Tilo Kircher

Technische Universität Dresden, Dresden, Saxony, Germany

Are you Tilo Kircher?

Claim your profile

Publications (314)1026.51 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: Speech-associated gesturing leads to memory advantages for spoken sentences. However, unexpected or surprising events are also likely to be remembered. With this study we test the hypothesis that different neural mechanisms (semantic elaboration and surprise) lead to memory advantages for iconic and unrelated gestures. During fMRI-data acquisition participants were presented with video clips of an actor verbalising concrete sentences accompanied by iconic gestures (IG; e.g., circular gesture; sentence: “The man is sitting at the round table”), unrelated free gestures (FG; e.g., unrelated up down movements; same sentence) and no gestures (NG; same sentence). After scanning, recognition performance for the three conditions was tested. Videos were evaluated regarding semantic relation and surprise by a different group of participants. The semantic relationship between speech and gesture was rated higher for IG (IG>FG), whereas surprise was rated higher for FG (FG>IG). Activation of the hippocampus correlated with subsequent memory performance of both gesture conditions (IG+FG>NG). For the IG condition we found activation in the left temporal pole and middle cingulate cortex (MCC; IG>FG). In contrast, for the FG condition posterior thalamic structures (FG>IG) as well as anterior and posterior cingulate cortices were activated (FG>NG). Our behavioral and fMRI-data suggest different mechanisms for processing related and unrelated co-verbal gestures, both of them leading to enhanced memory performance. Whereas activation in MCC and left temporal pole for iconic co-verbal gestures may reflect semantic memory processes, memory enhancement for unrelated gestures relies on the surprise response, mediated by anterior/posterior cingulate cortex and thalamico-hippocampal structures.
    Brain Research. 04/2014;
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: Background: Changes in fiber tract architecture have gained attention as a potentially important aspect of schizophrenia neuropathology. Although the exact pathogenesis of these abnormalities yet remains to be elucidated, a genetic component is highly likely. Neuregulin-1 (NRG1) is one of the best-validated schizophrenia susceptibility genes. We here report the impact of the Neuregulin-1 rs35753505 variant on white matter structure in healthy young individuals with no family history of psychosis. Methods: We compared fractional anisotropy in 54 subjects that were either homozygous for the risk C allele carriers (n = 31) for rs35753505 or homozygous for the T allele (n = 23) using diffusion tensor imaging with 3T. Tract-Based Spatial Statistics (TBSS), a method especially developed for diffusion data analysis, was used to improve white matter registration and to focus the statistical analysis to major fiber tracts. Results: Statistical analysis showed that homozygous risk C allele carriers featured elevated fractional anisotropy (FA) in the right perihippocampal region and the white matter proximate to the left area 4p as well as the right hemisphere of the cerebellum. We found three clusters of reduced FA values in homozygous C allele carriers: in the left superior parietal region, the right prefrontal white matter and in the deep white matter of the left frontal lobe. Conclusion: Our results highlight the importance of Neuregulin-1 for structural connectivity of the right medial temporal lobe. This finding is in line with well known neuropathological findings in this region in patients with schizophrenia.
    Brain and behavior. 03/2014; 4(2):215-26.
  • [show abstract] [hide abstract]
    ABSTRACT: Memory impairments are common in major depression. Neural processing during non-emotional episodic memory in depressed patients has only sparsely been investigated, since the majority of studies have focused on emotional stimuli. The aim of this study was to explore neural correlates of episodic memory in depressive patients and to assess brain regions related to subsequent memory performance. Forty-six participants (23 depressed patients) performed a non-emotional episodic memory encoding and retrieval task while brain activation was measured with functional magnetic resonance imaging. Patients with depression showed decreased activation in the right prefrontal cortex and right cingulate cortex during memory encoding, but increased activation in the right inferior frontal gyrus (IFG) during recognition memory. While a strong association between hippocampal and parahippocampal activation during memory encoding with subsequent memory performance became evident in healthy controls, this relationship was absent in patients with depression. Taken together, these findings demonstrate that memory related brain regions are affected in their appropriate functioning during memory encoding in depressed patients. Therefore, patients with depression may rely to a greater degree on other brain regions such as the IFG during episodic memory retrieval. Hum Brain Mapp, 2014. © 2014 Wiley Periodicals, Inc.
