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Alexander L. Gerlach

Bio: Alexander L. Gerlach is an academic researcher from University of Cologne. The author has contributed to research in topics: Anxiety & Panic disorder. The author has an hindex of 38, co-authored 162 publications receiving 4748 citations. Previous affiliations of Alexander L. Gerlach include Stanford University & University of Marburg.


Papers
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Journal ArticleDOI
TL;DR: This review provides an overview of methods which are frequently used to assess heartbeat perception in clinical studies and summarizes presently available results referring to interoceptive sensitivity with respect to heartbeat in anxiety-related traits (anxiety sensitivity, state/trait anxiety), panic disorder and other anxiety disorders.

411 citations

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TL;DR: In their Facebook profiles, users communicate abundant social comparison information conveying mainly positive self-portrayals, and thereby, social networking sites like Facebook provide a fertile ground for envy as discussed by the authors.
Abstract: In their Facebook profiles, users communicate abundant social comparison information conveying mainly positive self-portrayals. Thereby, social networking sites like Facebook provide a fertile ground for envy. This has been proposed as a mechanism for the potential negative effects of Facebook use on well-being and depression. This article reviews research on this process. Studies show that (especially passive) Facebook use indeed predicts different measures of social comparison as well as envy. In several studies social comparison or envy mediate a positive association between Facebook use and undesirable affective outcomes such as depression. However, causal relationships have not yet been sufficiently established. Methodological and conceptual variety across studies limits their comparability, but reveals viable ideas for future research.

293 citations

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TL;DR: Therapist-guided Exposure is more effective for agoraphobic avoidance, overall functioning, and panic attacks in the follow-up period than is CBT without therapist-guided exposure.
Abstract: OBJECTIVE: Cognitive-behavioral therapy (CBT) is a first-line treatment for panic disorder with agoraphobia (PD/AG). Nevertheless, an understanding of its mechanisms and particularly the role of therapist-guided exposure is lacking. This study was aimed to evaluate whether therapist-guided exposure in situ is associated with more pervasive and long-lasting effects than therapist-prescribed exposure in situ. METHOD: A multicenter randomized controlled trial, in which 369 PD/AG patients were treated and followed up for 6 months. Patients were randomized to 2 manual-based variants of CBT (T+/T-) or a wait-list control group (WL; n = 68) and were treated twice weekly for 12 sessions. CBT variants were identical in content, structure, and length, except for implementation of exposure in situ: In the T+ variant (n = 163), therapists planned and supervised exposure in situ exercises outside the therapy room; in the T- group (n = 138), therapists planned and discussed patients' in situ exposure exercises but did not accompany them. Primary outcome measures were (a) Hamilton Anxiety Scale, (b) Clinical Global Impression, (c) number of panic attacks, and (d) agoraphobic avoidance (Mobility Inventory). RESULTS: For T+ and T- compared with WL, all outcome measures improved significantly with large effect sizes from baseline to post (range = -0.5 to -2.5) and from post to follow-up (range = -0.02 to -1.0). T+ improved more than T- on the Clinical Global Impression and Mobility Inventory at post and follow-up and had greater reduction in panic attacks during the follow-up period. Reduction in agoraphobic avoidance accelerated after exposure was introduced. A dose-response relation was found for Time × Frequency of Exposure and reduction in agoraphobic avoidance. CONCLUSIONS: Therapist-guided exposure is more effective for agoraphobic avoidance, overall functioning, and panic attacks in the follow-up period than is CBT without therapist-guided exposure. Therapist-guided exposure promotes additional therapeutic improvement--possibly mediated by increased physical engagement in feared situations--beyond the effects of a CBT treatment in which exposure is simply instructed.

183 citations

Journal ArticleDOI
TL;DR: In this article, a multilevel approach was applied to further elucidate the role of neuropeptide S in the etiology of human anxiety, and the functional NPSR A/T (Asn 107 Ile) variant (rs324981) was investigated for association with panic disorder.
Abstract: Animal studies have suggested neuropeptide S (NPS) and its receptor (NPSR) to be involved in the pathogenesis of anxiety-related behavior. In this study, a multilevel approach was applied to further elucidate the role of NPS in the etiology of human anxiety. The functional NPSR A/T (Asn 107 Ile) variant (rs324981) was investigated for association with (1) panic disorder with and without agoraphobia in two large, independent case–control studies, (2) dimensional anxiety traits, (3) autonomic arousal level during a behavioral avoidance test and (4) brain activation correlates of anxiety-related emotional processing in panic disorder. The more active NPSR rs324981 T allele was found to be associated with panic disorder in the female subgroup of patients in both samples as well as in a meta-analytic approach. The T risk allele was further related to elevated anxiety sensitivity, increased heart rate and higher symptom reports during a behavioral avoidance test as well as decreased activity in the dorsolateral prefrontal, lateral orbitofrontal and anterior cingulate cortex during processing of fearful faces in patients with panic disorder. The present results provide converging evidence for a female-dominant role of NPSR gene variation in panic disorder potentially through heightened autonomic arousal and distorted processing of anxiety-relevant emotional stimuli. Molecular Psychiatry (2011) 16, 938–948; doi:10.1038/mp.2010.81; published online 6 July 2010

