@article{BohleRimpelSchauenburgetal.2019, author = {Bohle, Hannah and Rimpel, J{\´e}r{\^o}me and Schauenburg, Gesche and Gebel, Arnd and Stelzel, Christine and Heinzel, Stephan and Rapp, Michael A. and Granacher, Urs}, title = {Behavioral and Neural Correlates of Cognitive-Motor Interference during Multitasking in Young and Old Adults}, series = {Neural Plasticity}, journal = {Neural Plasticity}, publisher = {Hindawi}, address = {New York}, issn = {2090-5904}, doi = {10.1155/2019/9478656}, pages = {20}, year = {2019}, abstract = {The concurrent performance of cognitive and postural tasks is particularly impaired in old adults and associated with an increased risk of falls. Biological aging of the cognitive and postural control system appears to be responsible for increased cognitive-motor interference effects. We examined neural and behavioral markers of motor-cognitive dual-task performance in young and old adults performing spatial one-back working memory single and dual tasks during semitandem stance. On the neural level, we used EEG to test for age-related modulations in the frequency domain related to cognitive-postural task load. Twenty-eight healthy young and 30 old adults participated in this study. The tasks included a postural single task, a cognitive-postural dual task, and a cognitive-postural triple task (cognitive dual-task with postural demands). Postural sway (i.e., total center of pressure displacements) was recorded in semistance position on an unstable surface that was placed on top of a force plate while performing cognitive tasks. Neural activation was recorded using a 64-channel mobile EEG system. EEG frequencies were attenuated by the baseline postural single-task condition and demarcated in nine Regions-of-Interest (ROIs), i.e., anterior, central, posterior, over the cortical midline, and both hemispheres. Our findings revealed impaired cognitive dual-task performance in old compared to young participants in the form of significantly lower cognitive performance in the triple-task condition. Furthermore, old adults compared with young adults showed significantly larger postural sway, especially in cognitive-postural task conditions. With respect to EEG frequencies, young compared to old participants showed significantly lower alpha-band activity in cognitive-cognitive-postural triple-task conditions compared with cognitive-postural dual tasks. In addition, with increasing task difficulty, we observed synchronized theta and delta frequencies, irrespective of age. Taskdependent alterations of the alpha frequency band were most pronounced over frontal and central ROIs, while alterations of the theta and delta frequency bands were found in frontal, central, and posterior ROIs. Theta and delta synchronization exhibited a decrease from anterior to posterior regions. For old adults, task difficulty was reflected by theta synchronization in the posterior ROI. For young adults, it was reflected by alpha desynchronization in bilateral anterior ROIs. In addition, we could not identify any effects of task difficulty and age on the beta frequency band. Our results shed light on age-related cognitive and postural declines and how they interact. Modulated alpha frequencies during high cognitive-postural task demands in young but not old adults might be reflective of a constrained neural adaptive potential in old adults. Future studies are needed to elucidate associations between the identified age-related performance decrements with task difficulty and changes in brain activity.}, language = {en} } @article{DeekenRezoHinzetal.2019, author = {Deeken, Friederike and Rezo, Anna and Hinz, Matthias and Discher, Robert and Rapp, Michael A.}, title = {Evaluation of technology-based interventions for informal caregivers of patients with dementia}, series = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry}, volume = {27}, journal = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry}, number = {4}, publisher = {Elsevier}, address = {New York}, issn = {1064-7481}, doi = {10.1016/j.jagp.2018.12.003}, pages = {426 -- 445}, year = {2019}, abstract = {Objective: The aim of this study was to estimate the efficacy of technology-based interventions for informal caregivers of people with dementia (PWD). Methods: PubMed, PsycINFO, and Cochrane Library databases were searched in August 2018, with no restrictions in language or publication date. Two independent reviewers identified 33 eligible randomized controlled trials (RCTs) conducting a technology-based intervention for informal carers of PWD. Meta-analyses for the outcome measures caregiver depression and caregiver burden were conducted with subgroup analyses according to mode of delivery (telephone, computer/web-based, combined interventions). To assess methodologic quality, the Cochrane risk-of-bias assessment was rated. Results: Meta-analyses revealed a small but significant postintervention effect of technology-based interventions for caregiver depression and caregiver burden. Combined interventions showed the strongest effects. Conclusion: Technology-based interventions have the potential to support informal caregivers of PWD. Because of advantages such as high flexibility and availability, technology-based interventions provide a promising alternative compared with "traditional services," e.g., those for people living in rural areas. More high-quality RCTs for specific caregiver groups are needed.