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Garneau J, Savard J, Dang-Vu TT, Gouin JP. Predicting response to stepped-care cognitive behavioral therapy for insomnia using pre-treatment heart rate variability in cancer patients. Sleep Med 2024; 121:160-170. [PMID: 38991424 DOI: 10.1016/j.sleep.2024.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/04/2024] [Accepted: 06/21/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVE This study examined whether high frequency heart-rate variability (HF-HRV) and HF-HRV reactivity to worry moderate response to cognitive behavioural therapy for insomnia (CBT-I) within both a standard and stepped-care framework among cancer patients with comorbid insomnia. Biomarkers such as HF-HRV may predict response to CBT-I, a finding which could potentially inform patient allocation to different treatment intensities within a stepped-care framework. METHODS 177 participants (86.3 % female; Mage = 55.3, SD = 10.4) were randomized to receive either stepped-care or standard CBT-I. 145 participants had their HRV assessed at pre-treatment during a rest and worry period. Insomnia symptoms were assessed using the Insomnia Severity Index (ISI) and daily sleep diary across five timepoints from pre-treatment to a 12-month post-treatment follow-up. RESULTS Resting HF-HRV was significantly associated with pre-treatment sleep efficiency and sleep onset latency but not ISI score. However, resting HF-HRV did not predict overall changes in insomnia across treatment and follow-up. Similarly, resting HF-HRV did not differentially predict changes in sleep diary parameters across standard or stepped-care groups. HRV reactivity was not related to any of the assessed outcome measures in both cross-sectional and longitudinal analyses. CONCLUSION Although resting HF-HRV was related to initial daily sleep parameters, HF-HRV measures did not significantly predict longitudinal responses to CBT-I. These findings suggest that HF-HRV does not predict treatment responsiveness to CBT-I interventions of different intensity in cancer patients.
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Affiliation(s)
- James Garneau
- Department of Psychology, Concordia University, 7141 Sherbrooke St. W, Montréal, H4B 1R6, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), CIUSSS Centre-Sud-de-l'île-de-Montréal, 4565 Queen Mary Rd, Montréal, H3W 1W5, Canada.
| | - Josée Savard
- School of Psychology, Université Laval, 2325 Rue des Bibliothèques, Québec, G1V 0A6, Canada; CHU de Québec-Université Laval Research Center, 2705 Bd Laurier, Québec, G1V 4G2, Canada; Université Laval Cancer Research Center, 9 Rue McMahon, Québec, G1R 3S3, Canada.
| | - Thien Thanh Dang-Vu
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), CIUSSS Centre-Sud-de-l'île-de-Montréal, 4565 Queen Mary Rd, Montréal, H3W 1W5, Canada; Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke St. W, Montréal, H4B 1R6, Canada.
| | - Jean-Philippe Gouin
- Department of Psychology, Concordia University, 7141 Sherbrooke St. W, Montréal, H4B 1R6, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), CIUSSS Centre-Sud-de-l'île-de-Montréal, 4565 Queen Mary Rd, Montréal, H3W 1W5, Canada.
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Susman ES, Weisz JR, McLaughlin KA, Coulombe P, Evans SC, Thomassin K. Is respiratory sinus arrhythmia a modifiable index of symptom change in cognitive behavioral therapy for youth? A pooled-data analysis of a randomized trial. Psychother Res 2024:1-15. [PMID: 38285175 PMCID: PMC11284247 DOI: 10.1080/10503307.2024.2308149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 01/12/2024] [Indexed: 01/30/2024] Open
Abstract
OBJECTIVE We evaluated whether respiratory sinus arrhythmia (RSA) reactivity and resting RSA-physiological markers reflecting the increase in heart rate with inspiration and decrease during expiration related to parasympathetic influence on the heart-are modifiable and predict symptom change during youth psychotherapy. Methods: Diverse youth (N = 158; ages 7-15; 48.1% female) received the Modular Approach to Therapy for Children and completed pre-treatment (pre), post-treatment (post), and 18-months postbaseline (18Mo) assessments. We measured resting RSA, RSA reactivity during stress induction, and psychopathology symptoms. Results: Pre-to-post and pre-to-18Mo, reactivity decreased, and resting RSA increased. Changes in reactivity and resting RSA, separately, did not predict reduced psychopathology. Yet, decreased reactivity combined with increased resting RSA predicted reduced psychopathology over time, suggesting that observed RSA changes were beneficial for some. Higher dosage of a module utilizing slow-breathing, muscle-relaxation, and imagery predicted greater pre-to-18Mo changes in reactivity and resting RSA, whereas a similar module with less emphasis on slow-breathing did not. Conclusions: Findings raise the possibility that youth reactivity and resting RSA could be modifiable during cognitive behavioral therapy and contribute to the amelioration of psychopathology. More studies are needed to determine whether resting RSA and RSA reactivity are modifiable indices of symptom change in slow-breathing practices and psychotherapy. CLINICALTRIALS.GOV IDENTIFIER NCT03153904, registered May 15, 2017.
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Affiliation(s)
- Eli S. Susman
- Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA 94704
| | - John R. Weisz
- Department of Psychology, Harvard University, 33 Kirkland St, Cambridge, MA 02138
| | - Katie A. McLaughlin
- Department of Psychology, Harvard University, 33 Kirkland St, Cambridge, MA 02138
| | | | - Spencer C. Evans
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146 USA
| | - Kristel Thomassin
- Department of Psychology, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1
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3
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Battaglini AM, Grocott B, Jopling E, Rnic K, Tracy A, LeMoult J. Patterns of respiratory sinus arrhythmia and trajectories of anxiety and depressive symptoms in early adolescence. Biol Psychol 2024; 185:108723. [PMID: 37981096 DOI: 10.1016/j.biopsycho.2023.108723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/12/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
In children and adults, individual differences in patterns of respiratory sinus arrhythmia (RSA; i.e., interactions between resting RSA and RSA reactivity to stress) have emerged as a central predictor of internalizing symptoms. However, it is unclear whether individual differences in patterns of RSA also contribute to internalizing symptoms during the key developmental period of early adolescence, when rates of internalizing symptoms sharply increase. In the present multi-wave longitudinal study, we assessed whether patterns of RSA predicted trajectories of the two most common types of internalizing symptoms among adolescents: anxiety and depression. In the baseline session, we assessed RSA at rest and in response to a psychosocial stressor (Trier Social Stress Test [TSST]) in a sample of 75 early adolescents (Mage = 12.85). Youth then completed measures of anxiety and depressive symptoms at baseline and four times over approximately two years. Findings indicate that RSA patterns predicted trajectories of anxiety, but not depression. Specifically, region of significance analyses indicated that individuals with high resting RSA who demonstrated RSA augmentation to the lab stressor evinced decreasing anxiety over the follow-up period. In direct contrast, adolescents with high resting RSA in combination with RSA withdrawal to the stressor exhibited a trajectory of increasing anxiety. Findings provide preliminary evidence for understanding RSA as a developmentally salient risk or protective factor.
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4
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Stange JP, Li J, Xu EP, Ye Z, Zapetis SL, Phanord CS, Wu J, Sellery P, Keefe K, Forbes E, Mermelstein RJ, Trull TJ, Langenecker SA. Autonomic complexity dynamically indexes affect regulation in everyday life. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2023; 132:847-866. [PMID: 37410429 PMCID: PMC10592626 DOI: 10.1037/abn0000849] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Affect regulation often is disrupted in depression. Understanding biomarkers of affect regulation in ecologically valid contexts is critical for identifying moments when interventions can be delivered to improve regulation and may have utility for identifying which individuals are vulnerable to psychopathology. Autonomic complexity, which includes linear and nonlinear indices of heart rate variability, has been proposed as a novel marker of neurovisceral integration. However, it is not clear how autonomic complexity tracks with regulation in everyday life, and whether low complexity serves as a marker of related psychopathology. To measure regulation phenotypes with diminished influence of current symptoms, 37 young adults with remitted major depressive disorder (rMDD) and 28 healthy comparisons (HCs) completed ambulatory assessments of autonomic complexity and affect regulation across one week in everyday life. Multilevel models indicated that in HCs, but not rMDD, autonomic complexity fluctuated in response to regulation cues, increasing in response to reappraisal and distraction and decreasing in response to negative affect. Higher complexity across the week predicted greater everyday regulation success, whereas greater variability of complexity predicted lower (and less variable) negative affect, rumination, and mind-wandering. Results suggest that ambulatory assessment of autonomic complexity can passively index dynamic aspects of real-world affect and regulation, and that dynamic physiological reactivity to regulation is restricted in rMDD. These results demonstrate how intensive sampling of dynamic, nonlinear regulatory processes can advance our understanding of potential mechanisms underlying psychopathology. Such measurements might inform how to test interventions to enhance neurovisceral complexity and affect regulation success in real time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Jonathan P. Stange
- Department of Psychology, University of Southern California
- Department of Psychiatry and Behavioral Sciences, University of Southern California
| | - Jiani Li
- Department of Psychology, University of Southern California
| | - Ellie P. Xu
- Department of Psychology, University of Southern California
| | - Zihua Ye
- Department of Psychology, University of Illinois at Urbana-Champaign
| | | | | | - Jenny Wu
- Department of Psychology, University of Massachusetts Boston
| | - Pia Sellery
- Department of Psychology, University of Colorado at Boulder
| | - Kaley Keefe
- Department of Psychology, University of Southern California
| | - Erika Forbes
- Department of Psychiatry, University of Pittsburgh
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5
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Burkhouse KL, Kujawa A. Annual Research Review: Emotion processing in offspring of mothers with depression diagnoses - a systematic review of neural and physiological research. J Child Psychol Psychiatry 2023; 64:583-607. [PMID: 36511171 DOI: 10.1111/jcpp.13734] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Theories of the intergenerational transmission of depression emphasize alterations in emotion processing among offspring of depressed mothers as a key risk mechanism, raising questions about biological processes contributing to these alterations. The objective of this systematic annual research review was to examine and integrate studies of the associations between maternal depression diagnoses and offspring's emotion processing from birth through adolescence across biological measures including autonomic psychophysiology, electroencephalography (EEG), magnetoencephalography (MEG), event-related potentials (ERP), and structural and functional magnetic resonance imaging (MRI). METHODS The review was conducted in accordance with the PRISMA 2020 standards. A systematic search was conducted in PsycInfo and PubMed in 2022 for studies that included, 1) mothers with and without DSM-defined depressive disorders assessed via a clinical or diagnostic interview, and 2) measures of offspring emotion processing assessed at the psychophysiological or neural level between birth and 18 years of age. RESULTS Findings from 64 studies indicated that young offspring of mothers with depression histories exhibit heightened corticolimbic activation to negative emotional stimuli, reduced left frontal brain activation, and reduced ERP and mesocorticolimbic responses to reward cues compared to offspring of never-depressed mothers. Further, activation of resting-state networks involved in affective processing differentiate offspring of depressed relative to nondepressed mothers. Some of these alterations were only apparent among youth of depressed mothers exposed to negative environmental contexts or exhibiting current emotional problems. Further, some of these patterns were observable in infancy, reflecting very early emerging vulnerabilities. CONCLUSIONS This systematic review provides evidence that maternal depression is associated with alterations in emotion processing across several biological units of analysis in offspring. We present a preliminary conceptual model of the role of deficient emotion processing in pathways from maternal depression to offspring psychopathology and discuss future research avenues addressing limitations of the existing research and clinical implications.
