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  1. Article: Gaze Behavior in Social Fear Conditioning: An Eye-Tracking Study in Virtual Reality.

    Reichenberger, Jonas / Pfaller, Michael / Mühlberger, Andreas

    Frontiers in psychology

    2020  Volume 11, Page(s) 35

    Abstract: The vigilance-avoidance hypothesis of selective attention assumes that socially anxious persons initially direct their attention toward fear-related stimuli and subsequently avoid these social stimuli to reduce emotional distress. New technical ... ...

    Abstract The vigilance-avoidance hypothesis of selective attention assumes that socially anxious persons initially direct their attention toward fear-related stimuli and subsequently avoid these social stimuli to reduce emotional distress. New technical developments provide tools to implicit measure overt attention on fear-related stimuli via eye-tracking in ecological valid virtual environments presented via a head-mounted display. We examined in 27 low (LSA) and 26 high socially anxious (HSA) individuals fear ratings, physical behavior (duration of approach), hypervigilance (time to first fixation), and attentional avoidance (count of fixations) toward virtual female and male agents (CS) during social fear conditioning (SFC) and extinction in virtual reality (VR). As hypothesized, generally SFC was successfully induced and extinguished concerning the fear ratings. Our findings partly support the vigilance-avoidance hypothesis as HSA directed especially at the first half of the fear acquisition their initial attention more at CS+ than CS- agents, and avoided subsequently the CS+ more than the CS- agents during the fear acquisition. In contrast, in LSA participants initial and sustained attention did not differ between CS+ and CS- agents during fear acquisition. We conclude that HSA individuals guide their initial attention to emotionally threatening stimuli and subsequently avoid the threatening stimuli to possibly reduce their emotional distress, whereas LSA individuals regulate themselves less in their (fear) responses during SFC. Measuring implicit gaze behavior within a well-controlled virtual environment is an interesting innovative tool to in deeply investigate the impact of attention on emotional learning processes.
    Language English
    Publishing date 2020-01-23
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2563826-9
    ISSN 1664-1078
    ISSN 1664-1078
    DOI 10.3389/fpsyg.2020.00035
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Efficacy of biofeedback in the treatment of migraine and tension type headaches.

    Pfaller, Andreas

    Pain physician

    2010  Volume 13, Issue 1, Page(s) 94–6; author reply 96

    MeSH term(s) Biofeedback, Psychology/methods ; Biofeedback, Psychology/physiology ; Clinical Trials as Topic/standards ; Clinical Trials as Topic/statistics & numerical data ; Humans ; Meta-Analysis as Topic ; Migraine Disorders/therapy ; Models, Neurological ; Outcome Assessment (Health Care)/methods ; Outcome Assessment (Health Care)/standards ; Relaxation Therapy/methods ; Reproducibility of Results ; Skin Temperature/physiology ; Tension-Type Headache/therapy ; Treatment Outcome
    Language English
    Publishing date 2010-01
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 2146393-1
    ISSN 2150-1149 ; 1533-3159
    ISSN (online) 2150-1149
    ISSN 1533-3159
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Look at the Audience? A Randomized Controlled Study of Shifting Attention From Self-Focus to Nonsocial vs. Social External Stimuli During Virtual Reality Exposure to Public Speaking in Social Anxiety.

    Wechsler, Theresa F / Pfaller, Michael / van Eickels, Rahel E / Schulz, Luise H / Mühlberger, Andreas

    Frontiers in psychiatry

    2021  Volume 12, Page(s) 751272

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2021-12-14
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564218-2
    ISSN 1664-0640
    ISSN 1664-0640
    DOI 10.3389/fpsyt.2021.751272
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Knowledge and care regarding long-term cardiovascular risk after hypertensive disorders of pregnancy and gestational diabetes.

