Tanja Michael

• D.Phil. (University of Oxford), Professor (Saarland University)
• Chair at Saarland University

We present performance results concerning the validation for anxiety level detection based on trained mathematical models using supervised machine learning techniques. The model training is based on biosignals acquired in a randomized controlled trial. Wearable sensors were used to collect electrocardiogram, electrodermal activity, and respiration...

Background: Hospitals, police stations, and fire departments are highly demanding workplaces. Staff members are regularly exposed to various stressors including traumatic events. Correspondingly, several studies report high rates of mental health issues among these occupations. Nevertheless, despite these challenging circumstances, some staff membe...

Introduction: It is claimed that the coronavirus disease 2019 (COVID-19) pandemic has had a negative impact on mental health. However, to date, prospective studies are lacking. Moreover, it is important to identify which factors modulate the stress response to the pandemic. Previously, sense of coherence (SOC) has emerged as a particularly importa...

Background and objectives Field research indicates that lower intelligence may predispose trauma-exposed individuals towards the development of re-experiencing symptoms. However, this assumption requires further testing in controlled prospective studies. In the current analog study, we tested whether lower fluid intelligence and lower working memor...

Fear-extinction based psychotherapy (exposure) is the most effective method for treating anxiety disorders. Notwithstanding, since some patients show impairments in the unlearning of fear and insufficient fear remission, there is a growing interest in using cognitive enhancers as adjuvants to exposure. As insulin plays a critical role in stress pro...

Reactivating a target memory and subsequently playing the computer game Tetris is thought to reduce intrusive memories and is being explored clinically. However, the current literature on the effect of Tetris on intrusions has limitations. To examine whether the previous finding from experimental research that Tetris reduces trauma film related int...

Background: Although meta-analyses suggest comparable efficacy of cognitive-behavioral therapy (CBT) in older adults compared to working-age adults, little is known about its effectiveness in naturalistic settings across different age groups. Hence, this study compared symptom change, attrition rates, and treatment duration in outpatient CBT betwee...

Objective: The way we interpret information shapes our perception of reality. Predictive processing frameworks propose that the ability to update interpretations based on disconfirming information is key to recovery from potentially traumatic events (PTEs). However, direct evidence for this assumption is scarce and comes from studies using paradigm...

Background: Perceived social support is an established predictor of post-traumatic stress disorder (PTSD) after exposure to a traumatic event. Gender is an important factor that could differentiate responses to social support, yet this has been little explored. Symptoms of complex PTSD are also common following trauma but have been under-researched...

Zusammenfassung: Theoretischer Hintergrund: Psychische Störungen sind mit langen Krankheitsausfällen und hohen betrieblichen und gesellschaftlichen Kosten verbunden. Psychotherapeutische Behandlungen können die Arbeitsfähigkeit verbessern und zu einer Reduktion von Arbeitsunfähigkeitstagen führen. Methode: Im Rahmen des KODAP-Projektes (Koordinatio...

Background The introduction of Compulsive Sexual Behavior Disorder (CSBD) into the 11th International Classification of Diseases has raised expectations for better treatment options for CSBD. Furthermore, the treatment demand has increased, particularly for pornography use disorder (PUD), a subtype of CSBD. Presumably due to the easy access to Inte...

Childhood maltreatment (CM) is thought to be associated with altered responses to social stimuli and interpersonal signals. However, limited evidence exists that CM is linked to larger comfortable interpersonal distance (CID) – the physical distance humans prefer towards others during social interactions. However, no previous study has investigated...

Tetris has been suggested to reduce intrusive memories and is being explored as a clinical intervention. However, the literature on the ‘Tetris effect’ has several shortcomings, which we aimed to address. We conducted a multi-site independent replication in healthy participants with a large sample size and detailed pre-registration. Experiment 1 (N...

Recent accounts of predictive processing in posttraumatic stress disorder (PTSD) suggest that trauma-exposed individuals struggle to update trauma-related hypotheses predicting danger, which may be involved in the etiology and maintenance of this disorder. Initial research supports this account, documenting an association between trauma-exposure, i...

Previous studies showed that glucose has beneficial effects on memory function and can enhance contextual fear learning. To derive potential therapeutic interventions, further research is needed regarding the effects of glucose on fear extinction. In two experimental studies with healthy participants (Study 1: N=68, 39 females; Study 2: N=89, 67 fe...

Background Research suggests that exposure therapy delivered in the morning is more successful than delivered in the evening, which is often explained by higher diurnal endogenous cortisol levels. However, this “morning exposure effect” might also be explained by other factors such as sleep or vigilance. Methods The current study aimed to disentan...

