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Wiltshire CN, Kouri N, Wanna CP, Minton ST, France JM, Reda MH, Davie W, Basarkod S, Winters S, Hinrichs R, Stenson AF, Jovanovic T. Resting heart rate associations with violence exposure and posttraumatic stress symptoms: sex differences in children. Biol Sex Differ 2024; 15:28. [PMID: 38549155 PMCID: PMC10976797 DOI: 10.1186/s13293-024-00606-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/18/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Traumatic events experienced in childhood can lead to increased risk of cardiovascular disorders in adulthood. Black Americans are disproportionately affected, as they are at increased risk for experiencing childhood trauma and cardiovascular diseases in adulthood. One of the hypothesized mechanisms of this association is through long-lasting dysregulation of the autonomic nervous system, a hallmark physiological biomarker of posttraumatic stress disorder (PTSD), which is twice as prevalent in women compared to men. METHODS Ninety-one, majority Black American children, aged 9 were recruited to be a part of our longitudinal study of child development at research centers in Atlanta, GA and Detroit, MI. Resting HR was measured through a electrocardiogram (ECG) recording using the Biopac MP150. Self-report measures of violence exposure and PTSD symptoms were administered by research staff. RESULTS Children with more violence exposure reported increased PTSS as well as lower resting HR. Regression analysis showed evidence of sex modifying this relationship, (B = -0.64, p < 0.05), such that the association between resting HR and PTSS was stronger in girls than in boys. In our exploratory analysis with standard clinical cutoffs of resting HR, the normative HR group was found to significantly moderate the relationship between violence exposure and PTSS in boys, (B = -2.14, p < 0.01), but not girls (B = -0.94, p = 0.27). CONCLUSION In our sample of primarily Black urban children, we found that violence exposure was associated with slower, more adult-like HR, that girls showed greater PTSS associated with slower HR while boys did not, and that girls with lower than normative HR showed significantly higher PTSS compared to girls with normative HR. Our sample's demonstration of psychological consequences in addition to the physiological implications could provide new information about a psychobiological sequelae of violence exposure.
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Affiliation(s)
- Charis N Wiltshire
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US.
- Department of Psychiatry, Emory University School of Medicine, 69 Jesse Hill Jr Dr. SE, 30303, Atlanta, GA, US.
| | - Nicole Kouri
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - Cassandra P Wanna
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - Sean T Minton
- Department of Psychiatry, Emory University School of Medicine, 69 Jesse Hill Jr Dr. SE, 30303, Atlanta, GA, US
| | - John M France
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - Mariam H Reda
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - William Davie
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - Sattvik Basarkod
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - Sterling Winters
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - Rebecca Hinrichs
- Department of Psychiatry, Emory University School of Medicine, 69 Jesse Hill Jr Dr. SE, 30303, Atlanta, GA, US
| | - Anais F Stenson
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - Tanja Jovanovic
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
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Fort D, Deforges C, Messerli-Bürgy N, Michael T, Baud D, Lalor J, Rimmele U, Horsch A. Tackling childbirth-related intrusive memories with a single-session behavioural intervention involving a visuospatial task: protocol for a single-blind, waitlist-controlled randomised trial. BMJ Open 2023; 13:e073874. [PMID: 37247964 DOI: 10.1136/bmjopen-2023-073874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
INTRODUCTION Approximately 12.3% of mothers experience childbirth-related post-traumatic stress symptoms (CB-PTSS). However, evidence-based interventions to treat CB-PTSS are lacking. Intrusive memories (IM), a key CB-PTSS, are distressing and can trigger other PTSS by reliving the traumatic event. Emerging evidence shows that a behavioural intervention involving a visuospatial task (BI-VT) can reduce the number of IM and PTSS, supposedly by interfering with the reconsolidation of the trauma memory. This study aims to test the efficacy of a single-session BI-VT targeting IM to reduce the number of childbirth-related (CB-)IM and PTSS, in comparison to a waitlist control group (WCG). METHODS AND ANALYSIS In this multicentre, single-blind, randomised controlled trial being undertaken at one regional and one university hospital in Switzerland, 60 participants will be allocated to the Immediate Intervention Group (IIG), receiving the immediate intervention on day 15, and 60 participants to the WCG receiving the delayed intervention on day 30. All participants will report their CB-IM during the 2 weeks preimmediate and postimmediate intervention in diaries. The IIG will additionally report their CB-IM over weeks 5 and 6 postimmediate intervention. Self-report questionnaires will assess CB-PTSS at 2 weeks preimmediate and postimmediate intervention in both groups, and at 6 weeks postimmediate intervention in the IIG. A feedback questionnaire will evaluate the intervention acceptability. The primary outcome will be group differences in the number of CB-IM between the 2 weeks preimmediate and postimmediate intervention. Secondary outcomes will be CB-PTSS at 2 and 6 weeks postimmediate intervention, the number of CB-IM at weeks 5 and 6 postimmediate intervention, and intervention acceptability. ETHICS AND DISSEMINATION Ethical approval was granted by the Human Research Ethics Committee of the Canton of Vaud (study number 202200652). Participants will provide an informed consent before study participation. Results will be presented in peer-reviewed journals and at conferences. TRIAL REGISTRATION NUMBER NCT05381155.
