Cardiac vagal control as a marker of emotion regulation in healthy adults: A review

Insight and non-insight problem solving: A heart rate variability study

Occasionally, problems are solved with a sudden Aha! moment (insight), while the mundane approach to solving problems is analytical (non-insight). At first glance, non-insight appears to depend on the availability and taxation of cognitive resources to execute the step-by-step approach, whereas insight does not, or to a lesser extent. However, this remains debated. To investigate the reliance of both solution types on cognitive resources, we assessed the involvement of the prefrontal cortex using vagally mediated heart rate variability (vmHRV) as an index. Participants (N = 68) solved 70 compound remote associates word puzzles solvable with insight and non-insight. Before, during, and after solving the word puzzles, we measured the vmHRV. Our results showed that resting-state vmHRV (trait) showed a negative association with behavioural performance for both solution types. This might reflect inter-individual differences in inhibitory control. As the solution search requires one to think of remote associations, inhibitory control might hamper rather than aid this process. Furthermore, we observed, for both solution types, a vmHRV increase from resting-state to solution search (state), lingering on in the post-task recovery period. This could mark the increase of prefrontal resources to promote an open-minded stance, essential for divergent thinking, which arguably is crucial for this task. Our findings suggest that, at a general level, both solution types share common aspects. However, a closer analysis of early and late solutions and puzzle difficulty suggested that metacognitive differentiation between insight and non-insight improved with higher trait vmHRV, and that a unique association between trait vmHRV and puzzle difficulty was present for each solution type.

The dynamic role of the left dlPFC in neurovisceral integration: Differential effects of theta burst stimulation on vagally mediated heart rate variability and cognitive-affective processing

Adapting to the ever-changing demands of the environment requires a complex interplay between cognitive-affective, neuronal, and autonomic processes. Vagally mediated heart rate variability (vmHRV) is positively associated with both cognitive-affective functioning and prefrontal cortex (PFC) activity. Accordingly, the Neurovisceral Integration Model has posited a shared role of the PFC in the regulation of cognitive-affective processes and autonomic nervous system (ANS) activity. While there are numerous correlational findings in this regard, no study so far has investigated whether the manipulation of PFC activity induces changes in vmHRV and cognitive-affective processing in an inter-dependent manner. In a sample of 64 participants, we examined the effects of continuous (cTBS; n = 21) and intermittent theta-burst stimulation (iTBS; n = 20) compared to sham stimulation (n = 23) over the left dorsolateral PFC (dlPFC) on vmHRV and cognitive-affective processing within an emotional stop-signal task (ESST). Our results revealed that both resting vmHRV and vmHRV reactivity predicted cognitive-affective processing. Furthermore, we found a dampening effect of cTBS on resting and on-task vmHRV, as well as an enhancing effect of iTBS on ESST performance. Our results show no direct association between vmHRV changes and ESST performance alterations following stimulation. We interpret our results in the light of a hierarchical model of neurovisceral integration, suggesting a dynamical situation-dependent recruitment of higher-order cortical areas like the dlPFC in the regulation of the ANS. In conclusion, our results highlight the complex interplay between PFC activity, autonomic regulation, and cognitive-affective processing, emphasizing the need for further research to understand the causal dynamics of the underlying neural mechanisms.

Emotion suppression and acute physiological responses to stress in healthy populations: a quantitative review of experimental and correlational investigations

Emotion suppression may be linked to poor health outcomes through elevated stress-related physiology. The current meta-analyses investigate the magnitude of the association between suppression and physiological responses to active psychological stress tasks administered in the laboratory. Relevant articles were identified through Medline, PsychINFO, PubMed, and ProQuest. Studies were eligible if they (a) used a sample of healthy, human subjects; (b) assessed physiology during a resting baseline and active psychological stress task; and (c) measured self-report or experimentally manipulated suppression. Twenty-four studies were identified and grouped within two separate random effects meta-analyses based on study methodology, namely, manipulated suppression (k = 12) and/or self-report (k = 14). Experimentally manipulated suppression was associated with greater physiological stress reactivity compared to controls (Hg = 0.20, 95% CI [0.08, 0.33]), primarily driven by cardiac, hemodynamic, and neuroendocrine parameters. Self-report trait suppression was not associated with overall physiological stress reactivity but was associated with greater neuroendocrine reactivity (r = 0.08, 95% CI [0.01, 0.14]). Significant moderator variables were identified (i.e., type/duration of stress task, nature of control instructions, type of physiology, and gender). This review suggests that suppression may exacerbate stress-induced physiological arousal; however, this may differ based upon the chosen methodological assessment of suppression.

Humanity's evolved nest and its relation to cardiac vagal regulation in the first years of life

BACKGROUND

The Evolved Developmental Niche (EDN) is a millions-year-old developmental system that matches the maturational schedule of the offspring, optimizing health. Every animal has a developmental niche.

AIMS

Humanity has fallen away from providing its EDN. Does it matter?

STUDY DESIGN

Several components of humanity's EDN were reviewed (breastfeeding, positive touch, allomothers, responsive care, free play) in relation to cardiac vagal nerve regulation, a signal of healthy development. Focal subjects were young children.

OUTCOME MEASURES

A review of research on the selected EDN components in relation to vagal nerve function was performed. Data were available for all but the allomother component, which is typically not measured by western researchers, although allomothers provide EDN components alongside parents.

RESULTS

Apart from the lack of research on allomother effects, all these EDN components have been shown to influence cardiac vagal regulation in young children.

CONCLUSIONS

Converging evidence suggests that providing the EDN in early life may not only support aspects of a child's primal health system, but bolster capacities for social health and wellness, the cornerstone of a positive life trajectory.

Heart rate variability and psychological health: The key role of trait emotional awareness

Studies have shown that Trait Emotional Awareness (TEA) - the ability to recognize one's emotions - and Heart Rate Variability (HRV) are both negatively associated with psychological disorders. Although these studies imply that TEA is related to HRV and may explain the association between HRV and psychological disorders, there is limited research investigating this implication. Such investigation is essential to illuminate the psychophysiological processes linked to psychological disorders. The present study aims to investigate a) the association between TEA and HRV, b) the association between HRV and psychological disorders, and c) whether TEA explains the association between HRV and psychological disorders. A sample of 41 German students completed self-report questionnaires as indicators of psychological disorders, including the Hospital Anxiety and Depression Scale (HADS; Snaith & Zigmond, 1983) for anxiousness and depressiveness, as well as the somatization scale of the Hopkins Symptom Checklist (HSCL; Derogatis et al., 1976) for physical complaints. HRV was measured at baseline (resting HRV) and during exposure to a fear-provoking movie clip (reactive HRV). As hypothesized, a) TEA showed a positive association with reactive HRV, b) HRV showed negative associations with anxiousness and physical complaints, and c) TEA explained the relationships between reactive HRV and anxiousness, as well as physical complaints. Contrary to our hypothesis, we did not find any association between HRV and depressiveness. We discussed the contribution of TEA to psychophysiological health, limited generalizability of the current study, and direct future research to explore the underlying mechanisms linking TEA to health.

Distinguishing Emotion Regulation Success in Daily Life From Maladaptive Regulation and Dysregulation

ACADEMIC ABSTRACT

This paper aims to motivate research on emotion regulation success in naturalistic settings. We define emotion regulation success as achieving one's emotion regulation goal and differentiate it from related concepts (i.e., maladaptive regulation and dysregulation). As goals vary across individuals and situations, it is insufficient to conceptualize emotion regulation success as maximizing positive affect and minimizing negative affect. Instead, emotion regulation success can be measured through novel approaches targeting the achievement of emotion regulation goals. In addition to utilizing novel data analytic tools (e.g., response surface analyses), future research can make use of informant reports and observing ambulatory behavior or physiology. Considering emotion regulation goals when measuring daily emotion regulation success has the potential to answer key questions about personality, development, and mental health.

PUBLIC ABSTRACT

People differ in how they want to feel in daily situations (e.g., excited) and why they want to feel that way (e.g., to make others feel better), depending on factors such as culture or age. Although people manage their emotions to reach these goals, most research assessing emotion regulation success has not taken individual goals into account. When assessing if people successfully regulate their emotions, most research in daily life has been focused on whether people feel more positive or less negative. To help study emotion regulation success in a more thoughtful and inclusive way, we propose a new approach to conceptualizing emotion regulation success that incorporates individual differences in what motivates people to regulate and discuss future research directions and applications.