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Affiliation(s)
- Katie L Burkhouse
- The Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Autumn Kujawa
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
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6
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Rahal D, Bower JE, Irwin MR, Fuligni AJ, Chiang JJ. Resting respiratory sinus arrhythmia is related to emotion reactivity to social-evaluative stress. J Affect Disord 2023; 320:725-734. [PMID: 36162680 PMCID: PMC10392612 DOI: 10.1016/j.jad.2022.09.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 08/20/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Higher resting parasympathetic nervous system activity, as indexed by respiratory sinus arrhythmia (RSA), has been considered a marker of emotion regulatory capacity and is consistently related to better mental health. However, it remains unclear how resting RSA relates to emotion reactivity to acute social-evaluative stress, a potent predictor of depression and other negative outcomes. METHOD A sample of 89 participants (Mage = 18.36, SD = 0.51; 58.43 % female) provided measures of RSA at rest and then completed the Trier Social Stress Test, a standardized laboratory-based social-evaluative stress task that involves public speaking and mental arithmetic while being evaluated by two confederate judges. Participants reported a variety of emotions (e.g., negative emotion, positive emotion) at baseline and immediately after the stress task. RESULTS Participants with higher resting RSA showed greater increases in negative emotion, guilt, depressive emotion, and anger, as well as greater decreases in positive emotion after the task. LIMITATION Data were limited to a relatively small sample of late adolescents, who may be particularly responsive to social-evaluative stress compared to adults. CONCLUSIONS Findings suggest that higher resting RSA may enhance emotion responses to social-evaluative stress in adolescents, potentially due to active engagement and responding to rather than passively viewing stimuli. Higher resting RSA may promote flexible emotion responses to the social environment, which may account for associations between higher RSA and better mental health.
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Affiliation(s)
- Danny Rahal
- Pennsylvania State University, Edna Bennett Pierce Prevention Research Center, State College, PA 16802, USA.
| | - Julienne E Bower
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA; University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA; University of California, Los Angeles, Norman Cousins Center for Psychoneuroimmunology, Los Angeles, CA 90095, USA
| | - Michael R Irwin
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA; University of California, Los Angeles, Norman Cousins Center for Psychoneuroimmunology, Los Angeles, CA 90095, USA
| | - Andrew J Fuligni
- University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA; University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA; University of California, Los Angeles, Norman Cousins Center for Psychoneuroimmunology, Los Angeles, CA 90095, USA
| | - Jessica J Chiang
- Georgetown University, Department of Psychology, Washington, DC 20005, USA
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7
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Choi JW, Thakur H, Cohen JR. Cardiac autonomic functioning across stress and reward: Links with depression in emerging adults. Int J Psychophysiol 2021; 168:1-8. [PMID: 34280425 DOI: 10.1016/j.ijpsycho.2021.07.625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/02/2021] [Accepted: 07/12/2021] [Indexed: 11/19/2022]
Abstract
The autonomic nervous system (ANS) has received much attention as a potential low-cost, peripheral indicator of depression. Despite theoretical support, however, results have been mixed as to whether indices of the ANS reliably index depression. In response, the present study sought to clarify the relation between ANS activity and depression by examining cardiac autonomic balance (CAB) and cardiac autonomic regulation (CAR), two composite indices of the parasympathetic and sympathetic nervous system, within both a stressful and rewarding context. We hypothesized that CABStress, representing the difference between the parasympathetic and sympathetic branches in response to stress, and CARReward, representing the summation of the two branches in response to reward, will be most indicative of depressogenic risk. We examined the parasympathetic (i.e., respiratory sinus arrhythmia) and sympathetic (i.e., pre-ejection period) responses of 97 emerging adults (Mage = 18.93) for a stress (i.e., negative mood induction) and reward (i.e., probabilistic learning) task, as well as their depressive symptoms at baseline, 3-week, and 6-week follow-up. Analyses found partial support for our hypotheses, revealing greater CARReward (i.e., coactivation of both branches) was related to lower depressive symptoms. Further, exploratory analyses examining gender differences found lower CABStress (i.e., sympathetically-oriented response) was predictive of an increasing trajectory of depression, but only among males. Overall, the current study highlights the importance of simultaneously examining both branches of the ANS across various environmental contexts. Research and clinical implications of the current findings are discussed.
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Affiliation(s)
- Jae Wan Choi
- Department of Psychology, University of Illinois at Urbana-Champaign, USA.
| | - Hena Thakur
- Department of Psychology, University of Illinois at Urbana-Champaign, USA.
| | - Joseph R Cohen
- Department of Psychology, University of Illinois at Urbana-Champaign, USA.
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8
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Pham T, Lau ZJ, Chen SHA, Makowski D. Heart Rate Variability in Psychology: A Review of HRV Indices and an Analysis Tutorial. SENSORS (BASEL, SWITZERLAND) 2021; 21:3998. [PMID: 34207927 PMCID: PMC8230044 DOI: 10.3390/s21123998] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/04/2021] [Accepted: 06/04/2021] [Indexed: 12/16/2022]
Abstract
The use of heart rate variability (HRV) in research has been greatly popularized over the past decades due to the ease and affordability of HRV collection, coupled with its clinical relevance and significant relationships with psychophysiological constructs and psychopathological disorders. Despite the wide use of electrocardiograms (ECG) in research and advancements in sensor technology, the analytical approach and steps applied to obtain HRV measures can be seen as complex. Thus, this poses a challenge to users who may not have the adequate background knowledge to obtain the HRV indices reliably. To maximize the impact of HRV-related research and its reproducibility, parallel advances in users' understanding of the indices and the standardization of analysis pipelines in its utility will be crucial. This paper addresses this gap and aims to provide an overview of the most up-to-date and commonly used HRV indices, as well as common research areas in which these indices have proven to be very useful, particularly in psychology. In addition, we also provide a step-by-step guide on how to perform HRV analysis using an integrative neurophysiological toolkit, NeuroKit2.
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Affiliation(s)
- Tam Pham
- School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore; (T.P.); (Z.J.L.); (D.M.)
| | - Zen Juen Lau
- School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore; (T.P.); (Z.J.L.); (D.M.)
| | - S. H. Annabel Chen
- School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore; (T.P.); (Z.J.L.); (D.M.)
- Centre for Research and Development in Learning, Nanyang Technological University, Singapore 637460, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 636921, Singapore
- National Institute of Education, Nanyang Technological University, Singapore 637616, Singapore
| | - Dominique Makowski
- School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore; (T.P.); (Z.J.L.); (D.M.)
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9
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Kaliush PR, Terrell S, Vlisides-Henry RD, Lin B, Neff D, Shakiba N, Conradt E, Crowell SE. Influences of adversity across the lifespan on respiratory sinus arrhythmia during pregnancy. Dev Psychobiol 2021; 63:e22132. [PMID: 34053065 DOI: 10.1002/dev.22132] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/26/2021] [Accepted: 04/28/2021] [Indexed: 12/27/2022]
Abstract
There is limited understanding of factors across the lifespan that influence pregnant women's respiratory sinus arrhythmia (RSA), which could have implications for their health and offspring development. We examined associations among 162 English- and Spanish-speaking pregnant women's childhood maltreatment history, emotion dysregulation, recent life stress, and resting RSA during the third trimester. Moderated mediation analyses indicated that more severe childhood maltreatment history (95% confidence interval (CI) [0.26, 0.63]) and higher emotion dysregulation (95% CI [0.001, 0.006]) predicted more stress during pregnancy, and childhood maltreatment history interacted with emotion dysregulation to predict resting RSA (95% CI [-0.04, -0.0003]). Exploratory analyses revealed that women's health-related stress during pregnancy mediated the relation between emotion dysregulation and RSA regardless of childhood maltreatment severity (95% CI [-0.007, -0.002]). These findings suggest that women's resting RSA during pregnancy may reflect physical and emotional stress accumulation across the lifespan and that relations between early life adversity and prenatal psychophysiology may be buffered by protective factors, such as emotion regulation. In addition, these findings underscore the importance of distinguishing between types of prenatal stress. Given the implications for women's health and offspring development, we urge researchers to continue exploring factors associated with pregnant women's psychophysiology.
