Orienting in a defensive world: mammalian modifications of our evolutionary heritage. A Polyvagal Theory

Social skills and psychopathology are associated with autonomic function in children: a cross-sectional observational study

In recent years, the increase of psychopathological disorders in the population has become a health emergency, leading to a great effort to understand psychological vulnerability mechanisms. In this scenario, the role of the autonomic nervous system (ANS) has become increasingly important. This study investigated the association between ANS, social skills, and psychopathological functioning in children. As an ANS status proxy, we measured heart rate variability (HRV). Infants admitted to the neonatal intensive care unit of the University Hospital of Padova because of preterm birth or neonatal hypoxic-ischemic encephalopathy were sequentially recruited from January 2011 to June 2013 and followed long-term up to school age in this cross-sectional observational study. We recorded 5 minutes of HRV immediately before measuring performance in social abilities tasks (affect recognition and theory of mind, NEPSY-II) in 50 children (mean age 7.4 ± 1.4 years) with and without risk factors for developing neuropsychiatric disorders due to pre-/perinatal insults without major sequelae. Children also completed extensive cognitive, neuropsychological, and psychosocial assessment. Parents were assessed with psychopathological interviews and a questionnaire (CBCL 6-18). Analysis in a robust Bayesian framework was used to unearth dependencies between HRV, social skills, and psychopathological functioning. Social task scores were associated with HRV components, with high frequency the most consistent. HRV bands were also associated with the psychopathological questionnaire. Only normalized HRV high frequency was able to distinguish impaired children in the affect recognition task. Our data suggest that ANS may be implicated in social cognition both in typical and atypical developmental conditions and that HRV has cross-disease sensitivity. We suggest that HRV parameters may reflect a neurobiological vulnerability to psychopathology. The study was approved by the Ethics Committee of the University Hospital of Padova (Comitato Etico per la Sperimentazione, Azienda Opedaliera di Padova, approval No. 1693P).

Respiratory Sinus Aarrhythmia (RSA) stress response in preschool age varies by serotonin transporter polymorphism (5-HTTLPR): A preliminary report

The serotonin transporter promoter region polymorphism (5-HTTLPR) has been implicated in stress regulation, with increased stress reactivity often being found in carriers of the low-expressing short (S) allele. Nevertheless, the role of the 5-HTTLPR in influencing parasympathetic stress reactivity, as indexed by Respiratory Sinus Arrhythmia (RSA), is still unknown. This study examined, for the first time, whether the 5-HTTLPR was associated with variations in RSA response to maternal separation in a sample of 69 healthy 5-year-old children. Preschoolers' RSA was measured during an age-adapted version of the Strange Situation Procedure (SSP). The 5-HTTLPR polymorphism was tested as a predictor of RSA dynamic response to the SSP through multilevel models. A significant interaction between 5-HTTLPR and SSP episodes was found. In particular, whereas a significant decrease in RSA levels was observed during the stranger episode in the whole sample, S allele carriers showed a significant decrease in RSA levels from the stranger episode to the first separation episode, followed by an increase for the rest of the procedure. Albeit preliminary, data support the view that the 5-HTTLPR may contribute to individual differences in RSA stress reactivity from preschool age.

Links between Oppositional Defiant Disorder Dimensions, Psychophysiology, and Interpersonal versus Non-interpersonal Trauma

The etiology of oppositional defiant disorder (ODD) is not well understood but appears to have both biologically-based roots and can develop following adverse experiences. The current study is the first to examine the interaction between biologically-based factors and type of trauma experience (i.e., interpersonal and non-interpersonal) and associations with ODD. The psychophysiological factors included baseline resting heart rate, respiratory sinus arrhythmia (RSA), and cortisol. ODD was measured as two dimensions of irritable and defiant/vindictive. The sample included 330 children, 3-7 years-old, oversampled for a history of trauma. Results showed the interactions between baseline physiological arousal variables and trauma type in predicting ODD dimensions were not supported. However, the baseline RSA by trauma interaction was a significant predictor of defiance/vindictiveness among boys, but not girls, when interpersonal trauma was compared to controls. Several other gender differences emerged. Among boys, both interpersonal and non-interpersonal trauma were predictive of ODD dimensions; however, among girls, non-interpersonal trauma was not. Among girls, there was a significant negative bivariate relationship between baseline cortisol and irritability. Also, when the sample was restricted to those with interpersonal trauma only and controls, baseline RSA was negatively associated with irritability in girls only (controlling for trauma). Finally, retrospective reports revealed that children who met criteria for ODD diagnosis and experienced interpersonal trauma were more likely to exhibit ODD symptoms prior to their trauma compared to those who experienced non-interpersonal trauma. Results are discussed in the context of previous mixed findings, and avenues for future research are highlighted.

Associations between coping strategies and insomnia: a longitudinal study of Japanese workers

STUDY OBJECTIVES

Coping with stress is important because stress disturbs sleep. However, only a few longitudinal studies have investigated the association between coping and insomnia. We examined whether individuals with insomnia symptoms used more maladaptive coping strategies than individuals without insomnia symptoms, and evaluated the association between insomnia symptoms and coping strategies.

METHODS

In this prospective cohort study, Japanese workers were enrolled and observed over a 2-year period. During both years, self-administered questionnaires on coping and insomnia symptoms were administered. Coping was assessed using the Brief-Coping Orientation to Problems Experienced, and insomnia symptoms were examined using the Athens Insomnia Scale. Generalized estimating equation modeling identified the effects of coping strategies on insomnia severity.

RESULTS

In total, 1358 of 1855 workers at baseline were followed up. Individuals with insomnia symptoms showed a higher use of maladaptive coping strategies and less use of humor and instrumental support than individuals without insomnia symptoms. Active coping, humor, emotional support, and instrumental support were negatively associated with insomnia severity. In contrast, venting, substance use, behavioral disengagement, and self-blame were positively associated with insomnia severity.

CONCLUSIONS

This study showed that individuals with insomnia symptoms use both adaptive and maladaptive coping strategies and are more likely to use maladaptive strategies than individuals without insomnia symptoms. In the future, interventions focused on educating people about adaptive coping strategies should be conducted to determine whether coping strategies may prevent insomnia symptoms.

Review of Perioperative Music Medicine: Mechanisms of Pain and Stress Reduction Around Surgery

Clinical-experimental considerations and an approach to understanding the autonomic basis of improved surgical outcomes using Perioperative Music Medicine (PMM) are reviewed. Combined surgical, psycho-physiological, and experimental perspectives on Music Medicine (MM) and its relationship to autonomic nervous system (ANS) function are discussed. Considerations are given to the inter-related perioperative effects of MM on ANS, pain, and underlying vagal and other neural circuits involved in emotional regulation and dysregulation. Many surgical procedures are associated with significant pain, which is routinely treated with post-operative opioid medications, which cause detrimental side effects and delay recovery. Surgical trauma shifts the sympathetic ANS to a sustained activation impairing physiological homeostasis and causing psychological stress, as well as metabolic and immune dysfunction that contribute to postoperative mortality and morbidity. In this article, we propose a plan to operationalize the study of mechanisms mediating the effects of MM in perioperative settings of orthopedic surgery. These studies will be critical for the implementation of PMM as a routine clinical practice and to determine the potential limitations of MM in specific cohorts of patients and how to improve the treatment.

