Christine Kuehner

• PhD
• Head of Department at Central Institute of Mental Health

Premenstrual dysphoric disorder (PMDD) is characterized by pronounced affective core symptoms as well as other psychological and physical symptoms that occur in the luteal phase, usually in the premenstrual week and subside after the onset of menstruation. The PMDD has been included in the International Classification of Diseases 11 (ICD-11) in the...

Premenstrual dysphoric disorder (PMDD) is characterized by a cyclical symptom course. Previous research provides limited findings on possible menstrual-cycle-related psychological and psychoendocrinological processes in PMDD. By using ambulatory assessment (AA), we aimed to compare mood and cortisol cyclicity in individuals with PMDD and healthy co...

Objective: Alcohol use disorder (AUD) constitutes a critical public health issue and has sex-specific characteristics. Initial evidence suggests that progesterone and estradiol might reduce or increase alcohol intake, respectively. However, there is a need for a better understanding of how the menstrual cycle in females and the ratio of progestero...

Background Lifetime traumatic events are prevalent in women with Premenstrual Dysphoric Disorder (PMDD) and predict stronger premenstrual symptom intensities. Less is known about the unique effects of childhood adversity on PMDD. This study aims to investigate the menstrual cycle related course of mood, stress appraisal and cortisol activity over t...

In Major Depressive Disorder, first evidence shows heightened mood-reactivity toward daily events. Related longitudinal studies in remitted patients with recurrent major depression are lacking. Long-term changes in such short-term within-person associations can be analysed via measurement burst designs. Two bursts, separated by approximately 4.4 ye...

Rumination has been proposed as an important risk factor for depression, whereas mindful attention is considered a protective form of self-focusing. Experimental studies have demonstrated differential effects of these modes when induced in the lab. However, their impact on daily life processes is poorly understood, particularly in individuals vulne...

Habitual modes of thinking such as repetitive negative thinking (RNT), but also momentary cognitive processes such as mindwandering could be vulnerability factors for the course of Major Depressive Disorder (MDD). On the physiological level, cortisol represents an important biological stress marker of the hypothalamic-pituitary-adrenal (HPA) axis....

Subthreshold premenstrual symptoms can be impairing even if the diagnostic criteria for premenstrual dysphoric disorder (PMDD) are not reached. Previous research suggests shared psychological risk factors without a clear differentiation of premenstrual syndrome (PMS) from PMDD. This study focuses on a sample with a wide range of premenstrual sympto...

Major Depressive Disorder is a recurrent condition. Potential risk factors for future episodes are maladaptive cognitions such as rumination and unfavorable reactivity toward negative daily events. Positive thoughts and positive daily events, in contrast, could act as a buffer against mood deterioration. The aim of the present study is (1) to exami...

Background: Alcohol use disorder (AUD) is a critical public health issue with sex-specific characteristics and the need for a better mechanistic understanding. Initial evidence suggests that progesterone can reduce alcohol intake, while estradiol leads to an increase. However, we lack knowledge about how progesterone relative to estradiol influence...

Individuals who sleep poorly report spending more time mind wandering during the day. However , past research has relied on self-report measures of sleep or measured mind wandering during laboratory tasks, which prevents generalization to everyday contexts. We used ambulatory assessments to examine the relations between several features of sleep (d...

Zusammenfassung. Theoretischer Hintergrund: Das BDI-II ist ein Selbstbeurteilungsinstrument zur Erfassung des Schweregrads einer Depression. Es liegen kaum Analysen mit Modellen aus der Item-Response-Theorie (IRT) vor. Fragestellung: Wie hoch ist die Messgenauigkeit des BDI-II über die unterschiedlichen Ausprägungen des latenten Traits (Depressivit...

Background The psychological risk factors of premenstrual dysphoric disorder (PMDD) are not fully understood, but initial evidence points to a potential role of unfavorable cognitive emotion regulation (ER-) strategies. Given the symptom cyclicity of PMDD, ambulatory assessment is ideally suited to capture psychological and physiological processes...

