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Gielkens EMJ, Rossi G, van Alphen SPJ, Sobczak S. A First Exploration: Can Eye Movement Desensitization and Reprocessing Improve Cognition in Older Adults With Posttraumatic Stress Disorder? J Geriatr Psychiatry Neurol 2024; 37:206-221. [PMID: 37869986 DOI: 10.1177/08919887231207639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
OBJECTIVES In older adults, PTSD is associated with decreased verbal learning and executive dysfunction. Therefore, feasibility of EMDR-treatment to improve cognitive performance in older adults with PTSD was examined. Additionally, we investigated pre-treatment correlation with often co-occurring risk factors for cognitive decline (sleep problems, depressive disorder, physical inactivity, childhood traumatic events). DESIGN Multicenter design with pre-post measurements. SETTING Psychiatric Dutch hospitals Mondriaan Mental Health Center and Altrecht. PARTICIPANTS 22 treatment-seeking PTSD-outpatients (60-84 years). INTERVENTION Weekly one-hour EMDR session during 3, 6, or 9 months. MEASUREMENTS PTSD was assessed with Clinician-Administered PTSD-scale for DSM-5 (CAPS-5). Verbal learning memory was measured with Auditory Verbal Learning Test (RAVLT), interference with Stroop Colour-Word Test (SCWT) and working memory with Wechsler Adult Intelligence Scale-Digit Span (WAIS-IV-DS). RESULTS A Linear mixed-model showed significant improvement on RAVLT immediate-recall (F (1, 21) = 15.928, P = .001, 95% CI -6.98-2.20), delayed-recall (F (1, 21) = 7.095, P = .015, 95% CI -2.43-.30), recognition (F (21) = 8.885, P = .007, 95% CI -1.70- -.30), and SCWT (F (1 ,21) = 5.504, P = .029, 95% CI 4.38-72.78) but not on WAIS-IV-DS (F (20) = -1.237, P = .230, 95% CI -3.07-.78). There was no significant influence of therapy duration and CAPS-5 pre-treatment scores. There were small-medium nonsignificant correlations between CAPS-5 and cognitive performance pre-post differences, and between most cognitive measures and sleep problems, depressive disorder, and physical inactivity. CONCLUSIONS Cognitive functioning on memory and attention possible increased in older adults with PTSD after EMDR treatment. Further research is needed with a larger sample and a control condition to corroborate these findings and to identify the possible mediating role of modifiable risk factors.
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Affiliation(s)
- Ellen M J Gielkens
- Department Clinical Center of Excellence for Older Adults with Personality Disorders, Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
- Psychology Department, Personality and Psychopathology Research Group (PEPS), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Gina Rossi
- Psychology Department, Personality and Psychopathology Research Group (PEPS), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Sebastiaan P J van Alphen
- Department Clinical Center of Excellence for Older Adults with Personality Disorders, Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
- Psychology Department, Personality and Psychopathology Research Group (PEPS), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Sjacko Sobczak
- Department Clinical Center of Excellence for Older Adults with Personality Disorders, Mondriaan Mental Health Center, Heerlen-Maastricht, the Netherlands
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Research Center Innovations in Care, Rotterdam University of Applied Sciences (RUAS), Rotterdam, The Netherlands
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Temple J, Gemma Cherry M, Gray V, Jones A, Fisher P. Experience sampling methodology study of anxiety and depression in adolescents with epilepsy: The role of metacognitive beliefs and perseverative thinking. Epilepsy Behav 2024; 151:109599. [PMID: 38160577 DOI: 10.1016/j.yebeh.2023.109599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/10/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
Emotional distress is common in young people with epilepsy (YPwE). According to the Self-Regulatory Executive Function (S-REF) model, maladaptive metacognitive beliefs and perseverative thinking are fundamental in the development and maintenance of emotional distress. As emotional distress and perseverative thinking can highly fluctuate over short intervals in YPwE, it is important to account for this variability when testing the utility of psychological models. Experience sampling methodology (ESM) was therefore used to explore the momentary relationship between metacognitive beliefs, perseverative thinking, and emotional distress in YPwE. Eighteen participants diagnosed with epilepsy (aged 12-17 years) completed the 10-day ESM period. Participants were prompted to complete the ESM assessment five times daily. The ESM assessment assessed participant's momentary levels of metacognitive beliefs, perseverative thinking (i.e., worry and rumination), and emotional distress (i.e., anxiety and depression). A series of multilevel regression analyses indicated that metacognitive beliefs were significantly positively associated with worry, rumination, anxiety and depression. After controlling for worry and rumination, respectively, metacognitive beliefs did not account for additional variance in anxiety or depression. Findings provide preliminary support for the utility of the S-REF model for emotional distress in YPwE. Metacognitive therapy, which is underpinned by the S-REF model, may be an appropriate intervention for emotional distress in YPwE. Future studies should assess the mediational relationship between metacognitive beliefs, perseverative thinking, and emotional distress using time-lagged models.
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Affiliation(s)
- James Temple
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK; Mersey Care NHS Foundation Trust, Liverpool, UK
| | - Mary Gemma Cherry
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK; Clinical Health Psychology Service, Liverpool University NHS Foundation Trust, Liverpool, UK.
| | - Victoria Gray
- Psychological Services (Paediatrics), Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Andrew Jones
- Department of Psychology, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Peter Fisher
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK; Clinical Health Psychology Service, Liverpool University NHS Foundation Trust, Liverpool, UK
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Schricker IF, Nayman S, Reinhard I, Kuehner C. Reactivity toward daily events: Intraindividual variability and change in recurrent depression - A measurement burst study. Behav Res Ther 2023; 168:104383. [PMID: 37586185 DOI: 10.1016/j.brat.2023.104383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/29/2023] [Accepted: 07/31/2023] [Indexed: 08/18/2023]
Abstract
In Major Depressive Disorder, first evidence shows heightened mood-reactivity toward daily events. Related longitudinal studies in remitted patients with recurrent major depression are lacking. Long-term changes in such short-term within-person associations can be analysed via measurement burst designs. Two bursts, separated by approximately 4.4 years, consisted of a baseline session and an Ambulatory Assessment (burst-1: 3 days, burst-2: 5 days). Via smartphone, 54 initially remitted patients with recurrent major depression indicated their negative and positive affect, rumination, self-acceptance, and the occurrence of negative and positive daily events ten times and collected saliva cortisol samples five times per day. In bursts with higher depression levels, patients showed blunted negative affect- and cortisol-reactivity and stronger decreases in positive affect and self-acceptance toward negative daily events, as well as stronger increases in self-acceptance following positive daily events. However, patients with higher depression levels demonstrated stronger ruminative stress-reactivity within bursts. Furthermore, patients with higher depression levels showed an increase of affective stress-reactivity over bursts, such that negative affect more strongly increased and positive affect more strongly decreased following negative daily events over bursts. Following positive daily events, patients with higher depression levels showed stronger decreases in negative affect within bursts and a decrease of self-acceptance-reactivity over bursts. To conclude, measurement burst designs enable to examine intraindividual variability and change of micro-level processes, and possible moderators thereof, potentially providing prognostic information for the course of recurrent major depression.
