Stress task specific impairments of cardiovascular functioning in obese participants

Stress-induced brain responses are associated with BMI in women

Overweight and obesity are associated with altered stress reactivity and increased inflammation. However, it is not known whether stress-induced changes in brain function scale with BMI and if such associations are driven by peripheral cytokines. Here, we investigate multimodal stress responses in a large transdiagnostic sample using predictive modeling based on spatio-temporal profiles of stress-induced changes in activation and functional connectivity. BMI is associated with increased brain responses as well as greater negative affect after stress and individual response profiles are associated with BMI in females (pperm < 0.001), but not males. Although stress-induced changes reflecting BMI are associated with baseline cortisol, there is no robust association with peripheral cytokines. To conclude, alterations in body weight and energy metabolism might scale acute brain responses to stress more strongly in females compared to males, echoing observational studies. Our findings highlight sex-dependent associations of stress with differences in endocrine markers, largely independent of peripheral inflammation.

Blunted Cardiovascular Reactivity Predicts Worse Performance in Working Memory Tasks

When we experience psychological challenges in the environment, our heart rate usually rises to make us more able to solve the task, but there is an individual difference in cardiovascular reactivity (CVR). Extreme CVR to environmental demands has been associated with worse health outcomes, with blunted CVR (little or no rise in heart rate) related to maladaptive behavior, including depression. The blunted CVR has been explained by motivational disengagement, which involves giving up on a task when facing obstacles. Disengagement is thought to be a habitual response that people might not be aware of, and, therefore, objective measures such as test performance might serve as a good measure of engagement. In this study, 66 participants solved different cognitive tasks while their CVR was measured. The aim was to test the association between test performance and reactivity, measured with the difference in heart rate at baseline and the mean heart rate while solving the tasks. Our results show a significant association between reactivity scores and performance in all tests, of various difficulty, indicating that blunted cardiovascular reactivity predicts poorer cognitive performance. Furthermore, we find an association between reactivity in one test and the performance in the other tests, suggesting that disengagement from environmental demands can be more general and not depend on the task at hand. The results, therefore, support earlier research suggesting that blunted CVR is associated with worse cognitive performance, and extends the literature by indicating that disengagement could be a more general maladaptive response to the environment.

Obesity: Heart Rate Variability during standardized psychosocial stress induction

Obesity is related to a higher risk of cardiovascular diseases (CVD). An altered stress reactivity of the parasympathetic nervous system (PNS) is a promising predictor of CVD and other negative health outcomes. Therefore, the aim of this study was to compare heart rate (HR) and heart rate variability parameters, root mean square successive differences (RMSSD) and power in the high frequency range 0.15-0.4 Hz (HF-HRV), of individuals with obesity and healthy weight controls during psychosocial stress induction. Thirty-four obese men and women (BMI: 33.80 ± 4.62 kg/m²), and thirty-four age- and gender-matched healthy weight controls (BMI: 22.29 ± 1.81 kg/m²) underwent the Trier Social Stress Test (TSST). Before, during, and after the TSST, their HR, RMSSD, and HF-HRV were measured. The individuals with obesity showed a lower stress reactivity in HR, and less stress recovery in RMSSD, compared to healthy weight controls. Obesity appears related to blunted HR reactivity, which is associated with CVD. In addition, impaired recovery of RMSSD also found in individuals with obesity may reflect health-damaging processes as well.

Cardiovascular stress reactivity, habituation, and adiposity

The relationship between adiposity and cardiovascular disease morbidity and mortality is complex. One pathway through which adiposity may influence future health outcomes is by altering how biological systems respond to stress. The current study aimed to examine the association between two metrics of adiposity (body mass index and waist-hip ratio) and two indices of cardiovascular stress responses (reactivity and habituation). A sample of 455 participants (Mean age = 19.47, SD = 1.25 years; BMI = 24.32, SD = 5.04 kg/m² ; 62% female; 17.9% Hispanic/Latino; 65.2% White, 18.7% Asian, 7.9% Black, 0.2% American Indian/Alaska Native, and 7% other) completed two acute psychosocial stress tasks. Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded throughout each stressor. In unadjusted and adjusted models, there were no statistically significant associations between adiposity and HR, SBP, or DBP stress reactivity or habituation. The current data do not support the hypothesis that adiposity influences health by altering cardiovascular responses to acute psychological stress. Results are at odds with prior population-level studies and the single prior study examining adiposity and habituation. At the same time, results are in line with mounting evidence that adiposity itself does not drive poor cardiovascular outcomes seen in people classified as overweight or obese.

Body mass index in relation to cardiovascular recovery from psychological stress among trauma-exposed women

Delayed cardiovascular recovery has been associated with greater heart disease risks. However, relative to stress reactivity, cardiovascular recovery has been understudied. Further, few studies have examined associations of recovery with modifiable factors that might inform efforts to enhance recovery. The focus of the present study was whether body mass index (BMI) was associated with recovery following two stress tasks (speech and mental arithmetic). Based on the conceptualization that obesity may lead to impaired post-stress recovery, we also examined whether higher BMI accounted for previously reported associations between elevated PTSD symptoms and delayed recovery. The sample consisted of 50 trauma-exposed civilian women ages 19-49 (M±SD = 30 ± 8). The stress tasks were followed by 15-min post-task rest periods. Cardiovascular recovery was assessed as percentage return to baseline; the recovery measures consisted of heart rate (HR), cardiac output (CO), systolic blood pressure (SBP) and diastolic blood pressure (DBP). PTSD severity was based on structured interview. Higher BMI was associated with significantly less CO recovery from the speech task and less HR recovery from mental arithmetic. Higher BMI was associated with more SBP recovery from the math task, but was not associated with DBP recovery. The indirect effects of BMI in the PTSD/CO recovery relationship based on the Sobel test of mediation were significant. These results partially support the hypotheses that BMI is associated with cardiovascular recovery and that associations of PTSD with recovery may be mediated by BMI.