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Affiliation(s)
| | - Sarah Terrell
- Department of Human Development and Family Studies, Pennsylvania State University, Pennsylvania, USA
| | | | - Betty Lin
- Department of Psychology, University at Albany, State University of New York, New York, USA
| | - Dylan Neff
- Department of Psychology, University of Utah, Utah, USA
| | - Nila Shakiba
- Department of Psychology, University of Utah, Utah, USA
| | - Elisabeth Conradt
- Department of Psychology, University of Utah, Utah, USA.,Department of Pediatrics, University of Utah, Utah, USA.,Department of Obstetrics and Gynecology, University of Utah, Utah, USA
| | - Sheila E Crowell
- Department of Psychology, University of Utah, Utah, USA.,Department of Obstetrics and Gynecology, University of Utah, Utah, USA.,Department of Psychiatry, University of Utah, Utah, USA
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10
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Dang K, Kirk MA, Monette G, Katz J, Ritvo P. Meaning in life and vagally-mediated heart rate variability: Evidence of a quadratic relationship at baseline and vagal reactivity differences. Int J Psychophysiol 2021; 165:101-111. [PMID: 33745963 DOI: 10.1016/j.ijpsycho.2021.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 12/17/2022]
Abstract
Higher meaning in life (MIL) consistently predicts better health, but the physiological processes underlying this relationship are not well understood. This study examined the relationship between MIL and vagally-mediated heart rate variability (VmHRV) under resting (N = 77), stressor (n = 73), and mindfulness intervention (n = 72) conditions. Regression was used for MIL-VmHRV analyses at baseline, and longitudinal mixed models were used to examine phasic changes in VmHRV as a function of MIL. Regression revealed a quadratic MIL-VmHRV relationship, and mixed models linked higher MIL to greater stress-reactivity but not enhanced stress-attenuation. MIL and mindfulness did not interact to influence VmHRV recovery after experimental stress. Findings suggest that cardiac vagal tone and cardiac vagal reactivity are linked to MIL, shedding light on the physiology underlying MIL and its health associations.
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Affiliation(s)
- Kevin Dang
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Megan A Kirk
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Georges Monette
- Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
| | - Joel Katz
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; Department of Psychology, York University, Toronto, Ontario, Canada
| | - Paul Ritvo
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; Department of Psychology, York University, Toronto, Ontario, Canada.
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11
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Bylsma LM. Emotion context insensitivity in depression: Toward an integrated and contextualized approach. Psychophysiology 2021; 58:e13715. [PMID: 33274773 PMCID: PMC8097691 DOI: 10.1111/psyp.13715] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 07/31/2020] [Accepted: 08/17/2020] [Indexed: 12/12/2022]
Abstract
Major depressive disorder (MDD) is characterized by pervasive mood disturbance as well as deficits in emotional processing, reactivity, and regulation. There is accumulating evidence that MDD is characterized by emotional patterns consistent with environmental disengagement, as reflected in attenuated positive and negative emotional reactivity, consistent with Emotion Context Insensitivity (ECI) theory. However, MDD individuals vary considerably in the extent to which they exhibit specific alterations in patterns of emotional responding. Emotions are complex, multicomponent processes that invoke responses across multiple functional domains and levels of analysis, including subjective experience, behavior, autonomic regulation, cognition, and neural processing. In this article, I review the current state of the literature on emotional responding and MDD from the lens of ECI. I focus on the importance of assessing emotional indices from multiple levels of analysis across development and contexts. I also discuss methodological and measurement issues that may contribute to inconsistent findings. In particular, I emphasize how psychophysiological measures can help elucidate emotional processes that underlie the pathophysiology of MDD as part of an integrated and contextualized approach.
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Affiliation(s)
- Lauren M Bylsma
- Departments of Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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12
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Petrescu L, Petrescu C, Mitruț O, Moise G, Moldoveanu A, Moldoveanu F, Leordeanu M. Integrating Biosignals Measurement in Virtual Reality Environments for Anxiety Detection. SENSORS 2020; 20:s20247088. [PMID: 33322014 PMCID: PMC7763206 DOI: 10.3390/s20247088] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/03/2020] [Accepted: 12/09/2020] [Indexed: 12/13/2022]
Abstract
This paper proposes a protocol for the acquisition and processing of biophysical signals in virtual reality applications, particularly in phobia therapy experiments. This protocol aims to ensure that the measurement and processing phases are performed effectively, to obtain clean data that can be used to estimate the users' anxiety levels. The protocol has been designed after analyzing the experimental data of seven subjects who have been exposed to heights in a virtual reality environment. The subjects' level of anxiety has been estimated based on the real-time evaluation of a nonlinear function that has as parameters various features extracted from the biophysical signals. The highest classification accuracy was obtained using a combination of seven heart rate and electrodermal activity features in the time domain and frequency domain.
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Affiliation(s)
- Livia Petrescu
- Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania;
| | - Cătălin Petrescu
- Faculty of Automatic Control and Computers, University Politehnica of Bucharest, 060042 Bucharest, Romania; (C.P.); (A.M.); (F.M.); (M.L.)
| | - Oana Mitruț
- Faculty of Automatic Control and Computers, University Politehnica of Bucharest, 060042 Bucharest, Romania; (C.P.); (A.M.); (F.M.); (M.L.)
- Correspondence:
| | - Gabriela Moise
- Faculty of Letters and Sciences, Petroleum-Gas University of Ploiesti, 100680 Ploiesti, Romania;
| | - Alin Moldoveanu
- Faculty of Automatic Control and Computers, University Politehnica of Bucharest, 060042 Bucharest, Romania; (C.P.); (A.M.); (F.M.); (M.L.)
| | - Florica Moldoveanu
- Faculty of Automatic Control and Computers, University Politehnica of Bucharest, 060042 Bucharest, Romania; (C.P.); (A.M.); (F.M.); (M.L.)
| | - Marius Leordeanu
- Faculty of Automatic Control and Computers, University Politehnica of Bucharest, 060042 Bucharest, Romania; (C.P.); (A.M.); (F.M.); (M.L.)
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13
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Emotion regulation deficits mediate childhood sexual abuse effects on stress sensitization and depression outcomes. Dev Psychopathol 2020; 34:157-170. [PMID: 33023709 DOI: 10.1017/s095457942000098x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Child sexual abuse (CSA) is a notable risk factor for depressive disorders. Though multiply determined, increased sensitivity to stress (stress sensitization) and difficulty managing distress (emotion regulation) may reflect two pathways by which CSA confers depression risk. However, it remains unclear whether stress sensitization and emotion regulation deficits contribute to depression risk independently or in a sequential manner. That is, the frequent use of maladaptive emotion regulation responses and insufficient use of those that attenuate distress (adaptive emotion regulation) may lead to stress sensitization. We tested competing models of CSA, stress sensitization, and emotion regulation to predict depression symptoms and depressive affects in daily life among adults with and without histories of CSA. Results supported a sequential mediation: CSA predicted greater maladaptive repertoires that, in turn, exacerbated the effects of stress on depression symptoms. Maladaptive responses also exacerbated the effects of daily life stress on contemporaneous negative affect (NA) levels and their increase over time. Independent of stress sensitization, emotion regulation deficits also mediated CSA effects on both depressive outcomes, though the effect of maladaptive strategies was specific to NA, and adaptive responses to positive affect. Our findings suggest that emotion regulation deficits and stress sensitization play key intervening roles between CSA and risk for depression.
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14
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Byrd AL, Vine V, Beeney JE, Scott LN, Jennings JR, Stepp SD. RSA reactivity to parent-child conflict as a predictor of dysregulated emotion and behavior in daily life. Psychol Med 2020; 52:1-9. [PMID: 32799942 PMCID: PMC7908813 DOI: 10.1017/s0033291720002810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Individual variability in tonic (resting) and phasic (reactivity) respiratory sinus arrhythmia (RSA) may underlie risk for dysregulated emotion and behavior, two transdiagnostic indicators that permeate most psychological disorders in youth. The interaction between tonic and phasic RSA may specify unique physiological profiles during the transition to adolescence. The current study utilized clinically referred youth (Mage = 12.03; s.d. = 0.92) to examine baseline RSA, RSA reactivity, and their interaction as predictors of dysregulated emotion and behavior in daily life. METHOD Participants were 162 youth (47% female; 60% minority) in psychiatric treatment for any mood or behavior problem. RSA was assessed during three, 2-minute baselines and an 8-minute parent-child conflict discussion task. Dysregulated emotion and behavior were assessed during a 4-day ecological momentary assessment protocol that included 10 time-based prompts over a long weekend. RESULTS Greater RSA withdrawal to the conflict was associated with dysregulated basic emotion (sadness, anger, nervousness, stress) in daily life. Two distinct interactions also emerged, such that baseline RSA was related to dysregulated complex emotion (shame, guilt, loneliness, emptiness) and dysregulated behavior as a function of RSA reactivity to conflict. Lower baseline RSA and greater RSA withdrawal were associated with dysregulated complex emotion, while higher baseline RSA and greater RSA withdrawal were associated with dysregulated behavior. CONCLUSIONS Findings point to physiological profiles that increase the risk of dysregulated emotion and behavior during the transition to adolescence. Excessive RSA withdrawal uniquely, and in combination with baseline RSA, increased risk for dysregulation in daily life, underscoring the role of autonomic stress responding as a risk factor for psychopathology.
