Ulrich Ebner-Priemer

Karlsruhe Institute of Technology, Carlsruhe, Baden-Württemberg, Germany

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Publications (51)149.58 Total impact

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    ABSTRACT: Emotional lability (EL), characterized by negative emotional traits and emotional instability, is frequently reported in children and adults with attention deficit hyperactivity disorder (ADHD). However, EL is primarily assessed using retrospective self-report, which is subject to reporting bias and does not consider the potential influence of positive and negative everyday experiences.
    Psychological Medicine 12/2014; 44(16):3571-83. · 5.59 Impact Factor
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    Mario Wenzel, Thomas Kubiak, Ulrich Ebner-Priemer
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    ABSTRACT: Ambulatory Assessment (AA) comprises the use of in-field methods to assess individuals’ behavior, physiology, and the experience as they unfold in naturalistic settings. We propose that AA is favorable for the investigation of gene–environment interactions and for the search for endophenotypes, being able to assess the experienced environment and to track basic regulatory processes, such as stress reactivity, affective instability, and reward experience, which are potential common factors that underlie psychiatric disorders.In this article, we (a) first describe briefly the rationale of AA and summarize the key advantages of the approach, (b) highlight within-subject regulatory processes, such as stress reactivity, affective instability, and reward experience, (c) describe studies that used AA to examine genetic influences in psychiatric disorders, and (d) briefly review longitudinal studies that have investigated phenotypes of psychiatric disorders.The reported studies yielded promising, although sometimes inconclusive evidence for genetic effects on endophenotypes of psychiatric disorders. Moreover, most studies were twin or family studies, especially in stress-sensitivity research; thus, it is unclear which specific single nucleotide polymorphisms contribute to the endophenotypes of psychiatric disorders. We do hope that within-subject regulatory processes will enable us to clarify the fundamental psychological dimensions that cut across traditional disorders and link them to their genetic underpinnings.
    Neuroscience Research. 11/2014;
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    ABSTRACT: Behavioral studies suggest a relationship between autobiographical memory, rumination, and depression. The objective of the current study was to determine whether remitted depressed patients show alterations in connectivity of the posterior cingulate cortex (PCC; a node in the default mode network) with the parahippocampal gyri (PHG; a region associated with autobiographical memory) while intensively recalling negative memories and whether this is related to daily life symptoms and to the further course of depression.Sad mood was induced with keywords of personal negative life events in participants with remitted depression (n=29) and matched healthy controls (n=29) during fMRI. Additionally, daily life assessments of mood and rumination and a six-months follow-up were conducted.Remitted depressed participants showed greater connectivity than healthy controls of the PCC with the PHG, which was even stronger in patients with more previous episodes. Furthermore, patients with increased PCC-PHG connectivity showed a sadder mood and more rumination in daily life, and a worsening of rumination and depression scores during follow-up.A relationship of negative autobiographical memory processing, rumination, sad mood, and depression on a neural level seems likely. The identified increased connectivity probably indicates a 'scar' of recurrent depression and may represent a prognostic factor for future depression.
