Christine Schneider

Publications of Christine Schneider

• Clinical significance of sleep bruxism on several occlusal and functional parameters.

  Authors: Michelle A Ommerborn, Maria Giraki, Christine Schneider, Lars Michael Fuck, Stefan Zimmer, Matthias Franz, Wolfgang Hans-michael Raab, Ralf Schaefer

  Cranio : the journal of craniomandibular practice. 10/2010; 28(4):238-48.

  The aim of this study was to evaluate the association between various functional and occlusal parameters and sleep bruxism. Thirty-nine (39) sleep bruxism patients and 30 controls participated inThe aim of this study was to evaluate the association between various functional and occlusal parameters and sleep bruxism. Thirty-nine (39) sleep bruxism patients and 30 controls participated in this investigation. The assessment of sleep bruxism was performed using the Bruxcore Bruxism-Monitoring Device (BBMD) combined with a new computer-based analyzing method. Sixteen functional and/or occlusal parameters were recorded. With a mean slide of 0.95 mm in the sleep bruxism group and a mean slide of 0.42 mm in the control group (Mann Whitney U test; p<0.003), results solely demonstrated a significant group difference regarding the length of a slide from centric occlusion to maximum intercuspation. The results suggest that the slightly pronounced slide could be of clinical importance in the development of increased wear facets in patients with current sleep bruxism activity. Following further evaluation including polysomnographic recordings, the BBMD combined with this new analyzing technique seems to be a clinically feasible instrument that allows the practitioner to quantify abrasion over a short period.

• Correlation between stress, stress-coping and current sleep bruxism.

  Authors: Maria Giraki, Christine Schneider, Ralf Schäfer, Preeti Singh, Matthias Franz, Wolfgang H M Raab, Michelle A Ommerborn

  Head & face medicine. 03/2010; 6:2.

  Stress is discussed as a potential factor in the development of sleep bruxism (SB). The aim of this study was to investigate whether specific stress-factors correlate with SB-activity. Sixty-nineStress is discussed as a potential factor in the development of sleep bruxism (SB). The aim of this study was to investigate whether specific stress-factors correlate with SB-activity. Sixty-nine subjects, of which 48 were SB-patients, completed three German questionnaires assessing different stress-parameters and stress-coping-strategies: Short questionnaire for recognition of stress-factors (Kurzer Fragebogen zur Erfassung von Belastungen, KFB), Questionnaire for recuperation and strain (Erholungs-Belastungs-Fragebogen, EBF-24 A/3) and the stress-coping questionnaire (Stressverarbeitungsfragebogen-78, SVF-78). The diagnosis of SB was based on the clinical criteria of the American Academy of Sleep Medicine (AASM). The degree of SB-activity was measured by the Bruxcore-Bruxism-Monitoring-Device (BBMD, Bruxcore, Boston, USA), worn for five consecutive nights and analyzed using a computer-based method. Non-parametric Spearman correlation coefficients, rho, were calculated between the psychometric data and the amount of SB-activity measured by a pixel score of the BBMD. Significant correlations were found for 'daily problems' (r = 0.461, p < 0.01), 'trouble at work' (r = 0.293), 'fatigue' (r = 0.288), 'physical problems' (r = 0.288) and the coping-strategy 'escape' (r = 0.295) (all p < 0.05). Within the limitations of this study it could be shown that subjects with high SB-activity tend to feel more stressed at work and in their daily life, which in turn might influence their physical state. These subjects also seem to deal with stress in a negative way. However, due to the rather low to almost moderate correlation coefficients and the descriptive character of the study, further investigations are necessary to examine a possible causal relationship.

• Correlation between stress, stress-coping and current sleep bruxism

  Authors: Maria Giraki, Christine Schneider, Ralf Schäfer, Preeti Singh, Matthias Franz, Wolfgang Raab, Michelle Ommerborn

  Head & Face Medicine. 01/2010;

