TY - JOUR A1 - Ritz, Thomas A1 - Enlow, Michelle Bosquet A1 - Schulz, Stefan M. A1 - Kitts, Robert A1 - Staudenmayer, John A1 - Wright, Rosalind J. T1 - Respiratory Sinus Arrhythmia as an Index of Vagal Activity during Stress in Infants: Respiratory Influences and Their Control JF - PLoS One N2 - Respiratory sinus arrhythmia (RSA) is related to cardiac vagal outflow and the respiratory pattern. Prior infant studies have not systematically examined respiration rate and tidal volume influences on infant RSA or the extent to which infants' breathing is too fast to extract a valid RSA. We therefore monitored cardiac activity, respiration, and physical activity in 23 six-month old infants during a standardized laboratory stressor protocol. On average, 12.6% (range 0-58.2%) of analyzed breaths were too short for RSA extraction. Higher respiration rate was associated with lower RSA amplitude in most infants, and lower tidal volume was associated with lower RSA amplitude in some infants. RSA amplitude corrected for respiration rate and tidal volume influences showed theoretically expected strong reductions during stress, whereas performance of uncorrected RSA was less consistent. We conclude that stress-induced changes of peak-valley RSA and effects of variations in breathing patterns on RSA can be determined for a representative percentage of infant breaths. As expected, breathing substantially affects infant RSA and needs to be considered in studies of infant psychophysiology. KW - responses KW - heart-rate-variability KW - pulmonary gas-exchange KW - still-face KW - baroreflex mechanism KW - period variability KW - preterm infants KW - waking states KW - reactivity KW - attention Y1 - 2012 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-135396 VL - 7 IS - 12 ER - TY - JOUR A1 - Winter, Anna A1 - Schulz, Stefan M. A1 - Schmitter, Marc A1 - Brands, Roman C. A1 - Straub, Anton A1 - Kübler, Alexander A1 - Borgmann, Anna A1 - Hartmann, Stefan T1 - Oral-health-related quality of life in patients with medication-related osteonecrosis of the jaw: a prospective clinical study JF - International Journal of Environmental Research and Public Health N2 - Medication-related osteonecrosis of the jaw (MRONJ) represents an adverse side effect of antiresorptive and antiangiogenic medications. It is associated with impaired quality of life, oral health, and oral function and can be classified into various stages. The purpose of this prospective clinical study is to evaluate the impact of stages I and II MRONJ on oral-health-related quality of life (OHRQoL) and related parameters. Patients’ OHRQoL, satisfaction with life, oral discomfort, and oral health were assessed using the German version of the Oral Health Impact Profile (OHIP-G49), visual analog scales (VAS), and Satisfaction with Life Scale (SWLS) at baseline (T0), 10 days (T1), and 3 months after treatment (T2) in 36 patients. Data were analyzed using Kolmogorov–Smirnov test, two-way mixed ANOVAs, and follow-up Mann–Whitney U tests. The impact of treatment effects on the original seven OHIP domain structures and the recently introduced four-dimensional OHIP structure were evaluated using linear regression analysis. Thirty-six patients received surgical MRONJ treatment. Before treatment, patients’ perceived OHRQoL, oral discomfort, oral health, and satisfaction with life were negatively affected by MRONJ. Surgical treatment significantly improved OHRQoL and related parameters (all p ≤ 0.012). This improvement was greater in patients with higher impairment at T0. OHRQoL and oral restrictions were still impaired after treatment in patients who needed prosthetic treatment. The four-dimensional structure revealed valuable information beyond the standard seven OHIP domains. Increased awareness of MRONJ risks and an interdisciplinary treatment approach for MRONJ patients are needed. KW - oral-health-related quality of life KW - satisfaction with life KW - oral health KW - medication-related osteonecrosis of the jaw KW - treatment benefit KW - OHIP-49 KW - SWLS Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-288141 SN - 1660-4601 VL - 19 IS - 18 ER - TY - THES A1 - Schulz, Stefan M. T1 - Mediators of Social Anxiety - External Social Threat-Cues vs. Self-Related Negative Cognitions T1 - Mediatoren Sozialer Angst - Bedrohliche Soziale Umweltreize vs. Selbstbezogene Negative Gedanken N2 - Sozial ängstliche Menschen richten ihre Aufmerksamkeit in sozial bedrohlichen Situationen nach innen auf selbstbezogene negative Gedanken (z.B. „Ich schaffe das nicht!“). Außerdem richten sie ihre Aufmerksamkeit unwillkürlich bevorzugt auf potenziell bedrohliche soziale Umweltreize und beurteilen diese im Vergleich zu niedrig sozial ängstlichen Kontrollpersonen besonders negativ. Einschlägige Modelle und die Fachliteratur lassen den Schluss zu, dass selbstbezogene negative Gedanken und die systematisch verzerrte Verarbeitung bedrohlicher sozialer Umweltreize Mediatoren für Zusammenhänge zwischen sozialer Ängstlichkeit und akuter Angst in sozial bedrohlichen Situationen sind. Zudem finden sich Hinweise auf Wechselwirkungen zwischen den angenommenen Mediatoren. Auf dieser Grundlage wurde ein Arbeitsmodell zu Mediatoren sozialer Angst erstellt. In drei Experimenten wurden von diesem Modell abgeleitete Hypothesen überprüft. Die Ergebnisse der drei Experimente zeigten eindrucksvoll in subjektiven und physiologischen Daten (Herzratenvariabilität bzw. parasympathische Aktivierung), dass selbstbezogene negative Gedanken tatsächlich ein Mediator sozialer Angst sind. Im Vergleich dazu spielt die verzerrte automatische Verarbeitung bedrohlicher sozialer Umweltreize zumindest in ökologisch validen, sozial bedrohlichen Situationen eine vernachlässigbare Rolle. N2 - Based on a review of models and empirical findings a working model is proposed, suggesting that self-related negative cognitions and biased processing of external social threat-cues are mediators of social anxiety. Hypotheses derived from this model were tested in three experiments. The first experiment examined whether levels of trait social anxiousness predicted fearful responding to external social threat-cues (angry vs. neutral and happy facial expressions) during social evaluation. Higher trait social anxiousness predisposes to an inward focus on one’s