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Klinik für Psychiatrie und Psychotherapie

Research group Schiele / Domschke

Anxiety Research
Research group leaders:
Dr. Miriam Schiele, Dipl.-Psych.
Phone: +49 (0)761 270 - 69690
Email: miriam.schiele@uniklinik-freiburg.de

Univ.-Prof. Dr. Dr. Katharina Domschke, M.A. (USA)
Phone: +49 (0)761 270 - 65060
Email: katharina.domschke@uniklinik-freiburg.de
Secretariat: Tanja Gunser
Phone: +49 (0)761 270 – 65540
Email: tanja.gunser@uniklinik-freiburg.de
Group members: Dr. Jörg Angenendt
Dr. Christian Klesse
Dr. Elena Reinhold

Angelika Pawik-Stöhr, Study nurse
Ursula Wein, Study nurse
Yannick Lieb, BSc, student research assistant

Research focus

State and trait markers of anxiety disorders
Anxiety disorders constitute the most prevalent mental disorders in Europe with a 12-month prevalence estimate of 14%. In accordance with the vulnerability-stress model of mental disorders, a multitude of interacting factors play a crucial role in their pathogenesis and maintenance. Gaining a better understanding of the state and trait markers associated with different anxiety disorders, their clinical subtypes and symptom dimensions is of utmost importance for advancing diagnostic, prognostic and therapeutic options, which are therefore investigated by our group.

Treatment outcome prediction and personalized treatment of anxiety disorders
While highly effective psychotherapeutic as well as pharmacological treatment options are available, not all patients with anxiety disorders respond to the first-line treatments in a clinically meaningful way. A precise prediction of individual treatment response offers the chance to optimize individual treatment selection early on. Our research focuses on synthesizing clinical, psychological, neurobiological and environmental information in an effort to determine personalized treatment options for the individual patient.

Mechanisms of action underlying successful behavioral change through psychotherapy
For the treatment of anxiety disorders, cognitive behavioural therapy (CBT) is considered the standard first line treatment. However, the precise mechanisms of action mediating psychotherapeutic outcome are still poorly understood. Therefore, employing a multi-level approach, our aim is to identify correlates and putative mechanisms of clinical change occurring over the course of psychotherapy.

Prevention of anxiety disorders
Anxiety disorders are characterized by a considerably earlier age‐of‐onset than other mental disorders and typically first manifest during childhood and adolescence. Childhood anxiety disorders often persist into adulthood or progress toward other anxiety disorders or other mental disorders across the life span. The identification of individual risk factors predisposing to the later manifestation of an anxiety disorder thus allows for the development and application of targeted preventive measures in at-risk populations in order to reduce disorder incidence and in turn strengthen resilience, which constitutes another focus of our research.

Selected publications


  • Schiele MA, Domschke K (2018) Epigenetics at the crossroads between genes, environment and resilience in anxiety disorders. Genes Brain Behav 17:e12423.
  • Schiele MA, Bandelow B, Baldwin DS, Pini S, Domschke K (2020) A neurobiological framework of separation anxiety and related phenotypes. Eur Neuropsychopharmacol 33:45-57.
  • Schiele MA, Gottschalk MG, Domschke K (2020) The applied implications of epigenetics in anxiety, affective and stress-related disorders - a review and synthesis on psychosocial stress, psychotherapy and prevention. Clin Psychol Rev. 77:101830.
  • Matthies S*, Schiele MA*, Koentges C, Pini S, Schmahl C, Domschke K (2018) Please Don't Leave Me - Separation Anxiety and Related Traits in Borderline Personality Disorder. Curr Psychiatry Rep 20:83. (*shared first authorship)