  Abstract Background Stress is discussed as a potential factor in the development of sleep bruxism (SB). The aim of this study was to investigate whether specific stress-factors correlate withAbstract Background Stress is discussed as a potential factor in the development of sleep bruxism (SB). The aim of this study was to investigate whether specific stress-factors correlate with SB-activity. Methods Sixty-nine subjects, of which 48 were SB-patients, completed three German questionnaires assessing different stress-parameters and stress-coping-strategies: Short questionnaire for recognition of stress-factors (Kurzer Fragebogen zur Erfassung von Belastungen, KFB), Questionnaire for recuperation and strain (Erholungs-Belastungs-Fragebogen, EBF-24 A/3) and the stress-coping questionnaire (Stressverarbeitungsfragebogen-78, SVF-78). The diagnosis of SB was based on the clinical criteria of the American Academy of Sleep Medicine (AASM). The degree of SB-activity was measured by the Bruxcore-Bruxism-Monitoring-Device (BBMD, Bruxcore, Boston, USA), worn for five consecutive nights and analyzed using a computer-based method. Non-parametric Spearman correlation coefficients, rho, were calculated between the psychometric data and the amount of SB-activity measured by a pixel score of the BBMD. Results Significant correlations were found for 'daily problems' (r = 0.461, p < 0.01), 'trouble at work' (r = 0.293), 'fatigue' (r = 0.288), 'physical problems' (r = 0.288) and the coping-strategy 'escape' (r = 0.295) (all p < 0.05). Conclusions Within the limitations of this study it could be shown that subjects with high SB-activity tend to feel more stressed at work and in their daily life, which in turn might influence their physical state. These subjects also seem to deal with stress in a negative way. However, due to the rather low to almost moderate correlation coefficients and the descriptive character of the study, further investigations are necessary to examine a possible causal relationship.

• [Factor structure and reliability of the Toronto Alexithymia Scale (TAS-20) in the German population]

  Authors: Kerstin Popp, Ralf Schäfer, Christine Schneider, Elmar Brähler, Oliver Decker, Jochen Hardt, Matthias Franz

  Psychotherapie, Psychosomatik, medizinische Psychologie. 06/2008; 58(5):208-14.

  The 20-item Toronto Alexithymia Scale (TAS-20) is the most widely used instrument in alexithymia measurement. In the present study the original factor structure of the Canadian population is comparedThe 20-item Toronto Alexithymia Scale (TAS-20) is the most widely used instrument in alexithymia measurement. In the present study the original factor structure of the Canadian population is compared with two other factor structures extracted from a representative German population (n = 1859) with maximum likelihood confirmatory factor analysis (CFA). A three-factor-model with the factors "difficulties in identifying and describing feelings", "external oriented thinking" and "importance of emotional introspection" described the data best and most reliable, anyway none of the models met all criteria of CFA. This model is different from the Canadian original model, but describes alexithymia just as well.

• Alexithymia in the German general population.

  Authors: Matthias Franz, Kerstin Popp, Ralf Schaefer, Wolfgang Sitte, Christine Schneider, Jochen Hardt, Oliver Decker, Elmar Braehler

  Social psychiatry and psychiatric epidemiology. 02/2008; 43(1):54-62.

  The Toronto-Alexithymia-Scale (TAS-20) is used worldwide as a valid measurement of alexithymia. Until now, population-based standardization and cut-off values of the German TAS-20 version have notThe Toronto-Alexithymia-Scale (TAS-20) is used worldwide as a valid measurement of alexithymia. Until now, population-based standardization and cut-off values of the German TAS-20 version have not been available. This study provides these by means of a representative German sample and by investigating the factorial structure of the TAS-20. Data were generated from a representative random sample of the German general population (1,859 subjects aged between 20 and 69). The TAS-20 sum score was normally distributed. The mean value was 49.5 (SD=9.3) in men and 48.2 (SD=9.2) in women. Divorce, single and low social status were associated with enhanced sum scores. Ten percent of the population exceeded the TAS-20 sum score threshold of >or=61. The 66th percentile reached 53 for men and 52 for women. Factor analysis identified three factors that match the scales of the English original version. An additional fourth factor ("importance of emotional introspection") was extracted. Total explanation of variance by these four factors was 52.27%. The sum score of the German TAS-20 version is suited for the standardized measure of alexithymia. For selecting alexithymic individuals in experimental studies, the cut-off >or=61 is possibly too restrictive. Therefore, we propose the 66th percentile for the identification of high alexithymics. The TAS-20 sum score is associated with important socio-demographic variables. The factorial structure is reliable; the fourth factor ("importance of emotional introspection") provides differentiation of content and allows for enhanced explanation of variance.

• Cortical augmenting in alexithymic subjects after unpleasant acoustic stimulation.