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Affiliation(s)
- Amy L. Byrd
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Vera Vine
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joseph E. Beeney
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lori N. Scott
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - J. Richard Jennings
- Department of Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephanie D. Stepp
- Department of Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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15
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Inflexible autonomic responses to sadness predict habitual and real-world rumination: A multi-level, multi-wave study. Biol Psychol 2020; 153:107886. [PMID: 32437904 DOI: 10.1016/j.biopsycho.2020.107886] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 03/28/2020] [Accepted: 03/30/2020] [Indexed: 12/16/2022]
Abstract
Inflexibility of the autonomic nervous system is relevant to depression vulnerability, but the downstream behavioral consequences of autonomic inflexibility are not well understood. Rumination, a perseverative thinking style that characterizes depression, is one candidate phenotype relevant to autonomic inflexibility. Undergraduates (N = 134) completed a sadness induction while respiratory sinus arrhythmia was measured, and completed four waves of follow-up over twelve weeks during which rumination, stressful events, and symptoms of depression were measured. Individuals with less autonomic flexibility had higher levels of trait rumination, and were more likely to ruminate in daily life, regardless of stress exposure, whereas individuals with more autonomic flexibility ruminated more only in the context of stress. These findings provide the first evidence that autonomic inflexibility may confer vulnerability to context-insensitive rumination. This work suggests a potential behavioral mechanism by which autonomic inflexibility leads to problems with self-regulation and depression, suggesting multiple avenues for intervention to target these markers of vulnerability.
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16
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The utility of combining respiratory sinus arrhythmia indices in association with internet addiction. Int J Psychophysiol 2020; 151:35-39. [DOI: 10.1016/j.ijpsycho.2020.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/16/2020] [Accepted: 02/17/2020] [Indexed: 11/19/2022]
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17
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Fantini-Hauwel C, Batselé E, Gois C, Noel X. Emotion Regulation Difficulties Are Not Always Associated With Negative Outcomes on Women: The Buffer Effect of HRV. Front Psychol 2020; 11:697. [PMID: 32425846 PMCID: PMC7212345 DOI: 10.3389/fpsyg.2020.00697] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/23/2020] [Indexed: 11/13/2022] Open
Abstract
The Heart Rate Variability (HRV) is regularly associated with depression and trait emotion regulation. However, the interaction between HRV and emotional disturbances is still debated. Only a few studies indicate that HRV moderates the effect of personality traits involved in psychopathological disorders. Since the regulation of emotions is a transdiagnostic factor for most psychological disorders, this study aimed to explore whether HRV moderates the relationship between trait emotion dysregulation and depressive symptoms. We collected data from 148 participants via online questionnaires and HRV measurements at rest. Results show for the 114 female remaining in the study that whereas high emotion regulation difficulties led to higher depressive symptoms severity when resting HRV is low, depressive symptoms remain stable in the same condition but when resting HRV is high. Overall, high resting HRV appears to dampen the consequences of trait emotion regulation difficulties. Further studies are needed to confirm this result, but this suggests that usual response tendencies could be overcome by deactivating or inhibitory processes such as those implied in cognitive flexibility reflected through HRV, according to the neurovisceral integration model.
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Affiliation(s)
- Carole Fantini-Hauwel
- Department of Psychology, Research Center for Clinical Psychology, Psychopathology and Psychosomatics, Université libre de Bruxelles, Brussels, Belgium
| | - Elise Batselé
- Department of Psychology, Research Center for Clinical Psychology, Psychopathology and Psychosomatics, Université libre de Bruxelles, Brussels, Belgium
| | - Cassandra Gois
- Department of Psychology, Research Center for Clinical Psychology, Psychopathology and Psychosomatics, Université libre de Bruxelles, Brussels, Belgium
| | - Xavier Noel
- Department of Medicine, Psychological Medicine Laboratory, Faculty of Medicine, Université libre de Bruxelles, Brussels, Belgium
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18
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Gao L, Li P, Hu C, To T, Patxot M, Falvey B, Wong PM, Scheer FAJL, Lin C, Lo MT, Hu K. Nocturnal heart rate variability moderates the association between sleep-wake regularity and mood in young adults. Sleep 2020; 42:5307029. [PMID: 30722058 DOI: 10.1093/sleep/zsz034] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 01/03/2019] [Accepted: 01/29/2019] [Indexed: 01/06/2023] Open
Abstract
STUDY OBJECTIVES Sleep-wake regularity (SWR) is often disrupted in college students and mood disorders are rife at this age. Disrupted SWR can cause repetitive and long-term misalignment between environmental and behavioral cycles and the circadian system which may then have psychological and physical health consequences. We tested whether SWR was independently associated with mood and autonomic function in a healthy adult cohort. METHODS We studied 42 college students over a 3 week period using daily sleep-wake diaries and continuous electrocardiogram recordings. Weekly SWR was quantified by the interdaily stability of sleep-wake times (ISSW) and mood was assessed weekly using the Beck Depression Inventory-II. To assess autonomic function, we quantified the high-frequency (HF) power of heart rate variability (HRV). Linear mixed effects models were used to assess the relationship between repeated weekly measures of mood, SWR, and HF. RESULTS Low weekly ISSW predicted subsequent poor mood and worsening mood independently of age, sex, race, sleep duration, and physical activity. Although no association was found between ISSW and HF, the ISSW-mood association was significantly moderated by nocturnal HF, i.e. reported mood was lowest after a week with low ISSW and high HF. Prior week mood scores did not significantly predict the subsequent week's ISSW. CONCLUSIONS Irregular sleep-wake timing appears to precede poor mood in young adults. Further work is needed to understand the implications of high nocturnal HRV in those with low mood and irregular sleep-wake cycles.
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Affiliation(s)
- Lei Gao
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA
| | - Peng Li
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Chelsea Hu
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Tommy To
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Melissa Patxot
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Brigid Falvey
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Patricia M Wong
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Frank A J L Scheer
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Chen Lin
- Institute of Translational and Interdisciplinary Medicine and Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan
| | - Men-Tzung Lo
- Institute of Translational and Interdisciplinary Medicine and Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan
| | - Kun Hu
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
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19
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Jonsson K, Peterson M. Peak expiratory flow rate and thoracic mobility in people with fibromyalgia. A cross sectional study. Scand J Pain 2019; 19:755-763. [PMID: 31343985 DOI: 10.1515/sjpain-2019-0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 06/19/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Fibromyalgia (FM) is characterized by chronic widespread pain and affects approximately 1-3% of the general population. Respiratory function has not been given much consideration in people with FM. Few studies have been published concerning FM and respiratory function and conflicting data still exist. The aim of this study was to compare differences in forced expiration, but also to investigate chest expansion, spinal mobility and segmental pain intensity between a group with fibromyalgia and healthy controls. METHODS Forty-one women with diagnosed FM based on American College of Rheumatology 1990 criteria and forty-one controls without pain matched for age and gender participated in this cross-sectional study. For evaluation of forced expiration, a Wright peak expiratory flow rate meter was used. A tape measure was used to measure the mobility of the thorax at maximum inhalation and exhalation known as chest expansion. Spinal mobility was measured with the Cervico-thoracic ratio method. The spinal mobility was measured as range of motion from C7 to 15 cm below in flexion and manual palpation was conducted between C7-T5. For differences in pain intensity a palpation-index was defined for each level, respectively; C7-T1, T1-2, T2-3, T3-4 and T4-5 by calculating the mean value for the four different palpation points for each motion segment. A combined measure of expiration and thoracic mobility (expiratory/inspiratory ratio) was calculated by dividing peak expiratory flow rate (L/min) with chest expansion (cm). Statistical analyses included descriptive statistics to describe subjects and controls, means and standard deviation to compare differences between groups and student-t and Chi-square (χ2) tests, using SPSS 22 software. Confidence interval was set to 95%. RESULTS In the FM group 17 had the diagnosis for more than 5 years and 24 less than 5 years. The FM group demonstrated significantly lower forced expiration (p < 0.018), less thoracic expansion (p < 0.001), reduced spinal mobility (p < 0.029), higher expiratory-inspiratory ratio value (p < 0.001) and increased palpation pain over C7-T5 (p < 0.001) compared to healthy controls. There were more smokers in the FM group (n = 9) compared to the controls (n = 5) though this difference was not statistically significant (p < 0.24) and excluding the few smokers yielded similar result. No significant correlations for manual palpation, chest expansion, peak expiratory flow rate and spinal mobility were found in the FM group. CONCLUSIONS Women with FM demonstrated significantly lower forced expiration and thoracic mobility compared to healthy controls. IMPLICATIONS The results of this study point to a plausible restriction of respiratory function which in turn may have effect on physical endurance and work capacity in people with FM.