159 citations

Journal ArticleDOI
TL;DR: In a quasi-experimental online study, depressed and nondepressed participants indicated their self-esteem and were then presented with specifically set up Facebook profiles that were either attractive or unattractive.
Abstract: The co-occurrence of depression and envy is both plausible and empirically established. However, little is known about the mechanisms underlying this correlation. An account is proposed according to which low self-esteem in depressed individuals leads to upward social comparison and thus makes envy more likely. This effect should frequently occur in online social networks like Facebook because they allow for easy impression management and hence provide high comparison standards. In a quasi-experimental online study, depressed and nondepressed participants indicated their self-esteem and were then presented with specifically set up Facebook profiles that were either attractive or unattractive. Participants were asked to compare themselves to the profile owner and to report their resulting feelings of inferiority and envy. Depressed participants were more envious, especially after seeing the attractive profile. Envy was associated with higher self-reported inferiority and also correlated negatively with sel...

143 citations


Cited by
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TL;DR: A review of 134 publications that report experimental investigations of emotional effects on peripheral physiological responding in healthy individuals suggests considerable ANS response specificity in emotion when considering subtypes of distinct emotions.

2,241 citations

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TL;DR: The problem of which cues, internal or external, permit a person to label and identify his own emotional state has been with us since the days that James first tendered his doctrine that "the bodily changes follow directly the perception of the exciting fact".
Abstract: The problem of which cues, internal or external, permit a person to label and identify his own emotional state has been with us since the days that James (1890) first tendered his doctrine that \"the bodily changes follow directly the perception of the exciting fact, and that our feeling of the same changes as they occur is the emotion\" (p. 449). Since we are aware of a variety of feeling and emotion states, it should follow from James' proposition that the various emotions will be accompanied by a variety of differentiable bodily states. Following James' pronouncement, a formidable number of studies were undertaken in search of the physiological differentiators of the emotions. The results, in these early days, were almost uniformly negative. All of the emotional states experi-

1,828 citations

Journal ArticleDOI
TL;DR: It is proposed that the P-FIT provides a parsimonious account for many of the empirical observations, to date, which relate individual differences in intelligence test scores to variations in brain structure and function.
Abstract: Is there a biology of intelligence which is characteristic of the normal human nervous system?" Here we review 37 modern neuroimaging studies in an attempt to address this question posed by Halstead (1947) as he and other icons of the last century endeavored to understand how brain and behavior are linked through the expression of intelligence and reason. Reviewing studies from functional (i.e., functional magnetic resonance imaging, positron emission tomography) and structural (i.e., magnetic resonance spectroscopy, diffusion tensor imaging, voxel-based morphometry) neuroimaging paradigms, we report a striking consensus suggesting that variations in a distributed network predict individual differences found on intelligence and reasoning tasks. We describe this network as the Parieto-Frontal Integration Theory (P-FIT). The P-FIT model includes, by Brodmann areas (BAs): the dorsolateral prefrontal cortex (BAs 6, 9, 10, 45, 46, 47), the inferior (BAs 39, 40) and superior (BA 7) parietal lobule, the anterior cingulate (BA 32), and regions within the temporal (BAs 21, 37) and occipital (BAs 18, 19) lobes. White matter regions (i.e., arcuate fasciculus) are also implicated. The P-FIT is examined in light of findings from human lesion studies, including missile wounds, frontal lobotomy/leukotomy, temporal lobectomy, and lesions resulting in damage to the language network (e.g., aphasia), as well as findings from imaging research identifying brain regions under significant genetic control. Overall, we conclude that modern neuroimaging techniques are beginning to articulate a biology of intelligence. We propose that the P-FIT provides a parsimonious account for many of the empirical observations, to date, which relate individual differences in intelligence test scores to variations in brain structure and function. Moreover, the model provides a framework for testing new hypotheses in future experimental designs.

1,285 citations

Journal Article
TL;DR: For instance, this paper found that brain activation in males is lateralized to the left inferior frontal gyrus regions; in females the pattern of activation is very different, engaging more diffuse neural systems that involve both the left and right inferior frontal cortex.
Abstract: A MUCH debated question is whether sex differences exist in the functional organization of the brain for language1–4. A long-held hypothesis posits that language functions are more likely to be highly lateralized in males and to be represented in both cerebral hemispheres in females5,6, but attempts to demonstrate this have been inconclusive7–17. Here we use echo-planar functional magnetic resonance imaging18–21 to study 38 right-handed subjects (19 males and 19 females) during orthographic (letter recognition), phonological (rhyme) and semantic (semantic category) tasks. During phonological tasks, brain activation in males is lateralized to the left inferior frontal gyrus regions; in females the pattern of activation is very different, engaging more diffuse neural systems that involve both the left and right inferior frontal gyrus. Our data provide clear evidence for a sex difference in the functional organization of the brain for language and indicate that these variations exist at the level of phonological processing.

1,247 citations