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Affiliation(s)
- Isabelle Florence Schricker
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Sibel Nayman
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany.
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Schricker IF, Nayman S, Reinhard I, Kuehner C. Trait and state effects of different modes of thinking on salivary cortisol in daily life in patients with recurrent major depression and healthy individuals. Psychoneuroendocrinology 2023; 155:106307. [PMID: 37290378 DOI: 10.1016/j.psyneuen.2023.106307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/10/2023]
Abstract
Habitual modes of thinking such as repetitive negative thinking (RNT), but also momentary cognitive processes such as mindwandering could be vulnerability factors for the course of Major Depressive Disorder (MDD). On the physiological level, cortisol represents an important biological stress marker of the hypothalamic-pituitary-adrenal (HPA) axis. Being a dynamic and non-invasive measure, salivary cortisol can be assessed in daily life via Ambulatory Assessment (AA). So far, consensus exists on a dysregulation of the HPA axis in MDD. However, findings are ambiguous and AA-studies examining both trait and state level effects of cognitive processes on cortisol release in daily life in patients with recurrent major depression (rMDD) and healthy controls (HCs) are lacking. A sample of 119 (nrMDD=57, nHCs=62) participants underwent a baseline session, including self-rated questionnaires (RNT, mindfulness) followed by a 5-day AA, where participants indicated the occurrence of mindwandering and levels of mentalshift problems ten times per day via smartphone, and collected saliva cortisol samples five times per day. Via multilevel models, we found habitual RNT, but not mindfulness, to predict higher cortisol levels, with the effects being stronger in rMDD patients. State mindwandering and mentalshift problems predicted increased cortisol 20 min later across groups. State cognitions did not mediate the effects of habitual RNT on cortisol release. Our results suggest independent mechanisms of action for trait and state cognitions on cortisol activity in daily life and indicate a greater physiological vulnerability toward trait RNT and the tendency to experience mentalshift problems in patients with recurrent major depression.
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Affiliation(s)
- Isabelle Florence Schricker
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Sibel Nayman
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany.
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Reciprocal Prospective Effects of Momentary Cognitions and Affect in Daily Life and Mood Reactivity Toward Daily Events in Remitted Recurrent Depression. Behav Ther 2023; 54:274-289. [PMID: 36858759 DOI: 10.1016/j.beth.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 09/05/2022] [Accepted: 09/09/2022] [Indexed: 11/20/2022]
Abstract
Major depressive disorder is a recurrent condition. Potential risk factors for future episodes are maladaptive cognitions, such as rumination and unfavorable reactivity toward negative daily events. Positive thoughts and positive daily events, in contrast, could act as a buffer against mood deterioration. The aim of the present study is to (a) examine differences in daily affect and cognitions in remitted depressed patients with a history of recurrent episodes (rMDD) and healthy controls, (b) analyze reciprocal prospective effects of momentary cognitions and affect, and (c) investigate effects of daily events on affect and cognitions in both groups. A sample of N = 102 participants underwent an ecological momentary assessment (EMA) phase of 5 consecutive days, where rMDD patients (n = 51) and healthy controls (n = 51) indicated their momentary rumination, positive thoughts, affect, and the occurrence of daily events 10 times per day. Via multilevel lag models, we found higher rumination to predict a decrease of positive affect (PA) in the rMDD group, but no effect of rumination on subsequent negative affect (NA) in either group. Higher positive thoughts predicted an increase in PA and a decrease in NA, similarly strong in both groups. Regarding daily events, rMDD patients reported a stronger increase in NA and rumination following negative daily events compared to controls, whereas an observed subsequent decrease of PA and positive thoughts was not moderated by group. Following positive daily events, rMDD patients showed a stronger increase in PA and positive thoughts and a stronger decrease in NA and rumination than controls. For interventions targeting relapse prevention, our results indicate the implementation of strategies fostering the responsiveness to positive events and the up-regulation of positive affect.
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The Impact of Emotion Regulation on the Relationship Between Momentary Negative Affect and End-of-Day Worry and Rumination. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10339-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Associations of Different Emotion Regulation Strategies with Coping-Efficacy, Rumination and Stress. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10307-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Abstract
Background
In order to investigate the relationship between stress-reactive rumination and the implementation of different emotion-regulation strategies (ERS), the pilot study at hand assessed ecological momentary assessment data twice per day from currently depressed patients (n = 21) and healthy controls (n = 23).
Methods
We analyzed differences in the implementation of ERS (body-based, behavioral, cognitive, social and multiple) and the occurrence of stress, rumination and self-efficacy between the groups as well as associations of ERS implementation at a given time-point and later levels of stress and rumination.
Results
Overall, patients reported higher subjective stress levels as well as increased ruminative thinking as a response to life stress and, in addition, a more frequent implementation of ERS. Comparing the implementation of ERS, cognitive ERS were implemented most often in the clinical group in comparison to healthy controls. All ERS were associated with increased self-efficacy at the time-point they were implemented. The implementation of cognitive ERS (e.g., reframing) at a given time-point significantly predicted reduced rumination and stress at later time-points.
Conclusions
Clinical and non-clinical groups seem to differ in their implementation of ERS. While the implementation of all investigated ERS is related to increased coping-efficacy, ERS on a cognitive level seem to be advantageous in reducing stress as well as rumination.
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Zarate D, Stavropoulos V, Ball M, de Sena Collier G, Jacobson NC. Exploring the digital footprint of depression: a PRISMA systematic literature review of the empirical evidence. BMC Psychiatry 2022; 22:421. [PMID: 35733121 PMCID: PMC9214685 DOI: 10.1186/s12888-022-04013-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 05/17/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This PRISMA systematic literature review examined the use of digital data collection methods (including ecological momentary assessment [EMA], experience sampling method [ESM], digital biomarkers, passive sensing, mobile sensing, ambulatory assessment, and time-series analysis), emphasizing on digital phenotyping (DP) to study depression. DP is defined as the use of digital data to profile health information objectively. AIMS Four distinct yet interrelated goals underpin this study: (a) to identify empirical research examining the use of DP to study depression; (b) to describe the different methods and technology employed; (c) to integrate the evidence regarding the efficacy of digital data in the examination, diagnosis, and monitoring of depression and (d) to clarify DP definitions and digital mental health records terminology. RESULTS Overall, 118 studies were assessed as eligible. Considering the terms employed, "EMA", "ESM", and "DP" were the most predominant. A variety of DP data sources were reported, including voice, language, keyboard typing kinematics, mobile phone calls and texts, geocoded activity, actigraphy sensor-related recordings (i.e., steps, sleep, circadian rhythm), and self-reported apps' information. Reviewed studies employed subjectively and objectively recorded digital data in combination with interviews and psychometric scales. CONCLUSIONS Findings suggest links between a person's digital records and depression. Future research recommendations include (a) deriving consensus regarding the DP definition and (b) expanding the literature to consider a person's broader contextual and developmental circumstances in relation to their digital data/records.