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Affiliation(s)
- Kent Jonsson
- Department of Geriatric and Rehabilitation Medicine, Nykoping Hospital, Nykoping, Sweden.,Department of Public Health and Caring Sciences, Section of Family Medicine, Uppsala University, Uppsala, Sweden
| | - Magnus Peterson
- Department of Public Health and Caring Sciences, Section of Family Medicine, Uppsala University, Uppsala, Sweden.,Samariterhemmet Academic Primary Health Care Centre, Region Uppsala, Sweden
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20
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Pace-Schott EF, Amole MC, Aue T, Balconi M, Bylsma LM, Critchley H, Demaree HA, Friedman BH, Gooding AEK, Gosseries O, Jovanovic T, Kirby LA, Kozlowska K, Laureys S, Lowe L, Magee K, Marin MF, Merner AR, Robinson JL, Smith RC, Spangler DP, Van Overveld M, VanElzakker MB. Physiological feelings. Neurosci Biobehav Rev 2019; 103:267-304. [DOI: 10.1016/j.neubiorev.2019.05.002] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/27/2019] [Accepted: 05/03/2019] [Indexed: 12/20/2022]
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21
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Hamilton JL, Stange JP, Burke TA, Franzen PL, Alloy LB. Sleep disturbance and physiological regulation among young adults with prior depression. J Psychiatr Res 2019; 115:75-81. [PMID: 31121395 PMCID: PMC6582965 DOI: 10.1016/j.jpsychires.2019.05.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/10/2019] [Accepted: 05/15/2019] [Indexed: 12/13/2022]
Abstract
Sleep disturbance and respiratory sinus arrhythmia (RSA) are well-known to be independently associated with depression. Yet, it remains unclear how sleep disturbance and impaired physiological regulation (indexed by RSA) may synergistically contribute to depression risk. The current study examined the relationship between sleep disturbance (duration, insomnia) on daily depressive symptoms, and whether RSA moderated this relationship in a sample of young adults with a history of depression. To examine hypotheses, participants (N = 102, ages 18-22) completed a laboratory socio-evaluative stressor task to assess RSA at rest and reactivity. Participants then completed daily measures of sleep duration, insomnia symptoms, and depressive symptoms for two weeks. For main effects, multilevel modeling indicated that shorter overall sleep duration (but not insomnia) predicted higher depressive symptoms, and individual fluctuations in insomnia symptoms (but not sleep duration) predicted higher levels of next-day depressive symptoms. Lower resting RSA, but not reactivity, potentiated these relationships. Individual differences in sleep disturbance (duration and insomnia) predicted prospective levels of depressive symptoms among individuals with lower physiological regulation (indexed by lower RSA), who were particularly vulnerable to the daily effects of sleep disturbance on depressed mood. These results suggest the need to examine both daily sleep disturbance and physiological regulation to understand who may be at greatest risk for depression.
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Affiliation(s)
| | - Jonathan P Stange
- University of Chicago at Illinois, Department of Psychiatry, United States
| | - Taylor A Burke
- (c)Temple University, Department of Psychology, United States
| | - Peter L Franzen
- University of Pittsburgh, Department of Psychiatry, United States
| | - Lauren B Alloy
- (c)Temple University, Department of Psychology, United States
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22
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Beauchaine TP, Hinshaw SP, Bridge JA. Nonsuicidal Self-Injury and Suicidal Behaviors in Girls: The Case for Targeted Prevention in Preadolescence. Clin Psychol Sci 2019; 7:643-667. [PMID: 31485384 PMCID: PMC6726409 DOI: 10.1177/2167702618818474] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Non-suicidal self-injury (NSSI) affects 15-20% of adolescents-disproportionately girls-and is a strong predictor of eventual suicide attempts and suicide. Many girls now initiate NSSI before age 10. These early-starters exhibit greater frequency of NSSI, use more diverse methods, and are hospitalized more often, yet there are no empirically supported prevention programs for preadolescents. Obstacles to prevention include ascertaining who is sufficiently vulnerable and specifying mechanistic intervention targets. Recent research indicates that (1) preadolescent girls with ADHD who are also maltreated are at alarming risk for NSSI and suicide attempts by adolescence, and (2) the conjoint effects of these vulnerabilities are sufficiently potent for targeted prevention. Research also indicates that existing interventions are effective in altering child- and family-level mechanisms of NSSI. These interventions alter neurobiological markers of vulnerability, which can be used as proximal efficacy signals of prevention response, without waiting for NSSI and suicide attempts to emerge.
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Affiliation(s)
| | - Stephen P Hinshaw
- Departments of Psychology and Psychiatry, The University of California, Berkeley; University of California, San Francisco
| | - Jeffrey A Bridge
- Center for Suicide Prevention and Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH
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23
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Mestanikova A, Mestanik M, Ondrejka I, Hrtanek I, Cesnekova D, Jurko A, Visnovcova Z, Sekaninova N, Tonhajzerova I. Complex cardiac vagal regulation to mental and physiological stress in adolescent major depression. J Affect Disord 2019; 249:234-241. [PMID: 30780116 DOI: 10.1016/j.jad.2019.01.043] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/22/2018] [Accepted: 01/22/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Cardiovagal control is known to be reduced in major depressive disorder (MDD), however, the neurocardiac reflex control to distinct types of stressors is still unclear. We aimed to study parasympathetically mediated cardiac reflex functioning in response to mental and physiological stressors using heart rate variability (HRV) linear and nonlinear analysis in adolescent MDD. METHODS We examined 60 adolescents (40 girls) with MDD (age 14.9 ± 0.3 years) and 60 age and gender-matched controls. ECG was continuously recorded during stress protocol: baseline, Go/NoGo test, recovery, supine position, and orthostasis. Evaluated HRV linear and nonlinear indices: RR interval, pNN50, rMSSD, HF-HRV, Poincaré plot (SD1), symbolic dynamics 2UV%. Cardiovagal reactivity expressed as percentual change (%) was calculated in response to both stressors. RESULTS In each phase of stress protocol, the MDD group had significantly reduced HRV parameters compared to controls, except for symbolic dynamics index 2UV% in supine position. The reactivity of HRV indices was significantly greater in response to orthostasis in MDD compared to controls. No significant differences were found in response to Go/NoGo test. LIMITATIONS The smoking status and the menstrual cycle phase potentially affecting the HRV parameters were not monitored. Future research is needed to expand a sample size with respect to sex and to study neurocardiac response to other different stressors in MDD. CONCLUSIONS This study revealed reduced resting cardiovagal regulation and greater vagal withdrawal indicating abnormal neurocardiac reflex functioning to physiological stressor (orthostasis) in adolescent MDD patients. Nonlinear HRV analysis was sensitive to detect cardiac-linked regulatory differences in adolescent depression.
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Affiliation(s)
- Andrea Mestanikova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Michal Mestanik
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia.
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia.
| | - Dana Cesnekova
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovakia.
| | - Alexander Jurko
- Pediatric Cardiology, Kollarova 13, 036 01 Martin, Slovak Republic.
| | - Zuzana Visnovcova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Nikola Sekaninova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
| | - Ingrid Tonhajzerova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic; Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 036 01 Martin, Slovak Republic.
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24
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Dochnal R, Vetró Á, Kiss E, Baji I, Lefkovics E, Bylsma LM, Yaroslavsky I, Rottenberg J, Kovacs M, Kapornai K. Emotion Regulation Among Adolescents With Pediatric Depression As a Function of Anxiety Comorbidity. Front Psychiatry 2019; 10:722. [PMID: 31649566 PMCID: PMC6790632 DOI: 10.3389/fpsyt.2019.00722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 09/09/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Both depression and anxiety (two of the most common internalizing psychopathologies among youths) are associated with difficulties in emotion regulation (ER). Little is known about whether anxiety as a comorbid condition has an effect on the habitual use of different ER strategies in youngsters with depression histories. We aimed 1) to compare ER in adolescents with histories of childhood onset major depressive disorder (MDD) with and without comorbid anxiety and 2) to examine whether certain ER response clusters (Cognitive, Social, and Behavioral/Physical) characterize comorbid children and adolescents. Methods: We analyzed data on 217 youth (11-18 years old) with depression history: 85 subjects with lifetime anxiety comorbidity (comorbid group) and 132 without lifetime anxiety (non-comorbid group). Psychiatric diagnosis was established by a comprehensive Diagnostic and Statistical Manual of Mental Disorders (DSM) IV-based diagnostic procedure. ER strategies were examined via the self-rated "Feelings and Me" Child version questionnaire (FAM-C). Results: The comorbid group used maladaptive ER strategies significantly more frequently than the non-comorbid youngsters. The Behavioral/Physical and Social ER skills, especially those reflecting social withdrawal and self-harm, were responsible for the higher maladaptive scores. Limitations: Because our study is a cross-sectional analysis, we have no information about the development or the onset of maladaptive ER strategies. Therefore, we were unable to examine whether maladaptive ER was a risk factor or a consequence of the internalizing psychopathology and comorbidity. Conclusions: Comorbid anxiety worsens the impaired use of ER strategies in depression-prone youths. Further longitudinal research is needed to explore the causal role of dysfunctional ER in the development of internalizing psychopathology.