Autonomic Measures in Differentiating Depressive Disorders: A Potential AID

Objective

The present study aimed at exploring the potential utility of autonomic regulation as a useful marker in the diagnostic differentiation between unipolar and bipolar depression.

Method

Respiratory sinus arrhythmia (RSA), low-frequency (LF) of heart rate variability, and systolic blood pressure (SBP) were assessed in patients with bipolar depression (31) and major depressive disorder (MDD=32), and in healthy controls (HCs=32). Since bipolar depressed subjects were maintained on specific medications to manage manic/hypomanic symptoms, we explored whether mood stabilizers (atypical antipsychotics and anticonvulsants or their combinations) could independently affect the physiological parameters.

Results

When the autonomic measures were analyzed by a multivariate analysis of variance (MANCOVA), after controlling for BMI, the combination of variables (RSA, LF, SBP) discriminated patients with bipolar depression and MDD from HC (F₍6_{, 178)}=3.036, p=0.007, Λ=0.823, partial η²=0.093). In any case, we cannot exclude that mood stabilizers might have affected SBP values in the bipolar group. To deconstruct this multivariate effect, pairwise ANOVAs and discriminant analyses contrasted groups and documented that RSA was the primary variable distinguishing the groups. Discriminant function analyses showed that RSA had a significant discriminating weight between bipolar depressed patients and HC subjects (p<0.0005). By contrast, RSA showed a trend towards the statistical significance in discriminating between bipolar depression and MDD patients (p=0.06).

Conclusions

The assessment of RSA and SBP in outpatient settings might be helpful in the differential diagnosis of affective disorders.

Parents' Maltreatment Histories, Dimensions of Emotion Regulation, and Connections to Offspring Self-Regulation: A Sex-Specific Transmission Pathway

Introduction

Parents with childhood maltreatment histories are at risk for emotion regulation (ER) problems, which are associated with reduced self-regulation among their offspring. However, gaps remain in the literature regarding this indirect transmission pathway. First, ER consists of multiple dimensions and it is unclear which dimension is most affected by childhood maltreatment. Second, less is known regarding which parental ER dimension is linked to offspring self-regulation. Thus, the present study aimed to examine the direct and indirect associations between parental maltreatment histories and child self-regulatory capacity via dimensions of parental ER.

Methods

In this cross-sectional study, 101 youth (75% African American/Black; 53% female; M _age = 10.28; SD = 1.19) and their primary caregivers were recruited from a low-income community in the Southeastern United States. Structural equation modeling was used to model the effect of parents' self-reported childhood maltreatment on youth physiological self-regulation (measured by heart rate variability reactivity [HRV-R]), via parents' self-reported ER.

Results

Parental maltreatment history was significantly associated with five of the six components of ER. Further, the indirect effect of parents' childhood maltreatment on child HRV-R was significant when parents reported more difficulty engaging goal-directed behaviors. Moderation analyses by sex showed that daughters had greater dysregulation regardless of parental maltreatment histories, while parents' ER was found to play a more significant role in the intergenerational transmission of dysregulation to sons.

Conclusions

The current study extends the literature on self-regulation development in children of low-income, maltreatment-exposed parents. Our study may inform parent-child interventions for improving self-regulation.

Using Virtual Reality to Examine the Association Between Respiratory Sinus Arrhythmia and Adolescent Substance Use

Early substance use is associated with long-term negative health outcomes. Emotion regulation (ER) plays an important role in reducing risk, but detecting those vulnerable because of ER deficits is challenging. Respiratory sinus arrhythmia (RSA), a biomarker of ER, may be useful for early identification of substance use risk. To examine this, we enrolled 23 adolescents (M_age = 14.0; 56% minority) with and without a history of substance use and collected RSA during a neutral baseline, virtual reality challenge scene, and neutral recovery. ANOVAs indicated that adolescents who reported having used a substance were not different from non-using peers on baseline or challenge RSA but demonstrated lower RSA during recovery. This suggests that adolescents with a history of substance use exhibit slower return to baseline RSA after experiencing a challenging situation compared to non-using peers. RSA, an index of ER, may be useful in identifying adolescents at risk for early substance use.

Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory

The quest to understand the pathophysiology of autism spectrum disorder (ASD) has led to extensive literature that purports to provide evidence for autonomic dysfunction based on heart rate and heart rate variability (HRV), in particular respiratory sinus arrhythmia (RSA), a measure of parasympathetic functioning. Many studies conclude that autism is associated with vagal withdrawal and sympathetic hyperactivation based on HRV and electrodermal analyses. We will argue that a critical analysis of the data leads to the hypothesis that autonomic nervous system dysfunction is not a dominant feature of autism. Most children with ASD have normal parasympathetic baseline values and normal autonomic responses to social stimuli. The existing HRV and electrodermal data cannot lead to the conclusion of an over-excitation of the sympathetic nervous system. A small subgroup of ASD children in experimental settings has relatively low RSA values and relatively high heart rates. The data suggest that this is likely associated with a relatively high level of anxiety during study conditions, associated with co-morbidities such as constipation, or due to the use of psychoactive medication. Many studies interpret their data to conform with a preferred hypothesis of autonomic dysfunction as a trait of autism, related to the polyvagal theory, but the HRV evidence is to the contrary. HRV analysis may identify children with ASD having autonomic dysfunction due to co-morbidities.

Adolescent girls' intrapersonal and interpersonal parasympathetic regulation during peer support is moderated by trait and state co-rumination

Effective emotion regulation (ER) is integral to adolescents' mental well-being and socioemotional development. During adolescence, peer interactions have an increasingly salient influence on the development of effective ER, but not all supportive peer interactions support adaptive ER. Co-rumination reflects the tendency to seek ER support by engaging with peers in negatively focused discussion of ongoing problems. We examined associations between co-rumination (state and trait) with measures of individual's autonomic (i.e., respiratory sinus arrhythmia, RSA) and affective regulation (self-report) among 30 female close-friend dyads (ages 11-17; 74% White) while engaged in a support-seeking discussion in the laboratory. We found that trait co-rumination corresponded with RSA withdrawal during peer support, suggesting a potential mechanism by which co-rumination contributes to dysregulated ER. We also examined dyadic patterns of physiological regulation via prospective change actor partner interdependence models (APIM). Partner effects were moderated by behaviorally coded state co-rumination. Dyads with high state co-rumination displayed coupled RSA movement in opposite directions, while dyads with low state co-rumination exhibited coupled RSA movement in the same direction. These findings are consistent with similar physiologic linkages in close relationships observed in other developmental periods. Results highlight the importance of multimodal assessment for characterizing social ER processes across development.

Predicting the effectiveness of engagement and disengagement emotion regulation based on emotional reactivity in borderline personality disorder

Improving emotion regulation is central to borderline personality disorder (BPD) treatment, but little research indicates which emotion regulation strategies are optimally effective and when. Basic emotion science suggests that engagement emotion regulation strategies that process emotional content become less effective as emotional intensity increases, whereas disengagement strategies that disengage from it do not. This study examined whether emotional reactivity to emotional stimuli predicts the effectiveness of engagement and disengagement emotion regulation across self-report, general physiologic (heart rate), sympathetic (skin conductance responses), and parasympathetic (respiratory sinus arrythmia) emotion in BPD, healthy, and clinical control (i.e. generalized anxiety disorder; GAD) groups. 120 participants (40 per group) were exposed to emotion inductions and then instructed to implement engagement (mindful awareness) and disengagement (distraction) strategies while self-report and physiological emotion measurements were taken. In the BPD and GAD groups, higher heart rate or respiratory sinus arrythmia reactivity, respectively, predicted improved mindful awareness effectiveness. Higher skin conductance reactivity predicted worsened distraction effectiveness in BPD. Higher reactivity may potentiate engagement emotion regulation, and exacerbate disengagement from emotional content, in BPD. Future research should examine other domains of emotion regulation that may be influenced by emotional intensity, and other forms of emotional intensity that may influence them.