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Affiliation(s)
- Daniel Zarate
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
| | - Vasileios Stavropoulos
- grid.1019.90000 0001 0396 9544Institute for Health and Sport, Victoria University, Melbourne, Australia ,grid.5216.00000 0001 2155 0800Department of Psychology, University of Athens, Athens, Greece
| | - Michelle Ball
- grid.1019.90000 0001 0396 9544Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Gabriel de Sena Collier
- grid.1019.90000 0001 0396 9544Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Nicholas C. Jacobson
- grid.254880.30000 0001 2179 2404Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Hanover, USA ,grid.254880.30000 0001 2179 2404Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, USA ,grid.254880.30000 0001 2179 2404Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, USA ,grid.254880.30000 0001 2179 2404Quantitative Biomedical Sciences Program, Dartmouth College, Hanover, USA
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Sleep quality, valence, energetic arousal, and calmness as predictors of device-based measured physical activity during a three-week mHealth intervention. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2022. [PMCID: PMC9008661 DOI: 10.1007/s12662-022-00809-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Physical inactivity is known to be a risk factor for several noncommunicable diseases and has a high prevalence in today’s society. Therefore, it is crucial to understand the psychological factors associated with physical activity (PA). Recent developments in the field of ambulatory assessment and technological advances are promising to enhance our understanding of this relationship by analyzing longitudinal data within- and between-persons. These analyses can reveal important factors to design behavior change interventions to enhance PA. Therefore, this study used an ecological momentary assessment during the 3‑week intervention period in the SMARTFAMILY2.0 trial and aimed to investigate whether valence, calmness, energetic arousal, and sleep quality predict daily steps and moderate to vigorous PA. Overall, 49 adults (35–60 years) and 40 children (5–19 years) were included in this analysis and self-rated their mental state within our smartphone application while also wearing a hip-worn accelerometer for 21 consecutive days (996 days included) during the intervention period. Multilevel analyses were conducted to predict daily PA while considering covariables (e.g., child/adult and non-wear time) both within- and between-persons. The results indicated that higher than average ratings of a person’s valence and energetic arousal on one day predicted increased PA while higher than average calmness predicted decreased PA at the same day within this person. Sleep quality and between-person effects of the affective states showed no clear associations to PA. Overall, these results showed that within-person associations of valence, calmness, and energetic arousal should be considered when designing PA interventions for both children and adults. The influence of sleep quality, as well as between-person effects, should be further explored by future studies.
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Gossmann K, Schmid RF, Loos C, Orthmann ABA, Rosner R, Barke A. How does burnout relate to daily work-related rumination and well-being of psychotherapists? A daily diary study among psychotherapeutic practitioners. Front Psychiatry 2022; 13:1003171. [PMID: 36684003 PMCID: PMC9846319 DOI: 10.3389/fpsyt.2022.1003171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE This is the first study to use a daily diary design to investigate the relationship between daily work-related rumination (WRR), daily well-being, and burnout symptoms among psychotherapeutic practitioners. METHOD In total, N = 58 psychotherapeutic practitioners participated in the study. For 4 weeks, the participants received a daily evening prompt on weekdays asking about their WRR and well-being. The burnout level of the psychotherapists was assessed using Maslach Burnout Inventory (MBI) prior to the daily diary period and afterward. The MBI measures the level of work-related distress on three subscales: emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA). Two main analyses were performed: Based on the hierarchical structure of the data we performed random intercept and slopes models. These models examined the association between daily WRR and daily well-being, and the relationship between pre-burnout and daily WRR and daily mood. Secondly, linear regressions with the post-MBI subscales as criterion and the daily diary variables as predictors were calculated to assess their contribution to post-burnout. RESULTS The compliance rate in our study was 76.8%. Daily WRR and pre-assessment EE were associated with all aspects of reduced daily well-being: bad mood, increased nervousness, and tiredness after work. Daily tiredness and nervousness played a differential role in predicting post-burnout. CONCLUSION Our results indicated that daily rumination and pre-EE were associated with reduced daily well-being. As we are the first to present a daily diary study among psychotherapists, we examined the feasibility of the daily diary design in particular and ecological momentary assessment (EMA) in general in this population. Compliance rates compared well with other EMA studies, indicating that EMAs were a feasible assessment option for psychotherapeutic practitioners.
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Affiliation(s)
- Katharina Gossmann
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
| | | | - Carina Loos
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
| | | | - Rita Rosner
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Antonia Barke
- Division of Clinical Psychology and Psychological Intervention, Institute for Psychology, University of Duisburg-Essen, Essen, Germany
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Mewes R, Feneberg AC, Doerr JM, Nater UM. Psychobiological Mechanisms in Somatic Symptom Disorder and Depressive Disorders: An Ecological Momentary Assessment Approach. Psychosom Med 2022; 84:86-96. [PMID: 34508045 DOI: 10.1097/psy.0000000000001006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Persistent somatic symptoms cause strong impairment in persons with somatic symptom disorder (SSD) and depressive disorders (DDs). Specific negative psychological factors (NPFs), such as catastrophizing, negative affectivity, and behavioral avoidance, are assumed to contribute to this impairment and may maintain symptoms via dysregulations of biological stress systems. We examined the associations between NPF and somatic symptoms in the daily life of women with SSD or DD and investigated the mediating role of psychobiological stress responses. METHODS Twenty-nine women with SSD and 29 women with DD participated in an ecological momentary assessment study. For 14 days, intensity of and impairment by somatic symptoms, NPF, and stress-related biological measures (cortisol, alpha-amylase) were assessed five times per day using an electronic device and saliva samples. Multilevel models were conducted. RESULTS The greater the number of NPF, the higher the concurrent and time-lagged intensity of and impairment by somatic symptoms in both groups (12.0%-38.6% of variance explained; χ2(12) p < .001 for all models). NPFs were associated with higher cortisol levels in women with DD and with lower levels in women with SSD (interaction NPF by group: B = -0.04, p = .042 for concurrent; B = -0.06, p = .019 for time-lagged). In women with SSD, lower cortisol levels were associated with higher intensity at the next measurement time point (group by cortisol: B = -1.71, p = .020). No mediation effects were found. CONCLUSIONS NPFs may be considered as transdiagnostic factors in the development and treatment of impairing somatic symptoms. Our findings will allow the development of new treatment strategies that use ecological momentary intervention approaches focusing on NPF.