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Affiliation(s)
- Roberta Dochnal
- Department of Child and Adolescent Psychiatry, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Ágnes Vetró
- Department of Child and Adolescent Psychiatry, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Enikö Kiss
- Department of Child and Adolescent Psychiatry, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Ildikó Baji
- Department of Child and Adolescent Psychiatry, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Eszter Lefkovics
- Department of Child and Adolescent Psychiatry, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Lauren M Bylsma
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ilya Yaroslavsky
- Department of Psychology, Cleveland State University, Cleveland, OH, United States
| | - Jonathan Rottenberg
- Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Maria Kovacs
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Krisztina Kapornai
- Department of Child and Adolescent Psychiatry, Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
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25
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Schwerdtfeger AR, Dick K. Episodes of momentary resilience in daily life are associated with HRV reductions to stressful operations in firefighters: an ambulatory assessment approach using bayesian multilevel modeling. JOURNAL OF POSITIVE PSYCHOLOGY 2018. [DOI: 10.1080/17439760.2018.1497689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Katharina Dick
- Department of Psychology, University of Wuppertal, Germany
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26
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Cardiac vagal dysfunction moderates patterns of craving across the day in moderate to heavy consumers of alcohol. PLoS One 2018; 13:e0200424. [PMID: 30016350 PMCID: PMC6049906 DOI: 10.1371/journal.pone.0200424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/26/2018] [Indexed: 01/09/2023] Open
Abstract
Background Alcohol craving, a known correlate of vulnerability to Alcohol Use Disorder (AUD), has been found to be inversely related to cardiac vagal tone (CVT). Here we examine how resting CVT, CVT reactivity to a postural challenge, and their interaction influence craving during imposed alcohol abstinence and their usual drinking among moderate to heavy drinkers. Methods Participants were recruited from the local community (final n = 29) and assessed for CVT functioning via respiratory sinus arrhythmia (RSA) at rest (RSA-rest) and during a postural challenge (RSA-react). Craving intensity was assessed throughout the day during 3-day periods of imposed alcohol abstinence (abstained days) and drinking as usual (normal days) via Ecological Momentary Assessment (EMA). Multilevel statistical modeling assessed relationships between patterns of CVT and diurnal craving. The primary hypothesis of interest was that the interaction of RSA-rest with RSA-react would be significantly associated with increased craving across the day. Results Overall, craving increased throughout the day and significantly decreased after drinking (p < 0.001). There was a significant interaction between RSA-rest and RSA-react with plots revealing that this effect was driven by an aberrant craving pattern among participants with higher RSA-rest and a sluggish vagal brake in response to a postural shift—atypical RSA-react. Conclusion Although additional research is needed to corroborate these findings, our results suggest that moderate-heavy drinkers characterized by higher RSA-rest and atypical RSA-react exhibit aberrant patterns of craving across the day that may represent a risk factor for AUD.
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MacNeil S, Deschênes SS, Caldwell W, Brouillard M, Dang-Vu TT, Gouin JP. High-Frequency Heart Rate Variability Reactivity and Trait Worry Interact to Predict the Development of Sleep Disturbances in Response to a Naturalistic Stressor. Ann Behav Med 2018; 51:912-924. [PMID: 28527014 DOI: 10.1007/s12160-017-9915-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND High-frequency heart rate variability (HF-HRV) reactivity was proposed as a vulnerability factor for stress-induced sleep disturbances. Its effect may be amplified among individuals with high trait worry or sleep reactivity. PURPOSE This study evaluated whether HF-HRV reactivity to a worry induction, sleep reactivity, and trait worry predict increases in sleep disturbances in response to academic stress, a naturalistic stressor. METHOD A longitudinal study following 102 undergraduate students during an academic semester with well-defined periods of lower and higher academic stress was conducted. HF-HRV reactivity to a worry induction, trait worry using the Penn State Worry Questionnaire, and sleep reactivity using the Ford Insomnia Stress Reactivity Test were measured during the low stress period. Sleep disturbances using the Pittsburgh Sleep Quality Index were assessed twice during the lower stress period and three times during the higher stress period. RESULTS Greater reductions in HF-HRV in response to the worry induction predicted increases in sleep disturbances from the lower to the higher academic stress period. Trait worry moderated this association: individuals with both higher trait worry and greater HF-HRV reactivity to worry had larger increases in stress-related sleep disturbances over time, compared to participants with lower trait worry and HF-HRV reactivity. A similar, but marginally significant effect was found for sleep reactivity. CONCLUSION This study supports the role of HF-HRV reactivity as a vulnerability factor for stress-induced sleep disturbances. The combination of high trait worry and high HF-HRV reactivity to worry might identify a subgroup of individuals most vulnerable to stress-related sleep disturbances.
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Affiliation(s)
- Sasha MacNeil
- Department of Psychology, Concordia University, Montreal, Canada
| | - Sonya S Deschênes
- Department of Psychiatry, McGill University, Montreal, QC, Canada.,Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Warren Caldwell
- Department of Psychology, Concordia University, Montreal, Canada
| | | | - Thien-Thanh Dang-Vu
- Department of Exercise Science, Concordia University, Montreal, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal and Department of Neurosciences, Université de Montréal, Montreal, Canada.,PERFORM Center, Concordia University, Montreal, Canada
| | - Jean-Philippe Gouin
- Department of Psychology, Concordia University, Montreal, Canada. .,PERFORM Center, Concordia University, Montreal, Canada.
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Haiblum-Itskovitch S, Czamanski-Cohen J, Galili G. Emotional Response and Changes in Heart Rate Variability Following Art-Making With Three Different Art Materials. Front Psychol 2018; 9:968. [PMID: 29967587 PMCID: PMC6015920 DOI: 10.3389/fpsyg.2018.00968] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 05/24/2018] [Indexed: 01/12/2023] Open
Abstract
Art therapy encourages the use of art materials to express feelings and thoughts in a supportive environment. Art materials differ in fluidity and are postulated to thus differentially enhance emotional response (the more fluid the material the more emotion elicited). Yet, to the best of our knowledge, this assumption has not been empirically tested. The current study aimed to examine the emotional and physiological responses to art-making with different art materials. We were particularly interested in vagal activity, indexed by heart rate variability (HRV), because of its association with numerous health related outcomes. In this study, 50 adults (mean age 33 ± 10.27 years, 52% males) participated in a repeated measures experiment, in which they were requested to draw with three art materials (order randomized) differing in their level of fluidity (pencil, oil-pastels, and gouache paint) intermittent with periods of music. We measured the emotional response to art-making with each material using a self-report measure and matrices of HRV using a wearable electrocardiogram device. We calculated two indices of HRV, one indicative of parasympathetic nervous system (PNS) activity, and one indicative of sympathetic nervous system (SNS) activity. Art-making with gouache paint and oil-pastels resulted in improved positive mood, while pencil did not. Art-making explained approximately 35% of the variability in parasympathetic reactivity, which may indicate changes in emotional regulation processes during the art-making task. Yet, fluidity was not sufficient to explain the reaction to art-making. Surprisingly, the largest suppression of PNS and augmentation of the SNS occurred during art-making with oil-pastels and not with Gouache. Moreover, PNS and SNS reactivity to oil-pastels were related to emotional valance, which may point to emotional engagement. We can conclude that art-making with oil-pastels, first created in Japan in 1924 to increase self-expression of students, results in a unique emotional and physiological responses. These findings might be explained by the enhanced tactile experience of art-making with oil-pastels along with their relative fluidity, triggering an arousal pattern. Further studies that take the format and presentation of the materials as well as the content of the artwork, into account, are needed.
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Affiliation(s)
- Shai Haiblum-Itskovitch
- Emili Sagol Creative Arts Therapies Research Center, School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Johanna Czamanski-Cohen
- Emili Sagol Creative Arts Therapies Research Center, School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Department of Psychiatry, Faculty of Medicine, The University of Arizona, Tucson, AZ, United States
| | - Giora Galili
- The Department of Education and Psychology, The Open University of Israel, Ra’anana, Israel
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29
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McKillop HN, Connell AM. Physiological linkage and affective dynamics in dyadic interactions between adolescents and their mothers. Dev Psychobiol 2018; 60:582-594. [PMID: 29748953 DOI: 10.1002/dev.21630] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 01/13/2018] [Accepted: 02/21/2018] [Indexed: 11/07/2022]
Abstract
This study examined physiological linkage (specifically, linkage in respiratory sinus arrhythmia; RSA) between parents and youth (aged 11-17) across conflict and fun activity discussion tasks. We also examined whether observed, momentary negative affect or parental depressive symptoms, would moderate patterns of RSA linkage across the interaction tasks. RSA linkage was assessed using a multilevel actor-partner interdependence model (APIM). Participants were 59 mother-adolescent dyads, including mothers with or without clinically significant depressive symptoms. Both mothers and teens evidenced stable RSA over time (actor effect), although the stability of maternal RSA was moderated by maternal depression, with maternal depressive symptoms related to slower RSA return to baseline. There was a significant partner influence on youth RSA, with maternal RSA positively related to subsequent youth RSA. However, this effect was moderated by maternal depression and maternal negative affect (NA), with low maternal depression/low maternal NA related to dyadic synchrony, whereas high depression or high NA led to attenuation of this relationship. Results demonstrate the importance of understanding the dynamic and complex nature of family interactions in the context of depression.
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30
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Social stress response in adolescents with bipolar disorder. Psychoneuroendocrinology 2018; 91:159-168. [PMID: 29567620 PMCID: PMC6823638 DOI: 10.1016/j.psyneuen.2018.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/05/2018] [Accepted: 02/17/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Theoretical models posit that stressors contribute to the onset and maintenance of bipolar disorder in adolescence through disruptions in stress physiology, but physiological response to stressors has not been evaluated in adolescents with bipolar illness. The present study tests the hypothesis that adolescents with bipolar disorder will have greater reactivity to a laboratory social stress task than healthy adolescents. METHOD Adolescents with bipolar illness (n = 27) and healthy adolescents (n = 28) completed a modified version of the Trier Social Stress Task. Stress response was assessed using high frequency heart rate variability (HF-HRV), heart rate (HR), mean arterial blood pressure (MAP), salivary cortisol, and subjective stress. Multilevel models were used to test for group differences in resting-state physiology, and stress reactivity and recovery. RESULTS Adolescents with bipolar disorder had greater reactivity in HF-HRV (z = 3.32), but blunted reactivity in MAP (z = -3.08) and cortisol (z = -2.60), during the stressor compared to healthy adolescents. They also had lower resting HF-HRV (z = -3.49) and cortisol (z = -2.86), and higher resting HR (z = 3.56), than healthy adolescents. CONCLUSIONS These results indicate that bipolar disorder is associated with disruptions in autonomic and endocrine response to stress during adolescence, including greater HF-HRV reactivity. Further research should evaluate whether these individual differences in stress physiology precede and predict the onset of mood episodes.
