@article{NeuederAndreattaPauli2019,
  author    = {Neueder, Dorothea and Andreatta, Marta and Pauli, Paul},
  title     = {Contextual fear conditioning and fear generalization in individuals with panic attacks},
  series = {Frontiers in Behavioral Neuroscience},
  volume    = {13},
  journal   = {Frontiers in Behavioral Neuroscience},
  doi       = {10.3389/fnbeh.2019.00152},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201318},
  pages     = {152},
  year      = {2019},
  abstract  = {Context conditioning is characterized by unpredictable threat and its generalization may constitute risk factors for panic disorder (PD). Therefore, we examined differences between individuals with panic attacks (PA; N = 21) and healthy controls (HC, N = 22) in contextual learning and context generalization using a virtual reality (VR) paradigm. Successful context conditioning was indicated in both groups by higher arousal, anxiety and contingency ratings, and increased startle responses and skin conductance levels (SCLs) in an anxiety context (CTX+) where an aversive unconditioned stimulus (US) occurred unpredictably vs. a safety context (CTX-). PA compared to HC exhibited increased differential responding to CTX+ vs. CTX- and overgeneralization of contextual anxiety on an evaluative verbal level, but not on a physiological level. We conclude that increased contextual conditioning and contextual generalization may constitute risk factors for PD or agoraphobia contributing to the characteristic avoidance of anxiety contexts and withdrawal to safety contexts and that evaluative cognitive process may play a major role.},
  language  = {en}
}
@article{WoelkSuetterlinKochetal.2014,
  author    = {W{\"o}lk, Julian and S{\"u}tterlin, Stefan and Koch, Stefan and V{\"o}gele, Claus and Schulz, Stefan M.},
  title     = {Enhanced cardiac perception predicts impaired performance in the Iowa Gambling Task in patients with panic disorder},
  series = {Brain and Behavior},
  volume    = {4},
  journal   = {Brain and Behavior},
  number    = {2},
  issn      = {2162-3279},
  doi       = {10.1002/brb3.206},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-119865},
  pages     = {238-46},
  year      = {2014},
  abstract  = {OBJECTIVE: Somatic marker theory predicts that somatic cues serve intuitive decision making; however, cardiovascular symptoms are threat cues for patients with panic disorder (PD). Therefore, enhanced cardiac perception may aid intuitive decision making only in healthy individuals, but impair intuitive decision making in PD patients. METHODS: PD patients and age-and sex-matched volunteers without a psychiatric diagnosis (n=17, respectively) completed the Iowa Gambling Task (IGT) as a measure of intuitive decision making. Interindividual differences in cardiac perception were assessed with a common mental-tracking task. RESULTS: In line with our hypothesis, we found a pattern of opposing associations (Fisher's Z=1.78, P=0.04) of high cardiac perception with improved IGT-performance in matched control-participants (r=0.36, n=14) but impaired IGT-performance in PD patients (r=-0.38, n=13). CONCLUSION: Interoceptive skills, typically assumed to aid intuitive decision making, can have the opposite effect in PD patients who experience interoceptive cues as threatening, and tend to avoid them. This may explain why PD patients frequently have problems with decision making in everyday life. Screening of cardiac perception may help identifying patients who benefit from specifically tailored interventions.},
  language  = {en}
}
@article{KlaukeWinterGajewskaetal.2012,
  author    = {Klauke, Benedikt and Winter, Bernward and Gajewska, Agnes and Zwanzger, Peter and Reif, Andreas and Herrmann, Martin J. and Dlugos, Andrea and Warrings, Bodo and Jacob, Christian and M{\"u}hlberger, Andreas and Arolt, Volker and Pauli, Paul and Deckert, J{\"u}rgen and Domschke, Katharina},
  title     = {Affect-Modulated Startle: Interactive Influence of Catechol-O-Methyltransferase Val158Met Genotype and Childhood Trauma},
  series = {PLoS One},
  volume    = {7},
  journal   = {PLoS One},
  number    = {6},
  doi       = {10.1371/journal.pone.0039709},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-132184},
  pages     = {e39709},
  year      = {2012},
  abstract  = {The etiology of emotion-related disorders such as anxiety or affective disorders is considered to be complex with an interaction of biological and environmental factors. Particular evidence has accumulated for alterations in the dopaminergic and noradrenergic system - partly conferred by catechol-O-methyltransferase (COMT) gene variation - for the adenosinergic system as well as for early life trauma to constitute risk factors for those conditions. Applying a multi-level approach, in a sample of 95 healthy adults, we investigated effects of the functional COMT Val158Met polymorphism, caffeine as an adenosine A2A receptor antagonist (300 mg in a placebo-controlled intervention design) and childhood maltreatment (CTQ) as well as their interaction on the affect-modulated startle response as a neurobiologically founded defensive reflex potentially related to fear- and distress-related disorders. COMT val/val genotype significantly increased startle magnitude in response to unpleasant stimuli, while met/met homozygotes showed a blunted startle response to aversive pictures. Furthermore, significant gene-environment interaction of COMT Val158Met genotype with CTQ was discerned with more maltreatment being associated with higher startle potentiation in val/val subjects but not in met carriers. No main effect of or interaction effects with caffeine were observed. Results indicate a main as well as a GxE effect of the COMT Val158Met variant and childhood maltreatment on the affect-modulated startle reflex, supporting a complex pathogenetic model of the affect-modulated startle reflex as a basic neurobiological defensive reflex potentially related to anxiety and affective disorders.},
  language  = {en}
}