The Interplay of Peer Victimization and Parasympathetic Nervous System Activity on Acute Inflammatory Stress Responses in Adolescence

This study examined the extent to which adolescent peer victimization predicted acute inflammatory responses to stress, and whether both resting parasympathetic nervous system (PNS) activity and PNS stress reactivity moderated this association. 83 adolescents (Mage = 14.89, SDage = 0.52, 48% female) reported their history of peer victimization and were exposed to a standardized social stress task before and after which dried blood spot samples were collected to assay inflammatory markers. Inflammatory responses to the stress task were assessed with a latent inflammatory change factor using the cytokines interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α). PNS functioning, indexed by high-frequency heart rate variability, was measured at rest and during the stressor. Contrary to hypotheses, analyses revealed no direct relation between peer victimization and acute inflammatory responses, and resting PNS activity did not moderate this association. However, peer victimization predicted stronger inflammatory responses among adolescents with weaker PNS reactivity to the stress task (b = 0.63, p = .02). This association was not observed among adolescents with stronger PNS reactivity, for whom a negative but non-significant trend was found. Weaker PNS reactivity may thus indicate victimized adolescents' vulnerability for acute inflammatory responses, whereas stronger PNS reactivity may indicate adolescents' resilience to a social stressor.

Night time heart rate predicts next-day pain in fibromyalgia and primary back pain

Introduction

Primary chronic pain is pain that persists for over 3 months without associated measurable tissue damage. One of the most consistent findings in primary chronic pain is its association with autonomic hyperactivation. Yet whether the autonomic hyperactivation causes the pain or results from it is still unclear. It is also unclear to what extent autonomic hyperactivation is related to experienced pain intensity in different subtypes or primary chronic pain.

Objectives

Our first aim was to test lagged relationships between the markers of autonomic activation (heart rate) and pain intensity to determine its directionality. The main question here was whether autonomic biomarkers predict pain intensity or whether pain intensity predicts autonomic biomarkers. The second aim was to test whether this relationship is different between people with primary back pain and people with fibromyalgia.

Methods

Sixty-six patients with chronic pain were observed over an average of 81 days. Sleep heart rate and heart rate variability were measured with a wearable sensor, and pain intensity was assessed from daily subjective reports.

Results

The results showed a predictive relationship between sleep heart rate and next-day pain intensity (P < 0.05), but not between daily pain intensity and next night heart rate. There was no interaction with the type of chronic pain.

Conclusions

These findings suggest that autonomic hyperactivation, whether stress-driven or arising from other causes, precedes increases in primary chronic pain. Moreover, the present results suggest that autonomic hyperactivation is a common mechanism underlying the pain experience in fibromyalgia and chronic back pain.

Diurnal variation of cardiac autonomic activity in adolescent non-suicidal self-injury

Heart rate (HR) and vagally mediated heart rate variability (HRV) are two distinct biomarkers of cardiac autonomic activity. Decreased cardiac vagal activity (or decreased HRV) in particular has been linked with impairments in the functional flexibility of the central autonomic network (CAN), resulting in impaired stress and emotion regulatory capacities. Decreased HRV is widely used as trait marker of psychopathology. Repetitive engagement in non-suicidal self-injury (NSSI) in adolescence correlates with both deficits in stress and emotion regulation, as well as decreased HRV. Existing research has, however, focused on short-term recordings of HR and HRV under resting and phasic conditions. In this study, we examined whether diurnal variation of cardiac autonomic activity, indexed by cosinor parameters of HR and HRV derived from 48 h of ambulatory ECG recording under natural conditions over a weekend, are altered in female adolescents with NSSI disorder compared to controls (HC; N = 30 per study group). Several important confounds, including physical activity, were controlled for. Female adolescents with NSSI show higher rhythm-adjusted 24 h mean levels and greater respective amplitude of HR, as well as lower rhythm-adjusted 24 h mean levels and smaller respective amplitude of HRV. Peak levels in both HR and HRV in the NSSI group were reached approximately 1 h later compared to HC. Severity of exposure to early life maltreatment might be linked with altered amplitudes of 24 h HR and HRV. Diurnal rhythms of cardiac autonomic activity might hold promise as objective indicators of disordered stress and emotion regulation in developmental psychopathology, and as such should be investigated in future studies with rigorous assessment and control of potential confounds.

Blunted Cortisol Response to Acute Psychosocial Stress in Women With Premenstrual Dysphoric Disorder

BACKGROUND

Despite being considered a stress-related condition, it is not known whether the hypothalamic-pituitary-adrenal (HPA) axis is dysfunctional in response to acute psychosocial stress in premenstrual dysphoric disorder (PMDD). This is problematic because many women with PMDD report that they are not able to control their stress levels, and a blunted cortisol output has been identified in women with related psychiatric conditions, such as anxiety and depression. The present study is a part of the Premenstrual Hormonal and Affective State Evaluation (PHASE) project, and it aimed to characterize the cortisol trajectory in response to an acute psychosocial stress challenge.

METHODS

Women with PMDD and healthy controls with confirmed ovulatory cycles underwent the Trier Social Stress Test (TSST) procedure in the mid-late luteal phase of the menstrual cycle, throughout which we collected serum samples of cortisol that we analyzed using ultra-performance liquid chromatography tandem mass spectrometry.

RESULTS

The linear mixed model analysis indicated a significant time*diagnosis interaction (P = .008) such that women with PMDD displayed significantly lower serum cortisol levels at +40 through +90 minutes from the time of stress induction.

CONCLUSION

This is the first study to show that women with PMDD have a blunted cortisol response to psychosocial stress. Combined with our earlier finding showing a greater parasympathetic nervous system withdrawal on heart oscillations in PMDD during acute stress, these and other results show that the dysregulated processing of stress in PMDD may be captured using objective study measures.

Emotion regulation and heart rate variability may identify the optimal posttraumatic stress disorder treatment: analyses from a randomized controlled trial

Introduction

High variability in response and retention rates for posttraumatic stress disorder (PTSD) treatment highlights the need to identify "personalized" or "precision" medicine factors that can inform optimal intervention selection before an individual commences treatment. In secondary analyses from a non-inferiority randomized controlled trial, behavioral and physiological emotion regulation were examined as non-specific predictors (that identify which individuals are more likely to respond to treatment, regardless of treatment type) and treatment moderators (that identify which treatment works best for whom) of PTSD outcome.

Methods

There were 85 US Veterans with clinically significant PTSD symptoms randomized to 6 weeks of either cognitive processing therapy (CPT; n = 44) or a breathing-based yoga practice (Sudarshan kriya yoga; SKY; n = 41). Baseline self-reported emotion regulation (Difficulties in Emotion Regulation Scale) and heart rate variability (HRV) were assessed prior to treatment, and self-reported PTSD symptoms were assessed at baseline, end-of-treatment, 1-month follow-up, and 1-year follow-up.

Results

Greater baseline deficit in self-reported emotional awareness (similar to alexithymia) predicted better overall PTSD improvement in both the short- and long-term, following either CPT or SKY. High self-reported levels of emotional response non-acceptance were associated with better PTSD treatment response with CPT than with SKY. However, all significant HRV indices were stronger moderators than all self-reported emotion regulation scales, both in the short- and long-term. Veterans with lower baseline HRV had better PTSD treatment response with SKY, whereas Veterans with higher or average-to-high baseline HRV had better PTSD treatment response with CPT.

Conclusions

To our knowledge, this is the first study to examine both self-reported emotion regulation and HRV, within the same study, as both non-specific predictors and moderators of PTSD treatment outcome. Veterans with poorer autonomic regulation prior to treatment had better PTSD outcome with a yoga-based intervention, whereas those with better autonomic regulation did better with a trauma-focused psychological therapy. Findings show potential for the use of HRV in clinical practice to personalize PTSD treatment.

Clinical trial registration

ClinicalTrials.gov identifier, NCT02366403.

Respiratory sinus arrhythmia (RSA), vagal tone and biobehavioral integration: Beyond parasympathetic function

Linchpin to the entire area of psychophysiological research and discussion of the vagus is the respiratory and cardiovascular phenomenon known as respiratory sinus arrhythmia (RSA; often synonymous with high-frequency heart-rate variability when it is specifically linked to respiratory frequency), i.e. rhythmic fluctuations in heart rate synchronized to inspiration and expiration. This article aims 1) to clarify concepts, terms and measures commonly employed during the last half century in the scientific literature, which relate vagal function to psychological processes and general aspects of health; and 2) to expand upon an earlier theoretical model, emphasizing the importance of RSA well beyond the current focus upon parasympathetic mechanisms. A close examination of RSA and its relations to the vagus may 1) dispel certain commonly held beliefs about associations between psychological functioning, RSA and the parasympathetic nervous system (for which the vagus nerve plays a major role), and 2) offer fresh perspectives about the likely functions and adaptive significance of RSA, as well as RSA's relationship to vagal control. RSA is neither an invariably reliable index of cardiac vagal tone nor of central vagal outflow to the heart. The model here presented posits that RSA represents an evolutionarily entrenched, cardiovascular and respiratory phenomenon that significantly contributes to meeting continuously changing metabolic, energy and behavioral demands.

