Stefan Sütterlin

Narcissists are described as individuals with dysfunctional personality traits such as lack of psychological awareness and empathy.
Theories of ethical behaviour assume that unethical actions trigger moral emotions of guilt and shame. Currently, there is a lack of
knowledge on moral emotions as dispositional traits and their potential influences on behaviour in individuals with narcissistic traits. The
present study examined vulnerable and grandiose narcissism’s differences in the propensity to experience guilt and shame as a proneness, across a range of personal transgressions. Guilt proneness was measured by negative evaluation of unethical behaviour, and whether this evaluation could influence reparation of tendencies of unethical action in vulnerable and grandiose narcissism. Shame proneness was
investigated by negative evaluation of the self, and then whether the previous tendency could affect unethical decision making and
behaviour (e.g., hiding), in vulnerable and grandiose narcissism. Two hundred and sixteen participants responded to the Guilt and Shame
Proneness Scale, the Narcissistic Personality Inventory Scale and the Hypersensitive Narcissism Scale in an online questionnaire. Findings
indicate that grandiose narcissism was negatively associated with guilt proneness, and the relation between the vulnerable narcissism and
guilt proneness was negative. Additionally, the results confirm a negative association between grandiose narcissism and shame proneness,
especially related to the subscale ‘shame negative self-evaluation’. Furthermore, guilt and shame proneness explained 20% of the variance
in vulnerable narcissism and 11% in grandiose narcissism. This research indicates that both vulnerable and grandiose narcissism have the
tendency to make unethical decisions, and they are more likely to enact inunethical behaviour. These findings are relevant for the detection
of narcissistic individual’s propensity to act unethically in social context.

Consistent across time and cultures, men and male adolescents older than 14 years of age appear underrepresented in mood disorders, and are far less likely than women to seek psychological help. The much higher rate of suicide amongst males suggests that depression in men might be underreported. One of the core human motives is to seek acceptance by others and avoid rejection. Rejection Sensitivity (RS) has been conceptualized as the cogni-tive-affective processing disposition to anxiously expect, readily perceive, and intensely respond to cues of rejection in the behavior of others. RS has been previously linked with the onset and course of depression, but—as yet—has not been investigated longitudinally in a clinical population. We investigated the predictive role of RS to symptom deterioration 6 months after end-of-treatment in 72 male inpatients with depressive spectrum disorder. The BDI was administered at intake, end-of-treatment and 6 month follow-up. RS scores were obtained at intake. Rejection Sensitivity had additional predictive power on BDI scores at 6 months follow-up controlling for BDI scores at end-of-treatment (ΔR 2 = .095). The results are discussed in terms of the importance of targeting RS during treatment, and highlight the fact that therapeutic follow-up care is paramount. Future research should investigate possible mediators of the RS–relapse-to-depression association, such as self-blame, rumination, neuroticism, pessimism, emotion dysregulation, and low self-esteem.

The objective of this study was to examine the association between perseverative cognition in the form of work-related rumination, and heart rate variability (HRV). We tested the hypothesis that high ruminators would show lower vagally mediated HRV relative to low ruminators during their leisure time. Individuals were classified as being low (n = 17) or high ruminators (n = 19), using the affective scale on the work-related rumination measure. HRV was assessed using a wrist sensor band (Microsoft Band 2). HRV was sampled between 8 pm and 10 pm over three workday evenings (Monday to Wednesday) while individuals carried out their normal evening routines. Compared to the low ruminators, high affective ruminators demonstrated lower HRV in the form of root mean square successive differences (RMSSDs), relative to the low ruminators, indicating lower parasympathetic activity. There was no significant difference in heart rate, or activity levels between the two groups during the recording periods. The current findings of this study may have implications for the design and delivery of interventions to help individuals unwind post work and to manage stress more effectively. Limitations and implications for future research are discussed.