Equine-assisted therapies are becoming increasingly popular for addressing physical and psychological disabilities in clients. The role of the horse’s welfare in equine-assisted service receives increasing attention in research. Several studies have shown that horses are able to perceive human emotions and respond to human stress responses. However...

Previous studies showed that glucose has beneficial effects on memory function and can enhance contextual fear learning. To derive potential therapeutic interventions, further research is needed regarding the effects of glucose on fear extinction. In two experimental studies with healthy participants (Study 1: N=68, 39 females; Study 2: N=89, 67 fe...

This systematic review and meta-analysis aimed to synthesize the available evidence on the relationship between gender nonconformity and mental health. We also aimed to identify potential cultural, individual, and methodological moderators that impact this relationship.

Resilience can be viewed as trajectory of stable good mental health or the quick recovery of mental health during or after stressor exposure. Resilience factors (RFs) are psychological resources that buffer the potentially negative effects of stress on mental health. A problem of resilience research is the large number of conceptually overlapping R...

Background: Refugees with exposure to multiple traumatic events are at high risk for developing posttraumatic stress disorder (PTSD) and depression. Narrative exposure therapy (NET) is an effective treatment for the core symptoms of PTSD, but it does not reliably reduce depressive symptoms. Endurance exercise on the other hand was consistently foun...

Climate change, COVID-19, and the Russia-Ukraine War are some of the great challenges of our time. These global crises affect young people in a particularly vulnerable phase of their lives. The current study aimed to assess the impact of these crises on mental health (depression, anxiety, and health-related quality of life) in secondary school stud...

Background Referrals for child and adolescent acute psychiatric treatment have spiked in the last two years. To provide these adolescents with a fast-acting intervention, a novel treatment approach for acute emotional dysregulation was evaluated in this study. Methods 156 adolescents between the age of 13 and 18 years who were admitted to a psychi...

Climate change, Covid-19, and the Russia-Ukraine war are some of the great challenges of our time. These global crises affect young people in a particularly vulnerable phase of their lives. The current study aimed to assess the impact of these crises on mental health (depression, anxiety, and health-related quality of life) in secondary school stud...

Distressing intrusive memories of a traumatic event are one of the hallmark symptoms of posttraumatic stress disorder. Thus, it is crucial to identify early interventions that prevent the occurrence of intrusive memories. Both, sleep and sleep deprivation have been discussed as such interventions, yet previous studies yielded contradicting effects....

Introduction Approximately 12.3% of mothers experience childbirth-related post-traumatic stress symptoms (CB-PTSS). However, evidence-based interventions to treat CB-PTSS are lacking. Intrusive memories (IM), a key CB-PTSS, are distressing and can trigger other PTSS by reliving the traumatic event. Emerging evidence shows that a behavioural interve...

Objective: The COVID-19 pandemic is a significant stressor, potentially putting the well-being of the general population at risk. However, a significant proportion of the population exhibits resilience, raising questions regarding psychological constructs that could contribute to resilient coping. Studies indicate that flexibility, defined as the a...

Background and aims: For the first time, the ICD-11 provides the diagnosis compulsive sexual behavior disorder (CSBD) that can be assigned for pornography use disorder (PUD). This study aimed to estimate the prevalence of PUD and associated consequences in Germany, to identify the psychotherapy demand among likely PUD (lPUD) cases and the treatmen...

Background Evidence-based treatments of posttraumatic stress disorder (PTSD) aim to promote fear extinction learning. Post-learning sleep, particularly slow wave sleep (SWS), promotes memory consolidation and recall. Thus, boosting SWS might strengthen extinction recall. The current study investigated whether sleep-directed hypnosis designed to inc...

Childhood gender nonconformity (CGNC) seems to be associated with more mental health problems in adulthood. Previous research has suggested that this link might be mediated via the increased risk for aversive childhood experiences (ACEs) as a negative social reaction to CGNC. However, no study yet examined the role of resilience factors in this rel...

Recent accounts of predictive processing in posttraumatic stress disorder (PTSD) suggest that trauma-exposed individuals struggle to update trauma-related hypotheses predicting danger, which may be involved in the etiology and maintenance of the disorder. While initial research supports this account, showing an association between trauma exposure,...

Background: Sense of coherence (SOC) as the key component of the salutogenesis framework is negatively correlated with mental health problems in adults but also in children and adolescents. Since SOC is conceptualized to develop and stabilize from childhood to young adulthood, these life phases are of critical importance for the salutogenesis conc...

Background Refugees with exposure to multiple traumatic events are at high risk for developing trauma-related mental disorders, including Posttraumatic Stress Disorder (PTSD) and depression. Narrative Exposure Therapy (NET) is an effective treatment for the core symptoms of PTSD, but many studies did not find that it significantly reduces depressiv...

