Birgit Kleim

Birgit Kleim
University of Zurich | UZH · Psychologisches Institut

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78
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Publications

Publications (78)
Article
Full-text available
Background: The core clinical feature of posttraumatic stress disorder (PTSD) is recurrent re-experiencing in form of intrusive memories. While a great number of biological processes are regulated by sleep and internal biological clocks, the effect of 24-hour biological cycles, named circadian rhythm, has not been investigated in the context of in...
Article
Full-text available
Background Trauma- and stress-related disorders, such as post-traumatic stress disorder (PTSD), are more common in females than in males. Sex hormones affect learning and emotional memory formation and may be associated with the development of PTSD. Most previous studies have indexed these hormones in isolation. Objectives: To investigate associati...
Article
Full-text available
Background: Network analysis has gained increasing attention as a new framework to study complex associations between symptoms of post-traumatic stress disorder (PTSD). A number of studies have been published to investigate symptom networks on different sets of symptoms in different populations, and the findings have been inconsistent. Objective: W...
Preprint
**Background.** Suicidal ideations (SI) are amongst the strongest predictors for suicide attempts, yet reliable prediction models for suicide risk are still lacking. One explanation for this is that endorsement and expression of SI are not uniform and may vary when indexed over time. Using intensive longitudinal assessments of SI with ecological mo...
Preprint
Full-text available
BACKGROUND Stress-related mental disorders are highly prevalent and pose a significant burden on individuals and society. Improving strategies of their treatment and prevention requires knowledge about risk and resilience. This multi-center study aims to contribute to this endeavor by investigating psychological resilience in healthy, but vulnerabl...
Preprint
Full-text available
Recently, cross-sectional relationships between psycho-social resilience factors (RFs) and resilience, operationalized as an outcome of low reactivity of mental health to stressor exposure (low ‘stressor reactivity’) during the first wave of the COVID-19 pandemic, were reported. Extending these findings, we here examine prospective relationships an...
Preprint
Recently, cross-sectional relationships between psycho-social resilience factors (RFs) and resilience, operationalized as an outcome of low reactivity of mental health to stressor exposure (low ‘stressor reactivity’) during the first wave of the COVID-19 pandemic, were reported. Extending these findings, we here examine prospective relationships an...
Article
Full-text available
Language is a potential source of predictors for suicidal thoughts and behaviors (STBs), as changes in speech characteristics, communication habits, and word choice may be indicative of increased suicide risk. We reviewed the current literature on STBs that investigated linguistic features of spoken and written language. Specifically, we performed...
Preprint
Background: Positive prospective mental imagery plays an important role in mental well-being, and depressive symptoms have been associated with difficulties in generating positive prospective mental images (PPMIs). We used a mobile app to gather PPMIs generated by young adults during the COVID-19 pandemic and analyzed content, characteristics, and...
Article
Full-text available
A considerable number of depressed patients do not respond to treatment. Accurate prediction of non-response to routine clinical care may help in treatment planning and improve results. A longitudinal sample of N = 239 depressed patients was assessed at admission to multi-modal day clinic treatment, after six weeks, and at discharge. First, patient...
Preprint
Background: Self-efficacy is associated with positive mental health outcomes. We developed and tested a digital self-efficacy training involving repeated recall of autobiographical self-efficacy memories.Methods: In this randomized controlled trial, we investigated the effects of our digital training on key mental health outcomes, including anxiety...
Article
Full-text available
Aversive autobiographical memories play a key role in the development and maintenance of many mental disorders. Imagery rescripting is a well-established psychotherapeutic intervention aiming to create a more adaptive version of an aversive memory by modifying its interpretation. Sleep has been shown to support reconsolidation of updated neutral me...
Preprint
Background: This paper describes the study protocol for our clinical trial “Optimizing Outcomes in Psychotherapy for Anxiety Disorders (OPTIMAX)” funded by the Swiss National Science Foundation (10001C_169827). The study aims to establish predictive features for forecasting response to cognitive behavior therapy (CBT) and to investigate mechanisms...
Article
Full-text available
The locus coeruleus (LC) is a brainstem structure that sends widespread efferent projections throughout the mammalian brain. The LC constitutes the major source of noradrenaline (NE), a modulatory neurotransmitter that is crucial for fundamental brain functions such as arousal, attention, and cognitive control. This role of the LC-NE is traditional...
Preprint
Introduction: Robust sensitivity to reward may help preserve positive emotions in the face of adversity and has been proposed as a key resilience factor. We describe the development, feasibility, and efficacy of an mHealth application, Imager, which targets reward sensitivity by training individuals to create mental images of future rewarding exper...