    Social Cognitive and Affective Neuroscience 02/2014; · 5.04 Impact Factor
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    ABSTRACT: Affective instability is a core feature of borderline personality disorder (BPD). The use of advanced assessment methodologies and appropriate statistical analyses has led to consistent findings that indicate a heightened instability in patients with BPD compared with healthy controls. However, few studies have investigated the specificity of affective instability among patients with BPD with regard to relevant clinical control groups. In this study, 43 patients with BPD, 28 patients with posttraumatic stress disorder (PTSD), 20 patients with bulimia nervosa (BN), and 28 healthy controls carried e-diaries for 24 hours and were prompted to rate their momentary affective states approximately every 15 minutes while awake. To quantify instability, we used 3 state-of-the-art indices: multilevel models for squared successive differences (SSDs), multilevel models for probability of acute changes (PACs), and aggregated point-by-point changes (APPCs). Patients with BPD displayed heightened affective instability for emotional valence and distress compared with healthy controls, regardless of the specific instability indices. These results directly replicate earlier studies. However, affective instability did not seem to be specific to patients with BPD. With regard to SSDs, PACs, and APPCs, patients with PTSD or BN showed a similar heightened instability of affect (emotional valence and distress) to that of patients with BPD. Our results give raise to the discussion if affective instability is a transdiagnostic or a disorder-specific mechanism. Current evidence cannot answer this question, but investigating psychopathological mechanisms in everyday life across disorders is a promising approach to enhance validity and specificity of mental health diagnoses. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Journal of Abnormal Psychology 02/2014; 123(1):258-72. · 4.86 Impact Factor
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    ABSTRACT: Die Symptomatik einer Depression ist durch reduzierte emotionale Schwingungsfähigkeit, negative Kognitionen, sozialen Rückzug und negatives Selbstwerterleben charakterisiert. Es wird eine erhöhte Reaktivität auf negative Stimuli (negative potentiation) bzw. eine reduzierte Sensitivität auf den emotionalen Kontext (emotion context insensitivity) angenommen (z.B. Peeters et al., 2010). Ziel dieser Studie ist die Untersuchung der Stabilität bzw. Instabilität von Affekt und Selbstwerterleben bei Depression mittels Ambulantes Assessment im Kontext der stationären psychotherapeutischen Behandlung. Geplant ist die Rekrutierung von 50 Patientinnen der Schön-Klinik Roseneck (Prien am Chiemsee) mit mindestens mittelgradiger depressiver Episode (ICD-10 F32.1/.2 bzw. F33.1/.2), welche über einen viertägigen Zeitraum mit elektronischen Tagebüchern ausge-stattet werden. Dabei werden mehrfach täglich in Alltagssituationen das Selbstwerterleben mit einer Kurzform der Rosenberg Self Esteem Scale (SES) und die momentane Stimmung mit einer Kurzform des Mehrdimensionalen Befindlichkeitsfragebogens (MDBF) erfasst. Als Vergleichsgruppen dienen bereits vorliegende Daten von 46 Patientinnen mit Borderline-Persönlichkeitsstörung (ZI Mannheim) und 57 gesunden Kontrollen (KIT Karlsruhe). Es werden das laufende Projekt und erste Ergebnisse vorgestellt. Ambulantes Assessment bieten wesentliche Vorteile gegenüber möglicherweise bei der Un-tersuchung von Depressionen besonders relevanten Verzerrungen retrospektiver Selbstein-schätzungen (Ebner-Priemer & Trull, 2009; 2013). Neben der Untersuchung zentraler auf-rechterhaltender Faktoren der Depression erlaubt die vorliegende Studie die Erprobung von Ambulantem Assessment unter stationären Routinebedingungen.
    "Verhaltensmedizin: State of the Art - Von der Forschung zur Praxis" 14. Kongress der Deutschen Gesellschaft für Verhaltensmedizin und Verhaltensmodifikation, Prien am Chiemsee; 09/2013
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    ABSTRACT: Intrusions and flashbacks are core features of posttraumatic stress disorder (PTSD). The frequency of these symptoms is usually assessed through retrospective questionnaires, which may be subject to recall bias of unknown magnitude. Electronic diaries that enable real-time assessment have been used to address recall biases in several psychiatric disorders. However, to our knowledge, this is the first study to apply this method to assess intrusions and flashbacks in PTSD related to childhood sexual abuse (CSA). Female patients with PTSD related to CSA (n = 28) were provided with electronic diaries for repeated real-time assessment of intrusions and flashbacks over the period of 1 week. At the end of this period, they were asked to retrospectively report how many such symptoms they recalled having experienced over the past week. The total number of symptoms reported in the electronic diaries (74.5 ± 62.0 intrusions and 24.4 ± 36.0 flashbacks for the week) was substantially higher than those reported in previous studies. Furthermore, electronic diaries revealed the occurrence of about 50% more intrusions and flashbacks than did the retrospective assessment (74.5 vs. 49.5 for intrusions, and 24.4 vs. 13.4 for flashbacks). Such high frequencies are not captured with existing assessment instruments and suggest a possible ceiling effect. Future research needs to clarify whether these high numbers are specific to highly symptomatic PTSD patients or might generalize to other populations of PTSD patients. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
