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Simei JLQ, de Souza JDR, Lisboa JR, Guimarães FS, Crippa JADS. Cannabidiol in anxiety disorders: Current and future perspectives. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2024; 177:205-234. [PMID: 39029985 DOI: 10.1016/bs.irn.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/21/2024]
Abstract
Anxiety disorders are highly prevalent psychiatric disorders, characterized by a chronic course and often accompanied by comorbid symptoms that impair functionality and decrease quality of life. Despite advances in basic and clinical research in our understanding of these disorders, currently available pharmacological options are associated with limited clinical benefits and side effects that frequently lead to treatment discontinuation. Importantly, a significant number of patients do not achieve remission and live with lifelong residual symptoms that limit daily functioning. Since the 1970s, basic and clinical research on cannabidiol (CBD), a non-psychotomimetic compound found in the Cannabis sativa plant, has indicated relevant anxiolytic effects, garnering attention for its therapeutic potential as an option in anxiety disorder treatment. This chapter aims to review the history of these studies on the anxiolytic effects of CBD within the current understanding of anxiety disorders. It highlights the most compelling current evidence supporting its anxiolytic effects and explores future perspectives for its clinical use in anxiety disorders.
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Affiliation(s)
- João Luís Queiroz Simei
- Department of Neuroscience and Behavior Sciences, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - José Diogo Ribeiro de Souza
- Department of Neuroscience and Behavior Sciences, Ribeirão Preto Medical School, University of São Paulo, Brazil.
| | - João Roberto Lisboa
- Department of Neuroscience and Behavior Sciences, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Francisco Silveira Guimarães
- National Institute for Science and Technology, Translational Medicine, Brazil; Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - José Alexandre de Souza Crippa
- Department of Neuroscience and Behavior Sciences, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Institute for Science and Technology, Translational Medicine, Brazil
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Mavragani A, Khau M, Lavoie-Hudon L, Vachon F, Drapeau V, Tremblay S. Comparing a Fitbit Wearable to an Electrocardiogram Gold Standard as a Measure of Heart Rate Under Psychological Stress: A Validation Study. JMIR Form Res 2022; 6:e37885. [PMID: 36542432 PMCID: PMC9813817 DOI: 10.2196/37885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 10/28/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Wearable devices collect physiological and behavioral data that have the potential to identify individuals at risk of declining mental health and well-being. Past research has mainly focused on assessing the accuracy and the agreement of heart rate (HR) measurement of wearables under different physical exercise conditions. However, the capacity of wearables to sense physiological changes, assessed by increasing HR, caused by a stressful event has not been thoroughly studied. OBJECTIVE This study followed 3 objectives: (1) to test the ability of a wearable device (Fitbit Versa 2) to sense an increase in HR upon induction of psychological stress in the laboratory; (2) to assess the accuracy of the wearable device to capture short-term HR variations caused by psychological stress compared to a gold-standard electrocardiogram (ECG) measure (Biopac); and (3) to quantify the degree of agreement between the wearable device and the gold-standard ECG measure across different experimental conditions. METHODS Participants underwent the Trier Social Stress Test protocol, which consists of an oral phase, an arithmetic stress phase, an anticipation phase, and 2 relaxation phases (at the beginning and the end). During the stress protocol, the participants wore a Fitbit Versa 2 and were also connected to a Biopac. A mixed-effect modeling approach was used (1) to assess the effect of experimental conditions on HR, (2) to estimate several metrics of accuracy, and (3) to assess the agreement: the Bland-Altman limits of agreement (LoA), the concordance correlation coefficient, the coverage probability, the total deviation index, and the coefficient of an individual agreement. Mean absolute error and mean absolute percent error were calculated as accuracy indices. RESULTS A total of 34 university students were recruited for this study (64% of participants were female with a mean age of 26.8 years, SD 8.3). Overall, the results showed significant HR variations across experimental phases. Post hoc tests revealed significant pairwise differences for all phases. Accuracy analyses revealed acceptable accuracy according to the analyzed metrics of accuracy for the Fitbit Versa 2 to capture the short-term variations in psychological stress levels. However, poor indices of agreement between the Fitbit Versa 2 and the Biopac were found. CONCLUSIONS Overall, the results support the use of the Fitbit Versa 2 to capture short-term stress variations. The Fitbit device showed acceptable levels of accuracy but poor agreement with an ECG gold standard. Greater inaccuracy and smaller agreement were found for stressful experimental conditions that induced a higher HR. Fitbit devices can be used in research to measure HR variations caused by stress, although they cannot replace an ECG instrument when precision is of utmost importance.
