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Background Although the Trier Social Stress Test (TSST) constitutes a valid paradigm for social stress induction, less is known about the effects of a virtual reality (VR) TSST on short- and long-term hypothalamic-pituitary-adrenal (HPA) axis and sympathetic-adreno-medullar (SAM) axis responses. Hence, this study set out to evaluate reactivity and habituation of self-reported stress and HPA and SAM reactivity in a real TSST and VR-TSST when compared to a placebo TSST. Method Sixty-eight healthy young adults (50% female) were randomly assigned to either a real TSST, a VR-TSST, or a placebo TSST, all of which were conducted three times (one day and one week post initial exposure). Social presence, self-reported stress, salivary cortisol, heart rate (HR), and heart rate variability (HRV) were analyzed using ANOVAs and multilevel models. Findings On the first exposure, both the real and VR-TSST showed significantly stronger cortisol and cardiovascular responses than the placebo. On the second visit, the cortisol response was still significantly high—and the HRV response low—for the real and VR-TSST. The third visit resulted in HR, HRV, and cortisol responses comparable to the placebo group. Furthermore, the real TSST induced more self-reported stress than the placebo on all three visits, the VR-TSST only on the first two visits. Social presence was stable across conditions and had no association with stress markers. Conclusion These findings imply that the replicability of stress exposures at shorter intervals seems problematic for the traditional TSST, and for the VR-TSST.

While ostracism constitutes a social stressor with negative effects on physical and mental health, social inclusion seems to increase resilience. This may be true not only for face-to-face settings, but also for computer-mediated interactions. Hence, this study examined the differences between ostracism and social inclusion in real-life or Virtual Reality (VR) regarding self-reported stress, neuroendocrine and cardiovascular reactivity in a subsequent real-life socio-evaluative task. 84 females were randomly assigned to a 3 (agency: face-to-face/human controlled VR-avatar/computer VR-agent) x 2 (inclusion status: inclusion/exclusion) between-subject design using a Cyberball paradigm. Subsequently, they were exposed to a real-life Trier Social Stress Test (TSST). Results indicate that the experience of ostracism constitutes a threat to fundamental social needs independent of agency. Excluded participants showed cardiovascular reactivity during TSST; also face-to-face and avatar excluded individuals had elevated salivary cortisol levels. Included participants reported more perceived social support during Cyberball and showed a blunted cortisol response to the TSST. These results suggest that face-to-face and avatar-related ostracism provokes responses in the hypothalamic–pituitary–adrenal (HPA) axis and the sympathetic nervous system (SNS). Furthermore, they reveal that social inclusion may act as a stress-protector as it alters HPA- and SNS-related stress responsiveness to subsequent stressors.

Given the increasing use of virtual characters, research is challenged to gain sufficient knowledge on the effects they may have on human cognitions, emotions and behaviors. Thus, this study set out to examine social avoidance tendencies and prosocial behaviors towards human controlled (avatars) and computer controlled entities (agents). A total of N = 95 healthy young adults were randomly assigned to an avatar or agent condition. Participants were exposed to a virtual stranger asking to sit at the table (prosocial behavior) as well as a virtual waiter handing over the false drink (social avoidance). Empathy, interaction anxiety, social and physical presence as well as subjective stress levels were assessed to control for confounding influences. Empathy emerged as a significant predictor of prosocial behavior. Social avoidance, in turn, was not predicted by any of the included variables. Also, there was no effect of agency on social presence, physical presence, social interaction anxiety and stress. Yet, participants showed significantly more social avoidance and prosocial behavior towards avatars. These seemingly contradictory results may be explained by an extension of prior theories: While intuitive responses (e.g., stress) follow the Media Equation Concept (Nass & Moon, 2000), more complex processes (e.g., empathy) may modulate agency dependent responses.

Preferential processing of threat-related information is a robust finding in anxiety disorders. The observation that attentional biases are also present in healthy individuals suggests factors other than clinical symptoms to play a role. Using a dot-probe paradigm while event-related potentials were recorded in 59 healthy adults, we investigated whether temperament and gender, both related to individual variation in anxiety levels, influence attentional processing. All participants showed protective attentional biases in terms of enhanced attention engagement with positive information, indexed by larger N1 amplitudes in positive compared to negative conditions. Taking gender differences into account, we observed that women showed enhanced attention engagement with negative compared to neutral information, indicated by larger P2 amplitudes in congruent than in incongruent negative conditions. Attentional processing was influenced by the temperament traits negative affect and effortful control. Our results emphasize that gender and temperament modulate attentional biases in healthy adults.

