Background: Suffering from cancer confronts both the patient and their partner with a number of p... more Background: Suffering from cancer confronts both the patient and their partner with a number of psychosocial challenges in various aspects of their life. These challenges may differentially impact on quality of life, coping ability and compliance to treatment. This especially holds true for haemato-oncological diseases. To date, psychological interventions have predominantly been developed for oncological patients however specific interventions for partners of haemato-oncological patients are rare. In this study we aim to conduct a psycho-oncological group-intervention for partners of patients with haemato-oncological diseases. The aim of the intervention is to significantly reduce symptoms of depression and anxiety in the partners and the patient, as well as enhancing dyadic coping. Methods: The design of the INPART-study is an unblinded, randomised controlled trial with 2 treatment conditions (experimental and control) and assessments at baseline, 3 and 6 months. It will be conducted at three study centres: the university medical centre's in Leipzig, Hannover and Ulm. The outcome criteria will be a reduction in depressive and anxiety symptoms as well as an improvement of dyadic coping. Discussion: This trial shall provide information regarding the efficiency of a psycho-oncological intervention for partners of patients with haemato-oncological diseases and give references to the possible outcome in terms of dyadic coping and the reduction of mental strain. The study was supported by a grant from the German José Carreras Leukaemia Foundation.
Using functional magnetic resonance imaging during a primed visual lexical decision task, we inve... more Using functional magnetic resonance imaging during a primed visual lexical decision task, we investigated the neural and functional mechanisms underlying modulations of semantic word processing through hypnotic suggestions aimed at altering lexical processing of primes. The priming task was to discriminate between target words and pseudowords pre-sented 200 ms after the prime word which was semantically related or unrelated to the tar-get. In a counterbalanced study design, each participant performed the task once at normal wakefulness and once after the administration of hypnotic suggestions to perceive the prime as a meaningless symbol of a foreign language. Neural correlates of priming were de-fined as significantly lower activations upon semantically related compared to unrelated tri-als. We found significant suggestive treatment-induced reductions in neural priming, albeit irrespective of the degree of suggestibility. Neural priming was attenuated upon suggestive treatment comp...
To compare cortical activation patterns associated with manual motor decision tasks at 1.5- and 3... more To compare cortical activation patterns associated with manual motor decision tasks at 1.5- and 3.0-T functional magnetic resonance (MR) imaging. The local ethics committee approved this study, and informed written consent was obtained. Ten right-handed healthy volunteers (eight men and two women; mean age, 35 years +/- 7 [standard deviation]) underwent functional MR imaging twice, once at 1.5 T and once at 3.0 T, while performing cognitive tasks that demanded manual motor decisions (letter-finger matching and lexical and semantic decisions). While stimulus presentation was blocked, an event-related model was employed to analyze subjects' individual responses. A group analysis of functional data was performed with a t test of 1.5- and 3.0-T results in the 10 subjects. Manual motor decisions activated a widespread network of motor- (primary motor, posterior parietal) and decision-related areas (superior frontal cortex or anterior cingulate) at both field strengths (P <.05, corrected). Moreover, additional functional activation was detected in medial (supplementary motor area) and dorsal premotor regions (P <.05, corrected) at 3.0-T functional MR imaging, which was not detectable with corresponding 1.5-T imaging. The mean t value for peak voxels in activated areas detectable with both systems was 1.3 times larger at 3.0 T than that at 1.5 T. Functional 3.0-T MR imaging allows detection of additional activation in cortical areas involved in higher executive motor functions compared with functional 1.5-T MR imaging.
Understanding the relevant meaning of a word with different meanings (homonym) in a given context... more Understanding the relevant meaning of a word with different meanings (homonym) in a given context requires activation of the neural representations of the relevant meaning and inhibition of the irrelevant meaning. The cognitive demand of such disambiguation is highest when the dominant, yet contextually irrelevant meaning of a polar homonym must be suppressed. This central process (semantic inhibition) for lexico-semantic ambiguity resolution was monitored with fMRI during semantic context verifications. Twenty-two healthy volunteers decided whether congruent or incongruent target words fitted into the contexts established by preceding sentences. Half of the sentences ended with a homonym, thereby allowing to cross the factors ambiguity and semantic congruency. BOLD increases related to the inhibitory attentional control over non-selected meanings during ambiguity processing occurred in a brain network including left dorsolateral prefrontal cortex (DLPFC), bilateral angular gyrus (AG), bilateral anterior superior temporal gyrus (aSTG) as well as right ventromedial temporal lobe. In left DLPFC (BA 46/9) and left AG (BA 39) BOLD activity to target words of the incongruent-ambiguous condition correlated with the individual amount of semantic interference experienced by the subjects. BOLD increases of incongruent versus congruent semantic verifications occurred in bilateral inferior frontal gyrus. The results of the present study suggest a specific role of left DLPFC and AG in the resolution of semantic interference from contextually inappropriate homonym meanings. These fronto-parietal areas might exert inhibitory control over temporal regions in service of attentional selection between relevant and irrelevant homonym meanings, by creating a sufficient activation difference between their respective representations.
