The Experts below are selected from a list of 21660 Experts worldwide ranked by ideXlab platform
Gustav Schelling - One of the best experts on this subject based on the ideXlab platform.
-
The role of glucocorticoids, catecholamines and endocannabinoids in the development of Traumatic memories and postTraumatic stress symptoms in survivors of critical illness
Neurobiology of learning and memory, 2013Co-Authors: Daniela Hauer, Ines Kaufmann, Claudia Strewe, Isabel Briegel, Patrizia Campolongo, Gustav SchellingAbstract:Critically ill patients are at an increased risk for Traumatic memories and post-Traumatic stress disorder (PTSD). Memories of one or more Traumatic events play an important part in the symptom pattern of PTSD. Studies in long-term survivors of intensive care unit (ICU) treatment demonstrated a clear and vivid recall of Traumatic experiences and the incidence and intensity of PTSD symptoms increased with the number of Traumatic memories present. Preclinical evidence has clearly shown that the consolidation and retrieval of Traumatic memories is regulated by an interaction between the noradrenergic, the glucocorticoid and the endocannabinoid system. Critically ill patients in the ICU frequently require treatment with adrenenergic or glucocorticoid drugs and often receive sedative medications; among them propofol is known to influence endocannabinoid signaling. Critical illness could therefore represent a useful model for investigating adrenergic, glucocorticoid as well as endocannabinoid effects on Traumatic Memory and PTSD development in stressed humans. The endocannabinoid system is an important regulator of HPA-axis activity during stress, an effect which has also been demonstrated in humans. Likewise, a single nucleotide polymorphism (SNP) of the glucocorticoid receptor (GR) gene (the BclI-SNP), which enhances the sensitivity of the glucocorticoid receptors to cortisol and possibly HPA-axis feedback function, was associated with enhanced emotional Memory performance in healthy volunteers. The presence of the BclI-SNP increased the risk for Traumatic memories and PTSD symptoms in patients after ICU therapy and was linked to lower basal cortisol levels. A number of small studies have demonstrated that the administration of cortisol to critically ill or injured patients results in a significant reduction of PTSD symptoms after recovery without influencing the number of Traumatic memories. These glucocorticoid effects can possibly be explained by a cortisol-induced temporary impairment in Traumatic Memory retrieval which has previously been demonstrated in both rats and humans. The hypothesis that stress doses of glucocorticoids or the pharmacologic manipulation of glucocorticoid-endocannabinoid interaction during Traumatic Memory consolidation and retrieval could be useful for prophylaxis and treatment of PTSD after critical illness should be tested in larger controlled studies.
-
Traumatic memories post Traumatic stress disorder and serum cortisol levels in long term survivors of the acute respiratory distress syndrome
Brain Research, 2009Co-Authors: Daniela Hauer, Gustav Schelling, Florian Weis, Till Krauseneck, Michael Vogeser, Benno RoozendaalAbstract:Survivors of the acute respiratory distress syndrome (ARDS) often report Traumatic memories from the intensive care unit (ICU) and display a high incidence of post-Traumatic stress disorder (PTSD). As it is known that subjects with PTSD often show sustained reductions in circulating cortisol concentrations, we examined the relationship between serum cortisol, Traumatic memories and PTSD in patients after ARDS. We evaluated 33 long-term survivors of ARDS (7.5+/-2.9 years after discharge from the ICU) for pre-defined categories of Traumatic Memory from the ICU, hypothalamic-pituitary-adrenocortical axis reactivity to corticotropin and PTSD (by psychiatric interview). During evaluation, patients with multiple Traumatic memories had significantly lower basal serum cortisol levels when compared to patients with no or only 1 category of Traumatic Memory, with no differences in peak cortisol levels after corticotropin stimulation between both subgroups. There was a significant negative correlation between basal cortisol levels and the number of Traumatic memories present. PTSD symptom scores correlated with the number of Traumatic memories but not with cortisol levels. These findings indicate that lower baseline cortisol levels in long-term survivors of ARDS are associated with an increased incidence of Traumatic memories from the ICU, and that more Traumatic memories are related to a higher incidence and intensity of PTSD symptoms.
