Background
In research, the focus of the Clinical Psychology and Sexual Medicine department is primarily on the areas of sexuality and couple relationships. In a tradition that now spans more than three decades, contributions have been made to each of the three major groups of sexual disorders: sexual dysfunctions, paraphilias and gender identity disorders. The focus has been on basic research (psychological and neurobiological) as well as on a broad spectrum of clinical issues.
Overarching goals
- Psycho-neuro-immunological and endocrinological basic research into the psychobiology of healthy and impaired sexual response
- Clinical research into new drug and psychotherapeutic treatment concepts for male and female sexual dysfunction, paraphilias/sexual delinquency and gender identity disorders
- Research into the dysregulation of sexual impulse control (so-called 'sex addiction'), particularly in the area of internet use
- In line with the central clinical fields of activity, our research area also focuses on psychotherapy research (process and outcome research, especially on inpatient psychotherapy) as well as behavioral therapy and behavioral medicine research
Effective psychotherapeutic treatment methods already exist for the treatment of borderline personality disorder (BPD). In addition, medication is also used to treat certain symptoms or accompanying psychiatric illnesses. However, there is still no form of drug therapy with official admission for BPD.
In the clinical study 'Botulinum toxin for the treatment of borderline personality disorder', IncobotulinumtoxinA (colloquially known as 'Botox') is being tested as a new drug treatment to improve the symptoms of BPD. This is in comparison to acupuncture treatment. Previous studies have shown that injecting botulinum toxin into the glabella region of the forehead reduces the expression of negative emotions. As a result, the patient's own negative emotions are perceived as less pronounced. These observations are based on the 'facial feedback hypothesis', which is based on the assumption of an interplay between facial expressions and mood. Accordingly, treatment of the forehead region can lead to an alleviation of symptoms, which in turn can have a positive effect on the typical borderline behavior patterns.
This project is funded by the German Research Foundation (DFG).
Resulting publications:
- Kruger THC, Magid M, Wollmer MA. Can Botulinum Toxin Help Patients with Borderline Personality Disorder? American Journal of Psychiatry 2016, 173(9): 940-941. DOI
- Stefanie Jung, M Axel Wollmer and Tillmann HC Kruger. The Hamburg Hannover Agitation Scale (H2A-Scale): Development and validation of a self-assessment tool for symptoms of agitation. Journal of Psychiatric Research, 2015, 69: 158-165. DOI
- Sinke C, Wollmer MA, Kneer J, Kahl KG, Kruger THC. Interaction between behavioral inhibition and emotional processing in borderline personality disorder using a pictorial emotional go/no-go paradigm. Psychiatry Res. 2017 256: 286-289. DOI
The research network 'Neurobiological Foundations of Pedophilia and Sexual Abuse Behavior against Children' (NeMUP), funded by the Federal Ministry of Education and Research, investigates mechanisms that may underlie child sexual abuse on the one hand and pedophilic sexual preference on the other. We assume that these are at least partially different mechanisms for two different phenomena, because not every pedophile commits child sexual abuse and not every child abuse is motivated by pedophilia. Imaging, psychometric and physiological methods are used here. The special study design is intended to deepen the understanding of the distinction between sexual preference and sexual behavior during the three-year funding period. The results will be used to develop and improve therapy and prevention strategies.
The locations of the network represent a network of leading medical-psychological research and care facilities for both pedophile men and sex offenders against children. The cooperation between outpatient-clinical facilities from the prevention network'Kein Täter werden' and facilities or Institutions of the penal system and the penal system is a unique constellation worldwide.
Further information can be found here, i.e. on the official homepage of the research network.