The medial temporal lobe (MTL) is well known to be crucial for various types of memory; however, ... more The medial temporal lobe (MTL) is well known to be crucial for various types of memory; however, controversy remains as to which of its substructures contribute to semantic processing and, if so, to what extent. The current study addresses the issue of MTL contributions to semantic processing during lexico-semantic ambiguity processing by using functional magnetic resonance imaging (fMRI) in combination with a context verification task (CVT). The CVT required decisions on the semantic fit of congruent and incongruent target words to the overall meaning of preceding sentential contexts with and without semantic ambiguity. In two of the four experimental conditions (congruent homographic, incongruent homographic), target decisions were critically dependent on the successful processing of prior sentence-final lexicosemantic ambiguity. Semantic context verification per se evidenced bilateral activations of the hippocampus that were part of a functional network including inferior prefrontal and superior parietal cortices. Commonalities in activation differences pertaining to the specific cognitive component of lexico-semantic ambiguity processing were found in a left temporal lobe network that comprised activation foci in the temporal pole, the parahippocampal and fusiform gyri. The present results suggest that the hippocampus may well contribute to semantic processing, namely by a mnemonic function that serves to link the target meaning representation with the meaning of a prior sentence context. Contrary to previous reports from human lesion studies, the present findings further suggest, that the specific cognitive component of lexico-semantic ambiguity processing is neither dependent on the hippocampus nor exclusively subserved by the temporal pole, but also recruits an associative semantic memory function from the parahippocampal gyrus as well as a more general (bottom-up) semantic function from the fusiform gyrus. V
IntroductionCancer burdens not only the patient but also the partner to a comparable extent. Part... more IntroductionCancer burdens not only the patient but also the partner to a comparable extent. Partners of patients with cancer are highly involved in the caring process and therefore often experience distress and report a low quality of life. Interventions for supporting partners are scarce. Existing ones are rarely used by partners because they are often time-consuming per se and offer only limited flexibility with regard to schedule and location. The online intervention PartnerCARE has been developed on the basis of caregiver needs and consists of six consecutive sessions and four optional sessions, which are all guided by an e-coach. The study aims to evaluate feasibility and acceptance of the online intervention PartnerCARE and the related trial process. In addition, first insights of the putative efficacy of PartnerCARE should be gained.Methods and analysisA two-arm parallel-group randomised controlled trial will be conducted to compare the PartnerCARE online intervention with a...
International Journal of Environmental Research and Public Health
Cancer is a very distressing disease, not only for the patients themselves, but also for their fa... more Cancer is a very distressing disease, not only for the patients themselves, but also for their family members and relatives. Therefore, patients are regularly monitored to decide whether psychological treatment is necessary and applicable. However, such monitoring processes are costly in terms of required staff and time. Mobile data collection is an emerging trend in various domains. The medical and psychological field benefits from such an approach, which enables experts to quickly collect a large amount of individual health data. Mobile data collection applications enable a more holistic view of patients and assist psychologists in taking proper actions. We developed a mobile application, FeelBack, which is designed to support data collection that is based on well-known and approved psychological instruments. A controlled pilot evaluation with 60 participants provides insights into the feasibility of the developed platform and it shows the initial results. 31 of these participants...
This review focuses on the question whether mindfulness in follow-up care can contribute to the p... more This review focuses on the question whether mindfulness in follow-up care can contribute to the prevention of breast cancer (BC) recurrence. We first introduce behavioral risk and protective factors in follow-up care by presenting current research outcomes modulating individual risk for recurrence. We argue that although increased self-awareness is undoubtedly beneficial for BC survivors, it may also trigger adverse effects in vulnerable individuals such as overarousal and impaired emotional regulation. Indeed, research shows that many BC survivors are often confronted with clinical levels of fear of recurrence and anxiety and depressive symptoms. Research on awareness about the impact of behavior on health and fear of recurrence also offers interesting insights which can help to better understand non-compliant responses of BC survivors to medical recommendations regarding lifestyle or screening in follow-up care. Given the high rate of clinically relevant symptoms such as fear of recurrence and anxiety that may be related to dysfunctional levels of self-monitoring, we review the effects of a therapeutic intervention called Mindfulness-Based Stress Reduction (MBSR) that appears promising in reintegrating self-observation with patient well-being.
Deficits in inhibitory function are assumed to underlie psychopathology in bipolar disorder (BD),... more Deficits in inhibitory function are assumed to underlie psychopathology in bipolar disorder (BD), especially in states of mania. A subdomain of inhibition, semantic inhibition (SI), referring to the suppression of irrelevant word meanings, may underlie formal thought disorder, such as flights of ideas. In the present study, we investigated SI in patients with BD during semantic ambiguity resolution using behavioral and eventrelated potential (ERP) measures. We presented 14 patients with BD with current manic, hypomanic, or mixed clinical states and 28 healthy controls sequentially with word triplets containing either a homonym (e.g., "organ") or a comparable unambiguous word (e.g., "piano"). Participants were instructed to make a decision whether or not the target word was related to the meaning field of the first two words. The inappropriate homonym meaning had to be inhibited to correctly perform the target decision. In addition to reaction times (RT) and error rates (ER), the N400 ERP component to the target, an electrophysiological index of semantic processing, was analyzed as measure of the amount of SI that had taken place. Analyses of the behavioral data revealed that BD patients exhibited an overall worse performance in terms of RT and ER. In the ERP data, we found differences in N400 amplitude to ambiguous and unambiguous conditions over the right hemisphere in patients with BD depending on target congruence: In incongruent trials, N400 amplitude was smaller in ambiguous than in unambiguous words. In congruent trials, in contrast, N400 amplitude was larger in ambiguous than in unambiguous words. Such ERP differences between ambiguous and unambiguous words were absent in controls. We conclude that N400 amplitude differences in the ambiguous and unambiguous conditions of the BD group may reflect insufficient suppression of irrelevant homonym meanings in the right hemisphere. Disturbed SI processes might contribute to formal thought disorder in BD.
