@article{StegmannAndreattaPaulietal.2021, author = {Stegmann, Yannik and Andreatta, Marta and Pauli, Paul and Wieser, Matthias J.}, title = {Associative learning shapes visual discrimination in a web-based classical conditioning task}, series = {Scientific Reports}, volume = {11}, journal = {Scientific Reports}, number = {1}, doi = {10.1038/s41598-021-95200-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-260480}, year = {2021}, abstract = {Threat detection plays a vital role in adapting behavior to changing environments. A fundamental function to improve threat detection is learning to differentiate between stimuli predicting danger and safety. Accordingly, aversive learning should lead to enhanced sensory discrimination of danger and safety cues. However, studies investigating the psychophysics of visual and auditory perception after aversive learning show divergent findings, and both enhanced and impaired discrimination after aversive learning have been reported. Therefore, the aim of this web-based study is to examine the impact of aversive learning on a continuous measure of visual discrimination. To this end, 205 participants underwent a differential fear conditioning paradigm before and after completing a visual discrimination task using differently oriented grating stimuli. Participants saw either unpleasant or neutral pictures as unconditioned stimuli (US). Results demonstrated sharpened visual discrimination for the US-associated stimulus (CS+), but not for the unpaired conditioned stimuli (CS-). Importantly, this finding was irrespective of the US's valence. These findings suggest that associative learning results in increased stimulus salience, which facilitates perceptual discrimination in order to prioritize attentional deployment.}, language = {en} } @article{HaspertWieserPaulietal.2020, author = {Haspert, Valentina and Wieser, Matthias J. and Pauli, Paul and Reicherts, Philipp}, title = {Acceptance-Based Emotion Regulation Reduces Subjective and Physiological Pain Responses}, series = {Frontiers in Psychology}, volume = {11}, journal = {Frontiers in Psychology}, issn = {1664-1078}, doi = {10.3389/fpsyg.2020.01514}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-207220}, year = {2020}, abstract = {Acceptance-based regulation of pain, which focuses on the allowing of pain and pain related thoughts and emotions, was found to modulate pain. However, results so far are inconsistent regarding different pain modalities and indices. Moreover, studies so far often lack a suitable control condition, focus on behavioral pain measures rather than physiological correlates, and often use between-subject designs, which potentially impede the evaluation of the effectiveness of the strategies. Therefore, we investigated whether acceptance-based strategies can reduce subjective and physiological markers of acute pain in comparison to a control condition in a within-subject design. To this end, participants (N = 30) completed 24 trials comprising 10 s of heat pain stimulation. Each trial started with a cue instructing participants to welcome and experience pain (acceptance trials) or to react to the pain as it is without employing any regulation strategies (control trials). In addition to pain intensity and unpleasantness ratings, heart rate (HR) and skin conductance (SC) were recorded. Results showed significantly decreased pain intensity and unpleasantness ratings for acceptance compared to control trials. Additionally, HR was significantly lower during acceptance compared to control trials, whereas SC revealed no significant differences. These results demonstrate the effectiveness of acceptance-based strategies in reducing subjective and physiological pain responses relative to a control condition, even after short training. Therefore, the systematic investigation of acceptance in different pain modalities in healthy and chronic pain patients is warranted.}, language = {en} } @article{KaethnerBaderPauli2019, author = {K{\"a}thner, Ivo and Bader, Thomas and Pauli, Paul}, title = {Heat pain modulation with virtual water during a virtual hand illusion}, series = {Scientific Reports}, volume = {9}, journal = {Scientific Reports}, doi = {10.1038/s41598-019-55407-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-202221}, pages = {19137}, year = {2019}, abstract = {Immersive virtual reality is a powerful method to modify the environment and thereby influence experience. The present study used a virtual hand illusion and context manipulation in immersive virtual reality to examine top-down modulation of pain. Participants received painful heat stimuli on their forearm and placed an embodied virtual hand (co-located with their real one) under a virtual water tap, which dispensed virtual water under different experimental conditions. We aimed to induce a temperature illusion by a red, blue or white light suggesting warm, cold or no virtual water. In addition, the sense of agency was manipulated by allowing participants to have high or low control over the virtual hand's movements. Most participants experienced a thermal sensation in response to the virtual water and associated the blue and red light with cool/cold or warm/hot temperatures, respectively. Importantly, the blue light condition reduced and the red light condition increased pain intensity and unpleasantness, both compared to the control condition. The control manipulation influenced the sense of agency, but did not influence pain ratings. The large effects revealed in our study suggest that context effects within an embodied setting in an immersive virtual environment should be considered within VR based pain therapy.