    Human Brain Mapping 03/2014; · 6.88 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: Major depression is associated with impairments in semantic verbal fluency (VF). However, the neural correlates underlying dysfunctional cognitive processing in depressed subjects during the production of semantic category members still remain unclear. In the current study, an overt and continuous semantic VF paradigm was used to examine these mechanisms in a representative sample of 33 patients diagnosed with a current episode of unipolar depression and 33 statistically matched healthy controls. Subjects articulated words in response to semantic category cues while brain activity was measured with functional magnetic resonance imaging (fMRI). Compared to controls, patients showed poorer task performance. On the neural level, a group by condition interaction analysis, corrected for task performance, revealed a reduced task-related deactivation in patients in the right parahippocampal gyrus, the right fusiform gyrus, and the right supplementary motor area. An additional and an increased task-related activation in patients were observed in the right precentral gyrus and the left cerebellum, respectively. These results indicate that a failure to suppress potentially interfering activity from inferior temporal regions involved in default-mode network functions and visual imagery, accompanied by an enhanced recruitment of areas implicated in speech initiation and higher-order language processes, may underlie dysfunctional cognitive processing during semantic VF in depression. The finding that patients with depression demonstrated both decreased performance and aberrant brain activation during the current semantic VF task demonstrates that this paradigm is a sensitive tool for assessing brain dysfunctions in clinical populations.
    European Archives of Psychiatry and Clinical Neuroscience 02/2014; · 2.75 Impact Factor
  • Schizophrenia Bulletin 02/2014; in press. · 8.80 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: Panic disorder with agoraphobia (PD/AG) is a prevalent mental disorder featuring a substantial complex genetic component. At present, only a few established risk genes exist. Among these, the gene encoding monoamine oxidase A (MAOA) is noteworthy given that genetic variation has been demonstrated to influence gene expression and monoamine levels. Long alleles of the MAOA-uVNTR promoter polymorphism are associated with PD/AG and correspond with increased enzyme activity. Here, we have thus investigated the impact of MAOA-uVNTR on therapy response, behavioral avoidance and brain activity in fear conditioning in a large controlled and randomized multicenter study on cognitive behavioral therapy (CBT) in PD/AG. The study consisted of 369 PD/AG patients, and genetic information was available for 283 patients. Carriers of the risk allele had significantly worse outcome as measured by the Hamilton Anxiety scale (46% responders vs 67%, P=0.017). This was accompanied by elevated heart rate and increased fear during an anxiety-provoking situation, that is, the behavioral avoidance task. All but one panic attack that happened during this task occurred in risk allele carriers and, furthermore, risk allele carriers did not habituate to the situation during repetitive exposure. Finally, functional neuroimaging during a classical fear conditioning paradigm evidenced that the protective allele is associated with increased activation of the anterior cingulate cortex upon presentation of the CS+ during acquisition of fear. Further differentiation between high- and low-risk subjects after treatment was observed in the inferior parietal lobes, suggesting differential brain activation patterns upon CBT. Taken together, we established that a genetic risk factor for PD/AG is associated with worse response to CBT and identify potential underlying neural mechanisms. These findings might govern how psychotherapy can include genetic information to tailor individualized treatment approaches.Molecular Psychiatry advance online publication, 15 January 2013; doi:10.1038/mp.2012.172.
    Molecular psychiatry 01/2014; 19(1):122-128. · 15.05 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: Panic disorder with agoraphobia is characterized by panic attacks and anxiety in situations where escape might be difficult. However, neuroimaging studies specifically focusing on agoraphobia are rare. Here we used functional magnetic resonance imaging (fMRI) with disorder-specific stimuli to investigate the neural substrates of agoraphobia. We compared the neural activations of 72 patients suffering from panic disorder with agoraphobia with 72 matched healthy control subjects in a 3-T fMRI study. To isolate agoraphobia-specific alterations we tested the effects of the anticipation and perception of an agoraphobia-specific stimulus set. During fMRI, 48 agoraphobia-specific and 48 neutral pictures were randomly presented with and without anticipatory stimulus indicating the content of the subsequent pictures (Westphal paradigm). During the anticipation of agoraphobia-specific pictures, stronger activations were found in the bilateral ventral striatum and left insula in patients compared with controls. There were no group differences during the perception phase of agoraphobia-specific pictures. This study revealed stronger region-specific activations in patients suffering from panic disorder with agoraphobia in anticipation of agoraphobia-specific stimuli. Patients seem to process these stimuli more intensively based on individual salience. Hyperactivation of the ventral striatum and insula when anticipating agoraphobia-specific situations might be a central neurofunctional correlate of agoraphobia. Knowledge about the neural correlates of anticipatory and perceptual processes regarding agoraphobic situations will help to optimize and evaluate treatments, such as exposure therapy, in patients with panic disorder and agoraphobia.
