Papers by Stefan Sütterlin
Metacognitive awareness and resting vagally mediated heart rate variability (HRV) as a physiologi... more Metacognitive awareness and resting vagally mediated heart rate variability (HRV) as a physiological trait marker of cognitive inhibitory control capacities are both associated with better well-being and seem to share a common neural basis. Executive functioning which is considered a prerequisite for delivering prospective metacognitive judgments has been found to be correlated with HRV. This pilot study addresses the question, whether metacognitive awareness and resting vagally mediated HRV are positively associated. A sample of 20 healthy participants was analyzed that completed a typical Judgment of Learning task after an electrocardiogram had been recorded. The root-mean-squares of successive differences were used to calculate vagally mediated HRV. Metacognitive awareness was measured by comparing the judgments of learning with the actual memory performance, yielding a deviation score. HRV was found to be positively correlated with metacognitive awareness. Results suggest that metacognitive abilities might relate to physiological trait markers of cognitive inhibitory control capacities. Further experimental studies are needed to investigate causal relations.
Narcissists are described as individuals with dysfunctional personality traits such as lack of ps... more Narcissists are described as individuals with dysfunctional personality traits such as lack of psychological awareness and empathy.
Theories of ethical behaviour assume that unethical actions trigger moral emotions of guilt and shame. Currently, there is a lack of
knowledge on moral emotions as dispositional traits and their potential influences on behaviour in individuals with narcissistic traits. The
present study examined vulnerable and grandiose narcissism’s differences in the propensity to experience guilt and shame as a proneness, across a range of personal transgressions. Guilt proneness was measured by negative evaluation of unethical behaviour, and whether this evaluation could influence reparation of tendencies of unethical action in vulnerable and grandiose narcissism. Shame proneness was
investigated by negative evaluation of the self, and then whether the previous tendency could affect unethical decision making and
behaviour (e.g., hiding), in vulnerable and grandiose narcissism. Two hundred and sixteen participants responded to the Guilt and Shame
Proneness Scale, the Narcissistic Personality Inventory Scale and the Hypersensitive Narcissism Scale in an online questionnaire. Findings
indicate that grandiose narcissism was negatively associated with guilt proneness, and the relation between the vulnerable narcissism and
guilt proneness was negative. Additionally, the results confirm a negative association between grandiose narcissism and shame proneness,
especially related to the subscale ‘shame negative self-evaluation’. Furthermore, guilt and shame proneness explained 20% of the variance
in vulnerable narcissism and 11% in grandiose narcissism. This research indicates that both vulnerable and grandiose narcissism have the
tendency to make unethical decisions, and they are more likely to enact inunethical behaviour. These findings are relevant for the detection
of narcissistic individual’s propensity to act unethically in social context.
Consistent across time and cultures, men and male adolescents older than 14 years of age appear u... more Consistent across time and cultures, men and male adolescents older than 14 years of age appear underrepresented in mood disorders, and are far less likely than women to seek psychological help. The much higher rate of suicide amongst males suggests that depression in men might be underreported. One of the core human motives is to seek acceptance by others and avoid rejection. Rejection Sensitivity (RS) has been conceptualized as the cogni-tive-affective processing disposition to anxiously expect, readily perceive, and intensely respond to cues of rejection in the behavior of others. RS has been previously linked with the onset and course of depression, but—as yet—has not been investigated longitudinally in a clinical population. We investigated the predictive role of RS to symptom deterioration 6 months after end-of-treatment in 72 male inpatients with depressive spectrum disorder. The BDI was administered at intake, end-of-treatment and 6 month follow-up. RS scores were obtained at intake. Rejection Sensitivity had additional predictive power on BDI scores at 6 months follow-up controlling for BDI scores at end-of-treatment (ΔR 2 = .095). The results are discussed in terms of the importance of targeting RS during treatment, and highlight the fact that therapeutic follow-up care is paramount. Future research should investigate possible mediators of the RS–relapse-to-depression association, such as self-blame, rumination, neuroticism, pessimism, emotion dysregulation, and low self-esteem.
