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Prof. Dr. Christian Schmahl

At the centre of the department's research is the psychopathology of stress-related disorders (in particular borderline personality disorder and post-traumatic stress disorder) and psychotherapeutic interventions derived from the knowledge of these mechanisms. Our aim is to gain a better understanding of dysfunctional emotional regulation and social interaction as well as the influence of stress on cognitive processes.

In particular, we use methods of experimental psychopathology, i.e. the modelling of pathomechanisms in behavioural experiments and their investigation with methods of imaging, peripheral physiology and neurochemistry. An example of our work is the investigation of the mechanism of self-injurious behaviour, which focuses on studies of pain processing as well as emotion regulation. From the understanding of these pathomechanisms new psychotherapeutic interventions are developed, such as real-time MRI-supported neurofeedback.

A further research focus is the investigation of the effect of psychotherapy with neurobiological methods, e.g. by investigating the regulation of emotions before and after psychotherapy with functional neuroimaging.

Improvement of the connectivity between amygdala and ventromedial prefrontal cortex (a) through four sessions of real-time fMRI neurofeedback training (b). The strengthening of connectivity is accompanied by an improvement in psychopathology, here dissociation (c).

National and International Joint Research Projects

  • Graduiertenkolleg 2350 „Impact of Adverse Childhood Experiences on Psychosocial and Somatic Conditions Across the Lifespan” (Heidelberg-Mannheim)
  • BMBF-Verbundprojekt “Self-Injury: Treatment, Assessment, Recovery” (Heidelberg-Mannheim-Ulm-Landau-Karlsruhe-Rostock)
  • BrainBoost- A Neurofeedback Booster for Emotion Regulation Therapy (University of Yale - Medizinische Fakultät Mannheim)

Selected Publications

  1. Herzog, J.I., Thome, J., Demirakca, T., Koppe, G., Ende, G., Lis, S., Rausch, S., Priebe, K., Müller-Engelmann, M., Steil, R., Bohus, M., Schmahl, C. Severity of type and timing of retrospectively reported childhood maltreatment on female amygdala and hippocampal volume. Scientific Reports (in press)
  2. Zaehringer, J.K., Ende, G., Santangelo, P., Kleindienst, N., Ruf, M., Bertsch, K., Bohus, M., Schmahl, C., Paret, C.  Improved emotion regulation after neurofeedback: A single-arm trial in patients with borderline personality disorder. Neuroimage Clinical (in press)
  3. Gradinger, T., Sack M., Cardinale, V., Thiaucourt, M., Baumgärtner, U., Schmahl, C., Ende, G. (2019). The glutamate to GABA ratio in the posterior insula is associated with pain perception in healthy women but not in women with borderline personality disorder. Pain, 160, 2487-2496.
  4. Mancke, F., Schmitt, R., Winter, D., Niedtfeld, I., Herpertz, S.C., & Schmahl, C. (2018). Assessing the marks of change: how psychotherapy alters the brain structure in women with borderline personality disorder. Journal of Psychiatry and Neuroscience, 43, 171-181.
  5. Lyssenko, L.*, Schmahl, C.*, Weidner, L., Vonderlin, R., Bohus, M., & Kleindienst, N. (2018). Dissociation in psychiatric disorders – a meta-analysis of studies using the Dissociative Experience Scale. American Journal of Psychiatry, 175, 37-46. (* Both authors contributed equally)
  6. Paret, C., Kluetsch, R., Zaehringer, J., Ruf, M., Demirakca, T., Bohus, M., Ende, G., & Schmahl, C. (2016). Alterations of amygdala-prefrontal connectivity with real-time fMRI neurofeedback in BPD Patients. Social Cognitive and Affective Neuroscience, 11, 952-960.
  7. Schulze, L., Schmahl, C., & Niedtfeld, I. (2016). Neural correlates of disturbed emotion processing in borderline personality disorder: A multimodal meta-analysis. Biological Psychiatry, 79(2), 97-106.
  8. Ende, G., Cackowski, S., Van Eijk, J., Sack, M., Demirakca, T., Kleindienst, N., Bohus, M., Sobanski, E., Krause-Utz, A., & Schmahl, C. (2015). Impulsivity and aggression in female BPD and ADHD patients: association with ACC glutamate and GABA concentrations. Neuropsychopharmacology, 41(2):410-418.
  9. Reitz, S., Kluetsch, R., Niedtfeld, I., Knorz, T., Lis, S., Paret, C., Kirsch, P., Meyer-Lindenberg, A., Treede, R.D., Baumgärtner, U., Bohus, M., & Schmahl, C. (2015). Incision and stress regulation in borderline personality disorder: neurobiological mechanisms of self-injurious behaviour. British Journal of Psychiatry, 207(2), 165-172.
  10. Niedtfeld, I., Schulze, L., Kirsch, P., Herpertz, S.C., Bohus, M., & Schmahl, C. (2010). Affect regulation and pain in borderline personality disorder: a possible link to the understanding of self-injury. Biological Psychiatry, 68(4), 383-391.

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