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Background Childhood maltreatment (CM) exerts long-lasting psychological and biological alterations in affected individuals and might also affect the endocannabinoid (eCB) system which modulates inflammation and the endocrine stress response. Here, we investigated the eCB system of women with and without CM and their infants using hair samples representing eCB levels accumulated during the last trimester of pregnancy and 10–12 months postpartum. Methods CM exposure was assessed with the Childhood Trauma Questionnaire. At both timepoints, 3 cm hair strands were collected from mothers and children (N = 170 resp. 150) to measure anandamide (AEA), 2/1-arachidonoylglycerol (2-AG/1-AG), stearoylethanolamide (SEA), oleoylethanolamide (OEA), and palmitoylethanolamide (PEA). Results Maternal hair levels of 2-AG/1-AG increased and SEA levels decreased from late pregnancy to one year postpartum. Maternal CM was associated with lower SEA levels in late pregnancy, but not one year later. In the children's hair, levels of 2-AG/1-AG increased while levels of SEA, OEA, and PEA decreased from late pregnancy to one year later. Maternal CM was not consistently associated with the eCB levels measured in children's hair. Conclusions We provide first evidence for longitudinal change in the eCB system of mothers and infants from pregnancy to one year later. While maternal CM influenced the maternal eCB system, we found no consistent intergenerational effects on early regulation of the eCB system in children. Longitudinal research on the importance of the eCB system for the course and immunoregulation of pregnancy as well as for the children's development.

Abstract. Background: Chronically stressed people often suffer from anxiety and depressive mood. Hypnosis is a technique that can induce a relaxation response and reduce negative stress symptoms. Objective: This explorative study investigated the impact of a single relaxation hypnosis session on stress-related psychological symptoms. Method: 47 suggestible, stressed individuals (87 % female) were randomized to a hypnosis group ( n = 23, 20-minute hypnosis) or a control group ( n = 24, 20-minute scientific documentary). Before and after the intervention, we assessed perceived stress, negative affect, anxiety, and depressive mood. Results: After the hypnosis intervention, depressive mood ( d = 0.36) and state anxiety ( d = 1.00) decreased, while negative affect remained stable ( d = 0.04). Perceived stress was reduced in both groups. Conclusion: A single relaxation hypnosis session decreased stress-related symptoms in chronically stressed individuals. Our results substantiated the stress-alleviating effects of hypnosis.

Major depressive disorder (MDD) involves peripheral low-grade pro-inflammatory activity. This multi-biomarker case-control study characterises the proinflammatory status in MDD beyond C-reactive protein (CRP) and Interleukin (IL)-6 levels through investigating concomitant alterations of immunoregulatory biomolecules. In 20 female MDD patients and 24 non-depressed women, circulating levels of CRP, IL-6, cortisol, selected endocannabinoids (ECs; anandamide [AEA], 2-arachidonylglycerol [2-AG]), and N-acylethanolamines (NAEs), as well as circulating cell-free mitochondrial DNA (ccf-mtDNA) were measured. We found higher serum CRP and plasma AEA levels in MDD and a positive association of CRP and AEA levels with current depressive symptoms. Blood levels of cortisol, ccf-mtDNA, 2-AG, and NAEs did depend on MDD diagnosis nor correlated with the severity of current depressive symptoms. CRP correlated positively with AEA, and AEA showed positive associations with 2-AG and NAE levels. In this study, female MDD outpatients with mild to moderate disorder severity did not substantially differ from non-depressed controls in the resting levels of multiple immunoregulatory markers in peripheral blood. Instead of investigating resting levels, future research on the role of inflammatory activity in MDD should focus on investigating the reactivity of pathways modulating the immune system upon exposure to physical and psychosocial stressors.