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Affiliation(s)
- Ricarda Mewes
- From the Outpatient Unit for Research, Teaching and Practice (Mewes) and Department of Clinical and Health Psychology (Feneberg, Nater), Faculty of Psychology, University of Vienna, Vienna, Austria; and Department of Neurology (Doerr), University Hospital Gießen and Marburg, Gießen, Germany
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Fischer S, Schumacher T, Knaevelsrud C, Ehlert U, Schumacher S. Genes and hormones of the hypothalamic-pituitary-adrenal axis in post-traumatic stress disorder. What is their role in symptom expression and treatment response? J Neural Transm (Vienna) 2021; 128:1279-1286. [PMID: 33825945 PMCID: PMC8423677 DOI: 10.1007/s00702-021-02330-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/22/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Less than half of all individuals with post-traumatic stress disorder (PTSD) remit spontaneously and a large proportion of those seeking treatment do not respond sufficiently. This suggests that there may be subgroups of individuals who are in need of augmentative or alternative treatments. One of the most frequent pathophysiological findings in PTSD is alterations in the hypothalamic-pituitary-adrenal (HPA) axis, including enhanced negative feedback sensitivity and attenuated peripheral cortisol. Given the role of the HPA axis in cognition, this pattern may contribute to PTSD symptoms and interfere with key processes of standard first-line treatments, such as trauma-focused cognitive behavioural therapy (TF-CBT). METHODS This review provides a comprehensive summary of the current state of research regarding the role of HPA axis functioning in PTSD symptoms and treatment. RESULTS Overall, there is preliminary evidence that hypocortisolaemia contributes to symptom manifestation in PTSD; that it predicts non-responses to TF-CBT; and that it is subject to change in parallel with positive treatment trajectories. Moreover, there is evidence that genetic and epigenetic alterations within the genes NR3C1 and FKBP5 are associated with this hypocortisolaemic pattern and that some of these alterations change as symptoms improve over the course of treatment. CONCLUSIONS Future research priorities include investigations into the role of the HPA axis in day-to-day symptom variation, the time scale in which biological changes in response to treatment occur, and the effects of sex. Furthermore, before conceiving augmentative or alternative treatments that target the described mechanisms, multilevel studies are warranted.
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Affiliation(s)
- Susanne Fischer
- Institute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Binzmuehlestrasse 14/Box 26, 8050, Zurich, Switzerland.
| | - Tabea Schumacher
- Department of Education and Psychology, Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Christine Knaevelsrud
- Department of Education and Psychology, Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Ulrike Ehlert
- Institute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Binzmuehlestrasse 14/Box 26, 8050, Zurich, Switzerland
| | - Sarah Schumacher
- Department of Education and Psychology, Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
- Health Faculty, Clinical Psychology and Psychotherapy, Health and Medical University Potsdam, Potsdam, Germany
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Lischetzke T, Schemer L, Glombiewski JA, In-Albon T, Karbach J, Könen T. Negative Emotion Differentiation Attenuates the Within-Person Indirect Effect of Daily Stress on Nightly Sleep Quality Through Calmness. Front Psychol 2021; 12:684117. [PMID: 34456798 PMCID: PMC8385208 DOI: 10.3389/fpsyg.2021.684117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/13/2021] [Indexed: 11/17/2022] Open
Abstract
The ability to differentiate between negative emotional states [negative emotion differentiation (NED)] has been conceptualized as a trait that facilitates effective emotion regulation and buffers stress reactivity. In the present research, we investigated the role of NED in within-person processes of daily affect regulation and coping during times of stress (the first COVID-19-related pandemic lockdown in April 2020). Using intensive longitudinal data, we analyzed whether daily stress had an indirect effect on sleep quality through calmness in the evening, and we tested whether NED moderated this within-person indirect effect by buffering the link between daily stress and calmness in the evening. A non-representative community sample (n = 313, 15–82 years old) participated in a 21-day ambulatory assessment with twice-daily surveys. The results of multilevel mediation models showed that higher daily stress was related to within-day change in calmness from morning to evening, resulting in less calmness in the evening within persons. Less calmness in the evening, in turn, was related to poorer nightly sleep quality within persons. As expected, higher NED predicted a less negative within-person link between daily stress and calmness in the evening, thereby attenuating the indirect effect of daily stress on nightly sleep quality through calmness. This effect held when we controlled for mean negative emotions and depression. The results provide support for a diathesis-stress model of NED, and hence, for NED as a protective factor that helps to explain why some individuals remain more resilient during times of stress than others.
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Affiliation(s)
- Tanja Lischetzke
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | - Lea Schemer
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | | | - Tina In-Albon
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | - Julia Karbach
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | - Tanja Könen
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
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14
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Abdel Hadi S, Bakker AB, Häusser JA. The role of leisure crafting for emotional exhaustion in telework during the COVID-19 pandemic. ANXIETY STRESS AND COPING 2021; 34:530-544. [PMID: 33769142 DOI: 10.1080/10615806.2021.1903447] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND After the worldwide outbreak of COVID-19 in 2020, many employees transitioned from in-office work to telework to slow down the spread of the virus. Building on the Job Demands-Resources model, we examined day-level relationships between job demands, home demands and emotional exhaustion during telework. Moreover, we tested if leisure crafting (i.e., the proactive pursuit and enactment of leisure activities targeted at goal setting, socializing, growth and development) is negatively related to emotional exhaustion. We expected that proactive personality would be positively related to leisure crafting. Finally, emotional exhaustion was predicted to relate negatively to job performance. METHODS We tested our assumptions using a daily diary study on seven consecutive days with 178 employees (964 observations in total). RESULTS Multilevel path analysis supports the assumptions that daily job demands as well as daily home demands during telework are positively related to emotional exhaustion. As predicted, we found leisure crafting to be negatively related to emotional exhaustion, and proactive personality to be positively related to leisure crafting. Finally, emotional exhaustion was negatively related to job performance. CONCLUSIONS Overall, our study supports a health-promoting role of leisure crafting above the unfavorable relationships between job demands and home demands with emotional exhaustion.
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Affiliation(s)
- Sascha Abdel Hadi
- Department of Psychology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Arnold B Bakker
- Center of Excellence for Positive Organizational Psychology, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Jan A Häusser
- Department of Psychology, Justus-Liebig-University Giessen, Giessen, Germany
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15
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Joseph NT, Jiang Y, Zilioli S. Momentary emotions and salivary cortisol: A systematic review and meta-analysis of ecological momentary assessment studies. Neurosci Biobehav Rev 2021; 125:365-379. [PMID: 33662445 DOI: 10.1016/j.neubiorev.2021.02.042] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 01/21/2021] [Accepted: 02/25/2021] [Indexed: 12/19/2022]
Abstract
An integrated view of the stress response requires consideration of both the emotional and hormonal sequelae of stress, which are regulated by the hypothalamic-pituitary-adrenal (HPA) axis. Understanding the extent of the association between emotions and cortisol at the momentary level can shed light on the biopsychological pathways linking stress to health. Research in this area has adopted heterogeneous approaches and produced mixed findings; thus, it is critical to conduct a systematic review and meta-analysis. Systematic searches in major databases identified 22 studies (negative emotions [k = 19; 38,418 momentary observations]; positive emotions [k = 15; 31,721 momentary observations]). Meta-analysis found a significant positive association between momentary negative emotions and cortisol (r = .06, p < .001) and a significant negative association between momentary positive emotions and cortisol (r = -.05, p = .003). No methodological differences moderated these associations. Our findings suggest that emotional states correlate with cortisol levels at the momentary level. We discuss the health implications of our findings and provide recommendations for advancing this area of research.