    Pfaller, Birgit / Busvine, Constance / Rosenauer, Alena / Schenzel, Andreas / Fournier, Camille / Aringer, Ida / Lösch, Alexander / Wiesholzer, Martin / Schubert, Susanne / Wichert-Schmitt, Barbara

    Wiener klinische Wochenschrift

    2024  Volume 136, Issue 3-4, Page(s) 110–117

    Abstract: Background: Adverse pregnancy outcomes (APO), such as preeclampsia (PE) and gestational diabetes (GDM) are substantial risk factors for cardiovascular disease (CVD) later in life. Identifying these high-risk female individuals during pregnancy offers ... ...

    Abstract Background: Adverse pregnancy outcomes (APO), such as preeclampsia (PE) and gestational diabetes (GDM) are substantial risk factors for cardiovascular disease (CVD) later in life. Identifying these high-risk female individuals during pregnancy offers the possibility of preventing long-term CVD and chronic kidney disease via a structured therapeutic and surveillance plan. We aimed to evaluate the current practice of postpartum care in women after APO and the impact on the women's awareness about their future risk for CVD.
    Methods: Women diagnosed with PE and GDM at the University Hospital of St. Poelten/Lilienfeld between 2015-2020 were identified and participated in a structured telephone interview about postpartum medical care and knowledge about the impact of APOs on long-term cardiovascular health.
    Results: Of 161 out of the 750 women contacted, 29% (n = 46) were diagnosed with PE and 71% (n = 115) with GDM. One third of all women and up to 44% of women diagnosed with PE, were unaware that APOs are related to CVD. Women diagnosed with PE were less likely to receive postpartum care information than those with GDM (30.4% vs. 49.6%, p = 0.027), and only one third of all women after APOs were counselled by a physician or healthcare professional. Of the women 50% received recommendations regarding lifestyle changes after delivery; significantly more women with GDM than women with PE (54% vs. 37%, p = 0.05). Only 14% had at least one long-term follow-up.
    Conclusion: This study identified a significant deficit of structured postpartum care and a lack of awareness among women after APO and their healthcare providers about the increased risk of long-term CVD.
    MeSH term(s) Pregnancy ; Female ; Humans ; Diabetes, Gestational/diagnosis ; Diabetes, Gestational/epidemiology ; Diabetes, Gestational/therapy ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Hypertension, Pregnancy-Induced/diagnosis ; Hypertension, Pregnancy-Induced/epidemiology ; Hypertension, Pregnancy-Induced/therapy ; Risk Factors ; Pre-Eclampsia ; Heart Disease Risk Factors
    Language English
    Publishing date 2024-01-03
    Publishing country Austria
    Document type Journal Article
    ZDB-ID 200462-8
    ISSN 1613-7671 ; 0043-5325 ; 0300-5178
    ISSN (online) 1613-7671
    ISSN 0043-5325 ; 0300-5178
    DOI 10.1007/s00508-023-02313-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Effects of rhythmic eye movements during a virtual reality exposure paradigm for spider-phobic patients.

    Reitmaier, Jessica / Schiller, Anika / Mühlberger, Andreas / Pfaller, Michael / Meyer, Marie / Shiban, Youssef

    Psychology and psychotherapy

    2021  Volume 95, Issue 1, Page(s) 57–78

    Abstract: Rhythmic eye movements performed during eye movement desensitization and reprocessing (EMDR) therapy have been shown to evoke a physiological de-arousal pattern.: Objectives: Here, we examined whether the efficacy of a virtual reality exposure therapy ...