The rapid technical progress in cyber threats and cyber security poses increased cognitive demands on cyber officers. The macrocognitive demand characteristics placed on the cyber officers exceed those in most common military contexts and are new in nature. Research on decision-making competence within the cyber domain is needed to identify strategies and give a better understanding of how these strategies can have consequences depending on task characteristics. Belief in one's capabilities to handle a certain task has been shown to be a key factor for cognitive performance. This study investigated how high self-efficacy negatively moderated intuitive decision-making tendencies on performance when facing a problem that required counterintuitive strategies. Twenty-seven cyber officer cadets from the Norwe-gian Defence Cyber Academy participated in an experiment assessing self-efficacy, interoceptive sensitivity, and decision-making. Participants with high situational self-efficacy generally performed better, but this relationship was moderated by interoceptive sensitivity. The findings suggest potential detrimental effects of intuitive decision-making tendencies in combination with high self-efficacy. Implications for training and feedback structures in cyber defense are discussed.

Central precocious puberty (CPP) develops due to premature activation of the hypothalamic-pituitary-gonadal (HPG) axis, resulting in early pubertal changes and rapid bone maturation. CPP is associated with lower adult height and increased risk for development of psychological problems. Standard treatment of CPP is based on postponement of pubertal development by blockade of the HPG axis with gonadotropin releasing hormone analogs (GnRHa) leading to abolition of gonadal sex hormones synthesis. Whereas the hormonal and auxological effects of GnRHa are well researched, there is a lack of knowledge whether GnRHa treatment influences psychological functioning of treated children, despite the fact that prevention of psychological problems is used as one of the main reasons for treatment initiation. In the present study we seek to address this issue by exploring differences in cognitive function, behavior, emotional reactivity, and psychosocial problems between GnRHa treated CPP girls and age-matched controls.
Fifteen girls with idiopathic CPP; median age 10.4 years, treated with slow-release GnRHa (triptorelin acetate – Decapeptyl SR ® 11.25) and 15 age-matched controls, were assessed with a comprehensive test battery consisting of paper and pencil tests, computerized tasks, behavioral paradigms, heart rate variability, and questionnaires filled in by the children’s parents. Both groups showed very similar scores with regard to cognitive performance, behavioral and psychosocial problems. Compared to controls, treated girls displayed significantly higher emotional reactivity (p = 0.016; Cohen’s d = 1.04) on one of the two emotional reactivity task conditions. Unexpectedly, the CPP group showed significantly lower resting heart rates than the controls (p = 0.004; Cohen’s d = 1.03); lower heart rate was associated with longer treatment duration (r = - 0.582, p = 0.037).
The results suggest that GnRHa treated CPP girls do not differ in their cognitive or psychosocial functioning from age matched controls. However, they might process emotional stimuli differently. The unexpected finding of lower heart rate that was associated with longer duration of the treatment should be further explored by methods appropriate for assessment of cardiac health.

Guilt is a moral emotion that is often looked upon as a negative trait. However, studies show that some individuals are more predisposed to think, feel and act in a more ethical manner because of a lower threshold to experience guilt. Some theories of helping behaviour emphasize the evolutionary mechanisms, while other theories stress the importance of social variables. This study investigated whether guilt proneness as a dispositional trait can be associated with prosocial behaviour. Five hundred sixty-nine participants reported in an online survey their own levels of guilt proneness, frequency of prosocial behaviour, and related cognitions such as empathy. This study is among the first to demonstrate how guilt proneness combined with empathy can explain additional variance in prosocial behaviour. The findings also indicate gender differences in the precursors of prosocial behaviour, suggesting women are more influenced by the effects of guilt proneness on prosocial behaviour than men.

Numerous studies have documented an inverse relationship between blood pressure and sensitivity to experimental nociceptive stimulation. The present study aimed to investigate possible associations between blood pressure and the occurrence and intensity of paradoxical pain induced by the thermal grill paradigm. Thirty-one healthy subjects were stimulated three times for 1 minute with the nonnoxious temperatures of 15°C and 41°C set at the interlaced cold and warm bars of a water bathdriven thermal grill. Blood pressure and heart rate were recorded concomitantly. On account of previous observations of an association between the sensitivity of the cardiac baroreflex and pain perception, this parameter was additionally obtained. Numerical rating scales were used to quantify subjective pain intensity and pain unpleasantness; subjects were classified as responders and nonresponders to thermal grill stimulation based on pain intensity ratings. Responders exhibited lower systolic and diastolic blood pressure than non-responders, and inverse linear associations arose between blood pressure and pain intensity and unpleasantness. Baroreflex sensitivity was unrelated to pain ratings. The findings confirmed the hypothesis of a blood pressure dependence of paradoxical pain and support the notion that the cardiovascular and pain regulatory systems interact not only in the processing of pain elicited by noxious input, but also in non-noxiously generated illusive pain. While this finding is not consistent with the assumption of an involvement of the baroreflex system in mediating the observed interaction, psychological traits and neurochemical factors are alternatively considered.

