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"Heinzel, Stephan"
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Development and validation of the socio-evaluative N-back task to investigate the impact of acute social stress on working memory
2025
Impaired working memory in response to social-evaluative stress might be a central cognitive mechanism underlying the persistence of mental health difficulties such as social anxiety. To investigate this, we developed the Socio-evaluative N-back Task (SENT), which can measure the impact of acute socio-evaluative stress on working memory (WM) performance. Moreover, we tested the SENT in a stratified sample with high (HSA) and low socially anxious (LSA) individuals (HSA = 30, LSA = 27,
N
= 57). Of the highly anxious individuals, thirteen were diagnosed with social anxiety disorder (SAD). The socio-evaluative stress condition, compared to a control condition, increased psychophysiological stress reactions, and reduced WM performance. Moreover, people with low anxiety displayed faster reaction times under socio-evaluative stress compared to a control condition. Conversely, individuals with high social anxiety demonstrated consistent reaction times regardless of whether they encounter a non-evaluative or socio-evaluative situation. This suggests that social anxiety is associated with a lack of differentiation between neutral and socio-evaluative situations. Additionally, this study indicates that the socio-evaluative N-back Task can be used to induce socio-evaluative stress responses while simultaneously measuring working memory and physiological stress responses.
Journal Article
The Impact of COVID-19 Lockdown on Daily Activities, Cognitions, and Stress in a Lonely and Distressed Population: Temporal Dynamic Network Analysis
by
Heinzel, Stephan
,
Haucke, Matthias
,
Liu, Shuyan
in
Accelerometers
,
Actigraphy
,
Activities of daily living
2022
The COVID-19 pandemic and its associated lockdown measures impacted mental health worldwide. However, the temporal dynamics of causal factors that modulate mental health during lockdown are not well understood.
We aimed to understand how a COVID-19 lockdown changes the temporal dynamics of loneliness and other factors affecting mental health. This is the first study that compares network characteristics between lockdown stages to prioritize mental health intervention targets.
We combined ecological momentary assessments with wrist-worn motion tracking to investigate the mechanism and changes in network centrality of symptoms and behaviors before and during lockdown. A total of 258 participants who reported at least mild loneliness and distress were assessed 8 times a day for 7 consecutive days over a 213-day period from August 8, 2020, through March 9, 2021, in Germany, covering a \"no-lockdown\" and a \"lockdown\" stage. COVID-19-related worry, information-seeking, perceived restriction, and loneliness were assessed by digital visual analog scales ranging from 0 to 100. Social activity was assessed on a 7-point Likert scale, while physical activity was recorded from wrist-worn actigraphy devices.
We built a multilevel vector autoregressive model to estimate dynamic networks. To compare network characteristics between a no-lockdown stage and a lockdown stage, we performed permutation tests. During lockdown, loneliness had the highest impact within the network, as indicated by its centrality index (ie, an index to identify variables that have a strong influence on the other variables). Moreover, during lockdown, the centrality of loneliness significantly increased. Physical activity contributed to a decrease in loneliness amid the lockdown stage.
The COVID-19 lockdown increased the central role of loneliness in triggering stress-related behaviors and cognition. Our study indicates that loneliness should be prioritized in mental health interventions during lockdown. Moreover, physical activity can serve as a buffer for loneliness amid social restrictions.