}, language = {en} } @article{WiemerRaunerStegmannetal.2021, author = {Wiemer, Julian and Rauner, Milena M. and Stegmann, Yannik and Pauli, Paul}, title = {Reappraising fear: is up-regulation more efficient than down-regulation?}, series = {Motivation and Emotion}, volume = {45}, journal = {Motivation and Emotion}, number = {2}, issn = {1573-6644}, doi = {10.1007/s11031-021-09871-9}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-269187}, pages = {221-234}, year = {2021}, abstract = {Catastrophizing thoughts may contribute to the development of anxiety, but functional emotion regulation may help to improve treatment. No study so far directly compared up- and down-regulation of fear by cognitive reappraisal. Here, healthy individuals took part in a cued fear experiment, in which multiple pictures of faces were paired twice with an unpleasant scream or presented as safety stimuli. Participants (N = 47) were asked (within-subjects) to down-regulate, to up-regulate and to maintain their natural emotional response. Valence and arousal ratings indicated successful up- and down-regulation of the emotional experience, while heart rate and pupil dilation increased during up-regulation, but showed no reduction in down-regulation. State and trait anxiety correlated with evaluations of safety but not threat stimuli, which supports the role of deficient safety learning in anxiety. Reappraisal did not modulate this effect. In conclusion, this study reveals evidence for up-regulation effects in fear, which might be even more efficient than down-regulation on a physiological level and highlights the importance of catastrophizing thoughts for the maintenance of fear and anxiety.}, language = {en} } @article{WinterKernGalletal.2021, author = {Winter, Carla and Kern, Florian and Gall, Dominik and Latoschik, Marc Erich and Pauli, Paul and K{\"a}thner, Ivo}, title = {Immersive virtual reality during gait rehabilitation increases walking speed and motivation: a usability evaluation with healthy participants and individuals with multiple sclerosis and stroke}, series = {Journal of Neuroengineering and Rehabilitation}, volume = {18}, journal = {Journal of Neuroengineering and Rehabilitation}, number = {1}, issn = {1743-0003}, doi = {10.1186/s12984-021-00848-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-258698}, year = {2021}, abstract = {Background: The rehabilitation of gait disorders in patients with multiple sclerosis (MS) and stroke is often based on conventional treadmill training. Virtual reality (VR)-based treadmill training can increase motivation and improve therapy outcomes. The present study evaluated an immersive virtual reality application (using a head-mounted display, HMD) for gait rehabilitation with patients to (1) demonstrate its feasibility and acceptance and to (2) compare its short-term effects to a semi-immersive presentation (using a monitor) and a conventional treadmill training without VR to assess the usability of both systems and estimate the effects on walking speed and motivation. Methods: In a within-subjects study design, 36 healthy participants and 14 persons with MS or stroke participated in each of the three experimental conditions (VR via HMD, VR via monitor, treadmill training without VR). Results: For both groups, the walking speed in the HMD condition was higher than in treadmill training without VR and in the monitor condition. Healthy participants reported a higher motivation after the HMD condition as compared with the other conditions. Importantly, no side effects in the sense of simulator sickness occurred and usability ratings were high. No increases in heart rate were observed following the VR conditions. Presence ratings were higher for the HMD condition compared with the monitor condition for both user groups. Most of the healthy study participants (89\%) and patients (71\%) preferred the HMD-based training among the three conditions and most patients could imagine using it more frequently. Conclusions For the first time, the present study evaluated the usability of an immersive VR system for gait rehabilitation in a direct comparison with a semi-immersive system and a conventional training without VR with healthy participants and patients. The study demonstrated the feasibility of combining a treadmill training with immersive VR. Due to its high usability and low side effects, it might be particularly suited for patients to improve training motivation and training outcome e. g. the walking speed compared with treadmill training using no or only semi-immersive VR. Immersive VR systems still require specific technical setup procedures. This should be taken into account for specific clinical use-cases during a cost-benefit assessment.