TY - JOUR A1 - Rabe, A. A1 - van Oorschot, B. A1 - Jentschke, E. T1 - Suizidalität bei Krebspatienten JF - Der Onkologe N2 - Hintergrund Die Diagnose Krebs und ihre Behandlung kann eine große Belastung für die Betroffenen darstellen. Neben körperlichen Beschwerden kann auch die Psyche in Mitleidenschaft gezogen werden. Fehlt es an entsprechenden Bewältigungsstrategien, kann der selbstbestimmte Tod als einziger Ausweg erscheinen. Ziel und Fragestellung Die vorliegende Übersichtsarbeit zur Suizidalität bei Krebspatienten befasst sich mit einem Thema, das in der Forschung und Praxis in Deutschland nur wenig Aufmerksamkeit findet. Material und Methoden Eine themenbezogene Literaturrecherche stellt die Basis der Arbeit dar. Ergebnisse Todeswünsche unter Krebspatienten sind nicht selten und können Suizidgedanken/-absichten beinhalten. Psychische Beschwerden, insbesondere Hoffnungslosigkeit und Depression, sind ernstzunehmende Risikofaktoren. Das Erkennen einer hohen psychischen Belastung/von Todeswünschen ist ein wichtiger Aspekt für die Suizidprävention. Für die Praxis empfiehlt sich zunächst die Verwendung von Fragebögen. Bei auffälligen Werten muss die Suizidalität proaktiv in einem persönlichen Gespräch exploriert werden. Betroffene sind meist ambivalent bezüglich ihrer Entscheidung für oder gegen das Leben. Dies stellt eine große Chance für Interventionen dar. Schlussfolgerungen Suizidalität kann verhindert werden, wenn die hohe Belastung erkannt wird. Bereits das Gespräch zwischen Arzt und Patient über Todeswünsche kann eine erste Entlastung darstellen. N2 - Background The diagnosis of cancer and its treatment can be a great strain for the affected patients. In addition to physical complaints, the psyche can also be gravely compromised. In the absence of appropriate coping strategies, self-determined death may appear to be the only way out. Objective The current review article on suicidality in cancer patients addresses a topic that receives little attention in research and practice in Germany. Materials and methods A topic-related literature search is the basis of the work. Results Death wishes among cancer patients are not rare and may include suicidal thoughts/intentions. Psychological complaints, especially hopelessness and depression, are serious risk factors. Recognition of a high level of psychological distress/death wish is an important aspect of suicide prevention. In practice, the use of questionnaires is initially recommended. In the case of conspicuous values, suicidal tendencies must be proactively explored in a personal interview. Those affected are usually ambivalent about their decision for or against life. This represents a great opportunity for interventions. Conclusion Suicidality can be prevented if the high burden is recognized. Even the conversation between doctor and patient about death wishes can provide initial relief. KW - coping skills KW - behavior and behaviormechanisms KW - attitude to death KW - emotional regulation KW - psychological distress KW - Bewältigungsfähigkeiten KW - Verhalten und Verhaltensmechanismen KW - Einstellung zum Tod KW - Emotionsregulierung KW - psychischer Stress Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-232401 SN - Suizidalität bei Krebspatienten VL - 26 ER - TY - JOUR A1 - Glotzbach, Evelyn A1 - Mühlberger, Andreas A1 - Gschwendtner, Kathrin A1 - Fallgatter, Andreas J A1 - Pauli, Paul A1 - Herrmann, Martin J T1 - Prefrontal Brain Activation During Emotional Processing: A Functional Near Infrared Spectroscopy Study (fNIRS) JF - The Open Neuroimaging Journal N2 - The limbic system and especially the amygdala have been identified as key structures in emotion induction and regulation. Recently research has additionally focused on the influence of prefrontal areas on emotion processing in the limbic system and the amygdala. Results from fMRI studies indicate that the prefrontal cortex (PFC) is involved not only in emotion induction but also in emotion regulation. However, studies using fNIRS only report prefrontal brain activation during emotion induction. So far it lacks the attempt to compare emotion induction and emotion regulation with regard to prefrontal activation measured with fNIRS, to exclude the possibility that the reported prefrontal brain activation in fNIRS studies are mainly caused by automatic emotion regulation processes. Therefore this work tried to distinguish emotion induction from regulation via fNIRS of the prefrontal cortex. 