Preprint
Full-text available
Stress-related mental disorders are highly prevalent and pose a significant burden on individuals and society. Improving strategies of their treatment and prevention requires knowledge about risk and resilience. This multi-center study aims to contribute to this endeavor by investigating psychological resilience in healthy, but vulnerable young adu...
Article
Full-text available
Background There is a substantial burden on global mental health as a result of the Coronavirus disease 2019 (COVID-19) pandemic that has become putting pressure on healthcare systems. There is increasing concern about rising suicidality consequential to the COVID-19 pandemic and the measures taken. Existing research about the impact of earlier epi...
Article
Full-text available
Medical personnel working in emergency rooms (ER) are at increased risk of mental health problems and suicidality. There is increasing evidence that mindfulness-based interventions can improve burnout and other mental health outcomes in health care providers. In contrast, few longitudinal prospective studies have examined protective functions of di...
Article
Full-text available
Background: Multi-sensor fitness trackers offer the perspective to longitudinally estimate sleep quality in a home environment with the potential to outperform traditional actigraphy. To benefit from these new tools to objectively assess sleep for clinical and research purposes, multi-sensor wearable devices require careful validation against the g...
Article
Full-text available
Background: The current COVID-19 coronavirus pandemic is an emergency on a global scale, with huge swathes of the population required to remain indoors for prolonged periods to tackle the virus. In this new context, individuals' health-promoting routines are under greater strain, contributing to poorer mental and physical health. Additionally, indi...
Article
Full-text available
Background: There is an increasing number of smartphone applications (apps) focusing on prevention, treatment, and diagnosis of depression. A promising approach to increase the effectiveness while reducing the individual's burden is the use of just-in-time adaptive intervention (JITAI) mechanisms. JITAIs are designed to improve the effectiveness o...
Article
Full-text available
Reappraisal of negative memories and experiences is central for mental health and well-being. Deficiency of reappraisal lies at the core of many psychiatric disorders and is a key target for treatment. Here we apply transcranial direct current stimulation (tDCS) to enhance reappraisal of negative emotional memories. In a randomised, sham-controlled...
Article
Full-text available
Several types of psychological treatment for posttraumatic stress disorder (PTSD) are considered well established and effective, but evidence of their long-term efficacy is limited. This systematic review and meta-analysis aimed to investigate the long-term outcomes across psychological treatments for PTSD. MEDLINE, Cochrane Library, PTSDpubs, Psyc...
Article
Background Nightmares are a hallmark symptom of posttraumatic stress disorder (PTSD). This strong association may reflect a shared pathophysiology in the form of altered autonomic activity and increased reactivity. Using an acoustic startle paradigm, we investigated the interrelationships of psychophysiological measures during wakefulness and PTSD...
Article
BACKGROUND Since the emergence of COVID-19, health care workers and first responders have been at a high risk for mental health symptoms owing to their exposure to the virus and increased work stress during the pandemic. Although interventions exist to address mental health issues following exposure to disasters, emergencies, and humanitarian crise...
Article
ZUSAMMENFASSUNG Einleitung Eine wachsende Zahl psychologischer Behandlungsangebote erfolgt über das Smartphone, bzw. über Apps. Viele der wissenschaftlich geprüften Apps basieren auf den Prinzipien der kognitiven Verhaltenstherapie (KVT), Goldstandard zur Behandlung vieler psychischer Problematiken. Ziel dieses Reviews war es, den Status Quo der Fo...
Article
Full-text available
Each year, more than 800 000 persons die by suicide, making it a leading cause of death worldwide. Recent innovations in information and communication technology may offer new opportunities in suicide prevention in individuals, hereby potentially reducing this number. In our project, we design digital indices based on both self-reports and passive...
Article
Full-text available
Depression and early life adversity (ELA) are associated with aberrant resting state functional connectivity (FC) of the default mode (DMN), salience (SN), and central executive networks (CEN). However, the specific and differential associations of depression and ELA with FC of these networks remain unclear. Applying a dimensional approach, here we...
Article
BACKGROUND Multiple symptoms of suicide risk have been assessed based on visual and auditory information, including flattened affect, reduced movement, and slowed speech. Objective quantification of such symptomatology from novel data sources can increase the sensitivity, scalability, and timeliness of suicide risk assessment. OBJECTIVE We aimed to...