Journal Article
Effects of a three-week executive control training on adaptation to task difficulty and emotional interference
by
Heinzel, Stephan
,
Kathmann, Norbert
,
Grützmann, Rosa
in
Acclimatization
,
Adaptation
,
Adjustment (Psychology)
2022
Intact executive functions are characterized by flexible adaptation to task requirements, while these effects are reduced in internalizing disorders. Furthermore, as executive functions play an important role in emotion regulation, deficits in executive functions may contribute to symptom generation in psychological disorders through increased emotional interference. Thus, the present study investigated transfer effects of a three-week executive control training on adaptation to task difficulty and emotional interference in healthy participants (
n
= 24) to further explore the training’s suitability for clinical application. To assess the adaptation to task difficulty, the proportion congruency effect on behavioral data (response times, error rates) and ERP measures (N2, CRN) was assessed in a flanker task with varying frequency of incompatible trials (25%, 75%). To quantify emotional interference, flanker stimuli were superimposed on neutral or negative pictures. Replicating previous results, the training increased interference control as indexed by decreased response times and errors rates, increased N2 amplitude and decreased CRN amplitude in incompatible trials after training. Proportion congruency effects were weaker than expected and not affected by the training intervention. The training lead to a shift in the time-point of emotional interference: before training negative pictures lead to a reduction in CRN amplitude, while after training this reduction was observed for the N2. This pattern illustrates that the training leads to a change in task processing mode from predominant response-related cognitive control to predominant stimulus-related cognitive control (N2), indicating a proactive processing mode.
Journal Article
Effects of a three-week executive control training on adaptation to task difficulty and emotional interference
by
Heinzel, Stephan
,
Kathmann, Norbert
,
Grützmann, Rosa
in
Adjustment (Psychology)
,
Analysis
,
Control
2022
Intact executive functions are characterized by flexible adaptation to task requirements, while these effects are reduced in internalizing disorders. Furthermore, as executive functions play an important role in emotion regulation, deficits in executive functions may contribute to symptom generation in psychological disorders through increased emotional interference. Thus, the present study investigated transfer effects of a three-week executive control training on adaptation to task difficulty and emotional interference in healthy participants (n = 24) to further explore the training's suitability for clinical application. To assess the adaptation to task difficulty, the proportion congruency effect on behavioral data (response times, error rates) and ERP measures (N2, CRN) was assessed in a flanker task with varying frequency of incompatible trials (25%, 75%). To quantify emotional interference, flanker stimuli were superimposed on neutral or negative pictures. Replicating previous results, the training increased interference control as indexed by decreased response times and errors rates, increased N2 amplitude and decreased CRN amplitude in incompatible trials after training. Proportion congruency effects were weaker than expected and not affected by the training intervention. The training lead to a shift in the time-point of emotional interference: before training negative pictures lead to a reduction in CRN amplitude, while after training this reduction was observed for the N2. This pattern illustrates that the training leads to a change in task processing mode from predominant response-related cognitive control to predominant stimulus-related cognitive control (N2), indicating a proactive processing mode.
Journal Article
Increased Psychological Distress, Loneliness, and Unemployment in the Spread of COVID-19 over 6 Months in Germany
by
Heinzel, Stephan
,
Haucke, Matthias N.
,
Liu, Shuyan
in
across cultures and over time
,
Adolescent
,
Adult
2021
Background: The COVID-19 pandemic poses a challenge to global mental health. Loneliness and isolation may put people at higher risk for increased psychological distress. However, there is a lack of research investigating the development of COVID-19-related distress over time. Materials and Methods: We undertook an online survey among general population (N = 1903) in Germany throughout 6 months from the peak transmission period in April to the off-peak period by September 2020. Results: We found that the average prevalence of psychological distress caused by the COVID-19 pandemic significantly rose from 24% to 66% between the peak and off-peak transmission period, respectively. Unemployment rate and loneliness increased negative mental health outcomes, although the number of active COVID-19 cases decreased from April to September. Psychological distress scores increased mostly in female, young, and lonely people. Conclusions: Our results underline the importance of considering innovative alternatives to facilitate employment opportunities, distant contacts, and self-help over the course of the pandemic. Our study highlights the urgent need to pay attention to mental health services specifically targeting female, young, unemployed, and lonely people.