The medial temporal lobe (MTL) is well known to be crucial for various types of memory; however, ... more The medial temporal lobe (MTL) is well known to be crucial for various types of memory; however, controversy remains as to which of its substructures contribute to semantic processing and, if so, to what extent. The current study addresses the issue of MTL contributions to semantic processing during lexico-semantic ambiguity processing by using functional magnetic resonance imaging (fMRI) in combination with a context verification task (CVT). The CVT required decisions on the semantic fit of congruent and incongruent target words to the overall meaning of preceding sentential contexts with and without semantic ambiguity. In two of the four experimental conditions (congruent homographic, incongruent homographic), target decisions were critically dependent on the successful processing of prior sentence-final lexicosemantic ambiguity. Semantic context verification per se evidenced bilateral activations of the hippocampus that were part of a functional network including inferior prefrontal and superior parietal cortices. Commonalities in activation differences pertaining to the specific cognitive component of lexico-semantic ambiguity processing were found in a left temporal lobe network that comprised activation foci in the temporal pole, the parahippocampal and fusiform gyri. The present results suggest that the hippocampus may well contribute to semantic processing, namely by a mnemonic function that serves to link the target meaning representation with the meaning of a prior sentence context. Contrary to previous reports from human lesion studies, the present findings further suggest, that the specific cognitive component of lexico-semantic ambiguity processing is neither dependent on the hippocampus nor exclusively subserved by the temporal pole, but also recruits an associative semantic memory function from the parahippocampal gyrus as well as a more general (bottom-up) semantic function from the fusiform gyrus. V V C 2005 Wiley-Liss, Inc.
To compare cortical activation patterns associated with manual motor decision tasks at 1.5- and 3... more To compare cortical activation patterns associated with manual motor decision tasks at 1.5- and 3.0-T functional magnetic resonance (MR) imaging. The local ethics committee approved this study, and informed written consent was obtained. Ten right-handed healthy volunteers (eight men and two women; mean age, 35 years +/- 7 [standard deviation]) underwent functional MR imaging twice, once at 1.5 T and once at 3.0 T, while performing cognitive tasks that demanded manual motor decisions (letter-finger matching and lexical and semantic decisions). While stimulus presentation was blocked, an event-related model was employed to analyze subjects' individual responses. A group analysis of functional data was performed with a t test of 1.5- and 3.0-T results in the 10 subjects. Manual motor decisions activated a widespread network of motor- (primary motor, posterior parietal) and decision-related areas (superior frontal cortex or anterior cingulate) at both field strengths (P <.05, corrected). Moreover, additional functional activation was detected in medial (supplementary motor area) and dorsal premotor regions (P <.05, corrected) at 3.0-T functional MR imaging, which was not detectable with corresponding 1.5-T imaging. The mean t value for peak voxels in activated areas detectable with both systems was 1.3 times larger at 3.0 T than that at 1.5 T. Functional 3.0-T MR imaging allows detection of additional activation in cortical areas involved in higher executive motor functions compared with functional 1.5-T MR imaging.
Understanding the relevant meaning of a word with different meanings (homonym) in a given context... more Understanding the relevant meaning of a word with different meanings (homonym) in a given context requires activation of the neural representations of the relevant meaning and inhibition of the irrelevant meaning. The cognitive demand of such disambiguation is highest when the dominant, yet contextually irrelevant meaning of a polar homonym must be suppressed. This central process (semantic inhibition) for lexico-semantic ambiguity resolution was monitored with fMRI during semantic context verifications. Twenty-two healthy volunteers decided whether congruent or incongruent target words fitted into the contexts established by preceding sentences. Half of the sentences ended with a homonym, thereby allowing to cross the factors ambiguity and semantic congruency. BOLD increases related to the inhibitory attentional control over non-selected meanings during ambiguity processing occurred in a brain network including left dorsolateral prefrontal cortex (DLPFC), bilateral angular gyrus (AG), bilateral anterior superior temporal gyrus (aSTG) as well as right ventromedial temporal lobe. In left DLPFC (BA 46/9) and left AG (BA 39) BOLD activity to target words of the incongruent-ambiguous condition correlated with the individual amount of semantic interference experienced by the subjects. BOLD increases of incongruent versus congruent semantic verifications occurred in bilateral inferior frontal gyrus. The results of the present study suggest a specific role of left DLPFC and AG in the resolution of semantic interference from contextually inappropriate homonym meanings. These fronto-parietal areas might exert inhibitory control over temporal regions in service of attentional selection between relevant and irrelevant homonym meanings, by creating a sufficient activation difference between their respective representations.