Interoception of breathing and its relationship with anxiety

Interoception, the perception of internal bodily states, is thought to be inextricably linked to affective qualities such as anxiety. Although interoception spans sensory to metacognitive processing, it is not clear whether anxiety is differentially related to these processing levels. Here we investigated this question in the domain of breathing, using computational modeling and high-field (7 T) fMRI to assess brain activity relating to dynamic changes in inspiratory resistance of varying predictability. Notably, the anterior insula was associated with both breathing-related prediction certainty and prediction errors, suggesting an important role in representing and updating models of the body. Individuals with low versus moderate anxiety traits showed differential anterior insula activity for prediction certainty. Multi-modal analyses of data from fMRI, computational assessments of breathing-related metacognition, and questionnaires demonstrated that anxiety-interoception links span all levels from perceptual sensitivity to metacognition, with strong effects seen at higher levels of interoceptive processes.

Model Integration: Can Understanding Biopsychosocial Gut-Brain Axis Mechanistic Pathways Improve our Clinical Reasoning in Primary Care?

Introduction

Most NPs practice in primary care settings. Cognitive tools to inform and advance NP understanding of biopsychosocial mechanisms can support early recognition, interdisciplinary collaboration, interventions, and prevention of negative outcomes.

Theory and Methods

We describe the development of a model to support NP consideration of gut-brain axis (GBA) evidence-based pathways, contributing variables, and related health outcomes.

Results

The model's outcomes are factors associated with homeostasis or disruption of biological, psychological, and social systems.

Discussion/conclusion

This cognitive tool aims to support NP awareness of multi-domain GBA relationships to consider with differential diagnoses and clinical treatment of the "whole body system".

Coupling between prefrontal brain activity and respiratory sinus arrhythmia in infants and adults

Self-regulation is an essential aspect of healthy child development. Even though infants are dependent on their caregivers for co-regulation during the first years, they begin to gain early regulatory abilities through social interactions as well as their own cognitive development. These early regulatory abilities continue to increase with the maturation of both the prefrontal cortex and the vagal system. Importantly, theoretical accounts have suggested that the prefrontal cortex and the vagal system are linked through forward and backward feedback loops via the limbic system. Decreased coupling within this link is suggested to be associated with psychopathology.

The primary goal of this study is to examine whether intrapersonal coupling of prefrontal brain activity and respiratory sinus arrythmia is evident in infancy. Using the simultaneous assessment of functional near-infrared spectroscopy and electrocardiography, we will use Cross-Recurrence Quantification Analysis to assess the coupling of prefrontal brain activity and respiratory sinus arrhythmia in 69 4–6-month-old infants and their mothers during rest.

Understanding the developmental emergence of the neurobiological correlates of self- regulation will allow us to help identify neurodevelopmental risk factors.

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In adults, self-regulation involves coupling between the prefrontal cortex (PFC) and vagal activity.

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We investigate whether the coupling of brain and respiratory sinus arrhythmia (RSA) activity is evident during infancy.

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Understanding the developing connection between the PFC and vagal system will help to elucidate the pathways involved in self-regulation.

Cardiac autonomic regulation and joint hypermobility in adolescents with functional abdominal pain disorders

BACKGROUND

Joint hypermobility (JH) is associated with autonomic nervous system dysregulation and functional abdominal pain disorders (FAPDs). Understanding the neurophysiological processes linking these conditions can inform clinical interventions. Autonomic activity regulates gastrointestinal (GI) sensorimotor function and may be a key mechanism. The aims of this study were to examine the relation of JH with dynamic autonomic activity and parasympathetic regulation in adolescents with FAPDs and identify optimal JH cutoff scores that best index autonomic regulation in FAPDs.

METHODS

A total of 92 adolescents with FAPDs and 27 healthy controls (age 8-18 years; 80% female) were prospectively enrolled. JH was assessed by Beighton scores. ECG recordings were conducted during supine, sitting, and standing posture challenges. ECG-derived variables-heart period (HP), respiratory sinus arrhythmia (RSA), and vagal efficiency (VE)-were analyzed using linear regression and mixed effects modeling.

KEY RESULTS

Beighton scores of ≥4 optimally distinguished autonomic function. Adolescents with FAPD and JH had reduced VE compared to adolescents with FAPDs without JH (B = 18.88, SE = 6.25, p = 0.003) and healthy controls (B = 17.56, SE = 8.63, p = 0.044). These subjects also had lower and less dynamic RSA and HP values during posture shifts, with strongest differences in supine position and using the VE metric.

CONCLUSIONS & INFERENCES

Suboptimal autonomic regulation indexed by reduced vagal efficiency may be a mechanism of symptoms in hypermobile FAPD patients with Beighton score ≥ 4. Autonomic disturbance may serve as potential intervention target for patients with JH and functional GI disorders.

Psychophysiological underpinnings of proactive and reactive aggression in young men and women

Reactive aggression is posited to occur as a result of hypersensitivity to threat, whereas fearlessness may drive proactive aggression. This study aimed to test if physiological fear reactivity differentially relates to self-report reactive and proactive aggression using immersive virtual reality fear (VR) induction. We collected subjective fear ratings and sympathetic (SNS; skin conductance) and parasympathetic (PNS; respiratory sinus arrhythmia) nervous system reactivity during an interactive VR horror video. Results showed that for men and women, reactive aggression was related to heightened SNS fear reactivity. For men, proactive aggression was related to hypoarousal of the PNS and SNS (coinhibition) during fear induction, whereas augmented PNS was related to proactive aggression in women. These results support the fearlessness hypothesis for proactive aggression in men, but this does not replicate in women. By contrast, hypersensitivity to fear is related to reactive aggression for both men and women.

Conduct problems among children in low-income, urban neighborhoods: A developmental psychopathology- and RDoC-informed approach

Conduct problems are associated with numerous negative long-term psychosocial sequelae and are among the most frequent referrals for children's mental health services. Youth residing in low-income, urban communities are at increased risk for conduct problems, but not all youth in these environments develop conduct problems, suggesting heterogeneity in risk and resilience processes and developmental pathways. The present study used a developmental psychopathology- and Research Domain Criteria (RDoC)-informed approach for conceptualizing risk and resilience for conduct problems among children from low-income, urban neighborhoods. Participants were 104 children (M = 9.93 ± 1.22 years; 50% male; 96% African American, 4% Latinx). We assessed four constructs reflecting cognitive and neurobiological processes associated with conduct problems using multiple levels of analysis and informants: autonomic nervous system reactivity, limbic system/orbitofrontal cortical functioning, dorsolateral prefrontal cortical functioning, and conduct problems. Latent profile analysis identified four profiles: typically developing (TD, n = 34); teacher-reported conduct problems (TCP, n = 14); emotion processing (EP, n = 27); and emotion expression recognition (EER, n = 29). External validation analyses demonstrated that profiles differed on various indices of conduct problems in expected ways. The EP profile exhibited lower levels of emotional lability and callous–unemotional behaviors, and higher levels of prosocial behavior. The TD profile demonstrated elevated emotional lability. Implications for etiological and intervention models are presented.