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Affiliation(s)
| | - Michelle Khau
- Faculty of Social Sciences, Laval University, Québec, QC, Canada
| | | | - François Vachon
- School of Psychology, Faculty of Social Sciences, Laval University, Québec, QC, Canada
| | - Vicky Drapeau
- Quebec Heart and Lung Institute Research Center, Department of Physical Education, Faculty of Educational Sciences, Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, QC, Canada
| | - Sébastien Tremblay
- School of Psychology, Faculty of Social Sciences, Laval University, Québec, QC, Canada
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Ying L, Yan Q, Shen X, Zhang C. Social Value Orientation Moderated the Effect of Acute Stress on Individuals' Prosocial Behaviors. Front Psychol 2022; 13:803184. [PMID: 35360587 PMCID: PMC8960429 DOI: 10.3389/fpsyg.2022.803184] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/26/2022] [Indexed: 11/17/2022] Open
Abstract
Acute stress is believed to lead to prosocial behaviors via a "tend-and-befriend" pattern of stress response. However, the results of the effect of acute stress on prosocial behavior are inconsistent. The current study explores the moderating effect of gender and social value orientation on the relationship between acute stress and individuals' pure prosocial behaviors (i.e., pure prosociality and prosocial third-party punishment). Specifically, eighty-one participants were selected and underwent the Trier Social Stress Test (or were in the control group), followed by the third-party punishment task and the dictator game. The results showed that, in general, the main effect of condition or respiratory sinus arrhythmia (RSA) reactivity on individual prosocial behaviors was significant and did not vary between genders. Furthermore, social value orientation (i.e., prosocial or self-orientation) might moderate the impact of RSA reactivity on the amount of punishment in the third-party punishment task. That is, individuals with self-orientation exhibited more prosocial third-party punishment as RSA reactivity decreased, while the effect did not occur for individuals with prosocial orientation. Taken together, the findings of the current study provide further evidence for the "tend-and-befriend" hypothesis and highlight the underlying physical mechanisms as well as the individual dependence of the effect of psychosocial stress on individuals' pure prosocial behaviors.
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Craw OA, Smith MA, Wetherell MA. Manipulating Levels of Socially Evaluative Threat and the Impact on Anticipatory Stress Reactivity. Front Psychol 2021; 12:622030. [PMID: 33692723 PMCID: PMC7937816 DOI: 10.3389/fpsyg.2021.622030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/02/2021] [Indexed: 11/13/2022] Open
Abstract
Previous work suggests that relative increases in socially evaluative threat modulate the psychobiological stress response. However, few studies have compared stressors which manipulate the level of socially evaluative threat to which the participant is exposed. Here we present two studies. In the first, we assessed the integrity of an ecologically valid, laboratory stressor (direct socially evaluated multitasking) and its effects on acute psychobiological reactivity and ability to evoke an anticipatory response prior to participation. Specifically, we assessed whether the expectation and experience of direct social evaluation (multitasking while standing and facing an evaluator) evokes greater reactivity than indirect evaluation (over-the-shoulder evaluation). In the second study, we sought to replicate the findings regarding acute stress reactivity whilst extending the assessment window to assess the extent to which the stressor evokes anticipatory responses. As hypothesized, greater reactivity was observed following direct social evaluation compared with indirect observation. Increases in anxiety, heart rate and blood pressure were demonstrated across both studies and the paradigm therefore provides an ecologically valid technique for the activation of psychological and cardiovascular stress responding. Additionally, anticipation of experiencing socially evaluated multitasking led to increases in anxiety, tension, and worry prior to the event itself, supporting previous suggestions that threat anticipation may prolong the activation of stress mechanisms. In the present studies we assessed whether the expectation and experience of direct social evaluation evokes greater reactivity than indirect evaluation. The findings have demonstrated that direct social evaluation of multitasking is a more potent stressor than multitasking with indirect evaluation. Furthermore, our findings indicate that the period of anticipation of stressful events may be critical to understanding the process of stress regulation, and as such we recommend extending the sampling window to allow for the investigation of these processes.
