152 Sinneswahrnehmung, Bewegung, Emotionen, Triebe
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Transkraniale Gleichstromstimulation (tDCS) stellt eine neue Therapieoption für Patienten mit neurologischen und psychiatrischen Erkrankungen dar. tDCS ist eine nichtinvasive Methode, mit der das Membranpotential von Nervenzellen verändert wird. Eine Depolarisation führt zu einer Erhöhung des Potentials, eine Hyperpolarisation bewirkt eine Senkung. Diesen neuromodulatorischen Effekt hat man sich in der vorliegenden Arbeit zunutze gemacht.
Im Versuchsaufbau wurde die Modulation von „sustained fear“ durch tDCS getestet. Das angewandte Paradigma ist nach dem Prinzip des NPU-Tests von Grillon aufgebaut. Mithilfe von vorhersehbaren und unvorhersehbaren aversiven Reizen (menschlicher Schrei) ist eine Einschätzung von kurz- („phasic“) und langanhaltenden („sustained“) Angstreaktionen möglich. Der Startle Reflex wurde zur Erfassung dieses Angstzustands aufgezeichnet. Gesunde Probanden (n=74) erfuhren eine 20-minütige tDCS Stimulation mit einer Stromstärke von 1 mA bei einer Elektrodengröße von 35 cm². Es ergab sich somit eine Stromdichte von 0,0286 mA/cm².
Es konnte ein signifikanter Effekt von tDCS auf „sustained fear“ nachgewiesen werden. Die neuromodulatorische Wirkung stellte sich bei anodaler Stimulation durch veränderte Startle Statistiken im Vergleich zur Sham Kontrollgruppe dar. „Phasic fear“ zeigte keine nachweisbare Wirkung der Gleichstromstimulation.
Gegenstand der Arbeit war außerdem die Untersuchung des Paradigmas zur Analyse von „phasic“ und „sustained fear“ auf subjektiver und psychophysiologischer Ebene. Mithilfe von Startle Daten und dreier spezieller Fragebögen war dies möglich (STAI X1, PANAS, SAM).
Die Startle Daten bewiesen eine Einflussnahme der Bedingungen (vorhersehbar, unvorhersehbar, neutral). Zudem war der Reflex davon abhängig, ob den Probanden eine Vorwarnung angezeigt wurde (ITI, Cue). Eine Vorankündigung der aversiven Reize bewirkte eine erhöhte Anspannung, weshalb die Startle Reaktion bei der vorhersehbaren Bedingung am stärksten ausfiel. Ohne Vorwarnung (ITI) war die durchschnittliche Reaktion auf einen unvorhersehbaren Schrei am größten. Nicht angekündigte Stimuli lösten eine starke Stressreaktion aus, woraufhin eine anhaltende Alarmbereitschaft bei den Probanden entstand. „Sustained fear“ ergab sich aus den unvorhersehbaren Bedingungen mit und ohne Warnhinweise (ITI U-Cue U).
Nach subjektiver Einschätzung der Versuchsteilnehmer/-innen bestätigte der STAI X1 und der PANAS einen Anstieg der emotionalen Anspannung durch das Paradigma. Der psychologische Einfluss des Paradigmas spiegelte sich auch im Rating des SAM-Tests wider. Vor allem der Effekt vorhersehbarer und unvorhersehbarer Ereignisse ergab übereinstimmend signifikante Werte, analog zu den Startle Daten.
Die statistische Auswertung zeigt Erfolg versprechende Ansätze in Bezug auf den Einfluss der Gleichstromstimulation auf das Angstverhalten. Durch den Versuchsaufbau einer plazebokontrollierten, randomisierten Doppelblindstudie kann von sehr verlässlichen Ergebnissen mit großer Aussagekraft ausgegangen werden.