Morally Distressing Experiences, Moral Injury, and Burnout in Florida Healthcare Providers during the COVID-19 Pandemic

Because healthcare providers may be experiencing moral injury (MI), we inquired about their healthcare morally distressing experiences (HMDEs), MI perpetrated by self (Self MI) or others (Others MI), and burnout during the COVID-19 pandemic. Participants were 265 healthcare providers in North Central Florida (81.9% female, M_age = 37.62) recruited via flyers and emailed brochures that completed online surveys monthly for four months. Logistic regression analyses investigated whether MI was associated with specific HMDEs, risk factors (demographic characteristics, prior mental/medical health adversity, COVID-19 protection concern, health worry, and work impact), protective factors (personal resilience and leadership support), and psychiatric symptomatology (depression, anxiety, and PTSD). Linear regression analyses explored how Self/Others MI, psychiatric symptomatology, and the risk/protective factors related to burnout. We found consistently high rates of MI and burnout, and that both Self and Others MI were associated with specific HMDEs, COVID-19 work impact, COVID-19 protection concern, and leadership support. Others MI was also related to prior adversity, nurse role, COVID-19 health worry, and COVID-19 diagnosis. Predictors of burnout included Self MI, depression symptoms, COVID-19 work impact, and leadership support. Hospital administrators/supervisors should recognize the importance of supporting the HCPs they supervise, particularly those at greatest risk of MI and burnout.

Autonomic Symptoms in Older Adults Are Common and Associated With Health-Related Quality of Life

Background: Autonomic symptoms are common in older adults, and a large body of literature focusing on age-related diseases shows that autonomic symptoms in these diseases constrain Health-Related Quality of Life (HRQoL). To our best knowledge, the association between autonomic symptoms in older adults, independent of specific diseases, and HRQoL has not yet been assessed. Aim: To assess the frequency and the effect of autonomic symptoms in general, as well as orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, bladder, and pupillomotor symptoms, on HRQoL in older adults. Methods: Cross-sectional data of the fourth visit of the Tübinger evaluation of Risk factors for Early detection of Neurodegeneration (TREND) study were included. Autonomic symptoms, as assessed with the Composite Autonomic Symptom Score 31 (COMPASS 31), were quantified and compared with HRQoL, as assessed with the EuroQol five-level version (EQ-5D-5L). Statistical analyses included Spearman's rank correlation and multiple linear regression analysis. Results: The analysis included 928 participants with a median of 68 years; 47% were women. Of those, 85% reported at least one autonomic symptom. Gastrointestinal and secretomotor symptoms were most common. The COMPASS 31 total score and all subdomains were significantly associated with reduced HRQoL. Among the subdomains, the strongest correlations with HRQoL were found for gastrointestinal and bladder symptoms. Overall, autonomic symptoms alone explained 20% of the variance of HRQoL; when depressive mood was added, the model explained 32%. Conclusion: Autonomic symptoms are associated with HRQoL and depressive symptoms in older adults.

Autonomic vulnerability to biased perception of social inclusion in borderline personality disorder

BACKGROUND

Individuals with Borderline Personality Disorder (BPD) feel rejected even when socially included. The pathophysiological mechanisms of this rejection bias are still unknown. Using the Cyberball paradigm, we investigated whether patients with BPD, display altered physiological responses to social inclusion and ostracism, as assessed by changes in Respiratory Sinus Arrhythmia (RSA).

METHODS

The sample comprised 30 patients with BPD, 30 with remitted Major Depressive Disorder (rMDD) and 30 Healthy Controls (HC). Self-report ratings of threats toward one's fundamental need to belong and RSA reactivity were measured immediately after each Cyberball condition.

RESULTS

Participants with BPD showed lower RSA at rest than HC. Only patients with BPD, reported higher threats to fundamental needs and exhibited a further decline in RSA after the Inclusion condition.

CONCLUSIONS

Individuals with BPD experience a biased appraisal of social inclusion both at the subjective and physiological level, showing higher feelings of ostracism and a breakdown of autonomic regulation to including social scenarios.

Presence of Three-Dimensional Sound Field Facilitates Listeners' Mood, Felt Emotion, and Respiration Rate When Listening to Music

Many studies have investigated the effects of music listening from the viewpoint of music features such as tempo or key by measuring psychological or psychophysiological responses. In addition, technologies for three-dimensional sound field (3D-SF) reproduction and binaural recording have been developed to induce a realistic sensation of sound. However, it is still unclear whether music listened to in the presence of 3D-SF is more impressive than in the absence of it. We hypothesized that the presence of a 3D-SF when listening to music facilitates listeners' moods, emotions for music, and physiological activities such as respiration rate. Here, we examined this hypothesis by evaluating differences between a reproduction condition with headphones (HD condition) and one with a 3D-SF reproduction system (3D-SF condition). We used a 3D-SF reproduction system based on the boundary surface control principle (BoSC system) to reproduce a sound field of music in the 3D-SF condition. Music in the 3D-SF condition was binaurally recorded through a dummy head in the BoSC reproduction room and reproduced with headphones in the HD condition. Therefore, music in the HD condition was auditorily as rich in information as that in the 3D-SF condition, but the 3D-sound field surrounding listeners was absent. We measured the respiration rate and heart rate of participants listening to acousmonium and pipe organ music. The participants rated their felt moods before and after they listened to music, and after they listened, they also rated their felt emotion. We found that the increase in respiration rate, the degree of decrease in well-being, and unpleasantness for both pieces in the 3D-SF condition were greater than in the HD condition. These results suggest that the presence of 3D-SF enhances changes in mood, felt emotion for music, and respiration rate when listening to music.

The Brainstem-Informed Autism Framework: Early Life Neurobehavioral Markers

Autism spectrum disorders (ASD) have long-term implications on functioning at multiple levels. In this perspective, we offer a brainstem-informed autism framework (BIAF) that traces the protracted neurobehavioral manifestations of ASD to early life brainstem dysfunctions. Early life brainstem-mediated markers involving functions of autonomic/arousal regulation, sleep-wake homeostasis, and sensorimotor integration are delineated. Their possible contributions to the early identification of susceptible infants are discussed. We suggest that the BIAF expands our multidimensional understanding of ASD by focusing on the early involvement of brainstem systems. Importantly, we propose an integrated BIAF screener that brings about the prospect of a sensitive and reliable early life diagnostic scheme for weighing the risk for ASD. The BIAF screener could provide clinicians substantial gains in the future and may carve customized interventions long before the current DSM ASD phenotype is manifested using dyadic co-regulation of brainstem-informed autism markers.

Caregiver and Young Child Biological Attunement In Distress Contexts: A Systematic Review and Narrative Synthesis

The objective of the current study was to systematically review the literature on caregiver-child biological attunement within distress contexts during the first three years of life. A total of 9932 unique abstracts were identified through Medline, Embase, PsycINFO, CINAHL, and Scopus databases. Thirty-six studies provided data from caregivers and their infants or toddlers within a distress paradigm, used biological indicators of distress, and assessed the relations between caregiver and child biological indicators. Findings were synthesized based on biological indicators, type of analysis, and measurement epochs pre- and post-distress. Most articles examined cortisol. Associations between caregiver and child cortisol indicators were moderate to large, though findings varied depending on the analysis used and measurement epochs examined. Many of the findings examining relations between mother and child cardiac, sAA, and EEG indicators were weak or inconsistent, likely due to the limitations of methodological approaches used to capture the complexity of the caregiver-child attunement process. Gaps in the literature and suggestions for future research are discussed.