    Abstract Rhythmic eye movements performed during eye movement desensitization and reprocessing (EMDR) therapy have been shown to evoke a physiological de-arousal pattern.
    Objectives: Here, we examined whether the efficacy of a virtual reality exposure therapy (VRET) paradigm for phobic patients could be improved by adding rhythmic eye movements.
    Design: Spider-phobic patients (N = 53) were randomly assigned to either a group performing rhythmic eye movements or a control group undergoing exposure without such eye movements.
    Methods: During the VRET session, heart rate, electrodermal activity, eye movements, and subjective fear ratings were recorded. Participants underwent behavioural avoidance tests before and after treatment as well as a follow-up 10-14 days later. Questionnaire data were assessed before exposure and at follow-up.
    Results: There were clear treatment effects in both groups with almost no group differences (i.e., the subjective fear ratings and the skin conductance response).
    Conclusions: Contrary to our expectation, the implementation of rhythmic eye movements during virtual exposure did not enhance the effectiveness of the treatment. However, the eye movement group did show a significantly lower heart rate during exposure compared with the control group which might indicate a less stressful treatment.
    Practitioner points: One-session Virtual Reality Exposure Therapy reduced fear of spiders effectively. Performing rhythmic eye movements during exposure did not enhance therapy effects. Rhythmic eye movements during exposure resulted in lower heart rate than standard exposure.
    MeSH term(s) Animals ; Eye Movements ; Humans ; Phobic Disorders/therapy ; Spiders ; Virtual Reality
    Language English
    Publishing date 2021-09-06
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 2063873-5
    ISSN 2044-8341 ; 1476-0835
    ISSN (online) 2044-8341
    ISSN 1476-0835
    DOI 10.1111/papt.12363
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Testinformation

    Pfaller, Andreas

    Diagnostica

    2011  Volume 57, Issue 1

    Publishing date 2011-01-11
    Document type Article
    ZDB-ID 212493-2
    ISSN 2190-622X ; 0012-1924 ; 0012-1924
    ISSN (online) 2190-622X ; 0012-1924
    ISSN 0012-1924
    DOI 10.1026/0012-1924/a000035
    Database Hogrefe publisher's database

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  7. Article: Gaze behavior in social fear conditioning

    Reichenberger, Jonas / Pfaller, Michael / Mühlberger, Andreas

    Frontiers in Psychology

    An eye-tracking study in virtual reality

    2020  

    Abstract: The vigilance-avoidance hypothesis of selective attention assumes that socially anxious persons initially direct their attention toward fear-related stimuli and subsequently avoid these social stimuli to reduce emotional distress. New technical ... ...

    Title translation Blickverhalten bei der Konditionierung sozialer Angst: Eine Eye-Tracking-Studie in virtueller Realität
    Abstract The vigilance-avoidance hypothesis of selective attention assumes that socially anxious persons initially direct their attention toward fear-related stimuli and subsequently avoid these social stimuli to reduce emotional distress. New technical developments provide tools to implicit measure overt attention on fear-related stimuli via eye-tracking in ecological valid virtual environments presented via a head-mounted display. We examined in 27 low (LSA) and 26 high socially anxious (HSA) individuals fear ratings, physical behavior (duration of approach), hypervigilance (time to first fixation), and attentional avoidance (count of fixations) toward virtual female and male agents (CS) during social fear conditioning (SFC) and extinction in virtual reality (VR). As hypothesized, generally SFC was successfully induced and extinguished concerning the fear ratings. Our findings partly support the vigilance-avoidance hypothesis as HSA directed especially at the first half of the fear acquisition their initial attention more at CS+ than CS- agents, and avoided subsequently the CS+ more than the CS- agents during the fear acquisition. In contrast, in LSA participants initial and sustained attention did not differ between CS+ and CS- agents during fear acquisition. We conclude that HSA individuals guide their initial attention to emotionally threatening stimuli and subsequently avoid the threatening stimuli to possibly reduce their emotional distress, whereas LSA individuals regulate themselves less in their (fear) responses during SFC. Measuring implicit gaze behavior within a well-controlled virtual environment is an interesting innovative tool to in deeply investigate the impact of attention on emotional learning processes.
    Keywords Attention ; Aufmerksamkeit ; Augenbewegungen ; Avoidance ; Blickfixierung ; Conditioned Fear ; Eye Fixation ; Eye Movements ; Fear ; Furcht ; Konditionierte Furcht ; Social Phobia ; Soziale Phobie ; Vermeidung ; Vigilance ; Vigilanz ; Virtual Reality ; Virtuelle Realität
    Language English
    Document type Article
    ZDB-ID 2563826-9
    ISSN 1664-1078
    ISSN 1664-1078
    DOI 10.3389/fpsyg.2020.00035
    Database PSYNDEX

