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Chen LK. Age, happiness, and health: Exploring the synergy of positive emotions in healthy aging. Arch Gerontol Geriatr 2023; 114:105167. [PMID: 37657407 DOI: 10.1016/j.archger.2023.105167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Affiliation(s)
- Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan.
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2
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van Oort J, Tendolkar I, Collard R, Geurts DEM, Vrijsen JN, Duyser FA, Kohn N, Fernández G, Schene AH, van Eijndhoven PFP. Neural correlates of repetitive negative thinking: Dimensional evidence across the psychopathological continuum. Front Psychiatry 2022; 13:915316. [PMID: 35942479 PMCID: PMC9356323 DOI: 10.3389/fpsyt.2022.915316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022] Open
Abstract
Repetitive negative thinking (RNT) captures an important transdiagnostic factor that predisposes to a maladaptive stress response and contributes to diverse psychiatric disorders. Although RNT can best be seen as a continuous symptom dimension that cuts across boundaries from health to various psychiatric disorders, the neural mechanisms underlying RNT have almost exclusively been studied in health and stress-related disorders, such as depression and anxiety disorders. We set out to study RNT from a large-scale brain network perspective in a diverse population consisting of healthy subjects and patients with a broader range of psychiatric disorders. We studied 46 healthy subjects along with 153 patients with a stress-related and/or neurodevelopmental disorder. We focused on three networks, that are associated with RNT and diverse psychiatric disorders: the salience network, default mode network (DMN) and frontoparietal network (FPN). We investigated the relationship of RNT with both network connectivity strength at rest and with the stress-induced changes in connectivity. Across our whole sample, the level of RNT was positively associated with the connectivity strength of the left FPN at rest, but negatively associated with stress-induced changes in DMN connectivity. These findings may reflect an upregulation of the FPN in an attempt to divert attention away from RNT, while the DMN result may reflect a less flexible adaptation to stress, related to RNT. Additionally, we discuss how our findings fit into the non-invasive neurostimulation literature. Taken together, our results provide initial insight in the neural mechanisms of RNT across the spectrum from health to diverse psychiatric disorders.
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Affiliation(s)
- Jasper van Oort
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Indira Tendolkar
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Rose Collard
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | - Dirk E. M. Geurts
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behavior, Radboud University and Radboud University Medical Center, Nijmegen, Netherlands
| | - Janna N. Vrijsen
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
- Pro Persona Mental Health Care, Depression Expertise Center, Nijmegen, Netherlands
| | - Fleur A. Duyser
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | - Nils Kohn
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behavior, Radboud University and Radboud University Medical Center, Nijmegen, Netherlands
| | - Guillén Fernández
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behavior, Radboud University and Radboud University Medical Center, Nijmegen, Netherlands
| | - Aart H. Schene
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Philip F. P. van Eijndhoven
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
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3
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Almdahl IS, Martinussen LJ, Agartz I, Hugdahl K, Korsnes MS. Inhibition of emotions in healthy aging: age-related differences in brain network connectivity. Brain Behav 2021; 11:e02052. [PMID: 33543596 PMCID: PMC8119855 DOI: 10.1002/brb3.2052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 01/12/2021] [Accepted: 01/17/2021] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Successful inhibition of distracting emotions is important for preserving well-being and daily functioning. There is conflicting evidence regarding the impact of healthy aging on emotional inhibition, and possible age-related alterations in the neuronal underpinnings of emotional interference processing are unexplored. METHODS Thirty younger (mean age 26 years; 15 women) and 30 older (mean age 71 years; 13 women) healthy adults performed a face-word emotional Stroop task while undergoing functional magnetic resonance imaging of the brain. A resting-state scan was acquired for calculating the amplitude of low-frequency fluctuations as an estimate of vascular reactivity. Comparisons of brain activation during the task were assessed in a whole-brain, voxel-wise analysis, contrasting congruent, and incongruent conditions. The canonical regions of the frontoparietal, salience, dorsal attention, and default mode networks were used as seed regions for assessing functional connectivity within and between large-scale brain networks. Task performance was evaluated using response accuracy and response time. RESULTS The older adults had longer response times and lower task accuracy than the younger adults, but the emotional interference effect was not significantly different between the groups. Whole-brain analysis revealed no significant age-related differences in brain activation patterns. Rescaling the data for estimated variability in vascular reactivity did not affect the results. In older adults, there was relatively stronger functional connectivity with the default mode network, the sensorimotor network, and the dorsal attention network for the frontoparietal and salience network seeds during the task. Conversely, younger adults had relatively stronger connections within and between the frontoparietal and salience networks. CONCLUSION In this first fMRI study of emotional Stroop interference in older and younger adults, we found that the emotional interference effect was unchanged in healthy aging and replicated the finding from non-emotional task studies that older adults have greater between-network and less within-network connectivity compared to younger adults.