    Psychological Assessment 07/2013; · 2.99 Impact Factor
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    ABSTRACT: The influence of naturally occurring emotional and cognitive experiences on hypothalamic-pituitary-adrenal axis (HPAA) activity is still underinvestigated, particularly in clinical populations. The present study examined effects of mood and rumination on cortisol levels in daily life in remitted depressed patients with recurrent episodes or a chronic precourse (n=31) and healthy controls (n=32). Ambulatory assessment of subjective variables (valence, calmness, energetic-arousal, ruminative self-focus), daily stressors, and saliva cortisol samples was performed five times a day on two consecutive workdays, whereby cortisol was collected 20min after the subjective assessments. In addition, depressive symptoms and trait rumination (brooding, reflection) were measured retrospectively. Multilevel models revealed that remitted depressed patients showed lower cortisol activity compared to healthy controls. Depressive symptoms and trait rumination did not predict HPAA activity, whereas, by controlling for daily stressors, higher daily means of ruminative self-focus and lower daily means of valence, energetic arousal and calmness were associated with higher daily cortisol levels. Separate analyses per group revealed that mean daily ruminative self-focus predicted higher cortisol in both samples. In contrast, lower daily means of calmness, but also of valence and energetic arousal, were significantly linked to higher cortisol output only in healthy controls, but not in the patient sample. These findings indicate that naturally occurring rumination and low mood are associated with increased activation of the HPAA in daily life. Moreover, our data revealed a potentially reduced mood-cortisol coupling in remitted recurrent depression, possibly indicating that during the course of recurrent depression HPAA activation might become less responsive toward subtle emotional experiences in natural contexts.
    Psychoneuroendocrinology 05/2013; 38(10):2258-2267. · 5.59 Impact Factor
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    ABSTRACT: BACKGROUND AND OBJECTIVES: Rumination has been proposed as a risk factor for depression, while mindful attention might be protective. Differential effects of these attention foci have so far only been examined in the laboratory. Therefore, we conducted an experimental ambulatory assessment study using ruminative and mindful attention inductions in everyday life to examine their effects in a natural context. METHODS: Fifty young adults carried palmtops over three weekdays (rumination induction day, mindful attention induction day, noninduction day; randomized cross-over design). Ten times a day, participants rated ruminative self-focus and mood. On the induction days, they were additionally subjected to 3-min inductions of ruminative or mindful attention at each assessment. RESULTS: The two induction modes exhibited differential immediate effects on ruminative self-focus and mood. While induced rumination immediately deteriorated valence and calmness, induced mindful attention specifically enhanced calmness. Depressive symptoms did not moderate these effects. While overall longer term effects of the inductions were missing, the mindful attention day was associated with slightly increasing positive valence over the day. LIMITATIONS: The results need to be replicated in high-risk and patient samples to demonstrate the clinical significance of identified effects. CONCLUSIONS: Results confirm the emotional relevance of rumination and mindful attention in real world settings. Future work may test whether adaptive attention-focusing instructions delivered in daily life can support clinical interventions.
    Journal of Behavior Therapy and Experimental Psychiatry 02/2013; 44(3):322-328. · 2.23 Impact Factor
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    ABSTRACT: Regularly conducted exercise programs effectively influence affective states. Studies suggest that this is also true for short bouts of physical activity (PA) of 10 min or less. Accordingly, everyday life activities of short duration might be used to regulate affective states. However, this association has rarely been studied in reference to unstructured activities in ongoing real-life situations. The current study examined the influence of various everyday life activities on three dimensions of mood (valence, calmness, energetic arousal) in a predominantly inactive sample. Ambulatory Assessment (AA) was used to investigate the association between actual PA and affective states during the course of 1 day. Seventy-seven students ages 19-30 participated in the study. PA was assessed with accelerometers, and affective state assessments were conducted hourly using an e-diary with a six-item mood scale that was specially designed for AA. Multilevel analyses indicated that the mood dimensions energetic arousal (p = 0.001) and valence (p = 0.005) were positively influenced by the intensity of the activity carried out in the 10-min prior to the assessment. As their activity increased, the participants' positive feelings and energetic arousal increased. However, the students' calmness was not affected by their activity levels. The findings highlight the importance of integrating short activity intervals of 10 min or less into everyday life routines to improve affective states.