Long-term stability of respiratory sinus arrhythmia among adults with and without a history of depression

Respiratory sinus arrhythmia (RSA) is an index of parasympathetic nervous system activity reflecting respiratory influences on heart rate. This influence is typically measured as high frequency heart rate variability (HF-HRV) or root mean square of successive differences (RMSSD) of adjacent inter-beat intervals. Examining the long-term stability of its measurement is important as levels of resting RSA have been conceptualized as a marker of individual differences; in particular, of an individual's autonomic regulation and affect-related processes, including emotion regulation. At present, it is not known if resting RSA levels reflect stable differences over a long-term period (i.e., >1 year). Even less is known about how RSA stability differs as a function of depression history and whether it relates to depression risk trajectories. In the present study, we examined the 1.5-year test-retest reliability of resting RSA using the intraclass correlation coefficient (ICC) in 82 adults: n = 41 with a history of depression (ever-depressed); n = 41 controls with no depression history (never-depressed). HF-HRV was fairly stable in both groups (ever-depressed ICC = 0.55, never-depressed ICC = 0.54). RMSSD was also fairly stable in ever-depressed adults (ICC = 0.57) and never-depressed controls (ICC = 0.40). ICC values for both indices did not differ between groups per overlapping 95% confidence intervals. Therefore, RSA stability as assessed by both frequency (HF-HRV) and time domain (RMSSD) measures was not attenuated by a depression history. Implications and the need for future research are discussed.

Weakened sympathetic response and lower parasympathetic activity in intimate partner violence perpetrators when empathizing: Influence of autonomous activation in affective approach and prosocial behavior

The autonomic nervous system (ANS) functioning has been proposed as a relevant method to characterize the therapeutic needs of intimate partner violence (IPV) perpetrators. Nevertheless, research has neglected the influence of the ANS on socio-affective functions in this population. The aim of the present study was to analyze the psychophysiological activity of IPV perpetrators (n = 52) compared to controls (n = 46) following an empathic induction task, performed through negative emotion-eliciting videos. We employed two general ANS markers (heart rate [HR] and respiratory rate [RR]), two sympathetic-related indexes (pre-ejection period [PEP] and skin conductance level [SCL]) and a parasympathetic biomarker (respiratory sinus arrhythmia [RSA]). Additionally, we explored the impact of psychophysiological activity on prosocial behavior using Hare's donation procedure. Compared to controls, IPV perpetrators reported lower HR and SCL following the task, as well as longer PEP, suggesting an attenuated sympathetic response to others' distress. No differences in the RSA response pattern were found, however, IPV perpetrators displayed lower overall RSA levels throughout the protocol, indicative of reduced parasympathetic activity. Besides, while no differences in prosocial performance were observed, greater sympathetic responses and overall parasympathetic activity predicted increased donations across the sample. Thus, a high sympathetic and parasympathetic activity might influence the occurrence of prosocial behavior. The present study provides further evidence supporting that IPV perpetrators cope differently with others' negative emotions. In line with this biopsychosocial perspective, insights are gained on the emotional processing of IPV perpetrators which, in turn, could contribute to improve IPV psychotherapeutic programs.

Subjective and physiological reactivity to emotional stressors in somatic symptom disorder

OBJECTIVE

We examined whether autonomic flexibility to experimentally presented stressors is reduced in somatic symptom disorder (SSD) as this would point to reduced vagal control as a proposed indicator of emotion regulation deficits.

METHOD

In this experimental study, the influence of health-related and social stressors on subjective and physiological reactivity was investigated in 29 subjects with SSD without any medical condition SSD(mc-), 33 subjects with SSD with medical condition SSD(mc+) and 32 healthy controls at the age from 18 to 70 years. Self-report and physiological variables were measured before and after/during stressor exposure, using state ratings of symptom intensity, disability, tension and mood, heart rate (HR), and heart rate variability (HRV).

RESULTS

Overall, the tension increased and the mood worsened after exposure to stressors compared to pre-exposure. Compared to HC, the two SSD groups showed higher symptom intensity, disability, tension and worse mood. The SSD(mc-) group revealed higher HR than HC (p = .012, d = -0.77). Compared to pre-exposure, symptom impairment increased after social stressor exposure in SSD(mc-) (p < .001, d = 1.36). HRV-root mean square of successive differences (RMSSD) only decreased in HC during exposure (p = .003, d = -1.09), not in the SSD groups. The two SSD groups did not differ in their reactivity to stressors.

CONCLUSION

HRV in SSD, seems to respond less flexibly to stressors, potentially reflecting overall physiological disturbance through reduced parasympathetic influence on HR. Stress reactivity in SSD(mc-) and SSD(mc+) do not seem to differ.

Resting heart rate variability and emotion regulation difficulties: Comparing Asian Americans and European Americans

Asian Americans and European Americans differ in emotion regulation (ER), particularly regarding strategies utilized to adaptively engage in ER. Resting heart rate variability (HRV), a biomarker of ER ability, is suggested to differ between Asian Americans and European Americans, but evidence for such differences has been inconsistent. Yet, research has not considered how Asian Americans and European Americans might differ in the well-established link between resting HRV and ER difficulties, which might lend a better understanding of such inconsistencies. In 374 college-aged individuals (66 Asian Americans; 311 European Americans; 190 women; mean age = 19.3 years [Min. 18, Max 38]), we examined if ethnicity moderated the link between resting HRV and self-reported ER difficulties. Resting HRV was obtained during a 5-min resting-baseline period, and ER difficulties were assessed using the Difficulties in ER Scale, which contained six facets of ER difficulties. Adjusting for gender and body mass index, moderation analyses showed a stronger association between resting HRV and ER difficulties in Asian Americans compared to European Americans. When examining facets of ER, ethnicity moderated only the link between resting HRV and difficulties in accessing ER strategies when facing negative emotions. At lower levels of HRV, Asian Americans reported greater difficulties in ER relative to European Americans. This effect diminished and trended in the opposite direction among those with higher HRV. In sum, these results provide novel evidence that higher resting HRV might be particularly important for adaptive ER among Asian Americans - a marginalized ethnic group - in the U.S.

Pulse rate variability: An alternative to heart rate variability in adults with spinal cord injury

Pulse rate variability (PRV) is often used as an alternative to heart rate variability (HRV) to measure psychophysiological function. However, its validity to do so is unclear, especially in adults with spinal cord injury (SCI). This study compared PRV and HRV in adults with higher-level SCI (SCI-H, n = 23), lower-level SCI (SCI-L, n = 22), and able-bodied participants (AB n = 44), in a seated position as a function of performance in a reactivity task (Oxford Sleep Resistance Test: OSLER). PRV and HRV was measured using reflective finger-based photoplethysmography (PPG) and electrocardiography, respectively, at baseline, immediately post-OSLER, and after five-minute recovery. Agreement between PRV and HRV was determined by Bland-Altman analysis and differences between PRV and HRV over time by linear mixed effects model (LMM) analysis. Concurrent validity was assessed through correlation analyses between PRV and HRV. Additional correlation analyses were performed with psychosocial factors. Results indicated insufficient to moderate agreement between PRV and HRV. LMM analyses indicated no differences over time for standard deviation of normal-to-normal intervals and low-frequency power but significant differences for root mean square of successive differences and high frequency power. Nevertheless, PRV and HRV were highly correlated (Median r = .878 (.675-.990)) during all assessment periods suggesting sufficient concurrent validity. Similar correlation patterns were also found for PRV and HRV with psychosocial outcomes. While differences existed, results suggest PRV derived from reflective finger-based PPG is a valid proxy of HRV in tracking psychophysiological function in adults with SCI and could therefore be used as a more accessible monitoring tool.

Resting parasympathetic activity is associated with malodor-induced change in perceived foreignness of speakers

INTRODUCTION

To protect against infection, individuals have evolved context-dependent pathogen-avoidant strategies, including selective social behaviors aimed at avoiding foreign individuals who may possess greater risk of infection. Parasympathetic nervous system (PNS) activity is associated with social engagement and regulation of the classical immune system but has not been widely investigated in relation to changes in intergroup perception and the behavioral immune system.