  Authors: Ralf Schäfer, Christine Schneider, Wolfgang Tress, Matthias Franz

  Journal of psychosomatic research. 11/2007; 63(4):357-64.

  OBJECTIVE: Alexithymia has a high prevalence in patients with chronic or somatoform pain disorders. Various investigations demonstrated a hypersensitivity and low tolerance of alexithymics to touchOBJECTIVE: Alexithymia has a high prevalence in patients with chronic or somatoform pain disorders. Various investigations demonstrated a hypersensitivity and low tolerance of alexithymics to touch and painful stimulation. It was argued that alexithymic characteristics may lead an individual to augment stimuli in order to prevent ignoring stimuli that might be dangerous. Therefore, there may be a relation to the reducer-augmenter construct. To test this hypothesis, cortical reactivity in response to unpleasant acoustical stimulation was measured. METHODS: Nineteen high alexithymics and 18 low alexithymics were stimulated with five series of acoustic stimuli (white noise) of different intensity levels. Evoked potentials were recorded at electroencephalogram electrodes Fz, Cz, and Pz. RESULTS: With ascending stimulus intensities, both groups showed increasing P1-N1 and N1-P2 peak-to-peak amplitudes. High alexithymics had higher P1-N1 amplitudes and a stronger intensity-dependent slope of P1-N1 amplitude. In contrast to that, N1-P2 amplitude of low alexithymics tended to decrease in response to the highest stimulus intensity level. CONCLUSION: High alexithymic subjects seem to behave like cortical augmenters. This may be due to a disturbed transmarginal inhibition, which may normally serve as a protective physiological mechanism.

• In vivo evaluation of noncarious cervical lesions in sleep bruxism subjects.

  Authors: Michelle A Ommerborn, Christine Schneider, Maria Giraki, Ralf Schafer, Preeti Singh, Matthias Franz, Wolfgang H-M Raab

  The Journal of prosthetic dentistry. 09/2007; 98(2):150-8.

  STATEMENT OF PROBLEM: Occlusal load has frequently been suggested to be involved in the development of a noncarious cervical lesion (NCL). However, there is a lack of clinical studies evaluating NCLsSTATEMENT OF PROBLEM: Occlusal load has frequently been suggested to be involved in the development of a noncarious cervical lesion (NCL). However, there is a lack of clinical studies evaluating NCLs and occlusal parameters in sleep bruxism (SB) subjects. PURPOSE: The purpose of this clinical study was to assess the frequency of NCLs and determine potential occlusal differences between SB subjects and healthy control subjects. MATERIAL AND METHODS: A total of 91 volunteers, 58 women and 33 men, with a mean (SD) age of 28.37 (4.89) years (range of 20 to 39 years), participated in this investigation. The clinical assessment of SB was based on the criteria of the American Academy of Sleep Medicine. The participants were divided into 2 groups; 58 subjects were assigned to the SB group and 33 subjects to the control group, following a thorough dental examination that was performed by a single trained dentist. Additionally, the following parameters were recorded: mean number of teeth present, existence/absence of NCLs, frequency of NCLs relating to the type of tooth, type of occlusal guidance scheme, existence of a slide from centric occlusion (CO) to maximum intercuspation (MI), length of the slide, and report of tooth hypersensitivity. Group differences were statistically analyzed using chi-square tests for the qualitative variables and Mann-Whitney U tests for the quantitative variables (alpha=.05). RESULTS: NCLs were significantly more prevalent in SB subjects (39.7%) than in the control subjects (12.1%) (P=.006). In SB subjects, the first premolars were the teeth most affected, and in control subjects, the first molars were most affected. Tooth hypersensitivity was reported in 62.1% of the SB subjects and in 36.4% of the control subjects (P=.018). The evaluation of occlusal guidance schemes revealed no significant difference between the groups. In SB subjects (70.7%), a slide from CO to MI was significantly more prevalent than in control subjects (42.4%) (P=.008). Moreover, SB subjects demonstrated a significantly longer mean (SD) slide of 0.77 (0.69) mm compared to that of control subjects of 0.4 (0.57) mm (P=.008). CONCLUSIONS: Within the limitations of this study, SB subjects demonstrated significantly more NCLs than the control group; whereas, the type of occlusal guidance scheme seems to be of minor importance in the development of NCLs.