Public speaking is a well-known psychosocial stress to occur in social-evaluative situations. This study examined self-reported, autonomic and endocrine stress responses to a 5-minźpublic speaking task. Participants were asked to present either in front of i) a real audience, or ii) a virtual audience or iii) an empty virtual lecture hall. Thus, the main objective of this study was to examine the influence of real or virtual social stimuli on stress reactivity. Additionally, possible sex differences in stress responses were evaluated. Sixty-six women and men (20-33 years) underwent a multidimensional assessment of stress including self-reported state anxiety, heart rate, heart rate variability and saliva cortisol secretion. Results showed comparable increases in all stress responses in both the real and the virtual public speaking group. These findings indicate that the Self Preservation Theory is not limited to physically present social entities, but may also be extended to virtual social stimuli; as such this observation is also in line with the so called Media Equation Concept. Implications of the current results for therapy and research are subsequently discussed. Social evaluation (real & virtual) leads to an increase in anxiety, HR and cortisol.Virtual stressors without social cues do not elicit a significant stress response.No sex differences in stress responses during real and virtual social evaluation.Data supports Media Equation Theory and Self-Preservation Theory in virtual reality.

Background:Impairments in facial emotion recognition (FER) have been detected in patients with Parkinson disease (PD). Presently, we aim at assessing differences in emotion recognition performance in PD patient groups with and without mild forms of cognitive impairment (MCI) compared to healthy controls.Methods:Performance on a concise emotion recognition test battery (VERT-K) of three groups of 97 PD patients was compared with an age-equivalent sample of 168 healthy controls. Patients were categorized into groups according to two well-established classifications of MCI according to Petersen's (cognitively intact vs. amnestic MCI, aMCI, vs. non-amnestic MCI, non-aMCI) and Litvan's (cognitively intact vs. single-domain MCI, sMCI, vs. multi-domain MCI, mMCI) criteria. Patients and controls underwent individual assessments using a comprehensive neuropsychological test battery examining attention, executive functioning, language, and memory (Neuropsychological Test Battery Vienna, NTBV), the Beck Depression Inventory, and a measure of premorbid IQ (WST).Results:Cognitively intact PD patients and patients with MCI in PD (PD-MCI) showed significantly worse emotion recognition performance when compared to healthy controls. Between-groups effect sizes were substantial, showing non-trivial effects in all comparisons (Cohen's ds from 0.31 to 1.22). Moreover, emotion recognition performance was higher in women, positively associated with premorbid IQ and negatively associated with age. Depressive symptoms were not related to FER.Conclusions:The present investigation yields further evidence for impaired FER in PD. Interestingly, our data suggest FER deficits even in cognitively intact PD patients indicating FER dysfunction prior to the development of overt cognitive dysfunction. Age showed a negative association whereas IQ showed a positive association with FER.

Although social anxiety disorders (SADs) are increasingly treated by means of virtual cue exposure, the mechanisms leading to sufficient anxiety levels and thus to a success of virtual reality exposure therapy are still poorly understood. Also, most studies with SAD participants fail to evaluate social presence, although it may be a more appropriate indicator for virtual social stress scenarios than physical presence. Hence, for the first time, this study sets out to examine the link between social presence, physical presence, and emotional responses to phobogenic virtual social stimuli. A group of n = 12 participants with SAD and n = 12 healthy controls were exposed to three social tasks in an interactive virtual environment (VE). Self-report measures of physical and social presence as well as state anxiety were used alongside heart rate measures to evaluate the virtual experience. Results show significantly higher anxiety levels-both self-report and physiological-in SAD participants than in controls. Also, socially anxious subjects reported to experience more copresence and mutual attention as well as a higher sense of being in the VE than their healthy peers. In sum, social presence experiences may be more predicative of the anxiety response in SAD individuals than physical presence. Especially attentional processes seem to crucially shape the interplay between presence and affective responses.

While virtual humans are increasingly used to benefit the elderly, considerably little is still known about older adults' virtual experiences. However, due to age-related changes, older adults' perceptions of virtual environments (VEs) may be unique. Hence, our objective was to examine possible gender differences in immersion, flow, and emotional states as well as physical and social presence in elderly males and females interacting either with a computer-controlled agent or a human-controlled avatar. Seventy-eight German-speaking older adults were randomly assigned to an avatar or an agent condition and were exposed to a brief social encounter in a virtual café. Results indicate no overall gender differences, but a significant effect of agency on social presence, physical presence, immersion, and flow. Participants in the avatar condition reported higher levels in all measures, except for involvement. Furthermore, significant gender × agency interactions were found, with females showing more social presence, spatial presence, and flow when interacting with a human-controlled avatar and more realism when conversing with an agent. Also, all participants showed significant changes in their affect post exposure. In sum, older adults' virtual experiences seem to follow unique patterns, yet, they do not preclude the elderly from successfully participating in VEs.