}, language = {en} } @article{StrackPauliWeyers, author = {Strack, Fritz and Pauli, Paul and Weyers, Peter}, title = {Editorial: Emotion and Behavior}, series = {Frontiers in Psychology}, volume = {7}, journal = {Frontiers in Psychology}, number = {313}, issn = {1664-1078}, doi = {10.3389/fpsyg.2016.00313}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-190177}, abstract = {No abstract available.}, language = {en} } @article{LangePauli2019, author = {Lange, Bastian and Pauli, Paul}, title = {Social anxiety changes the way we move—A social approach-avoidance task in a virtual reality CAVE system}, series = {PLoS ONE}, volume = {14}, journal = {PLoS ONE}, number = {12}, doi = {10.1371/journal.pone.0226805}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-200528}, pages = {e0226805}, year = {2019}, abstract = {Investigating approach-avoidance behavior regarding affective stimuli is important in broadening the understanding of one of the most common psychiatric disorders, social anxiety disorder. Many studies in this field rely on approach-avoidance tasks, which mainly assess hand movements, or interpersonal distance measures, which return inconsistent results and lack ecological validity. Therefore, the present study introduces a virtual reality task, looking at avoidance parameters (movement time and speed, distance to social stimulus, gaze behavior) during whole-body movements. These complex movements represent the most ecologically valid form of approach and avoidance behavior. These are at the core of complex and natural social behavior. With this newly developed task, the present study examined whether high socially anxious individuals differ in avoidance behavior when bypassing another person, here virtual humans with neutral and angry facial expressions. Results showed that virtual bystanders displaying angry facial expressions were generally avoided by all participants. In addition, high socially anxious participants generally displayed enhanced avoidance behavior towards virtual people, but no specifically exaggerated avoidance behavior towards virtual people with a negative facial expression. The newly developed virtual reality task proved to be an ecological valid tool for research on complex approach-avoidance behavior in social situations. The first results revealed that whole body approach-avoidance behavior relative to passive bystanders is modulated by their emotional facial expressions and that social anxiety generally amplifies such avoidance.}, language = {en} } @article{GromerKiserPauli2021, author = {Gromer, Daniel and Kiser, Dominik P. and Pauli, Paul}, title = {Thigmotaxis in a virtual human open field test}, series = {Scientific Reports}, volume = {11}, journal = {Scientific Reports}, doi = {10.1038/s41598-021-85678-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-259850}, pages = {6670}, year = {2021}, abstract = {Animal models are used to study neurobiological mechanisms in mental disorders. Although there has been significant progress in the understanding of neurobiological underpinnings of threat-related behaviors and anxiety, little progress was made with regard to new or improved treatments for mental disorders. A possible reason for this lack of success is the unknown predictive and cross-species translational validity of animal models used in preclinical studies. Re-translational approaches, therefore, seek to establish cross-species translational validity by identifying behavioral operations shared across species. To this end, we implemented a human open field test in virtual reality and measured behavioral indices derived from animal studies in three experiments (N=31, N=30, and N=80). In addition, we investigated the associations between anxious traits and such behaviors. Results indicated a strong similarity in behavior across species, i.e., participants in our study-like rodents in animal studies-preferred to stay in the outer region of the open field, as indexed by multiple behavioral parameters. However, correlational analyses did not clearly indicate that these behaviors were a function of anxious traits of participants. We conclude that the realized virtual open field test is able to elicit thigmotaxis and thus demonstrates cross-species validity of this aspect of the test. Modulatory effects of anxiety on human open field behavior should be examined further by incorporating possible threats in the virtual scenario and/or by examining participants with higher anxiety levels or anxiety disorder patients.