BACKGROUND: The purposes of this study were (1) to identify healthy and unhealthy patterns of cop... more BACKGROUND: The purposes of this study were (1) to identify healthy and unhealthy patterns of coping strategies after bereavement among spouses of cancer patients and (2) to explore the characteris-BACKGROUND: Whereas a grief-related disorder tapping prolonged disabling reactions might be included in the DSM 5, the mechanisms underlying it remain poorly described. Some studies highlighted the risk for bereaved spouses after a cancer to develop this disorder, especially when reporting an insecure attachment. However no qualitative study explores associations between attachment styles and adjustment to grief in this population. This study aims at enhancing knowledge about the delineation of this debilitating condition. METHOD: The interview of a male widower (57 years) of a cancer patient, presenting a disorganized attachment and meeting at 6 months post-death the criteria for PGD (Inventory of Complicated Grief, Prigerson et al., 1995) was subjected to an Interpretative Phenomenological Analysis (IPA, Smith, Flowers & Larkin, 2009). This standardized analysis targets the meaning making processes with regards to attachment styles. RESULTS: Three inter-related master themes are presented: (1) Forgetting, and continuing bonds;
BACKGROUND: The purposes of this study were (1) to identify healthy and unhealthy patterns of cop... more BACKGROUND: The purposes of this study were (1) to identify healthy and unhealthy patterns of coping strategies after bereavement among spouses of cancer patients and (2) to explore the characteris-BACKGROUND: Whereas a grief-related disorder tapping prolonged disabling reactions might be included in the DSM 5, the mechanisms underlying it remain poorly described. Some studies highlighted the risk for bereaved spouses after a cancer to develop this disorder, especially when reporting an insecure attachment. However no qualitative study explores associations between attachment styles and adjustment to grief in this population. This study aims at enhancing knowledge about the delineation of this debilitating condition. METHOD: The interview of a male widower (57 years) of a cancer patient, presenting a disorganized attachment and meeting at 6 months post-death the criteria for PGD (Inventory of Complicated Grief, Prigerson et al., 1995) was subjected to an Interpretative Phenomenological Analysis (IPA, Smith, Flowers & Larkin, 2009). This standardized analysis targets the meaning making processes with regards to attachment styles. RESULTS: Three inter-related master themes are presented: (1) Forgetting, and continuing bonds;
Inhibitory functioning is assumed to be deficient in some psychiatric disorders, most notably in ... more Inhibitory functioning is assumed to be deficient in some psychiatric disorders, most notably in patients with schizophrenia and obsessive-compulsive disorder (OCD). In order to investigate inhibitory functioning, priming tasks are commonly used. The present paradigm offers the opportunity to isolate specific distractor features (identity, location) for independent examination. Negative priming (NP) for stimulus identity and location was examined in patients with schizophrenia (N = 16), patients with OCD (N = 15) and matched controls (N = 16). All groups performed a referent size-selection task in which they were instructed successively to select the larger one of two cardinal numbers. The deeper processing of both stimuli was expected to yield large NP effects that allow the detection of subtle group differences. Large NP effects were found for stimulus identity in all three groups. Schizophrenic patients differed from normal controls with respect to the amount of incidental location priming. Subgroup analyses of OCD patients showed NP impairments for checkers when the response-stimulus interval (RSI) was short, but large identity NP when the RSI was long. OCD non-checkers showed normal NP patterns with short RSI, but reduced identity NP with longer RSI. Schizophrenic patients do not show the ability to use spatial selective attention in order to guide their actions as shown by normal controls. Information processing was differentially impaired in OCD subgroups (checkers and non-checkers) dependent on RSI variation. This result supports those studies that found reduced NP in OCD patients and points to the necessity of differential subgroup studies.
ABSTRACT Spinal injections are increasingly used not only for diagnostic reasons, but also for pa... more ABSTRACT Spinal injections are increasingly used not only for diagnostic reasons, but also for pain relief, particularly in patients suffering from chronic pain. The clinical condition of chronic pain represents a complex interaction of physical, psychological, and psychosocial factors, both with regard to onset and maintenance. Despite this omnipresence of psychological aspects involved in the treatment of chronic pain, they are hitherto only scarcely recognized in the context of spinal interventions. The present contribution aims at facilitating the recognition of psychological aspects before, during, and after spinal injections ranging from subsyndromal distress to clinically relevant emotional disorders. Recommendations for clinical practice are provided regarding identification and treatment of these psychological problems to reduce patients’ psychological distress and enhance treatment adherence and to promote the feasibility and efficacy of spinal interventions by reducing confounding factors that might compromise the possible benefit of the spinal injection or cause unwanted complications. A particular emphasis is on early detection and treatment of anxiety specifically associated with injection procedures with its varying compromising consequences depending on the differential psychophysiological response pattern. In conclusion, empirical support on psychological aspects in spinal injections is clearly needed and would be highly valuable in informing clinical practice. In light of this reasoning, it is beyond doubt that spinal interventions would profit from a deeper understanding of specific psychological aspects relevant in the context of spinal injections.