-
post Traumatic stress disorder in somatic disease lessons from critically ill patients
Progress in Brain Research, 2008Co-Authors: Gustav SchellingAbstract:Post-Traumatic stress disorder (PTSD) is a well-recognized complication of severe illness. PTSD has been described in patients after multiple trauma, burns, or myocardial infarction with a particularly high incidence in survivors of acute pulmonary failure (Acute Respiratory Distress Syndrome) or septic shock. Many patients with evidence of PTSD after critical illness have been treated in intensive care units (ICUs). Studies in long-term survivors of ICU treatment demonstrated a clear and vivid recall of different categories of Traumatic Memory such as nightmares, anxiety, respiratory distress, or pain with little or no recall of factual events. A high number of these Traumatic memories from the ICU has been shown to be a significant risk factor for the later development of PTSD in long-term survivors. In addition, patients in the ICU are often treated with stress hormones like epinephrine, norepinephrine, or cortisol. The number of the above-mentioned categories of Traumatic Memory increased with the totally administered dosages of catecholamines and cortisol, and the evaluation of these categories at different time points after discharge from the ICU showed better Memory consolidation with higher dosages of stress hormones administered. Conversely, the prolonged administration of beta-adrenergic antagonists during the recovery phase after cardiac surgery resulted in a lower number of Traumatic memories and a lower incidence of stress symptoms at 6 months after surgery. Findings with regard to the administration of the stress hormone cortisol were more complex, however. Several studies from our group have demonstrated that the administration of stress doses of cortisol to critically ill patients resulted in a significant reduction of PTSD symptoms measured after recovery without influencing the number of categories of Traumatic Memory. This can possibly be explained by a cortisol-induced temporary impairment in Traumatic Memory retrieval that has previously been demonstrated in both rats and humans. ICU therapy of critically ill patients can serve as a stress model that allows the delineation of stress hormone effects on Traumatic Memory and PTSD development. This could also result in new approaches for prophylaxis and treatment of stress-related disorders.
-
Effects of stress hormones on Traumatic Memory formation and the development of postTraumatic stress disorder in critically ill patients.
Neurobiology of learning and memory, 2002Co-Authors: Gustav SchellingAbstract:A majority of patients after intensive care treatment report Traumatic memories from their stay in the intensive care unit (ICU). Traumatic memories can be associated with the development of postTraumatic stress disorder (PTSD) in a subpopulation of these patients. In contrast to other patient populations at risk for PTSD, patients in the ICU often receive exogenously administered stress hormones like epinephrine, norepinephrine, or cortisol for medical reasons and are extensively monitored. ICU patients therefore represent a suitable population for studying the relationship between stress hormones, Traumatic memories, and the development of PTSD. Studies in long-term survivors of ICU treatment demonstrated a clear and vivid recall of different categories of Traumatic Memory such as nightmares, anxiety, respiratory distress, or pain with little or no recall of factual events. The number of categories of Traumatic Memory recalled increased with the total administered dosages of stress hormones (both catecholamines and cortisol), and the evaluation of these categories at different time points after discharge from the ICU showed better Memory consolidation with higher dosages of stress hormones administered. However, the administration of stress doses of cortisol to critically ill patients resulted in more complex findings as it caused a significant reduction in PTSD symptoms measured after recovery. This effect can possibly be explained by a differential influence of cortisol on Memory. Increased serum cortisol levels not only result in consolidation of emotional Memory but are also known to cause a temporary impairment in Memory retrieval which appears to be independent of glucocorticoid effects on Memory formation. Disrupting retrieval mechanisms with glucocorticoids during critical illness may therefore act protectively against the development of PTSD by preventing recall of Traumatic memories. Our findings indicate that stress hormones influence the development of PTSD through complex and simultaneous interactions on Memory formation and retrieval. Our studies also demonstrate that animal models of aversive learning are useful in analyzing and predicting clinical findings in critically ill humans.
Marcela Matos - One of the best experts on this subject based on the ideXlab platform.
-
Internalizing early memories of shame and lack of safeness and warmth: the mediating role of shame on depression.