Background Stressful event exposure, dysfunctional attitudes (DA), negative automatic thoughts (NAT), and declining positive automatic thoughts (PAT) have been associated with depressive relapse/recurrence. Few studies have investigated the course of these variables and their relevance for relapse/recurrence in remitted depression. Methods Following successful inpatient treatment, in 39 remitted depressive patients, stressful events, DA, NAT, PAT, and depressive relapse/recurrence were assessed five times during a 16-month follow-up. Data were analyzed with mixed effect models, and mediation effects were tested. Results Stressful events after discharge correlated with depressive relapse/recurrence. This association was mainly mediated by a stress-related decline of PAT within four months post discharge. Patients’ DA were relatively stable during the observation period and did not depend on stressful events, indicating DA as a risk trait for depressive relapse/recurrence. Mediation analyses revealed that independent of stress, DA were linked to depressive relapse/recurrence through more NAT. Conclusion Our findings suggest stressful events evoke relapse/recurrence in remitted depression through rapid deterioration of PAT after discharge from inpatient therapy. DA are expressed through NAT which additionally contribute to higher risk of depressive relapse/recurrence. Consequently, maintenance therapy requires techniques to promote the maintenance of PAT, and to effectively restructure DA and NAT.

Increasing prevalence of depression poses a huge challenge to the healthcare systems, and the success rates of current standard therapies are limited. While 30% of treated patients do not experience a full remission after treatment, more than 75% of patients suffer from recurrent depressive episodes. Eye Movement Desensitization and Reprocessing (EMDR) therapy represents an emerging treatment option of depression, and preliminary studies show promising effects with a probably higher remission rate when compared to control-therapies such as cognitive behavioral therapy. In the present study, 49 patients with severe depression were treated with an integrated systemic treatment approach including EMDR therapy that followed a specific protocol with a treatment algorithm for depression in a naturalistic hospital setting. Following their discharge from the hospital, the patients were followed up by a structured telephone interview after 3 and 12 months. 27 of the 49 (55%) patients fulfilled the Beck’s depression criteria of a full remission when they were discharged. At the follow-up interview, 12 months after discharge, 7 of the 27 patients (26%) reported a relapse, while the remaining 20 patients (74%) had stayed relapse-free. The findings of our observational study confirm reports of earlier studies in patients with depression, showing that EMDR therapy leads to a high rate of remission, and is associated with a decreased number of relapses. Patients with depression receiving EMDR treatment may be more resilient to stressors.

Women with a history of childhood maltreatment (CM) experience the postpartum period as particularly stressful and may benefit less from social support, implicating a higher risk for mental health problems and higher stress levels in mothers with CM.Thus, we investigated the complex relationship of CM and social support provided by different sources (intimate partner, parents, parents-in-law, friends) in predicting stress perception and mental health over the course of the first year postpartum.In N = 295 postpartum women we assessed CM experiences, stress perception, perceived social support and general mental health 3 and 12 months postpartum.Linear mixed effect models were used to examine the course of social support over the first year postpartum and path analyses were used to investigate mediation and moderation effects.We found that CM was linked to lower levels of perceived social support, accounted for more mental health problems, and amplified the negative association between perceived stress and maternal mental health. Most importantly, we showed that only partner support was beneficial for maternal mental health, and this association was mediated by reductions in perceived stress.CM as a major risk factor for mental health impairs the stress resilience of affected postpartum women. Extending previous research, our results reveal that the source of postpartum social support determines its benefits for maternal health. Our findings emphasize the need of at-risk mothers to be provided with additional sources of support to cope with daily practical, organizational and emotional challenges.

Posttraumatic stress disorder (PTSD) involves elevated levels of cellular oxidative stress which jeopardizes the integrity of essential cell compartments. Previously, we demonstrated higher levels of DNA lesions in peripheral blood mononuclear cells (PBMCs) in PTSD. Retaining vital levels of DNA integrity requires cells to mobilize compensatory efforts in elevating their DNA-repair capacity. Accordingly, we hypothesized to find increased expression rates of the DNA-repair genes X-ray repair cross complementing 1 (XRCC1), poly (ADP-ribose) polymerase 1 (PARP1), and polymerase β (Polβ) in PBMCs of PTSD patients as compared to controls, leading to functionally relevant changes in DNA-repair kinetics. In a cohort of 14 refugees with PTSD and 15 without PTSD, we found significantly higher XRCC1 expression in PTSD patients than controls (U = 161.0, p = 0.009, Cohen’s r = 0.49), and positive correlations between the severity of PTSD symptoms and the expression of XRCC1 (rS = 0.57, p = 0.002) and PARP1 (rS = 0.43, p = 0.022). Higher XRCC1 (F = 2.39, p = 0.010, η2p = 0.10) and PARP1 (F = 2.15, p = 0.022, η2p = 0.09) expression accounted for slower repair of experimentally X-ray irradiation-induced DNA damage, highlighting the possible physiological relevance of altered DNA-repair gene expression in PTSD. Our study provides first evidence for a compensatory regulation of DNA-repair mechanisms in PTSD. We discuss the implications of increased DNA damage and altered DNA-repair mechanisms in immune senescence, premature aging, and increased physical morbidity in PTSD.