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Affiliation(s)
| | - Yanping Jiang
- Department of Psychology, Wayne State University, United States
| | - Samuele Zilioli
- Department of Psychology, Wayne State University, United States; Department of Family Medicine and Public Health Sciences, Wayne State University, United States.
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16
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Sinnaeve R, Vaessen T, van Diest I, Myin-Germeys I, van den Bosch LMC, Vrieze E, Kamphuis JH, Claes S. Investigating the stress-related fluctuations of level of personality functioning: A critical review and agenda for future research. Clin Psychol Psychother 2021; 28:1181-1193. [PMID: 33590556 DOI: 10.1002/cpp.2566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 12/14/2022]
Abstract
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-11) proposed a dimensional approach to the assessment of personality disorders (PDs). Both models dictate that the clinician first determines PD severity before assessing maladaptive traits, invoking the level of personality functioning (LPF) construct. We consider LPF a promising dimensional construct for translational research because of its clinical importance and conceptual overlap with the Research Domain Criteria (RDoC) Social Processes. We aim to identify biomarkers that co-vary with fluctuations in LPF in adulthood, ultimately to predict persistent decrease in LPF, associated with suicidality and morbidity. However, a theoretical framework to investigate stress-related oscillations in LPF is currently missing. In this article, we aim to fill this hiatus with a critical review about stress and LPF. First, we discuss acute stress and LPF. We briefly present the basics of the neurophysiological stress response and review the literature on momentary and daily fluctuations in LPF, both at a subjective and physiological level. Second, we review the effects of chronic stress on brain function and social behaviour and recapitulate the main findings from prospective cohort studies. This review underlies our suggestions for multimethod assessment of stress-related oscillations in LPF and our theoretical framework for future longitudinal studies, in particular studies using the experience sampling method (ESM).
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Affiliation(s)
- Roland Sinnaeve
- University Psychiatric Center KU Leuven, Kortenberg, Belgium.,Department of Neurosciences, Mind Body Research, KU Leuven, Leuven, Belgium
| | - Thomas Vaessen
- Department of Neurosciences, Mind Body Research, KU Leuven, Leuven, Belgium.,Department of Neurosciences, Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Ilse van Diest
- Faculty of Psychology and Educational Sciences, Health Psychology Research Group, KU Leuven, Leuven, Belgium
| | - Inez Myin-Germeys
- Department of Neurosciences, Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | | | - Elske Vrieze
- University Psychiatric Center KU Leuven, Kortenberg, Belgium.,Department of Neurosciences, Mind Body Research, KU Leuven, Leuven, Belgium
| | - Jan Henk Kamphuis
- Faculty of Social and Behavioural Sciences, Programme group Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Stephan Claes
- University Psychiatric Center KU Leuven, Kortenberg, Belgium.,Department of Neurosciences, Mind Body Research, KU Leuven, Leuven, Belgium
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17
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Law KC, Rogers ML, Tucker RP, Bauer BW, Capron DW, Anestis MD, Joiner TE. Rumination in the Context of Anger and Sadness: Differential Effects on State Agitation. J Affect Disord 2021; 280:89-96. [PMID: 33207285 DOI: 10.1016/j.jad.2020.11.071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 10/26/2020] [Accepted: 11/08/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Agitation is an important transdiagnostic factor for several mental health disorders and a significant risk factor for dangerous or maladaptive coping behaviors. How an individual responds to experiences of agitation itself may also play a crucial role in conferring risk towards maladaptive behaviors. Specifically, ruminating on high arousal emotions, such as anger, will also be more likely to initiate and maintain agitation, thereby increasing risk for impulsive and maladaptive behaviors. METHODS Undergraduate students (N=117) were randomly assigned to an emotion induction condition (i.e., control, sadness only, anger only, sadness and anger) followed by either a control condition or a rumination induction. They completed measures on subjective emotional state and agitation at baseline, after emotion induction, after rumination induction, and at the end of session. RESULTS Agitation was influenced by negative affect broadly with each experimental condition leading to agitation. Anger influenced momentary change in agitation and sustained agitation when combined with rumination. LIMITATIONS The majority of participants in the current study were young, white females and the findings may not generalize to individuals of diverse genders and cultures who may have experience and cope with agitation differently. CONCLUSIONS Recognizing and mitigating rumination during moments of anger may help decrease a clients' use of problematic coping behaviors.
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Affiliation(s)
| | - Megan L Rogers
- Florida State University; Alpert Medical School of Brown University
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18
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Rothe N, Steffen J, Penz M, Kirschbaum C, Walther A. Examination of peripheral basal and reactive cortisol levels in major depressive disorder and the burnout syndrome: A systematic review. Neurosci Biobehav Rev 2020; 114:232-270. [DOI: 10.1016/j.neubiorev.2020.02.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/27/2020] [Accepted: 02/19/2020] [Indexed: 12/15/2022]
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19
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Beddig T, Reinhard I, Ebner-Priemer U, Kuehner C. Reciprocal effects between cognitive and affective states in women with Premenstrual Dysphoric Disorder: An Ecological Momentary Assessment study. Behav Res Ther 2020; 131:103613. [PMID: 32497737 DOI: 10.1016/j.brat.2020.103613] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/13/2020] [Accepted: 04/03/2020] [Indexed: 02/07/2023]
Abstract
Premenstrual Dysphoric Disorder (PMDD) is characterized by cyclical mood changes resulting in clinically significant distress and functional impairment. Studies on momentary cognitive and affective states and their interplay during daily life over the menstrual cycle in affected women are still lacking. Using Ecological Momentary Assessment with electronic diaries, 61 women with current PMDD and 61 healthy control women reported their current mood, rumination, and self-acceptance eight times a day over two consecutive days per cycle phase (menstrual, follicular, ovulatory, and late luteal phase). Results revealed that women with PMDD showed significant increases in negative affect and rumination and decreases in positive affect and self-acceptance toward the end of the cycle. Lagged analyses demonstrated stronger within-person reciprocal effects of cognitions and mood in PMDD women compared to controls with the effect of rumination on subsequent negative affect being limited to the late luteal phase. Identified stronger prospective associations between cognitive processes and mood deteriorations in women with PMDD suggest that affected women are more sensitive to detrimental effects of either dimension. Hence, therapeutic strategies aiming at reducing ruminative thoughts and improving self-acceptance such as mindfulness-based interventions could be promising for reducing the burden of PMDD.
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Affiliation(s)
- Theresa Beddig
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Ulrich Ebner-Priemer
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany.