METHOD

The current research investigated the relationship between parasympathetic activity and perceived foreignness of in and outgroup speakers during exposure to a pathogen-relevant odor (butyric acid). High-frequency heart rate variability was measured at rest and while participants rated foreignness of speakers with and without the odor present.

RESULTS

Findings show that exposure to the odor was associated with higher foreignness perceptions of outgroup speakers and lower foreignness perceptions of ingroup speakers. This effect was especially evident among individuals with higher resting parasympathetic activity.

CONCLUSION

These results suggest that the PNS may play a role in changes in social perceptions during a behavioral immune response.

Is Positive Affect as a Trait Related to Higher Heart Rate Variability in a Stressful Situation?

Most of the studies on the effect of trait positive affect (PA) and cardiovascular activity have focused on heart rate (HR) and blood pressure (BP) rather than heart rate variability (HRV). However, trait PA might sustain homeostasis for the autonomic system (ANS) by reducing activity in the sympathetic system (SNS) and increasing the activity in the parasympathetic system (PNS). A common index for the PNS is the vagal tone measured indirectly through HRV. The present study assessed whether trait PA influences cardiovascular response to various stress tasks by monitoring participants' HRV measured by RMSSD (root mean square of successive differences) along with HR and interbeat interval (IBI). A total of 54 participants performed various cognitive tasks and Trier Social Stress Tasks while their vital signs were monitored, and trait PA was measured with PANAS. The cognitive tasks included both high- and low-stress tasks, including fatigue-inducing 20 min Stroop tasks. The results showed overall higher HRV as measured by RMSSD for participants who have higher levels of trait PA, indicating more PNS activity compared with low-trait-PA individuals, particularly at the end of the task performance during the fatigue induction. High-trait-PA individuals also had a lower HR during the fatigue-inducing task and a higher IBI. The results support previous work by further indicating a more adaptive response and consequently better emotional regulation for high-trait-PA individuals in a complex, prolonged task setting.

Vagal Flexibility Moderates the Links between Observed Sensitive Caregiving in Infancy and Externalizing Behavior Problems in Middle Childhood

This study explored how patterns of physiological stress reactivity underpin individual differences in sensitivity to early rearing experiences and childhood risk for psychopathology. To examine individual differences in parasympathetic functioning, past research has largely relied on static measures of stress reactivity (i.e., residual and change scores) in infancy which may not adequately capture the dynamic nature of regulation across contexts. Using data from a prospective longitudinal study of 206 children (56% African Americans) and their families, this study addressed these gaps by employing the latent basis growth curve model to characterize the dynamic, non-linear patterns of change in infants' respiratory sinus arrhythmia (i.e., vagal flexibility) across the Face-to-Face Still-Face Paradigm. Furthermore, it investigated whether and how infants' vagal flexibility moderates the links between sensitive parenting, observed during a free play task when children were 6 months of age, and parent-report of children's externalizing problems at 7 years of age. Results of the structural equation models revealed that infants' vagal flexibility moderates the predictive relations between sensitive parenting in infancy and children's later externalizing problems. Simple slope analyses revealed that low vagal flexibility, characterized by less suppression and flatter recovery patterns, exacerbated risk for externalizing psychopathology in the context of insensitive parenting. Children with low vagal flexibility also benefited most from sensitive parenting, as indicated by the lower number of externalizing problems. Findings are interpreted in the light of the biological sensitivity to context model and provide evidence for vagal flexibility as a biomarker of individual's sensitivity to early rearing contexts.

Boosting affective control with bifrontal transcranial direct current stimulation (tDCS): a proof-of-concept study in healthy individuals

Affective control refers to the ability to regulate emotions and is considered a marker of mental health. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, holds promise to enhance affective control. In this between-subjects study in healthy individuals, we investigated the effects of bifrontal tDCS on core processes and higher-level markers of affective control. As such, we assessed direct tDCS effects on emotional interference during an affective control task and indirect effects on an instructed reappraisal task afterward. Results showed that the affective control task combined with active tDCS, compared to sham, resulted in enhanced cognitive emotion regulation. Specifically, participants in the active tDCS condition showed an increased propensity to use reappraisal and were more successful in doing so. Moreover, there was reduced vagally mediated heart rate variability indicative of attenuated emotion and self-regulation, in the sham, but not in the active condition. Surprisingly, there were no effects of tDCS on emotional interference during the affective control task, with Bayesian analyses showing extreme evidence against these effects. Nevertheless, there was a positive association between the emotional interference during the affective control task and participants' reappraisal success afterward for the active, but not the sham tDCS condition. The study offers valuable insights to guide future work on combined tDCS with affective control tasks or training on the ability to regulate emotions.

Evaluating Physician Emotion Regulation in Serious Illness Conversations Using Multimodal Assessment

CONTEXT

Emotion regulation by the physician can influence the effectiveness of serious illness conversations. The feasibility of multimodal assessment of emotion regulation during these conversations is unknown.

OBJECTIVES

To develop and assess an experimental framework for evaluating physician emotion regulation during serious illness conversations.

METHODS

We developed and then assessed a multimodal assessment framework for physician emotion regulation using a cross-sectional, pilot study on physicians trained in the Serious Illness Conversation Guide (SICG) in a simulated, telehealth encounter. Development of the assessment framework included a literature review and subject matter expert consultations. Our predefined feasibility endpoints included: an enrollment rate of ≥60% of approached physicians, >90% completion rate of survey items, and <20% missing data from wearable heart rate sensors. To describe physician emotion regulation, we performed a thematic analysis of the conversation, its documentation, and physician interviews.

RESULTS

Out of 12 physicians approached, 11 (92%) SICG-trained physicians enrolled in the study: five medical oncology and six palliative care physicians. All 11 completed the survey (100% completion rate). Two sensors (chest band, wrist sensor) had <20% missing data during study tasks. The forearm sensor had >20% missing data. The thematic analysis found that physicians': 1) overarching goal was to move beyond prognosis to reasonable hope; 2) tactically focused on establishing a trusting, supportive relationship; and 3) possessed incomplete awareness of their emotion regulation strategies.

CONCLUSION

Our novel, multimodal assessment of physician emotion regulation was feasible in a simulated SICG encounter. Physicians exhibited an incomplete understanding of their emotion regulation strategies.

Repressive and vigilant coping styles in stress and relaxation: evidence for physiological and subjective differences at baseline, but not for differential stress or relaxation responses

Introduction

Previous research suggested differential stress reactivity depending on individuals' coping style, e.g., as classified by the model of coping modes. Specifically, stronger physiological reactivity and weaker subjective stress ratings were found for repressors than for sensitizers. However, it remains to be investigated (i) whether these findings, which are largely based on social stress induction protocols, also generalize to other stressors, (ii) whether repressors vs. sensitizers also exhibit differential stress recovery following the application of a relaxation method, and (iii) which stress reactivity and recovery patterns are seen for the two remaining coping styles, i.e., fluctuating, and non-defensive copers. The current study thus examines stress reactivity in physiology and subjective ratings to a non-social stressor and the subsequent ability to relax for the four coping groups of repressors, sensitizers, fluctuating, and non-defensive copers.

Methods

A total of 96 healthy participants took part in a stress induction (Mannheim Multicomponent Stress Test) and a subsequent relaxation intervention. Subjective ratings of stress and relaxation, heart rate (HR), heart rate variability (HRV), and blood pressure were assessed during the experiment. HR and blood pressure are markers of the sympathetic stress response that can be regulated by relaxation, while HRV should increase with relaxation. To investigate long-term relaxation effects, subjective ratings were also assessed on the evening of testing.

Results

Despite successful stress induction, no differential responses (baseline to stress, stress to relaxation) were observed between the different coping groups on any of the measures. In contrast, a strong baseline effect was observed that persisted throughout the experiment: In general, fluctuating copers showed lower HR and higher HRV than non-defensive copers, whereas repressors reported lower subjective stress levels and higher levels of relaxation during all study phases. No differences in subjective ratings were observed in the evening of testing.

Conclusion

Contrary to previous research, no differential stress reactivity pattern was observed between coping groups, which could be due to the non-social type of stressor employed in this study. The novel finding of physiological baseline differences between fluctuating and non-defensive individuals is of interest and should be further investigated in other stressor types in future research.