Childhood maltreatment (CM) is thought to be associated with altered responses to socialstimuli and interpersonal signals. Correspondingly, first studies found that CM is linked tolarger comfortable interpersonal distance (CID). However, studies were limited in statisticalpower and only examined individuals from the European region. Moreover, littl...

Background: The COVID-19 outbreak in early 2020 was associated with an immediate increase in mental health problems in a significant percentage of the general population. Therefore, it is crucial to investigate how the COVID-19 pandemic – as a psychosocial stressor – affected the aetiological processes of mental disorders. Previous research has sho...

The high level of uncertainty brought about by the COVID-19 pandemic has affected the general population's well-being and capacity for adaptive responding. Studies indicate that flexibility, defined as the ability to choose and employ a variety of emotional , cognitive and behavioural strategies in accordance with changing contextual demands, may s...

The COVID-19 pandemic is a significant stressor potentially putting the well-being of the general population at risk. However, a significant proportion of the population exhibits resilience, raising questions regarding psychological constructs that could contribute to resilient coping. Studies indicate that flexibility, defined as the ability to ad...

Background Several studies have investigated the relationship between emotional attachment to pets and mental health with the majority of studies finding a negative relationship between emotional attachment to pets and mental health. Interestingly, attachment to pets differs from attachment to humans with studies showing that humans with an insecur...

Distressing intrusive memories of a traumatic event are the hallmark symptom of posttraumatic stress disorder. Thus, it is crucial to identify early interventions that prevent the occurrence of intrusive memories. Both, sleep and sleep deprivation have been discussed as interventions, yet previous studies yielded contradicting effects. Our systemat...

The COVID-19 pandemic greatly disrupted our daily lives. Worldwide, people were confronted with health, financial, and existential fears or trauma-like experiences. Recent studies have identified an increase in stress, anxiety, and fear symptoms in connection with the pandemic. Furthermore, fear learning processes are central mechanisms in the deve...

The COVID-19 pandemic is a major chronic stressor affecting all societies and almost all individuals. Consequently, research demonstrated a negative impact of COVID-19 on mental health in parts of the general population. However, not all people are affected equally thus making the identification of resilience factors modulating the pandemic's impac...

Background Self-directed passive aggression (SD-PAB) is defined as any behaviour harming one-self by inactivity and omission of own needs. Depressive disorders are a severe mental disorder that results from the interaction between stress exposure, coping strategies, and vulnerability. Previous cross-sectional studies found SD-PAB to be associated w...

Childhood maltreatment (CM) is linked to impairments in various domains of social functioning. Here, we argue that it is critical to identify factors that underlie impaired social functioning as well as processes that mediate the beneficial health effects of positive relationships in individuals exposed to CM. Key research recommendations are prese...

Extinction learning is considered an important underlying process of successful treatment of posttraumatic stress disorder (PTSD). However, sleep disturbances may impede this learning process: Current accounts postulate that sleep facilitates encoding by promoting neural plasticity during slow wave sleep (SWS). Based on this hypothesis, we tested w...

Background The self-control model of depression suggests depressive symptoms to derive from distorted self-monitoring, dysfunctional self-evaluation and reduced self-reward as well as increased self-punishment. Building on this model a relationship between self-directed passive-aggressive behaviour, that is, harmful inactivity, and depression has b...

Background: Research suggests that companion animals have a beneficial effect on mental health. However, there are also studies finding null or negative relationships between pet ownership and mental health. It has been suggested that attachment to pets accounts for these diverging findings. Interestingly, there is some research suggesting that att...

Introduction. The high level of uncertainty brought by the COVID-19 pandemic has affected the general population’s well-being and ability to cope with daily challenges. Studies indicate that flexibility, defined as the ability to employ and adapt a variety of emotional, cognitive, and behavioral strategies in accordance with changing contextual dem...

Background: While most clinical aggression questionnaires focus on the assessment of active aggression, the recently developed Test of Passive Aggression (TPA) assesses both self-directed (TPA-SD) and other-directed passive aggression (TPA-OD). Reliability and factorial validity of the TPA have been demonstrated in a clinical sample, while previous...

Sense of coherence (SOC) as the key component of the salutogenesis framework is negatively correlated with psychopathological symptoms in adults but also in children and adolescents. Since SOC is conceptualized to develop and stabilize from childhood to early adulthood, these life phases are of critical importance for the salutogenesis concept. Ind...