20 healthy women viewed neutral pictures as a baseline condition, fearful pictures as induction condition and reappraised fearful pictures as regulation condition in randomized order. As predicted, the view-fearful condition led to higher arousal ratings than the view-neutral condition with the reappraise-fearful condition in between. For the fNIRS results the induction condition showed an activation of the bilateral PFC compared to the baseline condition (viewing neutral). The regulation condition showed an activation only of the left PFC compared to the baseline condition, although the direct comparison between induction and regulation condition revealed no significant difference in brain activation. Therefore our study underscores the results of previous fNIRS studies showing prefrontal brain activation during emotion induction and rejects the hypothesis that this prefrontal brain activation might only be a result of automatic emotion regulation processes. KW - fNIRS KW - Emotional processing KW - emotional regulation Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-141714 VL - 5 ER - TY - JOUR A1 - Herrmann, Martin J. A1 - Beier, Jennifer S. A1 - Simons, Bibiane A1 - Polak, Thomas T1 - Transcranial Direct Current Stimulation (tDCS) of the Right Inferior Frontal Gyrus Attenuates Skin Conductance Responses to Unpredictable Threat Conditions JF - Frontiers in Human Neuroscience N2 - Patients with panic and post-traumatic stress disorders seem to show increased psychophysiological reactions to conditions of unpredictable (U) threat, which has been discussed as a neurobiological marker of elevated levels of sustained fear in these disorders. Interestingly, a recent study found that the right inferior frontal gyrus (rIFG) is correlated to the successful regulation of sustained fear during U threat. Therefore this study aimed to examine the potential use of non-invasive brain stimulation to foster the rIFG by means of anodal transcranial direct current stimulation (tDCS) in order to reduce psychophysiological reactions to U threat. Twenty six participants were randomly assigned into an anodal and sham stimulation group in a double-blinded manner. Anodal and cathodal electrodes (7 * 5 cm) were positioned right frontal to target the rIFG. Stimulation intensity was I = 2 mA applied for 20 min during a task including U threat conditions (NPU-task). The effects of the NPU paradigm were measured by assessing the emotional startle modulation and the skin conductance response (SCR) at the outset of the different conditions. We found a significant interaction effect of condition × tDCS for the SCR (F(2,48) = 6.3, p < 0.01) without main effects of condition and tDCS. Post hoc tests revealed that the increase in SCR from neutral (N) to U condition was significantly reduced in verum compared to the sham tDCS group (t(24) = 3.84, p < 0.001). Our results emphasize the causal role of rIFG for emotional regulation and the potential use of tDCS to reduce apprehension during U threat conditions and therefore as a treatment for anxiety disorders. KW - transcranial direct current stimulation KW - emotional regulation KW - sustained fear KW - right inferior frontalgyrus KW - NPU Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-146486 VL - 10 IS - 352 ER - TY - JOUR A1 - Herrmann, Martin J. A1 - Glotzbach, Evelyn A1 - Mühlberger, Andreas A1 - Gschwendtner, Kathrin A1 - Fallgatter, Andreas J. A1 - Pauli, Paul T1 - Prefrontal Brain Activation During Emotional Processing: A Functional Near Infrared Spectroscopy Study (fNIRS) JF - The Open Neuroimaging Journal N2 - The limbic system and especially the amygdala have been identified as key structures in emotion induction and regulation. Recently research has additionally focused on the influence of prefrontal areas on emotion processing in the limbic system and the amygdala. Results from fMRI studies indicate that the prefrontal cortex (PFC) is involved not only in emotion induction but also in emotion regulation. However, studies using fNIRS only report prefrontal brain activation during emotion induction. So far it lacks the attempt to compare emotion induction and emotion regulation with regard to prefrontal activation measured with fNIRS, to exclude the possibility that the reported prefrontal brain activation in fNIRS studies are mainly caused by automatic emotion regulation processes. Therefore this work tried to distinguish emotion induction from regulation via fNIRS of the prefrontal cortex. 20 healthy women viewed neutral pictures as a baseline condition, fearful pictures as induction condition and reappraised fearful pictures as regulation condition in randomized order. As predicted, the view-fearful condition led to higher arousal ratings than the view-neutral condition with the reappraise-fearful condition in between. For the fNIRS results the induction condition showed an activation of the bilateral PFC compared to the baseline condition (viewing neutral). The regulation condition showed an activation only of the left PFC compared to the baseline condition, although the direct comparison between induction and regulation condition revealed no significant difference in brain activation. Therefore our study underscores the results of previous fNIRS studies showing prefrontal brain activation during emotion induction and rejects the hypothesis that this prefrontal brain activation might only be a result of automatic emotion regulation processes. KW - fNIRS KW - Emotional processing KW - emotional regulation Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-97437 ER -