Tonic and phasic cardiac vagal activity predict cognitive-affective processing in an emotional stop-signal task

Both the Neurovisceral Integration Model and the Vagal Tank Theory propose cardiac vagal activity (CVA) as proxy for self-regulatory or processing resources required for attentional and top-down control as key mechanisms in executive functioning or emotion-regulation. These resources have, according to the Dual Competition Model, limited capacity and are prioritized for processing the most salient of different competing stimuli. As such, emotional and especially negative or threatening stimuli attract these self-regulatory/processing resources, and may thus interfere with ongoing cognitive processes if not integrated adaptively. Here, we investigated whether tonic and phasic CVA represent self-regulatory/processing resources and thus predict response inhibition in an emotional stop-signal task as a measure of cognitive-affective integration. Thereby, we examined not only the independent effects of tonic and phasic CVA, but whether and how the interaction of both variables predicts response inhibition. We assumed that the effects of CVA on response inhibition would be more pronounced in negatively-valenced trials compared to positive or neutral ones. Our results show that CVA significantly predicted response inhibition, with higher tonic CVA predicting faster, and larger phasic withdrawal CVA predicting slower stop-signal reaction times. The interactive effects of tonic and phasic CVA revealed that high tonic CVA levels prevented the negative effects of CVA withdrawal on response inhibition. Contrary to our assumption, we did not find differential effects of tonic and phasic CVA on trials with different valences. Our results support the notion of CVA as index for self-regulatory/processing resources. However, further research is needed to investigate how CVA is related to specific neural processes of cognitive-affective processing.

Maternal age differences in cognitive regulation: examination of associations and interactions between RSA and EEG frontoparietal alpha power coherence

Strong cognitive regulation is advantageous for flexible, responsive parenting. Optimal cognitive regulation is reliant on associations between physiological mechanisms of central and peripheral nervous system functioning. Across middle adulthood there may be shifts in how cognitive regulation functions, reflecting changes in the associations and interactions between these physiological mechanisms. Two physiological indicators of cognitive regulation are autonomic regulation of the heart (e.g., respiratory sinus arrhythmia, RSA) and activity of the brain's frontoparietal network (e.g., frontoparietal EEG alpha power coherence, FPc). In the current study we examined maternal age differences (N = 90, age M = 32.35 years, SD = 5.86 years) in correlations and interactions between RSA and FPc in the statistical prediction of cognitive regulation [i.e., executive function (EF), effortful control (EC), cognitive reappraisal (CR)]. Age-related patterns involving interaction between RSA and FPc were found, pointing to a potential shift from optimization to compensation for changes with aging or alternately, the effects of age-based decrements in functioning. Findings are discussed in the context of adult developmental changes in maternal caregiving.

The Protective Role of the Autonomic Nervous System in Intergenerational Cycles of Neglect

Offspring of parents who experienced childhood neglect are at increased risk for developing internalizing problems. Empirical evidence suggests this link is principally mediated through parenting behavior. However, such intergenerational cycles of adversity are found to be disrupted in many families. Parasympathetic nervous system functioning is well documented to mediate individuals' emotion regulation biologically. Respiratory sinus arrhythmia (RSA) is a validated biomarker for parasympathetic activity. The goal of the current study was to investigate the moderating role of parent RSA reactivity in the effect of parents' childhood neglect on their children's internalizing problems, through parental acceptance. Physiological and survey data were collected from 145 dyads (94% mothers; Youth Mage = 12.9, Youth SDage = 0.85). Results suggest that the effect of parents' childhood neglect on their child's internalizing problems was conditional on parents' RSA reactivity. Specifically, higher levels of parents' neglect were only linked to increased risk for youth internalizing problems if parents exhibited a lack of RSA withdrawal. Further, this moderating effect was found to be mediated through parental acceptance. Findings suggest understanding intergenerational consequences of child maltreatment contexts should include consideration of bioregulatory factors.

Linking heart rate variability to psychological health and brain structure in adolescents with and without conduct disorder

Aims

Heart rate variability (HRV) measures have been suggested in healthy individuals as a potential index of self-regulation skills, which include both cognitive and emotion regulation aspects. Studies in patients with a range of psychiatric disorders have however mostly focused on the potential association between abnormally low HRV at rest and specifically emotion regulation difficulties. Emotion regulation deficits have been reported in patients with Conduct Disorder (CD) however, the association between these emotion regulation deficits and HRV measures has yet to be fully understood. This study investigates (i) the specificity of the association between HRV and emotion regulation skills in adolescents with and without CD and (ii) the association between HRV and grey matter brain volumes in key areas of the central autonomic network which are involved in self-regulation processes, such as insula, lateral/medial prefrontal cortices or amygdala.

Methods

Respiratory sinus arrhythmia (RSA) measures of HRV were collected from adolescents aged between 9-18 years (693 CD (427F)/753 typically developing youth (TD) (500F)), as part of a European multi-site project (FemNAT-CD). The Inverse Efficiency Score, a speed-accuracy trade-off measure, was calculated to assess emotion and cognitive regulation abilities during an Emotional Go/NoGo task. The association between RSA and task performance was tested using multilevel regression models. T1-weighted structural MRI data were included for a subset of 577 participants (257 CD (125F); 320 TD (186F)). The CerebroMatic toolbox was used to create customised Tissue Probability Maps and DARTEL templates, and CAT12 to segment brain images, followed by a 2 × 2 (sex × group) full factorial ANOVA with RSA as regressor of interest.

Results

There were no significant associations between RSA and task performance, neither during emotion regulation nor during cognitive regulation trials. RSA was however positively correlated with regional grey matter volume in the left insula (pFWE = 0.011) across all subjects.

Conclusion

RSA was related to increased grey matter volume in the left insula across all subjects. Our results thus suggest that low RSA at rest might be a contributing or predisposing factor for potential self-regulation difficulties. Given the insula's role in both emotional and cognitive regulation processes, these brain structural differences might impact either of those.

Experimental Investigation of the Influence of Positive Emotion Dysregulation on Risky Behavior Following Idiographic Emotion Inductions

An experimental paradigm with subjective and objective assessments was used to further explicate the role of positive emotion dysregulation on risky behavior. Participants were 151 community women currently experiencing intimate partner violence and using substances (Mage = 40.81, 43.0% white). Participants were randomly assigned to positive, negative, and neutral idiographic emotion inductions. Subjective (state self-report) and objective (high frequency heart rate variability [hfHRV], skin conductance response, and salivary cortisol) markers of emotion dysregulation were assessed, following which participants completed subjective (state urges for substances) and objective (Balloon Analogue Risk Task) measures of risky behavior. Results showed (a) greater self-reported state emotion dysregulation and lower hfHRV predicted more urges for substances in the positive (versus negative and neutral) emotion induction conditions; and (b) lower hfHRV predicted more behavioral risk-taking propensity in the positive (versus neutral) emotion induction condition. Findings provide additional support for the influence of positive emotion dysregulation on risky behavior.

Somatovisceral influences on emotional development

Frameworks of emotional development have tended to focus on how environmental factors shape children's emotion understanding. However, individual experiences of emotion represent a complex interplay between both external environmental inputs and internal somatovisceral signaling. Here, we discuss the importance of afferent signals and coordination between central and peripheral mechanisms in affective response processing. We propose that incorporating somatovisceral theories of emotions into frameworks of emotional development can inform how children understand emotions in themselves and others. We highlight promising directions for future research on emotional development incorporating this perspective, namely afferent cardiac processing and interoception, immune activation, physiological synchrony, and social touch.

Facilitating dyadic synchrony in psychotherapy sessions: Systematic review and meta-analysis

Objective: This paper highlights the facilitation of dyadic synchrony as a core psychotherapist skill that occurs at the non-verbal level and underlies many other therapeutic methods. We define dyadic synchrony, differentiate it from similar constructs, and provide an excerpt illustrating dyadic synchrony in a psychotherapy session. Method: We then present a systematic review of 17 studies that have examined the associations between dyadic synchrony and psychotherapy outcomes. We also conduct a meta-analysis of 8 studies that examined whether there is more synchrony between clients and therapists than would be expected by chance. Results: Weighted box score analysis revealed that the overall association of synchrony and proximal as well as distal outcomes was neutral to mildly positive. The results of the meta-analysis indicated that real client-therapist dyad pairs exhibited synchronized behavioral patterns to a much greater extent than a sample of randomly paired people who did not actually speak. Conclusion: Our discussion revolves around how synchrony can be facilitated in a beneficial way, as well as situations in which it may not be beneficial. We conclude with training implications and therapeutic practices.