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Affiliation(s)
- Ina S Almdahl
- Department of Old Age Psychiatry, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Liva J Martinussen
- Department of Old Age Psychiatry, Oslo University Hospital, Oslo, Norway.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.,Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Maria S Korsnes
- Department of Old Age Psychiatry, Oslo University Hospital, Oslo, Norway.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
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4
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Measuring inter-individual differences in stress sensitivity during MR-guided prostate biopsy. Sci Rep 2021; 11:2454. [PMID: 33510379 PMCID: PMC7844251 DOI: 10.1038/s41598-021-82199-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 01/05/2021] [Indexed: 11/25/2022] Open
Abstract
People often experience high level of distress during invasive interventions, which may exceed their coping abilities. This may be in particular evident when confronted with the suspicion of cancer. Taking the example of prostate biopsy sampling, we aimed at investigating the impact of an MRI guided prostate biopsy on the acute stress response and its mechanistic basis. We recruited 20 men with a clinical suspicion of prostate cancer. Immediately before an MRI guided biopsy procedure, we conducted fMRI in the same scanner to assess resting-state brain connectivity. Physiological and hormonal stress measures were taken during the procedure and associated with questionnaires, hair cortisol levels and brain measures to elucidate mechanistic factors for elevated stress. As expected, patients reported a stress-related change in affect. Decreased positive affect was associated with higher hair but not saliva cortisol concentration. Stronger use of maladaptive emotion regulation techniques, elevated depression scores and higher within-salience-network connectivity was associated with stronger increase in negative affect and/or decrease of positive affect during the procedure. While being limited in its generalization due to age, sample size and gender, our proof of concept study demonstrates the utility of real-life stressors and large-scale brain network measures in stress regulation research with potential impact in clinical practice.
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Morita K, Kimura H, Tsuka H, Nishio F, Yoshida M, Tsuga K. Association between salivary alpha-amylase and subjective and objective oral parafunctions in community-dwelling elderly individuals. J Dent Sci 2020; 15:310-314. [PMID: 32952889 PMCID: PMC7486515 DOI: 10.1016/j.jds.2020.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 05/03/2020] [Indexed: 12/19/2022] Open
Abstract
Background/purpose Stress in the elderly is caused by loss of physical and psychological health. Although there have been many reports on the intraoral environment affecting physical health, few reports exist on stress and the intraoral environment in the elderly. The aim of this study was to investigate the relationship between salivary α-amylase as an index of stress value and the intraoral environment. Materials and methods Three hundred and nineteen participants were community-dwelling independent individuals over 65 years old. The outcome variable was salivary α-amylase. After measurement, salivary α-amylase was classified into four groups (0 = 0–30, 1 = 31–45, 2 = 46–60, 3 = 61–200). The predictor variables were physical status (which includes age and male body-mass index) and subjective and objective symptoms (which include present teeth, torus palatinus, torus mandibularis, temporomandibular joint noise, bruxism, and dental attrition). These variables were compared among participants using univariate analysis and multiple logistic regression analysis. Results The participants included 77 men and 242 women, with a mean age of 75.8 ± 5.4 years (65–94 years). Although temporomandibular joint noise and dental attrition were significantly positively correlated with salivary α-amylase, bruxism was significantly negatively correlated with salivary α-amylase (p < 0.05). Stepwise regression analysis revealed a significant relationship between salivary α-amylase and temporomandibular joint noise, bruxism, and dental attrition. Conclusion High salivary α-amylase is associated with a high rate of temporomandibular joint noise and dental attrition, and a low rate of bruxism among elderly participants.