A Pilot Study of a Parent Emotion Socialization Intervention: Impact on Parent Behavior, Child Self-Regulation, and Adjustment

Adequate emotion regulation in children is crucial for healthy development and is influenced by parent emotion socialization. The current pilot study aimed to test, for the first time in a Scandinavian population, whether an emotion-focused intervention, Tuning in to Kids (TIK), had positive effects on parent emotion-related socialization behaviors (ERSBs), and children's self-regulation, anxiety, and externalizing behavior problems. We conducted a controlled trial of the 6-week evidence-based TIK parenting program with 20 parents of preschool children aged 5–6 years and 19 wait-list controls. Assessments at baseline and 6 months after the intervention included parent-report questionnaires on parent ERSBs and child adjustment, as well as aspects of children's self-regulation assessed with two behavioral tasks, the Emotional Go/No-Go task (EGNG) and the AX-Continuous Performance Task (AX-CPT). Results showed a significant increase in reported parent emotion coaching behavior and an uncorrected significant decrease in parents' report of child externalizing problems in intervention participants compared to controls. The behavioral data showed an uncorrected significant improvement in child emotion discrimination in the control condition compared to the intervention condition, while measures of children's executive control improved from baseline to follow-up for both conditions but were not significantly different between conditions. These findings suggest that this emotion-focused parenting intervention contributed to improvement in parents' emotion coaching and their appraisal of child externalizing problems, while children's self-regulation showed mainly normative developmental improvements. Further research with a larger sample will be the next step to determine if these pilot findings are seen in an adequately powered study.

Reconceptualizing non-pharmacologic approaches to Neonatal Abstinence Syndrome (NAS) and Neonatal Opioid Withdrawal Syndrome (NOWS): A theoretical and evidence-based approach. Part II: The clinical application of nonpharmacologic care for NAS/NOWS

There has been increasing emphasis on the importance of the development of self-regulatory capacities of the individual as the cornerstone of development. The caregivers' abilities to manage their own attention, emotions, physiology and behaviors influence the development of the child's self-regulatory and interactive capacities, and thereby their overall development. Newborns prenatally exposed to psychoactive substances and/or to other prenatal stressors such as maternal poor nutrition, increased maternal stress, trauma, difficult and/or impoverished environments, in tandem with genetic predispositions, can result in alterations to their neurodevelopment that predispose them to self-regulatory problems that can be expressed at any stage of life. The care of infants with Neonatal Abstinence Syndrome (NAS)/Neonatal Opioid Withdrawal Syndrome (NOWS) and their mother/caregiver is a window of opportunity to assess the regulatory and co-regulatory capacities of both, and to provide holistic interventions with the goal of empowering the mother/caregiver in their own self-knowledge/self-regulation capacities and their crucial role in promoting the healthy development of their children. Non-pharmacologic care for the infant with NAS/NOWS is the first line of treatment and of paramount importance. Yet, current approaches are based on a limited scope of infant functioning, and the scoring systems in current use do not result in individualized and specific non-pharmacologic care of the infant, which can result in excessive or insufficient medication and a lack of caregiver appreciation for the infant's strengths, difficulties and early development. The interventions described here are based on the infant's signs of dysregulation in four neurobehavioral subsystems that can be dysregulated by NAS/NOWS, the infant's adaptive or maladaptive responses to return to a regulated functioning, and the co-regulatory behaviors of the infant and the mother/caregiver. In Part I of this two-part series on re-conceptualizing non-pharmacologic care for NAS/NOWS we laid the foundation for a new treatment approach, one grounded in developmental theory and evidence-based observations of infant and interpersonal neurobiology. Here, in Part II, we outline actionable, individually tailored evaluations and approaches to non-pharmacologic NAS/NOWS treatment based on strategies to support the regulatory capacities and development of 4 key domains: 1) autonomic; 2) motor/tone; 3) sleep/awake state control; and 4) sensory modulation subsystems.

Infant physiological activity and the early emergence of social communication

Early in life, social engagement is facilitated by effective regulation during times of rest and stress. Physiological regulation during social play and in response to sudden environmental changes or social stressors may play an important role in sustaining social engagement in infancy and facilitate the acquisition of early social-communication skills. The aim of this study was to investigate the role of physiological activity during social play, including respiratory sinus arrhythsmia (RSA) and heart rate-defined attention, in the early emergence of social-communication skills. Using RSA as an index of vagal tone, we measured vagal tone, vagal suppression, and heart rate-defined sustained attention during a social interaction with a caregiver (i.e., the Still-Face procedure) in 21 infants aged 3-4 months. At 9 months, caregivers reported on their infant's early social-communication skills. Results suggest that RSA, RSA suppression, and heart rate-defined sustained attention to a caregiver are significantly associated with early-emerging social-communication skills at 9 months. In addition, RSA and heart rate-defined sustained attention during social play were highly related. Suppression of RSA during the Still-Face phase of the infant-caregiver interaction emerged as a particularly strong predictor of later-developing social-communication skills, including 9-month-olds' ability to use eye gaze, facial expression, and gestures to communicate.

High-Frequency Heart Rate Variability and Emotion-Driven Impulse Control Difficulties During Adolescence: Examining Experienced and Expressed Negative Emotion as Moderators

Emotion-driven impulse control difficulties are associated with negative psychological outcomes. Extant research suggests that high frequency heart rate variability (HF-HRV) may be indicative of emotion-driven impulse control difficulties and potentially moderated by negative emotion. In the current study, 248 eleven- to 14-year-olds and their parent engaged in a negatively emotionally arousing conflict task at Time 1. Adolescents' HF-HRV and negative emotional expression and experience were assessed before, during, and/or after the task. Adolescents reported on their levels of emotion-driven impulse control difficulties at Time 1 and one year later. Results revealed that higher levels of HF-HRV reactivity (i.e., higher HF-HRV augmentation) predicted higher levels of emotion-driven impulse control difficulties one year later among adolescents who experienced higher negative emotion. These findings suggest that negative emotional context should be considered when examining HF-HRV reactivity as a risk factor for emotion-driven impulse control difficulties and associated outcomes.

Deep Breathing Increases Heart Rate Variability in Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus

BACKGROUND/OBJECTIVE

Autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have been associated with an impaired function of the autonomic nervous system and reduced vagus nerve (VN) tone measured through lower heart rate variability (HRV). Targeting the VN through electrical stimulation has been proposed as a treatment strategy with promising results in patients with RA. Moreover, it has been suggested that the VN can be stimulated physiologically through deep breathing. In this study, the aim was to investigate if the VN can be stimulated through deep breathing in patients with RA and SLE, as measured by HRV.

METHODS

Fifty-seven patients with RA and SLE performed deep breathing exercises for 30 minutes in this explorative study. Before the breathing exercise, 2 electrocardiogram recordings were obtained to determine the patient's baseline HRV during rest. After the 30-minute breathing exercise, 5 minutes of electrocardiogram recordings were obtained to determine postintervention HRV and used as a measure of vagal activity.