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Affiliation(s)
- Olivia A. Craw
- Stress Research Group, Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Michael A. Smith
- Stress Research Group, Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Mark A. Wetherell
- Stress Research Group, Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
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Pantuza JJ, Alexandre IO, Medeiros AMD, Marinho ACF, Teixeira LC. Sense of Coherence and the fear of public speaking in university students. Codas 2020; 32:e20190071. [PMID: 33053083 DOI: 10.1590/2317-1782/20202019071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 09/19/2019] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To test the association between the Sense of Coherence (SOC) and the fear of public speaking in university students. METHOD Cross-sectional study was carried out with a sample of 1124 undergraduate students of a Brazilian public university. An online questionnaire was used divided into three blocks: the first evaluated the sociodemographic data and the somatic symptoms of the fear of public speaking; the second evaluated the SOC, through the SOC-13 questionnaire; and the third was composed by the Scale for Self-Assessment in Public Speaking (SSPS), with questions that point out cognitive aspects of this activity. The students were divided into two groups (high SOC and low SOC) through the Two-step Cluster analysis. Data were analyzed descriptively and by the Mann-Whitney test and bi and multivariate logistic regression models, with significance set at 5%. RESULTS The students who reported not being afraid to speak in public were more likely to belong to the high SOC group (OR = 3.19, 95% CI = 2.30-4.42). Students from the high SOC group self-assessed more positively on the SSPS scale (p <0.001). CONCLUSION College students over 30 years old, on the second half of graduation, with breathing discomfort, who do not report fear of public speaking and who perceive themselves more positively for public speaking, they have the highest SOC. Thus, it is observed the importance of considering the SOC as an important coping resource, given the great interference of emotional aspects in public speech.
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A systematic review of the Trier Social Stress Test methodology: Issues in promoting study comparison and replicable research. Neurobiol Stress 2020; 13:100235. [PMID: 33344691 PMCID: PMC7739033 DOI: 10.1016/j.ynstr.2020.100235] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/27/2022] Open
Abstract
Since its development in 1993, the Trier Social Stress Test (TSST) has been used widely as a psychosocial stress paradigm to activate the sympathetic nervous system and hypothalamic-pituitary-adrenal axis (HPAA) stress systems, stimulating physiological functions (e.g. heart rate) and cortisol secretion. Several methodological variations introduced over the years have led the scientific community to question replication between studies. In this systematic review, we used the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) to synthesize procedure-related data available about the TSST protocol to highlight commonalities and differences across studies. We noted significant discrepancies across studies in how researchers applied the TSST protocol. In particular, we highlight variations in testing procedures (e.g., number of judges, initial number in the arithmetic task, time of the collected saliva samples for cortisol) and discuss possible misinterpretation in comparing findings from studies failing to control for variables or using a modified version from the original protocol. Further, we recommend that researchers use a standardized background questionnaire when using the TSST to identify factors that may influence physiological measurements in tandem with a summary of this review as a protocol guide. More systematic implementation and detailed reporting of TSST methodology will promote study replication, optimize comparison of findings, and foster an informed understanding of factors affecting responses to social stressors in healthy people and those with pathological conditions.