    Frontiers in Psychology 01/2013; 4:102. · 2.80 Impact Factor
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    ABSTRACT: [This corrects the article on p. e69674 in vol. 8.].
    PLoS ONE 01/2013; 8(10). · 3.53 Impact Factor
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    Wolfgang Schlicht, Ulrich W Ebner-Priemer, Martina Kanning
    Frontiers in Psychology 01/2013; 4:916. · 2.80 Impact Factor
  • Philip Santangelo, Ulrich W. Ebner-Priemer, Timothy J. Trull
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    ABSTRACT: The Experience Sampling Method (ESM) can improve our understanding of how psychopathological symptoms unfold over time in everyday life. We discuss major benefits of ESM by presenting selected studies involving (a) real-time assessment (i.e., assessments focusing on individuals' momentary states, experiences, or behaviors); (b) real-world assessments enhancing laboratory-to-life generalizability; (c) multiple assessments over time allowing the study of dynamic processes; (d) multimodal assessment integrating psychological, physiological, and behavioral data; (e) assessment of setting or context specificities allowing for context-sensitive analyses; and (f) the provision of immediate interactive feedback. Furthermore, we offer recommendations concerning design issues for ESM studies, namely with regard to (a) choosing a sampling strategy, (b) participants' burden, compliance, and reactivity, (c) hardware and software solutions, (d) mathematical procedures when analyzing ESM data, and (e) visualization of ESM data. Regardless of remaining challenges, ESM offers great potential in clinical psychology with its possible application as a therapeutic tool and by revealing a comprehensive and generalizable picture of patients' and research participants' symptomatology.
    The Oxford Handbook of Research Strategies for Clinical Psychology, Edited by J. Comer, P. Kendall, 01/2013: pages 188-210; Oxford University Press.
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    ABSTRACT: Increased intra-subject variability of reaction times (ISV-RT) is one of the most consistent findings in attention-deficit/hyperactivity disorder (ADHD). Although the nature of this phenomenon is still unclear, it has been hypothesised to reflect interference from the Default Mode Network (DMN). So far, ISV-RT has been operationally defined either as a frequency spectrum of the underlying RT time series, or as a measure of dispersion of the RT scores distribution. Here, we use a novel RT analysis framework to link these hitherto unconnected facets of ISV-RT by determining the sensitivity of different measures of RT dispersion to the frequency content of the underlying RT time series. N=27 patients with ADHD and N=26 healthy controls performed several visual N-back tasks. Different measures of RT dispersion were repeatedly modelled after individual frequency bands of the underlying RT time series had been either extracted or suppressed using frequency-domain filtering. We found that the intra-subject standard deviation of RT preserves the "1/f noise" characteristic typical of human RT data. Furthermore and most importantly, we found that the ex-Gaussian parameter τ is rather exclusively sensitive to frequencies below 0.025 Hz in the underlying RT time series and that the particularly slow RTs, which nourish τ, occur regularly as part of an quasi-periodic, ultra-slow RT fluctuation. Overall, our results are compatible with the idea that ISV-RT is modulated by an endogenous, slowly fluctuating process that may reflect DMN interference.
