TY - JOUR A1 - Heissel, Andreas A1 - Pietrek, Anou F. A1 - Rapp, Michael Armin A1 - Heinzel, Stephan A1 - Williams, Geoffrey T1 - Perceived health care climate of older people attending an exercise program BT - validation of the german short version of the health care climate questionnaire JF - Journal of aging and physical activity : JAPA ; the official journal of the International Society for Aging and Physical Activity N2 - 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. KW - autonomy support KW - basic psychological need satisfaction and frustration KW - depression KW - need support KW - physical activity Y1 - 2019 U6 - https://doi.org/10.1123/japa.2018-0350 SN - 1063-8652 SN - 1543-267X VL - 28 IS - 2 SP - 276 EP - 286 PB - Human Kinetics Publ. CY - Champaign ER - TY - GEN A1 - Garbusow, Maria A1 - Nebe, Stephan A1 - Sommer, Christian A1 - Kuitunen-Paul, Sören A1 - Sebold, Miriam Hannah A1 - Schad, Daniel A1 - Friedel, Eva A1 - Veer, Ilya M. A1 - Wittchen, Hans-Ulrich A1 - Rapp, Michael Armin A1 - Ripke, Stephan A1 - Walter, Henrik A1 - Huys, Quentin J. M. A1 - Schlagenhauf, Florian A1 - Smolka, Michael N. A1 - Heinz, Andreas T1 - Pavlovian-To-Instrumental Transfer and Alcohol Consumption in Young Male Social Drinkers BT - Behavioral, Neural and Polygenic Correlates T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe N2 - 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. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 841 KW - Pavlovian-to-instrumental transfer KW - amygdala KW - alcohol KW - polygenic risk KW - high risk drinkers Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-473280 SN - 1866-8364 IS - 841 ER - TY - GEN A1 - Awasthi, Swapnil A1 - Kaminski, Jakob A1 - Rapp, Michael Armin A1 - Schlagenhauf, Florian A1 - Walter, Henrik A1 - Ruggeri, Barbara A1 - Ripke, Stephan A1 - Schumann, Gunter A1 - Heinz, Andreas T1 - A neural signature of malleability BT - general intelligence correlates with ventral striatal activation and epigenetic makers of dopamine neurotransmission T2 - European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology N2 - General intelligence has a substantial genetic background in children, adolescents, and adults, but environmental factors also strongly correlate with cognitive performance as evidenced by a strong (up to one SD) increase in average intelligence test results in the second half of the previous century. This change occurred in a period apparently too short to accommodate radical genetic changes. It is highly suggestive that environmental factors interact with genotype by possible modification of epigenetic factors that regulate gene expression and thus contribute to individual malleability. This modification might as well be reflected in recent observations of an association between dopamine-dependent encoding of reward prediction errors and cognitive capacity, which was modulated by adverse life events. Y1 - 2019 U6 - https://doi.org/10.1016/j.euroneuro.2017.08.139 SN - 0924-977X SN - 1873-7862 VL - 29 SP - S858 EP - S859 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Sturm, Heidrun A1 - Wildermuth, Ronja A1 - Stolz, Regina A1 - Bertram, L. A1 - Eschweiler, G. W. A1 - Thomas, C. A1 - Rapp, Michael Armin A1 - Joos, S. T1 - Diverging awareness of postoperative delirium and cognitive dysfunction in German Health Care Providers JF - Clinical interventions in agins N2 - Purpose: Postoperative cognitive dysfunction (POCD) appears in up to 30% of patients suffering from postoperative delirium (POD). Both are associated with higher mortality and postoperative complications, prolonged hospital stays, and increased costs. Multi-modal models with pre-admission risk reduction counselling, perioperative monitoring, and training of multidisciplinary patient care providers have been shown to decrease the prevalence of both. The aim of our study is to understand how far those measures are known and implemented in routine care and to detect potential gaps in the current practice regarding risk