Subjektive Krankheitsrepräsentationen sind relevant für Outcomes der Adipositasbehandlung

Adipositas wird von der WHO als chronische Erkrankung beschrieben; Gewichtsreduktionsprogramme sind langfristig häufig nicht erfolgreich. Das Common-Sense-Modell (CSM) der Selbstregulation nach Leventhal nimmt an, dass kognitive und affektive subjektive Repräsentationen von chronischen Gesundheitszuständen das Selbstregulationsverhalten der Betroffenen und darüber den Krankheitsverlauf beeinflussen. Es scheint somit geeignet, um relevante Einflüsse auf Faktoren der Entstehung und Aufrechterhaltung der Adipositas zu identifizieren und neue Ansatzpunkte der Behandlung abzuleiten. Bislang wurden vor allem Ursachenrepräsentationen untersucht. Das CSM postuliert jedoch weitere kognitive (z. B. über Verlauf, Kontrollierbarkeit und Verständnis) sowie emotionale Repräsentationen, die bislang weitestgehend unberücksichtigt blieben

User-oriented development of global emission inventories: Bottom-up modeling of emissions from land transport, aviation and shipping in the DLR project ELK

The transport sector accounts for about one quarter of worldwide anthropogenic carbon dioxide emissions. Since a robust growth in transport activity is expected over the coming decades, reducing associated emissions to mitigate human-caused climate change is a particular challenge. In order to achieve high-quality comparative monitoring, to develop scenarios for future emissions, and to enable a robust assessment of climate protection measures, the allocation of emissions to the subsector level is a necessary prerequisite. The DLR project ELK - EmissionsLandKarte (en.: emission map) contributes here in several respects: (1) requirements are specified in an application-based manner, i.e. compatibility with existing inventories, such as the ones generated for IPCC, is ensured and insufficiencies in spatial resolution and methodological detail are addressed, (2) an input database congruent with both statistical data and SSP scenarios is provided, and (3) bottom-up calculations are performed that allow attribution of climate impacts to specific transport services, as well as prospective analyses where, for example, activity levels change or alternative fuels affect regional emission factors. The resulting prototype global gas and particle emission inventories for land transport, aviation and shipping reflect the status quo as of 2019. For land transport, fine-grained activity and vehicle fleet data as well as technology-specific emission factors are applied. This allows emissions from passenger and freight transport to be disaggregated by mode and vehicle type. New approaches for spatial disaggregation of emissions will increase transparency of the methodology. For aviation, calculations are based on fleet composition and transport performance for both passenger and cargo traffic at the airport pair level, while real flight tracks serve as the foundation for spatial allocation. For both transport sectors, complementary analyses are performed to characterize particulate emissions in order to fill gaps in data availability. For shipping, transport performance on inland waterways and maritime routes are considered, including technical data describing propulsion and bunkering. Finally, all mode-specific results are subjected to an innovative uncertainty assessment aligned with the needs of other emission inventory creators through a detailed evaluation per uncertainty factor, as well as aggregated values for climate modelers and practitioners. The consistent assessment of uncertainty factors along the entire calculation chain, such as activity levels, emission factors, and proxy data used for spatial or temporal disaggregation, promotes comparability across all transport sectors. In this paper, we outline the new methodological approaches for mapping transport emissions and present first results

Disorder specific rewarding stimuli in anorexia nervosa

Objective: To enhance our understanding of rewarding stimuli in anorexia nervosa (AN) and to provide a basis for future research on reward processes disorder specific rewarding stimuli were investigated. Method: We developed a set of pictures with ‘disorder specific reward’ stimuli and evaluated valence, arousal and reward ratings in 25 patients with AN and 25 healthy controls (HC). Results: We found higher valence, arousal and reward ratings in AN compared to HC for the ‘disorder specific reward’ stimuli. From our six sub categories of the ‘disorder specific re-ward’ stimuli the categories ‘sport’, ‘losing weight’ and ‘healthy food’ showed higher reward ratings compared to the categories ‘discipline’, ‘thin bodies’ and ‘appreciation of others’. Discussion: The previously used category ‘thin bodies’ for investigations of the reward system might be less effective than stimuli from the categories ‘sport’, ‘losing weight’ and ‘healthy food’