    PLoS ONE 01/2013; 8(10):e69674. · 3.53 Impact Factor
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    Martina K Kanning, Ulrich W Ebner-Priemer, Wolfgang Michael Schlicht
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    ABSTRACT: Several meta-analyses have investigated the association between physical activity and affective states and have found evidence suggesting that exercise exerts a positive effect on affective state. However, in this field of research, most studies have conducted between-subject analyses. Nonetheless, there is more and more interest in the within-subject associations between physical activity and momentary affective states in everyday life. This position statement pertains to this up-and-coming field of research and provides methodological recommendations for further studies. The paper is divided into three parts: first, we summarize and evaluate three methodological requirements necessary for the proper evaluation of within-subject associations between physical activity and momentary affective states in everyday life. We propose that the following issues should be considered: (a) to address the dynamic nature of such relationships, repeated assessments are necessary; (b) as activities performed in everyday life are mostly spontaneous and unconscious, an objective assessment of physical activity is useful; (c) given that recall of affective states is often affected by systematic distortions, real-time assessment is preferable. In sum, we suggest the use of ambulatory assessment techniques, and more specifically the combination of accelerometer-assessment of physical activity with an electronic diary assessment of the momentary affective state and additional context information. Second, we summarize 22 empirical studies published between 1980 and 2012 using ambulatory assessment to investigate within-subject associations between momentary affective states and physical activity in everyday life. Generally, the literature overview detects a positive association, which appears stronger among those studies that were of high methodological quality. Third, we propose the use of ambulatory assessment intervention (AAIs) strategies to change people's behavior and to enable people to be active as often as possible during the day (e.g., reducing sitting time, taking more steps per day).
    Frontiers in Psychology 01/2013; 4:187. · 2.80 Impact Factor
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    Timothy J Trull, Ulrich W. Ebner-Priemer
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    ABSTRACT: Ambulatory assessment (AA) covers a wide range of assessment methods to study people in their natural environment, including self-report, observational, and biological/physiological/behavioral. AA methods minimize retrospective biases while gathering ecologically valid data from patients' everyday life in real time or near real time. Here, we report on the major characteristics of AA, and we provide examples of applications of AA in clinical psychology (a) to investigate mechanisms and dynamics of symptoms, (b) to predict the future recurrence or onset of symptoms, (c) to monitor treatment effects, (d) to predict treatment success, (e) to prevent relapse, and (f) as interventions. In addition, we present and discuss the most pressing and compelling future AA applications: technological developments (the smartphone), improved ecological validity of laboratory results by combined lab-field studies, and investigating gene-environment interactions. We conclude with a discussion of acceptability, compliance, privacy, and ethical issues. Expected final online publication date for the Annual Review of Clinical Psychology Volume 9 is March 26, 2013. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.
    Annual Review of Clinical Psychology 11/2012; · 12.42 Impact Factor
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    ABSTRACT: Rumination has been proposed as an important cognitive risk factor for depressive states. Experimental studies in the laboratory have demonstrated negative effects of induced rumination on mood and cognition. However, it is not known whether respective effects can also be generalized to naturalistic contexts. Therefore, the present study transferred rumination inductions to daily life within a novel experimental ambulatory assessment approach. Forty young adults carried palmtop computers for 2 days with ten assessments of momentary ruminative self-focus and mood per day. On one of the 2 days (induction day), participants were subjected to 3-min rumination inductions at each assessment (cross-over design). Analyses revealed that the rumination inductions immediately increased momentary ruminative self-focus and deteriorated positive mood. Higher increases in ruminative self-focus after inductions were linked to stronger reductions in positive mood. Momentary preinduction ruminative self-focus and mood on the induction day did not differ from momentary ruminative self-focus and mood on the noninduction day, indicating a lack of significant longer-term effects over the day. This is the first study revealing immediate effects of induced rumination in daily life, thereby assuring external validity of previous laboratory findings. Future studies could extend this induction approach to further dysfunctional and functional attention foci.
    Personality and Individual Differences 10/2012; 53:790-795. · 1.86 Impact Factor
  • Philip Santangelo, Martin Bohus, Ulrich W Ebner-Priemer
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    ABSTRACT: The use of Ecological Momentary Assessment (EMA) has led to increased insight into borderline personality disorder (BPD) symptoms, especially regarding affective instability. EMA is characterized by a series of repeated assessments of current affective, behavioral, and contextual experiences or physiological processes while participants engage in normal daily activities. EMA has several advantages. It enables researchers to avoid biased recollection, to investigate within-person processes, and to enhance real-life generalizability. This review is dedicated to four main objectives: (1) to discuss the characteristics of EMA in studying BPD symptomatology; (2) to provide an extensive overview of EMA findings in BPD structured into findings regarding DSM-IV criteria and findings regarding emotional dysregulation as stated in the biosocial theory of Linehan; (3) to discuss challenges of EMA and to give recommendations for the proper use of it; and (4) to highlight prospects and promising applications that should be addressed.