Article
Full-text available
Individuals may show different responses to stressful events. Here, we investigate the neurobiological basis of stress resilience, by showing that neural responsitivity of the noradrenergic locus coeruleus (LC-NE) and associated pupil responses are related to the subsequent change in measures of anxiety and depression in response to prolonged real-...
Preprint
BACKGROUND There is an increasing number of smartphone applications (apps) focusing on prevention, treatment, and diagnosis of depression. A promising approach to increase the effectiveness while reducing the individual’s burden is the use of just-in-time adaptive intervention (JITAI) mechanisms. OBJECTIVE With this work, we systematically assess...
Article
Full-text available
Cognitive models assume that the incomplete integration of a traumatic experience into the autobiographical memory results in typical symptoms associated with post-traumatic stress disorder (PTSD) such as intrusive re-experiencing. Sleep supports the integration of new experiences into existing memory networks through memory consolidation. In fifty...
Article
Self-efficacy is a key construct in behavioral science with significant impact on mental health and wellbeing. A growing body of work has shown that perceptions of self-efficacy can be increased through recall of autobiographical episodes (AEs) of mastery ("self-efficacy memories") in experimental settings. Doing so contributes to improvements in c...
Preprint
BACKGROUND Since the emergence of COVID-19, health care workers and first responders have been at high risk for mental health symptoms due to their exposure to the virus and higher work stress during the pandemic. Although interventions exist to address mental health issues following exposure to disasters, emergencies, and humanitarian crises, cons...
Article
Full-text available
Background Since the emergence of COVID-19, health care workers and first responders have been at a high risk for mental health symptoms owing to their exposure to the virus and increased work stress during the pandemic. Although interventions exist to address mental health issues following exposure to disasters, emergencies, and humanitarian crise...
Article
Full-text available
Background Dynamic trajectories of psychopathology, such as post-traumatic stress disorder (PTSD) provide a key to understanding human adjustment processes after trauma exposure. Recent studies have suggested more heterogeneous mental health outcomes than the initially identified four adjustment trajectories. To explore this heterogeneity, we inves...
Preprint
Medical personnel working in emergency rooms (ER) are at increased risk of mental health problems and suicidality. There is increasing evidence that mindfulness-based interventions can improve burnout and other mental health outcomes in health care providers. In contrast, few longitudinal prospective studies have examined protective functions of di...
Article
Full-text available
Abstract The SARS-CoV-2 pandemic is not only a threat to physical health but is also having severe impacts on mental health. Although increases in stress-related symptomatology and other adverse psycho-social outcomes, as well as their most important risk factors have been described, hardly anything is known about potential protective factors. Resi...
Preprint
Full-text available
Reappraisal of negative memories and experiences is central for mental health and well-being. Deficiency of reappraisal lies at the core of many psychiatric disorders and is a key target for treatment. Here we apply transcranial direct current stimulation (tDCS) to enhance reappraisal of negative emotional memories. In a randomized, sham-controlled...
Preprint
Full-text available
BACKGROUND Multisensor fitness trackers offer the ability to longitudinally estimate sleep quality in a home environment with the potential to outperform traditional actigraphy. To benefit from these new tools for objectively assessing sleep for clinical and research purposes, multisensor wearable devices require careful validation against the gold...
Article
Full-text available
Background: A growing number of psychological interventions are delivered via smartphones with the aim of increasing the efficacy and effectiveness of these treatments and providing scalable access to interventions for improving mental health. Most of the scientifically tested apps are based on cognitive behavioral therapy (CBT) principles, which a...
Preprint
BACKGROUND Multiple symptoms of suicide risk are assessed based on visual and auditory information including flattened affect, reduced movement, and slowed speech. Objective quantification of such symptomatology from novel data sources can increase the sensitivity, scalability, and timeliness of suicide risk assessment. OBJECTIVE The goal of this...
Article
Full-text available
Background Multiple symptoms of suicide risk have been assessed based on visual and auditory information, including flattened affect, reduced movement, and slowed speech. Objective quantification of such symptomatology from novel data sources can increase the sensitivity, scalability, and timeliness of suicide risk assessment. Objective We aimed to...
Preprint
Full-text available
Background Multiple symptoms of suicide risk are assessed based on visual and auditory information including flattened affect, reduced movement, and slowed speech. Objective quantification of such symptomatology from novel data sources can increase the sensitivity, scalability, and timeliness of suicide risk assessment. Methods In the current stud...
Article
Posttraumatic stress disorder (PTSD) is characterized by intrusive re-experiencing of emotional memories of a traumatic event. Such memories are formed after exposure to trauma in the context of a cascading stress response including high levels of emotional arousal and stress hormone release. Sleep could be a key modulator of early memory formation...