}, language = {en} } @article{GarbusowNebeSommeretal.2019, author = {Garbusow, Maria and Nebe, Stephan and Sommer, Christian and Kuitunen-Paul, S{\"o}ren and Sebold, Miriam and Schad, Daniel and Friedel, Eva and Veer, Ilya M. and Wittchen, Hans-Ulrich and Rapp, Michael A. and Ripke, Stephan and Walter, Henrik and Huys, Quentin J. M. and Schlagenhauf, Florian and Smolka, Michael N. and Heinz, Andreas}, title = {Pavlovian-To-Instrumental Transfer and Alcohol Consumption in Young Male Social Drinkers}, series = {Journal of Clinical Medicine}, volume = {8}, journal = {Journal of Clinical Medicine}, number = {8}, publisher = {MDPI}, address = {Basel}, issn = {2077-0383}, doi = {10.3390/jcm8081188}, pages = {14}, year = {2019}, abstract = {In animals and humans, behavior can be influenced by irrelevant stimuli, a phenomenon called Pavlovian-to-instrumental transfer (PIT). In subjects with substance use disorder, PIT is even enhanced with functional activation in the nucleus accumbens (NAcc) and amygdala. While we observed enhanced behavioral and neural PIT effects in alcohol-dependent subjects, we here aimed to determine whether behavioral PIT is enhanced in young men with high-risk compared to low-risk drinking and subsequently related functional activation in an a-priori region of interest encompassing the NAcc and amygdala and related to polygenic risk for alcohol consumption. A representative sample of 18-year old men (n = 1937) was contacted: 445 were screened, 209 assessed: resulting in 191 valid behavioral, 139 imaging and 157 genetic datasets. None of the subjects fulfilled criteria for alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders-IV-TextRevision (DSM-IV-TR). We measured how instrumental responding for rewards was influenced by background Pavlovian conditioned stimuli predicting action-independent rewards and losses. Behavioral PIT was enhanced in high-compared to low-risk drinkers (b = 0.09, SE = 0.03, z = 2.7, p < 0.009). Across all subjects, we observed PIT-related neural blood oxygen level-dependent (BOLD) signal in the right amygdala (t = 3.25, p(SVC) = 0.04, x = 26, y = -6, z = -12), but not in NAcc. The strength of the behavioral PIT effect was positively correlated with polygenic risk for alcohol consumption (r(s) = 0.17, p = 0.032). We conclude that behavioral PIT and polygenic risk for alcohol consumption might be a biomarker for a subclinical phenotype of risky alcohol consumption, even if no drug-related stimulus is present. The association between behavioral PIT effects and the amygdala might point to habitual processes related to out PIT task. In non-dependent young social drinkers, the amygdala rather than the NAcc is activated during PIT; possible different involvement in association with disease trajectory should be investigated in future studies.}, language = {en} } @article{HeisselPietrekRappetal.2019, author = {Heissel, Andreas and Pietrek, Anou F. and Rapp, Michael A. and Heinzel, Stephan and Williams, Geoffrey}, title = {Perceived health care climate of older people attending an exercise program}, series = {Journal of aging and physical activity : JAPA ; the official journal of the International Society for Aging and Physical Activity}, volume = {28}, journal = {Journal of aging and physical activity : JAPA ; the official journal of the International Society for Aging and Physical Activity}, number = {2}, publisher = {Human Kinetics Publ.}, address = {Champaign}, issn = {1063-8652}, doi = {10.1123/japa.2018-0350}, pages = {276 -- 286}, year = {2019}, abstract = {The role of perceived need support from exercise professionals in improving mental health was examined in a sample of older adults, thereby validating the short Health Care Climate Questionnaire. A total of 491 older people (M = 72.68 years; SD = 5.47) attending a health exercise program participated in this study. Cronbach's alpha was found to be high (alpha = .90). Satisfaction with the exercise professional correlated moderately with the short Health Care Climate Questionnaire mean value (r = .38; p < .01). The mediator analyses yielded support for the self-determination theory process model in older adults by showing both basic need satisfaction and frustration as mediating variables between perceived autonomy support and depressive symptoms. The short Health Care Climate Questionnaire is an economical instrument for assessing basic need satisfaction provided by the exercise therapist from the participant's perspective. Furthermore, this cross-sectional study supported the link from coaching style to the satisfaction/frustration of basic psychological needs, which in turn, predicted mental health. Analyses of criterion validity suggest a revision of the construct by integrating need frustration.