Andreas Jochen Fallgatter

Objective: Women with premenstrual syndrome (PMS) experience affective lability, irritability, depressed mood, and anxiety during the late luteal phase of the menstrual cycle. Stress reactivity may contribute to the development of these symptoms, yet neural correlates remain unexplored. We examined neural, behavioral and endocrine stress responses across menstrual cycle phases in women with and without PMS. Methods: 26 women with PMS and 24 women without PMS participated in two fMRI sessions, during the mid-follicular (days 5 to 11) and late-luteal phases (days −7 to −1). Participants completed the Montreal Imaging Stress Task (MIST). Subjective stress ratings and salivary cortisol were collected at six time points before and after stress induction. Stress-related brain activation was assessed using whole-brain and region-of-interest analyses. Results: Subjective stress ratings increased as expected from before to after the MIST, with no group or phase differences. Salivary cortisol was significantly higher during the mid-follicular phase, with no group effect or significant pre-post MIST difference. While the stress task elicited activation patterns in stress-related regions, whole-brain analysis revealed no significant effects of group (PMS vs. no PMS) or menstrual cycle phase (follicular vs. luteal) on the neural stress response. Considering premenstrual symptom severity as a predictor revealed significant group-by-symptom severity interactions in the right inferior frontal gyrus and the right superior temporal gyrus. Conclusion: Using a within-subject repeated-measures design, we found neural responses to psychosocial stress to be stable across menstrual cycle phases. Individual differences in symptom severity may nevertheless be associated with differences in stress-related brain activation.

Objective: Psychotherapy is the first‐line treatment for eating disorders (EDs), yet only about half of patients benefit long‐term. Bulimia nervosa (BN), Binge‐Eating‐Disorder (BED), and non‐underweight EDs with regular binge eating (> 2 binge‐eating episodes per month within the last 3 months) (OSFED/UFED) form a transdiagnostic group characterized by elevated impulsivity. Inhibitory control training (ICT) approaches targeting impulsivity may be relevant. However, the role of feedback within ICT remains insufficiently understood. Method: MIND BINGES is a prospective randomized controlled proof‐of‐principle trial including 67 patients with regular binge‐eating behavior. ICT was a food‐modified antisaccade paradigm and comprised six sessions over 2 weeks. Patients were randomized to one of three conditions: (a) ICT with task performance feedback (TF), (b) ICT without feedback (TNF), or (c) control group without ICT. The primary outcome was the reduction of binge‐eating frequency 4 and 12 weeks after ICT. Secondary outcomes included ED psychopathology, inhibitory control performance, impulsivity, and self‐efficacy. Results: All three groups reduced binge‐eating frequency 4 and 12 weeks after ICT compared to the baseline. Four weeks after ICT, TF resulted in significantly greater reductions in binge‐eating episodes compared to TNF and CG. These differences washed out after 12 weeks. Across secondary outcomes, all groups improved over time. Discussion: Feedback contributes to short term reductions in binge‐eating behavior and may inform development of mechanism‐based interventions for ED. Further, reductions of the control group in binge‐eating episodes imply unspecific effects of study participation and demand further investigation of low‐threshold interventions. Trial Registration: DRKS00033023

Objective: This study evaluated the latent structure and conceptual validity of the Research Domain Criteria (RDoC), General Health, and Clinical/Psychosocial clusters of the German Center for Mental Health (DZPG) Minimum Data Set (MDS). It aimed to determine whether these clusters represent interpretable constructs and demonstrate cross-group comparability across clinical and non-clinical populations, providing a data-driven basis for item selection within a Delphi consensus process. Methods: Two subsamples were analyzed: a representative sample ( N = 2,287) and a clinic-recruited sample ( N = 322) from six DZPG sites. Multi-group confirmatory factor analyses tested the latent structure and assessed configural, metric, and scalar measurement invariance between non-clinical vs. clinical/help-seeking groups. Results: All three MDS clusters demonstrated excellent baseline model fit (RDoC: CFI = .990, RMSEA = .037; General Health: CFI = .993, RMSEA = .037; Clinical/Psychosocial factors: CFI = .992, RMSEA = .026). Analyses confirmed configural and scalar invariance across all clusters but indicated non-invariance at the metric level for the General Health cluster. Conclusions: The results provide initial evidence for the structural validity and cross-group comparability of the RDoC and Clinical/Psychosocial clusters, while indicating limitations regarding metric non-invariance within the General Health cluster. They informed a Delphi consensus process and support the MDS as a scalable framework for diverse populations, particularly relevant for the DZPG’s effort to harmonize mental health data across institutions and contexts.

