismatch negativity latency and cognitive function in schizophrenia.

Background: The Mismatch Negativity (MMN) is an event-related potential (ERP) sensitive to early auditory deviance detection and has been shown to be reduced in schizophrenia patients. Moreover, MMN amplitude reduction to duration deviant tones was found to be related to functional outcomes particularly, to neuropsychological (working memory and verbal domains) and psychosocial measures. While MMN amplitude is thought to be correlated with deficits of early sensory processing, the functional significance of MMN latency remains unclear so far.

Attenuated Readiness Potential in the Absence of Executive Dysfunction in Adults With ADHD.

Objective: Patients with ADHD display a decreased contingent negative variation in Go/NoGo tasks. It is unclear whether the attenuation is due to deficits of executive function or to disorder of motor planning. The readiness potential (RP) recorded during self-initiated movements could cast light on this question.

[Determinants of direct cost in schizophrenia patients with persistent positive symptoms].

Objective: To analyze direct costs and cost determinants in psychotic patients with persistent positive symptoms (PPS).

Methods: A total of 330 patients with PPS were recruited via 6 university clinics and interviewed about service utilization in the previous 3 months. After monetary valuation, costs were analyzed via generalized linear mixed models with gamma distribution and log-link function to identify determinants of direct costs.

Associations between therapy skills and patient experiences of change processes in cognitive behavioral therapy for psychosis.

Despite the promising findings in relation to the efficacy of cognitive behavioral therapy for psychosis (CBTp), little attention has been paid to the therapy skills necessary to deliver CBTp and to the influence of such skills on processes underlying therapeutic change. Our study investigated the associations between general and technical therapy skills and patient experiences of change processes in CBTp. The study sample consisted of 79 patients with psychotic disorders who had undergone CBTp.

In search of the trauma memory: a meta-analysis of functional neuroimaging studies of symptom provocation in posttraumatic stress disorder (PTSD).

Notwithstanding some discrepancy between results from neuroimaging studies of symptom provocation in posttraumatic stress disorder (PTSD), there is broad agreement as to the neural circuit underlying this disorder. It is thought to be characterized by an exaggerated amygdalar and decreased medial prefrontal activation to which the elevated anxiety state and concomitant inadequate emotional regulation are attributed. However, the proposed circuit falls short of accounting for the main symptom, unique among anxiety disorders to PTSD, namely, reexperiencing the precipitating event in the form of recurrent, distressing images and recollections.

Sleep-related cognitive function and the K-complex in schizophrenia.

Sleep parameters have been reported to be related to cognitive function in a variety of ways. Problem solving and procedural learning were found to be improved after sleep but training also affected subsequent sleep and some parameters were related to cognitive trait variables, e.g.

Mental retrieval of treatment context in dental phobia.

Background: The effect of mental retrieval of an exposure session was investigated during a follow-up examination in dental phobia patients.

Method: The exposure session took place at the psychology unit and the follow-up a week later at the dental clinic prior to dental treatment while patients were seated in the dental chair. During exposure, individuals with dental phobia (N = 72) were shown a video of a dental appointment, after which they were instructed to imagine themselves receiving dental treatment.

A practice-based comparison of brief cognitive behavioural treatment, two kinds of hypnosis and general anaesthesia in dental phobia.

Background: A practice-based study was carried out to assess the comparative effectiveness and acceptability of standardised hypnosis, hypnosis with individualised imagery, cognitive behavioural treatment (CBT) and general anaesthesia (GA) in the treatment of dental phobia.

Methods: A 4-group design was used with 4 repeated measurement occasions. Of an initial total of 137 dental phobics, 77 completed the study with sample sizes of between 14 and 29 patients in the 4 groups.

Cognitive behavioural therapy versus supportive therapy for persistent positive symptoms in psychotic disorders: the POSITIVE Study, a multicenter, prospective, single-blind, randomised controlled clinical trial.

Background: It has been demonstrated that cognitive behavioural therapy (CBT) has a moderate effect on symptom reduction and on general well being of patients suffering from psychosis. However, questions regarding the specific efficacy of CBT, the treatment safety, the cost-effectiveness, and the moderators and mediators of treatment effects are still a major issue. The major objective of this trial is to investigate whether CBT is specifically efficacious in reducing positive symptoms when compared with non-specific supportive therapy (ST) which does not implement CBT-techniques but provides comparable therapeutic attention.

Effects of additional prolonged exposure to psychoeducation and relaxation in acute stress disorder.

We investigated the effect of prolonged exposure (PE) on the heart rate (HR) and skin conductance response to trauma-related stimuli in acute stress disorder (ASD). Forty recent trauma victims with ASD were randomly assigned to three sessions of either PE or supportive counseling (SC) with both groups also receiving psychoeducation and progressive relaxation. Assessments were carried out before and after treatment and again after 3 months.

Does the cognitive dispute of psychotic symptoms do harm to the therapeutic alliance?

We examined whether the cognitive dispute of psychotic symptoms has a negative impact on the course of the therapeutic alliance. Sixty-seven patients with persistent psychotic symptoms received either cognitive behavioral therapy (CBT) or supportive therapy. Questionnaire-based alliance ratings were repeatedly obtained throughout the course of therapy.

Clinical symptoms of major depression are associated with the intensity dependence of auditory event-related potential components.

The intensity (loudness) dependent amplitude change (IDAP) of the auditory event-related potential (ERP) has been shown to be associated with the outcome of treatment with selective serotonin reuptake inhibitors in major depression. The purpose of the present study is to evaluate associations between clinical symptoms of major depression and the IDAP as an indirect indicator of cortical serotonergic function. We assessed 40 in-patients suffering from a major depressive episode (DSM-IV) prior to antidepressant treatment.

Treatment effects of serotonergic and noradrenergic antidepressants on the intensity dependence of auditory ERP components in major depression.

The intensity dependent amplitude change of auditory evoked potentials (IDAP), an assumed indicator of the level of central nervous serotonergic neurotransmission, was measured in major depressive disorder (MDD, DSM-IV: 296.2, 296.3; APA 1994) before and after treatment with either a selective serotonin reuptake inhibitor or a selective noradrenaline reuptake inhibitor antidepressant and compared with the results of a healthy control group.

Dysfunctional cognitive appraisal and psychophysiological reactivity in acute stress disorder.

The present study investigated the extent of dysfunctional appraisal as measured with the Posttraumatic Cognitions Inventory (PTCI) and physiological responses to trauma-related material in patients with acute stress disorder (ASD; N=44) in comparison to participants without trauma exposure (N=27). Heart-rate (HR), skin conductance responses (SCR), and viewing time were recorded in response to - for trauma victims - idiosyncratically trauma-relevant and control pictures. ASD patients evidenced greater dysfunctional appraisal than control participants with regard to the PTCI scales Self and World and also an accelerative HR reaction and greater SCRs to trauma-relevant pictures.

[Research into the feasibility of cognitive behavioural therapy in the treatment of psychotic disorders].

Psychotherapy in psychotic disorders is a rare condition and is confronted with much scepticism. On the background of intensive research - in particular in Great Britain, sufficient empirical evidence is available from randomised clinical trials to recommend Cognitive Behavioural Treatment for routine care. However, many research questions are open.

The influence of baseline symptoms and insight on the therapeutic alliance early in the treatment of schizophrenia.

Background: The consistent association between therapeutic alliance and outcome underlines the importance of identifying factors which predict the development of a positive alliance. However, only few studies have examined the association between pretreatment characteristics and alliance formation in patients with schizophrenia.

Objective: The study examined whether symptoms and insight would predict the therapeutic alliance in psychotherapy of schizophrenia.