Article
Background The higher prevalence of major depressive disorder (MDD) in females relative to males is well-established. Some authors have posited this difference arises to divergent symptom profiles in females vs. males. However, empirical tests of this hypothesis have yielded equivocal results. Here, we investigate sex differences in MDD of individu...
Article
Posttraumatic stress disorder (PTSD) is characterized by intrusive re-experiencing of emotional memories of a traumatic event. Such memories are formed after exposure to trauma in the context of a cascading stress response including high levels of emotional arousal and stress hormone release. Sleep could be a key modulator of early memory formation...
Article
Cognitive control lies at the core of human adaptive behaviour. Humans vary substantially in their ability to execute cognitive control in order to optimally face environmental challenges, but the neural origins of this heterogeneity are currently not well understood. Recent theoretical frameworks implicate the locus coeruleus noradrenergic arousal...
Article
Zu den zentralen Aussagen der revidierten S3-Leitlinie Posttraumatische Belastungsstörung (PTBS) gehört die Empfehlung, dass bei der PTBS die traumafokussierte Psychotherapie die Behandlung erster Wahl ist, bei der der Schwerpunkt auf der Verarbeitung der Erinnerung an das traumatische Ereignis und / oder seiner Bedeutung liegt. Eine traumafokussie...
Article
Full-text available
Why do some individuals experience intrusive emotional memories following stressful or traumatic events whereas others do not? Attentional control may contribute to the development of such memories by shielding attention to ongoing tasks from affective reactions to task-irrelevant emotional stimuli. The present study investigated whether individual...
Article
Background: PTSD is characterised by severe sleep disturbances, which is increasingly recognised to in many cases consist of similar symptomology to sleep disorders such as REM Behaviour Disorder (RBD). The present study aimed to investigate whether different aspects of sleep quality influence intrusive memory development and whether PTSD status mo...
Preprint
Full-text available
Very little is known about the role of effective cognitive therapy in reversing imbalances in brain activity after trauma. We hypothesised that exaggerated threat perception characteristic of post-traumatic stress disorder (PTSD), and subsequent recovery from this disorder, are underpinned by changes in the dynamics of large-scale brain networks. H...
Article
Study objectives Stress can adversely impact sleep health by eliciting arousal increase and a cascade of endocrine reactions that may impair sleep. To date, little is known regarding continuous effects of real-world stress on physiological sleep characteristics and potential effects on stress-related psychopathology. We examined effects of stress o...
Chapter
Full-text available
Die zentralen Bausteine der Diagnostik einer Posttraumatischen Belastungsstörung (PTBS) sind die Erfassung der traumatischen Ereignisse sowie die assoziierten Folgen auf symptomatischer und funktionaler Ebene. Für die Diagnosestellung nach der International Statistical Classification of Diseases and Related Health Problems (ICD-10) [16] sind die do...
Article
Full-text available
This consensus paper provides an overview of the state of the art in research on the aetiology and treatment of nightmare disorder and outlines further perspectives on these issues. It presents a definition of nightmares and nightmare disorder followed by epidemiological findings, and then explains existing models of nightmare aetiology in traumati...
Article
Full-text available
Background A key mechanism thought to underlie Posttraumatic Stress Disorder (PTSD) is enhanced emotional memory consolidation. Recent evidence in healthy controls revealed that women have greater negative memory consolidation following stress relative to men. This study examined emotional memory consolidation in women and men with PTSD, and in tra...
Data
A ZIP file containing the dataset and statistical analysis results reported in this manuscript. (ZIP)
Article
Full-text available
Identifying early predictors for psychiatric disorders, such as post-traumatic stress disorder (PTSD), is crucial for effective treatment and prevention efforts. Obtaining such predictors is challenging and methodologically limited, for example by individuals' distress, arousal, and reduced introspective ability. We investigated the predictive powe...
Article
Full-text available
Background: Peri- and post-traumatic factors predict the differential development of stress-associated mental disorders. Prospective designs assessing these risk factors in real-time under controlled experimental conditions can overcome limitations of retrospective designs. Therefore, we aimed to investigate multi-sensory, experimental analogues o...
Article
Full-text available
Posttraumatic Stress Disorder (PTSD) is characterised by dysfunctional appraisals of the trauma and its consequences including one’s own symptoms. Experimental studies have shown that Cognitive Bias Modification—Appraisal (CBM-App) training can reduce dysfunctional interpretations and analog trauma symptoms. One important question is how to enhance...