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  8. Article: Effects of rhythmic eye movements during a virtual reality exposure paradigm for spider-phobic patients

    Reitmaier, Jessica / Schiller, Anika / Mühlberger, Andreas / Pfaller, Michael / Meyer, Marie / Shiban, Youssef

    Psychology and Psychotherapy: Theory, Research and Practice

    2022  Volume 95, Issue 1, Page(s) 57–78

    Abstract: Rhythmic eye movements performed during eye movement desensitization and reprocessing (EMDR) therapy have been shown to evoke a physiological de-arousal pattern. Objectives: Here, we examined whether the efficacy of a virtual reality exposure therapy ( ... ...

    Title translation Auswirkungen von rhythmischen Augenbewegungen während eines Virtual-Reality-Expositionsparadigmas bei Patienten mit Spinnenphobie (DeepL)
    Abstract Rhythmic eye movements performed during eye movement desensitization and reprocessing (EMDR) therapy have been shown to evoke a physiological de-arousal pattern. Objectives: Here, we examined whether the efficacy of a virtual reality exposure therapy (VRET) paradigm for phobic patients could be improved by adding rhythmic eye movements. Design: Spider-phobic patients (N = 53) were randomly assigned to either a group performing rhythmic eye movements or a control group undergoing exposure without such eye movements. Methods: During the VRET session, heart rate, electrodermal activity, eye movements, and subjective fear ratings were recorded. Participants underwent behavioural avoidance tests before and after treatment as well as a follow-up 10-14 days later. Questionnaire data were assessed before exposure and at follow-up. Results: There were clear treatment effects in both groups with almost no group differences (i.e., the subjective fear ratings and the skin conductance response). Conclusions: Contrary to our expectation, the implementation of rhythmic eye movements during virtual exposure did not enhance the effectiveness of the treatment. However, the eye movement group did show a significantly lower heart rate during exposure compared with the control group which might indicate a less stressful treatment. Practitioner points One-session Virtual Reality Exposure Therapy reduced fear of spiders effectively. Performing rhythmic eye movements during exposure did not enhance therapy effects. Rhythmic eye movements during exposure resulted in lower heart rate than standard exposure.
    Keywords Augenbewegungen ; Eye Movements ; Phobias ; Phobien ; Psychotherapeutic Outcomes ; Psychotherapieergebnisse ; Therapieerfolgskontrolle ; Treatment Effectiveness Evaluation ; Virtual Reality Exposure Therapy ; Virtuelle Expositionstherapie
    Language English
    Document type Article
    ZDB-ID 2063873-5
    ISSN 2044-8341 ; 1476-0835
    ISSN (online) 2044-8341
    ISSN 1476-0835
    DOI 10.1111/papt.12363
    Database PSYNDEX

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  9. Article: Interpersonal Distance During Real-Time Social Interaction: Insights From Subjective Experience, Behavior, and Physiology.

    Kroczek, Leon O H / Pfaller, Michael / Lange, Bastian / Müller, Mathias / Mühlberger, Andreas

    Frontiers in psychiatry

    2020  Volume 11, Page(s) 561

    Abstract: Physical distance is a prominent feature in face-to-face social interactions and allows regulating social encounters. Close interpersonal distance (IPD) increases emotional responses during interaction and has been related to avoidance behavior in social ...