Following the idea of using virtual environments (VEs) as mood induction procedures (MIPs), this study set out to examine whether five different virtual park scenarios would each elicit a specific affective state (i.e., joy, sadness, boredom, anger and anxiety). Within this main objective, a subset of two additional goals was identified: first, to analyze whether the sense of presence would differ across emotionally charged VEs, and second, to examine the link between a more objective measure of affective arousal, electrodermal activity (EDA), and presence. Following a between-subject design, 120 students were randomly assigned to one of the five VEs. Results show that almost all of the five virtual park scenarios were able to elicit the intended emotion. Additionally, presence levels were the same across all VEs suggesting that presence did not confound the emotional reaction to the VEs. Furthermore, EDA seems to be a poor indicator of presence as it is not significantly correlated with self-reported presence. The implications of these findings for both future research and practice are addressed in a comprehensive discussion. Four virtual park scenarios elicited the intended emotional states.Presence levels were the same across different virtual environments.Skin conductance level seems to be a poor indicator of presence.

Verschiedene Studien deuten auf einen starken Zusammenhang zwischen Substanzmissbrauch, sozialen sowie emotionalen Kompetenzen und kriminellem Verhalten hin. Es zeigt sich, dass die Starkung sozialer und emotionaler Kompetenzen als ein entscheidender Faktor angesehen werden kann, um Drogen- und Alkoholabusus zu reduzieren. Einige dieser Trainingsprogramme wurden bereits fur eine Behandlung inhaftierter Rechtsbrecher adaptiert und haben sich in forensischen Settings als sehr effektiv erwiesen. Andere Trainingsmasnahmen hingegen konnten nur geringe Effekte aufweisen. Daher war es das Ziel der vorliegenden Studie, die Effektivitat eines bereits bestehenden sozialen Kompetenztrainings, das in einer Justizanstalt fur drogenabhangige Straftater Anwendung findet, im Hinblick auf Anwendbarkeit und Effizienz zu untersuchen. Die Ergebnisse deuten auf eine eher geringe Wirksamkeit dieses Trainingsprogramms hin. Zwar zeigten die Insassen nach dem Training einen insgesamt hoheren Selbstwert, jedoch nur wenig Veranderung in Bereichen, die entscheidend mit sozialen und emotionalen Kompetenzen im Zusammenhang stehen. Die Entwicklung eines neuen Behandlungskonzepts, dessen Ziel es ist, entscheidende Kompetenzen wie Wutmanagement und Empathiefahigkeit zu starken, wird diskutiert.

Collaborative virtual environments (CVEs) hold the immense potential of enhancing social inclusion and social support not only in younger but especially also in older people. However, there is still considerably little knowledge about the experiences of elderly when using CVEs. Additionally, there is reason to assume that men and women regardless of their age might also differ in their perceptions of CVEs, with this difference very likely being mediated by empathic abilities. Consequently, the main objective of the current study was to evaluate gender specific experiences of social and physical presence in a group of older (N=62) and younger adults (N=62) with respect to possible mediating influences of empathy. Results indicate no differences in physical and social presence between the two age groups, yet they support past findings that men experience more spatial presence, involvement and a higher sense of being there than women. Also, the empathy scale Fantasy considerably mediated gender differences in spatial presence, thus strengthening the theoretical assumption of a relationship between presence and empathy. Implications and future directions of these findings are discussed in detail.

Die vorliegende explorative Studie wird der Kritik an der kognitiven Ausrichtung des Konzeptes der Einwilligungsfähigkeit gerecht, indem sie erstmals mögliche emotionale Korrelate der Fähigkeit, in eine wissenschaftliche Untersuchung einzuwilligen, untersucht. Bei 21 gesunden Älteren und 20 Patienten mit leichter bis mittelschwerer Demenz wurde einerseits die Einwilligungsfähigkeit mittels einer deutschen Version des MacCAT-CR erfasst und andererseits die situationsbezogene emotionale Befindlichkeit und situative Ängstlichkeit erhoben. Die Ergebnisse deuten darauf hin, dass sich vor allem die positive Stimmung während des MacCAT-CR-Interviews auf die Einschätzung der Einwilligungsfähigkeit günstig auswirken kann. Ferner wurde ein signifikanter Einfluss der positiven Stimmung auf den Ausgang der Entscheidung für oder gegen eine Studienteilnahme aufgezeigt. Die Bedeutung dieser Ergebnisse für die Einwilligungsfähigkeitsforschung insbesondere bei Demenz-Patienten wird im Anschluss diskutiert und Vorschläge für künftige Forschungsprojekte unterbreitet.