Introduction: Individuals diagnosed with mild cognitive impairment (MCI) have an increased risk of developing dementia. Since there are currently no curative pharmacological therapies for MCI, nonpharmacological and exercise-related medical therapies represent a promising approach. This study aims to evaluate the effects of nonpharmacological interventions on cognitive performance in individuals with MCI. Methods and analysis: The study will be a prospective, randomized, sham-controlled, single-centre superiority trial with a parallel-group design. A total of 100 patients aged ≥ 60 years with MCI will be randomly assigned to one of the three intervention groups or the control group. The three intervention arms comprise high-intensity interval training (HIIT), yoga, and intermittent hypoxia-hyperoxia exposure (IHHE), whereas participants in the control group will receive a sham application of IHHE (IHHE-S). The primary outcome is the cognitive function after 3-month intervention period assessed by Montreal Cognitive Assessment. The secondary outcomes and the evaluation of modifiable risk factors for dementia include quality of life, laboratory data, physical activity, anthropometric data, and cardiorespiratory fitness. All harms and (serious) adverse events will be assessed systematically at each study visit. Ethics and dissemination: This study has been approved by the Ethics committee of the Medical Faculty of the University of Tübingen (494/2025BO1). Research findings will be published in peer-reviewed journals and presented to stakeholders and at scientific conferences. Trial registration: The study was registered on the German Clinical Trial Register DRKS on 04.12.2025 (DRKS00038438). Strengths and limitations of this study: - The randomized, sham-controlled study design represents a key methodological strength, allowing reliable comparisons between the intervention groups and the control group while accounting for potential placebo effects. - The 12-month follow-up from baseline provides the opportunity to evaluate the long-term effects of the interventions. - Blinding of participants and therapists cannot be fully implemented across all study groups because of the nature of the interventions.

Humans tend to attribute social characteristics to moving geometric shapes as if they were animate beings (eg, kissing each other while dancing). This ability is considered an integral component of day-to-day life and a fundamental key to navigating effective social communication. The Heider-and-Simmel (HS)-like paradigm is suitable for investigating mechanisms of social attribution across lifespans and population groups, particularly in clinical contexts. As vast majority of mental and neurodevelopmental disorders are gender-specific, the present study delves into possible gender impacts on inferring social interaction in HS-like movies. The outcome indicates that typically developing females and males do not differ in recognition accuracy and processing speed of social interaction in HS-like animations, though males take longer and tend to be less accurate in recognition of similar control movies, more often mistaking them for social interaction. The signal detection analysis shows that females tend to be more tuned to social interaction (in terms of sensitivity index, d′) without gender difference in response bias (decision criterion c). In both genders, decision criteria are liberal (c < 0), pointing to a tendency to anthropomorphize control animations. The outcome sheds light on the nature of gender impact on perception of interaction as well as on neural underpinnings of social attribution in the gendered brain.