The long-term impact of the COVID-19 pandemic on mental health is only starting to emerge. Beyond direct effects on mental health, it is crucial to investigate how negative psychological responses to the COVID-19 pandemic might affect etiological processes of different mental disorders. In the current online study, we investigated whether a negativ...

In individuals with a history of child maltreatment (CM), impairments in many domains of social functioning are well-documented but poorly understood. We summarize evidence for the detrimental effects of CM on social functioning and present key research recommendations focused on: 1. Identifying alterations in specific inter- and intra- personal pr...

Several studies have found evidence of altered cortisol levels in patients with posttraumatic stress disorder (PTSD). Based on these findings, it is assumed that these patients may show signs of cortisol dysregulation after trauma. Posttrauma cortisol levels are thus considered a potential biomarker of PTSD. However, longitudinal studies using indi...

Background: The COVID-19 pandemic is a multidimensional long-term stressor. Consequently, research demonstrated a negative impact of COVID-19 on mental health in parts of the general population. However, not all people are affected equally making the identification of resilience factors modulating the pandemic’s impact on mental health an important...

Several studies have found evidence of altered cortisol levels in patients with posttraumatic stress disorder (PTSD). Based on these findings, it is assumed that these patients may show signs of cortisol dysregulation after trauma. Posttrauma cortisol levels are thus considered a potential biomarker of PTSD. However, longitudinal studies using indi...

Although in vivo exposure therapy is highly effective in the treatment of specific phobias, only a minority of patients seeks therapy. Exposure to virtual objects has been shown to be better tolerated, equally efficacious, but the technology has not been made widely accessible yet. We developed an augmented reality (AR) application (app) to reduce...

Although in vivo exposure therapy is highly effective in the treatment of specific phobias, only a minority of patients seeks therapy. Exposure to virtual objects has been shown to be better tolerated, equally efficacious, but the technology has not been made widely accessible yet. We developed an augmented reality (AR) application (app) to reduce...

Background Self-directed passive aggressive behaviour is defined as self-harm by inactivity or omission. Based on the self-control model of depression suggesting depressive symptoms to derive from distorted self-monitoring, self-evaluation and reduced self-reward as well as increased self-punishment and reduced self-reward, a relationship between s...

Background: To date, most research on aggression in mental disorders focused on active-aggressive behavior and found self-directed and other-directed active aggression to be a symptom and risk-factor of psychopathology. On the other hand, passive-aggressive behavior has been investigated less frequently and only in research on psychodynamic defense...

Introduction Previous research indicates that traumatized individuals with post-traumatic stress disorder (PTSD) symptoms may show alterations in interpersonal distance regulation that are not evident in traumatized individuals without PTSD symptoms. However, the underlying mechanisms of these alterations are yet to be investigated. Moreover, it is...

Background: Previous research indicates that PTSD patients may show alterations in interpersonal distance regulation (IDR). However, it is not clear whether altered IDR is correlated with psychopathology after trauma and whether attentional processes might be involved in these alterations. Objective: The current study investigated IDR and attention...

Recent studies show that sleep reduces intrusive memories after analog trauma. This effect is assumed to be caused by sleep’s impact on memory consolidation. However, the underlying processes of this phenomenon have not been uncovered. Thus, the current study investigates the hypothesis that sleep reduces intrusive memories by supporting the select...

Die aktualisierte S3-Leitlinie zur posttraumatischen Belastungsstörung der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften enthält 15 Empfehlungen zu Diagnostik und Behandlung im Erwachsenenalter. Von zentraler Bedeutung sind die traumafokussierte kognitive Verhaltenstherapie oder Eye Movement Desensitization and Reproce...

Die COVID-19-Pandemie macht deutlich, dass medizinisches Personal Extrembelastungen ausgesetzt ist. Bilder entkräfteter Ärzte und Pflegekräfte, die bis zur Erschöpfungsgrenze und darüber hinaus arbeiten, beherrschten die Berichterstattung und lassen auch die psychischen Folgen ihres Einsatzes erahnen. Zahlreiche weitere Berufsgruppen wie Polizisten...

Background and objectives: In anxiety disorders, cognitive behavioural therapy (CBT) improves information- processing biases such as implicit fear evaluations and avoidance tendencies, which predicts treatment response. Thus, these cognitive biases might constitute important treatment targets. This study investigated (i) whether information-process...

Introduction. It is claimed that the COVID-19 pandemic has a negative impact on mental health. However, prospective data supporting this assertion are missing. Moreover, it is important to identify which factors modulate the stress response to the pandemic. Sense of coherence (SOC) has emerged as a particularly important resistance factor. Objecti...

Individuals working in high-risk occupations (e.g., emergency staff) are exposed to high levels of occupational stress including traumatic events. Correspondingly, several studies report high rates of mental health problems among these occupations. Pet ownership has been associated with better mental health. However, to date a study on the associat...