    Psychological Medicine 01/2014; · 5.59 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: Neurosteroids are synthesized both in brain and peripheral steroidogenic tissue from cholesterol or steroidal precursors. Neurosteroids have been shown to be implicated in neural proliferation, differentiation, and activity. Preclinical and clinical studies also suggest a modulatory role of neurosteroids in anxiety-related phenotypes. However, little is known about the contribution of genetic variants in genes relevant for the neurosteroidogenesis to anxiety disorders. We performed an association analysis of single nucleotide polymorphisms (SNPs) in five genes related to the neurosteroidal pathway with emphasis on progesterone and allopregnanolone biosynthesis (steroid-5-alpha-reductase 1A (SRD5A1), aldo-keto reductase family 1 C1-C3 (AKR1C1-AKR1C3) and translocator protein 18 kDA (TSPO) with panic disorder (PD) and dimensional anxiety in two German PD samples (cases N = 522, controls N = 1,115). Case-control analysis for PD and SNPs in the five selected genes was negative in the combined sample. However, we detected a significant association of anticipatory anxiety with two intronic SNPs (rs3930965, rs41314625) located in the gene AKR1C1 surviving correction for multiple testing in PD patients. Stratification analysis for gender revealed a female-specific effect of the associations of both SNPs. These results suggest a modulatory effect of AKR1C1 activity on anxiety levels, most likely through changes in progesterone and allopregnanolone levels within and outside the brain. In summary, this is the first evidence for the gender-specific implication of the AKR1C1 gene in the expression of anticipatory anxiety in PD. Further analyses to unravel the functional role of the SNPs detected here and replication analyses are needed to validate our results.
    Depression and Anxiety 01/2014; · 4.61 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: BACKGROUND: Although several neurophysiological models have been proposed for panic disorder with agoraphobia (PD/AG), there is limited evidence from functional magnetic resonance imaging (fMRI) studies on key neural networks in PD/AG. Fear conditioning has been proposed to represent a central pathway for the development and maintenance of this disorder; however, its neural substrates remain elusive. The present study aimed to investigate the neural correlates of fear conditioning in PD/AG patients. Method The blood oxygen level-dependent (BOLD) response was measured using fMRI during a fear conditioning task. Indicators of differential conditioning, simple conditioning and safety signal processing were investigated in 60 PD/AG patients and 60 matched healthy controls. RESULTS: Differential conditioning was associated with enhanced activation of the bilateral dorsal inferior frontal gyrus (IFG) whereas simple conditioning and safety signal processing were related to increased midbrain activation in PD/AG patients versus controls. Anxiety sensitivity was associated positively with the magnitude of midbrain activation. CONCLUSIONS: The results suggest changes in top-down and bottom-up processes during fear conditioning in PD/AG that can be interpreted within a neural framework of defensive reactions mediating threat through distal (forebrain) versus proximal (midbrain) brain structures. Evidence is accumulating that this network plays a key role in the aetiopathogenesis of panic disorder.
    Psychological Medicine 01/2014; 44(2):381–394. · 5.59 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: Genetic studies found the A allele of the single nucleotide polymorphism rs1006737 in the CACNA1C gene, which encodes for the alpha 1C subunit of the voltage-dependent, L-type calcium ion channel Cav1.2, to be overrepresented in patients with major depressive disorder (MDD). Altered prefrontal brain functioning and impaired semantic verbal fluency (SVF) are robust findings in these patients. A recent functional magnetic resonance imaging (fMRI) study found the A allele to be associated with poorer performance and increased left inferior frontal gyrus (IFG) activation during SVF tasks in healthy subjects. In the present study, we investigated the effects of rs1006737 on neural processing during SVF in MDD. In response to semantic category cues, 40 patients with MDD and 40 matched controls overtly generated words while brain activity was measured with fMRI. As revealed by whole brain analyses, genotype significantly affected brain activity in patients. Compared to patients with GG genotype, patients with A allele demonstrated increased task-related activation in the left middle/inferior frontal gyrus and the bilateral cerebellum. Patients with A allele also showed enhanced functional coupling between left middle/inferior and right superior/middle frontal gyri. No differential effects of genotype on SVF performance or brain activation were found between diagnostic groups. The current data provide further evidence for an impact of rs1006737 on the left IFG and demonstrate that genetic variation in CACNA1C modulates neural responses in patients with MDD. The observed functional alterations in prefrontal and cerebellar areas might represent a mechanism by which rs1006737 influences susceptibility to MDD.