Behavioural and cognitive psychotherapy, 2013Co-Authors: Marcela Matos, José Pinto-gouveia, Cristiana DuarteAbstract:Background: Growing evidence supports the association between early memories of shame and lack of safeness and current shame and depression. Nevertheless, it is unclear whether shame serves as a mediator between such early memories and depressive symptoms. Aims: This study aimed at testing whether the impact of shame Traumatic Memory, centrality of shame Memory, early memories of warmth and safeness (predictors), on depressive symptoms (outcome) would be mediated by current external and internal shame. Method: Student participants ( N = 178) recalled an early shame experience and completed self-report instruments measuring centrality and Traumatic characteristics of the shame Memory, early memories of warmth and safeness, external and internal shame and depressive symptoms. Results: Path analysis’ results revealed that internal shame fully mediated the relationship between shame Traumatic Memory, centrality of shame Memory, and early memories of warmth and safeness, and depression. However, current feelings of external shame, highly linked to internal shame, did not significantly predict depression. Conclusion: These findings shed light on the role of internalizing early shame and lack of safeness memories into a sense of self as globally self-condemning in the vulnerability to experience depressive symptoms.
-
Understanding the Importance of Attachment in Shame Traumatic Memory Relation to Depression: The Impact of Emotion Regulation Processes
Clinical psychology & psychotherapy, 2011Co-Authors: Marcela Matos, José Pinto-gouveia, Vânia CostaAbstract:Background: Early relationships are crucial to human brain maturation, well-being, affect regulation and self-other schema. Shame Traumatic memories are related to psychopathology, and recent research has shown that the quality and type of attachment relationships may be crucial in shame Traumatic memories in relation to psychopathology. The current study explores a mediator model of emotion regulation processes (rumination, thought suppression and dissociation) on the association between shame Traumatic Memory, with attachment figures and with others, and depressive symptoms. Method: Ninety subjects from the general community population completed the Shame Experiences Interview (SEI), assessing shame experiences from childhood and adolescence, and a battery of self-report scales measuring shame Traumatic Memory, rumination, thought suppression, dissociation and depression. Results: Mediator analyses show that emotion regulation processes, such as brooding, thought suppression and dissociation, mediate the association between shame Traumatic Memory with others and depression. In contrast, shame Traumatic Memory with attachment figures has a direct effect on depression, not mediated by emotion regulation processes, with only brooding partially mediating this relation. Conclusion: The current findings shed light on the importance of attachment figures on the structuring of shame Traumatic memories and on their impact on psychopathological symptoms, adding to recent neuroscience research and Gilbert’s approach on shame and compassion. In addition, our results emphasize the relevance of addressing shame memories, mainly those that involve attachment figures, particularly when working with patients suffering from depressive symptoms and/or that find compassion difficult or scary. Copyright © 2011 John Wiley & Sons, Ltd. Key Practitioner Message: The quality of attachment relationships is important in how shame memories are structured and in their relation to psychopathology. The relationship between shame Traumatic Memory with attachment figures and depressive symptoms is not mediated by emotion regulation processes (rumination, thought suppression and dissociation). In contrast, these processes emerge as mediators on the association between shame Traumatic Memory with others and depression. For people suffering from depressive symptoms, having been shamed by an attachment figure may be a major block to develop self-compassion and receive compassion from others and may constitute an important obstacle to recovery. When working with patients suffering from depressive symptoms and/or that find compassion difficult or scary, it is important to target shame memories, especially those that involve attachment figures. In therapy with individuals with depressive symptoms and who reveal shame Traumatic memories involving others, it may not only be pertinent to target these memories but also to evaluate and intervene on emotion regulation processes, particularly rumination, thought suppression and dissociation.
-
Shame as a Traumatic Memory.