An introduction to the 'Psycho-Physiological-Stress-Test' (PPST)-A standardized instrument for evaluating stress reactions

Using a standardized instrument to evaluate patients' stress reactions has become more important in daily clinical routines. Different signs or symptoms of stress are often unilaterally explored: the physiological, psychological or social aspects of stress disorders are each viewed on a single dimension. However, all dimensions afflict patients who have persistent health problems due to chronic stress. Therefore, it is important to use a multidimensional approach to acquire data. The 'Psycho-Physiological-Stress-Test' (PPST) was established to achieve a comprehensive understanding of stress and was further developed at the Charité-Universitätsmedizin Berlin in collaboration with the Psychological Department of Freie Universität Berlin. The PPST includes a series of varying stress phases, embedded in two periods of rest. Physiological and psychological parameters are simultaneously measured throughout the test session. Specifically, the PPST activates the sympathetic stress axis, which is measured by heart rate, blood pressure, respiration depth and rate, electro dermal activation and muscle tension (frontalis, masseter, trapezius). Psychological data are simultaneously collected, and include performance, motivation, emotion and behavior. After conducting this diagnostic test, it is possible to identify individual stress patterns that can be discussed with the individual patient to develop and recommend (outpatient) treatment strategies. This paper introduces the PPST as a standardized way to evaluate stress reactions by presenting the results from a sample of psychosomatic inpatients (n = 139) who were treated in Charité-Universitätsmedizin Berlin, Germany. We observed that the varying testing conditions provoked adjusted changes in the different physiological parameters and psychological levels.

The behavioural, cognitive, and neural corollaries of blunted cardiovascular and cortisol reactions to acute psychological stress

Recent research shows that blunted cardiovascular and cortisol reactions to acute psychological stress are associated with adverse behavioural and health outcomes: depression, obesity, bulimia, and addictions. These outcomes may reflect suboptimal functioning of the brain's fronto-limbic systems that are needed to regulate motivated behaviour in the face of challenge. In support of this, brain imaging data demonstrate fronto-limbic hypoactivation during acute stress exposure. Those demonstrating blunted reactions also show impairments of motivation, including lower cognitive ability, more rapid cognitive decline, and poorer performance on motivation-dependent tests of lung function. Persons exhibiting blunted stress reactivity display well established temperament characteristics, including neuroticism and impulsivity, characteristic of various behavioural disorders. Notably, the outcomes related to blunted stress reactivity are similar to those that define Reward Deficiency Syndrome. Accordingly, some individuals may be characterised by a broad failure in cardiovascular and cortisol responding to both stress and reward, reflecting fronto-limbic dysregulation. Finally, we proffer a model of blunted stress reactivity, its antecedents and sequelae, and identify future research priorities.

The Relationship between Stress and Severe Obesity: A Case-Control Study

Background

Several etiological factors for obesity have been identified, whereas other factors related to obesity, such as stress, remain poorly understood. This study used psychiatric methods to examine the relationship between stress and obesity.

Methods

Matched study and control groups were established, and the female and male control subjects were selected separately by random sampling. The control subjects were matched with the case subjects with respect to place of residence, sex, age, date that a pension was granted, and occupation. Psychiatric and psychological methods were assessed using a questionnaire and statistical analyses.

Results

Psychiatric interviews indicated that stress was more prevalent in the study group than in the control group. Separation from parents was nearly significantly more frequently in the study group than in the control group. The questionnaire on coping mechanisms revealed that case subjects tended to resolve their problems in an active manner.

Conclusions

The aim of this case-control study was to examine the relationship between stress and obesity in individuals receiving a disability pension. We identified stress factors that affect the development of obesity. We believe our study is both necessary and important, as these findings provide valuable insight into the relationship between severe obesity and stress.

Stress-induced cardiac autonomic reactivity and preclinical atherosclerosis: does arterial elasticity modify the association?

The effect of acute mental stress on atherosclerosis can be estimated using arterial elasticity measured by carotid artery distensibility (Cdist). We examined the interactive effect of acute stress-induced cardiac reactivity and Cdist to preclinical atherosclerosis assessed by carotid intima-media thickness (IMT) in 58 healthy adults aged 24-39 years participated in the epidemiological Young Finns Study. Cdist and IMT were measured ultrasonographically. Impedance electrocardiography was used to measure acute mental stress-induced cardiac autonomic responses: heart rate (HR), respiratory sinus arrhythmia and pre-ejection period after the mental arithmetic and the public speaking tasks. Interactions between HR reactivity and Cdist in relation to preclinical atherosclerosis were found. The results imply that elevated HR reactivity to acute mental stress is related to less atherosclerosis among healthy participants with higher arterial elasticity. Possibly, increased cardiac reactivity in response to challenging tasks is an adaptive reaction related to better cardiovascular health.