}, language = {en} } @article{CheethamWuPaulietal.2015, author = {Cheetham, Marcus and Wu, Lingdan and Pauli, Paul and Jancke, Lutz}, title = {Arousal, valence, and the uncanny valley: psychophysiological and self-report findings}, series = {Frontiers in Psychology}, volume = {6}, journal = {Frontiers in Psychology}, number = {981}, doi = {10.3389/fpsyg.2015.00981}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-151519}, year = {2015}, abstract = {The main prediction of the Uncanny Valley Hypothesis (UVH) is that observation of humanlike characters that are difficult to distinguish from the human counterpart will evoke a state of negative affect. Well-established electrophysiological [late positive potential (LPP) and facial electromyography (EMG)] and self-report [Self-Assessment Manikin (SAM)] indices of valence and arousal, i.e., the primary orthogonal dimensions of affective experience, were used to test this prediction by examining affective experience in response to categorically ambiguous compared with unambiguous avatar and human faces (N = 30). LPP and EMG provided direct psychophysiological indices of affective state during passive observation and the SAM provided self-reported indices of affective state during explicit cognitive evaluation of static facial stimuli. The faces were drawn from well-controlled morph continua representing the UVH' dimension of human likeness (DHL). The results provide no support for the notion that category ambiguity along the DHL is specifically associated with enhanced experience of negative affect. On the contrary, the LPP and SAM-based measures of arousal and valence indicated a general increase in negative affective state (i.e., enhanced arousal and negative valence) with greater morph distance from the human end of the DHL. A second sample (N = 30) produced the same finding, using an ad hoc self-rating scale of feelings of familiarity, i.e., an oft-used measure of affective experience along the UVH' familiarity dimension. In conclusion, this multi-method approach using well-validated psychophysiological and self-rating indices of arousal and valence rejects for passive observation and for explicit affective evaluation of static faces the main prediction of the UVH.}, language = {en} } @article{ReichertsPauliMoesleretal.2019, author = {Reicherts, Philipp and Pauli, Paul and M{\"o}sler, Camilla and Wieser, Matthias J.}, title = {Placebo manipulations reverse pain potentiation by unpleasant affective stimuli}, series = {Frontiers in Psychiatry}, volume = {10}, journal = {Frontiers in Psychiatry}, number = {663}, doi = {10.3389/fpsyt.2019.00663}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201200}, year = {2019}, abstract = {According to the motivational priming hypothesis, unpleasant stimuli activate the motivational defense system, which in turn promotes congruent affective states such as negative emotions and pain. The question arises to what degree this bottom-up impact of emotions on pain is susceptible to a manipulation of top-down-driven expectations. To this end, we investigated whether verbal instructions implying pain potentiation vs. reduction (placebo or nocebo expectations)—later on confirmed by corresponding experiences (placebo or nocebo conditioning)—might alter behavioral and neurophysiological correlates of pain modulation by unpleasant pictures. We compared two groups, which underwent three experimental phases: first, participants were either instructed that watching unpleasant affective pictures would increase pain (nocebo group) or that watching unpleasant pictures would decrease pain (placebo group) relative to neutral pictures. During the following placebo/nocebo-conditioning phase, pictures were presented together with electrical pain stimuli of different intensities, reinforcing the instructions. In the subsequent test phase, all pictures were presented again combined with identical pain stimuli. Electroencephalogram was recorded in order to analyze neurophysiological responses of pain (somatosensory evoked potential) and picture processing [visually evoked late positive potential (LPP)], in addition to pain ratings. In the test phase, ratings of pain stimuli administered while watching unpleasant relative to neutral pictures were significantly higher in the nocebo group, thus confirming the motivational priming effect for pain perception. In the placebo group, this effect was reversed such that unpleasant compared with neutral pictures led to significantly lower pain ratings. Similarly, somatosensory evoked potentials were decreased during unpleasant compared with neutral pictures, in the placebo group only. LPPs of the placebo group failed to discriminate between unpleasant and neutral pictures, while the LPPs of the nocebo group showed a clear differentiation. We conclude that the placebo manipulation already affected the processing of the emotional stimuli and, in consequence, the processing of the pain stimuli. In summary, the study revealed that the modulation of pain by emotions, albeit a reliable and well-established finding, is further tuned by reinforced expectations—known to induce placebo/nocebo effects—which should be addressed in future research and considered in clinical applications.