Background: Suffering from cancer confronts both the patient and their partner with a number of p... more Background: Suffering from cancer confronts both the patient and their partner with a number of psychosocial challenges in various aspects of their life. These challenges may differentially impact on quality of life, coping ability and compliance to treatment. This especially holds true for haemato-oncological diseases. To date, psychological interventions have predominantly been developed for oncological patients however specific interventions for partners of haemato-oncological patients are rare. In this study we aim to conduct a psycho-oncological group-intervention for partners of patients with haemato-oncological diseases. The aim of the intervention is to significantly reduce symptoms of depression and anxiety in the partners and the patient, as well as enhancing dyadic coping. Methods: The design of the INPART-study is an unblinded, randomised controlled trial with 2 treatment conditions (experimental and control) and assessments at baseline, 3 and 6 months. It will be conducted at three study centres: the university medical centre's in Leipzig, Hannover and Ulm. The outcome criteria will be a reduction in depressive and anxiety symptoms as well as an improvement of dyadic coping. Discussion: This trial shall provide information regarding the efficiency of a psycho-oncological intervention for partners of patients with haemato-oncological diseases and give references to the possible outcome in terms of dyadic coping and the reduction of mental strain. The study was supported by a grant from the German José Carreras Leukaemia Foundation.
Using functional magnetic resonance imaging during a primed visual lexical decision task, we inve... more Using functional magnetic resonance imaging during a primed visual lexical decision task, we investigated the neural and functional mechanisms underlying modulations of semantic word processing through hypnotic suggestions aimed at altering lexical processing of primes. The priming task was to discriminate between target words and pseudowords pre-sented 200 ms after the prime word which was semantically related or unrelated to the tar-get. In a counterbalanced study design, each participant performed the task once at normal wakefulness and once after the administration of hypnotic suggestions to perceive the prime as a meaningless symbol of a foreign language. Neural correlates of priming were de-fined as significantly lower activations upon semantically related compared to unrelated tri-als. We found significant suggestive treatment-induced reductions in neural priming, albeit irrespective of the degree of suggestibility. Neural priming was attenuated upon suggestive treatment comp...
To compare cortical activation patterns associated with manual motor decision tasks at 1.5- and 3... more To compare cortical activation patterns associated with manual motor decision tasks at 1.5- and 3.0-T functional magnetic resonance (MR) imaging. The local ethics committee approved this study, and informed written consent was obtained. Ten right-handed healthy volunteers (eight men and two women; mean age, 35 years +/- 7 [standard deviation]) underwent functional MR imaging twice, once at 1.5 T and once at 3.0 T, while performing cognitive tasks that demanded manual motor decisions (letter-finger matching and lexical and semantic decisions). While stimulus presentation was blocked, an event-related model was employed to analyze subjects' individual responses. A group analysis of functional data was performed with a t test of 1.5- and 3.0-T results in the 10 subjects. Manual motor decisions activated a widespread network of motor- (primary motor, posterior parietal) and decision-related areas (superior frontal cortex or anterior cingulate) at both field strengths (P <.05, corrected). Moreover, additional functional activation was detected in medial (supplementary motor area) and dorsal premotor regions (P <.05, corrected) at 3.0-T functional MR imaging, which was not detectable with corresponding 1.5-T imaging. The mean t value for peak voxels in activated areas detectable with both systems was 1.3 times larger at 3.0 T than that at 1.5 T. Functional 3.0-T MR imaging allows detection of additional activation in cortical areas involved in higher executive motor functions compared with functional 1.5-T MR imaging.
Understanding the relevant meaning of a word with different meanings (homonym) in a given context... more Understanding the relevant meaning of a word with different meanings (homonym) in a given context requires activation of the neural representations of the relevant meaning and inhibition of the irrelevant meaning. The cognitive demand of such disambiguation is highest when the dominant, yet contextually irrelevant meaning of a polar homonym must be suppressed. This central process (semantic inhibition) for lexico-semantic ambiguity resolution was monitored with fMRI during semantic context verifications. Twenty-two healthy volunteers decided whether congruent or incongruent target words fitted into the contexts established by preceding sentences. Half of the sentences ended with a homonym, thereby allowing to cross the factors ambiguity and semantic congruency. BOLD increases related to the inhibitory attentional control over non-selected meanings during ambiguity processing occurred in a brain network including left dorsolateral prefrontal cortex (DLPFC), bilateral angular gyrus (AG), bilateral anterior superior temporal gyrus (aSTG) as well as right ventromedial temporal lobe. In left DLPFC (BA 46/9) and left AG (BA 39) BOLD activity to target words of the incongruent-ambiguous condition correlated with the individual amount of semantic interference experienced by the subjects. BOLD increases of incongruent versus congruent semantic verifications occurred in bilateral inferior frontal gyrus. The results of the present study suggest a specific role of left DLPFC and AG in the resolution of semantic interference from contextually inappropriate homonym meanings. These fronto-parietal areas might exert inhibitory control over temporal regions in service of attentional selection between relevant and irrelevant homonym meanings, by creating a sufficient activation difference between their respective representations.