The psychophysiology of guilt in healthy adults

Guilt is a negative emotion, elicited by realizing one has caused actual or perceived harm to another person. Anecdotally, guilt often is described as a visceral and physical experience. However, while the way that the body responds to and contributes to emotions is well known in basic emotions, little is known about the characteristics of guilt as generated by the autonomic nervous system. This study investigated the physiologic signature associated with guilt in adults with no history of psychological or autonomic disorder. Healthy adults completed a novel task, including an initial questionnaire about their habits and attitudes, followed by videos designed to elicit guilt, as well as the comparison emotions of amusement, disgust, sadness, pride, and neutral. During the video task, participants' swallowing rate, electrodermal activity, heart rate, respiration rate, and gastric activity rate were continuously recorded. Guilt was associated with alterations in gastric rhythms, electrodermal activity, and swallowing rate relative to some or all the comparison emotions. These findings suggest that there is a mixed pattern of sympathetic and parasympathetic activation during the experience of guilt. These results highlight potential therapeutic targets for modulation of guilt in neurologic and psychiatric disorders with deficient or elevated levels of guilt, such as frontotemporal dementia, posttraumatic stress disorder, and Obsessive-compulsive disorder.

Can heart rate variability be a bio-index of hope? A pilot study

Background

Hope can affect the thinking habits, emotional regulations, and behaviors of individuals. Hope is considered as a positive trait by clinicians, who often assess the level of hope in psychological evaluations. Previous measurements of hope were largely based on self-reported questionnaires leading to the problem of subjectivity. Heart Rate Variability (HRV) is a bio index that is an objective, quick, cost effective, and non-invasive measurement. HRV has been used in the evaluation of physical health and some psychiatric conditions. However, it has not been tested for its potential to be a bio-index of the level of hope.

Method

This pilot cross-sectional observational study aimed to examine the relationships between HRV and the level of hope among adult Chinese people in Hong Kong. Convenience sampling was used and 97 healthy participants were recruited. Their level of hope was measured by the Dispositional Hope Scale-Chinese (DHS-C), and their HRV was quantified by emWave Pro Plus, a reliable sensor of HRV. Spearman's correlation coefficient analysis was performed on the HRV measurements and DHS-C.

Results

The DHS-C's overall mean score was 45.49. The mean scores of the subscale DHS-C (Agency) was 22.46, and the mean scores of DHS-C (Pathway) was 23.03. It was also revealed that there were significant, weak, and negative correlations between the level of hope and four out of ten HRV metrics. One HRV metric was found to have a significant, weak, and positive correlation with the level of hope.

Conclusion

This study provided initial evidence to support the use of HRV as a bio-index of hope. Implications of the current study and recommendations for future research directions are discussed.

Does anxiety explain why math-anxious people underperform in math?

Math-anxious people consistently underperform in math. The most widely accepted explanation for why this underperformance occurs is that math-anxious people experience heightened anxiety when faced with math, and this in-the-moment anxiety interferes with performance. Surprisingly, this explanation has not been tested directly. Here, using both self-report and physiological indices of anxiety, we directly test how much in-the-moment anxiety explains math-anxious underperformance. Results indicate that in-the-moment anxiety indeed explains why math-anxious people underperform-but only partially, suggesting a need to seriously consider alternative mechanisms. Results also showed that while some highly math-anxious individuals-those with high levels of heart rate variability-experienced less in-the-moment anxiety, they nevertheless performed no better at math. For these individuals, math-anxious underperformance must occur for reasons unrelated to in-the-moment anxiety. More broadly, our findings point to substantial individual heterogeneity in the mechanisms underlying math-anxious underperformance. Accounting for this mechanistic heterogeneity may prove vital for optimally boosting math performance in math-anxious individuals.

Differential Momentary Reports of Stress and Affect Associated With Alcohol Consumption in Middle-Aged Versus Younger Adults

Background: Stress is a motivator to consume alcohol, a well-documented relapse risk, and is known to differentially affect biological and psychological processes as people age.Objectives: Because alcohol consumption is known to acutely decrease stress and increase affect, this study examined differences in ratings of stress and affect in middle-aged versus younger adults who regularly consume alcohol.Methods: A sample of younger (n = 17) and middle-aged (n = 18) drinkers was studied during a 3-day period of typical alcohol consumption. Resting levels of respiratory sinus arrhythmia (RSA) were measured during a baseline study visit since RSA is a well-documented biomarker of stress and is known to decrease with age. Ecological momentary assessment (EMA) survey ratings (n = 1,598) were modeled using hierarchical regression to assess differences in stress and affect throughout the day between the two age groups.Results: As anticipated, middle-aged participants had lower RSA than those who were younger. Although the middle-aged adults showed overall lower stress, generally they also experienced higher affect than the younger adults. Middle-aged adults experienced a significant reduction in stress following drinking while no such effect was observed in the younger adults.Conclusions: To our knowledge, this is the first investigation using EMA methodology to examine stress and affect between younger and middle-aged adults who habitually consume alcohol. These cross-sectional data suggest potential momentary stress relief to engaging with moderate alcohol consumption in a middle-aged population. Future work must address this important motivational process in curtailing maintenance of alcohol consumption and preventing escalation of consumption.

Cardiac Vagal Regulation Is Impeded in Children With Cyclic Vomiting Syndrome

INTRODUCTION

The pathophysiology underlying cyclic vomiting syndrome (CVS) remains undefined. Scant data and distinct clinical features point to altered autonomic nervous system function. Autonomic signaling can be noninvasively assessed through cardiac indices of parasympathetic vagal regulation, which is reduced in children with disorders of gut-brain interaction. We aimed to examine dynamic cardiac vagal regulation in children with CVS compared with that in healthy controls (HC).

METHODS

A total of 31 children with CVS evaluated in a tertiary care CVS center and 66 HC (ages 8-18 years) underwent cardiac autonomic function assessment. Electrocardiogram recordings were conducted during 3-minute sit/stand/sit posture challenges. The electrocardiogram-derived variables heart period, respiratory sinus arrhythmia (RSA), and vagal efficiency (VE) were analyzed using linear regression and mixed-effects modeling.

RESULTS

After exclusion of medication confounders, 23 patients with CVS were included in analyses. Both groups were comparable in age, gender, and body mass index. Compared with HC, children with CVS had shorter heart period (standardized mean difference range: 1.15-1.22, all P values < 0.05) and lower RSA (SMD range: 0.66-0.88, all P values < 0.05). Patients with CVS had significantly lower VE during the entire course of posture shifts, compared with HC ( B = -19.87, SE = 6.95, t = -2.86, P = 0.005, SMD = 0.76).

DISCUSSION

Children with CVS have suboptimal parasympathetic autonomic regulation compared with HC, indexed by reduced RSA and VE, even during their interepisodic well phase. Abnormal vagal modulation may underlie CVS pathophysiology, comorbidities, and triggers. Assessing VE during posture stressors could inform therapeutic interventions.

Allopregnanolone Is Associated with a Stress-Induced Reduction of Heart Rate Variability in Premenstrual Dysphoric Disorder

Human survival and wellbeing require appropriate responses to stress, including a highly coordinated and efficient nervous system control of the heart rhythm. During stress, a greater disinhibition of the vagal nerve is reflective of poor stress adaptability, which may be relevant in premenstrual dysphoric disorder (PMDD)-a debilitating affective condition thought to be marked by dysregulated stress processing and sensitivity to allopregnanolone. In the present study, women with PMDD (n = 17) and healthy controls (n = 18), who did not take medication, smoke, or consume illicit drugs, and who were free of other psychiatric conditions, participated in the Trier Social Stress Test, during which we measured the high frequency of the heart rate (HF-HRV) and allopregnanolone using ultra-performance liquid chromatography tandem mass spectrometry. Relative to their baseline, women who have PMDD, but not the healthy controls, experienced a reduction in HF-HRV during stress anticipation (p ≤ 0.05) and stress (p ≤ 0.01). Their recovery from stress was significantly delayed (p ≤ 0.05). Absolute peak HF-HRV change from baseline was significantly predicted by baseline allopregnanolone only in the PMDD group (p ≤ 0.01). The present study shows how an interaction between stress and allopregnanolone-which have both been separately implicated in PMDD-underlies PMDD expression.