• Effects of an occlusal splint compared with cognitive-behavioral treatment on sleep bruxism activity.

  Authors: Michelle A Ommerborn, Christine Schneider, Maria Giraki, Ralf Schäfer, Jörg Handschel, Matthias Franz, Wolfgang H-M Raab

  European journal of oral sciences. 03/2007; 115(1):7-14.

  The impact of an occlusal splint (OS) compared with cognitive-behavioral treatment (CBT) on the management of sleep bruxism (SB) has been poorly investigated. The aim of this study was to evaluateThe impact of an occlusal splint (OS) compared with cognitive-behavioral treatment (CBT) on the management of sleep bruxism (SB) has been poorly investigated. The aim of this study was to evaluate the efficacy of an OS with CBT in SB patients. Following a randomized assignment, the OS group consisted of 29, and the CBT group of 28, SB patients. The CBT comprised problem-solving, progressive muscle relaxation, nocturnal biofeedback, and training of recreation and enjoyment. The treatment took place over a period of 12 wk, and the OS group received an OS over the same time period. Both groups were examined pretreatment, post-treatment, and at 6 months of follow-up for SB activity, self-assessment of SB activity and associated symptoms, psychological impairment, and individual stress-coping strategies. The analyses demonstrated a significant reduction in SB activity, self-assessment of SB activity, and psychological impairment, as well as an increase of positive stress-coping strategies in both groups. However, the effects were small and no group-specific differences were seen in any dependent variable. This is an initial attempt to compare CBT and OS in SB patients, and the data collected substantiate the need for further controlled evaluations, using a three-group randomized design with repeated measures to verify treatment effects.

• Maladaptive coping strategies in patients with bruxism compared to non-bruxing controls.

  Authors: Christine Schneider, Ralf Schaefer, Michelle A Ommerborn, Maria Giraki, Alexandra Goertz, Wolfgang H-M Raab, Matthias Franz

  International journal of behavioral medicine. 02/2007; 14(4):257-61.

  BACKGROUND: Sleep bruxism is the non-functional grinding or clenching of teeth during sleep. It may lead to tooth damage and myofascial pain. Although stress is discussed as a main causal agent,BACKGROUND: Sleep bruxism is the non-functional grinding or clenching of teeth during sleep. It may lead to tooth damage and myofascial pain. Although stress is discussed as a main causal agent, there is a lack of studies concerning coping strategies in patients with sleep bruxism. PURPOSE: The aim of the present study was to investigate whether bruxers, compared to non-bruxing individuals, apply maladaptive coping strategies. METHOD: Seventy-five sleep bruxers and 38 non-bruxers were selected by dental examination and tested by a German coping questionnaire (SVF78). RESULTS: A significant difference in positive coping strategies was observed between the two groups. Bruxers reported less positive coping strategies, mainly less "reaction control" and "positive self-instructions." In general, males reported less negative coping strategies. CONCLUSION: The reported effects demonstrate a deficit of functional coping strategies in bruxers, whereas strategies that enhance stress do not seem to be associated with sleep bruxism. Findings do not admit the conclusion that there is a causal association of maladaptive coping and bruxism. However, they support the approach of a multidisciplinary therapy involving psychological treatment.

• A new analyzing method for quantification of abrasion on the Bruxcore device for sleep bruxism diagnosis.

  Authors: Michelle A Ommerborn, Maria Giraki, Christine Schneider, Ralf Schaefer, Andreas Gotter, Matthias Franz, Wolfgang H-M Raab

  Journal of orofacial pain. 02/2005; 19(3):232-8.

  AIMS: To evaluate a newly developed semi-automatic computer-based method to analyze the objectivity of the Bruxcore Bruxism-Monitoring Device (BBMD) by assessing the interrater reliability. TheAIMS: To evaluate a newly developed semi-automatic computer-based method to analyze the objectivity of the Bruxcore Bruxism-Monitoring Device (BBMD) by assessing the interrater reliability. The capability of the BBMD to differentiate between sleep bruxers (SB) and healthy controls was also verified by estimating the sensitivity, specificity, and predictive values. METHODS: Forty-eight SB and 21 controls took part in this investigation. After a detailed clinical dental examination, each participant received a BBMD to be worn for 5 consecutive nights. The BBMDs were then scanned and rated by 2 independent examiners using the new method, which counted the abraded area in pixels. Interrater reliability was assessed by intraclass correlation coefficient (ICC) analyses. RESULTS: The analyses showed a very high interrater reliability of ICC = 0.99, and comparison of the mean pixel scores revealed values that were approximately 8 times higher for the SB than for the controls. With a selected pixel score cutoff point of 2900, a sensitivity of 79.2% and a specificity of 95.2% were found. The clinical diagnosis was correctly predicted in 97.4% of the SB and 66.7% of the controls. CONCLUSION: The results support the assumption that the newly developed analyzing method for the assessment of the BBMD is a clinically suitable, objective, and applicable method that seems to be able to differentiate between SB and a healthy control sample. These data, however, need to be confirmed in further investigations using polysomnographic recordings.