The medial temporal lobe (MTL) is well known to be crucial for various types of memory; however, ... more The medial temporal lobe (MTL) is well known to be crucial for various types of memory; however, controversy remains as to which of its substructures contribute to semantic processing and, if so, to what extent. The current study addresses the issue of MTL contributions to semantic processing during lexico-semantic ambiguity processing by using functional magnetic resonance imaging (fMRI) in combination with a context verification task (CVT). The CVT required decisions on the semantic fit of congruent and incongruent target words to the overall meaning of preceding sentential contexts with and without semantic ambiguity. In two of the four experimental conditions (congruent homographic, incongruent homographic), target decisions were critically dependent on the successful processing of prior sentence-final lexicosemantic ambiguity. Semantic context verification per se evidenced bilateral activations of the hippocampus that were part of a functional network including inferior prefrontal and superior parietal cortices. Commonalities in activation differences pertaining to the specific cognitive component of lexico-semantic ambiguity processing were found in a left temporal lobe network that comprised activation foci in the temporal pole, the parahippocampal and fusiform gyri. The present results suggest that the hippocampus may well contribute to semantic processing, namely by a mnemonic function that serves to link the target meaning representation with the meaning of a prior sentence context. Contrary to previous reports from human lesion studies, the present findings further suggest, that the specific cognitive component of lexico-semantic ambiguity processing is neither dependent on the hippocampus nor exclusively subserved by the temporal pole, but also recruits an associative semantic memory function from the parahippocampal gyrus as well as a more general (bottom-up) semantic function from the fusiform gyrus. V
IntroductionCancer burdens not only the patient but also the partner to a comparable extent. Part... more IntroductionCancer burdens not only the patient but also the partner to a comparable extent. Partners of patients with cancer are highly involved in the caring process and therefore often experience distress and report a low quality of life. Interventions for supporting partners are scarce. Existing ones are rarely used by partners because they are often time-consuming per se and offer only limited flexibility with regard to schedule and location. The online intervention PartnerCARE has been developed on the basis of caregiver needs and consists of six consecutive sessions and four optional sessions, which are all guided by an e-coach. The study aims to evaluate feasibility and acceptance of the online intervention PartnerCARE and the related trial process. In addition, first insights of the putative efficacy of PartnerCARE should be gained.Methods and analysisA two-arm parallel-group randomised controlled trial will be conducted to compare the PartnerCARE online intervention with a...
International Journal of Environmental Research and Public Health
Cancer is a very distressing disease, not only for the patients themselves, but also for their fa... more Cancer is a very distressing disease, not only for the patients themselves, but also for their family members and relatives. Therefore, patients are regularly monitored to decide whether psychological treatment is necessary and applicable. However, such monitoring processes are costly in terms of required staff and time. Mobile data collection is an emerging trend in various domains. The medical and psychological field benefits from such an approach, which enables experts to quickly collect a large amount of individual health data. Mobile data collection applications enable a more holistic view of patients and assist psychologists in taking proper actions. We developed a mobile application, FeelBack, which is designed to support data collection that is based on well-known and approved psychological instruments. A controlled pilot evaluation with 60 participants provides insights into the feasibility of the developed platform and it shows the initial results. 31 of these participants...
This review focuses on the question whether mindfulness in follow-up care can contribute to the p... more This review focuses on the question whether mindfulness in follow-up care can contribute to the prevention of breast cancer (BC) recurrence. We first introduce behavioral risk and protective factors in follow-up care by presenting current research outcomes modulating individual risk for recurrence. We argue that although increased self-awareness is undoubtedly beneficial for BC survivors, it may also trigger adverse effects in vulnerable individuals such as overarousal and impaired emotional regulation. Indeed, research shows that many BC survivors are often confronted with clinical levels of fear of recurrence and anxiety and depressive symptoms. Research on awareness about the impact of behavior on health and fear of recurrence also offers interesting insights which can help to better understand non-compliant responses of BC survivors to medical recommendations regarding lifestyle or screening in follow-up care. Given the high rate of clinically relevant symptoms such as fear of recurrence and anxiety that may be related to dysfunctional levels of self-monitoring, we review the effects of a therapeutic intervention called Mindfulness-Based Stress Reduction (MBSR) that appears promising in reintegrating self-observation with patient well-being.
Deficits in inhibitory function are assumed to underlie psychopathology in bipolar disorder (BD),... more Deficits in inhibitory function are assumed to underlie psychopathology in bipolar disorder (BD), especially in states of mania. A subdomain of inhibition, semantic inhibition (SI), referring to the suppression of irrelevant word meanings, may underlie formal thought disorder, such as flights of ideas. In the present study, we investigated SI in patients with BD during semantic ambiguity resolution using behavioral and eventrelated potential (ERP) measures. We presented 14 patients with BD with current manic, hypomanic, or mixed clinical states and 28 healthy controls sequentially with word triplets containing either a homonym (e.g., "organ") or a comparable unambiguous word (e.g., "piano"). Participants were instructed to make a decision whether or not the target word was related to the meaning field of the first two words. The inappropriate homonym meaning had to be inhibited to correctly perform the target decision. In addition to reaction times (RT) and error rates (ER), the N400 ERP component to the target, an electrophysiological index of semantic processing, was analyzed as measure of the amount of SI that had taken place. Analyses of the behavioral data revealed that BD patients exhibited an overall worse performance in terms of RT and ER. In the ERP data, we found differences in N400 amplitude to ambiguous and unambiguous conditions over the right hemisphere in patients with BD depending on target congruence: In incongruent trials, N400 amplitude was smaller in ambiguous than in unambiguous words. In congruent trials, in contrast, N400 amplitude was larger in ambiguous than in unambiguous words. Such ERP differences between ambiguous and unambiguous words were absent in controls. We conclude that N400 amplitude differences in the ambiguous and unambiguous conditions of the BD group may reflect insufficient suppression of irrelevant homonym meanings in the right hemisphere. Disturbed SI processes might contribute to formal thought disorder in BD.