Accumulating evidence suggests that individuals with greater executive resources spend less time mind wandering. Independent strands of research further suggest that this association depends on concentration and a guilty�dysphoric daydreaming style. However, it remains unclear whether this association is specifc to particular features of executive...

Zusammenfassung Ziel der Studie Untersuchung der diagnostischen Klassifikationsgüte und Validität des deutschsprachigen Beck-Depressions-Inventars (BDI-II) in einem kombinierten Datensatz aus Erwachsenenstichproben. Methode Das BDI-II und das SKID-I als externes Kriterium wurden an 638 Personen erhoben (385 mit akuter oder remittierter Depression,...

Borderline personality disorder (BPD) is commonly characterized by pervasive instability. Affective instability, despite being a diagnostic criterion in the DSM-5, is commonly seen as a transdiagnostic feature, but recent studies have brought new attention to the importance of self-esteem instability as a potential defining feature of BPD. However,...

Sarcopenia, similar to hypercortisolism, is characterized by loss of muscle mass and strength. Cortisol circadian rhythm changes with aging (blunted late-day nadir values) were suggested to contribute to this decline. We aimed to explore the relationship between diurnal salivary cortisol values and sarcopenia diagnosis and its components in postmen...

Purpose of Review In contrast to premenstrual dysphoric disorder (PMDD), premenstrual exacerbations (PMEs) of ongoing mood disorders are understudied. The aim of this review is to describe diagnostic issues, epidemiology, underlying mechanisms, and treatment for PME in unipolar depression and bipolar disorder, and to discuss clinical and research i...

Zusammenfassung Die COVID-19-Pandemie hat erhebliche Auswirkungen auf die psychische Gesundheit. Neben Ängsten um die ökonomische Situation, die eigene Gesundheit und die Gesundheit anderer Menschen können auch Maßnahmen der Pandemiekontrolle wie Distanzierung und die dadurch bedingte Isolation psychosoziale Folgen haben. Schließlich kann die Infek...

Procrastination is a prevalent problem among university students and associated with high long-term costs, but the short-term antecedents and consequences of procrastination are not well understood. Some related negative outcomes could be consequences as well as predictors of procrastination. The aim of the present study was to investigate possible...

Zusammenfassung Ziel der Studie Zusammenhangsanalyse von wahrgenommenen Alltagsbelastungen während der COVID-19-Krise und Persönlichkeitsaspekten mit dem aktuellen psychischen Befinden in der Bevölkerung sowie Vergleich der psychischen Symptomatik mit einem Survey von 2018. Methodik Zufallsstichprobe aus der Bevölkerung (n = 721), die zu coronabezo...

Importance Childhood abuse significantly increases the risk of developing posttraumatic stress disorder (PTSD), often accompanied by symptoms of borderline personality disorder (BPD) and other co-occurring mental disorders. Despite the high prevalence, systematic evaluations of evidence-based treatments for PTSD after childhood abuse are sparse. O...

Background Depression is related to default mode network (DMN) connectivity and higher respiration pattern variability (RPV). In addition, DMN connectivity and RPV are interrelated and predict a poorer clinical course of depression. The association of RPV and depression might further be boosted by anxiety levels. Aim of the present study was to inv...

Background: In 2003, we carried out the first epidemiological study on the frequency and effects of stalking in Germany that was based on a random population sample. We repeated the study with the same design in 2018 in order to assess any potential alterations over time in the frequency of stalking and of psychological problems in the affected pe...

Elevated cortisol levels have been associated with poorer cognitive performance in cross-sectional studies; this may be both a factor contributing to neurodegeneration and cognitive decline, and a result of developing brain pathologies. However, it is still unclear (I) whether cortisol measures predict later cognitive decline, and (II) whether cort...

Premenstrual Dysphoric Disorder (PMDD) is characterized by cyclical mood changes resulting in clinically significant distress and functional impairment. Studies on momentary cognitive and affective states and their interplay during daily life over the menstrual cycle in affected women are still lacking. Using Ecological Momentary Assessment with el...