Agitation is a common problem in patients suffering from dementia and encompasses a variety of be... more Agitation is a common problem in patients suffering from dementia and encompasses a variety of behaviors such as repetitive acts, restlessness, wandering, and aggressive behaviors. Agitation reduces the probability of positive social interaction and increases the psychological and organizational burden. While medical interventions are common, there is need for complementary or alternative methods. Music intervention has been brought forward as a promising method to reduce agitation in dementia. While interventions, target groups and research designs differ, there has so far not been a systematic overview assessing the effect of music intervention for agitation in patients with dementia. A meta-analysis was conducted in order to investigate possible effects of music interventions. Twelve studies met inclusion criteria. Music intervention had a medium overall effect on agitation in dementia, suggesting robust clinical relevance. While the moderate number of studies does not allow for further differentiation between sub-types of music intervention, the subgroup comparisons indicated promising pathways for future systematic reviews. This meta-analysis is the first systematic and quantitative overview supporting clinically and statistically robust effects of music intervention on agitation in dementia. The analysis provides further arguments for this non-pharmacological approach and highlights needs for future systematic research reviews for the investigation of intervention types.
tDog aggression affects many, with nearly 5 million dog bites reported yearly in the United State... more tDog aggression affects many, with nearly 5 million dog bites reported yearly in the United States alone.Dog bites inflict considerable physical, emotional, and monetary costs annually (American Humane Asso-ciation, 2014). One physiological measure that might serve as an index of aggression in dogs is heart ratevariability (HRV). HRV refers to the vagally mediated beat-to-beat change in heart rate. Low HRV hasbeen associated with impaired emotional and behavioral regulation and stress in both humans and ani-mals. To assess whether this measure corresponds with aggression in dogs, the present study measuredresting HRV in dogs with and without bite histories. It was observed that dogs with bite histories hadsignificantly lower HRV (p = 0.024), and that owner reported aggression negatively correlated with HRV(p = 0.009). Dogs with a history of biting show poorer autonomic regulation as evidenced by their lowerHRV. Knowing this information can help us to target dogs that may be at risk for biting and to devise andtest treatments for dogs to improve behavioral and autonomic regulation.
The objective of this study was to examine the association between perseverative cognition in the... more The objective of this study was to examine the association between perseverative cognition in the form of work-related rumination, and heart rate variability (HRV). We tested the hypothesis that high ruminators would show lower vagally mediated HRV relative to low ruminators during their leisure time. Individuals were classified as being low (n = 17) or high ruminators (n = 19), using the affective scale on the work-related rumination measure. HRV was assessed using a wrist sensor band (Microsoft Band 2). HRV was sampled between 8 pm and 10 pm over three workday evenings (Monday to Wednesday) while individuals carried out their normal evening routines. Compared to the low ruminators, high affective ruminators demonstrated lower HRV in the form of root mean square successive differences (RMSSDs), relative to the low ruminators, indicating lower parasympathetic activity. There was no significant difference in heart rate, or activity levels between the two groups during the recording periods. The current findings of this study may have implications for the design and delivery of interventions to help individuals unwind post work and to manage stress more effectively. Limitations and implications for future research are discussed.
The rapid technical progress in cyber threats and cyber security poses increased cognitive demand... more The rapid technical progress in cyber threats and cyber security poses increased cognitive demands on cyber officers. The macrocognitive demand characteristics placed on the cyber officers exceed those in most common military contexts and are new in nature. Research on decision-making competence within the cyber domain is needed to identify strategies and give a better understanding of how these strategies can have consequences depending on task characteristics. Belief in one's capabilities to handle a certain task has been shown to be a key factor for cognitive performance. This study investigated how high self-efficacy negatively moderated intuitive decision-making tendencies on performance when facing a problem that required counterintuitive strategies. Twenty-seven cyber officer cadets from the Norwe-gian Defence Cyber Academy participated in an experiment assessing self-efficacy, interoceptive sensitivity, and decision-making. Participants with high situational self-efficacy generally performed better, but this relationship was moderated by interoceptive sensitivity. The findings suggest potential detrimental effects of intuitive decision-making tendencies in combination with high self-efficacy. Implications for training and feedback structures in cyber defense are discussed.