}, language = {en} } @article{GromerReinkeChristneretal.2019, author = {Gromer, Daniel and Reinke, Max and Christner, Isabel and Pauli, Paul}, title = {Causal interactive links between presence and fear in virtual reality height exposure}, series = {Frontiers in Psychology}, volume = {10}, journal = {Frontiers in Psychology}, number = {141}, doi = {10.3389/fpsyg.2019.00141}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-201855}, year = {2019}, abstract = {Virtual reality plays an increasingly important role in research and therapy of pathological fear. However, the mechanisms how virtual environments elicit and modify fear responses are not yet fully understood. Presence, a psychological construct referring to the 'sense of being there' in a virtual environment, is widely assumed to crucially influence the strength of the elicited fear responses, however, causality is still under debate. The present study is the first that experimentally manipulated both variables to unravel the causal link between presence and fear responses. Height-fearful participants (N = 49) were immersed into a virtual height situation and a neutral control situation (fear manipulation) with either high versus low sensory realism (presence manipulation). Ratings of presence and verbal and physiological (skin conductance, heart rate) fear responses were recorded. Results revealed an effect of the fear manipulation on presence, i.e., higher presence ratings in the height situation compared to the neutral control situation, but no effect of the presence manipulation on fear responses. However, the presence ratings during the first exposure to the high quality neutral environment were predictive of later fear responses in the height situation. Our findings support the hypothesis that experiencing emotional responses in a virtual environment leads to a stronger feeling of being there, i.e., increase presence. In contrast, the effects of presence on fear seem to be more complex: on the one hand, increased presence due to the quality of the virtual environment did not influence fear; on the other hand, presence variability that likely stemmed from differences in user characteristics did predict later fear responses. These findings underscore the importance of user characteristics in the emergence of presence.}, language = {en} } @article{WinklerLiPaulietal.2023, author = {Winkler, Markus H. and Li, Yonghui and Pauli, Paul and M{\"u}hlberger, Andreas}, title = {Modulation of smoking cue reactivity by social context—Implications for exposure therapy in virtual reality}, series = {Frontiers in Virtual Reality}, volume = {4}, journal = {Frontiers in Virtual Reality}, doi = {10.3389/frvir.2023.926679}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-306199}, year = {2023}, abstract = {Rationale: Social factors are considered important for the initiation and maintenance of drug abuse. Virtual reality (VR) research on cue reactivity and exposure frequently incorporates social stimuli as part of complex drug-intake scenarios. Attempts are rarely made to dissect the impact of the different components and their interactive effects. The present study critically extends this line of research by investigating the modulatory effects of social context on the reactivity evoked by proximal smoking cues. Methods: Thirty-two smokers and 33 never-smokers were presented in VR with proximal cues and neutral stimuli, embedded in a social context or a neutral context. A virtual hand model was used to translate real hand movements into VR. Each trial started with the presentation of the different stimulus-context combinations. Discrete stimuli were presented on the table in front of the participants, and contextual stimuli were presented at the end of the table. Afterward, participants were instructed to grasp the target stimulus (a cigarette vs. a pencil) in front of them. After successful contact, the stimulus appeared in the virtual hand. Modulation of cue reactivity by social context was assessed by self-report, physiological measures, and overt approach behavior. Results: The results revealed modulatory effects of social context on the responses to proximal smoking cues in smokers. In contrast to never-smokers, smoking cues evoked craving in smokers, which was attenuated in a social context. Furthermore, social context increased the latency to approach and contact the cigarette in the group of smokers but did not affect behavioral approach responses in never-smokers. Other data provided indications for interactive, but also main effects of cues and contexts. Interestingly, cue-evoked craving was increased after contact with the virtual cigarette. Conclusion: The present study critically extends previous research by providing evidence for the modulation of cue reactivity by social context. The results are particularly important given the well-established role of drug-associated environmental contexts in the stimulus control of addictive behaviors. Our results emphasize the need to address social context effects on cue reactivity in basic research and treatment and further suggest that changes in the perceived availability of smoking might enhance or inhibit cue-evoked reactivity.