Die nachgewiesene tDCS Wirkung gilt es nun anhand weiterführender Studien genauer zu untersuchen. Variable Parameter wie Stromintensität, Stimulationsdauer, Elektrodengröße und -position, aber auch interindividuelle Aspekte wie Alter, Geschlecht oder genetische Unterschiede müssen in Vergleichsuntersuchungen möglicherweise mit einem größeren Probandenkollektiv überprüft werden. Darüber hinaus wurde die Studie zunächst an gesunden Probanden getestet. Für eine Anwendung von tDCS bei Angststörungen müssen gesondert Versuche durchgeführt werden.
Die Daten liefern einen wichtigen Beitrag zur tDCS Forschung und haben weitreichende Bedeutung für die Entwicklung neuer Therapiemöglichkeiten im klinischen Alltag.
Background
In this study, we evaluated electrooculography (EOG), an eye tracker and an auditory brain-computer interface (BCI) as access methods to augmentative and alternative communication (AAC). The participant of the study has been in the locked-in state (LIS) for 6 years due to amyotrophic lateral sclerosis. He was able to communicate with slow residual eye movements, but had no means of partner independent communication. We discuss the usability of all tested access methods and the prospects of using BCIs as an assistive technology.
Methods
Within four days, we tested whether EOG, eye tracking and a BCI would allow the participant in LIS to make simple selections. We optimized the parameters in an iterative procedure for all systems.
Results
The participant was able to gain control over all three systems. Nonetheless, due to the level of proficiency previously achieved with his low-tech AAC method, he did not consider using any of the tested systems as an additional communication channel. However, he would consider using the BCI once control over his eye muscles would no longer be possible. He rated the ease of use of the BCI as the highest among the tested systems, because no precise eye movements were required; but also as the most tiring, due to the high level of attention needed to operate the BCI.
Conclusions
In this case study, the partner based communication was possible due to the good care provided and the proficiency achieved by the interlocutors. To ease the transition from a low-tech AAC method to a BCI once control over all muscles is lost, it must be simple to operate. For persons, who rely on AAC and are affected by a progressive neuromuscular disease, we argue that a complementary approach, combining BCIs and standard assistive technology, can prove valuable to achieve partner independent communication and ease the transition to a purely BCI based approach. Finally, we provide further evidence for the importance of a user-centered approach in the design of new assistive devices.
Experienzielle Kommunikation. Wie kann soziales Miteinander in komplexen Situationen gelingen?
(2016)
Wie ist im „Chaos“ der Postmoderne ein soziales Miteinander möglich, das Stabilität und Halt bietet und in dem sich Individuen dennoch in ihrer Autonomie völlig frei entfalten können?
Tony Hofmann skizziert in seiner Dissertation Antworten auf diese essenzielle Frage. Das Herzstück des Buches, das „Prozessmodell der experienziellen Kommunikation“, zeichnet sich durch eine achtsamkeitsorientierte, körper- und erlebensbezogene Grundhaltung aus (Focusing). Menschen, die experienziell kommunizieren, erleben
• Kongruenz der eigenen Intention mit den tatsächlichen, ausgesprochenen Worten (Ich - Ich),
• ein schöpferisches Potenzial im Kontakt mit dem jeweiligen Gegenüber (Ich - Du) und
• die Freiheit, auf die (oft unvorhersehbare) Eigendynamik eines Gesprächs aktiv Bezug nehmen zu können (Ich - Es/Wir).
Hiervon ausgehend werden pädagogische Prinzipien und konkrete Fragesätze abgeleitet, die in der Praxis anwendbar sind. Sie ermöglichen eine stimmige Bezogenheit aufeinander, bei der Gegensätze zur Ressource werden.
Die Arbeit richtet sich an Kolleginnen und Kollegen, die an Hochschulen, aber auch in pädagogischen, sonderpädagogischen und psychosozialen Praxisfeldern tätig sind, und die ein Interesse daran haben, ein eindeutiges und klar kommunizierbares fachliches Profil, sowie persönliche Stimmigkeit im beruflichen Handeln zu entwickeln.
Anxiety is an affective state characterized by a sustained, long-lasting defensive response, induced by unpredictable, diffuse threat. In comparison, fear is a phasic response to predictable threat. Fear can be experimentally modeled with the help of cue conditioning. Context conditioning, in which the context serves as the best predictor of a threat due to the absence of any conditioned cues, is seen as an operationalization of sustained anxiety.