Major depressive disorder (MDD) has been associated with lower mitochondrial energy production and higher oxidative stress. We investigated whether these alterations manifest in patients with current mild to moderate MDD severity. We observed no differences in mitochondrial respiration and density (i.e., citrate-synthase activity) in peripheral blood mononuclear cells and oxidative stress markers (i.e., 8-hydroxy-2'-deoxyguanosine, 8-isoprostane) in blood serum of 20 female MDD patients compared to 24 non-depressed women. Alterations in mitochondrial energy production and oxidative stress did not linearly depend on the current severity of MDD. However, biological alterations might rather manifest with higher MDD severity/chronicity and at higher age.

Zusammenfassung Hintergrund Rettungsdienstmitarbeiter*innen (RDM) sind wiederholt mit traumatischen Einsatzerlebnissen und chronischem arbeitsbedingtem Stress konfrontiert. Um dieser Belastung standzuhalten, ist die Bewältigung von emotionalem Stress entscheidend. Allerdings ist kaum bekannt, welche Strategien RDM zur Regulation unangenehmer Emotionen einsetzen und wie sich diese Strategien auf das Wohlbefinden und die Gesundheit der RDM auswirken. Ziel der Arbeit Wir untersuchten, inwieweit RDM die Emotionsregulationsstrategien Neubewerten, Akzeptanz, Problemlösen, Grübeln (Rumination), Unterdrücken und Vermeiden anwenden und welche Zusammenhänge diese Strategien mit dem Stresserleben, der Arbeitszufriedenheit und der Belastungssymptomatik der RDM zeigen. Material und Methoden In einer Querschnittserhebung schätzten 102 RDM zweier südwestdeutscher Rettungswachen anhand standardisierter Fragebogen ihren Emotionsregulationsstil, ihr berufliches Stresserleben, ihre Arbeitszufriedenheit und ihre depressiven, posttraumatischen und körperlichen Belastungssymptome ein. Ergebnisse Korrelationsanalysen ergaben, dass die Neigung zu häufigem Grübeln, Vermeiden und Unterdrücken mit höherem Stresserleben, stärkeren Belastungssymptomen und geringerer Arbeitszufriedenheit einhergeht. Die Akzeptanz unangenehmer Gefühle war mit geringeren Belastungssymptomen assoziiert, während Neubewerten und Problemlösen keine Korrelation mit dem Stresserleben, der Zufriedenheit und der Belastungssymptomatik der RDM zeigten. Diskussion Unsere Ergebnisse bestätigen die dysfunktionale Rolle von Grübeln, Vermeiden und Unterdrücken für das Wohlbefinden und die Gesundheit in Risikoberufen. Die kontextspezifische Wirksamkeit von Emotionsregulationsstrategien sollte bei der Planung zielgruppenspezifischer Präventionsmaßnahmen stärker berücksichtigt werden.