Up to 95% of teens and young adults in western societies are online, and research shows striking evidence that users suffering from social fears use the Internet more frequently. Social phobia (SP) is one of the most common anxiety disorders, characterized by early onset and more frequent histories of childhood and adolescent shyness. SP is often untreated because adolescent sufferers hesitate to talk to teachers or attend any face-to-face treatment. Furthermore, teachers and caregivers, responsible for educating these young adults, often lack the clinical-psychological knowledge to help. Therefore, we developed an online training for providing educative knowledge about social skills, social fears and body relaxation methods (including evidence-based cognitive-behavioural therapy (CBT) elements combined with elements from social skills trainings (SST)). Until now, no such online tool was readily available for teachers and caregivers in Europe's German-speaking areas. In addition, the transformation of a well-evaluated (offline) SST with CBT elements into an attractive online form rendered a definite challenge. To assist teachers and caregivers, we developed an online-based self-administered SST with CBT elements especially for adolescents and young adults. The novelty of the project was its development in close cooperation with target groups to ensure usability and acceptance. This multi-stage program for the prevention of social fears and social phobia includes the promotion of social skills moreover cognitive restructuring. Fourteen text- and comic-based sessions (one session per week, each session takes 30-40 min) provide knowledge about social fears and social skills. The effectiveness was evaluated using pre- and post-tests with 61 training participants and 47 control group students. Preliminary results showed promising and significant effects in the intervention group: a decrease of social fears as well as an increase of social skills. These findings suggest that our self-administered online training is effective preventing social fears, and may be considered as an educative tool for teachers and caregivers (providing evidence-based information about social fears, social skills and body relaxation methods).

Scientific reports 7(1), 17210 (2017). doi:10.1038/s41598-017-17485-w, Published by Nature Publishing Group, London

Hintergrund: In der Forschung mit Demenz-Patienten ist es entscheidend, mögliche Beeinträchtigungen der Einwilligungsfähigkeit zu ermitteln. Fragestellung: Ziel der Studie war es, zu untersuchen, ob sich der Mini-Mental-Status-Test (MMST) dazu eignet, Beeinträchtigungen der Einwilligungsfähigkeit bei einer hypothetischen Studie vorherzusagen. Methoden: Die Einwilligungsfähigkeit wurde bei 24 Demenz-Patienten und 24 gesunden Gleichaltrigen mit dem MacArthur-Competence-Assessment-Tool (MacCAT) erfasst. Zusätzlich wurden neuropsychologische Korrelate ermittelt. Ergebnisse: Der MMST konnte die Einwilligungsfähigkeit vorhersagen: MMST-Schwellenwerte unter 23 wiesen mit hoher Sicherheit auf eine Einwilligungsunfähigkeit für die hypothetische Studiensituation hin. Gedächtnis und Sprachfunktionen korrelierten hoch mit der Einwilligungsfähigkeit. Schlussfolgerungen: Kognitive Leistung als wesentliche Determinante der Einwilligungsfähigkeit ist stets hinsichtlich einer konkreten Situation zu beurteilen. Studien stimmen überein, dass die Einwilligungsfähigkeit bei MMST-Schwellenwerten unter 23 eingehender untersucht werden sollte.

article i nfo Deficits in facial affect recognition as one aspect of social cognitive deficits are treatment targets to improve functional outcome in schizophrenia. According to preliminary results antipsychotics alone show little effects on affect recognition. A few randomized intervention studies have evaluated special psychosocial treatment programs on social cognition. In this study, the effects of a computer-based training of affect recognition were investigated as well as its impact on facial affect recognition and functional outcome, particularly on patients' quality of life. Forty clinically stabilized schizophrenic patients were randomized to a six-week training on affect recogni- tion (TAR) or treatment as usual including occupational therapy (TAU) and completed pre- and post- treatment assessments of emotion recognition, cognition, quality of life and clinical symptoms. Between pre- and post treatment, the TAR group achieved significant improvements in facial affect recogni- tion, in particular in recognizing sad faces and, in addition, in the quality of life domain social relationship. These changes were not found in the TAU group. Furthermore, the TAR training contributes to enhancing some aspects of cognitive functioning and negative symptoms. These improvements in facial affect recogni- tion and quality of life were independent of changes in clinical symptoms and general cognitive functions. The findings support the efficacy of an affect recognition training for patients with schizophrenia and the generalization to social relationship. Further development is needed in the impact of a psychosocial interven- tion in other aspects of social cognition and functional outcome.

This study examined problematic gaming behavior and depressive tendencies among people who play different types of online-games. Other game-related variables were investigated to determine if other differences between three game types could be established. Participants in the current research (n=468) can be classified into three independent groups. Subjected users either solely played massive multiplayer online role-playing games (MMORPGs) or they preferred online-ego-shooters (OES) or real-time-strategy games (RTS). Results indicate that MMORPG users show more often problematic gaming behavior, depressive tendencies and lower self-esteem compared to users playing other online-games. MMORPG users reported to playing significantly more often in order to escape from real-life problems, which might be a valuable coping strategy but might also lead to problematic gaming behavior.