Journal Article
Neural correlates of training and transfer effects in working memory in older adults
2016
As indicated by previous research, aging is associated with a decline in working memory (WM) functioning, related to alterations in fronto-parietal neural activations. At the same time, previous studies showed that WM training in older adults may improve the performance in the trained task (training effect), and more importantly, also in untrained WM tasks (transfer effects). However, neural correlates of these transfer effects that would improve understanding of its underlying mechanisms, have not been shown in older participants as yet. In this study, we investigated blood-oxygen-level-dependent (BOLD) signal changes during n-back performance and an untrained delayed recognition (Sternberg) task following 12sessions (45min each) of adaptive n-back training in older adults. The Sternberg task used in this study allowed to test for neural training effects independent of specific task affordances of the trained task and to separate maintenance from updating processes. Thirty-two healthy older participants (60–75years) were assigned either to an n-back training or a no-contact control group. Before (t1) and after (t2) training/waiting period, both the n-back task and the Sternberg task were conducted while BOLD signal was measured using functional Magnetic Resonance Imaging (fMRI) in all participants. In addition, neuropsychological tests were performed outside the scanner. WM performance improved with training and behavioral transfer to tests measuring executive functions, processing speed, and fluid intelligence was found. In the training group, BOLD signal in the right lateral middle frontal gyrus/caudal superior frontal sulcus (Brodmann area, BA 6/8) decreased in both the trained n-back and the updating condition of the untrained Sternberg task at t2, compared to the control group. fMRI findings indicate a training-related increase in processing efficiency of WM networks, potentially related to the process of WM updating. Performance gains in untrained tasks suggest that transfer to other cognitive tasks remains possible in aging.
•Working memory training leads to neural activation decrease in the right MFG in aging.•Neural changes in transfer task are related to updating (compared to maintenance).•Neural correlates of training and transfer effects overlap in the right MFG.•Behavioral transfer to executive functions, processing speed, fluid intelligence•Results advance understanding of neural mechanisms of training and transfer.
Journal Article
Effect of acute and long-term exercise on leptin levels in depressed outpatients
by
Ströhle, Andreas
,
Heissel, Andreas
,
Heinen, Darlene
in
Antidepressants
,
Bicycles
,
Biostatistics
2023
Background
Depression is a leading cause of disability worldwide and a significant contributor to the global burden of disease. Altered leptin levels are known to be associated with depressive symptoms, however discrepancies in the results of increased or decreased levels exist. Due to various limitations associated with commonly used antidepressant drugs, alternatives such as exercise therapy are gaining more importance. Therefore, the current study investigates whether depressed patients have higher leptin levels compared to healthy controls and if exercise is efficient to reduce these levels.
Methods
Leptin levels of 105 participants with major depressive disorder (MDD; 45.7% female, age mean ±
SEM
: 39.1 ± 1.0) and 34 healthy controls (HC; 61.8% female, age mean ±
SEM
: 36.0 ± 2.0) were measured before and after a bicycle ergometer test. Additionally, the MDD group was separated into three groups: two endurance exercise intervention groups (EX) differing in their intensities, and a waiting list control group (WL). Leptin levels were measured pre and post a 12-week exercise intervention or the waiting period.
Results
Baseline data showed no significant differences in leptin levels between the MDD and HC groups. As expected, correlation analyses displayed significant relations between leptin levels and body weight (HC:
r
= 0.474,
p
= 0.005; MDD:
r
= 0.198,
p
= 0.043) and even more with body fat content (HC:
r
= 0.755,
p
< 0.001; MDD:
r
= 0.675,
p
< 0.001). The acute effect of the bicycle ergometer test and the 12-week training intervention showed no significant changes in circulating leptin levels.
Conclusion
Leptin levels were not altered in patients with major depression compared to healthy controls and exercise, both the acute response and after 12 weeks of endurance training, had no effect on the change in leptin levels.
Trial registration
The study was registered at the German register for clinical studies (DRKS) and the International Clinical Trials Registry Platform of the World Health Organization
https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00008869
on 28/07/2015.