Alkoholabhängigkeit : ein Leitfaden zur Gruppentherapie

Dieser Leitfaden beinhaltet eine umfassende, übersichtliche und in sich abgeschlossene Therapieeinheit für die strukturierte Behandlung von Patienten mit Alkoholabhängigkeit. Er wurde für ambulante und stationäre Gruppentherapien entwickelt und evaluiert, bietet aber auch wertvolle Anregungen für die einzeltherapeutische Arbeit mit alkoholabhängigen Patienten. Neu ist die Integration aktueller Befunde aus der Neurobiologie sowie der sich daraus ableitenden Folgerungen für die psychotherapeutische Behandlung. Die Beschreibung der einzelnen Therapiemodule mit einfacher Verfügbarkeit der Arbeitsmaterialien als Download ermöglicht eine schnelle und praxisnahe Integration des Konzeptes in den therapeutischen Alltag

Do alcohol-dependent patients show different neural activation during response inhibition than healthy controls in an alcohol-related fMRI go/no-go-task?

Rationale: Alcohol dependence is associated with impaired response inhibition and heightened cue reactivity towards alcohol-related stimuli. Several brain areas, but mainly prefrontal structures, have been linked to response inhibition in addiction. This study aimed at combining both aspects: salience of drug-associated cues and response inhibition using a go/no-go task with alcohol-associated stimuli during functional magnetic resonance imaging (fMRI). Objectives: Nineteen abstinent alcohol-dependent patients (ADP) and 21 healthy control subjects (HC) were compared on blood oxygen level-dependent (BOLD) responses during successful inhibition of no-go stimuli and successful reactions to go stimuli. Results: ADP and HC did not significantly differ in their behavioural performance in the task. However, both groups performed worse during the inhibition of alcoholic-associated stimuli compared to neutral stimuli. On the neural level, ADP displayed enhanced BOLD activity relative to HC during successful response inhibition in several areas involved in visual processing, cognitive and impulse control, including occipital structures, anterior cingulate gyrus, medial frontal gyrus and medial orbitofrontal cortex. Conclusions: We interpret these findings as a possible compensation strategy for impaired cognitive processing. Furthermore, the results underline the impact of salience of alcohol-related stimuli on response inhibition, which seems to affect both ADP and HC

Food addiction and its relationship to weight- and addiction-related psychological parameters in individuals with overweight and obesity

$\textbf {Background and Aims:}$ It is assumed that a relevant subgroup of individuals experiences an addiction-like eating behaviour (Food Addiction), characterized by an impaired control over eating behaviour, emotional eating and food craving. Individuals experiencing Food Addiction partially share common symptomatology with Binge-Eating-Disorder and Bulimia Nervosa. The aim of this study was to investigate the prevalence of Food Addiction, general psychopathology, and associations with weight- and addiction-related constructs in individuals with overweight and obesity, who did not suffer from Binge-Eating-Disorder or Bulimia Nervosa. $\textbf {Methods:}$ $\it N$=213 (67.1% female; $M_{BMI}$=33.35$kg/m^{2}$, $SD_{BMI}$=3.79$kg/m^{2}$) participants who were included in a weight loss program (I-GENDO project) reported BMI and completed questionnaires before the start of the treatment. Food Addiction severity, depressive symptoms, alcohol use disorder, internet use disorder, psychological distress, impulsivity personality trait, impulsive and emotional eating behaviour, food related inhibitory control, weight bias internalization, and self-efficacy were assessed. $\textbf {Results:}$ The prevalence of Food Addiction was 15% with higher, although not statistically significant, prevalence in female (18.2%) compared to male (8.6%) participants. Food Addiction was associated with higher BMI at baseline assessment, low self-esteem, impulsive and emotional eating behaviour, weight bias internalization, and deficits in food-related inhibitory control. In addition, correlations were found between Food Addiction and severity of depressive symptoms, internet use disorder, and psychological distress. $\textbf {Conclusion:}$ A relevant subgroup of participants experiences Food Addiction even when controlling for Binge-Eating-Disorder and Bulimia Nervosa. Future studies are warranted that investigate whether Food Addiction affects treatment success