    Journal of psychiatric research 01/2014; · 3.72 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: Speech-associated gesturing leads to memory advantages for spoken sentences. However, unexpected or surprising events are also likely to be remembered. With this study we test the hypothesis that different neural mechanisms (semantic elaboration and surprise) lead to memory advantages for iconic and unrelated gestures. During fMRI-data acquisition participants were presented with video clips of an actor verbalising concrete sentences accompanied by iconic gestures (IG; e.g., circular gesture; sentence: “The man is sitting at the round table”), unrelated free gestures (FG; e.g., unrelated up down movements; same sentence) and no gestures (NG; same sentence). After scanning, recognition performance for the three conditions was tested. Videos were evaluated regarding semantic relation and surprise by a different group of participants. The semantic relationship between speech and gesture was rated higher for IG (IG>FG), whereas surprise was rated higher for FG (FG>IG). Activation of the hippocampus correlated with subsequent memory performance of both gesture conditions (IG+FG>NG). For the IG condition we found activation in the left temporal pole and middle cingulate cortex (MCC; IG>FG). In contrast, for the FG condition posterior thalamic structures (FG>IG) as well as anterior and posterior cingulate cortices were activated (FG>NG). Our behavioral and fMRI-data suggest different mechanisms for processing related and unrelated co-verbal gestures, both of them leading to enhanced memory performance. Whereas activation in MCC and left temporal pole for iconic co-verbal gestures may reflect semantic memory processes, memory enhancement for unrelated gestures relies on the surprise response, mediated by anterior/posterior cingulate cortex and thalamico-hippocampal structures.
    Brain Research. 01/2014;
  • [show abstract] [hide abstract]
    ABSTRACT: Depression often involves anxiety symptoms and shows a strong comorbidity with panic disorder. However, the neural basis is unclear. The aim of the current study was to use semantic priming to investigate the neural correlates of panic and anxiety-related information processing in depression. In a lexical decision task, panic/agoraphobia-disorder-related and neutral word-pairs were presented during functional magnetic resonance imaging. Participants comprised 19 patients with major depression but without comorbid anxiety and 19 demographically matched controls. On a behavioral level, comparable significant priming effects were found for the neutral condition, while only patients showed a significant inhibition effect (slower reaction time for panic-related stimuli) for the panic condition. On a neural level, significant group differences emerged in left fronto-parietal (enhanced activation for patients) and left temporo-occipital regions (reduced activation for patients). The results showed that depressed patients recruit not only areas related to the interaction of emotion and semantic processing but also regions that are related to fear circuitry to process panic-related information. Hence, in the context of depression, there seems to be a pathological processing of panic-related information that could play an important role during the disorder and should be considered.
    Psychiatry Research Neuroimaging 01/2014; · 3.36 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: Self-concept is deeply affected in schizophrenia. Positive symptoms in particular are related to disturbed self/other distinctions. The neural networks underlying self-evaluation in schizophrenia have barely been investigated. The study reported here involved 13 patients with schizophrenia and 13 matched controls. During functional MRI, participants decided in three conditions whether the presented positive and negative personality traits characterized themselves, an intimate person, or included a certain letter. Based on the responses, each experimental condition was designed using a flexible factorial model. Controls and patients showed a similar behavioral pattern during self-evaluation, with group comparison revealing decreased activation in patients in the left inferior temporal gyrus and both temporal poles during self-ascription of traits, and in the anterior medial prefrontal cortex during evaluation of an intimate person. In patients, positive symptoms correlated positively with brain activation in the left parahippocampus during trait self-ascription. Hence, while evaluating themselves, schizophrenia patients revealed decreased activation in areas related to self-awareness overlapping with networks involved in theory of mind, empathy and social knowledge. Moreover, patients' brain activation during self-reflection was affected by the current positive symptomatology. The close interaction between self and other highlights the clinical and social relevance of self-processing deficits in schizophrenia.