Safeguarding the rights of minorities is crucial for just societies. However, there are conceivable situations where minority rights might seriously impede the rights of the majority. Favoring the minority in such cases constitutes a violation of utilitarian principles. To explore the emotional, cognitive, and punitive responses of observers of such utilitarian rule transgressions, we conducted an online study with 1004 participants. Two moral scenarios (vaccine policy and epidemic) were rephrased in the third-party perspective. In both public health-related scenarios, the protagonist opted against the utilitarian option, which resulted in more fatalities in total, but avoided harm to a minority. Importantly, in vaccine policy, members of the minority cannot be identified beforehand and thus harm to them would have been rather accidental. Contrariwise, in epidemic, minority members are identifiable and would have needed to be deliberately selected. While the majority of participants chose not to punish the scenarios’ protagonists at all, 30.1% judged that protecting the minority over the interests of the majority when only accidental harm would have occurred (vaccine policy) was worthy of punishment. In comparison, only 11.2% opted to punish a protagonist whose decision avoided deliberately selecting (and thus harming) a minority at the cost of the majority (epidemic). Emotional responses and appropriateness ratings paralleled these results. Furthermore, complex personality × situation interactions revealed the influence of personality features, i.e., trait psychopathy, empathy, altruism, authoritarianism, need for cognition and faith in intuition, on participants’ responses. The results further underscore the need to consider the interaction of situational features and inter-individual differences in moral decisions and sense of justice.

Major depressive disorder (MDD) involves peripheral low-grade pro-inflammatory activity. This multi-biomarker case-control study characterises the proinflammatory status in MDD beyond C-reactive protein (CRP) and Interleukin (IL)-6 levels through investigating concomitant alterations of immunoregulatory biomolecules.In 20 female MDD patients and 24 non-depressed women, circulating levels of CRP, IL-6, cortisol, selected endocannabinoids (ECs; anandamide [AEA], 2-arachidonylglycerol [2-AG]), andWe found higher serum CRP and plasma AEA levels in MDD and a positive association of CRP and AEA levels with current depressive symptoms. Blood levels of cortisol, ccf-mtDNA, 2-AG, and NAEs did depend on MDD diagnosis nor correlated with the severity of current depressive symptoms. CRP correlated positively with AEA, and AEA showed positive associations with 2-AG and NAE levels.In this study, female MDD outpatients with mild to moderate disorder severity did not substantially differ from non-depressed controls in the resting levels of multiple immunoregulatory markers in peripheral blood. Instead of investigating resting levels, future research on the role of inflammatory activity in MDD should focus on investigating the reactivity of pathways modulating the immune system upon exposure to physical and psychosocial stressors.

Background Childhood maltreatment (CM) exerts various long-lasting psychological and biological changes in affected individuals, with inflammation being an interconnecting element. Besides chronic low-grade inflammation, CM might also affect the energy production of cells by altering the function and density of mitochondria, i.e. the body's main energy suppliers. Here, we compared mitochondrial respiration and density in intact peripheral blood mononuclear cells (PBMC), from women with and without CM between two time points, i.e. at the highly inflammatory phase within 1 week after parturition (t0) and again after 1 year (t2). Methods CM exposure was assessed with the Childhood Trauma Questionnaire. Whole blood was collected from n = 52 healthy women within the study ‘My Childhood – Your Childhood’ at both time points to isolate and cryopreserve PBMC. Thawed PBMC were used to measure mitochondrial respiration and density by high-resolution respirometry followed by spectrophotometric analyses of citrate-synthase activity. Results Over time, quantitative respiratory parameters increased, while qualitative flux control ratios decreased, independently of CM. Women with CM showed higher mitochondrial respiration and density at t0, but not at t2. We found significant CM group × time interaction effects for ATP-turnover-related respiration and mitochondrial density. Conclusions This is the first study to longitudinally investigate mitochondrial bioenergetics in postpartum women with and without CM. Our results indicate that CM-related mitochondrial alterations reflect allostatic load, probably due to higher inflammatory states during parturition, which normalize later. However, later inflammatory states might moderate the vulnerability for a second-hit on the level of mitochondrial bioenergetics, at least in immune cells., publishedVersion

Abstract. Background: Emergency medical services (EMS) personnel are frequently confronted with multiple stressful and potentially traumatic events as well as adverse working conditions. Objective: This narrative review provides an overview of the impact of adverse mission experiences and working conditions on the mental and physical health of EMS personnel. Methods: We summarize the empirical findings on prevalence rates as well as individual vulnerability factors and resilience. Results: EMS personnel show the highest prevalence rates of stress-related health problems among first responders. The article outlines prevention and intervention approaches that contribute to maintaining and improving the mental and physical health of EMS personnel. Conclusion: In the future, further evidence-based intervention measures should be developed to adequately support this professional group.

