[Interdisciplinary, collaborative D-A-CH (Germany, Austria and Switzerland) consensus statement concerning the diagnostic and treatment of myalgic encephalomyelitis/chronic fatigue syndrome]. / Interdisziplinäres, kollaboratives D-A-CH Konsensus-Statement zur Diagnostik und Behandlung von Myalgischer Enzephalomyelitis/Chronischem Fatigue-Syndrom.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe, chronic multisystemic disease which, depending on its severity, can lead to considerable physical and cognitive impairment, loss of ability to work and the need for nursing care including artificial nutrition and, in very severe cases, even death.The aim of this D-A-CH (Germany, Austria, Switzerland) consensus statement is 1) to summarize the current state of knowledge on ME/CFS, 2) to highlight the Canadian Consensus Criteria (CCC) as clinical criteria for diagnostics with a focus on the leading symptom post-exertional malaise (PEM) and 3) to provide an overview of current options and possible future developments, particularly with regard to diagnostics and therapy. The D-A-CH consensus statement is intended to support physicians, therapists and valuer in diagnosing patients with suspected ME/CFS by means of adequate anamnesis and clinical-physical examinations as well as the recommended clinical CCC, using the questionnaires and other examination methods presented. The overview of the two pillars of therapy for ME/CFS, pacing and symptom-relieving therapy options, is intended not only to provide orientation for physicians and therapists, but also to support decision-makers from healthcare policy and insurance companies in determining which therapy options should already be reimbursable by them at this point in time for the indication ME/CFS.

Event-related potentials during exposure to aversion and its anticipation: the moderating effect of intolerance of uncertainty.

The aim of the present study was to investigate the moderating effect of intolerance of uncertainty (IU) on exposure to aversion and its anticipation using event-related potentials (ERPs). Sixteen subjects high in IU and 16 subjects low in IU underwent an affective cueing paradigm where a warning cue signaled the valence of a subsequent picture. A minus signaled the occurrence of a negative picture, a circle of a neutral picture, and a question mark of either an aversive or a neutral picture (probability of 50%). The major findings were that during anticipation, increased P200 amplitudes were observed in individuals high in IU. During exposure, uncertainty about the outcome modulated the P200, N200 and late positive potential (LPP). Also, only in the IU-high group and only in the late time window of the LPP, aversive pictures were processed differently depending on the preceding warning cue. The present findings underline the importance of affective uncertainty for subjects high in IU and the results are explained in terms of heightened attention allocation to uncertainty and a dampening effect of worry on subsequent emotional processing.

Threat engagement, disengagement, and sensitivity bias in worry-prone individuals as measured by an emotional go/no-go task.

BACKGROUND AND OBJECTIVES: The goal of the present study was to investigate a threat engagement, disengagement, and sensitivity bias in individuals suffering from pathological worry. METHODS: Twenty participants high in worry proneness and 16 control participants low in worry proneness completed an emotional go/no-go task with worry-related threat words and neutral words. RESULTS: Shorter reaction times (i.e., threat engagement bias), smaller omission error rates (i.e., threat sensitivity bias), and larger commission error rates (i.e., threat disengagement bias) emerged only in the high worry group when worry-related words constituted the go-stimuli and neutral words the no-go stimuli. Also, smaller omission error rates as well as larger commission error rates were observed in the high worry group relative to the low worry group when worry-related go stimuli and neutral no-go stimuli were used. LIMITATIONS: The obtained results await further replication within a generalized anxiety disorder sample. Also, further samples should include men as well. CONCLUSIONS: Our data suggest that worry-prone individuals are threat-sensitive, engage more rapidly with aversion, and disengage harder.