Susanne Fischer

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Title
Prof. Dr.
Last Name
Fischer
First name
Susanne
Email
susanne.fischer@unisg.ch

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    Stress beliefs shape daily affective reactivity to social and work stressors: A 7-day ecological momentary assessment study.
    (2026-07-30)
    Laferton, Johannes A C
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    Conrad, Daniela
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    Zimmermann-Viehoff, Frank
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    Kunas, Stefanie
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    Euteneuer, Frank
    Stress beliefs-general expectations about the nature and consequences of stress-have been linked to health and performance, yet their role in shaping responses to everyday stress remains less understood. This study examined whether stress beliefs moderate affective reactivity and stress regulation strategies in response to naturally occurring stressors in daily life. In a 7-day ecological momentary assessment study, 104 university students completed thrice-daily reports (1,939 observations) on social and work-related stressors, positive and negative affect, and two stress regulation strategies-situation selection and response modification-as proposed in the stress optimization model (Crum et al., 2020). At baseline, stress beliefs were assessed alongside variables to characterize the sample. Negative stress beliefs moderated the association between daily stressors and positive affect: Individuals with high negative stress beliefs showed reduced positive affect during social stress and no increase in positive affect under higher workload. By contrast, those with low or moderate negative stress beliefs maintained positive affect during social stress and showed increased positive affect under higher workload-consistent with a challengelike appraisal. Additionally, controllability beliefs buffered increases in negative affect in response to daily social stress, with lower beliefs linked to stronger affective reactivity. By contrast, stress beliefs did not moderate associations between daily stressors and the investigated stress regulation strategies. These findings suggest that stress beliefs tune affective reactivity to everyday social and work stressors, identifying them as a potential intervention target given the established links between affect and long-term health. The generalizability of these findings should be confirmed across broader populations. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
    cris-layout.advanced-attachment.dc.type:journal article
    Journal:Emotion
    DOI:10.1037/emo0001705
    URI:https://alexandria.unisg.ch/handle/20.500.14171/134049
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    Menstrual Cycle Informed Psychotherapy: Preliminary findings in Women with Spider Phobia.
    (2026-09-05)
    Zorzini, Gianna
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    Ritter, Patricia Patra
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    Pallich, Gianandrea
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    Galli, Ursula
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    Ehlert, Ulrike
    BACKGROUND: Anxiety disorders are the most frequent mental disorders worldwide. Although exposure therapy is the gold-standard treatment for anxiety disorders, almost half of patients fail to achieve sufficient improvements. While much has been learned about for whom psychotherapy works and why, far less is understood about when it works. Emerging evidence indicates that estradiol and progesterone may affect fear extinction, yet studies examining the effects of menstrual cycle phase on exposure therapy outcomes remain lacking. This study is the first to investigate to what extent biologically informed menstrual cycle phase affects exposure therapy outcomes in women with spider phobia. METHOD: N=45 women with spider phobia in 1) the early to mid-follicular phase, 2) the mid-luteal phase, or 3) using hormonal contraceptives (HC), participated in a group-based exposure therapy. Symptoms were assessed at baseline, one-week post-therapy, and at 12-14 weeks follow-up, using the Spider Phobia Questionnaire (SPQ), the Fear of Spiders Questionnaire (FSQ), and a behavioral approach test (BAT). RESULTS: Both phobic fear and avoidance behavior improved significantly over time. Although improvement did not differ between menstrual cycle groups, higher progesterone levels on the day of exposure therapy were associated with less improvement in behavioral avoidance. CONCLUSION: The present findings provide preliminary evidence that ovarian hormones on the day of exposure therapy may affect exposure-based outcomes, particularly reductions in behavioral avoidance. More research in larger samples is needed to further investigate menstrual cycle phase effects in exposure-based treatment. If replicated, the findings would attest to the potential of bio-rhythm informed psychotherapy.