RESULTS

No change was observed in the HRV between the 2 recordings prior the exercise, but the heart rate and HRV significantly decreased and increased, respectively, after the deep breathing exercise.

CONCLUSIONS

HRV can be modulated in patients with RA and SLE; this may have implications for future treatment with medications in conjunction with deep breathing. However, the biological and clinical effect of deep breathing must be investigated in future studies.

Can binaural beats facilitate autonomic recovery following exposure to an acute stressor?

BACKGROUND AND PURPOSE

Binaural beats are seen as a new type of 'digital-drug'. The aim of this study was to determine if binaural beats could facilitate physiological recovery from a mental stressor.

MATERIALS AND METHODS

92 adults were exposed five times each to a 2-min mental stressor and a subsequent 4-min rest period containing silence or 1-of-4 examples of binaural beats (2, 5, 10, and 24 Hz). Physiological recovery across the five rest periods, as measured using skin conductance, heart rate, and breathing, were compared using one-way analysis of variance.

RESULTS

Binaural beats were linked to enhanced physiological recovery relative to silence. However, the expected pattern of results whereby lower frequency binaural beats would be associated with greater physiological recovery, was not observed.

CONCLUSION

Our findings do not support a relationship between binaural beats and systematic changes in emotional states as measured physiologically. On the basis of our results the acute administration of binaural beats in primary care to lower sympathetic arousal cannot yet be considered an evidence-based practice.

Autonomic responses to facial expression tasks in children with autism spectrum disorders: Cross-section study

BACKGROUND

The autonomic nervous system has an influence on emotions and behavior modulation, however, the relationship between autonomic modulation impairment and the autism spectrum disorder (ASD) is yet to be fully described.

AIMS

To evaluate the autonomic responses of children with and without ASD through the non-linear, and linear heart rate variability (HRV) measures, and assess the correlation between these responses, the severity and behavioral symptoms of autism.

METHODS AND PROCEDURES

27 children diagnosed with ASD (EG = experimental group) and 28 matching controls (CG = control group) were evaluated. The HRV was evaluated in 15 min sections at the following moments: I) Resting condition; II) During facial expression tasks; and III) Recovery. The severity and behavioral symptoms of autism were evaluated by the Childhood Autism Rating Scale (CARS) and Autistic Behaviors Checklist (ABC) scales.

OUTCOMES AND RESULTS

The facial expression tasks influenced the activity of the autonomic nervous system in both groups, however the EG experienced more autonomic changes. These changes were mostly evidenced by the non-linear indices. Also, the CARS and ABC scales showed significant correlations with HRV indices.

CONCLUSIONS AND IMPLICATIONS

Children with ASD presented an autonomic modulation impairment, mostly identified by the non-linear indices of HRV. Also, this autonomic impairment is associated with the severity and behavioral symptoms of autism.

High vagal tone and rapid extinction learning as potential transdiagnostic protective factors following childhood violence exposure

Childhood exposure to violence is strongly associated with psychopathology. High resting respiratory sinus arrhythmia (RSA) is associated with lower levels of psychopathology in children exposed to violence. High RSA may help to protect against psychopathology by facilitating fear extinction learning, allowing more flexible autonomic responses to learned threat and safety cues. In this study, 165 youth (79 female, aged 9-17; 86 exposed to violence) completed assessments of violence exposure, RSA, and psychopathology, and a fear extinction learning task; 134 participants returned and completed psychopathology assessments 2 years later. Resting RSA moderated the longitudinal association of violence exposure with post-traumatic stress disorder (PTSD) symptoms and externalizing psychopathology, such that the association was weaker among youths with higher RSA. Higher skin conductance responses (SCR) during extinction learning to the threat cue (CS+) was associated with higher internalizing symptoms at follow-up and greater SCR to the safety cue (CS-) was associated with higher PTSD, internalizing, and externalizing symptoms, as well as the p-factor, controlling for baseline symptoms. Findings suggest that higher RSA may protect against emergence of psychopathology among children exposed to violence. Moreover, difficulty extinguishing learned threat responses and elevated autonomic responses to safety cues may be associated with risk for future psychopathology.

A Systematic Review of Somatic Symptoms in School Refusal

OBJECTIVE

School refusers often display somatic symptoms that are temporally related to school attendance. The aim of this systematic review is to summarize characteristics and causes of somatic symptoms and their management in the context of school refusal. Findings of this review may help clinicians in their daily practice.

METHODS

PubMed and PsycINFO databases were systematically searched (according to PRISMA guidelines) for articles mentioning somatic symptoms in school refusal by May 2020. Among 1025 identified studies, 148 were included.

RESULTS

Unspecific somatic symptoms were frequently the first complaints in school refusal. Abdominal pain, headache, nausea, vomiting, muscular or joint ache, diarrhea, dizziness, fatigue, and palpitation were the most commonly encountered symptoms and were usually not accounted for by an identifiable physical disease. Anxiety was the most recurrent etiology found, but physicians' lack of awareness about psychological comorbidities often delayed psychological/psychiatric referral. Successful therapies consisted of dialectical behavior therapy, anxiety management through relaxation/breathing training, and ignoring the somatic symptoms.

CONCLUSIONS

Somatic symptoms in school refusal are frequent but poorly understood. Their management could include interventions targeting anxiety, psychotherapies such as emotional awareness and expression therapy, third-wave behavioral therapies, and psychoeducation. A multidisciplinary approach through strengthened collaboration between school staff, physicians, and psychologists/psychiatrists is needed to improve well-being in children who experience somatic symptoms as related to school avoidance.

Is Low Heart Rate Variability Associated with Emotional Dysregulation, Psychopathological Dimensions, and Prefrontal Dysfunctions? An Integrative View

Several studies have suggested a correlation between heart rate variability (HRV), emotion regulation (ER), psychopathological conditions, and cognitive functions in the past two decades. Specifically, recent data seem to support the hypothesis that low-frequency heart rate variability (LF-HRV), an index of sympathetic cardiac control, correlates with worse executive performances, worse ER, and specific psychopathological dimensions. The present work aims to review the previous findings on these topics and integrate them from two main cornerstones of this perspective: Porges' Polyvagal Theory and Thayer and Lane's Neurovisceral Integration Model, which are necessary to understand these associations better. For this reason, based on these two approaches, we point out that low HRV is associated with emotional dysregulation, worse cognitive performance, and transversal psychopathological conditions. We report studies that underline the importance of considering the heart-brain relation in order to shed light on the necessity to implement psychophysiology into a broader perspective on emotions, mental health, and good cognitive functioning. This integration is beneficial not only as a theoretical ground from which to start for further research studies but as a starting point for new theoretical perspectives useful in clinical practice.