Depression is assumed to be both a risk factor for rejection and a result of it, and as such constitutes an important factor in rejection research. Attachment theory has been applied to understand psychological disorders, such as depression, and can explain individual differences in responses to rejection. Research on autonomic nervous system activity to rejection experiences has been contradictory, with opposing strings of argumentation (activating vs. numbing). We investigated autonomic nervous system-mediated peripheral physiological responses (heart rate) to experimentally manipulated ostracism (Cyberball) in 97 depressed patients with organized (n = 52) and disorganized attachment status (n = 45). Controlling for baseline mean heart rate levels, depressed patients with disorganized attachment status responded to ostracism with significantly higher increases in heart rate than depressed patients with organized attachment status (p = .029; ηp 2 = .051). These results suggest that attachment status may be a useful indicator of autonomic responses to perceived social threat, which in turn may affect the therapeutic process and the patient-therapist relationship.

Creating an optimized health care environment to maximize the probability and magnitude of placebo effects draws on a number of well-researched mechanisms such as the patient’s positive expectation toward treatment outcome. Patient-centered communication styles influence expectations and can thus be considered as a form of supplemental treatment. Unconsciously processed contextual triggering and facilitating placebo effects are omnipresent in clinical settings as well as in all other social and physical environments. Contextual cues in both the social and physical domain exert influences on the recipient’s emotional state and recreational experiences. While the majority of research focuses on improving the patients’ expectations, classical conditioning effects of nonsocial contextual factors have been largely neglected in discussions on practical implementation of placebo-enhancing environments. Built on the empirically well-supported argument that conditioning processes act as a powerful tool to mobilize self-healing resources just as verbally induced expectations do, we argue for a stronger consideration of the effects of permanent, nonsocial and nonverbal environmental contexts. Environmental psychology is a new field of research within the psychological domain and offers a toolbox of opportunities for medical psychological research and health care practitioners to improve the treatment outcomes and benefits of health care environments.

Recent theoretical accounts of addiction have acknowledged that addiction to substances and behaviors share inherent similarities (eg, insensitivity to future consequences and self-regulatory deficits). This recognition is corroborated by inquiries into the neurobiological correlates of addiction, which has indicated that different manifestations of addictive pathology share common neural mechanisms. This review of the literature will explore the feasibility of the somatic marker hypothesis as a unifying explanatory framework of the decision-making deficits that are believed to be involved in addiction development and maintenance. The somatic marker hypothesis provides a neuroanatomical and cognitive framework of decision making, which posits that decisional processes are biased toward long-term prospects by emotional marker signals engendered by a neuronal architecture comprising both cortical and subcortical circuits. Addicts display markedly impulsive and compulsive behavioral patterns that might be understood as manifestations of decision-making processes that fail to take into account the long-term consequences of actions. Evidence demonstrates that substance dependence, pathological gambling, and Internet addiction are characterized by structural and functional abnormalities in neural regions, as outlined by the somatic marker hypothesis. Furthermore, both substance dependents and behavioral addicts show similar impairments on a measure of decision making that is sensitive to somatic marker functioning. The decision-making deficits that characterize addiction might exist a priori to addiction development; however, they may be worsened by ingestion of substances with neurotoxic properties. It is concluded that the somatic marker model of addiction contributes a plausible account of the underlying neurobiology of decision-making deficits in addictive disorders that is supported by the current neuroimaging and behavioral evidence. Implications for future research are outlined.