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Soares MC, Gerlai R, Maximino C. The integration of sociality, monoamines and stress neuroendocrinology in fish models: applications in the neurosciences. JOURNAL OF FISH BIOLOGY 2018; 93:170-191. [PMID: 30043474 DOI: 10.1111/jfb.13757] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 07/12/2018] [Indexed: 06/08/2023]
Abstract
Animal-focused research has been crucial for scientific advancement, but rodents are still taking a starring role. Starting as merely supporting evidence found in rodents, the use of fish models has slowly taken a more central role and expanded its overall contributions in areas such as social sciences, evolution, physiology and recently in translational medical research. In the neurosciences, zebrafish Danio rerio have been widely adopted, contributing to our understanding of the genetic control of brain processes and the effects of pharmacological manipulations. However, discussion continues regarding the paradox of function versus structure, when fishes and mammals are compared and on the potentially evolutionarily conserved nature of behaviour across fish species. From a behavioural standpoint, we explore aversive-stress and social behaviour in selected fish models and refer to the extensive contributions of stress and monoaminergic systems. We suggest that, in spite of marked neuroanatomical differences between fishes and mammals, stress and sociality are conserved at the behavioural and molecular levels. We also suggest that stress and sociality are mediated by monoamines in predictable and non-trivial ways and that monoamines could bridge the relationship between stress and social behaviour. To reconcile the level of divergence with the level of similarity, we need neuroanatomical, pharmacological, behavioural and ecological studies conducted in the laboratory and in nature. These areas need to add to each other to enhance our understanding of fish behaviour and ultimately how this all may lead to better model systems for translational studies.
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Affiliation(s)
- Marta C Soares
- Centro de Investigação em Biodiversidade e Recursos Genéticos - CIBIO, Universidade do Porto, Vairão, Portugal
| | - Robert Gerlai
- Department of Psychology, University of Toronto Mississauga, Mississauga, Canada
| | - Caio Maximino
- Laboratório de Neurociências e Comportamento 'Frederico Guilherme Graeff', Instituto de Estudos em Saúde e Biológicas - IESB, Universidade Federal do Sul e Sudeste do Pará, Marabá, Brazil
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Wetherell MA, Craw O, Smith K, Smith MA. Psychobiological responses to critically evaluated multitasking. Neurobiol Stress 2017; 7:68-73. [PMID: 28540348 PMCID: PMC5432679 DOI: 10.1016/j.ynstr.2017.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 04/06/2017] [Accepted: 05/10/2017] [Indexed: 11/02/2022] Open
Abstract
In order to understand psychobiological responses to stress it is necessary to observe how people react to controlled stressors. A range of stressors exist for this purpose; however, laboratory stressors that are representative of real life situations provide more ecologically valid opportunities for assessing stress responding. The current study assessed psychobiological responses to an ecologically valid laboratory stressor involving multitasking and critical evaluation. The stressor elicited significant increases in psychological and cardiovascular stress reactivity; however, no cortisol reactivity was observed. Other socially evaluative laboratory stressors that lead to cortisol reactivity typically require a participant to perform tasks that involve verbal responses, whilst standing in front of evaluative others. The current protocol contained critical evaluation of cognitive performance; however, this was delivered from behind a seated participant. The salience of social evaluation may therefore be related to the response format of the task and the method of evaluation. That is, the current protocol did not involve the additional vulnerability associated with in person, face-to-face contact, and verbal delivery. Critical evaluation of multitasking provides an ecologically valid technique for inducing laboratory stress and provides an alternative tool for assessing psychological and cardiovascular reactivity. Future studies could additionally use this paradigm to investigate those components of social evaluation necessary for eliciting a cortisol response.
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Affiliation(s)
- Mark A Wetherell
- Psychobiology Research Group, Department of Psychology, Northumbria University Newcastle, UK
| | - Olivia Craw
- Psychobiology Research Group, Department of Psychology, Northumbria University Newcastle, UK
| | - Kenny Smith
- School of Philosophy, Psychology and Language Sciences, University of Edinburgh, UK
| | - Michael A Smith
- Psychobiology Research Group, Department of Psychology, Northumbria University Newcastle, UK.,Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, Australia
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Graeff FG. Translational approach to the pathophysiology of panic disorder: Focus on serotonin and endogenous opioids. Neurosci Biobehav Rev 2017; 76:48-55. [DOI: 10.1016/j.neubiorev.2016.10.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/30/2016] [Accepted: 10/13/2016] [Indexed: 12/18/2022]
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Katsumata S. [How to improve success rates of the compounds acting on CNS using biomarkers]. Nihon Yakurigaku Zasshi 2017; 149:148-153. [PMID: 28381657 DOI: 10.1254/fpj.149.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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