“I don’t want to miss a symptom” – The role of biased interoception in somatic symptoms and illness anxiety

Somatic symptom disorder and illness anxiety disorder both involve preoccupation with signals from the body. According to predictive coding theory, the perception of somatic signals is guided by predictions from the brain. Pathological forms of somatic symptoms have been linked to a “better safe than sorry” decision strategy. This strategy is intended to avoid missing important signals at the cost of overreporting these signals. Predictions may thus lead to the assumption that a somatic signal is present, even when sensory evidence is sparse or missing altogether. In interoceptive tasks, the individual tendency to overreport signals (liberal response bias) can be distinguished from accuracy. In a systematic review and meta-analysis, results from 68 studies showed that interoceptive accuracy was reduced in functional syndromes, but not in somatic symptoms and illness anxiety. At the same time, a more liberal response bias was consistently associated with somatic symptoms and illness anxiety in the eight included studies. In a study with healthy participants, it was attempted to manipulate predictions to test whether tactile sensations are overreported under these circumstances. To this end, sham Wi-Fi exposure was used, given that many individuals belief that Wi-Fi exposure is able to induce physical symptoms. Indeed, participants tended to overreport sensations in the sham Wi-Fi as compared to a no-Wi-Fi condition, providing evidence for a predictive coding account of symptom perception. In a second study, individuals with pathological illness anxiety and healthy controls conducted a tactile detection task. It was expected that participants with pathological illness anxiety would show a more liberal response bias, and that this liberalization would be stronger in trials including illness words. Unexpectedly, response bias did not differ between groups in any of the conditions. Implications of the findings for clinical practice and future research are discussed

Digital Reading in Higher Education: A Comparison of Teacher Students with Other Student Groups

Digitale Lesefähigkeiten sind für Lehramtsstudierende in zweifacher Form bedeutsam: Sie werden im Rahmen der eigenen Ausbildung benötigt und stellen eine an Schülerinnen und Schüler zu vermittelnde Fähigkeit dar. Dass Lehramtsstudierende mit digitalen wissenschaftlichen Texten kompetent umgehen, gewann im Rahmen der digital organisierten ‹Corona-Semester› besondere Bedeutung. Vor diesem Hintergrund untersucht der vorliegende Beitrag, wie Lehramtsstudierende den Umgang mit digitaler Lektüre in Lehrveranstaltungen wahrnahmen, wie sie ihre eigene Arbeit mit diesen Texten – auch in emotionaler und motivationaler Hinsicht sowie mit Blick auf den Austausch über das Gelesene – einschätzten und welche Hilfestellung sie von Seiten der Universitäten und Hochschulen erhielten. Mithilfe einer online durchgeführten Umfrage wurden die Einschätzungen Lehramtsstudierender mit denen von Studierenden aus anderen Studiengängen (N = 4701) verglichen. Die Untersuchung hat gezeigt: Lehramtsstudierende berichteten nicht nur von grösseren Schwierigkeiten im effizienten Umgang mit Texten am Bildschirm, sondern schätzten auch ihre Konzentration und Stimmung beim Lesen negativer ein als Studierende anderer Fächer. Insgesamt stellten sich Lehramtsstudierende weniger selbstständig und intrinsisch motiviert dar als andere Studierende. Handlungsbedarf zeichnet sich insbesondere in dem Sinne ab, dass Studierenden verstärkt für das digitale Lesen adäquate Textformate bereitzustellen sind. Auch sollten Hochschulen Studierende insgesamt stärker im Umgang mit digitalen Texten unterstützen.  Digital reading skills are essential for teacher students in two ways: They are needed in the context of the students’ own education, and they represent a skill to be taught to pupils. The need for teacher students to be competent in dealing with digital scientific texts becomes particularly important in the context of the digitally organized ‹corona semesters›. In view of the above, this article examines how teacher students perceived the handling of digital texts in their courses, how they assessed their own work with these texts – also in emotional and motivational terms as well as with regard to the communication about what they read – and what support they received from their universities and colleges. With an online survey, the assessments of teacher students were compared with those of students from other fields of study (N = 4701). The study showed that teacher students seem to have greater difficulties in dealing efficiently with texts on the screen and rate their concentration and mood while reading more negatively than other students. Overall, teacher students were less self-reliant and intrinsically motivated than others. There is a need for action, particularly in the sense that students should be supplied with more adequate text formats for digital reading. Further, universities should provide students with more support in using digital texts

Internet-based psychotherapy in children with obsessive-compulsive disorder (OCD): protocol of a randomized controlled trial

Background: Obsessive-compulsive disorder (OCD) in children can lead to a huge burden on the concerned patients and their family members. While successful state-of-the art cognitive behavioral interventions exist, there is still a lack of available experts for treatment at home, where most symptoms manifest. Internet-based cognitive behavioral therapy (iCBT) could overcome these restrictions; however, studies about iCBT in children with OCD are rare and mostly target computerized self-help resources and only email contact with the therapist. Therefore, we intended to build up and to evaluate an iCBT approach for children with OCD, replacing successful elements of traditional in-office face-to-face CBT, with face-to-face teleconferences, online materials, and apps. Methods: With the help of a pilot feasibility study, we developed the iCBT consisting of 14 teleconference sessions with the child and parents. The sessions are supported by an app assessing daily and weekly symptoms and treatment course completed by children and parents. Additionally, we obtain heart rate and activity scores from the child via wristbands during several days and exposure sessions. Using a waiting list randomized control trial design, we aim to treat and analyze 20 children with OCD immediately after a diagnostic session whereas the control group of another set of 20 OCD patients will be treated after waiting period of 16 weeks. We will recruit 30 patients in each group to take account for potential dropouts. Outcomes for the treatment group are evaluated before randomization (baseline, t0), 16 weeks (end of treatment, t1), 32 weeks (follow-up 1, t2), and 48 weeks after randomization (follow-up 2, t3). For the waiting list group, outcomes are measured before the first randomization (baseline), at 16 weeks (waiting list period), 32 weeks (end of treatment), 48 weeks after the first randomization (follow-up I), and 64 weeks after the first randomization (follow-up II). Discussion: Based on our experience of feasibility during the pilot study, we were able to develop the iCBT approach and the current study will investigate treatment effectiveness. Building up an iCBT approach, resembling traditional in-office face-to-face therapy, may ensure the achievement of well-known therapy effect factors, the acceptance in both patients and clinicians, and the wide distribution within the health system. Trial registration: ClinicalTrials.gov NCT05037344 . Registered May 2019, last release August 13th, 2021