The word length effect shows a connection between word length and working memory performance. Alt... more The word length effect shows a connection between word length and working memory performance. Although the relationship between digit verbal length and digit span has been investigated between languages, it has not been investigated within a language. It was hypothesized that this effect can be shown as a connection between the prevalence of digits with two syllables and digit span score. The study examined the effect of amount of syllables on Norwegian digit span test scores by altering the prevalence of two-syllable digits using three conditions in a repeated measures design (N = 54). Results suggest that an elimination of two-syllable digits in a digit span test significantly reduced forward span test score (Cohen’s d = 0.36), but had no effect on backward span scores. These results suggest that a balanced distribution of two-syllable digits in a forward digit span tests should theoretically increase the test’s comparability and reduce language-related biases thus increasing the test’s parallel-form reliability. A peak-span model is proposed to integrate the findings into previous research on the word length effect.
Emotion regulation and associated autonomic activation develop throughout childhood and adolescen... more Emotion regulation and associated autonomic activation develop throughout childhood and adolescence under the influence of the family environment. Specifically, physiological indicators of autonomic nervous system activity such as interoceptive sensitivity and vagally mediated heart rate variability (HRV) can inform on emotion regulation. Although the effect of parental emotion socialization on emotion regulation appears to be influenced by auto-nomic processes, research on physiological regulation and the influence of parental factors remains scarce. This study investigated the relationship between self-reported habitual emotion regulation strategies and HRV at rest as well as interoceptive sensitivity in forty-six youngsters (27 female; age: M = 13.00, SD = 2.13). Secondly, the association between these autonomic correlates and parental psychopathology was also studied. Whereas better interoceptive sensitivity was related to reduced maladaptive emotion regulation, specifically rumination, high HRV was related to more use of external emotion regulation strategies (i.e., support seeking). In addition, increased HRV and decreased interoceptive sensitivity were associated with maternal internalizing and there was evidence for a possible mediation effect of HRV in the relationship between maternal internalizing and child external emotion regulation. This study elucidates the link between cognitive emotion regulation strategies and underlying physiological regulation in adolescents but also indicates a putative influence of maternal internalizing symptoms on emotion regulation in their offspring.
The reliable measurement of quality of life (QoL) presents a challenge in individuals with alcoho... more The reliable measurement of quality of life (QoL) presents a challenge in individuals with alcohol-related brain damage. This study investigated vagally mediated heart rate variability (vmHRV) as a physiological predictor of QoL. Self- and proxy ratings of QoL and dysexecutive symptoms were collected once, while vmHRV was repeatedly assessed over a 3-week period at weekly intervals in a sample of nine alcohol-related brain damaged patients. We provide robustness checks, bootstrapped correlations with confidence intervals, and standard errors for mean scores. We observed low to very low heart rate variability scores in our patients in comparison to norm values found in healthy populations. Proxy ratings of the QoL scale “subjective physical and mental performance” and everyday executive dysfunctions were strongly related to vmHRV. Better proxy-rated QoL and fewer dysexecutive symptoms were observed in those patients with higher vmHRV. Overall, patients showed low parasympathetic activation favoring the occurrence of dysfunctional emotion regulation strategies.