Original articles

  • Neufang S, Geiger MJ, Homola GA, Mahr M, Schiele MA, Gehrmann A, Schmidt B, Gajewska A, Nowak J, Meisenzahl-Lechner E, Pham M, Romanos M, Akhrif A, Domschke K (2019) Cognitive-behavioral therapy effects on alerting network activity and effective connectivity in panic disorder. Eur Arch Psychiatry Clin Neurosci 269:587-598.
  • Schiele MA, Herzog K, Kollert L, Böhnlein J, Repple J, Rosenkranz K, Leehr EJ, Ziegler C, Lueken U, Dannlowski U, Pauli P, Arolt V, Zwanzger P, Deckert J, Erfurth A, Domschke K (2020) Affective temperaments (TEMPS-A) in panic disorder and healthy probands: Genetic modulation by 5-HTT variation. World J Biol Psychiatry 31:1-7.
  • Schiele MA, Herzog K, Kollert L, Schartner C, Leehr EJ, Böhnlein J, Repple J, Rosenkranz K, Lonsdorf TB, Dannlowski U, Zwanzger P, Reif A, Pauli P, Deckert J, Domschke K (2020) Extending the vulnerability-stress model of mental disorders: three-dimensional NPSR1 × environment × coping interaction study in anxiety. Br J Psychiatry, doi: 10.1192/bjp.2020.73.
  • Schiele MA, Kollert L, Lesch KP, Arolt V, Zwanzger P, Deckert J, Ziegler C, Domschke K (2019) Hypermethylation of the serotonin transporter gene promoter in panic disorder-Epigenetic imprint of comorbid depression? Eur Neuropsychopharmacol 29:1161-1167.
  • Schiele MA, Reinhard J, Reif A, Domschke K, Romanos M, Deckert J, Pauli P (2016) Developmental aspects of fear: Comparing the acquisition and generalization of conditioned fear in children and adults. Dev Psychobiol 58:471-81.
  • Schiele MA, Reif A, Lin J, Alpers GW, Andersson E, Andersson G, Arolt V, Bergström J, Carlbring P, Eley TC, Esquivel G, Furmark T, Gerlach AL, Hamm A, Helbig-Lang S, Hudson JL, Lang T, Lester KJ, Lindefors N, Lonsdorf TB, Pauli P, Richter J, Rief W, Roberts S, Rück C, Schruers KRJ, Thiel C, Wittchen H-U, Domschke K, Weber H, Lueken U (2021) Therapygenetic effects of 5-HTTLPR on cognitive-behavioral therapy in anxiety disorders: A meta-analysis. Eur Neuropsychopharmacol, doi: 10.1016/j.euroneuro.2021.01.004
  • Schiele MA, Ziegler C, Kollert L, Katzorke A, Schartner C, Busch Y, Gromer D, Reif A, Pauli P, Deckert J, Herrmann MJ, Domschke K(2018) Plasticity of Functional MAOA Gene Methylation in Acrophobia. Int J Neuropsychopharmacol 21:822-827.
  • Stegmann Y*, Schiele MA*, Schümann D, Lonsdorf TB, Zwanzger P, Romanos M, Reif A, Domschke K, Deckert J, Gamer M, Pauli P (2019) Individual differences in human fear generalization-pattern identification and implications for anxiety disorders. Transl Psychiatry 18;9:307. (*shared first authorship)
  • Ziegler C, Richter J, Mahr M, Gajewska A, Schiele MA, Gehrmann A, Schmidt B, Lesch KP, Lang T, Helbig-Lang S, Pauli P, Kircher T, Reif A, Rief W, Vossbeck-Elsebusch AN, Arolt V, Wittchen HU, Hamm AO, Deckert J, Domschke K (2016) MAOA gene hypomethylation in panic disorder-reversibility of an epigenetic risk pattern by psychotherapy. Transl Psychiatry 6:e773.

Book chapters

  • Domschke K, Deckert J (2017) Prävention von Angststörungen, in: Handbuch Präventive Psychiatrie, Hrsg.: Klosterkötter J, Maier W; Schattauer, Stuttgart; ISBN 978-3-7945-3050-2
  • Schiele MA, Domschke K (2018) Prävention von Angsterkrankungen, in: Angst: Medizin. Psychologie. Gesellschaft., Hrsg.: Zwanzger P, Medizinisch Wissenschaftliche Verlagsgesellschaft, Berlin; ISBN 978-3954664061