    Journal of personality disorders 09/2012; · 3.08 Impact Factor
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    ABSTRACT: Emotion dysregulation in Borderline Personality Disorder (BPD) is characterized by high baseline negative intensity, high reactivity, and slow return to baseline. Patients with BPD often engage in self-injurious behavior because it leads to immediate relief of stress levels. We aimed to assess stress regulation as well as the influence of tissue damage on subjective (aversive tension) and objective (heart rate) stress correlates in BPD. In 14 unmedicated patients with BPD and 18 healthy controls, a stress induction was followed by an incision into the forearm conducted by an investigator. For aversive tension, we found elevated baseline levels as well as slower return to baseline in BPD. In controls, incision resulted in a short-term increase of aversive tension, whereas tension and heart rate decreased in the BPD group. Our preliminary results support the hypothesis that tissue damage may play a role in disturbed stress regulation in BPD.
    Journal of personality disorders 08/2012; 26(4):605-15. · 3.08 Impact Factor
  • Philip Santangelo, Susanne Koudela, Ulrich Ebner-Priemer
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    ABSTRACT: Over the past two decades, a growing body of research in Borderline Personality Disorder (BPD) has been accumulated using computer-assisted infield methods to assess self-report data, physiological data as well as environmental aspects of BPD patients in everyday life situations. In psychological and psychiatric research, the assessment method uniting all these aspects of assessment has been coined "Ambulatory Assessment". This method combines many advantages besides real-life and real-time assessment, e.g. objective and unobtrusive assessments as well as assessments of setting- or context-specificities. A seminal field of application is the use of electronic devices as therapeutic tools, giving interactive feedback to patients, i.e. providing interventions at the very moments when patients are most in need of additional support. By giving two examples of BPD diagnostic criteria, we outline the key technical needs in order to take the use of sensor technology in psychological research and therapy to a higher level. The following key technical needs have been identified: (1) tools for emotion detection providing an objective measure of current emotional states; (2) tools for identifying persons; (3) tools for detecting instances of self-destructive behavior like alcohol or drug use or speeding/reckless-driving; (4) tools for integrating and analyzing information of various sensors in order to give automated feedback to the patient in real time. In a nutshell, even though Ambulatory Assessment has been successfully used in BPD research over the past few years, the method may offer many more options of applications in research and even more in therapy. However, psychologists and psychiatrists lack the technological knowledge to realize possible new applications of Ambulatory Assessment. In order to increase the usefulness of Ambulatory Assessment in psychological research and therapy, multidisciplinary teams, including technology experts as well as clinical psychologists, are clearly needed.
  • ACSM’s 59th Annual Meeting and 3rd World Congress on Exercise is Medicine – 2012; 05/2012

Publication Stats

685 Citations
149.58 Total Impact Points


  • 2009–2014
    • Karlsruhe Institute of Technology
      Carlsruhe, Baden-Württemberg, Germany
    • Freie Universität Berlin
      • Department of Education and Psychology
      Berlin, Land Berlin, Germany
    • Universitätsklinikum Jena
      Jena, Thuringia, Germany
  • 2013
    • Universität Stuttgart
      Stuttgart, Baden-Württemberg, Germany
  • 2005–2013
    • Central Institute of Mental Health
      • Klinik für Abhängiges Verhalten und Suchtmedizin
      Mannheim, Baden-Württemberg, Germany
  • 2009–2012
    • University of Missouri
      • Department of Psychological Sciences
      Columbia, MO, United States
    • Universität Heidelberg
      • Central Institute of Mental Health
      Heidelburg, Baden-Württemberg, Germany
  • 2008
    • Universitätsklinikum Freiburg
      • Department of Psychiatry and Psychotherapy
      Freiburg, Lower Saxony, Germany