@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}
}
@phdthesis{Segebarth2021,
  author    = {Segebarth, Dennis},
  title     = {Evaluation and validation of deep learning strategies for bioimage analyses},
  doi       = {10.25972/OPUS-24372},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-243728},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Significant advances in fluorescence imaging techniques enable life scientists today to gain insights into biological systems at an unprecedented scale. The interpretation of image features in such bioimage datasets and their subsequent quantitative analysis is referred to as bioimage analysis. A substantial proportion of bioimage analyses is still performed manually by a human expert - a tedious process that is long known to be subjective. Particularly in tasks that require the annotation of image features with a low signal-to-noise ratio, like in fluorescence images of tissue samples, the inter-rater agreement drops. However, like any other scientific analysis, also bioimage analysis has to meet the general quality criteria of quantitative research, which are objectivity, reliability, and validity. Thus, the automation of bioimage analysis with computer-aided approaches is highly desirable. Albeit conventional hard-coded algorithms are fully unbiased, a human user has to set its respective feature extraction parameters. Thus, also these approaches can be considered subjective. Recently, deep learning (DL) has enabled impressive advances in computer vision research. The predominant difference between DL and conventional algorithms is the capability of DL models to learn the respective task on base of an annotated training dataset, instead of following user-defined rules for feature extraction. This thesis hypothesized that DL can be used to increase the objectivity, reliability, and validity of bioimage analyses, thus going beyond mere automation. However, in absence of ground truth annotations, DL models have to be trained on manual and thus subjective annotations, which could cause the model to incorporate such a bias. Moreover, model training is stochastic and even training on the same data could result in models with divergent outputs. Consequently, both the training on subjective annotations and the model-to-model variability could impair the quality of DL-based bioimage analyses. This thesis systematically assessed the impacts of these two limitations experimentally by analyzing fluorescence signals of a protein called cFOS in mouse brain sections. Since the abundance of cFOS correlates with mouse behavior, behavioral analyses could be used for cross-validation of the bioimage analysis results. Furthermore, this thesis showed that pooling the input of multiple human experts during model training and integration of multiple trained models in a model ensemble can mitigate the impact of these limitations. In summary, the present study establishes guidelines for how DL can be used to increase the general quality of bioimage analyses.},
  subject      = {Deeplearning},
  language  = {en}
}
@phdthesis{Klinke2022,
  author    = {Klinke, Christopher Matthias},
  title     = {Experimental investigation of the effect of distal stress induction on threat conditioning in humans},
  doi       = {10.25972/OPUS-22556},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-225562},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Stress constitutes a major risk factor for the development of psychiatric disorders, such as PTSD and anxiety disorders, by shifting the brain into a state of sensitization and makes it more vulnerable when being exposed to further aversive events. This was experimentally in-vestigated in rodents by examining the effect of a distal stress induction on threat conditioning, where stress impaired extinction learning and caused spontaneous recovery. However, this effect has never been experimentally investigated in humans, so far. Thus, the aim of this dissertation was to investigate the effect of distal stress on threat conditioning in humans. Therefore, two subsequent studies were conducted. For both studies, the threat conditioning paradigm comprised threat acquisition, extinction learning, and re-extinction. In the threat acquisition phase, two geometrical shapes were used as conditioned stimulus (CS), from which one (CS+) was paired with a painful electric stimulus (unconditioned stimulus, US), but not the other one (CS-). During extinction learning 24 h later and re-extinction seventeen days later, CSs were again presented but without any US delivery. In Study 1, 69 participants underwent either a stress (socially evaluated cold pressor test; SECPT) or sham protocol 10 days prior to threat conditioning. Furthermore, context effects were examined by placing the stress protocol in the same context (context-A stress, and sham group) or a different context (context-B stress group) than conditioning. Results revealed that the context-A, but not context-B, stress group displayed impaired safety learning (i.e. potenti-ation towards CS-) for startle response during threat acquisition. Moreover, the same stress group showed impaired threat extinction, evident in sustained CS discrimination in valence and arousal ratings during extinction learning, and memory recall. In sum, distal stress on the one hand impaired safety learning during threat conditioning on a level of startle response. On the other hand, stress impaired