• Visual event-related potentials in subjects with alexithymia: modified processing of emotional aversive information?

  Authors: Matthias Franz, Ralf Schaefer, Christine Schneider, Wolfgang Sitte, Jessica Bachor

  The American journal of psychiatry. 05/2004; 161(4):728-35.

  OBJECTIVE: A modified autonomous response (e.g., electrodermal activity) in subjects with alexithymia (a reduced ability to identify and communicate emotions) while processing emotional informationOBJECTIVE: A modified autonomous response (e.g., electrodermal activity) in subjects with alexithymia (a reduced ability to identify and communicate emotions) while processing emotional information is well known. However, the functional and neurobiological bases of this impairment are unclear. Do subjects with alexithymia suffer from a primary lack of perception ("emotional blindness"), or is alexithymia based on incomplete information processing due to immature undifferentiated cognitive schemes? The study investigates if subjects with alexithymia show a modified central response as a correlate of classifying emotional aversive stimuli. METHOD: Twenty subjects with high alexithymia and 20 with low alexithymia (selected by the 20-item Toronto Alexithymia Scale) were investigated within a modified odd-ball paradigm. Three different stimulus categories were presented: aversive (probes) and affective neutral pictures (nontargets and instructed targets). Visual event-related EEG potentials and subjective data were recorded. RESULTS: All subjects showed elevated positive amplitudes or mean activity after probe presentation in the latency range: 150-260, 280-450, and 600-1500 msec. Subjects with alexithymia displayed increased positive components (especially P2) of visual event-related potentials after probe presentation than subjects without alexithymia. Subjects without alexithymia more frequently verbalized the emotional impact of these aversive pictures than subjects with alexithymia. CONCLUSIONS: These findings do not support the assumption of a primary lack of perception in alexithymia. Subjects with alexithymia show central correlates of perception and classification of aversive pictures. They may need more effort and cognitive recourses to process emotional information. Nevertheless, spontaneous verbal reference to emotional stimulus aspects is reduced.

• [Evidence of validity of the German version of the TAS-20. Contribution to the 52nd conference of the German Board of Psychosomatic Medicine in Bad Honnef (2001)]

  Authors: Ralf Schäfer, Christine Schneider, Wolfgang Sitte, Matthias Franz

  Psychotherapie, Psychosomatik, medizinische Psychologie. 12/2002; 52(11):449-53.

  419 patients (psychosomatic-C/L-service unit; neurotic spectrum, somatoform and personality disorders) were investigated by collecting data of clinical and psychometrical variables (SCL-90-R,419 patients (psychosomatic-C/L-service unit; neurotic spectrum, somatoform and personality disorders) were investigated by collecting data of clinical and psychometrical variables (SCL-90-R, NEO-FFI, IIP-D). The aim was to evaluate whether the sum score and the three factors of the German 20-item-version of the Toronto-Alexithymia-Scale (TAS-20) postulated by Bagby correlate with other clinical variables in a convergent way. The TAS-20 sum score and the factors (F1) "Difficulties identifying feelings" and (F2) "Difficulties describing one's feelings" correlated convergently with the NEO-FFI-scales "neuroticism" and "openness for new experiences", with numerous scales of the SCL-90-R, as well as with the scales "cool/repelling" and "introverted/social avoiding" interaction style of the IIP-D. Factor (F3) "Externally oriented thinking" correlated with "Extraversion" but was not related to clinical impairment (SCL-90 R). The results could be interpreted in terms of convergent validity of the TAS-20. In addition, alexithymic patients seem to be impaired with respect to interpersonal communication and they are subjectively able to perceive appreciate this restriction.