Childhood maltreatment (CM) comprises experiences of abuse and neglect during childhood. CM causes psychological as well as biological alterations in affected individuals. In humans, it is hardly explored whether these CM consequences can be transmitted directly on a biological level to the next generation. Here, we investigated the associations between maternal CM and mitochondrial bioenergetics (mitochondrial respiration and intracellular mitochondrial density) in immune cells of mothers and compared them with those of their newborns. In n = 102 healthy mother-newborn dyads, maternal peripheral blood mononuclear cells and neonatal umbilical cord blood mononuclear cells were collected and cryopreserved shortly after parturition to measure mitochondrial respiration and intracellular mitochondrial density with high-resolution respirometry and spectrophotometric analyses, respectively. Maternal CM was assessed with the Childhood Trauma Questionnaire. Maternal and neonatal mitochondrial bioenergetics were quantitatively comparable and positively correlated. Female newborns showed higher mitochondrial respiration compared to male newborns. Maternal CM load was significantly and positively associated with mitochondrial respiration and density in mothers, but not with mitochondrial respiration in newborns. Although maternal and neonatal mitochondrial bioenergetics were positively correlated, maternal CM only had a small effect on mitochondrial density in newborns, which was not significant in this study after adjustment for multiple comparisons. The biological relevance of our finding and its consequences for child development need further investigation in future larger studies. This study reports data on mitochondrial bioenergetics of healthy mother-newborn dyads with varying degrees of CM.

Research on the effectiveness and applicability of eye movement desensitization and reprocessing (EMDR) via videoconference is sparse. Considering the emerging use of internet-based psychotherapy during the COVID-19 pandemic, information on videoconference-based EMDR (eEMDR) would be beneficial for many therapists. In this study, 23 therapists from the EMDR-Institute in Germany provided information about their experiences with eEMDR in a questionnaire-based survey. Information on the effectiveness and the course of 102 eEMDR sessions was recorded. Results showed the potential of eEMDR as an effective and viable method. The decrease in the subjective unit of disturbance (SUD), which is an important indicator of treatment outcome, was found to be at a similar level compared to that of previous EMDR studies that were not administered in eEMDR format. The most important predictor of the SUD decrease was the type of bilateral stimulation used in eEMDR sessions. Eye movements resulted in significantly greater SUD reductions than tapping. Perceived disadvantages and impediments for the implementation of eEMDR were mainly of bureaucratic and technical concerns. In addition, about one-third of the therapists stated that some patients were not willing to engage in eEMDR. In our study, eEMDR proved to be a practically applicable therapy method and therefore, therapists can consider using eEMDR. These findings will hopefully encourage EMDR therapists and their patients to use eEMDR due to its effectiveness and viability as an online treatment approach., publishedVersion

Intelligence and Need for Cognition (NFC) have repeatedly been shown to be directly related to better academic performance, but no study so far has investigated their combined predictive validity or possible interactive effects in their relation to academic success. We examined their predictive value and a possible moderating role of NFC in the relationship between intelligence and school performance. 290 students completed the NFC scale, worked on the Intelligence Structure Test 2000 R (reasoning module), and reported their Grade Point Average (GPA) of the university entrance diploma (Abitur). To control for broader personality traits, the Big Five Factors were assessed as well. Analyses revealed that intelligence and NFC each significantly predicted higher GPA. Furthermore, NFC moderated the relation between intelligence and GPA: at higher NFC scores, the relation of reasoning ability on GPA was diminished, pointing to a compensating effect of NFC. Bayesian analyses comparing the likelihood of a moderation versus an additive model in the complete sample supported the moderation hypotheses, while in a sample without outliers, both models were equivocally likely. The results highlight the relevance of considering NFC in the prediction of school success and point to the necessity of further clarifying its moderating role.