    Social Cognitive and Affective Neuroscience 12/2013; · 5.04 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: Decision-making is an everyday routine that entails several subprocesses. Decisions under uncertainty occur when either prior information is incomplete or the outcomes of the decision are unclear. The aim of the present study was to disentangle the neural correlates of information gathering as well as reaching a decision and to explore effects of uncertainty acceptance or avoidance in a large sample of healthy subjects. Sixty-four healthy volunteers performed a decision-making under uncertainty task in a multi-center approach while BOLD signal was measured with fMRI. Subjects either had to indicate via button press from which of two bottles red or blue balls were drawn (decision-making under uncertainty condition), or they had to indicate whether 8 red balls had been presented (baseline condition). During the information gathering phase (contrasted against the counting phase) a widespread network was found encompassing (pre-)frontal, inferior temporal and inferior parietal cortices. Reaching a decision was correlated with activations in the medial frontal cortex as well as the posterior cingulate and the precuneus. Effects of uncertainty acceptance were found within a network comprising of the superior frontal cortex as well as the insula and precuneus while uncertainty avoidance was correlated with activations in the right middle frontal cortex. The results depict two distinct networks for information gathering and the indication of having made a decision. While information-gathering networks are modulated by uncertainty avoidance and-acceptance, underlying networks of the decision itself are independent of these factors.
    Behavioural brain research 12/2013; · 3.22 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: Decisions are called decisions under uncertainty when either prior information is incomplete or the outcomes of the decision are unclear. Alterations in these processes related to decisions under uncertainty have been linked to delusions. In patients with schizophrenia, the underlying neural networks have only rarely been studied. We aimed to disentangle the neural correlates of decision-making and relate them to neuropsychological and psychopathological parameters in a large sample of patients with schizophrenia and healthy subjects. Fifty-seven patients and fifty-seven healthy volunteers from six centers had to either indicate via button-press from which of two bottles red or blue balls were drawn (decision-making under uncertainty condition), or indicate whether eight red balls had been presented (baseline condition) while BOLD signal was measured with fMRI. Patients based their decisions on less conclusive evidence and had decreased activations in the underlying neural network, comprising of medial and lateral frontal as well as parietal areas, as compared to healthy subjects. While current psychopathology was not correlated with brain activation, positive symptoms led to longer decision latencies in patients. These results suggest that decision-making under uncertainty in schizophrenia is affected by a complex interplay of aberrant neural activation. Furthermore, reduced neuropsychological functioning in patients was related to impaired decision-making and task performance was modulated by distinct positive symptoms.
    Schizophrenia Research 12/2013; · 4.59 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: Genome-wide association studies have identified the CACNA1C single nucleotide polymorphism (SNP) rs1006737 as one of the most consistent genetic findings as susceptibility locus for major psychiatric disorders. Furthermore, animal and genetic imaging studies have reported strong functional evidence for the association of CACNA1C with learning, memory, neural plasticity, and its association with the hippocampal formation. In the present study we investigated the impact of the CACNA1C SNP rs1006737 on the fractional anisotropy (FA) in the hippocampal formation as well as on verbal learning and memory in healthy individuals. 118 healthy individuals (72 males, 46 females, age 18-56years) initially underwent diffusion tensor imaging (DTI), 100 of them were included in the final analysis. We used Tract-Based Spatial Statistics (TBSS) to examine the impact of the CACNA1C SNP rs1006737 on the hippocampal formation as predefined region of interest (ROI). Furthermore, all participants completed the Verbal Learning and Memory Test (VLMT). In the VLMT genotype was significantly associated with learning performance. Bonferroni corrected post-hoc tests indicated a diminished performance at the beginning of the learning curve in risk allele carriers compared to non-risk allele carriers. The TBSS ROI analysis revealed one cluster of reduced FA in risk allele carriers compared to non-risk allele carriers located in the right hippocampal formation. Moreover, an association between the initial learning performance and FA values was found. These findings demonstrate that genetic variation in the CACNA1C SNP rs1006737 is associated with FA reduction in the hippocampal formation as well as with differences in learning performance in healthy individuals.
