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PhD, Dr. phil. Dorothée Bentz

Faculty of Psychology
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Projects & Collaborations

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Schweizer Befragung zur Behandlung von Zwangsstörungen: Wo stehen wir, und wohin soll es gehen aus der Perspektive von Betroffenen und Behandelnden

Research Project  | 2 Project Members

Zwangsstörungen (OCD) betreffen etwa 2-3 % der Bevölkerung und haben erhebliche Auswirkungen auf das Leben der Betroffenen. Typische Symptome sind aufdringliche Zwangsgedanken und zwanghafte Handlungen, die den Alltag massiv beeinträchtigen. Ohne Behandlung verlaufen Zwangsstörungen oft chronisch und können zu sozialer Isolation, beruflichen Einschränkungen und psychischer Belastung führen.

Die Exposition mit Reaktionsverhinderung (ERP) ist eine nachweislich effektive Methode zur Behandlung von Zwangsstörungen. Dabei setzen sich Betroffene in einem therapeutischen Rahmen den angstauslösenden Reizen aus, ohne die gewohnten Zwangshandlungen auszuführen. Diese Methode unterstützt sie dabei, alternative Bewältigungsstrategien zu entwickeln. Obwohl die Wirksamkeit von ERP gut belegt ist, zeigen internationale Studien, dass sie in der Praxis selten angeboten wird. Für die Schweiz fehlen bislang systematische Daten zur Anwendung von ERP und zur Versorgungslage von OCD-Betroffenen. 



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Examining mental representations of contamination stimuli in a population with obsessive-compulsive disorder, a data-driven approach

Research Project  | 2 Project Members

Exposure with response prevention (ERP) is the gold standard for treating obsessive-compulsive disorder (OCD) and is recommended by national and international treatment guidelines. Despite recent developments in this approach, a large share of patients remains symptomatic after treatment, discontinue treatment or are reluctant to start treatment at all. One reason might be that the stimulus material used during ERP is not tailored to the patient, so it does not necessarily target the relevant dimensions of the OCD symptomatology. Currently, there exists no contamination OCD (C-OCD) stimuli set that is validated to provoke other emotions than anxiety, that offers a wide range of intensities along different emotions. It is conceivable that other dimensions of the stimuli are of relevance than the theory-driven dimensions rooted in preexisting emotional theories that represent a fixed model of mental representations, and therefore might miss important unknown domain specific dimensions that might be of higher relevance for some patients. This project intends to complement theory-driven approaches by a data-driven approach to identify relevant dimensions of C-OCD triggers by exploring their mental representations. Methodologically, crowdsourced similarity judgements will be implemented that will be analyzed with multidimensional scaling to identify underlying dimensions followed by a crowdsourced dimension-naming task. Further characterizing C-OCD stimuli and their mental representations as well as compiling a freely available database of contamination-OCD cues will inform the design of new personalized ERP approaches that counteract common problems of ERP treatments for OCD.


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Randomized placebo-controlled phase II study on the influence of valproic acid in combination with reactivation of fear memory on outcome of extinction-based therapy in patients with fear of spiders.

Research Project  | 1 Project Members

Exposure to feared objects or situations is the most common and effective treatment for specific phobia and anxiety disorders in general (Chambless & Ollendick, 2001). The proposed underlying mechanism of exposure therapy is extinction. During the extinction process new non-fear memory traces are generated to inhibit old fear memories (Milad & Quirk, 2002). Although extinction effectively reduces the fear response in short-term testing, extinction gains are often not permanent. Return of fear is correspondingly a common problem in treatment for anxiety disorders (Mystkowski et al. 2002, 2006; Craske & Mystkowski, 2006). And there is a need to develop new treatment approaches that focus on enhancing treatment stability. Accumulating evidence indicates that targeting reconsolidation processes after successful fear memory reactivation might be critical for stable fear reduction (e.g. reactivation/extinction protocol from Schiller et al., 2010). But, a recent animal study points to that this might only apply to recent and not remote memories (as phobia-related fear memories) (Gräff et al., 2014). Consistent with this evidence, a translational approach with patients with spider phobia found reactivation prior to exposure treatment not to be more effective than exposure treatment alone (Shiban, 2014). The aforementioned animal study from Gräff et al., 2014 further showed that by using inhibitors of histone deacetylases (HDACis) during reconsolidation the neuroplasticity of remote fear memories could be reinstated and even remote memories persistently attenuated by a reactivation/extinction protocol (Gräff et al., 2014). In the present study, we aim to translate the evidence from Gräff et al, 2014 into a clinical application. Consequently, the current study examines, if the combination of HDACis and reactivation with exposure treatment leads to reduced return of fear in patients with spider phobia. Patients with spider phobia receive in a randomized, double-blind design placebo or the HDACi valproic acid (500mg) in combination with reactivation of remote fear memory before a 30-minutes exposure treatment. For exposure treatment, we use a virtual reality (VR) environment, which allows exposure in a standardized manner. Strength of phobic fear is evaluated by means of behavioral (behavioral avoidance test, BAT), subjective (Questionnaires, visual analogue scales) and psychophysiological (skin conductance, ECG) measures before and 3 months after exposure therapy in VR. A positive influence of a one-time application of valproic acid in combination with reactivation of remote fear memory before exposure treatment on the stability of fear reduction would not only have potential for the treatment of specific phobias and other anxiety disorders, but also other disorders treated with exposure as for example addictive disorders.