Im Rahmen des Grundsatzes „Therapie statt Strafe“ steht drogenabhangigen Straftatern in Osterreich ein differenziertes Behandlungsspektrum als Alternative zur Haftverbusung zur Verfugung. Es wird untersucht, ob sich Zwangsklienten hinsichtlich Drogenanamnese, kriminellem Verhalten, psychischer und medizinischer Problematik sowie Ihrer Motivationslage von ‚Freiwilligen‘ unterscheiden. In einem Zeitraum von sechs Monaten wurden insgesamt 150 Klienten, die entweder ‚freiwillig‘ oder mit gerichtlicher Therapieauflage eine Behandlung ihrer Drogensucht begannen, mit standardisierten Instrumenten befragt. ‚Freiwillige‘ Klienten leiden vermehrt unter medizinischen Problemen und praktizieren riskantere Konsummuster wie den polytoxen sowie intravenosen Konsum, unterscheiden sich hinsichtlich des kriminellen Verhaltens jedoch kaum von Zwangsklienten.

Converging evidence has accumulated that menstrual cycle and thus hormonal levels can affect emotional behavior, in particular facial emotion recognition. Here we explored the association of ovarian hormone levels and amygdala activation during an explicit emotion recognition task in two groups of healthy young females: one group was measured while in their follicular phase (n = 11) and the other during their luteal phase (n = 11). Using a 3T scanner in combination with a protocol specifically optimized to reliably detect amygdala activation we found significantly stronger amygdala activation in females during their follicular phase. Also, emotion recognition performance was significantly better in the follicular phase. We observed significant negative correlations between progesterone levels and amygdala response to fearful, sad and neutral faces, further supporting a significant modulation of behavior and neural response by hormonal changes during the menstrual cycle. From an evolutionary point of view this significant influence of ovarian hormone level on emotion processing and an important neural correlate, the amygdala, may enable a higher social sensitivity in females during their follicular phase, thus facilitating socio-emotional behavior (and social interaction) which may possibly facilitate mating behavior as well.

Zusammenfassung. In vorliegender Online-Studie wurden gesundheitsbezogene psychologische Konstrukte bei Personen, die das Internet zur Suche von Gesundheitsinformationen genutzt hatten, erhoben. Von den 432 in die Stichprobe aufgenommenen Teilnehmern (Durchschnittsalter: 33.1 Jahre, Bereich: 16–76 Jahre) bezogen 33.1% darüber hinaus pharmazeutische Produkte über das World Wide Web. Untersucht wurde, ob sich jene Personen, die ausschließlich Gesundheitsinformationen online suchten, von Pharmakabeziehern hinsichtlich folgender Merkmale unterscheiden: Selbstwirksamkeitserwartung, internaler Kontrollüberzeugungen, Kohärenzsinn, dispositionellem Optimismus, wahrgenommener sozialer Unterstützung und Risikobereitschaft sowie der Einschätzung medizinischer Informationen im Internet. Pharmakabezieher konnten lediglich über erhöhte Ausprägungen von Risikobereitschaft und Selbstwirksamkeitserwartung von ausschließlich Informationssuchenden differenziert werden. Weiterhin zeigte sich, dass Pharmakabezieher netzbasierte medizinische Informationen emotionaler beurteilen. Die vorliegenden Ergebnisse werden in Hinblick auf potenzielle Gesundheitsgefährdungen der untersuchten Gruppe von Internet-Usern diskutiert.

PURPOSE OF THE STUDY: Quality of Life of patients with Total Hip Arthroplasty is analysed before and one year after surgery. The evaluation included the functional capacity of our patients in every day life comparing the preoperative situation with the result one year after surgery. Age and duration of symptoms were analysed with respect to their influence on the success of the procedure. Finally the question should be answered, if clinical examinations and questionnaires concerning Quality of Life result in comparable data. METHOD: 101 patients with an average age of 64.2 years were included into this study. All patients were evaluated preoperatively and one year after surgery using the Harris Hip Score, questionnaires for Quality of Life of the patients included the Nottingham Health Profile and the Functional Questionnaire Hannover. RESULTS: The pre- and postoperative means of the Nottingham Health Profile showed in five of the six dimensions a significant improvement of Quality of Life (pain, mobility, energy, emotional reaction, sleep). Only the scale "social isolation" remained unchanged between the pre- and postoperative situation. The means of the functional capacity according to the Hannover questionnaire improved from 57.92 to 39.79, a highly significant result. The Harris Hip Score was poor in 97% of the preoperative evaluations. This score improved to 80.2% excellent or good, 7.9% fair and 11.9% poor at one year after surgery. Age and duration of symptoms had no influence in any parameter of Quality of Life. A classification of parameters on Quality of Life according to the Harris-Hip-Score at the 1-year results demonstrates a clear grading concerning the excellent and poor results. Based on the patients evaluations a differentiation between good and poor results is not recorded. CONCLUSIONS: The objective evaluation of results after implantation of a total hip joint-endoprosthesis should not be based only on clinical scores (f.e. Harris-Hip-Score). Subjective informations by the patients using questionnaires on Quality of Life (f.e. NHP, FFbH-R) have to be included into these evaluations. The different judgments of the outcome of surgery underline the necessity, not only to use clinical scores but also to include the patients' feeling into the interpretation of the clinical result.