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Abstract
Abnormalities in parasympathetic nervous system activity have been linked to depression, but less is known about processes underlying this relationship. The present study evaluated resting and stress-reactive respiratory sinus arrhythmia (RSA) to a laboratory stressor as predictors of daily interpersonal stress generation and depressive symptoms, whether stress generation mediated the relationship between RSA and depressive symptoms, and potential sex differences. A sample of formerly depressed 102 emerging adults (18-22 years; 78% female) completed a laboratory stressor and daily assessments of stressors and depressive symptoms over two weeks. Multilevel modeling revealed that: 1) lower resting RSA predicted daily depressive symptoms; 2) less RSA reactivity predicted interpersonal stress generation, 3) interpersonal dependent stressors mediated the relationship between RSA reactivity and daily depressive symptoms, and 4) sex differences occurred in the resting RSA-depression relationship. These findings highlight the importance of resting RSA and RSA reactivity in the examination of depression and interpersonal processes.
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32
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Stange JP, Hamilton JL, Olino TM, Fresco DM, Alloy LB. Autonomic reactivity and vulnerability to depression: A multi-wave study. Emotion 2017; 17:602-615. [PMID: 27991819 PMCID: PMC5444964 DOI: 10.1037/emo0000254] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The ability of the autonomic nervous system to flexibly adapt to environmental changes is thought to indicate efficient use of self-regulatory resources. Deficits in autonomic reactivity appear to characterize current depression; however, whether autonomic reactivity confers vulnerability to future depression when individuals encounter environmental stressors is unknown. Fluctuations in respiratory sinus arrhythmia (RSA) and heart rate (HR) were evaluated in response to emotion-eliciting films among 134 undergraduates. Negative events and depressive symptoms were assessed 5 times across 12 weeks. Multilevel modeling demonstrated that smaller decreases in RSA in response to sadness, greater increases in HR following sadness, and smaller increases in HR to amusement were prospectively associated with greater depressive symptoms when individuals encountered high levels of idiographically assessed negative events. These results demonstrate that the lack of contextually appropriate autonomic reactivity may confer vulnerability to depression under conditions of environmental stress, perhaps due to attenuated capacity for effective self-regulation. (PsycINFO Database Record
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Stange JP, Hamilton JL, Fresco DM, Alloy LB. Flexible parasympathetic responses to sadness facilitate spontaneous affect regulation. Psychophysiology 2017; 54:1054-1069. [PMID: 28334441 DOI: 10.1111/psyp.12856] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 02/06/2017] [Accepted: 02/13/2017] [Indexed: 11/30/2022]
Abstract
The ability of the parasympathetic nervous system to flexibly adapt to changes in environmental context is thought to serve as a physiological indicator of self-regulatory capacity, and deficits in parasympathetic flexibility appear to characterize affective disorders such as depression. However, whether parasympathetic flexibility (vagal withdrawal to emotional or environmental challenges such as sadness, and vagal augmentation during recovery from sadness) could facilitate the effectiveness of adaptive affect regulation strategies is not known. In a study of 178 undergraduate students, we evaluated whether parasympathetic flexibility in response to a sad film involving loss would enhance the effectiveness of regulatory strategies (reappraisal, distraction, and suppression) spontaneously employed to reduce negative affect during a 2-min uninstructed recovery period following the induction. Parasympathetic reactivity and recovery were indexed by fluctuations in respiratory sinus arrhythmia and high-frequency heart rate variability. Cognitive reappraisal and distraction were more effective in attenuating negative affect among individuals with more parasympathetic flexibility, particularly greater vagal augmentation during recovery, relative to individuals with less parasympathetic flexibility. In contrast, suppression was associated with less attenuation of negative affect, but only among individuals who also had less vagal withdrawal during the sad film. Alternative models provided partial support for reversed directionality, with reappraisal predicting greater parasympathetic recovery, but only when individuals also experienced greater reductions in negative affect. These results suggest that contextually appropriate parasympathetic reactivity and recovery may facilitate the success of affect regulation. Impairments in parasympathetic flexibility could confer risk for affective disorders due to attenuated capacity for effective self-regulation.
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Affiliation(s)
- Jonathan P Stange
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | | | - David M Fresco
- Department of Psychological Sciences, Kent State University, Kent, Ohio
| | - Lauren B Alloy
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
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Nelson BW, Byrne ML, Sheeber L, Allen NB. Does Context Matter? A Multi-Method Assessment of Affect in Adolescent Depression Across Multiple Affective Interaction Contexts. Clin Psychol Sci 2017; 5:239-258. [PMID: 28670504 DOI: 10.1177/2167702616680061] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study utilized a multi-method approach (self-reported affect, observed behavior, and psychophysiology) to investigate differences between clinically depressed and non-depressed adolescents across three different affective interaction contexts with their parents. 152 adolescents (52 males, 14-18 y.o.), and their parents, participated in a laboratory session in which they discussed positive and negative aspects of their relationship, and reminisced on positive and negative memories. We found that across contexts depressed adolescents exhibited higher negative affect and behaviors, lower positive behaviors, and greater autonomic and sympathetic activity. Context specific findings indicated that depressed adolescents 1) exhibited greater persistence of negative affect and dysphoric behavior across the sequence of tasks, whereas these phenomena declined amongst their non-depressed peers, 2) depressed adolescents had greater increases in aggressive behaviors during negative interactions, and 3) depressed adolescents had greater parasympathetic withdrawal during negative interactions, while this response characterized the non-depressed group during positive interactions.
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35
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Hamilton JL, Alloy LB. Atypical reactivity of heart rate variability to stress and depression across development: Systematic review of the literature and directions for future research. Clin Psychol Rev 2016; 50:67-79. [PMID: 27697746 DOI: 10.1016/j.cpr.2016.09.003] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 07/29/2016] [Accepted: 09/17/2016] [Indexed: 11/26/2022]
Abstract
Heart rate variability has received growing attention in the depression literature, with several recent meta-analyses indicating that lower resting heart rate variability is associated with depression. However, the role of fluctuations in heart rate variability (or reactivity) in response to stress in depression remains less clear. The present review provides a systematic examination of the literature on heart rate variability reactivity to a laboratory-induced stressor task and depression, including 26 studies of reactivity in heart rate variability and clinical depression, remitted (or history of) depression, and subthreshold depression (or symptom-level depression) among adults, adolescents, and children. In addition to reviewing the findings of these studies, methodological considerations and conceptual gaps in the literature are addressed. We conclude by highlighting the importance of investigating the potential transactional relationship between heart rate variability reactivity and depression and possible mechanisms underlying this relationship.
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Affiliation(s)
- Jessica L Hamilton
- Temple University, Department of Psychology, 1701 N. 13th St., Philadelphia, PA 19122, United States.
| | - Lauren B Alloy
- Temple University, Department of Psychology, 1701 N. 13th St., Philadelphia, PA 19122, United States
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36
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Kovacs M, Yaroslavsky I, Rottenberg J, George CJ, Kiss E, Halas K, Dochnal R, Benák I, Baji I, Vetró A, Makai A, Kapornai K. Maladaptive mood repair, atypical respiratory sinus arrhythmia, and risk of a recurrent major depressive episode among adolescents with prior major depression. Psychol Med 2016; 46:2109-2119. [PMID: 27198823 DOI: 10.1017/s003329171600057x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Because depressive illness is recurrent, recurrence prevention should be a mainstay for reducing its burden on society. One way to reach this goal is to identify malleable risk factors. The ability to attenuate sadness/dysphoria (mood repair) and parasympathetic nervous system functioning, indexed as respiratory sinus arrhythmia (RSA), are impaired during depression and after it has remitted. The present study therefore tested the hypothesis that these two constructs also may mirror risk factors for a recurrent major depressive episode (MDE). METHOD At time 1 (T1), 178 adolescents, whose last MDE had remitted, and their parents, reported on depression and mood repair; youths' RSA at rest and in response to sad mood induction also were assessed. MDE recurrence was monitored until time 2 (T2) up to 2 years later. Mood repair at T1 (modeled as a latent construct), and resting RSA and RSA response to sadness induction (RSA profile), served to predict onset of first recurrent MDE by T2. RESULTS Consistent with expectations, maladaptive mood repair predicted recurrent MDE, above and beyond T1 depression symptoms. Further, atypical RSA profiles at T1 were associated with high levels of maladaptive mood repair, which, in turn, predicted increased risk of recurrent MDE. Thus, maladaptive mood repair mediated the effects of atypical RSA on risk of MDE recurrence. CONCLUSIONS This study documented that a combination of behavioral and physiological risk factors predicted MDE recurrence in a previously clinically referred sample of adolescents with depression histories. Because mood repair and RSA are malleable, both could be targeted for modification to reduce the risk of recurrent depression in youths.