communication and information flow between involved caregivers for patients at risk for POD/POCD. Patients and Methods: As part of a multicenter study, seven semi-structured focus group (FG) discussions with nurses and physicians from tertiary care hospitals (surgery, anesthesiology, and orthopedics, n=31) and general practitioners (GPs) in private practice (n=7) were performed. Transcribed discussions were analyzed using qualitative content analysis. Results: POD is present above all in the daily work of nurses, whereas physicians do not perceive it as a relevant problem. Physicians report that no regular risk assessment or risk communication was performed prior to elective surgery. Information about POD often gets lost during hand-offs and is not regularly reported in discharge letters. Thus, persisting cognitive dysfunction is often missed. The importance of standardized documentation and continuous education concerning risks, screening, and treatment was emphasized. The often-suggested pre-OP medication adjustment was seen as less important; in contrast, avoiding withdrawal was regarded as far more important. Conclusion: Altogether, it seems that standards and available best practice concepts are rarely implemented. In contrast to physicians, nurses are highly aware of delirium and ask for standardized procedures and more responsibility. Therefore, raising awareness regarding risks, screening tools, and effective preventive measures for POD/POCD seems an urgent goal. Nurses should have a central role in coordination and care of POD to prevent the risk for POCD. KW - cross-sectoral care KW - delirium prevention KW - postoperative cognitive dysfunction KW - POCD KW - dementia KW - clinical pathways KW - risk screening Y1 - 2019 U6 - https://doi.org/10.2147/CIA.S230800 SN - 1178-1998 VL - 14 SP - 2125 EP - 2135 PB - DOVE Medical Press CY - Albany ER - TY - JOUR A1 - Zech, Philipp A1 - Perez Chaparro, Camilo Germán Alberto A1 - Schuch, Felipe A1 - Wolfarth, Bernd A1 - Rapp, Michael Armin A1 - Heissel, Andreas T1 - Effects of Aerobic and Resistance Exercise on Cardiovascular Parameters for People Living With HIV BT - a Meta-analysis JF - JANAC-Journal of the Association of Nurses in AIDS Care N2 - People living with HIV (PLWH) have limited exercise capacity because of anemia, neuromuscular disorders, and pulmonary limitations. We used a meta-analysis to examine the effect of aerobic and resistance exercise alone and in combination on cardiovascular parameters. Subgroup meta-analyses were conducted and long-term effects of exercise were investigated. A systematic literature search was conducted up to July/August 2017. The Physiotherapy Evidence Database-scale was used to rate quality and assess the risk of bias on the papers. Standardized mean differences (SMDs) were calculated to assess the effect of exercise. Posttreatment comparison between the exercise and control groups revealed moderate and large effect sizes in favor of the intervention group for VO2max (SMD50.66, p < .0001) and the 6-minute walk test (SMD = 1.11, p = .0001). Exercise had a positive effect on cardiovascular parameters in PLWH. Exercise can be a prevention factor for PLWH dealing with multiple comorbidities. KW - aerobic exercise KW - cardiovascular KW - HIV KW - long-term effects KW - physical exercise KW - resistance training Y1 - 2019 U6 - https://doi.org/10.1097/JNC.0000000000000006 SN - 1055-3290 SN - 1552-6917 VL - 30 IS - 2 SP - 186 EP - 205 PB - Lippincott Williams & Wilkins CY - Philadelphia ER - TY - JOUR A1 - Deeken, Friederike A1 - Rezo, Anna A1 - Hinz, Matthias A1 - Discher, Robert A1 - Rapp, Michael Armin T1 - Evaluation of technology-based interventions for informal caregivers of patients with dementia BT - a Meta-Analysis of Randomized Controlled Trials JF - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry N2 - 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. KW - Caregiver KW - dementia KW - technology KW - meta-analysis Y1 - 2019 U6 - https://doi.org/10.1016/j.jagp.2018.12.003 SN - 1064-7481 SN - 1545-7214 VL - 27 IS - 4 SP - 426 EP - 445 PB - Elsevier CY - New York ER - TY - JOUR A1 - Meiberth, Dix Urs A1 - Rapp, Michael Armin A1 - Jessen, Frank T1 - Gedächtnisambulanzstrukturen in Deutschland – Ergebnisse einer Klinikbefragung JF - Psychiatrische Praxis N2 - Ziel der Studie Erfassung der Strukturen zur Frühdiagnostik von Demenzen an Krankenhäusern in Deutschland. Methodik Fragebogenerhebung. Ergebnisse 14 % von 1758 kontaktierten Einrichtungen antworteten. 