Major Depression is a stress-related disorder characterized by altered hypothalamic-pituitary-adrenal axis function. Mindfulness-based interventions have shown to improve subjective parameters of stress and to reduce relapse rates in depressed patients. However, research on their effects on diurnal patterns of cortisol and associations with subject...

Repetitive negative thinking (RNT) is a maladaptive response to sadness and a transdiagnostic risk-factor. A critical challenge hampering attempts to promote more adaptive responses to sadness is that the between-person characteristics associated with the tendency for RNT remain uncharacterized. From the perspective of the impaired disengagement hy...

Premenstrual Dysphoric Disorder (PMDD) is characterized by significant emotional, physical and behavioral distress during the late luteal phase that remits after menses onset. Outlined as a new diagnostic category in DSM-5, the mechanisms underlying PMDD are still insufficiently known. Previous research suggests that PMDD exacerbates with stressful...

Rumination, the perseverative thinking about one’s problems and emotions, is a maladaptive response to sadness and a risk factor for the development and course of depression. A critical challenge hampering attempts to promote more adaptive responses to sadness is that the between-person characteristics associated with the tendency to ruminate follo...

Purpose: Physical activity (PA) has been shown to influence salivary cortisol concentrations in small studies conducted among athletes. We assessed the association of activity status and patterns with salivary cortisol in the general population. Methods: Cross-sectional study including 1948 adults (54.9% women, 45-86 years). PA and sedentary beh...

Objective: The complex relationship between psychosocial stress over the lifetime, psychological factors, and cardio-metabolic risk is still poorly understood. Accordingly, our aims were 1) to independently assess the associations between childhood adversity, life-event stress in remote (earlier than the last 5 years) and recent adulthood and card...

Received: December 14, 2017 Accepted: March 27, 2018 Published online: May 16, 2018 Issue release date: June 2018

Mind wandering is often thought to have adverse consequences such as to deteriorate mood. However, more recent findings suggest that the effect of mind wandering on mood may depend on the specific thought contents that occur during mind-wandering episodes and may be influenced by trait-like interindividual differences. The current study examined pr...

Background: Psychotherapy has been shown to be an effective treatment option for depressive disorders; however, its effectiveness varies depending on patient and therapist characteristics and the individual form of the depressive disorder. Objectives: The aim of this article is to present the current evidence for psychotherapeutic antidepressive...

Background: Depressive disorders are associated with a high burden of suffering and significantly reduce the well-being and the self-esteem of affected patients. Psychotherapy is one of the main treatment options for depressive disorders. Objective: The aim of this article is to present the current evidence for antidepressive psychotherapeutic t...

Background Studies with healthy participants and patients with respiratory diseases suggest a relation between respiration and mood. The aim of the present analyses was to investigate whether emotionally challenged remitted depressed participants show higher respiration pattern variability (RPV) and whether this is related to mood, clinical outcome...

In diesem Kapitel werden gruppentherapeutische Verfahren in der Depressionsbehandlung dargestellt. Dabei beschränken wir uns auf störungsspezifi sche Gruppen, für die im deutschen Sprachraum auch Therapiemanuale und Therapiematerialien verfügbar sind.

People’s minds frequently wander towards self-generated thoughts, which are unrelated to external stimuli or demands. These phenomena, referred to as “spontaneous thought” (ST) and “mind wandering” (MW), have previously been linked with both costs and benefits. Current assessments of ST and MW have predominantly been conducted in the laboratory, wh...

PLOS ONE MindWandering-personlevel n = 43.sav. (SAV)

PLOS ONE CK_MW-Mediation_personperiod.sas7bdat. (SAS7BDAT)

German version of the ARSQ 2.0. (DOCX)

PLOoS ONE MindWandering-personperiod_2rows.sav. (SAV)

PLOoS ONE MindWandering-personperiod_50rows.sav. (SAV)

Zusammenfassung Im vorliegenden narrativen Review werden aktuelle Aspekte zu Diagnostik, Häufigkeit, Ätiologie und Behandlungsstrategien der Prämenstruellen Dysphorischen Störung (PMDS) vorgestellt. Die Störung ist gekennzeichnet durch emotionale, körperliche und verhaltensmäßige Veränderungen während der prämenstruellen Phase des Monatszyklus, die...