Central precocious puberty (CPP) develops due to premature activation of the hypothalamic-pituita... more Central precocious puberty (CPP) develops due to premature activation of the hypothalamic-pituitary-gonadal (HPG) axis, resulting in early pubertal changes and rapid bone maturation. CPP is associated with lower adult height and increased risk for development of psychological problems. Standard treatment of CPP is based on postponement of pubertal development by blockade of the HPG axis with gonadotropin releasing hormone analogs (GnRHa) leading to abolition of gonadal sex hormones synthesis. Whereas the hormonal and auxological effects of GnRHa are well researched, there is a lack of knowledge whether GnRHa treatment influences psychological functioning of treated children, despite the fact that prevention of psychological problems is used as one of the main reasons for treatment initiation. In the present study we seek to address this issue by exploring differences in cognitive function, behavior, emotional reactivity, and psychosocial problems between GnRHa treated CPP girls and age-matched controls.
Fifteen girls with idiopathic CPP; median age 10.4 years, treated with slow-release GnRHa (triptorelin acetate – Decapeptyl SR ® 11.25) and 15 age-matched controls, were assessed with a comprehensive test battery consisting of paper and pencil tests, computerized tasks, behavioral paradigms, heart rate variability, and questionnaires filled in by the children’s parents. Both groups showed very similar scores with regard to cognitive performance, behavioral and psychosocial problems. Compared to controls, treated girls displayed significantly higher emotional reactivity (p = 0.016; Cohen’s d = 1.04) on one of the two emotional reactivity task conditions. Unexpectedly, the CPP group showed significantly lower resting heart rates than the controls (p = 0.004; Cohen’s d = 1.03); lower heart rate was associated with longer treatment duration (r = - 0.582, p = 0.037).
The results suggest that GnRHa treated CPP girls do not differ in their cognitive or psychosocial functioning from age matched controls. However, they might process emotional stimuli differently. The unexpected finding of lower heart rate that was associated with longer duration of the treatment should be further explored by methods appropriate for assessment of cardiac health.
Guilt is a moral emotion that is often looked upon as a negative trait. However, studies show tha... more Guilt is a moral emotion that is often looked upon as a negative trait. However, studies show that some individuals are more predisposed to think, feel and act in a more ethical manner because of a lower threshold to experience guilt. Some theories of helping behaviour emphasize the evolutionary mechanisms, while other theories stress the importance of social variables. This study investigated whether guilt proneness as a dispositional trait can be associated with prosocial behaviour. Five hundred sixty-nine participants reported in an online survey their own levels of guilt proneness, frequency of prosocial behaviour, and related cognitions such as empathy. This study is among the first to demonstrate how guilt proneness combined with empathy can explain additional variance in prosocial behaviour. The findings also indicate gender differences in the precursors of prosocial behaviour, suggesting women are more influenced by the effects of guilt proneness on prosocial behaviour than men.
Recently, Garfinkel and Critchley (2013) proposed to distinguish between three facets of interoce... more Recently, Garfinkel and Critchley (2013) proposed to distinguish between three facets of interoception: interoceptive sensibility, interoceptive accuracy, and interoceptive awareness. This pilot study investigated how these facets interrelate to each other and whether interoceptive awareness is related to the metacognitive awareness of memory performance. A sample of 24 healthy students completed a heartbeat perception task (HPT) and a memory task. Judgments of confidence were requested for each task. Participants filled in questionnaires assessing interoceptive sensibility, depression, anxiety, and socio-demographic characteristics. The three facets of interoception were found to be uncorrelated and interoceptive awareness was not related to metacognitive awareness of memory performance. Whereas memory performance was significantly related to metamemory awareness, interoceptive accuracy (HPT) and interoceptive awareness were not correlated. Results suggest that future research on interoception should assess all facets of interoception in order to capture the multifaceted quality of the construct. Research on interoception has become a recognized field of interest in psychology during the past decades. In the broadest sense, the term interoception refers to the sense of the physiological condition of the body (Craig, 2003) and has been investigated in various contexts, such as clinical psychology (Dunn et al.
Like for classical nociceptive processing, we could find an inverse relationship between blood pr... more Like for classical nociceptive processing, we could find an inverse relationship between blood pressure reactivity and pain sensitivity in the present thermal grill paradigm. Participants displaying higher blood pressure responses in the experimental stimulation condition did not feel the illusive pain as compared to those with significantly lower blood pressure reactivity. These psychophysiological characteristics may be involved in the regulation of paradoxical pain sensitivity in addition to previously uncovered psychological factors [9] and hence explain part of the observed variance in the individual disposition to paradoxical pain perceptions.