52 % berichteten über 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 Störung. Schlussfolgerung Leitlinienbasierte Diagnostik und Früherkennungskonzepte sind in Gedächtnisambulanzen weitgehend etabliert. N2 - Objective To assess the structures for early and differential diagnosis of dementia in hospitals in Germany. Methods Written questionnaire to all German hospitals. Results 14 % of 1.758 hospitals responded. Of those, 52 % reported to offer a special service for early dementia diagnosis, mostly on an outpatient basis. The applied methods were in agreement with the national guideline for diagnosis and treatment of dementias, including technical diagnostics, such as neuroimaging and cerebrospinal fluid examinations. 46 % of the diagnostic spectrum were dementia. 41 % were either diagnosed as mild cognitive impairment (MCI) or as subjective cognitive decline (SCD). Conclusion Despite mostly insufficient reimbursement, a large proportion of the responding hospitals offer a specialized service, which largely adheres to guideline-based diagnostic procedures. The concepts of at-risk and prodromal stages of dementia seem to be largely established. T2 - Memory Clinics in Germany - Results of a Hospital Survey KW - dementia KW - Alzheimer KW - memory clinic KW - early diagnosis KW - Demenz KW - Alzheimer KW - Gedächtnisambulanz KW - Frühdiagnose Y1 - 2019 U6 - https://doi.org/10.1055/a-0825-9049 SN - 0303-4259 SN - 1439-0876 VL - 46 IS - 4 SP - 213 EP - 216 PB - Thieme CY - Stuttgart ER - TY - GEN A1 - Thomas, Christine A1 - Sabbah, Patricia A1 - Rapp, Michael Armin A1 - Eschweiler, Gerhard T1 - The Perioperative Care of Older Patients T2 - Deutsches Ärzteblatt international : a weekly online journal of clinical medicine and public health T2 - Bedarf für eine perioperative Altersmedizin Y1 - 2019 U6 - https://doi.org/10.3238/arztebl.2019.0373a SN - 1866-0452 VL - 116 IS - 21 SP - 373 EP - 373 PB - Dt. Ärzte-Verl. CY - Cologne ER - TY - JOUR A1 - Garbusow, Maria A1 - Nebe, Stephan A1 - Sommer, Christian A1 - Kuitunen-Paul, Sören A1 - Sebold, Miriam Hannah A1 - Schad, Daniel A1 - Friedel, Eva A1 - Veer, Ilya M. A1 - Wittchen, Hans-Ulrich A1 - Rapp, Michael Armin A1 - Ripke, Stephan A1 - Walter, Henrik A1 - Huys, Quentin J. M. A1 - Schlagenhauf, Florian A1 - Smolka, Michael N. A1 - Heinz, Andreas T1 - Pavlovian-To-Instrumental Transfer and Alcohol Consumption in Young Male Social Drinkers BT - Behavioral, Neural and Polygenic Correlates JF - Journal of Clinical Medicine N2 - 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. KW - Pavlovian-to-instrumental transfer KW - amygdala KW - alcohol KW - polygenic risk KW - high risk drinkers Y1 - 2019 U6 - https://doi.org/10.3390/jcm8081188 SN - 2077-0383 VL - 8 IS - 8 PB - MDPI CY - Basel ER - TY - JOUR A1 - Sebold, Miriam Hannah A1 - Garbusow, Maria A1 - Jetzschmann, P. A1 - Schad, Daniel A1 - Nebe, S. A1 - Schlagenhauf, Florian A1 - Heinz, A. A1 - Rapp, Michael Armin A1 - Romanczuk-Seiferth, Nina T1 - Reward and avoidance learning in the context of aversive environments and possible implications for depressive symptoms JF - Psychopharmacology N2 - 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. KW - Reward learning KW - Avoidance learning KW - Reinforcement learning KW - Computational psychiatry KW - Decision-making KW - Affective modulation KW - Depression symptoms Y1 - 2019 U6 - https://doi.org/10.1007/s00213-019-05299-9 SN - 0033-3158 SN - 1432-2072 VL - 236 IS - 8 SP - 2437 EP - 2449 PB - Springer CY - New York ER -