}, language = {en} } @article{HilgerHaegeZedleretal.2023, author = {Hilger, Kirsten and H{\"a}ge, Anne-Sophie and Zedler, Christina and Jost, Michael and Pauli, Paul}, title = {Virtual reality to understand pain-associated approach behaviour: a proof-of-concept study}, series = {Scientific Reports}, volume = {13}, journal = {Scientific Reports}, doi = {10.1038/s41598-023-40789-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-357817}, year = {2023}, abstract = {Pain-associated approach and avoidance behaviours are critically involved in the development and maintenance of chronic pain. Empirical research suggests a key role of operant learning mechanisms, and first experimental paradigms were developed for their investigation within a controlled laboratory setting. We introduce a new Virtual Reality paradigm to the study of pain-related behaviour and investigate pain experiences on multiple dimensions. The paradigm evaluates the effects of three-tiered heat-pain stimuli applied contingent versus non-contingent with three types of arm movements in naturalistic virtual sceneries. Behaviour, self-reported pain-related fear, pain expectancy and electrodermal activity were assessed in 42 healthy participants during an acquisition phase (contingent movement-pain association) and a modification phase (no contingent movement-pain association). Pain-associated approach behaviour, as measured by arm movements followed by a severe heat stimulus, quickly decreased in-line with the arm movement-pain contingency. Slower effects were observed in fear of movement-related pain and pain expectancy ratings. During the subsequent modification phase, the removal of the pain contingencies modified all three indices. In both phases, skin conductance responses resemble the pattern observed for approach behaviour, while skin conductance levels equal the pattern observed for the self-ratings. Our findings highlight a fast reduction in approach behaviour in the face of acute pain and inform about accompanying psychological and physiological processes. We discuss strength and limitations of our paradigm for future investigations with the ultimate goal of gaining a comprehensive understanding of the mechanisms involved in chronic pain development, maintenance, and its therapy.}, language = {en} } @article{BellingerWehrmannRohdeetal.2023, author = {Bellinger, Daniel and Wehrmann, Kristin and Rohde, Anna and Schuppert, Maria and St{\"o}rk, Stefan and Flohr-Jost, Michael and Gall, Dominik and Pauli, Paul and Deckert, J{\"u}rgen and Herrmann, Martin J. and Erhardt-Lehmann, Angelika}, title = {The application of virtual reality exposure versus relaxation training in music performance anxiety: a randomized controlled study}, series = {BMC Psychiatry}, volume = {23}, journal = {BMC Psychiatry}, doi = {10.1186/s12888-023-05040-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-357833}, year = {2023}, abstract = {Background Performance anxiety is the most frequently reported anxiety disorder among professional musicians. Typical symptoms are - on a physical level - the consequences of an increase in sympathetic tone with cardiac stress, such as acceleration of heartbeat, increase in blood pressure, increased respiratory rate and tremor up to nausea or flush reactions. These symptoms can cause emotional distress, a reduced musical and artistical performance up to an impaired functioning. While anxiety disorders are preferably treated using cognitive-behavioral therapy with exposure, this approach is rather difficult for treating music performance anxiety since the presence of a public or professional jury is required and not easily available. The use of virtual reality (VR) could therefore display an alternative. So far, no therapy studies on music performance anxiety applying virtual reality exposure therapy have investigated the therapy outcome including cardiovascular changes as outcome parameters. Methods This mono-center, prospective, randomized and controlled clinical trial has a pre-post design with a follow-up period of 6 months. 46 professional and semi-professional musicians will be recruited and allocated randomly to an VR exposure group or a control group receiving progressive muscle relaxation training. Both groups will be treated over 4 single sessions. Music performance anxiety will be diagnosed based on a clinical interview using ICD-10 and DSM-5 criteria for specific phobia or social anxiety. A behavioral assessment test is conducted three times (pre, post, follow-up) in VR through an audition in a concert hall. Primary outcomes are the changes in music performance anxiety measured by the German B{\"u}hnenangstfragebogen and the cardiovascular reactivity reflected by heart rate variability (HRV). Secondary outcomes are changes in blood pressure, stress parameters such as cortisol in the blood and saliva, neuropeptides, and DNA-methylation. Discussion The trial investigates the effect of VR exposure in musicians with performance anxiety compared to a relaxation technique on anxiety symptoms and corresponding cardiovascular parameters. We expect a reduction of anxiety but also a consecutive improvement of HRV with cardiovascular protective effects. Trial registration This study was registered on clinicaltrials.gov. (ClinicalTrials.gov Number: NCT05735860)}, language = {en} } @article{ZilligPauliWieseretal.2023, author = {Zillig, Anna-Lena and Pauli, Paul and Wieser, Matthias and Reicherts, Philipp}, title = {Better safe than sorry? - On the influence of learned safety on pain perception}, series = {PloS