Killing people is universally considered reprehensible and evokes in observers a need to punish perpetrators. Here, we explored how observers’ personality is associated with their cognitive, emotional, and punishing reactions towards perpetrators using data from 1,004 participants who responded to a set of fifteen third-party perspective moral dilemmas. Among those, four scenarios (architect, life boat, footbridge, smother for dollars) describing deliberate killings were compared to investigate the role of the content features “motive for killing” (selfish vs. utilitarian) and “evitability of victims’ death”. Participants’ moral appropriateness ratings, emotions towards perpetrators, and assigned punishments revealed complex scenario-personality interactions. Trait psychopathy was associated with harsher punishments in all scenarios but also with less concern about killing in general, an increased moral appreciation of utilitarian motives for killing, and a reduced concern about the killing of avoidable victims. Need for cognition was associated with considering a utilitarian motive for killing as a mitigating factor, while intuitive/authority-obedient thinking was linked to a strong focus on avoidability of harm as an aggravating factor when assigning punishments. Other-oriented empathy, trait anxiety, and justice sensitivity did not account for differences in third-party punishments. Our explorative findings highlight the importance of inter-individual differences for moral decision making and sense of justice.

Background Stress-related alterations in the regulation of several endocrine systems, including the hypothalamus-pituitary-adrenal (HPA) and -gonadal (HPG) axes and the endocannabinoid system are proposed to be involved in the etiology of major depressive disorder (MDD). Therefore, this study examines whether altered concentrations of glucocorticoids, testosterone, endocannabinoids, and related N-acylethanolamines accumulated in hair are present in MDD. Methods Female participants (range: 19–59, Mdn = 30.5 years) were recruited, including n = 21 with a current MDD episode and n = 27 nondepressed controls without any current mental disorder. Weight-standardized samples of 3 cm hair segments were analyzed which equals to three months of retrospectively assessed biomarkers in hair. Concentrations of cortisol, cortisone, testosterone, endocannabinoids (i.e., anandamide [AEA], 2-arachidonylglycerol [2-AG]), and selected N-acylethanolamines (i.e., stearoylethanolamide [SEA], oleoylethanolamide [OEA], palmitoylethanolamide [PEA]) were measured using mass spectrometry. Results Female MDD patients exhibited lower cortisol and cortisone levels in hair than nondepressed controls, whereas the hair concentrations of endocannabinoids, N-acylethanolamines, and testosterone did not differ between the groups. Conclusions Our results add to the heterogeneous body of findings on alterations in hair-stored glucocorticoids and endocannabinoids in MDD. As in previous studies, there was no evidence of altered testosterone concentrations in the hair of MDD patients. Larger and longitudinal studies are needed to comprehensively explore the overall picture of endocrine alterations in MDD.

Killing people is universally considered reprehensible and evokes in observers a need to punish perpetrators. To investigate how observers’ personality influences their cognitive, emotional, and punishing reactions towards perpetrators, we analyzed data from 1,004 participants who responded to three scenarios describing deliberate killings from a third-party perspective. Utilitarian motive of killing and inevitability of harm varied systematically between scenarios. Participants’ moral appropriateness judgments, emotions towards perpetrators, and assigned punishments revealed complex scenario-personality interactions. Trait psychopathy led to more understanding emotions but harsher punishments in all scenarios. Regarding utilitarian killings, need for cognition led to milder punishments, whereas intuitive/authority-obedient thinking led to stronger negative emotions and harsher punishments. Other-oriented empathy, trait anxiety, and justice sensitivity did not account for differences in third-party punishments. Our findings highlight the importance of interindividual differences on moral decision making and sense of justice.