Background Major depressive disorder (MDD) is characterized by a high risk for relapses and chronic developments. Clinical characteristics such as residual symptoms have been shown to negatively affect the long-term course of MDD. However, it is unclear so far how trait repetitive negative thinking (RNT) as well as cognitive and affective momentary...

PONE-D-16-35985 personlevel-T1T2T3.sav. (SAV)

PONE-D-16-35985 personperiod-T2T3.sav. (SAV)

Experimental procedure at baseline (T1). (DOCX)

Context: Increased evening cortisol levels, observed with aging and psychological stress, have been implicated in bone mineral density (BMD) loss. The effect on bone microarchitecture and fracture risk has never been studied. Objective: To study the relationship between salivary cortisol circadian rhythm and: 1) Trabecular Bone Score (TBS), a te...

Neurobiological research indicates that altered reward processing is among the most promising risk mechanisms in alcohol use disorder and depression. To elucidate differences and similarities between both disorders, we investigated clinical patients and at-risk individuals in two studies using a functional magnetic resonance imaging (fMRI) monetary...

Women are about twice as likely as are men to develop depression during their lifetime. This Series paper summarises evidence regarding the epidemiology on gender differences in prevalence, incidence, and course of depression, and factors possibly explaining the gender gap. Gender-related subtypes of depression are suggested to exist, of which the...

Die Peripartalzeit stellt eine kritische Phase für die Entwicklung und den Verlauf psychischer Erkrankungen dar. Psychische Störungen manifestieren sich hier entweder als Ersterkrankungen oder als Rezidive bzw. chronische Symptomatik mit Beginn und weiterem Verlauf innerhalb oder außerhalb der Peripartalzeit. Während für häufigere psychische Erkran...

Evidence for menstrual cycle-related mood fluctuations in the general population of women has been mixed. While most previous research has relied on retrospective self-report and did not consider possible moderators, the present study aimed to examine cycle-related mood variations in daily life and possible moderating effects of anxiety and trait r...

Depressive disorders are among the most frequently occurring reasons to seek counseling and one of the most common diseases in health care. The present paper provides a review of the most important psychotherapy relevant aspects of the current revision of the S3 Guideline/National Disease Management Guideline Unipolar Depression, published in Novem...

Introduction: The aim of this study was to evaluate if there is a significant effect of lunar phases on subjective and objective sleep variables in the general population. Methods: A total of 2125 individuals (51.2% women, age 58.8 ± 11.2 years) participating in a population-based cohort study underwent a complete polysomnography (PSG) at home....

Dysfunctional behavioural and neural processing of reward has been found in currently depressed individuals. However, little is known about altered reward processing in remitted depressed individuals. A total of 23 medication-free individuals with remitted major depressive disorder (rMDD) and 23 matched healthy controls (HCs) performed a reward tas...

Cognitive theories of recurrent depression suggest that the relationship between mood and cognition is altered by previous depressive episodes. In individuals remitted from depression (RMD) this would be linked to a larger susceptibility for new depressive symptoms. This study explored whether the association between mood and rumination indeed is d...

Dysfunctional processing of reward and punishment may play an important role in depression. However, functional magnetic resonance imaging (fMRI) studies have shown heterogeneous results for reward processing in fronto-striatal regions. We examined neural responsivity associated with the processing of reward and loss during anticipation and receipt...

Background: It has yet to be established whether gender moderates or predicts outcome of psychological and pharmacological treatments for adult depression because: (1) individual randomized trials typically lack sufficient statistical power to detect moderators and predictors and (2) meta-analyses cannot examine such associations directly. Method...

To the Editor In their report, Martin et al1 investigated a high-risk sample of the National Comorbidity Survey Replication Study (all fulfilling lifetime criteria for any mental disorder) and categorized items from 2 scales to their belongingness to either “male depression” or “gender inclusion,” the latter including “male symptoms” and traditiona...

