@phdthesis{Baur2016,
  author    = {Baur, Ramona},
  title     = {Adult Attention-Deficit/Hyperactivity Disorder (ADHD), Emotion Processing, and Emotion Regulation in Virtual Reality},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-142064},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2016},
  abstract  = {Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by symptoms of inattentiveness and hyperactivity/impulsivity. Besides, increasing evidence points to ADHD patients showing emotional dysfunctions and concomitant problems in social life. However, systematic research on emotional dysfunctions in ADHD is still rare, and to date most studies lack conceptual differentiation between emotion processing and emotion regulation. The aim of this thesis was to systematically investigate emotion processing and emotion regulation in adult ADHD in a virtual reality paradigm implementing social interaction. Emotional reactions were assessed on experiential, physiological, and behavioral levels. Experiment 1 was conducted to develop a virtual penalty kicking paradigm implying social feedback and to test it in a healthy sample. This paradigm should then be applied in ADHD patients later on. Pleasant and unpleasant trials in this paradigm consisted of hits respectively misses and subsequent feedback from a virtual coach. In neutral trials, participants were teleported to different spots of the virtual stadium. Results indicated increased positive affectivity (higher valence and arousal ratings, higher zygomaticus activations, and higher expression rates of positive emotional behavior) in response to pleasant compared to neutral trials. Reactions to unpleasant trials were contradictory, indicating increased levels of both positive and negative affectivity, compared to neutral trials. Unpleasant vs. neutral trials revealed lower valence ratings, higher arousal ratings, higher zygomaticus activations, slightly lower corrugator activations, and higher expression rates of both positive and negative emotional behavior. The intensity of emotional reactions correlated with experienced presence in the virtual reality. To better understand the impact of hits or misses per se vs. hits or misses with coach feedback healthy participants' emotional reactions, only 50\% of all shots were followed by coach feedback in experiment 2. Neutral trials consisted of shots over the free soccer field which were followed by coach feedback in 50 \% of all trials. Shots and feedback evoked more extreme valence and arousal ratings, higher zygomaticus activations, lower corrugator activations, and higher skin conductance responses than shots alone across emotional conditions. Again, results speak for the induction of positive emotions in pleasant trials whereas the induction of negative emotions in unpleasant trials seems ambiguous. Technical improvements of the virtual reality were reflected in higher presence ratings than in experiment 1. Experiment 3 investigated emotional reactions of adult ADHD patients and healthy controls after emotion processing and response-focused emotion regulation. Participants successively went through an ostensible online ball-tossing game (cyber ball) inducing negative emotions, and an adapted version of the virtual penalty kicking game. Throughout cyber ball, participants were included or ostracized by two other players in different experimental blocks. Participants were instructed to explicitly show, not regulate, or hide their emotions in different experimental blocks. Results provided some evidence for deficient processing of positive emotions in ADHD. Patients reported slightly lower positive affect than controls during cyber ball, gave lower valence ratings than controls in response to pleasant penalty kicking trials, and showed lower zygomaticus activations than controls especially during penalty kicking. Patients in comparison with controls showed slightly increased processing of unpleasant events during cyber ball (higher ratings of negative affect, especially in response to ostracism), but not during penalty kicking. Patients showed lower baseline skin conductance levels than controls, and impaired skin conductance modulations. Compared to controls, patients showed slight over-expression of positive as well as negative emotional behavior. Emotion regulation analyses revealed no major difficulties of ADHD vs. controls in altering their emotional reactions through deliberate response modulation. Moreover, patients reported to habitually apply adaptive emotion regulation strategies even more frequently than controls. The analyses of genetic high-risk vs. low-risk groups for ADHD across the whole sample revealed similar results as analyses for patients vs. controls for zygomaticus modulations during emotion processing, and for modulations of emotional reactions due to emotion regulation. To sum up, the virtual penalty kicking paradigm proved to be successful for the induction of positive, but not negative emotions. The importance of presence in virtual reality for the intensity of induced emotions could be replicated. ADHD patients showed impaired processing of primarily positive emotions. Aberrations in negative emotional responding were less clear and need further investigation. Results point to adult ADHD in comparison to healthy controls suffering from baseline deficits in autonomic arousal and deficits in arousal modulation. Deficits of ADHD in the deliberate application of response-focused emotion regulation could not be found.},
  subject      = {Aufmerksamkeitsdefizit-Syndrom},
  language  = {en}
}
@phdthesis{Schmidts2021,
  author    = {Schmidts, Constantin},
  title     = {Affective regulation of cognitive conflict},