The medial temporal lobe (MTL) is well known to be crucial for various types of memory; however, ... more The medial temporal lobe (MTL) is well known to be crucial for various types of memory; however, controversy remains as to which of its substructures contribute to semantic processing and, if so, to what extent. The current study addresses the issue of MTL contributions to semantic processing during lexico-semantic ambiguity processing by using functional magnetic resonance imaging (fMRI) in combination with a context verification task (CVT). The CVT required decisions on the semantic fit of congruent and incongruent target words to the overall meaning of preceding sentential contexts with and without semantic ambiguity. In two of the four experimental conditions (congruent homographic, incongruent homographic), target decisions were critically dependent on the successful processing of prior sentence-final lexicosemantic ambiguity. Semantic context verification per se evidenced bilateral activations of the hippocampus that were part of a functional network including inferior prefrontal and superior parietal cortices. Commonalities in activation differences pertaining to the specific cognitive component of lexico-semantic ambiguity processing were found in a left temporal lobe network that comprised activation foci in the temporal pole, the parahippocampal and fusiform gyri. The present results suggest that the hippocampus may well contribute to semantic processing, namely by a mnemonic function that serves to link the target meaning representation with the meaning of a prior sentence context. Contrary to previous reports from human lesion studies, the present findings further suggest, that the specific cognitive component of lexico-semantic ambiguity processing is neither dependent on the hippocampus nor exclusively subserved by the temporal pole, but also recruits an associative semantic memory function from the parahippocampal gyrus as well as a more general (bottom-up) semantic function from the fusiform gyrus. V V C 2005 Wiley-Liss, Inc.
To compare cortical activation patterns associated with manual motor decision tasks at 1.5- and 3... more To compare cortical activation patterns associated with manual motor decision tasks at 1.5- and 3.0-T functional magnetic resonance (MR) imaging. The local ethics committee approved this study, and informed written consent was obtained. Ten right-handed healthy volunteers (eight men and two women; mean age, 35 years +/- 7 [standard deviation]) underwent functional MR imaging twice, once at 1.5 T and once at 3.0 T, while performing cognitive tasks that demanded manual motor decisions (letter-finger matching and lexical and semantic decisions). While stimulus presentation was blocked, an event-related model was employed to analyze subjects' individual responses. A group analysis of functional data was performed with a t test of 1.5- and 3.0-T results in the 10 subjects. Manual motor decisions activated a widespread network of motor- (primary motor, posterior parietal) and decision-related areas (superior frontal cortex or anterior cingulate) at both field strengths (P <.05, corrected). Moreover, additional functional activation was detected in medial (supplementary motor area) and dorsal premotor regions (P <.05, corrected) at 3.0-T functional MR imaging, which was not detectable with corresponding 1.5-T imaging. The mean t value for peak voxels in activated areas detectable with both systems was 1.3 times larger at 3.0 T than that at 1.5 T. Functional 3.0-T MR imaging allows detection of additional activation in cortical areas involved in higher executive motor functions compared with functional 1.5-T MR imaging.
Understanding the relevant meaning of a word with different meanings (homonym) in a given context... more Understanding the relevant meaning of a word with different meanings (homonym) in a given context requires activation of the neural representations of the relevant meaning and inhibition of the irrelevant meaning. The cognitive demand of such disambiguation is highest when the dominant, yet contextually irrelevant meaning of a polar homonym must be suppressed. This central process (semantic inhibition) for lexico-semantic ambiguity resolution was monitored with fMRI during semantic context verifications. Twenty-two healthy volunteers decided whether congruent or incongruent target words fitted into the contexts established by preceding sentences. Half of the sentences ended with a homonym, thereby allowing to cross the factors ambiguity and semantic congruency. BOLD increases related to the inhibitory attentional control over non-selected meanings during ambiguity processing occurred in a brain network including left dorsolateral prefrontal cortex (DLPFC), bilateral angular gyrus (AG), bilateral anterior superior temporal gyrus (aSTG) as well as right ventromedial temporal lobe. In left DLPFC (BA 46/9) and left AG (BA 39) BOLD activity to target words of the incongruent-ambiguous condition correlated with the individual amount of semantic interference experienced by the subjects. BOLD increases of incongruent versus congruent semantic verifications occurred in bilateral inferior frontal gyrus. The results of the present study suggest a specific role of left DLPFC and AG in the resolution of semantic interference from contextually inappropriate homonym meanings. These fronto-parietal areas might exert inhibitory control over temporal regions in service of attentional selection between relevant and irrelevant homonym meanings, by creating a sufficient activation difference between their respective representations.
