@article{SchieleZieglerKollertetal.2018,
  author    = {Schiele, Miriam A. and Ziegler, Christiane and Kollert, Leonie and Katzorke, Andrea and Schartner, Christoph and Busch, Yasmin and Gromer, Daniel and Reif, Andreas and Pauli, Paul and Deckert, J{\"u}rgen and Herrmann, Martin J. and Domschke, Katharina},
  title     = {Plasticity of Functional MAOA Gene Methylation in Acrophobia},
  series = {International Journal of Neuropsychopharmacology},
  volume    = {21},
  journal   = {International Journal of Neuropsychopharmacology},
  number    = {9},
  doi       = {10.1093/ijnp/pyy050},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-228571},
  pages     = {822-827},
  year      = {2018},
  abstract  = {Epigenetic mechanisms have been proposed to mediate fear extinction in animal models. Here, MAOA methylation was analyzed via direct sequencing of sodium bisulfite-treated DNA extracted from blood cells before and after a 2-week exposure therapy in a sample of n = 28 female patients with acrophobia as well as in n = 28 matched healthy female controls. Clinical response was measured using the Acrophobia Questionnaire and the Attitude Towards Heights Questionnaire. The functional relevance of altered MAOA methylation was investigated by luciferase-based reporter gene assays. MAOA methylation was found to be significantly decreased in patients with acrophobia compared with healthy controls. Furthermore, MAOA methylation levels were shown to significantly increase after treatment and correlate with treatment response as reflected by decreasing Acrophobia Questionnaire/Attitude Towards Heights Questionnaire scores. Functional analyses revealed decreased reporter gene activity in presence of methylated compared with unmethylated pCpGfree_MAOA reporter gene vector constructs. The present proof-of-concept psychotherapy-epigenetic study for the first time suggests functional MAOA methylation changes as a potential epigenetic correlate of treatment response in acrophobia and fosters further investigation into the notion of epigenetic mechanisms underlying fear extinction.},
  language  = {en}
}
@article{GromerMadeiraGastetal.2018,
  author    = {Gromer, Daniel and Madeira, Oct{\´a}via and Gast, Philipp and Nehfischer, Markus and Jost, Michael and M{\"u}ller, Mathias and M{\"u}hlberger, Andreas and Pauli, Paul},
  title     = {Height Simulation in a Virtual Reality CAVE System: Validity of Fear Responses and Effects of an Immersion Manipulation},
  series = {Frontiers in Human Neuroscience},
  volume    = {12},
  journal   = {Frontiers in Human Neuroscience},
  number    = {372},
  issn      = {1662-5161},
  doi       = {10.3389/fnhum.2018.00372},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-196113},
  year      = {2018},
  abstract  = {Acrophobia is characterized by intense fear in height situations. Virtual reality (VR) can be used to trigger such phobic fear, and VR exposure therapy (VRET) has proven effective for treatment of phobias, although it remains important to further elucidate factors that modulate and mediate the fear responses triggered in VR. The present study assessed verbal and behavioral fear responses triggered by a height simulation in a 5-sided cave automatic virtual environment (CAVE) with visual and acoustic simulation and further investigated how fear responses are modulated by immersion, i.e., an additional wind simulation, and presence, i.e., the feeling to be present in the VE. Results revealed a high validity for the CAVE and VE in provoking height related self-reported fear and avoidance behavior in accordance with a trait measure of acrophobic fear. Increasing immersion significantly increased fear responses in high height anxious (HHA) participants, but did not affect presence. Nevertheless, presence was found to be an important predictor of fear responses. We conclude that a CAVE system can be used to elicit valid fear responses, which might be further enhanced by immersion manipulations independent from presence. These results may help to improve VRET efficacy and its transfer to real situations.},
  language  = {en}
}