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20
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Gort C, Marcusson-Clavertz D, Kuehner C. Procrastination, Affective State, Rumination, and Sleep Quality: Investigating Reciprocal Effects with Ambulatory Assessment. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2020. [DOI: 10.1007/s10942-020-00353-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Rosenkranz T, Takano K, Watkins ER, Ehring T. Assessing repetitive negative thinking in daily life: Development of an ecological momentary assessment paradigm. PLoS One 2020; 15:e0231783. [PMID: 32310979 PMCID: PMC7170251 DOI: 10.1371/journal.pone.0231783] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/31/2020] [Indexed: 12/24/2022] Open
Abstract
Repetitive negative thinking (RNT) is a transdiagnostic process and a promising target for prevention and treatment of mental disorders. RNT is typically assessed via self-report questionnaires with most studies focusing on one type of RNT (i.e., worry or rumination) and one specific disorder (i.e., anxiety or depression). However, responses to such questionnaires may be biased by memory and metacognitive beliefs. Recently, Ecological Momentary Assessment (EMA) has been employed to minimize these biases. This study aims to develop an EMA paradigm to measure RNT as a transdiagnostic process in natural settings. Based on empirical and theoretical considerations, an item pool was created encompassing RNT content and processes. We then (1) tested model fit of a content-related and a process-related model for assessing RNT as an individual difference variable, (2) investigated the reliability and construct validity of the proposed scale(s), and (3) determined the optimal sampling design. One hundred fifty healthy participants aged 18 to 40 years filled out baseline questionnaires on rumination, worry, RNT, symptoms of depression, anxiety, and stress. Participants received 8 semi-random daily prompts assessing RNT over 14 days. After the EMA phase, participants answered questionnaires on depression, anxiety, and stress again. Multilevel confirmatory factor analysis revealed excellent model fit for the process-related model but unsatisfactory fit for the content-related model. Different hybrid models were additionally explored, yielding one model with satisfactory fit. Both the process-related and the hybrid scale showed good reliability and good convergent validity and were significantly associated with symptoms of depression, anxiety, and stress after the EMA phase when controlling for baseline scores. Further analyses found that a sampling design of 5 daily assessments across 10 days yielded the best tradeoff between participant burden and information retained by EMA. In sum, this paper presents a promising paradigm for assessing RNT in daily life.
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Affiliation(s)
| | | | - Edward R. Watkins
- Mood Disorders Centre, School of Psychology, University of Exeter, Exeter, United Kingdom
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Munich, Germany
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22
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Sladek MR, Doane LD, Breitenstein RS. Daily rumination about stress, sleep, and diurnal cortisol activity. Cogn Emot 2020; 34:188-200. [PMID: 30961457 PMCID: PMC6783329 DOI: 10.1080/02699931.2019.1601617] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 03/23/2019] [Accepted: 03/25/2019] [Indexed: 01/24/2023]
Abstract
Rumination is an involuntary cognitive process theorized to prolong arousal and inhibit proper emotion regulation. Most available research has examined individual differences in cognitive dispositions to ruminate about stress as a risk marker for psychopathology and other health problems. This intensive longitudinal study extended previous research by examining day-to-day associations of rumination about stress with objectively-measured actigraph-based sleep and diurnal salivary cortisol activity. Sixty-one healthy participants (Mage = 20.91) completed up to five ecological momentary assessments (EMA) each day and wore actigraph wristwatches for eight days (N = 488). On three of these days, participants provided five saliva samples assayed for cortisol (N = 910). On average, greater daily stress levels were associated with shorter sleep duration and higher waking cortisol levels. In day-to-day analyses, greater daily stress levels, when combined with ruminating about daily stress more than usual, was associated with higher waking cortisol levels the following morning. Ruminating more than usual about daily stress, in the context of low-stress days, was also associated with flatter diurnal cortisol slopes the next day. These findings highlight the potential influences of daily stress, and rumination about stress, on sleep and diurnal cortisol activity - two important markers of health and well-being.
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Affiliation(s)
- Michael R. Sladek
- Department of Psychology, Arizona State University, Tempe, Arizona
- Harvard Graduate School of Education, Cambridge, MA, USA
| | - Leah D. Doane
- Department of Psychology, Arizona State University, Tempe, Arizona
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23
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Bourdon O, Raymond C, Marin MF, Olivera-Figueroa L, Lupien SJ, Juster RP. A time to be chronically stressed? Maladaptive time perspectives are associated with allostatic load. Biol Psychol 2020; 152:107871. [PMID: 32070718 DOI: 10.1016/j.biopsycho.2020.107871] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 02/01/2020] [Accepted: 02/13/2020] [Indexed: 11/30/2022]
Abstract
Living in the past, the present, or the future can affect stress and health. Our group has shown that acute stress (cortisol reactivity) is modulated by time perspectives, the ways we psychologically relate to time. Here, we expand this research with a comprehensive measure of multi-systemic chronic stress (allostatic load). Among 204 healthy adults (60 men; 144 women), we examined whether time perspectives modulate allostatic load measured with 23 neuroendocrine, immune, metabolic, and cardiovascular biomarkers. Five time perspective categories were measured (past negative, past positive, present hedonistic, present fatalistic, future). Multiple regressions controlling for sex, age, and depressive symptoms were used. Increased present fatalistic time perspective was positively correlated with allostatic load, while future time perspective was negatively correlated with allostatic load. Our preliminary findings link time perspective to multisystemic chronic stress and are discussed in the context of potential clinical implications.
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Affiliation(s)
- Olivier Bourdon
- Institut universitaire en santé mentale de Montréal, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Canada; Center on Sex⁎Gender, Allostasis, and Resilience, Canada
| | - Catherine Raymond
- Institut universitaire en santé mentale de Montréal, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Canada; Center on Sex⁎Gender, Allostasis, and Resilience, Canada; Center for Studies on Human Stress, Canada; Department of Neurological Sciences, Université de Montréal, Canada
| | - Marie-France Marin
- Institut universitaire en santé mentale de Montréal, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Canada; Department of Psychology, Université de Québec à Montréal, Canada
| | - Lening Olivera-Figueroa
- Yale University School of Medicine, Department of Psychiatry, United States; California Lutheran University, Graduate School of Psychology, United States
| | - Sonia J Lupien
- Institut universitaire en santé mentale de Montréal, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Canada; Center for Studies on Human Stress, Canada; Department of Psychiatry and Addiction, Université de Montréal, Canada
| | - Robert-Paul Juster
- Institut universitaire en santé mentale de Montréal, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Canada; Center on Sex⁎Gender, Allostasis, and Resilience, Canada; Department of Psychiatry and Addiction, Université de Montréal, Canada.