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    Journal:Psychotherapy and Psychosomatics
    DOI:10.1159/pps/aemag012
    URI:https://alexandria.unisg.ch/handle/20.500.14171/137646
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    Good morning or good evening: Daytime and cortisol as modulators of exposure therapy outcomes
    (Elsevier BV, 2026-12)
    Zorzini, Gianna
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    Ritter, Patricia
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    Pallich, Gianandrea
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    Galli, Ursula
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    Ehlert, Ulrike
    Background Although exposure therapy is considered the gold standard treatment for anxiety disorders, many patients do not respond sufficiently to it. This study investigated the effects of the time of day at which exposure therapy is delivered and endogenous cortisol levels during exposure on treatment success in patients with fear of spiders. It was hypothesized that individuals undergoing exposure therapy in the morning would experience greater symptom reductions compared to those undergoing therapy in the evening, and that higher endogenous cortisol levels would predict greater symptom reductions. Method 53 participants with symptoms of spider phobia were recruited to complete a four-hour group-based exposure therapy starting either at 8 a.m. or 5 p.m. in a double-blind design. Symptoms of spider phobia were assessed using the Structured Clinical Interview for DSM-IV. Therapy outcomes were assessed before, one week after therapy and at 3-months’ follow-up, using the Spider Phobia Questionnaire (SPQ), the Fear of Spiders Questionnaire (FSQ), and a behavioral approach test (BAT). Results Both phobic fear (FSQ: η²ₚ=0.70; SPQ: η²ₚ=0.59) and avoidance behavior (η²ₚ=0.70) significantly improved following exposure therapy. The morning group showed higher cortisol levels than the evening group (p = 0.036), however, symptom improvement did not differ between the groups (all p > 0.05). Exploratory analyses revealed that a lower cortisol change (AUCi) during individual exposure was associated with greater improvements in phobic fear (FSQ: η²ₚ=0.20; SPQ: η²ₚ=0.11). Conclusion Although daytime was not found to modify exposure therapy treatment success, preliminary evidence points to a potential role of cortisol change, warranting further investigation.
    cris-layout.advanced-attachment.dc.type:journal article
    Journal:Psychoneuroendocrinology
    Volume:194
    DOI:10.1016/j.psyneuen.2026.108018
    URI:https://alexandria.unisg.ch/handle/20.500.14171/138702
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    Physiotherapists’ Experiences and Needs Regarding Pain Neuroscience Education in Switzerland: An Online Survey
    (Georg Thieme Verlag KG, 2025-09-01)
    Alexandra Litzenburger
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    Susanne Fischer  
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    Journal:physioscience
    DOI:10.1055/a-2545-4057
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/123540
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    Network structure of functional somatic symptoms
    (Elsevier BV, 2025-01)
    Alexandra Litzenburger
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    Yannick Rothacher
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    Kay-Uwe Hanusch
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    Ulrike Ehlert
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    Urs M. Nater
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    Journal:Journal of Psychosomatic Research
    Volume:188
    DOI:10.1016/j.jpsychores.2024.111968
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/121945
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    Is solastalgia associated with mental health problems? A scoping review
    (BMJ, 2025-08)
    Alicia Vela Sandquist
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    Leonie Biele
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    Ulrike Ehlert
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    Susanne Fischer  
    Question As global ecological crises accelerate, it is becoming increasingly important to understand the impact of associated environmental changes on mental health. However, the psychological mechanisms underlying the link between environmental changes and mental health problems remain underexplored. This scoping review investigates whether solastalgia—a form of distress caused by environmental change—acts as a potential contributing factor to mental health problems. Study selection and analyses We conducted a systematic search of the databases PsycINFO and PubMed using the keyword ‘solastalgia’. Initially, only studies that quantitatively assessed solastalgia and used validated mental health measures were included. A second, non-preregistered search expanded the scope to include studies that mentioned solastalgia and mental health without requiring quantitative solastalgia measures. Findings The studies retrieved in the initial search showed that solastalgia was positively associated with depression, anxiety and post-traumatic stress disorder. The studies retrieved in the extended search supported these findings, with qualitative studies providing further evidence that solastalgia is a useful construct to understand the emotional responses of persons affected by environmental changes. Conclusions Solastalgia might be a factor contributing to the detrimental effects of climate change on mental health. Further quantitative research is warranted to inform the design of (preventive) interventions targeting solastalgia and thus mitigate climate change-induced mental health problems.
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    Journal:BMJ Mental Health
    Volume:28
    Issue:1
    DOI:10.1136/bmjment-2025-301639
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/123260
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    The overlooked burden of persistent physical symptoms: a call for action in European healthcare
    (Elsevier BV, 2025-01)
    Anne Toussaint
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    Angelika Weigel
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    Bernd Löwe
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    Jordi Blanch
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    Katleen Bogaerts
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    Journal:The Lancet Regional Health - Europe
    Volume:48
    DOI:10.1016/j.lanepe.2024.101140
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/121946
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    Seasonal variation in hair cortisol concentration: A systematic review.