Clinical psychology & psychotherapy, 2010Co-Authors: Marcela Matos, José Pinto-gouveiaAbstract:Background: This study explores the premise that shame episodes can have the properties of Traumatic memories, involving intrusions, flashbacks, strong emotional avoidance, hyper arousal, fragmented states of mind and dissociation. Method: A battery of self-report questionnaires was used to assess shame, shame Traumatic Memory and depression in 811 participants from general population (481 undergraduate students and 330 subjects from normal population). Results: Results show that early shame experiences do indeed reveal Traumatic Memory characteristics. Moreover, these experiences are associated with current feelings of internal and external shame in adulthood. We also found that current shame and depression are significantly related. Key to our findings is that those individuals whose shame memories display more Traumatic characteristics show more depressive symptoms. A moderator analysis suggested an effect of shame Traumatic Memory on the relationship between shame and depression. Limitations: The transversal nature of our study design, the use of self-reports questionnaires, the possibility of selective memories in participants' retrospective reports and the use of a general community sample, are some methodological limitations that should be considered in our investigation. Conclusion: Our study presents novel perspectives on the nature of shame and its relation to psychopathology, empirically supporting the proposal that shame memories have Traumatic Memory characteristics, that not only affect shame in adulthood but also seem to moderate the impact of shame on depression. Therefore, these considerations emphasize the importance of assessing and intervening on shame memories in a therapeutic context. Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message: Early shame experiences reveal Traumatic Memory characteristics and are related to current shame and to psychopathology. Individuals whose shame memories have more Traumatic characteristics are those who show more depressive symptoms. Shame Traumatic memories moderate the relationship between shame and depression, hence to the same shame, individuals who experienced shame as more Traumatic are the ones who show more depressive symptoms. Therapy for shame-based problems needs to incorporate strategies to assess and address individuals shame Traumatic memories.
José Pinto-gouveia - One of the best experts on this subject based on the ideXlab platform.
-
Internalizing early memories of shame and lack of safeness and warmth: the mediating role of shame on depression.
Behavioural and cognitive psychotherapy, 2013Co-Authors: Marcela Matos, José Pinto-gouveia, Cristiana DuarteAbstract:Background: Growing evidence supports the association between early memories of shame and lack of safeness and current shame and depression. Nevertheless, it is unclear whether shame serves as a mediator between such early memories and depressive symptoms. Aims: This study aimed at testing whether the impact of shame Traumatic Memory, centrality of shame Memory, early memories of warmth and safeness (predictors), on depressive symptoms (outcome) would be mediated by current external and internal shame. Method: Student participants ( N = 178) recalled an early shame experience and completed self-report instruments measuring centrality and Traumatic characteristics of the shame Memory, early memories of warmth and safeness, external and internal shame and depressive symptoms. Results: Path analysis’ results revealed that internal shame fully mediated the relationship between shame Traumatic Memory, centrality of shame Memory, and early memories of warmth and safeness, and depression. However, current feelings of external shame, highly linked to internal shame, did not significantly predict depression. Conclusion: These findings shed light on the role of internalizing early shame and lack of safeness memories into a sense of self as globally self-condemning in the vulnerability to experience depressive symptoms.
-
Understanding the Importance of Attachment in Shame Traumatic Memory Relation to Depression: The Impact of Emotion Regulation Processes
Clinical psychology & psychotherapy, 2011Co-Authors: Marcela Matos, José Pinto-gouveia, Vânia CostaAbstract:Background: Early relationships are crucial to human brain maturation, well-being, affect regulation and self-other schema. Shame Traumatic memories are related to psychopathology, and recent research has shown that the quality and type of attachment relationships may be crucial in shame Traumatic memories in relation to psychopathology. The current study explores a mediator model of emotion regulation processes (rumination, thought suppression and dissociation) on the association between shame Traumatic Memory, with attachment figures and with others, and depressive symptoms. Method: Ninety subjects from the general community population completed the Shame Experiences Interview (SEI), assessing shame experiences from childhood and adolescence, and a battery of self-report scales measuring shame Traumatic Memory, rumination, thought suppression, dissociation and depression. Results: Mediator analyses show that emotion regulation processes, such as brooding, thought suppression and dissociation, mediate the association between shame Traumatic Memory with others and depression. In contrast, shame Traumatic Memory with attachment figures has a direct effect on depression, not mediated by emotion regulation processes, with only brooding partially mediating this relation. Conclusion: The current findings shed light on the importance of attachment figures on the structuring of shame Traumatic memories and on their impact on psychopathological symptoms, adding to recent neuroscience research and Gilbert’s approach on shame and compassion. In addition, our results emphasize the relevance of addressing shame memories, mainly those that involve attachment figures, particularly when working with patients suffering from depressive symptoms and/or that find compassion difficult or scary. Copyright © 2011 John Wiley & Sons, Ltd. Key Practitioner Message: The quality of attachment relationships is important in how shame memories are structured and in their relation to psychopathology. The relationship between shame Traumatic Memory with attachment figures and depressive symptoms is not mediated by emotion regulation processes (rumination, thought suppression and dissociation). In contrast, these processes emerge as mediators on the association between shame Traumatic Memory with others and depression. For people suffering from depressive symptoms, having been shamed by an attachment figure may be a major block to develop self-compassion and receive compassion from others and may constitute an important obstacle to recovery. When working with patients suffering from depressive symptoms and/or that find compassion difficult or scary, it is important to target shame memories, especially those that involve attachment figures. In therapy with individuals with depressive symptoms and who reveal shame Traumatic memories involving others, it may not only be pertinent to target these memories but also to evaluate and intervene on emotion regulation processes, particularly rumination, thought suppression and dissociation.