}, language = {en} } @article{KlugeRappMehranetal.2019, author = {Kluge, Ulrike and Rapp, Michael A. and Mehran, Nassim and Abi Jumaa, Jinan and Aichberger, Marion Christina}, title = {Poverty, migration and mental health}, series = {Der Nervenarzt : Organ der Deutschen Gesellschaft f{\"u}r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\"u}r Neurologie}, volume = {90}, journal = {Der Nervenarzt : Organ der Deutschen Gesellschaft f{\"u}r Psychiatrie, Psychotherapie und Nervenheilkunde ; Mitteilungsblatt der Deutschen Gesellschaft f{\"u}r Neurologie}, number = {11}, publisher = {Springer}, address = {New York}, issn = {0028-2804}, doi = {10.1007/s00115-019-00790-2}, pages = {1103 -- 1108}, year = {2019}, abstract = {Poverty and social exclusion are closely related to an increased risk for the deterioration of mental health. In 2018 approximately 19\% of the German population were threatened by poverty and the associated social ostracization. Migrant groups in particular often show an increased risk for poverty and are often exposed to multiple socioeconomic stress factors depending on the context of migration, pre-migration and post-migration social factors. Numerous studies have shown that societal exclusion, precarious living conditions and the residential environment negatively affect mental health beyond the effects of pre-migration risk factors. This article provides a review and discussion on the relationship between mental health, poverty and related constructs, such as social cohesion, social capital and social exclusion in general as well as in specific risk groups, such as migrant and refugee populations.}, language = {en} } @article{MeiberthRappJessen2019, author = {Meiberth, Dix Urs and Rapp, Michael A. and Jessen, Frank}, title = {Ged{\"a}chtnisambulanzstrukturen in Deutschland - Ergebnisse einer Klinikbefragung}, series = {Psychiatrische Praxis}, volume = {46}, journal = {Psychiatrische Praxis}, number = {4}, publisher = {Thieme}, address = {Stuttgart}, issn = {0303-4259}, doi = {10.1055/a-0825-9049}, pages = {213 -- 216}, year = {2019}, abstract = {Ziel der Studie Erfassung der Strukturen zur Fr{\"u}hdiagnostik von Demenzen an Krankenh{\"a}usern in Deutschland. Methodik Fragebogenerhebung. Ergebnisse 14 \% von 1758 kontaktierten Einrichtungen antworteten. 52 \% berichteten {\"u}ber ein entsprechendes Angebot, zum großen Teil mit leitlinienorientierten Verfahren, wie Liquordiagnostik. Das Diagnosespektrum umfasste zu 46 \% Demenzen und zu 41 \% Diagnosen der leichten oder subjektiven kognitiven St{\"o}rung. Schlussfolgerung Leitlinienbasierte Diagnostik und Fr{\"u}herkennungskonzepte sind in Ged{\"a}chtnisambulanzen weitgehend etabliert.}, language = {de} } @article{Rapp2019, author = {Rapp, Michael A.}, title = {Die Versorgung f{\"u}r die n{\"a}chste Dekade sichern: Gerontopsychiatrie in der Krise?}, series = {Psychatrische Praxis}, volume = {46}, journal = {Psychatrische Praxis}, number = {6}, publisher = {Thieme}, address = {Stuttgart}, issn = {0303-4259}, doi = {10.1055/a-0971-5551}, pages = {305 -- 306}, year = {2019}, abstract = {Der demografische Wandel wird nicht nur mit einer rasanten Zunahme der Hochaltrigen einhergehen [1], was f{\"u}r die gerontopsychiatrische Versorgung aufgrund der altersassoziierten Inzidenzraten in erster Linie eine Zunahme an Demenzerkrankungen und Patienten mit Multimorbidit{\"a}t und Gebrechlichkeit bedeutet [2], sondern auch mit einer Zunahme j{\"u}ngerer alter Menschen vom 65. bis 75. Lebensjahr, was f{\"u}r die Gerontopsychiatrie eine Zunahme der Patienten mit Abh{\"a}ngigkeitserkrankungen, Erkrankungen aus dem schizophrenen Formenkreis und affektiven Erkrankungen bedeutet. Soziale Faktoren werden hier mehr und mehr eine zentrale Rolle spielen, da neben der Qualit{\"a}t der medizinischen Versorgung insbesondere die individuelle soziale Situation der Patienten mit einer erh{\"o}hten Morbidit{\"a}t und Mortalit{\"a}t einhergehen wird [3].}, language = {de} } @article{Rapp2019, author = {Rapp, Michael A.}, title = {Alterspsychiatrie ist Teil ganzheitlicher Altersmedizin, kein Teilbereich der Psychiatrie - Kontra}, series = {Psychatrische Praxis}, volume = {46}, journal = {Psychatrische Praxis}, number = {6}, publisher = {Thieme}, address = {Stuttgart}, issn = {0303-4259}, doi = {10.1055/a-0958-8403}, pages = {308 -- 309}, year = {2019}, abstract = {Wenn in der Medizin vom demografischen Wandel gesprochen wird [1], wird zumeist von einer rasanten Zunahme der Hochaltrigen gesprochen, bei denen aufgrund der differenziellen altersassoziierten Inzidenzraten in erster Linie eine Zunahme an Demenzerkrankungen, kardiovaskul{\"a}ren Erkrankungen, Krebserkrankungen und allgemeiner Multimorbidit{\"a}t und Gebrechlichkeit zu erwarten ist [2]. Dies ist unstrittig richtig, aber nur ein Teil der Folgen des demografischen Wandels f{\"u}r die psychiatrische Versorgung. Diese muss weiterhin die gesamte adulte Lebensspanne im Blick haben, da sonst Versorgungsengp{\"a}sse bei ohnehin vulnerablen Patienten verst{\"a}rkt werden, mit Folgen f{\"u}r die Morbidit{\"a}t und Mortalit{\"a}t auf Bev{\"o}lkerungsebene [3].