Respiratory sinus arrhythmia moderates the interpersonal consequences of brooding rumination

Brooding rumination is an intrapersonal emotion regulation strategy associated with negative interpersonal consequences. Resting respiratory sinus arrhythmia (RSA), a psychophysiological marker of self-regulatory capacity, may buffer the association between maladaptive emotion regulation and negative interpersonal behaviors. The current work examines the moderating effect of RSA on the association between brooding rumination and different negative interpersonal consequences. Across three convenience samples, individuals with lower RSA showed a stronger association between brooding rumination and more negative interpersonal behaviors as well as less perception of received instrumental social support (Study 1; n = 154), higher levels of interviewer-rated interpersonal stress (Study 2; n = 42) and a stronger indirect association between brooding rumination and depressive symptoms via daily interpersonal stress (Study 3; n = 222). These findings highlight the negative interpersonal consequences of brooding rumination, particularly among individuals with lower RSA.

Emotional memory in the lab: Using the Trier Social Stress Test to induce a sensory-rich and personally meaningful episodic experience

A myriad of clinical theories places emotional memory or mental representations at the root of mental disorders. Various cognitive-behavioural interventions are based on the assumption that targeting the underlying emotional memory is the working mechanism of treatment efficacy. To test the assumptions about the role of emotional memory in the development, maintenance, and treatment of mental disorders, we first need to establish ecologically valid paradigms that can induce emotional memory in the lab. For this, we used the Trier Social Stress Test (TSST), a standardized protocol to elicit social distress, paired with a neutral unfamiliar ambient odour, to create a sensory-rich and personally meaningful episodic experience. Seven days later, participants (N = 132) reactivated the memory of the TSST with the aid of auditory, olfactory, and visual retrieval cues, during which their heart rate and self-reported affective responses were collected. Although increases in heart rate were only observed during encoding, and not at retrieval, self-report ratings showed that cues which directly referred to the aversive experience evoked more negative valence, arousal, and feelings of lack of control during memory reactivation compared to control cues across sensory modalities. These findings are indicative of successful memory induction and corroborate the utility of ambient odours as retrieval aids. Moreover, the self-reported response to the reactivated emotional memory correlated with individual differences in indices of (social) anxiety and depression. Thereby, we provide preliminary evidence of the translational significance of this paradigm that offers potential for being a model to induce ecologically valid emotional memory in the lab.

Effects of neuromodulation on cognitive and emotional responses to psychosocial stressors in healthy humans

Physiological and psychological stressors can exert wide-ranging effects on the human brain and behavior. Research has improved understanding of how the sympatho-adreno-medullary (SAM) and hypothalamic-pituitary-adrenocortical (HPA) axes respond to stressors and the differential responses that occur depending on stressor type. Although the physiological function of SAM and HPA responses is to promote survival and safety, exaggerated psychobiological reactivity can occur in psychiatric disorders. Exaggerated reactivity may occur more for certain types of stressors, specifically, psychosocial stressors. Understanding stressor effects and how the body regulates these responses can provide insight into ways that psychobiological reactivity can be modulated. Non-invasive neuromodulation is one way that responding to stressors may be altered; research into these interventions may provide further insights into the brain circuits that modulate stress reactivity. This review focuses on the effects of acute psychosocial stressors and how neuromodulation might be effective in altering stress reactivity. Although considerable research into stress interventions focuses on treating pathology, it is imperative to first understand these mechanisms in non-clinical populations; therefore, this review will emphasize populations with no known pathology and consider how these results may translate to those with psychiatric pathologies.

Brief structured respiration practices enhance mood and reduce physiological arousal

Controlled breathwork practices have emerged as potential tools for stress management and well-being. Here, we report a remote, randomized, controlled study (NCT05304000) of three different daily 5-min breathwork exercises compared with an equivalent period of mindfulness meditation over 1 month. The breathing conditions are (1) cyclic sighing, which emphasizes prolonged exhalations; (2) box breathing, which is equal duration of inhalations, breath retentions, and exhalations; and (3) cyclic hyperventilation with retention, with longer inhalations and shorter exhalations. The primary endpoints are improvement in mood and anxiety as well as reduced physiological arousal (respiratory rate, heart rate, and heart rate variability). Using a mixed-effects model, we show that breathwork, especially the exhale-focused cyclic sighing, produces greater improvement in mood (p < 0.05) and reduction in respiratory rate (p < 0.05) compared with mindfulness meditation. Daily 5-min cyclic sighing has promise as an effective stress management exercise.

Better forbearance, lower depression: Evidence based on heart rate variability

Background

The relationship between forbearance, a psychological resource, and depression has to date remained inconclusive. The present study investigated heart rate variability (HRV) reactivity to acute stressor tasks in participants with different levels of forbearance to discover how forbearance influences depressive emotions when facing adversity.

Method

The study examined the relationship between forbearance and depression, comparing HRV reactivity to stressor tasks in participants with different levels of forbearance. The levels of reported forbearance were assessed by the Forbearance Scale (FS). The Patient Health Questionnaire-9 (PHQ-9) was used to assessed depression severity. HRV reactivity was evaluated at five stages: baseline, the active stressor task, the period of recovery after the active stressor task, the passive stressor task, the period of recovery after the passive stressor task.

Results

FS scores had a significant negative correlation with PHQ-9 and a significant positive correlation with HRV; significant differences existed between the basal HRV in the higher and lower FS groups. In the passive stressor task and the period of recovery after the active stressor task, significantly different HRV responses were identified between the two groups.

Discussion

Forbearance was correlated with depression and HRV. The present research found differences in HRV among subjects with different levels of forbearance in the baseline as well as stressor and recovery periods, suggesting that self-regulation dysfunction may exist among persons with lower levels of forbearance. Because of the higher levels of forbearance, the negative emotions of individuals caused by adversity are mitigated.

Resting respiratory sinus arrhythmia is related to emotion reactivity to social-evaluative stress

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.

Sleep and Daily Positive Emotions – Is Heart Rate Variability a Mediator?

Abstract. Sleep quality is considered a basic dimension of emotional health. The psychophysiological mechanisms underlying the associations between sleep quality and positive emotions are still largely unknown, yet autonomic regulation may play a role. This study employed a two-day ecological momentary assessment methodology in a sample of young adults to investigate whether subjective sleep quality reported in the morning was associated with daily positive emotional experience and whether this association was mediated by heart rate variability (HRV), a measure of cardiac vagal tone. Sleep quality was assessed using an electronic sleep diary upon awakening, while resting HRV and positive emotions were inspected at random times throughout the day using photoplethysmography and an electronic diary, respectively. Relevant confounding variables such as smoking, alcohol intake, and physical exercise between each measurement were also assessed. The sample included 121 participants (64.8% females, Mage = 25.97 ± 5.32 years). After controlling for relevant confounders including health behaviors and psychiatric comorbidities, mediation analysis revealed that greater sleep quality positively predicted daily HRV (β = .289, p < .001) which, in turn, had a direct influence on positive emotions (β = .244, p = .006). Also, sleep quality directly predicted positive emotional experience (β = .272, p = .001). Lastly, the model showed an indirect effect between sleep quality and positive emotions via HRV (β = .071, 95% BCI [.011, .146]). Results support the view of HRV as a process variable linking sleep to positive emotions. Experimental data is needed to consolidate the present findings.

Reduced heart rate variability and expressive suppression interact to prospectively predict COVID-19 pandemic-related post-traumatic stress symptoms

The COVID-19 pandemic is a unique period of stress that, in some cases, led to post-traumatic stress symptoms (PTSSs). Emotion regulation strategies are known to modulate the emotional response to stressful events. Expressive suppression (ES) is a maladaptive strategy related to the exacerbation of the physiological stress response. Heart rate variability (HRV), an index of cardiac autonomic balance strictly related to ES, was also shown to predict PTSSs. This was the first study to investigate whether the pre-pandemic ES use and resting-state HRV predicted pandemic-related PTSSs. Before the pandemic, 83 (58 females) university students completed the Emotion Regulation Questionnaire (ERQ), self-report measures of anxiety and depressive symptoms, and a three-minute resting-state electrocardiogram recording. After 12 months, 61 (45 females) participants completed a self-report measure of pandemic-related PTSSs and repeated the self-report psychological measures. Pre-pandemic anxiety symptoms prospectively predicted greater PTSSs. Moreover, a significant interaction between HRV and ES in predicting PTSSs emerged, whereby those who had higher levels of ES and reduced HRV showed higher PTSSs. These findings suggest that an integrated assessment of HRV and ES might be useful for identifying individuals who are more vulnerable to the development of PTSSs during crises.

e-Estesia: A Serious Game for Reducing Arousal, Improving Emotional Regulation and Increasing Wellbeing in Individuals with Gambling Disorder

Gambling disorder (GD) is associated with deficits in emotion regulation and impulsivity-related personality traits. In recent years there has been an increase in the use of serious games (SG) to address these factors with positive results. The aim of this study was to analyze the efficacy of the intervention with a new SG (e-Estesia), as an adjunct to a CBT intervention for GD. The sample comprised two groups (experimental group (n = 40) and control group (n = 64)) of patients with GD diagnosis. Both groups received 16 weekly CBT sessions and, concurrently, only the experimental group received 15 additional sessions with e-Estesia. Pre-post treatment with e-Estesia administered in both groups were: DSM-5 Criteria, South Oaks Gambling Screen, Symptom Checklist-Revised and measure of relapses, dropout and compliance of treatment. As regards the experimental group were also administered: Difficulties in Emotion Regulation Scale, Emotion Regulation Questionnaire, and Impulsive Behavior Scale. No statistically significant differences in the general psychopathological state, emotion regulation or impulsivity were found when comparing the groups. However, patients enrolled in the e-Estesia intervention had significantly less relapses and better indicators of treatment compliance than the control group. Considering these results, the use of complementary tools such as SG are useful for addressing GD.