    Abstract Physical distance is a prominent feature in face-to-face social interactions and allows regulating social encounters. Close interpersonal distance (IPD) increases emotional responses during interaction and has been related to avoidance behavior in social anxiety. However, a systematic investigation of the effects of IPD on subjective experience combined with measures of physiological arousal and behavioral responses during real-time social interaction has been missing. Virtual Reality allows for a controlled manipulation of IPD while maintaining naturalistic social encounters. The present study investigates IPD in social interaction using a novel paradigm in Virtual Reality. Thirty-six participants approached virtual agents and engaged in short interactions. IPD was varied between 3.5 and 1 m by manipulating the distance at which agents reacted to the participant's approach. Closer distances were rated as more arousing, less pleasant, and less natural than longer distances and this effect was significantly modulated by social anxiety scores. Skin conductance responses were also increased at short distances compared to longer distances. Finally, an interaction of IPD and social anxiety was observed for avoidance behavior, measured as participants' backward motion during interaction, with stronger avoidance related to close distances and high values of social anxiety. These results highlight the influence of IPD on experience, physiological response, and behavior during social interaction. The interaction of social anxiety and IPD suggests including the manipulation of IPD in behavioral tests in Virtual Reality as a promising tool for the treatment of social anxiety disorder.
    Language English
    Publishing date 2020-06-12
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564218-2
    ISSN 1664-0640
    ISSN 1664-0640
    DOI 10.3389/fpsyt.2020.00561
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Social Presence as a Moderator of the Effect of Agent Behavior on Emotional Experience in Social Interactions in Virtual Reality

    Michael Pfaller / Leon O. H. Kroczek / Bastian Lange / Raymund Fülöp / Mathias Müller / Andreas Mühlberger

    Frontiers in Virtual Reality, Vol

    2021  Volume 2

    Abstract: Background: Exposure therapy involves exposure to feared stimuli and is considered to be the gold-standard treatment for anxiety disorders. While its application in Virtual Reality (VR) has been very successful for phobic disorders, the effects of ... ...

    Abstract Background: Exposure therapy involves exposure to feared stimuli and is considered to be the gold-standard treatment for anxiety disorders. While its application in Virtual Reality (VR) has been very successful for phobic disorders, the effects of exposure to virtual social stimuli in Social Anxiety Disorder are heterogeneous. This difference has been linked to demands on realism and presence, particularly social presence, as a pre-requisite in evoking emotional experiences in virtual social interactions. So far, however, the influence of social presence on emotional experience in social interactions with virtual agents remains unknown.Objective: We investigated the relationship between realism and social presence and the moderating effect of social presence on the relationship between agent behavior and experienced emotions in virtual social interaction.Methods: Healthy participants (N = 51) faced virtual agents showing supportive and dismissive behaviors in two virtual environments (short interactions and oral presentations). At first, participants performed five blocks of short one-on-one interactions with virtual agents (two male and two female agents per block). Secondly, participants gave five presentations in front of an audience of 16 agents. In each scenario, agent behavior was a within subjects factor, resulting in one block of neutral, two blocks of negative, and two blocks of positive agent behavior. Ratings of agent behavior (valence and realism), experience (valence and arousal), and presence (physical and social) were collected after every block. Moderator effects were investigated using mixed linear models with random intercepts. Correlations were analyzed via repeated measures correlations.Results: Ratings of valence of agent behaviors showed reliable relationships with experienced valence and less reliable relationships with experienced arousal. These relationships were moderated by social presence in the presentation scenario. Results for the interaction scenario were weaker but potentially promising for experimental studies. Variations in social presence and realism over time were correlated but social presence proved a more reliable moderator.Conclusion: Our findings emphasize the role of social presence for emotional experience in response to specific agent behaviors in virtual social interactions. While these findings should be replicated with experimental designs and in clinical samples, variability in social presence might account for heterogeneity in efficacy of virtual exposure to treat social anxiety disorder.
    Keywords virtual reality ; social anxiety ; social presence ; virtual agents ; realism ; Electronic computers. Computer science ; QA75.5-76.95
    Language English
    Publishing date 2021-12-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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