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Affiliation(s)
- Koji Morita
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Hitomi Kimura
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Hiroki Tsuka
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Fumiko Nishio
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Mitsuyoshi Yoshida
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
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MacCormack JK, Stein AG, Kang J, Giovanello KS, Satpute AB, Lindquist KA. Affect in the Aging Brain: A Neuroimaging Meta-Analysis of Older Vs. Younger Adult Affective Experience and Perception. AFFECTIVE SCIENCE 2020; 1:128-154. [PMID: 36043210 PMCID: PMC9382982 DOI: 10.1007/s42761-020-00016-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 08/20/2020] [Indexed: 05/15/2023]
Abstract
We report the first functional neuroimaging meta-analysis on age-related differences in adult neural activity during affect. We identified and coded experimental contrasts from 27 studies (published 1997-2018) with 490 older adults (55-87 years, M age = 69 years) and 470 younger adults (18-39 years, M age = 24 years). Using multilevel kernel density analysis, we assessed functional brain activation contrasts for older vs. younger adult affect across in-scanner tasks (i.e., affect induction and perception). Relative to older adults, younger adults showed more reliable activation in subcortical structures (e.g., amygdala, thalamus, caudate) and in relatively more posterior aspects of specific brain structures (e.g., posterior insula, mid- and posterior cingulate). In contrast, older adults exhibited more reliable activation in the prefrontal cortex and more anterior aspects of specific brain structures (e.g., anterior insula, anterior cingulate). Meta-analytic coactivation network analyses further revealed that in younger adults, the amygdala and mid-cingulate were more central, locally efficient network nodes, whereas in older adults, regions in the superior and medial prefrontal cortex were more central, locally efficient network nodes. Collectively, these findings help characterize age differences in the brain basis of affect and provide insights for future investigations into the neural mechanisms underlying affective aging.
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Affiliation(s)
- Jennifer K. MacCormack
- Department of Psychiatry, University of Pittsburgh, 506 Old Engineering Hall, 3943 O’Hara St, Pittsburgh, PA 15213 USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Andrea G. Stein
- Department of Psychology, University of Wisconsin-Madison, Madison, WI USA
| | - Jian Kang
- Department of Biostatistics, University of Michigan, Ann Arbor, MI USA
| | - Kelly S. Giovanello
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | - Ajay B. Satpute
- Department of Psychology, Northeastern University, Boston, MA USA
| | - Kristen A. Lindquist
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
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Becoming Stressed: Does the Age Matter? Reviewing the Neurobiological and Socio-Affective Effects of Stress throughout the Lifespan. Int J Mol Sci 2020; 21:ijms21165819. [PMID: 32823723 PMCID: PMC7460954 DOI: 10.3390/ijms21165819] [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: 07/18/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 12/25/2022] Open
Abstract
Social and affective relations occur at every stage of our lives. Impairments in the quality of this “social world” can be exceptionally detrimental and lead to psychopathology or pathological behavior, including schizophrenia, autism spectrum disorder, affective disorders, social phobia or violence, among other things. Exposure to highly stressful or traumatic events, depending on the stage of life in which stress exposure occurs, could severely affect limbic structures, including the amygdala, and lead to alterations in social and affective behaviors. This review summarizes recent findings from stress research and provides an overview of its age-dependent effects on the structure and function of the amygdala, which includes molecular and cellular changes, and how they can trigger deviant social and affective behaviors. It is important to highlight that discoveries in this field may represent a breakthrough both for medical science and for society, as they may help in the development of new therapeutic approaches and prevention strategies in neuropsychiatric disorders and pathological behaviors.
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Gerhardsson A, Fischer H, Lekander M, Kecklund G, Axelsson J, Åkerstedt T, Schwarz J. Positivity Effect and Working Memory Performance Remains Intact in Older Adults After Sleep Deprivation. Front Psychol 2019; 10:605. [PMID: 30967813 PMCID: PMC6440387 DOI: 10.3389/fpsyg.2019.00605] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/04/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Older adults perform better in tasks which include positive stimuli, referred to as the positivity effect. However, recent research suggests that the positivity effect could be attenuated when additional challenges such as stress or cognitive demands are introduced. Moreover, it is well established that older adults are relatively resilient to many of the adverse effects of sleep deprivation. Our aim was to investigate if the positivity effect in older adults is affected by one night of total sleep deprivation using an emotional working memory task. Methods: A healthy sample of 48 older adults (60-72 years) was either sleep deprived for one night (n = 24) or had a normal night's sleep (n = 24). They performed an emotional working memory n-back (n = 1 and 3) task containing positive, negative and neutral pictures. Results: Performance in terms of accuracy and reaction times was best for positive stimuli and worst for negative stimuli. This positivity effect was not altered by sleep deprivation. Results also showed that, despite significantly increased sleepiness, there was no effect of sleep deprivation on working memory performance. A working memory load × valence interaction on the reaction times revealed that the beneficial effect of positive stimuli was only present in the 1-back condition. Conclusion: While the positivity effect and general working memory abilities in older adults are intact after one night of sleep deprivation, increased cognitive demand attenuates the positivity effect on working memory speed.