-
Shame as a Traumatic Memory.
Clinical psychology & psychotherapy, 2010Co-Authors: Marcela Matos, José Pinto-gouveiaAbstract:Background: This study explores the premise that shame episodes can have the properties of Traumatic memories, involving intrusions, flashbacks, strong emotional avoidance, hyper arousal, fragmented states of mind and dissociation. Method: A battery of self-report questionnaires was used to assess shame, shame Traumatic Memory and depression in 811 participants from general population (481 undergraduate students and 330 subjects from normal population). Results: Results show that early shame experiences do indeed reveal Traumatic Memory characteristics. Moreover, these experiences are associated with current feelings of internal and external shame in adulthood. We also found that current shame and depression are significantly related. Key to our findings is that those individuals whose shame memories display more Traumatic characteristics show more depressive symptoms. A moderator analysis suggested an effect of shame Traumatic Memory on the relationship between shame and depression. Limitations: The transversal nature of our study design, the use of self-reports questionnaires, the possibility of selective memories in participants' retrospective reports and the use of a general community sample, are some methodological limitations that should be considered in our investigation. Conclusion: Our study presents novel perspectives on the nature of shame and its relation to psychopathology, empirically supporting the proposal that shame memories have Traumatic Memory characteristics, that not only affect shame in adulthood but also seem to moderate the impact of shame on depression. Therefore, these considerations emphasize the importance of assessing and intervening on shame memories in a therapeutic context. Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message: Early shame experiences reveal Traumatic Memory characteristics and are related to current shame and to psychopathology. Individuals whose shame memories have more Traumatic characteristics are those who show more depressive symptoms. Shame Traumatic memories moderate the relationship between shame and depression, hence to the same shame, individuals who experienced shame as more Traumatic are the ones who show more depressive symptoms. Therapy for shame-based problems needs to incorporate strategies to assess and address individuals shame Traumatic memories.
Daniela Hauer - One of the best experts on this subject based on the ideXlab platform.