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24
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Izakova L, Hlavacova N, Segeda V, Kapsdorfer D, Morovicsova E, Jezova D. Salivary Aldosterone, Cortisol, and Their Morning to Evening Slopes in Patients with Depressive Disorder and Healthy Subjects: Acute Episode and Follow-Up 6 Months after Reaching Remission. Neuroendocrinology 2020; 110:1001-1009. [PMID: 31935730 DOI: 10.1159/000505921] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/11/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND/OBJECTIVE Cortisol is thought to be involved in the pathophysiology of affective disorders. Less attention has been given to other neuroendocrine factors. The aim of the present study was to test the hypothesis that adrenocortical steroids aldosterone and cortisol show different dynamic changes in the course of clinical depression with the assumption that aldosterone is a state marker of depression. METHODS A total of 78 adult subjects (39 patients with depressive disorder and 39 healthy controls) participated in a prospective non-interventional clinical study. Patients were investigated at the time of an acute episode and 6 months after reaching remission. The clinical and personal characteristics, and morning and evening salivary concentrations of aldosterone and cortisol were evaluated. RESULTS Patients with an acute depressive episode exhibited higher evening aldosterone and lower morning cortisol concentrations compared to healthy subjects. In these patients, both hormone concentrations showed flatter morning to evening slopes. Salivary aldosterone, but not cortisol concentrations, were lower in patients 6 months after reaching remission compared to those in the acute state. Similarly, 6 months of remission resulted in a steeper morning to evening slope of salivary aldosterone compared to the acute state. The cortisol rhythm remained dysregulated. A significant negative correlation between trait anxiety scores and morning cortisol concentrations in patients at 6 months of clinical remission was observed. CONCLUSION Diurnal changes in salivary aldosterone concentrations appear to be a state marker, whilst those of cortisol a trait marker of depression.
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Affiliation(s)
- Lubomira Izakova
- Department of Psychiatry, Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovakia
| | - Natasa Hlavacova
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Viktor Segeda
- Department of Psychiatry, Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovakia
| | - Daniela Kapsdorfer
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Eva Morovicsova
- Department of Psychiatry, Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovakia
| | - Daniela Jezova
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia ,
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25
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Ebner-Priemer UW, Reichert M, Tost H, Meyer-Lindenberg A. [Wearables for context-triggered assessment in psychiatry]. DER NERVENARZT 2019; 90:1207-1214. [PMID: 31641793 DOI: 10.1007/s00115-019-00815-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The breathtaking technological progress in the field of mobile computing, smartphones and wearables offers new opportunities for psychiatric research and therapy. Wearables enable not only the objective assessment of psychiatric symptoms in real time and everyday life but using continuous monitoring and analysis of relevant parameters can also define important situations, contexts and timing during which extended assessment strategies and real-life interventions can be implemented. The momentary effect of inner city green space exposure on well-being, motivational behavior feedback and geofencing for the detection of drinking episodes are used as examples to illustrate the core benefits of real-time analyses and feedback from wearables for psychiatric research and therapy.
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Affiliation(s)
- U W Ebner-Priemer
- Mental mHealth Lab, Lehrstuhl für Angewandte Psychologie, Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie, Engler-Bunte-Ring 15, Geb. 40.40, 76131, Karlsruhe, Deutschland.
| | - M Reichert
- Mental mHealth Lab, Lehrstuhl für Angewandte Psychologie, Institut für Sport und Sportwissenschaft, Karlsruher Institut für Technologie, Engler-Bunte-Ring 15, Geb. 40.40, 76131, Karlsruhe, Deutschland.,Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, J5, Mannheim, 76131, Deutschland
| | - H Tost
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, J5, Mannheim, 76131, Deutschland
| | - A Meyer-Lindenberg
- Klinik für Psychiatrie und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, J5, Mannheim, 76131, Deutschland
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26
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Beddig T, Reinhard I, Kuehner C. Stress, mood, and cortisol during daily life in women with Premenstrual Dysphoric Disorder (PMDD). Psychoneuroendocrinology 2019; 109:104372. [PMID: 31357135 DOI: 10.1016/j.psyneuen.2019.104372] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/27/2019] [Accepted: 07/03/2019] [Indexed: 01/26/2023]
Abstract
Premenstrual Dysphoric Disorder (PMDD) is characterized by significant emotional, physical and behavioral distress during the late luteal phase that remits after menses onset. Outlined as a new diagnostic category in DSM-5, the mechanisms underlying PMDD are still insufficiently known. Previous research suggests that PMDD exacerbates with stressful events, indicating a dysregulation of the hypothalamic-pituitary-adrenal axis. However, studies measuring stress-related processes in affected women in real-time and real-life are lacking. We conducted an Ambulatory Assessment (AA) study to compare subjective stress reactivity together with basal and stress-reactive cortisol activity across the menstrual cycle in women with and without PMDD. Women with current PMDD (n = 61) and age- and education matched controls (n = 61) reported momentary mood, rumination, and daily events via smartphones at semi-random time points 8 times a day over two consecutive days per cycle phase (menstrual, follicular, ovulatory, and late luteal). Twenty minutes after assessments participants collected saliva cortisol samples. Three additional morning samples determined the cortisol awakening response (CAR). Women with PMDD reported particular high daily life stress and high arousal negative affect (NAhigh) towards stressors during the late luteal phase. High momentary stress levels were linked to lower levels of high arousal positive affect (PAhigh) and to higher levels of rumination in PMDD women compared to controls irrespective of cycle phase. Across groups, more stress was linked to higher levels of low arousal NA (NAlow) and to lower levels of low arousal PA (PAlow). Moreover, PMDD was associated with a delayed CAR peak and a flattened diurnal cortisol slope. While neither group showed cortisol reactivity towards daily life stress directly, high momentary NAhigh and low momentary PA predicted high levels of cortisol across groups, whereas high momentary rumination predicted high cortisol output only in healthy women. In this AA-study we identified important stress-related psychological and endocrinological within-person variability in women with PMDD during daily life. Further research is warranted targeting identified AA-based mechanisms to study their predictive role for the clinical course of PMDD and to provide evidence-based therapeutic options for affected women.
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Affiliation(s)
- Theresa Beddig
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany.
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Lydon-Staley DM, Kuehner C, Zamoscik V, Huffziger S, Kirsch P, Bassett DS. Repetitive negative thinking in daily life and functional connectivity among default mode, fronto-parietal, and salience networks. Transl Psychiatry 2019; 9:234. [PMID: 31534117 PMCID: PMC6751201 DOI: 10.1038/s41398-019-0560-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 04/11/2019] [Accepted: 05/13/2019] [Indexed: 12/23/2022] Open
Abstract
Repetitive negative thinking (RNT) is a maladaptive response to sadness and a transdiagnostic risk-factor. A critical challenge hampering attempts to promote more adaptive responses to sadness is that the between-person characteristics associated with the tendency for RNT remain uncharacterized. From the perspective of the impaired disengagement hypothesis, we examine between-person differences in blood-oxygen-level-dependent (BOLD) functional networks underlying cognitive conflict signaling, self-referential thought, and cognitive flexibility, and the association between sadness and RNT in daily life. We pair functional magnetic resonance imaging with ambulatory assessments deployed 10 times per day over 4 consecutive days measuring momentary sadness and RNT from 58 participants (40 female, mean age = 36.69 years; 29 remitted from a lifetime episode of Major Depression) in a multilevel model. We show that RNT increases following sadness for participants with higher than average between-network connectivity of the default mode network and the fronto-parietal network. We also show that RNT increases following increases in sadness for participants with lower than average between-network connectivity of the fronto-parietal network and the salience network. We also find that flexibility of the salience network's pattern of connections with brain regions is protective against increases in RNT following sadness. Our findings highlight the importance of functional brain networks implicated in cognitive conflict signaling, self-referential thought, and cognitive flexibility for understanding maladaptive responses to sadness in daily life and provide support for the impaired disengagement hypothesis of RNT.