Internet-based psychotherapy in children with obsessive-compulsive disorder (OCD) : protocol of a randomized controlled trial

Funding Information: The study was evaluated and funded by the Ministry of Ministry of Social Affairs, Health and Integration Baden Württemberg, Germany. The ministry was not involved in any other steps of the study, including the original design, study analyses, data interpretation, or the paper preparation. Open Access funding enabled and organized by Projekt DEAL. Open Access funding enabled and organized by Project DEAL and by Open Access Publishing Fund of University of Tübingen. Publisher Copyright: © 2022, The Author(s).Background: Obsessive-compulsive disorder (OCD) in children can lead to a huge burden on the concerned patients and their family members. While successful state-of-the art cognitive behavioral interventions exist, there is still a lack of available experts for treatment at home, where most symptoms manifest. Internet-based cognitive behavioral therapy (iCBT) could overcome these restrictions; however, studies about iCBT in children with OCD are rare and mostly target computerized self-help resources and only email contact with the therapist. Therefore, we intended to build up and to evaluate an iCBT approach for children with OCD, replacing successful elements of traditional in-office face-to-face CBT, with face-to-face teleconferences, online materials, and apps. Methods: With the help of a pilot feasibility study, we developed the iCBT consisting of 14 teleconference sessions with the child and parents. The sessions are supported by an app assessing daily and weekly symptoms and treatment course completed by children and parents. Additionally, we obtain heart rate and activity scores from the child via wristbands during several days and exposure sessions. Using a waiting list randomized control trial design, we aim to treat and analyze 20 children with OCD immediately after a diagnostic session whereas the control group of another set of 20 OCD patients will be treated after waiting period of 16 weeks. We will recruit 30 patients in each group to take account for potential dropouts. Outcomes for the treatment group are evaluated before randomization (baseline, t0), 16 weeks (end of treatment, t1), 32 weeks (follow-up 1, t2), and 48 weeks after randomization (follow-up 2, t3). For the waiting list group, outcomes are measured before the first randomization (baseline), at 16 weeks (waiting list period), 32 weeks (end of treatment), 48 weeks after the first randomization (follow-up I), and 64 weeks after the first randomization (follow-up II). Discussion: Based on our experience of feasibility during the pilot study, we were able to develop the iCBT approach and the current study will investigate treatment effectiveness. Building up an iCBT approach, resembling traditional in-office face-to-face therapy, may ensure the achievement of well-known therapy effect factors, the acceptance in both patients and clinicians, and the wide distribution within the health system. Trial registration: ClinicalTrials.govNCT05037344. Registered May 2019, last release August 13th, 2021.Peer reviewe

The Internet as a Mental Health Advisor in Germany-Results of a National Survey

The internet constitutes a popular source of health information. However, the use of the internet and other modern media in the domain of mental health remains widely unclear. This study aimed at exploring the readiness for seeking information online and making use of online counseling and media-assisted psychotherapy. A representative survey of N = 2411 Germans was conducted. Results indicated that more than one fourth of Germans would consider seeking help online in case of psychic strain. Participants reported that they would use the internet when needing to research about mental health topics and to communicate with persons concerned on internet forums. Only a small number of participants had already used psychological online-counseling. The majority of subjects reported not having known about the possibility of online counseling. However, the willingness to make use of this option in the future was in a medium range. Concerning the treatment of mental disorders, participants showed a clear preference toward conventional face-to-face treatment. Less than 10% of participants considered the use of treatment supported by mobile phones, the internet, or virtual realities as likely. Certainly, readiness was significantly higher in persons who were already using the relevant devices-mobile phones, computers, and the internet. In the future, there will presumably be an increasing demand for media-assisted psychological counseling and interventions. Members of the health care system should therefore prepare for current developments and help enlighten patients with regard to the possibilities, and also the potential risks of e-mental health

Prepulse Inhibition of the Acoustic Startle Reflex in High Functioning Autism

High functioning autism is an autism spectrum disorder that is characterized by deficits in social interaction and communication as well as repetitive and restrictive behavior while intelligence and general cognitive functioning are preserved. According to the weak central coherence account, individuals with autism tend to process information detail-focused at the expense of global form. This processing bias might be reflected by deficits in sensorimotor gating, a mechanism that prevents overstimulation during the transformation of sensory input into motor action. Prepulse inhibition is an operational measure of sensorimotor gating, which indicates an extensive attenuation of the startle reflex that occurs when a startling pulse is preceded by a weaker stimulus, the prepulse

Portion of users of different health information sources (in %, N = 2411).

<p>Portion of users of different health information sources (in %, N = 2411).</p

Association between the willingness to use different kinds of media assisted psychotherapy and socio-demographic factors.

<p>n.s.: not significant.</p>*<p>p<0.1;</p>**<p>p<0.01;</p>***<p>p<0.001.</p