Several studies reported a significant influence of ovarian hormone status on cognition and person perception. In particular, it has been stated that female mating preferences are shifted during the menstrual cycle. It remains, however, unclear if facial emotion recognition, a prerequisite for successful social interaction, is also influenced by estradiol and progesterone levels. Hence, we investigated 32 healthy right-handed females, 15 during their follicular phase and 17 during their luteal phase and compared their recognition accuracy. Hormone levels were correlated with several neuropsychological parameters. Subjects were matched for age and education and did not differ in any neuropsychological function. Analysis of emotion recognition performance (ANOVA) revealed a significant effect of phase, showing higher accuracy in the follicular group. Furthermore, a significant negative correlation between progesterone level and emotion recognition performance emerged, indicating higher accuracy with lower progesterone levels, hence supporting the group differences. Our results indicate a significant association of menstrual cycle phase and thus ovarian hormone concentration on facial emotion recognition, with progesterone exerting a special influence on this social-emotional ability.

Background and aims: Health-related quality of life (HrQoL) is broadly accepted as an evaluation criterion of medical therapy effects. The major objectives of this work are a) measuring of the effects of rehabilitation therapy on the HrQoL of elderly patients after hip fracture, and b) study of discrepancies between the physician’s findings on one hand and subjective ratings of patients on the other, and their influence on HrQoL, depression, and independence in activities of daily living. Methods: The study sample consisted of 95 patients surgically treated after a fall-induced hip fracture (mean age=82 years; range=61–97). Using the median as splitting criterion, ratings of patients and physicians concerning disturbance-specific functional capacity were subdivided into positive and negative. This led to separation of the sample into four subgroups: the fortunate (congruent positive ratings), satisfaction paradox (positive subjective, negative objective ratings), dissatisfaction dilemma (negative subjective, objective positive ratings), and the unfortunate (congruent negative ratings). Results: The four patient sub-groups diverged in their estimations. The subgroups of the fortunate and satisfaction paradox have had the highest subjective gains in HrQoL. The subgroups of dissatisfaction dilemma and the unfortunate estimated their gains as similarly low on most of the tested scales. Conclusions: Results stress the importance of subjective factors in processes concerning therapy evaluations and their influence on HrQoL. The objective success of therapy is not of primary importance for the extent of the HrQoL, but subjective evaluation of it is.

Emotion recognition is essential for social interaction and communication and is a capacity in which the amygdala plays a central role. So far, neuroimaging results have been inconsistent as to whether the amygdala is more active during explicit or incidental facial emotion processing. In consideration of its functionality in fast automatic evaluation of stimuli and involvement in higher-order conscious processing, we hypothesize a similar response to the emotional faces presented regardless of attentional focus. Using high field functional magnetic resonance imaging (fMRI) specifically optimized for ventral brain regions we show strong and robust amygdala activation for explicit and implicit processing of emotional facial expressions in 29 healthy subjects. Bilateral amygdala activation was, however, significantly greater when subjects were asked to recognize the emotion (explicit condition) than when required to discern the age (implicit condition). A significant correlation between amygdala activation and emotion recognition, but not age discrimination performance, emphasizes the amygdala's enhanced role during conscious emotion processing.