    (2025-05-23)
    Feneberg, Anja C
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    Fischer, Susanne  
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    Skoluda, Nadine
    Hair cortisol concentration (HCC) is a crucial biomarker in psychoneuroendocrinological research, offering unique insights into long-term hypothalamic-pituitary-adrenal axis activity. Season has repeatedly shown associations with HCC. However, as of yet, no systematic attempt at quantifying season's influence on HCC has been undertaken. We conducted a systematic search of the bibliographic databases PubMed and PsycINFO. Twenty-nine between- and within-person studies fulfilled all eligibility criteria (N = 10,520 participants in total). Overall, 22 studies (76%) reported significant differences in HCC across seasons. Most between-personstudies reported lower HCC in winter/spring than in summer/autumn (10/15). This pattern was supported by 2/14 within-person studies, whereas others reported lower HCC in summer than in autumn (6/14). The remaining studies reported other patterns or no seasonal variations in HCC. In conclusion, there is accumulating evidence for seasonal variations in HCC, highlighting the need to consider the seasons in future research on HCC and health. Mechanisms related to meteorological, ecological, sociocultural, and lifestyle factors may underlie seasonal rhythmicity in cortisol secretion and accumulation in hair.
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    Journal:Frontiers in Neuroendocrinology
    Volume:78
    DOI:10.1016/j.yfrne.2025.101199
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/122860
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    Assessment of psychosocial aspects in adults in post-COVID-19 condition: the EURONET-SOMA recommendations on core outcome domains for clinical and research use
    (Springer Science and Business Media LLC, 2025-02-11)
    Stefan Salzmann
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    Lars de Vroege
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    Petra Engelmann
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    Per Fink
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    Susanne Fischer  
    Background Harmonizing core outcome domains allows for pooling data, comparing interventions, and streamlining research evaluation. At the same time clinicians require concise and feasible measures for routine practice. Considering the heterogeneity of post-COVID-19 condition, a biopsychosocial approach requires sufficient coverage of the psychosocial dimension with assessments. Previous recommendations for core outcome sets have serious limitations regarding the psychosocial aspects of post-COVID-19 condition. This paper specifically focuses on psychosocial outcomes for adults with post-COVID-19 condition, providing both a comprehensive set of outcome domains for research and a streamlined clinical core set tailored for routine clinical use. Methods In a structured Consensus Development Approach, the European Network to improve diagnostic, treatment, and healthcare for patients with persistent somatic symptoms (EURONET-SOMA) developed psychosocial core outcome domains and assessments regarding post-COVID-19 condition. The experts identified variables and instruments which should be considered in studies on adults suffering from post-COVID-19 condition, and which are feasible in the clinical setting and relevant for research. Results We identified three higher-order dimensions with each encompassing several domains: The first higher-order dimension, “outcomes”, encompasses (1) the classification/ diagnostics of post-COVID-19 condition, (2) somatic symptoms (including fatigue), (3) the psychopathological status and mental comorbidities, (4) the physical status and somatic comorbidities, (5) neurocognitive symptoms, and (6) illness consequences. The second higher-order domain “mechanisms” encompasses (7) cognitive components, (8) affective components, (9) behavioral components, (10) social components, and (11) psychobiological bridge markers (e.g., neuroimmunological and psychoneuroendocrinological variables). The third higher-order domain, “risk factors”, includes factors such as (12) socioeconomic status and sociocultural factors, (13) pre-existing mental and somatic health issues, (14) personality factors (e.g., neuroticism), (15) adverse childhood experiences, (16) ongoing disability or pension claim, and (17) social media use. For each domain, specific instruments are suggested for research purposes and clinical use. Conclusions The recommended core domains help to increase consistency in a biopsychosocial approach to post-COVID-19 condition across investigations, improve synergies, and facilitate decision-making when comparing different interventional approaches. It allows to better identify relevant subgroups in heterogeneous post-COVID-19 condition populations offering practical tools for routine clinical practice through the clinical core set.
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    Journal:BMC Medicine
    Volume:23
    Issue:1
    DOI:10.1186/s12916-025-03927-0
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/121947
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    Cold season air temperature as predictor of psychological well-being and mental health
    (Springer Science and Business Media LLC, 2025-05-21)
    Susanne Fischer  
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    Peter Ranacher
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    Xenia Sticher
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    Alexandra Mibus
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    Kathrin Naegeli
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    Journal:Scientific Reports
    Volume:15
    Issue:1
    DOI:10.1038/s41598-025-02486-x
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/122769
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