Numerous studies have documented an inverse relationship between blood pressure and sensitivity t... more Numerous studies have documented an inverse relationship between blood pressure and sensitivity to experimental nociceptive stimulation. The present study aimed to investigate possible associations between blood pressure and the occurrence and intensity of paradoxical pain induced by the thermal grill paradigm. Thirty-one healthy subjects were stimulated three times for 1 minute with the nonnoxious temperatures of 15°C and 41°C set at the interlaced cold and warm bars of a water bathdriven thermal grill. Blood pressure and heart rate were recorded concomitantly. On account of previous observations of an association between the sensitivity of the cardiac baroreflex and pain perception, this parameter was additionally obtained. Numerical rating scales were used to quantify subjective pain intensity and pain unpleasantness; subjects were classified as responders and nonresponders to thermal grill stimulation based on pain intensity ratings. Responders exhibited lower systolic and diastolic blood pressure than non-responders, and inverse linear associations arose between blood pressure and pain intensity and unpleasantness. Baroreflex sensitivity was unrelated to pain ratings. The findings confirmed the hypothesis of a blood pressure dependence of paradoxical pain and support the notion that the cardiovascular and pain regulatory systems interact not only in the processing of pain elicited by noxious input, but also in non-noxiously generated illusive pain. While this finding is not consistent with the assumption of an involvement of the baroreflex system in mediating the observed interaction, psychological traits and neurochemical factors are alternatively considered.
Depression is assumed to be both a risk factor for rejection and a result of it, and as such cons... more Depression is assumed to be both a risk factor for rejection and a result of it, and as such constitutes an important factor in rejection research. Attachment theory has been applied to understand psychological disorders, such as depression, and can explain individual differences in responses to rejection. Research on autonomic nervous system activity to rejection experiences has been contradictory, with opposing strings of argumentation (activating vs. numbing). We investigated autonomic nervous system-mediated peripheral physiological responses (heart rate) to experimentally manipulated ostracism (Cyberball) in 97 depressed patients with organized (n = 52) and disorganized attachment status (n = 45). Controlling for baseline mean heart rate levels, depressed patients with disorganized attachment status responded to ostracism with significantly higher increases in heart rate than depressed patients with organized attachment status (p = .029; ηp 2 = .051). These results suggest that attachment status may be a useful indicator of autonomic responses to perceived social threat, which in turn may affect the therapeutic process and the patient-therapist relationship.
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Papers by Stefan Sütterlin
Theories of ethical behaviour assume that unethical actions trigger moral emotions of guilt and shame. Currently, there is a lack of
knowledge on moral emotions as dispositional traits and their potential influences on behaviour in individuals with narcissistic traits. The
present study examined vulnerable and grandiose narcissism’s differences in the propensity to experience guilt and shame as a proneness, across a range of personal transgressions. Guilt proneness was measured by negative evaluation of unethical behaviour, and whether this evaluation could influence reparation of tendencies of unethical action in vulnerable and grandiose narcissism. Shame proneness was
investigated by negative evaluation of the self, and then whether the previous tendency could affect unethical decision making and
behaviour (e.g., hiding), in vulnerable and grandiose narcissism. Two hundred and sixteen participants responded to the Guilt and Shame
Proneness Scale, the Narcissistic Personality Inventory Scale and the Hypersensitive Narcissism Scale in an online questionnaire. Findings
indicate that grandiose narcissism was negatively associated with guilt proneness, and the relation between the vulnerable narcissism and
guilt proneness was negative. Additionally, the results confirm a negative association between grandiose narcissism and shame proneness,
especially related to the subscale ‘shame negative self-evaluation’. Furthermore, guilt and shame proneness explained 20% of the variance
in vulnerable narcissism and 11% in grandiose narcissism. This research indicates that both vulnerable and grandiose narcissism have the
tendency to make unethical decisions, and they are more likely to enact inunethical behaviour. These findings are relevant for the detection
of narcissistic individual’s propensity to act unethically in social context.