Background Health related quality of life (HRQOL) is an important issue in the context of dementia care. Objectives The purpose of this study was to investigate HRQOL in patients with subjective cognitive decline (SCD) and mild cognitive impairment (MCI) and its relation to Activity of Daily Living (ADL). Methods In this cross sectional study, four experimental groups (each n = 98), controls, SCD, naMCI and aMCI, were compared. For data collection, neuropsychological methods (NTBV) and psychological questionnaires (SF-36 and B-ADL) were used. Multivariate analysis of variance was calculated to detect differences in HRQOL between groups. Correlations between HRQOL and ADL were explored. Results The dimensions of HRQOL showed mainly consistent differences between the control and the SCD group and MCI subgroups. In almost every dimension of HRQOL, the control group scored higher than subjects with SCD, naMCI, or aMCI. The controls showed low to moderate negative correlations between HQROL and B-ADL in some dimensions of the HRQOL. In the SCD group, low negative correlations with ADL were observed in some HRQOL scales. Low to moderate correlations were found between each scale of the SF-36 and the B-ADL in both MCI subtypes. We found gender differences in HRQOL. Conclusion In conclusion, we could demonstrate that patients with SCD report reduced quality of life. This knowledge is important to get a better understanding of the individuals with SCD and may pave the way for the development of early intervention.

Background:Deficits in facial emotion recognition (FER) have been shown to substantially impair several aspects in everyday life of affected individuals (e.g. social functioning). Presently, we aim at assessing differences in emotion recognition performance in three patient groups suffering from mild forms of cognitive impairment compared to healthy controls.Methods:Performance on a concise emotion recognition test battery (VERT-K) of 68 patients with subjective cognitive decline (SCD), 44 non-amnestic (non-aMCI), and 25 amnestic patients (aMCI) with mild cognitive impairment (MCI) was compared with an age-equivalent sample of 138 healthy controls all of which were recruited within the framework of the Vienna Conversion to Dementia Study. Additionally, patients and controls underwent individual assessment using a comprehensive neuropsychological test battery examining attention, executive functioning, language, and memory (NTBV), the Beck Depression Inventory (BDI), and a measure of premorbid IQ (WST).Results:Type of diagnosis showed a significant effect on emotion recognition performance, indicating progressively deteriorating results as severity of diagnosis increased. Between-groups effect sizes were substantial, showing non-trivial effects in all comparisons (Cohen's ds from −0.30 to −0.83) except for SCD versus controls. Moreover, emotion recognition performance was higher in women and positively associated with premorbid IQ.Conclusions:Our findings indicate substantial effects of progressive neurological damage on emotion recognition in patients. Importantly, emotion recognition deficits were observable in non-amnestic patients as well, thus conceivably suggesting associations between decreased recognition performance and global cognitive decline. Premorbid IQ appears to act as protective factor yielding lesser deficits in patients showing higher IQs.

Background Attentional biases such as faster attentional orienting toward negative information were consistently replicated in high-anxious and depressive individuals, but findings in healthy individuals are inconsistent so far. Methods Using a dot-probe paradigm, we investigated whether temperament traits and gender, which are linked to (sub)clinical symptoms and attentional processing, influenced attentional biases in healthy adults. Results All participants showed protective attentional biases in terms of orienting their attention away from negative information. In both genders higher values of negative affect were compensated with stronger attentional engagement with positive stimuli. This effect was more pronounced in men than in women. Effortful control fulfilled its regulative function in terms of stronger avoidance of negative stimuli only among men. Limitations Reaction times after probe detection provide only a snapshot of attention and allow only for an indirect assessment of visual attention. Future research should emphasize methods that allow for continuous monitoring of attention allocation, therefore results of the present study await replication in psychophysiological or eye-tracking studies. Conclusion Our results highlight the importance of considering influencing factors such as gender and temperament traits for attentional biases in healthy adults.

Deep brain stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson's disease. There is some evidence that subthalamic stimulation not only affects motor function, but also mood, behaviour and cognition. In the present study we investigated the effects of subthalamic stimulation on psychiatric symptoms and psychosocial functioning in a consecutive series of patients with Parkinson's disease. 33 patients were assessed three times prior to surgery and at three, nine weeks as well as three, six and twelve months after surgery. We found significant improvements in depression, anxiety, psychological symptoms and distress after surgery. In most cases the amelioration followed surgery and was stable in the course of time. Individual analysis indicated deterioration in three patients despite motor improvement. The results suggest that stimulation of the subthalamic nucleus has a positive influence on psychiatric symptoms, psychosocial functioning and distress. We observed a decline in a minority of patients.

Zusammenfassung: Bei der Fähigkeit, Emotionen in Gesichtern zu erkennen, handelt es sich um eine angeborene und kulturübergreifende Leistung, die eine wesentliche evolutionäre sowie soziale Bedeutung hat. Über das Gedächtnis für emotionale Gesichter ist dagegen weniger bekannt. Aus diesem Grund wurden 278 Probanden mittels neu entwickeltem Emotionserkennungsverfahren (VERT 160) und emotionalem Gesichtergedächtnisverfahren (VIEMER) untersucht, um Einflussfaktoren wie Geschlecht und Alter auf die emotionale Diskriminationsfähigkeit und das emotionale Gedächtnis zu analysieren. Die Ergebnisse lassen keinen signifikanten Geschlechtereffekt erkennen. Das Alter zeigt einen hoch signifikanten Einfluss zugunsten der jüngeren Teilnehmer. Freude wurde am besten erkannt und Personen, die zuvor mit freudigem Gesicht zu sehen waren, auch besser wiedererkannt. Zusammenfassend unterstreichen die Ergebnisse die Notwendigkeit, soziodemografische Einflussvariablen auf emotionale Prozesse zu beachten.