" Background: While the neurophysiological mechanisms underlying the thermal grill illusion of pain (TGI) are thoroughly studied, psychological determinants remain mainly unknown. The present study aimed to investigate whether cognitive and affective personality traits encompassing rumination, interoception, and suggestibility may be identified as characteristics favouring the elicitation of paradoxical pain experiences.
Methods: The dominant hand of 54 healthy volunteers was stimulated with a water-bath driven thermal grill providing an interlaced temperature combination of 15 and 41°C. Pain intensity and pain unpleasantness perceptions were rated on a combined verbal-numerical scale (NRS). Traits were assessed via questionnaires, the heartbeat-tracking task, and warmth suggestions.
Results: Logistic regression analyses uncovered trait rumination and interoceptive accuracy (IA) as major predictors of the likelihood of the illusive pain occurrence (all p < .05). Rumination and suggestibility had an impact on unpleasant pain perceptions.
Conclusion: Our findings allowed to identify psychological factors substantially involved in the individual pre-disposition to reporting painful sensations in the thermal grill paradigm. These psychological characteristics may also be relevant in the context of central neuropathic pain, which to a large extent incorporates the same neural pathways."

The present study investigated the function of parental attention to child pain in regulating parental distress and pain control behaviour when observing their child performing a painful (cold pressor) task (CPT), as well as the moderating role of parental state anxiety. Participants were 62 school children and one of their parents. Parental attention towards or away from child pain (i.e., “Attend to Pain” vs. “Avoid Pain”) was experimentally manipulated during a viewing task pairing unfamiliar children’s neutral and pain faces. Prior to and following the viewing task, parental distress regulation was assessed by heart rate (HR) and heart rate variability (HRV). In a subsequent phase, parents observed their own child perform a CPT task, allowing assessment of parental pain control behavior (indexed by latency to stop their child’s CPT performance) and parental distress – assessed via self-report prior to and following observation of child CPT performance. Eye-tracking during the viewing task and self-reported attention to own child’s pain confirmed successful attention manipulation. Further, findings indicated that the impact of attentional strategy on parental emotion regulation (indexed by HR, self-report) and pain control behaviour depended upon parents’ state anxiety. Specifically, whereas low anxious parents reported more distress and demonstrated more pain control behaviour in the “Attend to Pain” condition, high anxious parents reported more distress and showed more pain control behaviour in the “Avoid Pain” condition. This inverse pattern was likewise apparent in physiological distress indices (HR) in response to the initial viewing task. Theoretical/clinical implications and further research directions are discussed.

""Objective: Somatic marker theory predicts that somatic cues serve intuitive decision-making; however, cardiovascular symptoms are threat cues for patients with panic disorder (PD). Therefore, enhanced cardiac perception may aid intuitive decision-making only in healthy individuals, but impair intuitive decision-making in PD patients.
Methods : PD patients and age- and sex-matched volunteers without a psychiatric diagnosis (n = 17, respectively) completed the Iowa Gambling Task (IGT) as a measure of intuitive decision-making. Inter-individual differences in cardiac perception were assessed with a common mental tracking task.
Results: In line with our hypothesis, we found a pattern of op posing associations (Fisher’s Z=1.78, p=.04) of high cardiac perception with improved IGT-performance in matched control-participants (r= .36, n = 14) but impaired IGT-performance in PD patients (r=-.38, n = 13)
Conclusion: Interoceptive skills, typically assumed to aid intuitive decision-making, can have the opposite effect in PD patients who experience interoceptive cues as threatening, and tend to avoid them. This may explain why PD patients frequently have problems with decision-making in everyday life. Screening of cardiac perception may help identifying patients who benefit from specifically tailored interventions.""

Previous studies suggest in line with dual process models that interoceptive skills affect controlled decisions via automatic or implicit processing. The “framing effect” is considered to capture implicit effects of task-irrelevant emotional stimuli on decision-making. We hypothesized that cardiac awareness, as a measure of interoceptive skills, is positively associated with susceptibility to the framing effect. Forty volunteers performed a risky-choice framing task in which the effect of loss versus gain frames on decisions based on identical information was assessed. The results show a positive association between cardiac awareness and the framing effect, accounting for 24% of the variance in the framing effect. These findings demonstrate that good interoceptive skills are linked to poorer performance in risky choices based on ambivalent information when implicit bias is induced by task-irrelevant emotional information. These findings support a dual process perspective on decision-making and suggest that interoceptive skills mediate effects of implicit bias on decisions.