Neurotypical people are generally quite adept at interpreting social signals from dynamic bodies and faces. This ability prevents one from incurring high costs associated with ineffective and maladaptive social interactions. Individuals with mental disorders, such as schizophrenia (SZ), often exhibit deficits in nonverbal social cognition. It remains unclear whether reading the language of bodies and faces is affected by SZ, and if this is indeed the case, how these potential deficits are related to one another. In the present study, participants (28 males with SZ and 28 typically developing, TD, matched controls) were administered face-to-face computer tasks on inferring emotions from dynamic point-light body motion and faces. The outcome indicates that SZ patients exhibit global impairments in both body and face reading, albeit patients demonstrate a similar emotion recognition profile as TD controls. In SZ patients only, a positive link was found between accuracy of recognizing emotions expressed through faces and bodies, whereas processing speed of emotions conveyed through bodies and faces was tied to each other in both SZ and TD individuals. For SZ patients, inferring social signals from dynamic faces and bodies may be rather challenging in terms of neurocognitive mechanisms, which is reflected in the tight link in recognition accuracy. Along with previous data on inferring emotions in the eyes collected in the same cohort, this work provides novel insights into the specific global aberrations in social cognition in SZ and offers a blueprint for the development of strategies for the targeted treatment of gender-specific mental disorders.

Background: Functional impairments associated with mental health conditions are on the rise. Predicting functional outcomes may improve the targeting of preventive interventions. While prognostic models have primarily focused on psychosis, early recognition services require a transdiagnostic approach. Objective: This study aimed to predict global functioning within a 2-year follow-up using baseline clinical and structural magnetic resonance imaging (MRI) data in a population-based sample of young, help-seeking individuals presenting with affective and anxiety symptoms as well as attention-deficit hyperactivity disorder. Methods: We classified 357 help-seeking individuals aged 18‐35 years recruited from 9 sites as “impaired” (Global Assessment of Functioning [GAF] ≤60; n=228) or “nonimpaired” (GAF>60; n=129) at year 1 and/or year 2 follow-up. GAF classification group status at follow-up was predicted using linear support vector machine (SVM), decision tree, and large language model (LLM) Llama-3 using clinical assessments and/or structural MRI. Leave-one-site-out (SVM) or external sample (LLM) was used for validation. Results: SVM achieved balanced accuracy of 69.2% using clinical features only. Items related to baseline occupational functioning, interpersonal relationships, cognitive functioning, psychotic and affective symptoms, as well as the presence of anxiety disorder, were most predictive. The decision tree further reduced the feature set to 5 predictive items, achieving balanced accuracy of 76.6%. Although amygdala and hippocampal subregions achieved balanced accuracy of 57.1%, structural MRI did not improve the overall prediction. Llama-3 performed comparably well to SVM (balanced accuracy of 72.6%). Conclusions: Machine learning demonstrated good performance in predicting global functioning. Interestingly, the out-of-the-box LLM performed comparably well without being trained or fine-tuned, highlighting the potential of leveraging free-text data for mental health prognosis.

Purpose: Premenstrual dysphoric disorder (PMDD) has been associated with altered grey matter architecture in a trait-like manner. Personality traits, shaped largely by genetics and linked to depressive disorders, may relate to structural properties of the brain and could represent a potential factor mediating vulnerability for PMDD. However, these possible associations remain largely unexplored. Methods: The present study assessed personality traits in participants with PMDD and healthy controls, as well as how personality is related to symptom severity and cortical surface measures in PMDD. Healthy controls and patients completed the Swedish Universities Scale of Personality. Following prospective validation of the PMDD diagnosis, patients had their brain scanned with magnetic resonance imaging (MRI) during the symptomatic luteal phase of the menstrual cycle. Personality of controls and patients was compared using Mann-Whitney U tests. Associations of personality with symptom severity and brain surface parameters were tested through correlation analysis. Results: PMDD was associated with higher scores in neuroticism and aggressiveness. Aggressiveness was positively correlated with the severity of irritability/anger, though not significant after correcting for multiple testing. Regarding cortical structural measures, aggressiveness was negatively correlated with cortical complexity of the parahippocampal gyrus. Conclusion: Considering neuroticism and aggressiveness during screening for PMDD could contribute to the identification of risk factors and personalized treatment of females suffering from PMDD.