}, language = {de} } @article{SeboldGarbusowJetzschmannetal.2019, author = {Sebold, Miriam and Garbusow, Maria and Jetzschmann, P. and Schad, Daniel and Nebe, S. and Schlagenhauf, Florian and Heinz, A. and Rapp, Michael A. and Romanczuk-Seiferth, Nina}, title = {Reward and avoidance learning in the context of aversive environments and possible implications for depressive symptoms}, series = {Psychopharmacology}, volume = {236}, journal = {Psychopharmacology}, number = {8}, publisher = {Springer}, address = {New York}, issn = {0033-3158}, doi = {10.1007/s00213-019-05299-9}, pages = {2437 -- 2449}, year = {2019}, abstract = {Background Aversive stimuli in the environment influence human actions. This includes valence-dependent influences on action selection, e.g., increased avoidance but decreased approach behavior. However, it is yet unclear how aversive stimuli interact with complex learning and decision-making in the reward and avoidance domain. Moreover, the underlying computational mechanisms of these decision-making biases are unknown. Methods To elucidate these mechanisms, 54 healthy young male subjects performed a two-step sequential decision-making task, which allows to computationally model different aspects of learning, e.g., model-free, habitual, and model-based, goal-directed learning. We used a within-subject design, crossing task valence (reward vs. punishment learning) with emotional context (aversive vs. neutral background stimuli). We analyzed choice data, applied a computational model, and performed simulations. Results Whereas model-based learning was not affected, aversive stimuli interacted with model-free learning in a way that depended on task valence. Thus, aversive stimuli increased model-free avoidance learning but decreased model-free reward learning. The computational model confirmed this effect: the parameter lambda that indicates the influence of reward prediction errors on decision values was increased in the punishment condition but decreased in the reward condition when aversive stimuli were present. Further, by using the inferred computational parameters to simulate choice data, our effects were captured. Exploratory analyses revealed that the observed biases were associated with subclinical depressive symptoms. Conclusion Our data show that aversive environmental stimuli affect complex learning and decision-making, which depends on task valence. Further, we provide a model of the underlying computations of this affective modulation. Finally, our finding of increased decision-making biases in subjects reporting subclinical depressive symptoms matches recent reports of amplified Pavlovian influences on action selection in depression and suggests a potential vulnerability factor for mood disorders. We discuss our findings in the light of the involvement of the neuromodulators serotonin and dopamine.}, language = {en} } @article{SeboldSpittaGleichetal.2019, author = {Sebold, Miriam and Spitta, G. and Gleich, T. and Dembler-Stamm, T. and Butler, Oisin and Zacharias, Kristin and Aydin, S. and Garbusow, Maria and Rapp, Michael A. and Schubert, Florian and Buchert, Ralph and Gallinat, J{\"u}rgen and Heinz, A.}, title = {Stressful life events are associated with striatal dopamine receptor availability in alcohol dependence}, series = {Journal of neural transmission}, volume = {126}, journal = {Journal of neural transmission}, number = {9}, publisher = {Springer}, address = {Wien}, issn = {0300-9564}, doi = {10.1007/s00702-019-01985-2}, pages = {1127 -- 1134}, year = {2019}, abstract = {Stress plays a key role in modulating addictive behavior and can cause relapse following periods of abstinence. Common effects of stress and alcohol on the dopaminergic system have been suggested, although the precise mechanisms are unclear. Here, we investigated 20 detoxified alcohol-dependent patients and 19 matched healthy controls and assessed striatal D2/D3 availability using [F-18]-fallypride positron emission tomography and stressful life events. We found a strong association between striatal D2/D3 availability and stress in patients, but not in healthy controls. Interestingly, we found increased D2/D3 receptor availability in patients with higher stress levels. This mirrors complex interactions between stress and alcohol intake in animal studies and emphasizes the importance to investigate stress exposure in neurobiological studies of addiction.}, language = {en} }