-
The role of glucocorticoids, catecholamines and endocannabinoids in the development of Traumatic memories and postTraumatic stress symptoms in survivors of critical illness
Neurobiology of learning and memory, 2013Co-Authors: Daniela Hauer, Ines Kaufmann, Claudia Strewe, Isabel Briegel, Patrizia Campolongo, Gustav SchellingAbstract:Critically ill patients are at an increased risk for Traumatic memories and post-Traumatic stress disorder (PTSD). Memories of one or more Traumatic events play an important part in the symptom pattern of PTSD. Studies in long-term survivors of intensive care unit (ICU) treatment demonstrated a clear and vivid recall of Traumatic experiences and the incidence and intensity of PTSD symptoms increased with the number of Traumatic memories present. Preclinical evidence has clearly shown that the consolidation and retrieval of Traumatic memories is regulated by an interaction between the noradrenergic, the glucocorticoid and the endocannabinoid system. Critically ill patients in the ICU frequently require treatment with adrenenergic or glucocorticoid drugs and often receive sedative medications; among them propofol is known to influence endocannabinoid signaling. Critical illness could therefore represent a useful model for investigating adrenergic, glucocorticoid as well as endocannabinoid effects on Traumatic Memory and PTSD development in stressed humans. The endocannabinoid system is an important regulator of HPA-axis activity during stress, an effect which has also been demonstrated in humans. Likewise, a single nucleotide polymorphism (SNP) of the glucocorticoid receptor (GR) gene (the BclI-SNP), which enhances the sensitivity of the glucocorticoid receptors to cortisol and possibly HPA-axis feedback function, was associated with enhanced emotional Memory performance in healthy volunteers. The presence of the BclI-SNP increased the risk for Traumatic memories and PTSD symptoms in patients after ICU therapy and was linked to lower basal cortisol levels. A number of small studies have demonstrated that the administration of cortisol to critically ill or injured patients results in a significant reduction of PTSD symptoms after recovery without influencing the number of Traumatic memories. These glucocorticoid effects can possibly be explained by a cortisol-induced temporary impairment in Traumatic Memory retrieval which has previously been demonstrated in both rats and humans. The hypothesis that stress doses of glucocorticoids or the pharmacologic manipulation of glucocorticoid-endocannabinoid interaction during Traumatic Memory consolidation and retrieval could be useful for prophylaxis and treatment of PTSD after critical illness should be tested in larger controlled studies.
-
Traumatic memories post Traumatic stress disorder and serum cortisol levels in long term survivors of the acute respiratory distress syndrome
Brain Research, 2009Co-Authors: Daniela Hauer, Gustav Schelling, Florian Weis, Till Krauseneck, Michael Vogeser, Benno RoozendaalAbstract:Survivors of the acute respiratory distress syndrome (ARDS) often report Traumatic memories from the intensive care unit (ICU) and display a high incidence of post-Traumatic stress disorder (PTSD). As it is known that subjects with PTSD often show sustained reductions in circulating cortisol concentrations, we examined the relationship between serum cortisol, Traumatic memories and PTSD in patients after ARDS. We evaluated 33 long-term survivors of ARDS (7.5+/-2.9 years after discharge from the ICU) for pre-defined categories of Traumatic Memory from the ICU, hypothalamic-pituitary-adrenocortical axis reactivity to corticotropin and PTSD (by psychiatric interview). During evaluation, patients with multiple Traumatic memories had significantly lower basal serum cortisol levels when compared to patients with no or only 1 category of Traumatic Memory, with no differences in peak cortisol levels after corticotropin stimulation between both subgroups. There was a significant negative correlation between basal cortisol levels and the number of Traumatic memories present. PTSD symptom scores correlated with the number of Traumatic memories but not with cortisol levels. These findings indicate that lower baseline cortisol levels in long-term survivors of ARDS are associated with an increased incidence of Traumatic memories from the ICU, and that more Traumatic memories are related to a higher incidence and intensity of PTSD symptoms.
Cristiana Duarte - One of the best experts on this subject based on the ideXlab platform.
-
Internalizing early memories of shame and lack of safeness and warmth: the mediating role of shame on depression.
Behavioural and cognitive psychotherapy, 2013Co-Authors: Marcela Matos, José Pinto-gouveia, Cristiana DuarteAbstract:Background: Growing evidence supports the association between early memories of shame and lack of safeness and current shame and depression. Nevertheless, it is unclear whether shame serves as a mediator between such early memories and depressive symptoms. Aims: This study aimed at testing whether the impact of shame Traumatic Memory, centrality of shame Memory, early memories of warmth and safeness (predictors), on depressive symptoms (outcome) would be mediated by current external and internal shame. Method: Student participants ( N = 178) recalled an early shame experience and completed self-report instruments measuring centrality and Traumatic characteristics of the shame Memory, early memories of warmth and safeness, external and internal shame and depressive symptoms. Results: Path analysis’ results revealed that internal shame fully mediated the relationship between shame Traumatic Memory, centrality of shame Memory, and early memories of warmth and safeness, and depression. However, current feelings of external shame, highly linked to internal shame, did not significantly predict depression. Conclusion: These findings shed light on the role of internalizing early shame and lack of safeness memories into a sense of self as globally self-condemning in the vulnerability to experience depressive symptoms.