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Affiliation(s)
- Andreas Gerhardsson
- Department of Psychology, Stockholm University, Stockholm, Sweden
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Håkan Fischer
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Mats Lekander
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Göran Kecklund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - John Axelsson
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Torbjörn Åkerstedt
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Johanna Schwarz
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Mayo LM, Heilig M. In the face of stress: Interpreting individual differences in stress-induced facial expressions. Neurobiol Stress 2019; 10:100166. [PMID: 31193535 PMCID: PMC6535645 DOI: 10.1016/j.ynstr.2019.100166] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 04/17/2019] [Accepted: 04/19/2019] [Indexed: 11/22/2022] Open
Abstract
Stress is an inevitable part of life that can profoundly impact social and emotional functioning, contributing to the development of psychiatric disease. One key component of emotion and social processing is facial expressions, which humans can readily detect and react to even without conscious awareness. Facial expressions have been the focus of philosophic and scientific interest for centuries. Historically, facial expressions have been relegated to peripheral indices of fixed emotion states. More recently, affective neuroscience has undergone a conceptual revolution, resulting in novel interpretations of these muscle movements. Here, we review the role of facial expressions according to the leading affective neuroscience theories, including constructed emotion and social-motivation accounts. We specifically highlight recent data (Mayo et al, 2018) demonstrating the way in which stress shapes facial expressions and how this is influenced by individual factors. In particular, we focus on the consequence of genetic variation within the endocannabinoid system, a neuromodulatory system implicated in stress and emotion, and its impact on stress-induced facial muscle activity. In a re-analysis of this dataset, we highlight how gender may also influence these processes, conceptualized as variation in the "fight-or-flight" or "tend-and-befriend" behavioral responses to stress. We speculate on how these interpretations may contribute to a broader understanding of facial expressions, discuss the potential use of facial expressions as a trans-diagnostic marker of psychiatric disease, and suggest future work necessary to resolve outstanding questions.
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Affiliation(s)
- Leah M. Mayo
- Center for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Linköping University, Sweden
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Schwarz J, Axelsson J, Gerhardsson A, Tamm S, Fischer H, Kecklund G, Åkerstedt T. Mood impairment is stronger in young than in older adults after sleep deprivation. J Sleep Res 2018; 28:e12801. [PMID: 30585371 PMCID: PMC7379256 DOI: 10.1111/jsr.12801] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/10/2018] [Accepted: 10/31/2018] [Indexed: 12/17/2022]
Abstract
Sleep deprivation commonly impairs affective regulation and causes worse mood. However, the majority of previous research concerns young adults. Because susceptibility to sleep deprivation and emotion regulation change distinctively across adult age, we tested here the hypothesis that the effect of sleep deprivation on mood is stronger in young than in older adults. In an experimental design, young (18–30 years) and older adults (60–72 years) participated in either a sleep control (young, n = 63; older, n = 47) or a total sleep deprivation condition (young, n = 61; older, n = 47). Sleepiness, mood and common symptoms of sleep deprivation were measured using established questionnaires and ratings. Sleep‐deprived participants felt more sleepy, stressed and cold, and reported lower vigour and positive affect, regardless of age. All the other outcome measures (negative affect, depression, confusion, tension, anger, fatigue, total mood disturbance, hunger, cognitive attenuation, irritability) showed a weaker response to sleep deprivation in the older group, as indicated by age*sleep deprivation interactions (ps < 0.05). The results show that older adults are emotionally less affected by sleep deprivation than young adults. This tolerance was mainly related to an attenuated increase in negative mood. This could possibly be related to the well‐known positivity effect, which suggests that older adults prioritize regulating their emotions to optimize well‐being. The results also highlight that caution is warranted when generalizing results from sleep deprivation studies across the adult lifespan.
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Affiliation(s)
- Johanna Schwarz
- Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - John Axelsson
- Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | | | - Sandra Tamm
- Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Håkan Fischer
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Göran Kecklund
- Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Torbjörn Åkerstedt
- Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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