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Affiliation(s)
- M Kovacs
- University of Pittsburgh School of Medicine,Pittsburgh, PA,USA
| | | | | | - C J George
- University of Pittsburgh Medical Center,PA,USA
| | - E Kiss
- Szeged University,Hungary
| | | | | | | | - I Baji
- Szeged University,Hungary
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Yaroslavsky I, Rottenberg J, Bylsma LM, Jennings JR, George C, Baji I, Benák I, Dochnal R, Halas K, Kapornai K, Kiss E, Makai A, Varga H, Vetró Á, Kovacs M. Parasympathetic nervous system activity predicts mood repair use and its effectiveness among adolescents with and without histories of major depression. JOURNAL OF ABNORMAL PSYCHOLOGY 2016; 125:323-36. [PMID: 26950752 DOI: 10.1037/abn0000149] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Depressive disorders that onset in the juvenile years have been linked to far-reaching adverse consequences, making it imperative to elucidate key mechanisms and contributory factors. Excessive use of regulatory responses that exacerbate sadness (maladaptive mood repair) or insufficient use of regulatory responses that reduce it (adaptive mood repair) may reflect behavioral mechanisms of depression risk. Cardiac vagal control, indexed by patterns of respiratory sinus arrhythmia (RSA), has received attention as a putative physiological risk factor for depression. Although mood repair and RSA are related, the nature of this relationship is not well characterized in the context of depression risk. Therefore, we tested alternative models of the relationships between RSA patterns (at rest and in response to a sad film), trait mood repair, and the effectiveness of a mood repair response in the laboratory (state mood repair) among adolescents with depression histories (n = 210) and emotionally healthy peers (n = 161). In our data, a mediation model best explained the association between the key constructs: Adolescents with normative RSA patterns exhibited lower levels of depression and trait maladaptive mood repair, and benefited more from instructed (state) mood repair in the laboratory. By contrast, adolescents with atypical RSA patterns exhibited higher levels of depression and dispositional maladaptive mood repair, which, in turn, mediated the relations of RSA patterns and depression symptoms. Atypical RSA patterns also predicted reduced benefits from laboratory mood repair.
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Affiliation(s)
| | | | - Lauren M Bylsma
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | | | - Charles George
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Ildikó Baji
- Department of Psychiatry, University of Szeged
| | | | | | - Kitti Halas
- Department of Psychiatry, University of Szeged
| | | | - Enikő Kiss
- Department of Psychiatry, University of Szeged
| | | | | | - Ágnes Vetró
- Department of Psychiatry, University of Szeged
| | - Maria Kovacs
- Department of Psychiatry, University of Pittsburgh School of Medicine
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Christensen KA, Aldao A, Sheridan MA, McLaughlin KA. Habitual reappraisal in context: peer victimisation moderates its association with physiological reactivity to social stress. Cogn Emot 2015; 31:384-394. [PMID: 26654477 DOI: 10.1080/02699931.2015.1103701] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although the emotion regulation strategy of reappraisal has been associated with adaptive outcomes, there is a growing evidence that it may not be adaptive in all contexts. In the present study, adolescents reported their use of habitual reappraisal and their experiences with peer victimisation, a chronic stressor that is associated with reduced well-being in this population. We examined how these variables predicted physiological reactivity (vagal withdrawal and changes in pre-ejection period) during a social stressor (i.e., Trier Social Stress Task). In line with previous research, at high levels of victimisation, habitual reappraisal predicted adaptive physiological reactivity (i.e., greater vagal withdrawal). Conversely, at low levels of victimisation, habitual reappraisal predicted maladaptive physiological reactivity (i.e., blunted vagal withdrawal). These findings were specific to parasympathetic reactivity. They suggest that habitual reappraisal may exert different effects on parasympathetic reactivity depending on the presence of stressors, and highlight the importance of examining the role of contextual factors in determining the adaptiveness of emotion regulation strategies.
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Affiliation(s)
- Kara A Christensen
- a Department of Psychology , The Ohio State University , Columbus , OH , USA
| | - Amelia Aldao
- a Department of Psychology , The Ohio State University , Columbus , OH , USA
| | - Margaret A Sheridan
- b Division of Developmental Medicine , Boston Children's Hospital , USA.,c Department of Pediatrics , Harvard Medical School , Boston , WA , USA
| | - Katie A McLaughlin
- d Department of Psychology , University of Washington , Seattle , WA , USA
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Bylsma LM, Yaroslavsky I, Rottenberg J, Jennings JR, George CJ, Kiss E, Kapornai K, Halas K, Dochnal R, Lefkovics E, Benák I, Baji I, Vetró Á, Kovacs M. Juvenile onset depression alters cardiac autonomic balance in response to psychological and physical challenges. Biol Psychol 2015; 110:167-74. [PMID: 26225465 PMCID: PMC4564352 DOI: 10.1016/j.biopsycho.2015.07.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 04/29/2015] [Accepted: 07/07/2015] [Indexed: 12/28/2022]
Abstract
Cardiac autonomic balance (CAB) indexes the ratio of parasympathetic to sympathetic activation (Berntson, Norman, Hawkley, & Cacioppo, 2008), and is believed to reflect overall autonomic flexibility in the face of environmental challenges. However, CAB has not been examined in depression. We examined changes in CAB and other physiological variables in 179 youth with a history of juvenile onset depression (JOD) and 161 healthy controls, in response to two psychological (unsolvable puzzle, sad film) and two physical (handgrip, and forehead cold pressor) challenges. In repeated measures analyses, controls showed expected reductions in CAB for both the handgrip and unsolvable puzzle, reflecting a shift to sympathetic relative to parasympathetic activation. By contrast, JOD youth showed increased CAB from baseline for both tasks (p's<.05). No effects were found for the forehead cold pressor or sad film tasks, suggesting that CAB differences may arise under conditions requiring greater attentional control or sustained effort.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Maria Kovacs
- University of Pittsburgh, Pittsburgh, PA, United States
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Atypical patterns of respiratory sinus arrhythmia index an endophenotype for depression. Dev Psychopathol 2015; 26:1337-52. [PMID: 25422965 DOI: 10.1017/s0954579414001060] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Can atypical patterns of parasympathetic nervous system activity serve as endophenotypes for depression? Using respiratory sinus arrhythmia (RSA) as an index of parasympathetic nervous system function, we examined this question in two studies: one involving mothers with and without depression histories and their offspring (at high and low risk for depression, respectively), and a further study of adolescent sibling pairs concordant and discordant for major depression. In both studies, subjects were exposed to sad mood induction; subjects' RSA was monitored during rest periods and in response to the mood induction. We used Gottesman and Gould's (2003) criteria for an endophenotype and a priori defined "atypical" and "normative" RSA patterns (combinations of resting RSA and RSA reactivity). We found that atypical RSA patterns (a) predicted current depressive episodes and remission status among women with histories of juvenile onset depression and healthy controls, (b) predicted longitudinal trajectories of depressive symptoms among high- and low-risk young offspring, (c) were concordant across mothers and their juvenile offspring, (d) were more prevalent among never-depressed youth at high risk for depression than their low-risk peers, and (e) were more concordant across adolescent sibling pairs in which both versus only one had a history of major depression. Thus, the results support atypical RSA patterns as an endophenotype for depression. Possible mechanisms by which RSA patterns increase depression risk and their genetic contributors are discussed.
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Aldao A, Dixon-Gordon KL, De Los Reyes A. Individual differences in physiological flexibility predict spontaneous avoidance. Cogn Emot 2015; 30:985-98. [DOI: 10.1080/02699931.2015.1042837] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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The contribution of coping-related variables and heart rate variability to visual search performance under pressure. Physiol Behav 2014; 139:532-40. [PMID: 25481358 DOI: 10.1016/j.physbeh.2014.12.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 11/24/2014] [Accepted: 12/02/2014] [Indexed: 01/30/2023]
Abstract
Visual search performance under pressure is explored within the predictions of the neurovisceral integration model. The experimental aims of this study were: 1) to investigate the contribution of coping-related variables to baseline, task, and reactivity (task-baseline) high-frequency heart rate variability (HF-HRV), and 2) to investigate the contribution of coping-related variables and HF-HRV to visual search performance under pressure. Participants (n=96) completed self-report measures of coping-related variables (emotional intelligence, coping style, perceived stress intensity, perceived control of stress, coping effectiveness, challenge and threat, and attention strategy) and HF-HRV was measured during a visual search task under pressure. The data show that baseline HF-HRV was predicted by a trait coping-related variable, task HF-HRV was predicted by a combination of trait and state coping-related variables, and reactivity HF-HRV was predicted by a state coping-related variable. Visual search performance was predicted by coping-related variables but not by HF-HRV.
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Ferri F, Ardizzi M, Ambrosecchia M, Gallese V. Closing the gap between the inside and the outside: interoceptive sensitivity and social distances. PLoS One 2013; 8:e75758. [PMID: 24098397 PMCID: PMC3787958 DOI: 10.1371/journal.pone.0075758] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 08/19/2013] [Indexed: 11/19/2022] Open
Abstract
Humans' ability to represent their body state from within through interoception has been proposed to predict different aspects of human cognition and behaviour. We focused on the possible contribution of interoceptive sensitivity to social behaviour as mediated by adaptive modulation of autonomic response. We, thus, investigated whether interoceptive sensitivity to one's heartbeat predicts participants' autonomic response at different social distances. We measured respiratory sinus arrhythmia (RSA) during either a Social or a Non-social task. In the Social task each participant viewed an experimenter performing a caress-like movement at different distances from their hand. In the Non-social task a metal stick was moved at the same distances from the participant's hand. We found a positive association between interoceptive sensitivity and autonomic response only for the social setting. Moreover, only good heartbeat perceivers showed higher autonomic response 1) in the social compared to the non-social setting, 2) specifically, when the experimenter's hand was moving at boundary of their peripersonal space (20 cm from the participant's hand). Our findings suggest that interoceptive sensitivity might contribute to interindividual differences concerning social attitudes and interpersonal space representation via recruitment of different adaptive autonomic response strategies.
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Affiliation(s)
- Francesca Ferri
- Department of Neuroscience, University of Parma, Parma, Italy
| | - Martina Ardizzi
- Department of Neuroscience, University of Parma, Parma, Italy
| | | | - Vittorio Gallese
- Department of Neuroscience, University of Parma, Parma, Italy
- Brain Center for Social and Motor Cognition, Italian Institute of Technology (IIT), Parma, Italy
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