    NeuroImage 11/2013; · 6.25 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: To assess the reproducibility of brain-activation and eye-movement patterns in a saccade paradigm when comparing subjects, tasks, and magnetic resonance (MR) systems. Forty-five healthy adults at two different sites (n = 45) performed saccade tasks with varying levels of target predictability: predictable (PRED), position predictable (pPRED), time predictable (tPRED), and prosaccade (SAC). Eye-movement pattern was tested with a repeated-measures analysis of variance. Activation maps reproducibility were estimated with the cluster overlap Jaccard index and signal variance coefficient of determination for within-subjects test-retest data, and for between-subjects data from the same and different sites. In all groups latencies increased with decreasing target predictability: PRED < pPRED < tPRED < SAC (P < 0,001). Activation overlap was good to fair (>0.40) in all tasks in the within-subjects test-retest comparisons and poor (<0.40) in the tPRED for different subjects. The overlap of the different tasks for within-groups data was higher (0.40-0.68) than for the between-groups data (0.30-0.50). Activation consistency was 60-85% in the same subjects, 50-79% in different subjects, and 50-80% in different sites. In SAC, the activation found in the same and in different subjects was more consistent than in other tasks (50-80%). The predictive saccade tasks produced evidence for brain-activation and eye-movement reproducibility.J. Magn. Reson. Imaging 2013;. © 2013 Wiley Periodicals, Inc.
    Journal of Magnetic Resonance Imaging 11/2013; · 2.57 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: Objective: The mechanisms of action underlying treatment are inadequately understood. This study examined 5 variables implicated in the treatment of panic disorder with agoraphobia (PD/AG): catastrophic agoraphobic cognitions, anxiety about bodily sensations, agoraphobic avoidance, anxiety sensitivity, and psychological flexibility. The relative importance of these process variables was examined across treatment phases: (a) psychoeducation/interoceptive exposure, (b) in situ exposure, and (c) generalization/follow-up. Method: Data came from a randomized controlled trial of cognitive behavioral therapy for PD/AG (n = 301). Outcomes were the Panic and Agoraphobia Scale (Bandelow, 1995) and functioning as measured in the Clinical Global Impression scale (Guy, 1976). The effect of process variables on subsequent change in outcome variables was calculated using bivariate latent difference score modeling. Results: Change in panic symptomatology was preceded by catastrophic appraisal and agoraphobic avoidance across all phases of treatment, by anxiety sensitivity during generalization/follow-up, and by psychological flexibility during exposure in situ. Change in functioning was preceded by agoraphobic avoidance and psychological flexibility across all phases of treatment, by fear of bodily symptoms during generalization/follow-up, and by anxiety sensitivity during exposure. Conclusions: The effects of process variables on outcomes differ across treatment phases and outcomes (i.e., symptomatology vs. functioning). Agoraphobic avoidance and psychological flexibility should be investigated and therapeutically targeted in addition to cognitive variables. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
    Journal of Consulting and Clinical Psychology 11/2013; · 4.85 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: We examined whether Anxiety Sensitivity (AS) and Experiential Avoidance (EA), two potentially relevant constructs in the evolution of anxiety and related disorders with significant implications for cognitive-behavioral treatments, differentially relate to symptom expressions of patients with panic disorder and agoraphobia. Within a multi-center study 369 patients meeting the DSM-IV-TR criteria for panic disorder with agoraphobia (PD/AG) completed the multidimensional Panic and Agoraphobia Scale (PAS), the Anxiety Sensitivity Index (ASI), the Acceptance and Action Questionnaire-II (AAQ-II) and the Beck Depression Inventory-II (BDI-II). Overlap, distinctiveness, and predictive validity of AS and EA were examined using explorative item analyses and multiple hierarchical regression analyses. AS and EA moderately correlated with each other (r=-.50,p <.01). EA explained additional variance in PAS-subscales Anticipatory Anxiety and Panic-Related Disability, but not in Panic Attacks, Agoraphobic Avoidance and Health Worries. ASI, AAQ-II and BDI-II explained a low to moderate amount of variation in the five PAS-subscales (R(2)=.04-.29; p <.005). AS and EA are overlapping, yet distinct constructs. Results suggest that EA contributes to a significantly improved understanding of vulnerability, at least in patients with PD/AG.