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 assoc...

Affective state can influence cognition leading to biased information processing, interpretation, attention, and memory. Such bias has been reported to be essential for the onset and maintenance of different psychopathologies, particularly affective disorders. However, empirical evidence has been very heterogeneous and little is known about the neu...

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 chron...

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...

Depressed psychiatric inpatients show particularly high rates of recurrence and chronicity. To identify predictors of their long-term illness course is of high importance for tertiary prevention. We followed up 68 unipolarly depressed psychiatric inpatients 1, 6, 42, and 66 months after discharge. Outcomes included time spent in episodes, time to r...

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 transferre...

The present study examines episode characteristics in unipolar psychotic depression. From a sample of unipolar endogenous depressed inpatients, patients with a psychotic index episode (n=19) were compared to nonpsychotic patients (n=86) with regard to case history, characteristics of the inpatient episode, residual symptoms at discharge from hospit...

Decompressive hemicraniectomy reduces mortality after space-occupying MCA infarction. Data on the general public's opinion toward interventions that can save lives but leave the survivors impaired are lacking. In this population-based epidemiological study in a German city, we surveyed 312 adults in a telephone interview. Here, we presented a scena...

Zusammenfassung. Theoretischer Hintergrund: Brooding und Reflection gelten als unterschiedlich adaptive Ruminationsfacetten, die mit einer international häufig verwendeten 10-Item-Version des Response Styles Questionnaire (RSQ) erfasst werden. Fragestellung: Ziel war die psychometrische Evaluation der deutschsprachigen Version dieses Kurzfragebogen...

In diesem Kapitel werden gruppentherapeutische Verfahren in der Depressionsbehandlung dargestellt. Dabei beschränken wir uns auf störungsspezifische Gruppen, für die im deutschen Sprachraum auch Therapiemanuale und Therapiematerialien verfügbar sind. Beschrieben werden psychoedukative Methoden, kognitiv-behaviorale Programme und Genussgruppen sowie...

Components of psychosocial functioning represent both relevant mental health outcomes and predictors for the further course of illness in patients with depression and other mental illnesses. Determinants of these outcomes beyond residual symptom levels have rarely been investigated. The present study aimed at investigating prospective effects of de...

Decompressive hemicraniectomy reduces mortality in patients with space-occupying MCA infarction. Quality of life in surviving patients is discussed controversially. We assessed attitudes of neurologists and nurses providing care to this patient group towards decompressive hemicraniectomy. A postal questionnaire on attitudes and opinions on prognosi...

Studies suggest that stalking victimization may have a serious mental health impact. The present article investigates gender differences in mental health and possible mediating effects of stalking victimization in a community sample. The study includes a postal survey of 665 German community residents on the experience of stalking and various menta...

Recent genetic studies showed evidence for a role of the single-nucleotide polymorphism rs2522833 within the PCLO gene in the etiology of major depression, and rs2522833 has been shown to modulate hypothalamic pituitary adrenal (HPA) axis activity during antidepressant treatment. Monoaminergic modulation of the HPA system may be one possible pathom...

Depressive disorders are highly prevalent in primary care practices. Germany's evidence-based and consensus-based S3-/National Clinical Practice Guideline "Unipolar Depression" may improve quality in German depression care. The guideline provides distinct and evidence-based recommendations, i.e. the 14-days "watchful waiting" for patients with a "m...

While altered cortisol concentrations have been observed in subjects with type 2 diabetes their circadian cortisol profile is unknown. Using a cross-sectional design, we studied 63 ambulatory individuals with type 2 diabetes and 916 non-diabetic control subjects of the Cooperative Research in the Region of Augsburg (KORA)-F3 study. Circadian cortis...

Depressive disorders are highly prevalent in primary care practices. Germany’s evidence-based and consensus-based S3-/National Clinical Practice Guideline “Unipolar Depression” may improve quality in German depression care. The guideline provides distinct and evidence-based recommendations, i.e. the 14-days “watchful waiting” for patients with a “m...