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Affiliation(s)
- Déborah Fort
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Camille Deforges
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Nadine Messerli-Bürgy
- Family and Development Research Center (FADO), Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland
| | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - David Baud
- Materno-Fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Joan Lalor
- School of Nursing and Midwifery, Trinity College Dublin, Dublin 2, Ireland
| | - Ulrike Rimmele
- Emotion and Memory Laboratory, Faculty of Education Sciences and Psychology, University of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences (CISA), University of Geneva, Geneva, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Neonatology Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Siciliano RE, Anderson AS, Compas BE. Autonomic nervous system correlates of posttraumatic stress symptoms in youth: Meta-analysis and qualitative review. Clin Psychol Rev 2022; 92:102125. [PMID: 35078039 PMCID: PMC8858870 DOI: 10.1016/j.cpr.2022.102125] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/25/2021] [Accepted: 01/09/2022] [Indexed: 11/17/2022]
Abstract
Physiological dysregulation is a key diagnostic criterion for posttraumatic stress disorder (PTSD). While PTSD is defined by trauma exposure, symptom presentations are varied. Similarly, findings of autonomic nervous system (ANS), including parasympathetic (PNS) and sympathetic nervous system (SNS), function in youth exposed to trauma are mixed (e.g., hyporeactivity and hyperreactivity). The present meta-analysis quantitatively assesses the relation between ANS measures broadly, and PNS- and SNS-specific measures, and posttraumatic stress symptoms (PTSS) in youth (ages 4.98 to 19.55 years) across 38 cross-sectional and longitudinal studies (N = 3488). Findings demonstrate that heightened ANS activity is related to increased PTSS during stress tasks (r = 0.07), while decreased SNS activity at rest corresponded to increased PTSS (r = -0.09). The correlation between PNS measures and PTSS was non-significant. The moderation effect of age on the relation between PNS activity measured during stress tasks and PTSS approached significance, such that younger children showed a stronger negative relation between symptoms and PNS activity compared to older youth. Qualitative review of included studies revealed significant variability across sample and stressor characteristics and study methodology. Findings indicate the importance of autonomic dysregulation in youth with PTSS. Additional considerations for future research are discussed.
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Affiliation(s)
- Rachel E. Siciliano
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Allegra S. Anderson
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Bruce E. Compas
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
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Abstract
The understanding that sports injury is the result of the interaction among many factors and that specific profiles could increase the risk of the occurrence of a given injury was a significant step in establishing programs for injury prevention. However, injury forecasting is far from being attained. To be able to estimate future states of a complex system (forecasting), it is necessary to understand its nature and comply with the methods usually used to analyze such a system. In this sense, sports injury forecasting must implement the concepts and tools used to study the behavior of self-organizing systems, since it is by self-organizing that systems (i.e., athletes) evolve and adapt (or not) to a constantly changing environment. Instead of concentrating on the identification of factors related to the injury occurrence (i.e., risk factors), a complex systems approach looks for the high-order variables (order parameters) that describe the macroscopic dynamic behavior of the athlete. The time evolution of this order parameter informs on the state of the athlete and may warn about upcoming events, such as injury. In this article, we describe the fundamental concepts related to complexity based on physical principles of self-organization and the consequence of accepting sports injury as a complex phenomenon. In the end, we will present the four steps necessary to formulate a synergetics approach based on self-organization and phase transition to sports injuries. Future studies based on this experimental paradigm may help sports professionals to forecast sports injuries occurrence.
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Khoury T, Ilan Y. Platform introducing individually tailored variability in nerve stimulations and dietary regimen to prevent weight regain following weight loss in patients with obesity. Obes Res Clin Pract 2021; 15:114-123. [PMID: 33653665 DOI: 10.1016/j.orcp.2021.02.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 02/09/2021] [Accepted: 02/13/2021] [Indexed: 02/07/2023]
Abstract
Prevention of weight regain following successful weight loss is a major challenge in the treatment of obesity, irrespective of the weight reduction method used. The majority of individuals regain the lost weight over time; thus, achieving long-term sustainability in weight loss remains an unresolved issue. A compensatory adaptation to the weight loss methods occurs in several body organs and partly explains the lack of sustainable effect. Variability is inherent in many biological systems, and patterns of variability constitute a body mechanism that is active at several levels, starting from the genes and cellular pathways through to the whole-organ level. This study aimed to describe a platform that introduces individually tailored variability in vagal nerve stimulation and dietary regimen to ensure prolonged and sustainable weight loss and prevent weight regain. The platform is intended to provide a method that can overcome the body's compensatory adaptation mechanisms while ensuring a prolonged beneficial effect.
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Affiliation(s)
- Tawfik Khoury
- Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel; Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Yaron Ilan
- Department of Medicine, Hebrew University-Hadassah Medical Center, PO Box 12000, IL-91120, Jerusalem, Israel.
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