  doi       = {10.25972/OPUS-21989},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-219897},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Kognitive Kontrolle beschreibt Prozesse die n{\"o}tig sind um zielgerichtetes Handeln im Angesicht von internen oder externen Widerst{\"a}nden zu erm{\"o}glichen. Wenn wir aus eigenen St{\"u}cken oder inspiriert durch unsere Umwelt Handlungen vorbereiten die unseren aktuellen Zielen entgegen stehen, kommt es zu Konflikten. Solche Konflikte k{\"o}nnen sich auf nachfolgendes Erleben und Verhalten auswirken. Aversive Konsequenzen von Konflikt k{\"o}nnten in einem Konflikt{\"u}berwachungsmodul registriert werden, welches anschließend Aufmerksamkeits{\"a}nderungen und Handlungstendenzen zur Reduzierung dieses negativen Affektes in Gang setzt. Wenn das der Fall w{\"a}re, k{\"o}nnten die vielfach beobachteten Verhaltensanpassungen an kognitiven Konflikt ein Ausdruck von Emotionsregulation sein. Ein theoretischer Eckpfeiler der gegenw{\"a}rtigen Forschung zur Emotionsregulation ist das Prozessmodell der Emotionsregulation, das aus den Regulationsstrategien Situationsauswahl, Situationsmodifikation, Aufmerksamkeitslenkung, kognitiven Ver{\"a}nderungen und Reaktionsmodulation besteht. Unter der Annahme, dass Konfliktanpassung und Affektregulation auf gemeinsamen Mechanismen fußen, habe ich aus dem Prozessmodell der Emotionsregulation Vorhersagen zur kognitiven Kontrolle abgeleitet und diese in elf Experimenten getestet (N = 509). Die Versuchsteilnehmer zeigten Situationsauswahl in Bezug auf Konflikte, allerdings nur dann, wenn sie ausdr{\"u}cklich auf Handlungs- und Ergebniskontingenzen hingewiesen wurden (Experimente 1 bis 3). Ich fand Anzeichen f{\"u}r einen Mechanismus, der der Situationsmodifikation {\"a}hnelt, aber keine Hinweise auf eine Beteiligung von Affekt (Experimente 4 bis 10). Eine {\"A}nderung der Konfliktbewertung hatte keinen Einfluss auf das Ausmaß der Konfliktadaptation (Experiment 11). Insgesamt gab es Hinweise auf eine explizite Aversivit{\"a}t kognitiver Konflikte, jedoch weniger auf implizite Aversivit{\"a}t, was darauf hindeutet, dass Konflikte vor allem dann Affektregulationsprozesse ausl{\"o}sen, wenn Menschen explizit Affektregulationsziele vor Augen haben.},
  subject      = {Affekt},
  language  = {en}
}
@phdthesis{Haspert2023,
  author    = {Haspert, Valentina},
  title     = {Improving acute pain management with emotion regulation strategies: A comparison of acceptance, distraction, and reappraisal},
  doi       = {10.25972/OPUS-29866},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-298666},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2023},
  abstract  = {Pain conditions and chronic pain disorders are among the leading reasons for seeking medical help and immensely burden patients and the healthcare system. Therefore, research on the underlying mechanisms of pain processing and modulation is necessary and warranted. One crucial part of this pain research includes identifying resilience factors that protect from chronic pain development and enhance its treatment. The ability to use emotion regulation strategies has been suggested to serve as a resilience factor, facilitating pain regulation and management. Acceptance has been discussed as a promising pain regulation strategy, but results in this domain have been mixed so far. Moreover, the allocation of acceptance in Gross's (1998) process model of emotion regulation has been under debate. Thus, comparing acceptance with the already established strategies of distraction and reappraisal could provide insights into underlying mechanisms. This dissertation project consisted of three successive experimental studies which aimed to investigate these strategies by applying different modalities of individually adjusted pain stimuli of varying durations. In the first study (N = 29), we introduced a within-subjects design where participants were asked to either accept (acceptance condition) or react to the short heat pain stimuli (10 s) without using any pain regulation strategies (control condition). In the second study (N = 36), we extended the design of study 1 by additionally applying brief, electrical pain stimuli (20 ms) and including the new experimental condition distraction, where participants should distract themselves from the pain experience by imagining a neutral situation. In the third study (N = 121), all three strategies, acceptance, distraction, and reappraisal were compared with each other and additionally with a neutral control condition in a mixed design. Participants were randomly assigned to one of three strategy groups, including a control condition and a strategy condition. All participants received short heat pain stimuli of 10 s, alternating with tonic heat pain stimuli of 3 minutes. In the reappraisal condition, participants were instructed to imagine the pain having a positive outcome or valence. The self-reported pain intensity, unpleasantness, and regulation ratings were measured in all studies. We further recorded the autonomic measures heart rate and skin conductance continuously and assessed the habitual emotion regulation styles and pain-related trait factors via questionnaires. Results revealed that the strategies acceptance, distraction, and reappraisal significantly reduced the self-reported electrical and heat pain stimulation with both durations compared to a neutral control condition. Additionally, regulatory efforts with acceptance in study 2 and with all strategies in study 3 were reflected by a decreased skin conductance level compared to the control condition. However, there were no significant differences between the strategies for any of the assessed variables. These findings implicate similar mechanisms underlying all three strategies, which led to the proposition of an extended process model of emotion regulation. We identified another sequence in the emotion-generative process and suggest that acceptance can flexibly affect at least four sequences in the process. Correlation analyses further indicated that the emotion regulation style did not affect regulatory success, suggesting that pain regulation strategies can be learned effectively irrespective of habitual tendencies. Moreover, we found indications that trait factors such as optimism and resilience facilitated pain regulation, especially with acceptance. Conclusively, we propose that acceptance could be flexibly used by adapting to different circumstances. The habitual use of acceptance could therefore be considered a resilience factor. Thus, acceptance appears to be a promising and versatile strategy to prevent the development of and improve the treatment of various chronic pain disorders. Future studies should further examine factors and circumstances that support effective pain regulation with acceptance.},
  subject      = {Schmerzforschung},
  language  = {en}
}