Fifteen girls with idiopathic CPP; median age 10.4 years, treated with slow-release GnRHa (triptorelin acetate – Decapeptyl SR ® 11.25) and 15 age-matched controls, were assessed with a comprehensive test battery consisting of paper and pencil tests, computerized tasks, behavioral paradigms, heart rate variability, and questionnaires filled in by the children’s parents. Both groups showed very similar scores with regard to cognitive performance, behavioral and psychosocial problems. Compared to controls, treated girls displayed significantly higher emotional reactivity (p = 0.016; Cohen’s d = 1.04) on one of the two emotional reactivity task conditions. Unexpectedly, the CPP group showed significantly lower resting heart rates than the controls (p = 0.004; Cohen’s d = 1.03); lower heart rate was associated with longer treatment duration (r = - 0.582, p = 0.037).
The results suggest that GnRHa treated CPP girls do not differ in their cognitive or psychosocial functioning from age matched controls. However, they might process emotional stimuli differently. The unexpected finding of lower heart rate that was associated with longer duration of the treatment should be further explored by methods appropriate for assessment of cardiac health.
Theories of ethical behaviour assume that unethical actions trigger moral emotions of guilt and shame. Currently, there is a lack of
knowledge on moral emotions as dispositional traits and their potential influences on behaviour in individuals with narcissistic traits. The
present study examined vulnerable and grandiose narcissism’s differences in the propensity to experience guilt and shame as a proneness, across a range of personal transgressions. Guilt proneness was measured by negative evaluation of unethical behaviour, and whether this evaluation could influence reparation of tendencies of unethical action in vulnerable and grandiose narcissism. Shame proneness was
investigated by negative evaluation of the self, and then whether the previous tendency could affect unethical decision making and
behaviour (e.g., hiding), in vulnerable and grandiose narcissism. Two hundred and sixteen participants responded to the Guilt and Shame
Proneness Scale, the Narcissistic Personality Inventory Scale and the Hypersensitive Narcissism Scale in an online questionnaire. Findings
indicate that grandiose narcissism was negatively associated with guilt proneness, and the relation between the vulnerable narcissism and
guilt proneness was negative. Additionally, the results confirm a negative association between grandiose narcissism and shame proneness,
especially related to the subscale ‘shame negative self-evaluation’. Furthermore, guilt and shame proneness explained 20% of the variance
in vulnerable narcissism and 11% in grandiose narcissism. This research indicates that both vulnerable and grandiose narcissism have the
tendency to make unethical decisions, and they are more likely to enact inunethical behaviour. These findings are relevant for the detection
of narcissistic individual’s propensity to act unethically in social context.
Fifteen girls with idiopathic CPP; median age 10.4 years, treated with slow-release GnRHa (triptorelin acetate – Decapeptyl SR ® 11.25) and 15 age-matched controls, were assessed with a comprehensive test battery consisting of paper and pencil tests, computerized tasks, behavioral paradigms, heart rate variability, and questionnaires filled in by the children’s parents. Both groups showed very similar scores with regard to cognitive performance, behavioral and psychosocial problems. Compared to controls, treated girls displayed significantly higher emotional reactivity (p = 0.016; Cohen’s d = 1.04) on one of the two emotional reactivity task conditions. Unexpectedly, the CPP group showed significantly lower resting heart rates than the controls (p = 0.004; Cohen’s d = 1.03); lower heart rate was associated with longer treatment duration (r = - 0.582, p = 0.037).
The results suggest that GnRHa treated CPP girls do not differ in their cognitive or psychosocial functioning from age matched controls. However, they might process emotional stimuli differently. The unexpected finding of lower heart rate that was associated with longer duration of the treatment should be further explored by methods appropriate for assessment of cardiac health.