One}, volume = {18}, journal = {PloS One}, number = {11}, doi = {10.1371/journal.pone.0289047}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-349905}, year = {2023}, abstract = {The experience of threat was found to result—mostly—in increased pain, however it is still unclear whether the exact opposite, namely the feeling of safety may lead to a reduction of pain. To test this hypothesis, we conducted two between-subject experiments (N = 94; N = 87), investigating whether learned safety relative to a neutral control condition can reduce pain, while threat should lead to increased pain compared to a neutral condition. Therefore, participants first underwent either threat or safety conditioning, before entering an identical test phase, where the previously conditioned threat or safety cue and a newly introduced visual cue were presented simultaneously with heat pain stimuli. Methodological changes were performed in experiment 2 to prevent safety extinction and to facilitate conditioning in the first place: We included additional verbal instructions, increased the maximum length of the ISI and raised CS-US contingency in the threat group from 50\% to 75\%. In addition to pain ratings and ratings of the visual cues (threat, safety, arousal, valence, and contingency), in both experiments, we collected heart rate and skin conductance. Analysis of the cue ratings during acquisition indicate successful threat and safety induction, however results of the test phase, when also heat pain was administered, demonstrate rapid safety extinction in both experiments. Results suggest rather small modulation of subjective and physiological pain responses following threat or safety cues relative to the neutral condition. However, exploratory analysis revealed reduced pain ratings in later trials of the experiment in the safety group compared to the threat group in both studies, suggesting different temporal dynamics for threat and safety learning and extinction, respectively. Perspective: The present results demonstrate the challenge to maintain safety in the presence of acute pain and suggest more research on the interaction of affective learning mechanism and pain processing.}, language = {en} } @article{GottschalkRichterZiegleretal.2019, author = {Gottschalk, Michael G. and Richter, Jan and Ziegler, Christiane and Schiele, Miriam A. and Mann, Julia and Geiger, Maximilian J. and Schartner, Christoph and Homola, Gy{\"o}rgy A. and Alpers, Georg W. and B{\"u}chel, Christian and Fehm, Lydia and Fydrich, Thomas and Gerlach, Alexander L. and Gloster, Andrew T. and Helbig-Lang, Sylvia and Kalisch, Raffael and Kircher, Tilo and Lang, Thomas and Lonsdorf, Tina B. and Pan{\´e}-Farr{\´e}, Christiane A. and Str{\"o}hle, Andreas and Weber, Heike and Zwanzger, Peter and Arolt, Volker and Romanos, Marcel and Wittchen, Hans-Ulrich and Hamm, Alfons and Pauli, Paul and Reif, Andreas and Deckert, J{\"u}rgen and Neufang, Susanne and H{\"o}fler, Michael and Domschke, Katharina}, title = {Orexin in the anxiety spectrum: association of a HCRTR1 polymorphism with panic disorder/agoraphobia, CBT treatment response and fear-related intermediate phenotypes}, series = {Translational Psychiatry}, volume = {9}, journal = {Translational Psychiatry}, doi = {10.1038/s41398-019-0415-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-227479}, year = {2019}, abstract = {Preclinical studies point to a pivotal role of the orexin 1 (OX1) receptor in arousal and fear learning and therefore suggest the HCRTR1 gene as a prime candidate in panic disorder (PD) with/without agoraphobia (AG), PD/AG treatment response, and PD/AG-related intermediate phenotypes. Here, a multilevel approach was applied to test the non-synonymous HCRTR1 C/T Ile408Val gene variant (rs2271933) for association with PD/AG in two independent case-control samples (total n = 613 cases, 1839 healthy subjects), as an outcome predictor of a six-weeks exposure-based cognitive behavioral therapy (CBT) in PD/AG patients (n = 189), as well as with respect to agoraphobic cognitions (ACQ) (n = 483 patients, n = 2382 healthy subjects), fMRI alerting network activation in healthy subjects (n = 94), and a behavioral avoidance task in PD/AG pre- and post-CBT (n = 271). The HCRTR1 rs2271933 T allele was associated with PD/AG in both samples independently, and in their meta-analysis (p = 4.2 × 10-7), particularly in the female subsample (p = 9.8 × 10-9). T allele carriers displayed a significantly poorer CBT outcome (e.g., Hamilton anxiety rating scale: p = 7.5 × 10-4). The T allele count was linked to higher ACQ sores in PD/AG and healthy subjects, decreased inferior frontal gyrus and increased locus coeruleus activation in the alerting network. Finally, the T allele count was associated with increased pre-CBT exposure avoidance and autonomic arousal as well as decreased post-CBT improvement. In sum, the present results provide converging evidence for an involvement of HCRTR1 gene variation in the etiology of PD/AG and PD/AG-related traits as well as treatment response to CBT, supporting future therapeutic approaches targeting the orexin-related arousal system.}, language = {en} }