Reconceptualizing non-pharmacologic approaches to Neonatal Abstinence Syndrome (NAS) and Neonatal Opioid Withdrawal Syndrome (NOWS): A theoretical and evidence-based approach

Discussions about non-pharmacologic interventions for Neonatal Abstinence Syndrome and Neonatal Opioid Withdrawal Syndrome (NAS/NOWS) have been minor compared with wider attention to pharmacologic treatments. Although historically under-recognized, non-pharmacologic interventions are of paramount importance for all substance-exposed infants and remain as a first line therapy for the care of infants affected by NAS. Here we examine the role of non-pharmacologic interventions for NAS/NOWS by incorporating theoretical perspectives from different disciplines that inform the importance of individualized assessment of the mother-caregiver/infant dyad and interventions that involve both individuals. NAS/NOWS is a complex, highly individualized constellation of signs/symptoms that vary widely in onset, duration, severity, expression, responses to treatment and influence on long-term outcomes. NAS/NOWS often occurs in infants with multiple prenatal/postnatal factors that can compromise neurobiological self-regulatory functioning. We propose to rethink some of the long-held assumptions, beliefs, and paradigms about non-pharmacologic care of the infant with NAS/NOWS, which is provided as non-specific or as "bundled" in current approaches. This paper is Part I of a two-part series on re-conceptualizing non-pharmacologic care for NAS/NOWS as individualized treatment of the dyad. Here, we set the foundation for a new treatment approach grounded in developmental theory and evidence-based observations of infant neurobiology and neurodevelopment. In Part II, we provide actionable, individually tailored evaluations and approaches to non-pharmacologic NAS/NOWS treatment based on measurable domains of infant neurobehavioral functioning.

Differences in affect integration in children with and without internalizing difficulties

Background:

Affect represents an important source of information about our internal state and the external world that can motivate and vitalize us. When affect is poorly integrated, this can lead to problems with self-regulation and psychopathology. Few studies have investigated affect integration in children.

Objective:

This study investigates differences in affect integration in children with and without internalizing difficulties.

Method:

Thirty-three Norwegian children (aged 9–13) with and 24 children without internalizing difficulties were interviewed with the Affect Consciousness Interview (ACI), a measure of affect integration. Data from the ACI was analyzed across nine affective categories (Interest/Excitement, Enjoyment/Joy, Fear/Panic, Anger/Rage, Shame/Humiliation, Sadness/Despair, Envy/Jealousy, Guilt/Remorse, and Tenderness/Care), and four dimensions (Awareness, Tolerance, Emotional, and Conceptual expressivity).

Results:

The children differed significantly in affect integration across all dimensions and all assessed affects, both positive and negative. Emotional Expressivity, Anger/Rage, and Sadness/Despair were particularly less integrated in the children with internalizing problems.

Conclusions:

Assessment of affect integration can provide useful information on possible underlying factors in internalizing problems in children and may help guide and personalize therapeutic interventions. Based on knowledge from empirical infant psychology interventions mimicking rich, early intersubjective experiences are recommended to increase affect integration.

Polyvagal Theory: A biobehavioral journey to sociality

A polyvagal perspective clarifies the neurobiological and biobehavioral shifts that occurred during evolutionary transition from asocial reptiles to social mammals. This transition enabled mammals, unlike their reptilian ancestors, to derive a biological benefit from social interactions. This innovation enabled social behavior to function as a neuromodulator that could efficiently regulate and optimize autonomic function to support homeostatic processes. This journey is highlighted by the phylogenetic transition during which the autonomic nervous system was repurposed to suppress defensive strategies to support and express sociality. The product of this transition was an autonomic nervous system with capacities to self-calm, to spontaneous socially engage others, and to mitigate threat reactions in ourselves and others through social cues. Thus, social behavior became embedded with specific neurobiological processes that had capabilities to support homeostatic functions leading to optimized health, growth, and restoration. Polyvagal Theory emphasizes sociality as the core process in mitigating threat reactions and supporting mental and physical health.

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Sociality in mammals co-evolved with a repurposed autonomic nervous system.

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Evolution repurposed the mammalian ventral vagal complex in the brainstem to support sociality.

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Social behavior functions as a neuromodulator optimizing behavioral, autonomic, and emotional state regulation.

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Neuroception reflexively detects risk or safety without awareness and shifts autonomic state to support adaptive behaviors.

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Unlike their reptilian ancestors, mammals have a neuroception to safety that fosters sociality by calming autonomic state.

Applying Heart Rate Variability to Monitor Health and Performance in Tactical Personnel: A Narrative Review

Human performance optimization of tactical personnel requires accurate, meticulous, and effective monitoring of biological adaptations and systemic recovery. Due to an increased understanding of its importance and the commercial availability of assessment tools, the use of heart rate variability (HRV) to address this need is becoming more common in the tactical community. Measuring HRV is a non-invasive, practical method for objectively assessing a performer's readiness, workload, and recovery status; when combined with additional data sources and practitioner input, it provides an affordable and scalable solution for gaining actionable information to support the facilitation and maintenance of operational performance. This narrative review discusses the non-clinical use of HRV for assessing, monitoring, and interpreting autonomic nervous system resource availability, modulation, effectiveness, and efficiency in tactical populations. Broadly, HRV metrics represent a complex series of interactions resulting from internal and external stimuli; therefore, a general overview of HRV applications in tactical personnel is discussed, including the influence of occupational specific demands, interactions between cognitive and physical domains, and recommendations on implementing HRV for training and recovery insights into critical health and performance outcomes.

Pre-pandemic autonomic nervous system activity predicts mood regulation expectancies during COVID-19 in Israel

Despite the unfolding impact of the COVID‐19 pandemic on psychological well‐being, there is a lack of prospective studies that target physiological markers of distress. There is a need to examine physiological predictors from the pre‐pandemic period to identify and treat individuals at‐risk. In this study, our aim was to use pre‐pandemic markers of autonomic nervous system (ANS) parasympathetic and sympathetic regulation to predict individuals' psychological well‐being during the crisis. We also assessed the role of mood regulation expectancies as a mediator of the association between pre‐pandemic physiological measures and COVID‐related well‐being. In May to June 2020, 185 Israeli adults completed online questionnaires assessing their mood regulation expectancies since COVID‐19 began, and their current well‐being. These individuals had participated in lab studies 1.5–3 years prior to this assessment, where their physiological measures were taken, including respiratory sinus arrhythmia (RSA) and skin conductance level (SCL). RSA was positively related to mood regulation expectancies during COVID‐19 (b = 3.46, 95% CI [0.84, 6.05]). Mood regulation expectancies, in turn, positively predicted well‐being during the crisis (b = 0.021, 95% CI [0.016, 0.027]). The mediation was significant and moderated by SCL (index = −0.09, 95% CI [−0.02, −0.0001]), such that it was strongest for individuals with low SCL. We point to pre‐pandemic physiological mechanisms underlying individuals' mental well‐being during the COVID‐19 pandemic. These findings have theoretical, diagnostic, and clinical implications that may refine our understanding of the physiological basis of resilience to the COVID‐19 pandemic and thus may be implemented to identify and assist individuals in these times.

Our study offers a unique psychophysiological approach to predicting mood regulation and mental well‐being during COVID‐19 from pre‐pandemic resting physiological activity. We show that pre‐pandemic markers of the autonomic nervous system, which were collected during routine 2–3 years prior to the pandemic, allow us to prospectively understand emotion regulation and well‐being during COVID‐19.