fear reaction to social threat. Using this strategy was expected to enhance fearful responding to angry facial expressions. A strategy of identifying with angry faces was expected to counteract fearful responding, but was expected to fail more often with increasing levels of trait social anxiousness. To examine these hypotheses, affective modulation of the startle eye-blink was assessed in forty-four undergraduate students. This measure served as a probe into the activation of brain structures involved in the automatic evaluation of environmental threat-cues. Trait and state anxiety as well as explicit emotional responding to the stimuli were assessed with questionnaires and ratings. Processing angry faces potentiated startle amplitudes as expected. Low arousal induced by the stimuli was a probable reason, why startle potentiation to happy faces emerged instead of attenuation. Trait social anxiousness and the cognitive strategies did not influence these effects. Yet, increased trait social anxiousness predicted decreased startle latency, indicating motor hyper-responsivity, which is part of the clinical representation of social anxiety disorder (SAD). Processing facial expressions and identifying with them disrupted this association. Previous studies support that similar strategies may enhance treatment of SAD. Individuals with SAD were expected to respond with increased arousal to external social threat-cues. Therefore, the second experiment examined whether nine individuals with SAD showed attentional (prepulse inhibition, PPI) or affective startle modulation to angry as compared to neutral and happy facial expressions. Corrugator supercilii activity was assessed as a behavioral indicator for effects of facial expressions. The remaining setup resembled the first experiment. Facial expressions did not modulate the startle reflex, but corrugator supercilii activity was sensitive to facial valence. However, the effects were not related to trait social anxiousness. Apparently, angry facial expressions do not act as phobic stimuli for individuals with SAD. The third experiment examined whether focusing on self-related negative cognitions or biased processing of external social threat-cues mediates relationships between trait social anxiety and anxious responding in a socially challenging situation. Inducing self-related negative cognitions vs. relaxation was expected to reveal a functional dependency on the supposed mediation in a multivariate assessment of criteria of the working model. Within this design, the impact of external social threat-cues (facial expressions and emotional words) was compared to control stimuli and context effects, using the startle paradigm. The findings provide first evidence for full statistical mediation of the associations between trait social anxiety and self-reported anxiety as well as parasympathetic withdrawal by self-related negative cognitions, when thirty-six undergraduate students anticipated public speaking. Apprehensive arousal, as indicated by increased skin conductance levels and heart rate, was present in all participants. Observer ratings of behavior during public speaking matched the self-rated quality of the performance. None of these measures were correlated with trait social anxiousness. Startle amplitude correlated with state and trait social anxiety, but was no mediator. Finally, there was no affective modulation of the startle amplitude by external social threat-cues. These studies advance both our current understanding of the factors that mediate social anxiety responses to situations and our knowledge of the physiological and anatomical mechanisms involved in social anxiety. Based on these findings a revised version of the working model on mediators of social anxiety is proposed in the hope it may aid further research for the ultimate goal of developing an empirically validated functional anatomical model of social anxiety. KW - Sozialangst KW - Mediator KW - Kognition KW - Physiologie KW - Mimik KW - Herzratenvariabilität KW - Affektive Schreckreflexmodulation KW - Emotionaler Gesichtsausdruck KW - Social Anxiety KW - Cognitive Model KW - Heart Rate Variability KW - Emotional Facial Expressions KW - Affective Startle Modulation Y1 - 2009 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-44684 ER - TY - JOUR A1 - Wölk, Julian A1 - Sütterlin, Stefan A1 - Koch, Stefan A1 - Vögele, Claus A1 - Schulz, Stefan M. T1 - Enhanced cardiac perception predicts impaired performance in the Iowa Gambling Task in patients with panic disorder JF - Brain and Behavior N2 - 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. KW - panic disorder KW - somatic marker hypothesis KW - cardiac perception KW - Iowa Gambling Task KW - decision making KW - interoception Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-119865 SN - 2162-3279 VL - 4 IS - 2 ER - TY - JOUR A1 - Ghafoor, Hina A1 - Nordbeck, Peter A1 - Ritter, Oliver A1 - Pauli, Paul A1 - Schulz, Stefan M. T1 - Can Religiosity and Social Support Explain Effects of Trait Emotional Intelligence on Health-Related Quality of Life: A Cross-Cultural Study JF - Journal of Religion and Health N2 - Religion and social support along with trait emotional intelligence (EI) help individuals to reduce stress caused by difficult situations. Their implications may vary across cultures in reference to predicting health-related quality of life (HRQoL). A convenience sample of N = 200 chronic heart failure (CHF) patients was recruited at cardiology centers in Germany (n = 100) and Pakistan (n = 100). Results indicated that trait-EI predicted better mental component of HRQoL in Pakistani and German CHF patients. Friends as social support appeared relevant for German patients only. Qualitative data indicate an internal locus of control in German as compared to Pakistani patients. Strengthening the beneficial role of social support in Pakistani patients is one example of how the current findings may inspire culture-specific treatment to empower patients dealing with the detrimental effects of CHF. KW - cross-cultural comparison KW - chronic heart failure KW - religion KW - social support KW - trait emotional intelligence KW - health-related quality of life Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-232823 SN - 0022-4197 VL - 61 IS - 1 ER -