Resulting publications:
- Kruger THC, Sinke Ch, Kneer J, Tenbergen G, Khan AQ, Burkert A, Müller-Engling L, Engler H, Gerwinn H, von Wurmb-Schwark N, Pohl A, Weiß S, Amelung T, Mohnke S, Massau C, Kärgel Ch, Walter M, Beier KM, Ponseti J, Schiffer B, Walter H, Jahn K and Frieling H. Child sexual offenders show prenatal and epigenetic alterations of the androgen system. Translational Psychiatry 2019, 9(1): 28. epigenetics. DOI
- Kneer J, Borchardt V, Kärgel C, Sinke C, Massau C, Tenbergen G, Ponseti J, Walter H, Beier KM, Schiffer B, Schiltz K, Walter M, Kruger THC. Diminished fronto-limbic functional connectivity in child sexual offenders. J Psychiatric Research 2019, 108: 48-56. (Resting-state fMRI: rsFMRI). DOI
- Charlotte Gibbels, Christopher Sinke, Jonas Kneer, Till Amelung, Sebastian Mohnke, Klaus Michael Beier, Henrik Walter, Kolja Schiltz, Hannah Gerwinn, Alexander Pohl, Jorge Ponseti, Carina Foedisch, Inka Ristow, Martin Walter, Christian Kaergel, Claudia Massau, Boris Schiffer 8 and Tillmann H.C. Kruger 1,* Two Sides of One Coin: A Comparison of Clinical and Neurobiological Characteristics of Convicted and Non-Convicted Pedophilic Child Sexual Abusers. J Clin Med 2019, 8, 947; doi:10.3390/jcm8070947. DOI
Hypersexuality is characterized by excessive sexual behavior that gets more and more out of control and causes problems for patients and their families. There is still no uniformly recognized diagnosis for hypersexuality and there is a lack of basic data that would be necessary for diagnostic classification. In order to reduce this data gap, the 'Sex@Brain Study' was initiated in the Department of Clinical Psychology and Sexual Medicine. The aim of this study is to investigate the clinical, neuropsychological and neurobiological basis of hypersexuality ('sex addiction'). A comprehensive characterization of men with excessive sexual behavior will be carried out. To this end, investigations will be carried out using questionnaires, neuropsychological tests and functional magnetic resonance imaging (fMRI). The findings should improve the diagnosis and treatment of these disorders in the future
Resulting publications:
- Sinke Ch, J.Engel, M. Veit, U Hartman, T. Hillemacher, J.Kneer. Krüger THC. Sexual cues alter working memory performance and brain processing in men with compulsive sexual behavior disorder. NeuroImage: Clinical, available online June 10, 2020, 102308 fMRI. DOI
- Engel J, Veit M, Sinke C, Heitland I, Kneer J, Hillemacher T, Hartmann U, Kruger THC. Same Same but Different: A Clinical Characterization of Men with Hypersexual Disorder in the Sex@Brain Study. Journal of Clinical Medicine 2019 8 (2). pii: E157. doi: 10.3390/jcm8020157. DOI
- Engel J, Kessler A, Veit M, Sinke C, Heitland I, Kneer J, Hartmann U, Kruger THC. Hypersexual behavior in a large online sample: Individual characteristics and signs of coercive sexual behavior. J Behav Addict. 2019 8: 213-222. DOI
Current information
There are various opportunities for doctoral theses and dissertations in the research areas of the Department of Clinical Psychology and Sexual Medicine. On the one hand, certain questions can be assigned as dissertation topics within larger research projects, both in the basic science and clinical-therapeutic areas. In addition, it is occasionally possible to make the analysis of existing data the subject of a doctoral thesis. In principle, interested doctoral students can also come to us with their own topic suggestions - as long as they fit into the research portfolio of the department - in order to check whether the corresponding work is feasible. There are also opportunities for psychology students (specializing in clinical psychology) to carry out their final theses.
Scientific collaborations
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Prof. Dr. Florian Beissner, Institute of Diagnostic and Interventional Neuroradiology
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PD Dr. Cordula Schippert, Gynacological Endocrinology and Reproductive Medicine
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Prof. Dr. Matthias Karst, Clinical Department of Anaesthesiology and Intensive Care Medicine
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Clinical Department of Psychiatry and Psychotherapy Charité Berlin
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Institute of Sexology and Sexual Medicine, Charité Berlin
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Clinical Department of Psychosomatics and Psychotherapy, Otto-von-Guericke University Magdeburg
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Institute for Sexual Medicine and Forensic Psychiatry and Psychotherapy, Kiel University Hospital
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Forensic Psychiatry, LWL University Hospital Bochum
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Computer Science and Applied Cognitive Science, University of Duisburg-Essen
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Clinical Department for Gerontopsychiatry, Asklepios Kliniken Ochsenzoll, Hamburg
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Institute for Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media
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School of Health Sciences - Geneva, University of Applied Sciences and Arts Western Switzerland
Equipment
The Department of Clinical Psychology and Sexual Medicine is equipped with modern computer technology and software (Presentation, e-Prime), which enables time-critical psychophysical experiments to be carried out on patients and healthy control subjects. In addition, the work area is equipped with a SKYRA 3T magnetic resonance tomograph (MRT) . This enables us to create high-resolution images of brain activity during behavioral experiments (fMRI) and at rest (rsMRI) as well as structural images and to compare them between groups of test subjects. The Department is also equipped with numerous physiological test procedures ("Testothek"), which are also used in clinical diagnostics and assessment procedures.
Research group members
Head of research group
Prof. Dr. med. Tillmann Krüger
Managing senior physician
Phone: +49 511 532 2407
Fax: +49 511 532-8407
Krueger.Tillmann@mh-hannover.de
Publications: ResearchGate
Further information can be found here: https: //www.mhh.de/sexualmedizin