Sense of coherence (SOC) constitutes the key component of salutogenesis theory. It reflects individuals’ confidence that their environment is comprehensible and manageable and that their lives are meaningful. Research demonstrates a strong cross‐sectional relationship between SOC and mental health. However, little is known about SOC’s temporal stab...

Background Hospitals, police stations, and fire departments are highly demanding work places. Staff members are regularly exposed to various stressors including traumatic events. Correspondingly, several studies report high rates of mental health issues among these occupations. Nevertheless, despite these challenging circumstances, some staff membe...

Anders als andere psychische Erkrankungen haben die akute und die posttraumatische Belastungsstörung einen konkreten Auslöser in dem ihnen vorausgehenden traumatischen Ereignis. Direkt nach dem Ereignis sollte v. a. psychosoziale Akuthilfe im Vordergrund stehen, um die Entstehung von Traumafolgestörungen zu verhindern. Mit wachsendem zeitlichem Abs...

Numerous studies have shown that post-learning sleep enhances visual episodic recognition memory. However, it remains unclear whether this consolidation benefit is moderated by the emotional valence of the learned material. To clarify whether sleep selectively enhances memory for emotional material, we conducted a meta-analysis including N = 1059 p...

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...

Numerous studies have shown that sleep enhances the consolidation of episodic memory. However, it remains unclear whether this consolidation benefit is moderated by the emotional valence of the learned material. To clarify whether sleep selectively enhances the consolidation of emotional material, we conducted a meta-analysis including N = 1,059 ob...

Background: According to clinical guidelines, trauma-focused psychotherapies (TF-PT) such as trauma-focused cognitive behavioural therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) are recommended as first-line treatments for posttraumatic stress disorder (PTSD). TF-CBT and EMDR are equally effective and have large effect siz...

Background: Recent findings suggest that disruptions of sleep-related memory processing are involved in the development of posttraumatic stress symptoms. More specifically, exposure to an analogue traumatic event resulted in fewer intrusive memories, when it was followed by sleep instead of continued wakefulness. However, competing evidence suggest...

Unwillkürliche belastende Erinnerungen und die Vermeidung traumaassoziierter Reize prägen in Folge einer Traumatisierung das Leben derjenigen, die eine Posttraumatische Belastungsstörung entwickeln. Die Teilhabe am Alltag ist in vielen Fällen nur noch eingeschränkt möglich. Traumafokussierte kognitive Verhaltenstherapien (t-KVT) bieten Verfahren, d...

Bei der Behandlung posttraumatischer Belastungsstörungen (PTBS) stellen traumafokussierte Psychotherapieverfahren die Methode der ersten Wahl dar. Obwohl diese Verfahren nachweislich zu einer starken Symptomreduktion führen, bildet sich die PTBS-Symptomatik nicht bei allen Betroffenen vollständig zurück. Erste Befunde zum Einsatz von adjuvanten The...

Heart rate (HR) alterations in the immediate aftermath of trauma-exposure have been proposed to be potentially useful markers for child and adolescent posttraumatic stress disorder (PTSD). However, it is not yet clear if this holds true for measures taken more distal to the trauma, and no studies have investigated the predictive validity of more se...

Cortisol is a stress hormone and potent modulator of learning and memory processes. If administered after learning, cortisol can enhance memory consolidation. Yet it is unknown whether cortisol administration after fear extinction learning strengthens extinction memory. Extinction is a crucial mechanism underlying psychotherapy of posttraumatic str...

In anxiety disorders, cognitive behavioural therapy (CBT) improves information-processing biases such as implicit fear evaluations and avoidance tendencies, which predicts treatment response, so they might constitute important treatment targets. This study investigated (i) whether information-processing biases changed following single-session compu...

Background: Antonovsky’s concept of sense of coherence (SOC) – as a global orientation reflecting an individual’s feeling of confidence in both the predictability of their internal and external environment and their ability to cope with stressful and challenging situations in life – shows a negative association with symptoms of post-traumatic stres...

Posttraumatic stress disorder (PTSD) is often considered to be a disorder of memory as patients suffer from fragmented uncontrollable memories (intrusions) whilst experiencing difficulties in intentionally retrieving details of the traumatic event. Recent research suggests that trait-related deficits in the identification of emotional states (alexi...

Social threat detection is important in everyday life. Studies of cortical activity have shown that event-related potentials (ERPs) of motivated attention are modulated during fear conditioning. The time course of motivated attention in learning and extinction of fear is however still largely unknown. We aimed to study temporal dynamics of learning...