Publications by authors named "Hans Ulrich Wittchen"

Background: The Personalized Advantage Index (PAI) shows promise as a method for identifying the most effective treatment for individual patients. Previous studies have demonstrated its utility in retrospective evaluations across various settings. In this study, we explored the effect of different methodological choices in predictive modelling underlying the PAI.

View Article and Find Full Text PDF
Article Synopsis
  • Anxiety disorders impact brain connectivity, but how this varies among different types of anxiety disorders (like panic disorder and social anxiety disorder) isn't fully understood due to limited studies.
  • Researchers examined the brain connectivity of 439 anxiety disorder patients and 105 healthy controls using resting-state fMRI, finding notable differences in connectivity patterns, especially in panic disorder and agoraphobia patients.
  • The study revealed that panic disorder patients had increased connectivity in brain regions linked to emotion regulation, unlike those with social anxiety disorder or specific phobia, suggesting the potential for personalized treatment approaches based on these neurological differences.
View Article and Find Full Text PDF

Background: Individuals with anxiety disorders (ADs) often display hypervigilance to threat information, although this response may be less pronounced following psychotherapy. This study aims to investigate the unconscious recognition performance of facial expressions in patients with panic disorder (PD) post-treatment, shedding light on alterations in their emotional processing biases.

Methods: Patients with PD (n=34) after (exposure-based) cognitive behavior therapy and healthy controls (n=43) performed a subliminal affective recognition task.

View Article and Find Full Text PDF
Article Synopsis
  • - The ENIGMA Anxiety Working Group studied brain structural differences between individuals with specific phobias and healthy participants, focusing on subtypes of phobias like animal and blood-injection-injury (BII) while examining how these differences relate to symptom severity and age.
  • - A total of 1,452 participants with phobias and 2,991 healthy subjects were analyzed, revealing that those with phobias exhibited smaller subcortical volumes and varying cortical thickness, especially noted in adults rather than youths.
  • - The results indicate that brain alterations in specific phobias are more significant than in other anxiety disorders, revealing distinct neural underpinnings linked to fear processing across different phobia types, highlighting a
View Article and Find Full Text PDF

Data-based predictions of individual Cognitive Behavioral Therapy (CBT) treatment response are a fundamental step towards precision medicine. Past studies demonstrated only moderate prediction accuracy (i.e.

View Article and Find Full Text PDF
Article Synopsis
  • Exposure-based cognitive-behavioral therapy has been shown to effectively treat anxiety disorders, but its impact on daily behaviors like social and physical activity had not been widely researched.
  • In a study involving 126 participants, including individuals with anxiety disorders and healthy controls, researchers tracked activities, social interactions, mood, and physical symptoms before, during, and after therapy using smartphones and motion sensors.
  • The findings revealed that therapy led to improvements in mood, social interactions, and physical activity levels, particularly in patients with initial higher depression scores, suggesting that this treatment could enhance overall daily functioning and reduce the risk of relapse.*
View Article and Find Full Text PDF

Background: Anxiety and depressive disorders share common features of mood dysfunctions. This has stimulated interest in transdiagnostic dimensional research as proposed by the Research Domain Criteria (RDoC) approach by the National Institute of Mental Health (NIMH) aiming to improve the understanding of underlying disease mechanisms. The purpose of this study was to investigate the processing of RDoC domains in relation to disease severity in order to identify latent disorder-specific as well as transdiagnostic indicators of disease severity in patients with anxiety and depressive disorders.

View Article and Find Full Text PDF

Despite striking empirical support, exposure-based treatments for anxiety disorders are underutilized. This is partially due to clinicians' concerns that patients may reject exposure or experience severe side effects, particularly in intensive forms of exposure. We examined acceptance and side effects of two randomly assigned variants of prediction error-based exposure treatment differing in temporal density (1 vs.

View Article and Find Full Text PDF

It is hypothesized that the ability to discriminate between threat and safety is impaired in individuals with high dispositional negativity, resulting in maladaptive behavior. A large body of research investigated differential learning during fear conditioning and extinction protocols depending on individual differences in intolerance of uncertainty (IU) and trait anxiety (TA), two closely-related dimensions of dispositional negativity, with heterogenous results. These might be due to varying degrees of induced threat/safety uncertainty.

View Article and Find Full Text PDF

This study aimed to build on the relationship of well-established self-report and behavioral assessments to the latent constructs positive (PVS) and negative valence systems (NVS), cognitive systems (CS), and social processes (SP) of the Research Domain Criteria (RDoC) framework in a large transnosological population which cuts across DSM/ICD-10 disorder criteria categories. One thousand four hundred and thirty one participants (42.1% suffering from anxiety/fear-related, 18.

View Article and Find Full Text PDF

Background: There is a notable comorbidity between externalizing disorders and anxiety disorders, which may be explained by the co-occurrence of two prevalent early-onset disorders, by shared vulnerability and risk factors, or as evidence that one disorder group might be causally related to the other.

Aim: To investigate the longitudinal trajectories of externalizing disorders, their interplay with anxiety disorders, and putative predictors for symptom progression in youth.

Methods: 1053 adolescents (14-17 years) from the general population were assessed at baseline and prospectively at 2, 4, and 10-year follow-up using a standardized interview of mental disorders (DIA-X/M-CIDI) to assess "early" (oppositional-defiant disorder, conduct disorder, ADHD) and "late" (antisocial behavior, substance use disorders) externalizing disorders as well as anxiety disorders.

View Article and Find Full Text PDF

Prejudices against minorities can be understood as habitually negative evaluations that are kept in spite of evidence to the contrary. Therefore, individuals with strong prejudices might be dominated by habitual or "automatic" reactions at the expense of more controlled reactions. Computational theories suggest individual differences in the balance between habitual/model-free and deliberative/model-based decision-making.