Journal Article
Objective risk and protective factors for momentary and daily loneliness:using digital phenotyping and temporal analysis
2025
Loneliness is a growing global health issue, yet real-time assessments of its objective risk and protective factors are limited. This study identifies momentary and daily predictors using digital phenotyping and temporal analysis. Analyzing 12788 momentary observations from social mobile sensing and actigraphy, we examined how they impact loneliness on average (between-person) and in daily fluctuations (within-person). Instant messenger app usage was associated with increased loneliness, both momentarily (B = 2.95,
p
= 0.017) and daily (B = 2.83,
p
= 0.018), within and between subjects. Social media usage was associated with higher within-person momentary loneliness (B = 0.53,
p
= 0.001). An exploratory network analysis suggested that physical activity is associated with in-person social interaction, which is negatively associated with loneliness, while social media may replace social interactions. Thus, objective risk factors include increased use of social media and instant messaging, whereas greater physical activity may serve as a protective factor.
Journal Article
Negative and positive self-beliefs in social anxiety: The strength of believing mediates the affective response
2023
Current cognitive models of social anxiety disorder (SAD) propose that individual, situation-specific self-beliefs are central to SAD. However, the role of differences in the degree to which individuals with social anxiety are convinced of self-beliefs, in particular positive ones, is still not fully understood. We compared how much high and low socially anxious individuals agree with their own negative and positive self-beliefs. Furthermore, we investigated whether agreeing with one's self-belief can explain the relation between negative affect in response to self-beliefs and social anxiety. Specifically, we were interested whether social anxiety increases negative affect in response to self-beliefs through an increase in agreement.
We developed a new experimental self-belief task containing positive and negative semi-idiosyncratic, situation specific self-beliefs typical of high social anxiety and included a direct measure of agreement with these beliefs. Using extreme group sampling, we a-priori selected high (n = 51) and low (n = 50) socially anxious individuals. By multi-level mediation analysis, we analyzed agreement with self-beliefs in both groups and its association with affect.
High and low socially anxious individuals chose similar self-beliefs. However, high socially anxious individuals (HSA) agreed more with negative self-beliefs and less with positive self-beliefs compared to low socially anxious individuals (LSA). HSA individuals reported increased negative affect after both, exposition to negative and positive self-beliefs compared to LSA. We found that social anxiety increases affective responses towards negative-self beliefs through an increase in agreeing with these self-beliefs.
These findings suggest that cognitive models of social anxiety can be improved by including not only the content of a self-belief but also the strength of such a belief. In addition, they emphasize the relevance of positive self-beliefs in social anxiety, which has frequently been overlooked.
Journal Article
Long-Term Impact of Economic Downturn and Loneliness on Psychological Distress: Triple Crises of COVID-19 Pandemic
by
Heinzel, Stephan
,
Haucke, Matthias N.
,
Liu, Shuyan
in
Causality
,
Clinical medicine
,
Coronaviruses
2021
Background: The COVID-19 crisis poses global mental health and global economy challenges. However, there is a lack of longitudinal research investigating whether financial instability and social disruption may increase the risk of developing mental health problems over time that may potentially outlast the pandemic. Methods: We conducted an online survey for members of the general population (n = 2703) in Germany during the twelve months spanning from April 2020 to March 2021. We investigated the development of COVID-19 related psychological distress, the number of unemployed people, federal government debt, income distribution, and loneliness over the time period. Results: Over a period of twelve months, 53.6% of respondents in Germany reported experiencing psychological distress, varying from mild levels, 34.2%, to severe levels, 19.4%, of distress. High federal government debt, high incident COVID-19 cases, low incomes, and the prevalence of loneliness were found to be associated with increased long-term mental health problems. Psychological distress scores were most strongly increased in female and young respondents as well as those who reported fewer years of education, low income, and higher loneliness. Conclusions: Our study highlights factors that have a long-term impact on mental health amid the COVID-19 pandemic. We suggest that specific mental-health services could be offered to support high-risk groups experiencing financial fragility and loneliness. For purposes of safeguarding their mental health there is a need to monitor and track such risk factors in real time.
Journal Article