Eine Dissertation aus Mannheim Michael Witthöft

[Juliane]

Attentional Bias, Memory Bias, and Symptom Attribution in
Idiopathic Environmental Intolerance and Classical Somatoform Disorders

INAUGURALDISSERTATION

ZUR ERLANGUNG DES AKADEMISCHEN GRADES EINES DOKTORS

DER SOZIALWISSENSCHAFTEN

DER UNIVERSITÄT MANNHEIM

Michael Witthöft, Dipl.-Psych.
November 2006



Gutachter:

Prof. Dr. Werner W. Wittmann

Prof. Dr. Fred Rist & PD Dr. Josef Bailer

ACKNOWLEDGEMENTS

The completion of this dissertation would not have been possible without the continous and manifold support of many friends, colleagues, and my family. First of all, I am grateful to Josef Bailer and Fred Rist for the opportunity to participate in the research project on Multiple Chemical Sensitivity, which provided a stimulating background for this thesis. I especially would like to thank Josef Bailer for providing me with continous support and confidence over the last years. I am very grateful that Josef gave me the opportunity and freedom to combine practical clinical work as a psychotherapist with scientific work in the realm of clinical and experimental psychology. Furthermore, I thank Fred Rist for his manifold support throughout all stages of the dissertation project and the generous opportunity to participate in different interesting worshops at the University of Münster. I also would like to thank Alexander Gerlach for his advice and numerous instructive and inspiring discussions.



SUMMARY (ab Seite 124)
Idiopathic Environmental Intolerance (IEI) refers to a polysymptomatic condition of unknown etiology, poorly understood pathogeneses, and somatoform-like phenomenology. Two studies were designed to assess cognitive biases in people with IEI (n = 54). Specificity of cognitive biases were tested in two control groups, that is, people with a traditional somatoform disorder according to DSM-IV (SFD; n = 44), and people without IEI and SFD (CG; n = 54).

The first study was designed to focus on psychological mechanisms and to detect and compare selective attention, memory bias, and abnormalities in explicit evaluative processes toward threat related words in IEI and SFD. Attentional biases toward somatic symptoms and IEI-trigger words were assessed with the emotional Stroop and the dot-probe paradigm. Memory bias was assessed with a recognition task. Ratings of explicit emotional evaluation were measured with the self-assessment manikin (SAM). The IEI and SFD group showed increased interference in naming the color of symptom words in the emotional Stroop task, whereas no differential interference effect was found for IEI-trigger words. The dot-probe task did not reveal evidence for group specific vigilance or avoidance reactions to critical
stimuli. The IEI group recognized IEI-trigger words that they had previously seen slightly better than the other groups. Participants with IEI rated trigger words as more unpleasant and more arousing than the two comparison groups. Indices of attentional bias and explicit emotional evaluation were correlated with somatoform symptoms, dysfunctional beliefs about body and health, and other psychological self-report measures. Results revealed implicit and explicit cognitive abnormalities in IEI similar to SFD that may trigger and maintain processes of somatosensory amplification.

The second study provided data from a 1-year follow-up investigation using an innovative cognitive experimental paradigm - the extrinsic affective Simon task (EAST). In the EAST we dissociated indicators of attentional bias and implicit attitudes toward bodily symptoms and IEI-trigger words. Attentional bias scores mirrored results of the first study, that is, elevated attentional bias toward physical symptom words but not IEI-trigger words in IEI and SFD compared to the CG. As indirect evidence for the existence of dysfunctional specific schemata in IEI, negative implicit attitudes toward IEI-trigger words were found only in IEI-participants. Whereas implicit negative attitudes seem specific for IEI, increased attentional biases toward symptom words in IEI and SFD replicate previous findings and are compatible with the notion of symptom focused attention contributing to somatosensory amplification and chronicity of medically unexplained symptoms in typical and atypical somatoform disorders.


Reviewtätigkeit Journal of Psychosomatic Research



Auszeichnung Mai 2006: Nachwuchswissenschaftler-Preis für hervorragende wissenschaftliche Leistungen im Bereich der klinisch-psychologischen Forschung – Fachgruppe Klinische Psychologie und Psychotherapie der Deutschen Gesellschaft für Psychologie (DGPs)

http://madoc.bib.uni-mannheim.de/madoc/volltexte/2007/1400/pdf/diss_mwitthoeft_2007.pdf