Paternal biopsychosocial resilience in triadic interactions among African American/Black families exposed to trauma and socioeconomic adversity

Fathers have a distinct and unique effect on child development, but little is known about fathering beyond White or majority White families. The current study includes African American/Black biological fathers (N = 88) and their two-year-old children. Fathers reported low incomes and high rates of depression and posttraumatic stress disorder (PTSD). Parenting behaviors were observed in high-stress and low-stress triadic contexts. In the high-stress condition, we assessed paternal responses to children's bids after the family was reunited following a separation paradigm. In the low-stress condition, we assessed parenting behaviors during a teaching task. Fathers' social baseline respiratory sinus arrhythmia (RSA) was obtained as an index of parasympathetic arousal. RSA moderated the association between PTSD and fathers' responsiveness (F = 6.90, p = .00, R²  = .30), with no association between PTSD and responsiveness demonstrated among fathers with the highest levels of RSA relative to the sample (effect = .04, p = .00; CI [0.02, 0.06]). RSA did not moderate the association between paternal depression and parenting behaviors (p > .05). Furthermore, responsiveness was only significantly associated with low-stress paternal teaching behaviors for fathers with lower RSA (F = 4.34, p = .01, R²  = .21; effect = -.19, p = .00; CI [0.06, 0.32]). Findings demonstrate significant relationships among RSA, PTSD, and parenting for African American/Black men in contexts of economic adversity.

Increased Vocalization of Rats in Response to Ultrasonic Playback as a Sign of Hypervigilance Following Fear Conditioning

We investigated the effects of prior stress on rats' responses to 50-kHz (appetitive) and 22-kHz (aversive) ultrasonic playback. Rats were treated with 0, 1, 6 or 10 shocks (1 s, 1.0 mA each) and were exposed to playbacks the following day. Previous findings were confirmed: (i) rats moved faster during 50-kHz playback and slowed down after 22-kHz playback; (ii) they all approached the speaker, which was more pronounced during and following 50-kHz playback than 22-kHz playback; (iii) 50-kHz playback caused heart rate (HR) increase; 22-kHz playback caused HR decrease; (iv) the rats vocalized more often during and following 50-kHz playback than 22-kHz playback. The previous shock affected the rats such that singly-shocked rats showed lower HR throughout the experiment and a smaller HR response to 50-kHz playback compared to controls and other shocked groups. Interestingly, all pre-shocked rats showed higher locomotor activity during 50-kHz playback and a more significant decrease in activity following 22-kHz playback; they vocalized more often, their ultrasonic vocalizations (USV) were longer and at a higher frequency than those of the control animals. These last two observations could point to hypervigilance, a symptom of post-traumatic stress disorder (PTSD) in human patients. Increased vocalization may be a valuable measure of hypervigilance used for PTSD modeling.

Recognizing emotions in bodies: Vagus nerve stimulation enhances recognition of anger while impairing sadness

According to the Polyvagal theory, the vagus nerve is the key phylogenetic substrate that supports efficient emotion recognition for promoting safety and survival. Previous studies showed that the vagus nerve affects people's ability to recognize emotions based on eye regions and whole facial images, but not static bodies. The purpose of this study was to verify whether the previously suggested causal link between vagal activity and emotion recognition can be generalized to situations in which emotions must be inferred from images of whole moving bodies. We employed transcutaneous vagus nerve stimulation (tVNS), a noninvasive brain stimulation technique that stimulates the vagus nerve by a mild electrical stimulation to the auricular branch of the vagus, located in the anterior protuberance of the outer ear. In two sessions, participants received active or sham tVNS before and while performing three emotion recognition tasks, aimed at indexing their ability to recognize emotions from static or moving bodily expressions by actors. Active tVNS, compared to sham stimulation, enhanced the recognition of anger but reduced the ability to recognize sadness, regardless of the type of stimulus (static vs. moving). Convergent with the idea of hierarchical involvement of the vagus in establishing safety, as put forward by the Polyvagal theory, we argue that our findings may be explained by vagus-evoked differential adjustment strategies to emotional expressions. Taken together, our findings fit with an evolutionary perspective on the vagus nerve and its involvement in emotion recognition for the benefit of survival.

Childhood abuse and social anxiety symptoms among young adults: Moderating role of respiratory sinus arrhythmia suppression to social stress

BACKGROUND

Childhood abuse (CA) has been considered as an environmental risk factor for the development of social anxiety symptoms. Respiratory sinus arrhythmia (RSA) is a biomarker that has been found to interact with environmental stressors to affect psychopathological symptoms. However, little is known whether RSA moderates the relationship between CA and social anxiety symptoms.

OBJECTIVE

The current study aimed to examine the relationships between CA and two forms of social anxiety symptoms including social performance anxiety symptoms (SPAS) and social interaction anxiety symptoms (SIAS), and the moderating role of baseline RSA and/or RSA suppression to a social-evaluative stress in these links.

PARTICIPANTS AND SETTING

A total of 157 Chinese undergraduate students (Mage = 18.96, SD = 0.85, 85 % females) participated in this study.

METHOD

Participants completed the short form of Childhood Trauma Questionnaire, Social Phobia Scale and Social Interaction Anxiety Scale to assess CA, SPAS and SIAS, and then underwent a social stress protocol (a public speech task) during which their baseline RSA and stress induced RSA were obtained.

RESULTS

CA was positively correlated with SPAS but was not correlated with SIAS. RSA suppression to social stress moderated the associations between CA and two forms of social anxiety symptoms, such that CA was positively associated with SPAS and SIAS among individuals with blunted RSA suppression, but not among those with greater RSA suppression.

CONCLUSIONS

Greater social stress RSA suppression as a better physiological regulation marker might ameliorate the negative effect of CA on social anxiety symptoms.

Allostatic load and mental health: a latent class analysis of physiological dysregulation

This study explored the associations between specific profiles of biological dysregulation and mental health outcomes in a national, community sample of healthy adults in the United States. A latent class analysis of data from the Midlife Development in the United States study (n = 1,757) was conducted to determine classes of biological dysregulation. Multinomial logistic regressions of class membership were employed to determine associations with measures related to depression, including whether or not individuals had sought treatment, Center for Epidemiological Studies Depression Scale, and both the generalized distress and anhedonia subscales of the Mood and Anxiety Symptoms Questionnaire. Four classes of dysregulation emerged: baseline/low dysregulation, metabolic and inflammatory dysregulation, parasympathetic dysregulation, and SAM pathway dysregulation. Individuals who met the criteria for depression measures were more likely to be in the metabolic and immune dysregulation and parasympathetic dysregulation groups as compared to the baseline group. The results suggest that mental health outcomes, such as depression, are differentially associated with specific profiles of biological dysregulation. A more nuanced approach to profiles of dysregulation could better inform treatment decisions.Lay summaryHigher levels of allostatic load, which represents the cumulative wear and tear of exposure to stress, are associated with increased rates of depression and anhedonia. Specifically, parasympathetic dysregulation and immunometabolic dysregulation are associated with negative mental health outcomes.

Adult ADHD and romantic relationships: What we know and what we can do to help

It has been widely maintained that enduring and healthy romantic relationships are critical to quality of life in adulthood, and can buffer the impact of adversity, including psychological disorder. Unfortunately, much research points toward adults with attention-deficit hyperactivity disorder (ADHD) having short-lived and discordant romantic relationships. Despite this ample evidence, relatively little research has focused on identifying specific factors that may strengthen or explain their relational difficulties, which would have obvious relationship distress prevention and intervention implications. The current study reviews the state of the literature on romantic relationships in adults with ADHD, including differences that have been established between ADHD and non-ADHD populations as well as distal and proximal factors that appear to increase risk of relationship distress of adults with ADHD. Finally, notable gaps in the literature are identified and implications are raised with regards to prevention and intervention efforts designed to address functional impairment in adults with ADHD.