This thesis used a differential context conditioning paradigm to examine sustained attention processes in a threat context compared to a safety context for the first time. In three studies, the attention mechanisms during the processing of contextual anxiety were examined by measuring heart rate responses and steady-state-visually evoked potentials (ssVEPs). An additional focus was set on the processing of social cues (i.e. faces) and the influence of contextual information on these cues. In a last step, the correlates of sustained anxiety were compared to evoked responses by phasic fear, which was realized in a previously established paradigm combining predictable and unpredictable threat.
In the first study, a contextual stimulus was associated with an aversive loud noise, while a second context remained unpaired. This conditioning paradigm created an anxiety context (CTX+) and a safety context (CTX-). After acquisition, a social agent vs. an object was presented as a distractor in both contexts. Heart rate and cortical responses, with ssVEPs by using frequency tagging, to the contexts and the distractors were assessed. Results revealed enhanced ssVEP amplitudes for the CTX+ compared to the CTX− during acquisition and during presentation of distractor stimuli. Additionally, the heart rate was accelerated in the acquisition phase, followed by a heart rate deceleration as a psychophysiological marker of contextual anxiety.
Study 2 used the same context conditioning paradigm as Study 1. In contrast to the first study, persons with different emotional facial expressions were presented in the anxiety and safety contexts in order to compare the differential processing of these cues within periods of threat and safety. A similar anxiety response was found in the second study, although only participants who
Abstract
VIII
were aware of the contingency between contexts and aversive event showed a sensory amplification of the threat context, indicated by heart rate response and ssVEP activation. All faces irrespective of their emotional expression received increased attentional resources when presented within the anxiety context, which suggests a general hypervigilance in anxiety contexts.
In the third study, the differentiation of predictable and unpredictable threat as an operationalization of fear and anxiety was examined on a cortical and physiological level. In the predictable condition, a social cue was paired with an aversive event, while in the unpredictable condition the aversive event remained unpaired with the respective cue. A fear response to the predictable cue was found, indicated by increased oscillatory response and accelerated heart rate. Both predictable and unpredictable threat yielded increased ssVEP amplitudes evoked by the context stimuli, while the response in the unpredictable context showed longer-lasting ssVEP activation to the threat context.
To sum up, all three studies endorsed anxiety as a long-lasting defensive response. Due to the unpredictability of the aversive events, the individuals reacted with hypervigilance in the anxiety context, reflected in a facilitated processing of sensory information and an orienting response. This hypervigilance had an impact on the processing of novel cues, which appeared in the anxiety context. Considering the compared stimuli categories, the stimuli perceived in a state of anxiety received increased attentional resources, irrespective of the emotional arousal conveyed by the facial expression. Both predictable and unpredictable threat elicited sensory amplification of the contexts, while the response in the unpredictable context showed longer-lasting sensory facilitation of the threat context.
No abstract available.
Biased cognitive processes are very likely involved in the maintenance of fears and anxiety. One of such cognitive processes is the perceived relationship between fear-relevant stimuli and aversive consequences. If this relationship is perceived although objective contingencies have been random, it is called an (a posteriori) illusory correlation. If this relationship is overestimated before objective contingencies are experienced, it is called an (a priori) expectancy bias. Previous investigations showed that fear-relevant illusory correlations exist, but very few is known about how and why this cognitive bias develops. In the present dissertation thesis, a model is proposed based on a review of the literature on fear-relevant illusory correlations. This model describes how psychological factors might have an influence on fear and illusory correlations. Several critical implications of the model were tested in four experiments.
Experiment 1 tested the hypothesis that people do not only overestimate the proportion of aversive consequences (startle sounds) following emotionally negative stimuli (pictures of mutilations) relative to neutral stimuli (pictures of household objects), but also following highly arousing positive stimuli (pictures of erotic scenes), because arousal might be an important determinant of illusory correlations. The result was a significant expectancy bias for negative stimuli and a much smaller expectancy bias for positive stimuli. Unexpectedly, expectancy bias was restricted to women. An a posteriori illusory correlation was not found overall, but only in those participants who perceived the aversive consequences following negative stimuli as particularly aversive.