Multi-trajectory analysis uncovers latent associations between psychological and physiological acute stress response patterns

Encounter with an acute stressor elicits multiple physiological and psychological response trajectories that spread at different times-scales and directions. Associating a single physiological response trajectory with a specific psychological response has remained a challenge, due to putative interactions between the different stress response pathways. Hence, multidimensional analysis of stress response trajectories may be better suited to account for response variability. To test this, 96 healthy female participants underwent a robust acute laboratory stress induction procedure while their psychological [positive and negative affect (PANAS)] and physiological [heart rate (HR), heart rate variability (HRV), saliva cortisol (CORT)] responses were recorded before, during and after stress. Combining these data using unsupervised group-based multi-trajectory modelling uncovered three latent classes that best accounted for variability across psychological and physiological stress response trajectories. These classes were labelled based on their psychological response patterns as: A prototypical response group that depict a moderate increase in negative and decrease in positive affect during stress, with both patterns recovering after stress offset (n = 55); A heightened response group that depict excessive affective responses during stress that recover after stress offset (n = 24); and a lack of recovery group that depict a moderate increase in negative and decrease in positive affect during stress, with both patterns not recovering after stress offset (n = 17). With respect to physiological acute stress trajectories, all three groups exhibited comparable increases in HR and CORT during stress that recovered after stress offset, yet only the prototypical group expressed the expected stress-induced reduction in HRV, while the other two groups exhibited blunted HRV response. Critically, focusing on a single physiological stress response trajectory, including HRV, did not account for psychological response variability and vice versa. Taken together, a multi-trajectory approach may better account for the multidimensionality of acute stress response and uncover latent associations between psychological and physiological response patterns. Compared to the other two groups, the prototypical group also exhibited significantly lower overall stress scores based on the DASS-21 scale. This, alongside the uncovered response patterns, suggest that latent psycho-physiological associations may shed light on stress response adaptivity or lack thereof.

Attachment avoidance and internalizing symptoms: Does respiratory sinus arrhythmia withdrawal make a difference?

OBJECTIVE

This study investigated the association between attachment avoidance and internalizing symptoms and the moderating role of parasympathetic nervous activity (indexed by respiratory sinus arrhythmia withdrawal) in the association.

METHODS

A sample of 109 (M_age = 18.94 years old, SD = 0.92; 69 male) Chinese college students participated in this study. Participants reported attachment avoidance and internalizing symptoms, and their physiological data were collected.

RESULTS

Results showed a positive link between attachment avoidance and internalizing symptoms. Further, respiratory sinus arrhythmia (RSA) withdrawal and attachment avoidance interactively predicted internalizing symptoms. Specifically, the positive relation between attachment avoidance and internalizing symptoms was only found among people of low, but not high, levels of RSA withdrawal.

CONCLUSION

Our study highlighted the importance of considering psychophysiological interactions in predicting internalizing symptoms in college students, and contributed to our understanding of the complicated factors underlying college students' internalizing problems.

Non-invasive vagus nerve stimulation boosts mood recovery after effort exertion

BACKGROUND

Mood plays an important role in our life which is illustrated by the disruptive impact of aberrant mood states in depression. Although vagus nerve stimulation (VNS) has been shown to improve symptoms of depression, the exact mechanism is still elusive, and it is an open question whether non-invasive VNS could be used to swiftly and robustly improve mood.

METHODS

Here, we investigated the effect of left- and right-sided transcutaneous auricular VNS (taVNS) v. a sham control condition on mood after the exertion of physical and cognitive effort in 82 healthy participants (randomized cross-over design) using linear mixed-effects and hierarchical Bayesian analyses of mood ratings.

RESULTS

We found that 90 min of either left-sided or right-sided taVNS improved positive mood [b = 5.11, 95% credible interval, CI (1.39-9.01), 9.6% improvement relative to the mood intercept, BF₁₀ = 7.69, p_LME = 0.017], yet only during the post-stimulation phase. Moreover, lower baseline scores of positive mood were associated with greater taVNS-induced improvements in motivation [r = -0.42, 95% CI (-0.58 to -0.21), BF₁₀ = 249].

CONCLUSIONS

We conclude that taVNS boosts mood after a prolonged period of effort exertion with concurrent stimulation and that acute motivational effects of taVNS are partly dependent on initial mood states. Collectively, our results show that taVNS may help quickly improve affect after a mood challenge, potentially by modulating interoceptive signals contributing to the reappraisal of effortful behavior. This suggests that taVNS could be a useful add-on to current behavioral therapies.

Autonomic cardiac profile in male and female healthcare professionals with and without preschoolers: differences evidenced by heart rate variability analysis

A reduced nocturnal cardiac vagal modulation has been observed in working women with preschoolers. Whether this adaptation also occurs in men remains an open question. The aim of this study was to analyze the cardiac autonomic profile of two groups of healthcare male professionals, one with and one without preschoolers, to be compared to females. Twenty-five working men with preschoolers (M_KID, age 35.41 ± 4.01 years) and 25 without (M_NOKID, 34.48 ± 6.00 years) were compared with 25 working women with preschoolers (W_KID, 37.7 ± 5.6 years) and 25 without (W_NOKID, 35.4 ± 7.2 years). A 24-h Holter electrocardiogram was performed for time and frequency domain analysis of the beat-to-beat variations of RR interval (RR) variability, during daytime (DAY) and nighttime (NIGHT). The power of RR variability in the high frequency band (HF_RR) was considered as an index of cardiac vagal modulation. RR variability indices were similar in M_KID and M_NOKID during both DAY and NIGHT. In contrast, W_KID showed a reduced nocturnal HF_RR compared to W_NOKID. The comparison of working men with and without preschoolers revealed no differences in the cardiac autonomic profile, in contrast with women. This suggests that sex and/or gender may represent a crucial factor in the cardiac neural control in the parental condition.

Depressive rumination and heart rate variability: A pilot study on the effect of biofeedback on rumination and its physiological concomitants

Objective

Recent studies suggest that lower resting heart rate variability (HRV) is associated with elevated vulnerability to depressive rumination. In this study, we tested whether increases in HRV after HRV-biofeedback training are accompanied by reductions in rumination levels.

Materials and methods

Sixteen patients suffering from depression completed a 6-week HRV-biofeedback training and fourteen patients completed a control condition in which there was no intervention (waitlist). The training included five sessions per week at home using a smartphone application and an ECG belt. Depressive symptoms and autonomic function at rest and during induced rumination were assessed before and after each of the two conditions. We used a well-established rumination induction task to provoke a state of pervasive rumination while recording various physiological signals simultaneously. Changes in HRV, respiration rate, skin conductance, and pupil diameter were compared between conditions and time points.

Results

A significant correlation was found between resting HRV and rumination levels, both assessed at the first laboratory session (r = -0.43, p < 0.05). Induction of rumination led to an acceleration of heart rate and skin conductance increases. After biofeedback training, resting vagal HRV was increased (p < 0.01) and self-ratings of state anxiety (p < 0.05), rumination (p < 0.05), perceived stress (p < 0.05), and depressive symptoms (QIDS, BDI; both p < 0.05) were decreased. In the control condition, there were no changes in autonomic indices or depressive symptomatology. A significant interaction effect group x time on HRV was observed.

Conclusion

Our results indicate that a smartphone-based HRV-biofeedback intervention can be applied to improve cardiovagal function and to reduce depressive symptoms including self-rated rumination tendencies.