SCHMERZ UND EMOTIONALER VERARBEITUNG IM PSYCHOLOGISCHEN TRAUMATA

Extreme psychological and physical traumas cause dramatic symptom patterns which are insufficiently described by the psychiatric diagnostic criteria of post traumatic stress disorders (PTSD). Additionally, due to the neurobiological proximity and similarity of processing mechanisms of physical and psychological pain stimulation and extremely negative emotions, the patients often suffer from persistent pains even after the somatic healing process is completed. Epidemiological studies confirm the joint occurrence of pain and PTSD. The close relationship and the etiological and behavioral similarities of both disorders have led to the development of joined vulnerability and mutual maintenance models. The particular suffering of patients with PTSD due to chronic pain necessitates pain-therapeutic interventions. On the other hand, in chronic pain patients, the etiological role of severe traumas should be considered.Extreme psychische und körperliche Traumatisierungen bewirken dramatische Symptommuster, die durch die psychiatrischen Diagnosekriterien der Posttraumatischen Belastungstörung (PTBS) nur unzureichend beschrieben werden. Aufgrund ähnlicher neurophysiologischer Verarbeitungen von psychischer und körperlicher Schmerzen und intensiver, negativer Emotionen leiden Menschen nach Traumatisierungen oft unter persistierenden Schmerzen – auch wenn die körperlichen Folgen der Traumata geheilt sind. Die vorliegenden epidemiologischen Studien bestätigen das simultane Auftreten von PTBS und chronischen Schmerzen. Die enge Beziehung zwischen Schmerzen und Symptomen der PTBS führten zu gemeinsamen Krankheitsmodellen zur Vulnerabilität und gegenseitigen Aufrechterhaltung der Symptome (vulnerability and mutual maintenance models). Daraus folgt die Notwendigkeit das Schmerzleiden von Patienten mit PTBS spezifisch schmerztherapeutisches zu behandeln. Andererseits sollte der ätiologischen Bedeutung von traumatischen Ereignissen für die Schmerzentstehung und – aufrechterhaltung bei Schmerzpatienten beachtet werden

Neural correlates of the perception of dynamic versus static facial expressions of emotion

Aim: This study investigated brain areas involved in the perception of dynamic facial expressions of emotion

Facial emotion recognition and alexithymia in adults with somatoform disorders

The primary aim of this study was to investigate facial emotion recognition (FER) in patients with somatoform disorders (SFD). Also of interest was the extent to which concurrent alexithymia contributed to any changes in emotion recognition accuracy. Twenty patients with SFD and 20 healthy, age, sex and education matched, controls were assessed with the Facially Expressed Emotion Labelling Test of FER and the 26-item Toronto Alexithymia Scale. Patients withSFD exhibited elevated alexithymia symptoms relative to healthy controls.Patients with SFD also recognized significantly fewer emotional expressions than did the healthy controls. However, the group difference in emotion recognition accuracy became nonsignificant once the influence of alexithymia was controlled for statistically. This suggests that the deficit in FER observed in the patients with SFD was most likely a consequence of concurrent alexithymia. It should be noted that neither depression nor anxiety was significantly related to emotion recognition accuracy, suggesting that these variables did not contribute the emotion recognition deficit. Impaired FER observed in the patients with SFD could plausibly have a negative influence on these individuals’ social functioning

The influence of neuroticism and psychological symptoms on the assessment of images in three-dimensional emotion space

Objective: The present study investigated the influence of neuroticism (NEO Five-Factor Inventory (NEO-FFI)) and psychological symptoms (Brief Symptom Inventory (BSI)) on pleasure, arousal, and dominance (PAD) ratings of the International Affective Picture System (IAPS)

The influence of neuroticism and psychological symptoms on the assessment of images in three-dimensional emotion space

Objective: The present study investigated the influence of neuroticism (NEO Five-Factor Inventory (NEO-FFI)) and psychological symptoms (Brief Symptom Inventory (BSI)) on pleasure, arousal, and dominance (PAD) ratings of the International Affective Picture System (IAPS)

Pain Intensity Recognition Rates via Biopotential Feature Patterns with Support Vector Machines

Background: The clinically used methods of pain diagnosis do not allow for objective and robust measurement, and physicians must rely on the patient’s report on the pain sensation. Verbal scales, visual analog scales (VAS) or numeric rating scales (NRS) count among the most common tools, which are restricted to patients with normal mental abilities. There also exist instruments for pain assessment in people with verbal and / or cognitive impairments and instruments for pain assessment in people who are sedated and automated ventilated. However, all these diagnostic methods either have limited reliability and validity or are very time-consuming. In contrast, biopotentials can be automatically analyzed with machine learning algorithms to provide a surrogate measure of pain intensity. Methods: In this context, we created a database of biopotentials to advance an automated pain recognition system, determine its theoretical testing quality, and optimize its performance. Eighty-five participants were subjected to painful heat stimuli (baseline, pain threshold, two intermediate thresholds, and pain tolerance threshold) under controlled conditions and the signals of electromyography, skin conductance level, and electrocardiography were collected. A total of 159 features were extracted from the mathematical groupings of amplitude, frequency, stationarity, entropy, linearity, variability, and similarity. Results: We achieved classification rates of 90.94% for baseline vs. pain tolerance threshold and 79.29% for baseline vs. pain threshold. The most selected pain features stemmed from the amplitude and similarity group and were derived from facial electromyography. Conclusion: The machine learning measurement of pain in patients could provide valuable information for a clinical team and thus support the treatment assessment

The impact of sex differences on odor identification and facial affect recognition in patients with schizophrenia spectrum disorders

Background: Social interactive functions such as facial emotion recognition and smell identification have been shown to differ between women and men. However, little is known about how these differences are mirrored in patients with schizophrenia and how these abilities interact with each other and with other clinical variables in patients vs. healthy controls. Methods: Standardized instruments were used to assess facial emotion recognition [Facially Expressed Emotion Labelling (FEEL)] and smell identification [University of Pennsylvania Smell Identification Test (UPSIT)] in 51 patients with schizophrenia spectrum disorders and 79 healthy controls; furthermore, working memory functions and clinical variables were assessed. Results: In both the univariate and the multivariate results, illness showed a significant influence on UPSIT and FEEL. The inclusion of age and working memory in the MANOVA resulted in a differential effect with sex and working memory as remaining significant factors. Duration of illness was correlated with both emotion recognition and smell identification in men only, whereas immediate general psychopathology and negative symptoms were associated with emotion recognition only in women. Conclusion: Being affected by schizophrenia spectrum disorder impacts one’s ability to correctly recognize facial affects and identify odors. Converging evidence suggests a link between the investigated basic and social cognitive abilities in patients with schizophrenia spectrum disorders with a strong contribution of working memory and differential effects of modulators in women vs. men