Experiment 2 tested the same hypothesis as experiment 1 using a paradigm that evoked distinct basic emotions (pictures inducing fear, anger, disgust or happiness). Only negative emotions resulted in illusory correlations with aversive outcomes (startle sounds), especially the emotions of fear and disgust. As in experiment 1, the extent of these illusory correlations was correlated with the perceived aversiveness of aversive outcomes. Moreover, only women overestimated the proportion of aversive outcomes during pictures that evoked fear, anger or disgust.
Experiment 3 used functional Magnetic Resonance Imaging (fMRI) to measure biased brain activity in female spider phobics during an illusory correlation paradigm. Both spider phobics and healthy controls expected more aversive outcomes (painful electrical shocks) following pictures of spiders than following neutral control stimuli (pictures of mushrooms). Spider phobics but not healthy controls overestimated the proportion of aversive outcomes following pictures of spiders in a trial-by-trial memory task. This a posteriori illusory correlation was correlated with enhanced shock aversiveness and activity in primary sensory-motor cortex in phobic participants. Moreover, spider phobics’ brain activity in the left dorsolateral prefrontal cortex was elevated in response to spider images. This activity also predicted the extent of the illusory correlation, which supports the theory that executive and attentional resources play an important role in the maintenance of illusory correlations.
Experiment 4 tested the hypothesis that the enhanced aversiveness of some outcomes would be sufficient to causally induce an illusory correlation. Neutral images (colored geometric figures) were paired with differently aversive outcomes (three startle sounds varying in intensity). Participants developed an illusory correlation between those images, which predicted the most aversive sound and this sound, which means that this association was overestimated relative to the other associations. The extent of the illusory correlation was positively correlated with participants’ self-reported anxiety. The results imply that the previously found relationship between illusory correlations and outcome aversiveness might reflect a causal impact of outcome aversiveness or salience on illusory correlations.
In sum, the conducted experiments indicate that illusory correlations between fear-relevant stimuli and aversive consequences might persist – among other factors - because of an enhanced aversiveness or salience of aversive consequences following feared stimuli. This assumption is based on correlational findings, a neural measure of outcome perception and a causal influence of outcome aversiveness on illusory correlations. Implications of these findings were integrated into a model of fear-relevant illusory correlations and potential implications are discussed. Future investigations should further elucidate the role of executive functions and gender effects. Moreover, the trial-by-trial assessment of illusory correlations is recommended to increase reliability of the concept. From a clinical perspective, the down-regulation of aversive experiences and the allocation of attention to non-aversive experiences might help to cure anxiety and cognitive bias.
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.
The perception of unpleasant stimuli enhances whereas the perception of pleasant stimuli decreases pain perception. In contrast, the effects of pain on the processing of emotional stimuli are much less known. Especially given the recent interest in facial expressions of pain as a special category of emotional stimuli, a main topic in this research line is the mutual influence of pain and facial expression processing. Therefore, in this mini-review we selectively summarize research on the effects of emotional stimuli on pain, but more extensively turn to the opposite direction namely how pain influences concurrent processing of affective stimuli such as facial expressions. Based on the motivational priming theory one may hypothesize that the perception of pain enhances the processing of unpleasant stimuli and decreases the processing of pleasant stimuli. This review reveals that the literature is only partly consistent with this assumption: pain reduces the processing of pleasant pictures and happy facial expressions, but does not – or only partly – affect processing of unpleasant pictures. However, it was demonstrated that pain selectively enhances the processing of facial expressions if these are pain-related (i.e., facial expressions of pain). Extending a mere affective modulation theory, the latter results suggest pain-specific effects which may be explained by the perception-action model of empathy. Together, these results underscore the important mutual influence of pain and emotional face processing.