threat extinction on a level of ratings. Noteworthy, the effect of distal stress was only found when the stressor was placed in the same context as later threat learning. Hence, suggesting that the combination of stressor and stressor-associated context exerted the effect on threat extinction. In Study 2, it was examined if distal stress induction could also have an impact on threat and extinction processes without the necessity of context association. Therefore, the same stress (n = 45) or sham protocol (n = 44) as in Study 1 was conducted in a different context than and 24 h prior to a threat conditioning paradigm. Similar to Study 1, weakened extinction learning was found in fear ratings for the stress (vs. sham) group, which was indicated by persistent CS+/CS- differentiation after the first block of extinction trials. Alterations in safety learning towards the CS- during threat acquisition were only supported by significant correlations between stress measures on the stress day and conditioned startle response of the CS- during acquisition. Taken together, in two subsequent studies this dissertation provided first evidence of impaired threat extinction after distal stress induction in humans. Furthermore, impairments in safety learning, as can be observed in PTSD, were additionally demonstrated. Interestingly, the effects were boosted and more profound when associating the stressor to the later learning context. These results have clinical implications as they can be translated to the notion that prior stress exposure makes an individual more vulnerable for later aversive events.},
  subject      = {Stress},
  language  = {en}
}
@phdthesis{HuttererneeHerzog2024,
  author    = {Hutterer, n{\´e}e Herzog, Katharina},
  title     = {Treatment-like use of discrimination training to reduce generalization of conditioned fear},
  doi       = {10.25972/OPUS-31728},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-317286},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {Anxiety patients overgeneralize fear, also because of an inability to perceptually discriminate threat and safety signals. Therefore, some studies have developed discrimination training that successfully reduced the occurrence of fear generalization. The present work is the first to take a treatment-like approach by using discrimination training after generalization has occurred. Therefore, two studies were conducted with healthy participants using the same fear conditioning and generalization paradigm, with two faces as conditioned stimuli (CSs), and four facial morphs between CSs as generalization stimuli (GSs). Only one face (CS+) was followed by a loud scream (unconditioned stimulus, US). In Study 1, participants underwent either fear-relevant (discriminating faces) or fear-irrelevant discrimination training (discriminating width of lines) or a non-discriminative control training between the two generalization tests, each with or without feedback (n = 20 each). Generalization of US expectancy was reduced more effectively by fear-relevant compared to fear-irrelevant discrimination training. However, neither discrimination training was more effective than non-discriminative control training. Moreover, feedback reduced generalization of US expectancy only in discrimination training. Study 2 was designed to replicate the effects of the discrimination-training conditions in a large sample (N = 244) and examine their benefits in individuals at risk for anxiety disorders. Again, feedback reduced fear generalization particularly well for US expectancy. Fear relevance was not confirmed to be particularly fear-reducing in healthy participants, but may enhance training effects in individuals at risk of anxiety disorder. In summary, this work provides evidence that existing fear generalization can be reduced by discrimination training, likely involving several (higher-level) processes besides perceptual discrimination (e.g., motivational mechanisms in feedback conditions). Its use may be promising as part of individualized therapy for patients with difficulty discriminating similar stimuli.},
  subject      = {Furcht},
  language  = {en}
}
@phdthesis{Zillig2024,
  author    = {Zillig, Anna-Lena Christina},
  title     = {Einfluss von Sicherheit auf die Schmerzverarbeitung},
  doi       = {10.25972/OPUS-35928},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-359282},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {Im Rahmen des interdisziplin{\"a}ren Promotionsschwerpunkts Resilienzfaktoren der Schmerzverarbeitung des evangelischen Studienwerks in Zusammenarbeit mit der Julius-Maximilians-Universit{\"a}t W{\"u}rzburg und der Otto-Friedrich-Universit{\"a}t Bamberg untersuche ich in diesem Promotionsprojekt den Einfluss von Sicherheit auf die Schmerzverarbeitung. Es ist bekannt, dass die Schmerzverarbeitung durch Emotionen moduliert werden kann. Man geht davon aus, dass negative Emotionen den Schmerz in der Regel verst{\"a}rken, w{\"a}hrend positive Emotionen zu einer Schmerzreduktion f{\"u}hren. Fr{\"u}here Studien fanden heraus, dass die Erwartung eines aversiven Ereignisses zu Bedrohung und st{\"a}rkeren Schmerzen f{\"u}hrt. Es stellt sich die Frage, ob das Gegenteil von Bedrohung, n{\"a}mlich Sicherheit, zu einer Verringerung der Schmerzen f{\"u}hren kann. Um diese Hypothese zu untersuchen, habe ich drei Experimente an gesunden ProbandInnen durchgef{\"u}hrt.},
  subject      = {Sicherheit},
  language  = {de}
}