Childhood maltreatment (CM) compromises resilience against stress and trauma throughout life. Therefore, it could present a major risk factor for the health of frequently trauma-exposed professionals such as emergency medical service (EMS) personnel.We investigated, whether EMS personnel's history of CM increased their risk for mental and physical stress symptoms after occupational trauma exposure.Data from 103 German EMS personnel (age: Mdn±QD = 26.00 ± 8.50 years) were collected as part of a cross-sectional survey distributed among employees of the regional German Red Cross EMS division (response rate 46.6%). The sample corresponded well to the division's entire staff in terms of socio-anagraphic characteristics.CM and occupational trauma exposure as well as posttraumatic, depressive, and somatic symptoms were assessed with self-report questionnaires.Moderation analyses indicated stronger positive associations between occupational trauma exposure and the severity of posttraumatic (β = .30, p.001), depressive (β = .20, p = .026), and somatic symptoms (β = .18, p = .059) among EMS personnel who reported a higher exposure to CM.Our study provides initial evidence that CM could increase the EMS personnel's vulnerability to the detrimental consequences of critical incidents on duty. Future research is needed (i) to replicate and generalize our observation on various trauma-exposed professions as well as (ii) to develop preventive measures for targeting the mediating and protective factors which influence the relationship between CM and the negative consequences of occupational trauma exposure.

Rescue workers are exposed to enduring emotional distress, as they are confronted with (potentially) traumatic mission events and chronic work-related stress. Thus, regulating negative emotions seems to be crucial to withstand the work-related strain. This cross-sectional study investigated the influence of six emotion regulation strategies (i.e., rumination, suppression, avoidance, reappraisal, acceptance, and problem solving) on perceived work-related stress and stress-related depressive, post-traumatic, and somatic symptoms in a representative sample of 102 German rescue workers. Multiple regression analyses identified rumination and suppression to be associated with more work-related stress and stress-related symptoms. Acceptance was linked to fewer symptoms and, rather unexpectedly, avoidance was linked to less work-related stress. No effects were observed for reappraisal and problem solving. Our findings confirm the dysfunctional role of rumination and suppression for the mental and physical health of high-risk populations and advance the debate on the context-specific efficacy of emotion regulation strategies.

Recent studies reported that training of working memory may improve performance in the trained function and beyond. Other executive functions, however, have been rarely or not yet systematically examined. The aim of this study was to test the effectiveness of inhibitory control (IC) training to produce true training-related function improvements in a sample of 122 healthy adults using a randomized, double-blind pretest/posttest/follow-up design. Two groups performed either adaptive (training group) or nonadaptive (active control) versions of go/no-go and stop-signal tasks for 3 weeks. Training gains as well as near-transfer to an untrained Stroop task and far-transfer to psychometric fluid intelligence were explored. Although the adaptive group could substantially improve overall IC task performance after training, no differences to the active control group occurred, neither at posttest nor at follow-up testing. A large decrease in response latency from pre- to posttest (and from pretest to 4 months' follow-up testing) was found when the training group was compared to the passive control group, which, however, does not sufficiently control for possible confounds. Thus, no conclusive evidence was found that this performance increase mirrors a true increase in IC function. The fact that training improvement was mainly related to response latency may indicate that individuals were more focused on performance gains in the prepotent go trials but less on the stop trials to meet the requirements of the tasks as well as possible. The challenges for response inhibition training studies are extensively discussed.

Major depressive disorder (MDD) causes enormous individual suffering and socioeconomic costs. Biochemical mechanisms leading to MDD are poorly understood and therapy success is not satisfactory. At present, there is evidence of low-grade inflammation, oxidative stress, and most interestingly, a disturbed energy metabolism in MDD and other mental disorders. Mitochondria play a central part in energy production and stress signaling. Mitochondrial electron transport chain uses molecular oxygen (O2) as final electron acceptor during adenosine triphosphate production attributing a crucial role to an intact O2 supply. Adaptation to altered O2 availability by the highly conserved hypoxic response is essential for maintaining allostasis. Previous research confirmed the role of O2 metabolism in the pathophysiology of MDD. In this perspective article, we compile the evidence linking O2 transport, O2 homeostasis, and mitochondrial energy metabolism to MDD. Furthermore, we hypothesize that inflammation and oxidative stress-related alterations in O2 transport might lead to a hypoxic response, which explains changes in O2 homeostasis and energy metabolism in MDD. Our forthcoming studies will investigate the interplay between energy metabolism and O2 homeostasis in MDD that aim to improve the overall understanding of the pathophysiology of MDD and to guide medical and psychological diagnostics towards a holistic strategy.