Aspekte affektiver und sozialer Neurowissenschaften sind Akzentsetzungen in der aktuellen Emotionsforschung, die eine Reihe von Implikationen für Psychiatrie, Psychologie und Psychotherapie haben. Entsprechende Versuchsdesigns müssen erstellt und validiert werden, um als geeignete «Paradigmen» im Rahmen neurobiologisch orientierter Studien zu Emotionen eingesetzt zu werden. Erst dann können Aussagen etwa zu Stressverarbeitungsmustern und Therapieeffizienz oder differentiellen Fragestellungen wie Geschlechtsunterschieden getroffen werden. Alle diese Untersuchungen können nur durchgeführt werden, wenn Personen dem experimentellen Procedere zustimmen, also ihre Einwilligung geben, wobei hierbei emotionale Elemente eine Rolle zu spielen scheinen.

The purpose of the present study was the assessment of health-related quality of life in adult long-term survivors of childhood cancer and the detection of possible treatment- and cancer-related late effects. The relation of objective medical data and subjective appraisal was also examined by combining the doctor’s and the patient’s views of the perceived health status. Seventy-eight young adults at the age of at least 18 years who had been diagnosed with cancer in the years 1975–1995 and were off therapy at least 5 years with no evidence of disease participated. Cancer survivors completed self-rating instruments [SF-36 Health Survey, Nottingham Health Profile (NHP), Beck’s Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) trait-anxiety scale]; the doctor assessed the patient’s health by means of the Common Toxicity Criteria (CTCv2). The cancer survivors showed a mostly higher-than-average positive subjective rating of the various areas of quality of life. In comparison to the general population, the cancer survivors showed lower extents of depression. In 64.1% of the cancer survivors, medical rating and self-assessment regarding the perceived health status corresponded. Cancer survivors who felt severely impaired regarding their subjectively perceived well-being showed worse results in some dimensions of quality of life than persons who subjectively felt mildly impaired. The so-called “unfortunate” persons showed the worst assessment of quality of life and the highest extent of depression and anxiety. The results of the present study may be helpful in planning an appropriate multidisciplinary, long-term follow-up of childhood cancer survivors.

Aim: Multiple aspects of health-related quality of life were assessed in elderly patients after total or partial knee arthroplasty. Method: 187 subjects who had undergone knee arthroplasty 5 years ago were asked to fill out 3 questionnaires, the Nottingham Health Profile, the SF-36 Health Survey and the Funktionsfragebogen Hannover. Results were compared to standard data. The impact of gender and age was analyzed, and 3 different types of prostheses were compared. Results: Response rate was 74% (n = 138). Regarding the main symptoms pain and subjective function, as well as almost all other aspects, quality of life proved to be significantly reduced compared to the age-matched general population. Correlations between age and quality of life scales were low. Different types of implants led to similar results in all scales but one. Conclusion: 5 years after knee arthroplasty the quality of life is markedly reduced compared to the general population. The impact of age, gender, and type of implant is low. In our sample, the SF-36 showed methodological advantages compared to the NHP for the measurement of subjective pain and function.

The link between anxiety and presence in a virtual environment (VE) is still a subject of an unresolved debate, with little empirical research to support theoretical claims. Thus, the current study analyzed presence, self-reported anxiety, and a physiological parameter (heart rate [HR]) in a sample of 30 high anxious and 35 low anxious participants. Both groups delivered a 5 minute speech in a virtual lecture hall. Results indicate no mediating influences of presence on group differences in self-reported state anxiety during the speech, but point toward negative correlations between state anxiety and the iGroup Presence Questionnaire (IPQ) scales "sense of being there" and "realism." Furthermore, HR was found to be unrelated to self-reported presence. Only the IPQ scale "spatial presence" showed a marginally significant influence on group differences in state anxiety. The present results support the assumption that presence and anxiety are logically distinct, meaning that presence does not directly influence the intensity of an emotion felt in a VE. Rather, it constitutes a precondition for an emotion to be at all elicited by a VE. Also, HR has proven to be no adequate substitute measure for presence, since it only assesses anxiety not presence. It may, however, mediate the interplay between trait anxiety and state anxiety. Possible implications of the current findings are discussed alongside the problem of using presence questionnaires that seem to be prone to subjective bias (i.e., participants confusing presence and emotion).