    International Journal of Clinical and Health Psychology 08/2013; 12:5-22. · 2.79 Impact Factor
  • Psychophysiology 08/2013; 45:S56-S56. · 3.29 Impact Factor

Publication Stats

4k Citations
1,026.51 Total Impact Points

Institutions

  • 2011–2014
    • Technische Universität Dresden
      • Department of Psychology
      Dresden, Saxony, Germany
    • Durham University
      • Department of Psychology
      Durham, ENG, United Kingdom
    • University of Pennsylvania
      • Center for Cognitive Neuroscience
      Philadelphia, PA, United States
  • 2007–2014
    • Philipps-Universität Marburg
      • • Institute for German Linguistics
      • • Fachbereich Psychologie
      Marburg, Hesse, Germany
    • University of Wuerzburg
      • Department of Psychiatry, Psychosomatics, and Psychotherapy
      Würzburg, Bavaria, Germany
    • University of Cologne
      • Department of Psychiatry and Psychotherapy
      Köln, North Rhine-Westphalia, Germany
    • University Hospital Essen
      • Klinik für Psychiatrie und Psychotherapie
      Essen, North Rhine-Westphalia, Germany
    • Universität Hamburg
      • Department of Psychiatry and Psychotherapy
      Hamburg, Hamburg, Germany
    • Ruhr-Universität Bochum
      • Arbeitsgruppe Klinische Psychologie und Psychotherapie
      Bochum, North Rhine-Westphalia, Germany
    • Psychiatrische Universitätsklinik Zürich
      Zürich, Zurich, Switzerland
    • Universität des Saarlandes
      • Klinische Neuropsychologie
      Homburg, Saarland, Germany
    • LWL-Klinik Marsberg
      Marsberg, North Rhine-Westphalia, Germany
    • University of Bonn
      • Department of Neurobiology
      Bonn, North Rhine-Westphalia, Germany
    • Universität Ulm
      • Klinik für Psychiatrie und Psychotherapie III (Ulm)
      Ulm, Baden-Wuerttemberg, Germany
    • University of Cambridge
      Cambridge, England, United Kingdom
    • Otto-Friedrich-Universität Bamberg
      Bamberg, Bavaria, Germany
    • Humboldt University of Berlin
      • Department of Psychology
      Berlin, Land Berlin, Germany
    • Universität Heidelberg
      Heidelburg, Baden-Württemberg, Germany
  • 2013
    • University of Queensland 
      • School of Psychology
      Brisbane, Queensland, Australia
  • 2012–2013
    • King's College London
      • • Institute of Psychiatry
      • • Department of Psychosis Studies
      Londinium, England, United Kingdom
    • Universität Osnabrück
      • Institute of Cognitive Science
      Osnabrück, Lower Saxony, Germany
    • University of Greifswald
      • Institute of Psychology
      Griefswald, Mecklenburg-Vorpommern, Germany
  • 2005–2013
    • RWTH Aachen University
      • Department of Psychiatry, Psychotherapy and Psychosomatics
      Aachen, North Rhine-Westphalia, Germany
    • Korea Advanced Institute of Science and Technology
      Sŏul, Seoul, South Korea
    • Hertie-Institute for Clinical Brain Research
      Tübingen, Baden-Württemberg, Germany
    • Universitätsklinikum Tübingen
      Tübingen, Baden-Württemberg, Germany
  • 2009–2011
    • University of Münster
      • Department of Psychiatry
      Münster, North Rhine-Westphalia, Germany
    • The University of York
      • Department of Psychology
      York, ENG, United Kingdom
    • University of Newcastle
      • Centre for Rural and Remote Mental Health
      Newcastle, New South Wales, Australia
  • 2005–2008
    • University Hospital RWTH Aachen
      • Department of Neurology
      Aachen, North Rhine-Westphalia, Germany
  • 1997–2007
    • University of Tuebingen
      • • Institute of Medical Psychology and Behavioral Neurobiology
      • • Department of Psychiatry and Psychotherapy
      • • Group of Clinical Psychology and Psychotherapy
      Tübingen, Baden-Württemberg, Germany
  • 2006
    • University of Birmingham
      Birmingham, England, United Kingdom
  • 2004
    • Max Planck Institute for Empirical Aesthetics
      Frankfurt, Hesse, Germany
  • 2001
    • Heinrich-Heine-Universität Düsseldorf
      • Klinik und Poliklinik für Psychiatrie und Psychotherapie der HHU, Rheinische Kliniken Düsseldorf
      Düsseldorf, North Rhine-Westphalia, Germany