BACKGROUND: The purposes of this study were (1) to identify healthy and unhealthy patterns of cop... more BACKGROUND: The purposes of this study were (1) to identify healthy and unhealthy patterns of coping strategies after bereavement among spouses of cancer patients and (2) to explore the characteris-BACKGROUND: Whereas a grief-related disorder tapping prolonged disabling reactions might be included in the DSM 5, the mechanisms underlying it remain poorly described. Some studies highlighted the risk for bereaved spouses after a cancer to develop this disorder, especially when reporting an insecure attachment. However no qualitative study explores associations between attachment styles and adjustment to grief in this population. This study aims at enhancing knowledge about the delineation of this debilitating condition. METHOD: The interview of a male widower (57 years) of a cancer patient, presenting a disorganized attachment and meeting at 6 months post-death the criteria for PGD (Inventory of Complicated Grief, Prigerson et al., 1995) was subjected to an Interpretative Phenomenological Analysis (IPA, Smith, Flowers & Larkin, 2009). This standardized analysis targets the meaning making processes with regards to attachment styles. RESULTS: Three inter-related master themes are presented: (1) Forgetting, and continuing bonds;
BACKGROUND: The purposes of this study were (1) to identify healthy and unhealthy patterns of cop... more BACKGROUND: The purposes of this study were (1) to identify healthy and unhealthy patterns of coping strategies after bereavement among spouses of cancer patients and (2) to explore the characteris-BACKGROUND: Whereas a grief-related disorder tapping prolonged disabling reactions might be included in the DSM 5, the mechanisms underlying it remain poorly described. Some studies highlighted the risk for bereaved spouses after a cancer to develop this disorder, especially when reporting an insecure attachment. However no qualitative study explores associations between attachment styles and adjustment to grief in this population. This study aims at enhancing knowledge about the delineation of this debilitating condition. METHOD: The interview of a male widower (57 years) of a cancer patient, presenting a disorganized attachment and meeting at 6 months post-death the criteria for PGD (Inventory of Complicated Grief, Prigerson et al., 1995) was subjected to an Interpretative Phenomenological Analysis (IPA, Smith, Flowers & Larkin, 2009). This standardized analysis targets the meaning making processes with regards to attachment styles. RESULTS: Three inter-related master themes are presented: (1) Forgetting, and continuing bonds;
Inhibitory functioning is assumed to be deficient in some psychiatric disorders, most notably in ... more Inhibitory functioning is assumed to be deficient in some psychiatric disorders, most notably in patients with schizophrenia and obsessive-compulsive disorder (OCD). In order to investigate inhibitory functioning, priming tasks are commonly used. The present paradigm offers the opportunity to isolate specific distractor features (identity, location) for independent examination. Negative priming (NP) for stimulus identity and location was examined in patients with schizophrenia (N = 16), patients with OCD (N = 15) and matched controls (N = 16). All groups performed a referent size-selection task in which they were instructed successively to select the larger one of two cardinal numbers. The deeper processing of both stimuli was expected to yield large NP effects that allow the detection of subtle group differences. Large NP effects were found for stimulus identity in all three groups. Schizophrenic patients differed from normal controls with respect to the amount of incidental location priming. Subgroup analyses of OCD patients showed NP impairments for checkers when the response-stimulus interval (RSI) was short, but large identity NP when the RSI was long. OCD non-checkers showed normal NP patterns with short RSI, but reduced identity NP with longer RSI. Schizophrenic patients do not show the ability to use spatial selective attention in order to guide their actions as shown by normal controls. Information processing was differentially impaired in OCD subgroups (checkers and non-checkers) dependent on RSI variation. This result supports those studies that found reduced NP in OCD patients and points to the necessity of differential subgroup studies.
ABSTRACT Spinal injections are increasingly used not only for diagnostic reasons, but also for pa... more ABSTRACT Spinal injections are increasingly used not only for diagnostic reasons, but also for pain relief, particularly in patients suffering from chronic pain. The clinical condition of chronic pain represents a complex interaction of physical, psychological, and psychosocial factors, both with regard to onset and maintenance. Despite this omnipresence of psychological aspects involved in the treatment of chronic pain, they are hitherto only scarcely recognized in the context of spinal interventions. The present contribution aims at facilitating the recognition of psychological aspects before, during, and after spinal injections ranging from subsyndromal distress to clinically relevant emotional disorders. Recommendations for clinical practice are provided regarding identification and treatment of these psychological problems to reduce patients’ psychological distress and enhance treatment adherence and to promote the feasibility and efficacy of spinal interventions by reducing confounding factors that might compromise the possible benefit of the spinal injection or cause unwanted complications. A particular emphasis is on early detection and treatment of anxiety specifically associated with injection procedures with its varying compromising consequences depending on the differential psychophysiological response pattern. In conclusion, empirical support on psychological aspects in spinal injections is clearly needed and would be highly valuable in informing clinical practice. In light of this reasoning, it is beyond doubt that spinal interventions would profit from a deeper understanding of specific psychological aspects relevant in the context of spinal injections.
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Papers by Klaus Hoenig