View Article and Find Full Text PDF

Background: Parkinson's disease (PD) is associated with various non-motor symptoms, including cognitive deterioration.

Objective: Here, we used data from the DEMPARK/LANDSCAPE cohort to describe the association between progression of cognitive profiles and the PD motor phenotypes: postural instability and gait disorder (PIGD), tremor-dominant (TR-D), and not-determined (ND).

Methods: Demographic, clinical, and neuropsychological six-year longitudinal data of 711 PD-patients were included (age: M = 67.

View Article and Find Full Text PDF

Late-life depression has multiple, heterogeneous clinical presentations. The aim of the study was to identify higher-order homogeneous clinical features (symptom complexes), while accounting for their potential causal interactions within the network approach to psychopathology. We analyzed cross-sectional data from community-dwelling adults aged 65-85 years recruited by the European MentDis_ICF65+ study (n = 2623, mean age 74, 49% females).

View Article and Find Full Text PDF
Article Synopsis
  • A multicenter randomized controlled trial was conducted to compare two types of exposure therapy for anxiety disorders: temporally intensified exposure (PeEx-I) and standard exposure (PeEx-S), each involving 12 sessions over 100 minutes.
  • Both therapies showed significant reductions in anxiety symptoms, with similar effectiveness at post-treatment and follow-up, but PeEx-I led to a faster response time—32% quicker than PeEx-S.
  • PeEx-I also resulted in less disability and improved quality of life at follow-up, while maintaining lower dropout rates and not increasing relapse rates, suggesting it may be a more effective approach.
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to evaluate the incidence rates and predictors of various mental disorders among the elderly in several European countries, as previous research focused mainly on depression and anxiety disorders.
  • A total of 2,592 elderly participants were surveyed, revealing that the overall one-year incidence of any mental disorder was 8.65%, with anxiety disorders having the highest rate at 5.18%.
  • The findings highlighted the importance of addressing psychosocial issues in the elderly and the need for improved mental health services, as many mental disorders, like somatoform and substance misuse, had not been previously reported in this demographic.
View Article and Find Full Text PDF

Objective: Patients seeking treatment for their asthma are most likely motivated by a change in their experience of symptoms, but primary complaints are not always related to the pulmonary system. This study aimed to determine the frequency of such extrapulmonary symptoms in asthma outpatients and their association with psychopathology and asthma outcomes.

Methods: This cross-sectional study utilized data collected as part of a nationwide, clinical-epidemiological study.

View Article and Find Full Text PDF

Further developments of exposure-based therapy (EBT) require more knowledge about transfer of treatment to non-trained everyday contexts. However, little is known about transfer effects of EBT. Using a standardized EBT protocol in 275 patients with panic disorder and agoraphobia we investigated the transfer of EBT to a highly standardized context during a Behavioral Avoidance Test (BAT; being entrapped in a small and dark test chamber) and not part of the exposure sessions.

View Article and Find Full Text PDF

Adapting threat-related memories towards changing environments is a fundamental ability of organisms. One central process of fear reduction is suggested to be extinction learning, experimentally modeled by extinction training that is repeated exposure to a previously conditioned stimulus (CS) without providing the expected negative consequence (unconditioned stimulus, US). Although extinction training is well investigated, evidence regarding process-related changes in neural activation over time is still missing.

View Article and Find Full Text PDF

Theoretically, panic disorder and agoraphobia pathology can be conceptualized as a cascade of dynamically changing defensive responses to threat cues from inside the body. Guided by this trans-diagnostic model we tested the interaction between defensive activation and vagal control as a marker of prefrontal inhibition of subcortical defensive activation. We investigated ultra-short-term changes of vagally controlled high frequency heart rate variability (HRV) during a standardized threat challenge (entrapment) in n = 232 patients with panic disorder and agoraphobia, and its interaction with various indices of defensive activation.

View Article and Find Full Text PDF

Hypotheses about the link between cannabis use and psychosis apply to the within-person level but have been tested mostly at the between-person level. We used a within-person design, in which a person serves as his own control, thus removing the need to consider confounding by any fixed (genetic and nongenetic) characteristic to study the prospective association between cannabis use and the incidence of attenuated psychotic experiences, and vice versa, adjusted for time-varying confounders. We combined 2 general population cohorts (at baseline: Early Developmental Stages of Psychopathology Study, n = 1395; Netherlands Mental Health Survey and Incidence Study-2, n = 6603), which applied a similar methodology to study cannabis use and attenuated psychotic experiences with repeated interviews (T0, T1, T2, and T3) over a period of approximately 10 years.

View Article and Find Full Text PDF

There is a recurring debate on the role of the serotonin transporter gene linked polymorphic region (5-HTTLPR) in the moderation of response to cognitive behavioral therapy (CBT) in anxiety disorders. Results, however, are still inconclusive. We here aim to perform a meta-analysis on the role of 5-HTTLPR in the moderation of CBT outcome in anxiety disorders.

View Article and Find Full Text PDF

Although effective therapies exist, treatment rates of anxiety disorders (AD) are low, raising the question why affected individuals do not receive treatment. We provide data from the nationally representative German Health Interview and Examination Survey-2011 (DEGS1) on the help-seeking behavior and perceived treatment barriers of 650 subjects with Diagnostic and Statistical Manual of Mental Disorders' (DSM-IV AD). Only 26% of all cases with AD in the community reported having had contact with mental health services because of their anxiety problems in their lifetime.

View Article and Find Full Text PDF