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Affiliation(s)
- D M Lydon-Staley
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - C Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - V Zamoscik
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - S Huffziger
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
- Institute Psychiatric and Psychosomatics Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - P Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159, Mannheim, Germany
| | - D S Bassett
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Department of Electrical & Systems Engineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Department of Physics & Astronomy, College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, 19104, USA.
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvani, Philadelphia, PA, 19104, USA.
- Santa Fe Institute, Santa Fe, NM, 87501, USA.
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Fang L, Marchetti I, Hoorelbeke K, Koster EHW. Do daily dynamics in rumination and affect predict depressive symptoms and trait rumination? An experience sampling study. J Behav Ther Exp Psychiatry 2019; 63:66-72. [PMID: 30471919 DOI: 10.1016/j.jbtep.2018.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 09/29/2018] [Accepted: 11/10/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES Rumination has been shown to prospectively predict the onset of depression. However, it is unclear how rumination and affect in daily life influence the development of depressive symptoms. The present study examined whether the structure of dynamics in rumination and affect could prospectively predict depressive symptoms and trait rumination in an undergraduate sample (n = 63). METHODS The main index used was entropy, which reflects the instability of a system's structure. Momentary rumination and affect were assessed eight times per day for a period of seven days. Additionally, depressive symptoms and trait rumination were measured at the beginning of the experiment and at six weeks follow-up. RESULTS The results showed that entropy significantly predicted trait rumination at follow-up (and depressive symptoms at trend level) while taking into account baseline depressive symptoms and trait rumination. LIMITATIONS The follow-up measurements conducted six weeks after the baseline were relatively short. Further research may test the predictive effect of the structure over a longer period and confirm its effect by using different indices that describe the structure. CONCLUSIONS These findings indicate that examining the structure of the dynamics in momentary rumination and affect holds promise for understanding the risk for depression.
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Affiliation(s)
- Lin Fang
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium.
| | - Igor Marchetti
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium
| | - Kristof Hoorelbeke
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium
| | - Ernst H W Koster
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium.
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Colombo D, Fernández-Álvarez J, Patané A, Semonella M, Kwiatkowska M, García-Palacios A, Cipresso P, Riva G, Botella C. Current State and Future Directions of Technology-Based Ecological Momentary Assessment and Intervention for Major Depressive Disorder: A Systematic Review. J Clin Med 2019; 8:E465. [PMID: 30959828 PMCID: PMC6518287 DOI: 10.3390/jcm8040465] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 03/26/2019] [Accepted: 04/01/2019] [Indexed: 12/20/2022] Open
Abstract
Ecological momentary assessment (EMA) and ecological momentary intervention (EMI) are alternative approaches to retrospective self-reports and face-to-face treatments, and they make it possible to repeatedly assess patients in naturalistic settings and extend psychological support into real life. The increase in smartphone applications and the availability of low-cost wearable biosensors have further improved the potential of EMA and EMI, which, however, have not yet been applied in clinical practice. Here, we conducted a systematic review, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to explore the state of the art of technology-based EMA and EMI for major depressive disorder (MDD). A total of 33 articles were included (EMA = 26; EMI = 7). First, we provide a detailed analysis of the included studies from technical (sampling methods, duration, prompts), clinical (fields of application, adherence rates, dropouts, intervention effectiveness), and technological (adopted devices) perspectives. Then, we identify the advantages of using information and communications technologies (ICTs) to extend the potential of these approaches to the understanding, assessment, and intervention in depression. Furthermore, we point out the relevant issues that still need to be addressed within this field, and we discuss how EMA and EMI could benefit from the use of sensors and biosensors, along with recent advances in machine learning for affective modelling.
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Affiliation(s)
- Desirée Colombo
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, Av. Sos Baynat, s/n, 12071 Castellón, Spain.
| | - Javier Fernández-Álvarez
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100 Milan, Italy.
| | - Andrea Patané
- Department of Computer Science, University of Oxford, Wolfson Building, Parks Rd, Oxford, OX1 3QD, UK.
| | - Michelle Semonella
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy.
| | - Marta Kwiatkowska
- Department of Computer Science, University of Oxford, Wolfson Building, Parks Rd, Oxford, OX1 3QD, UK.
| | - Azucena García-Palacios
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, Av. Sos Baynat, s/n, 12071 Castellón, Spain.
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, 28029 Madrid, Spain.
| | - Pietro Cipresso
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100 Milan, Italy.
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy.
| | - Giuseppe Riva
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20100 Milan, Italy.
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy.
| | - Cristina Botella
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, Av. Sos Baynat, s/n, 12071 Castellón, Spain.
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, 28029 Madrid, Spain.
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Cortisol, dehydroepiandrosterone sulfate, fatty acids, and their relation in recurrent depression. Psychoneuroendocrinology 2019; 100:203-212. [PMID: 30388594 DOI: 10.1016/j.psyneuen.2018.10.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 10/14/2018] [Accepted: 10/14/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Alterations in hypothalamic-pituitary-adrenal (HPA)-axis activity, fatty acid metabolism, and their relation have been associated with (recurrent) major depressive disorder (MDD), although conflicting findings exist. AIMS To determine whether alterations in HPA-axis activity and fatty acids in recurrent MDD remain during remission (i.e. reflect a potential trait factor). Furthermore, to test the association between HPA-axis activity and fatty acids in patients versus controls. METHODS We cross-sectionally compared 73 remitted unmedicated recurrent MDD patients with 46 matched never-depressed controls. Measurements included salivary cortisol and dehydroepiandrosterone sulfate (DHEAS) (awakening, evening, and after sad mood induction) and erythrocyte fatty acid parameters: (I) three main fatty acids [omega-3 docosahexaenoic acid (DHA), and the omega-3 eicosapentaenoic acid/omega-6 arachidonic acid (EPA/AA)-ratio], and (II) structural fatty acid indices [chain length, unsaturation and peroxidation]. RESULTS Patients showed higher cortisol awakening responses (p = 0.006) and lower evening cortisol/DHEAS ratios (p = 0.044) compared to matched controls. Fatty acids did not differ between patients and controls, but HPA-axis indicators were significantly associated with fatty acid parameters in both groups (0.001 ≤ p ≤ 0.043). Patients and controls significantly differed in the relations between awakening DHEAS or cortisol/DHEAS ratios and fatty acid parameters, including unsaturation and peroxidation indices (0.001≤ p ≤ 0.034). Significance remained after correction for confounders. CONCLUSIONS Our results further support alterations in HPA-axis activity, i.e. a lower baseline, but higher responsiveness of awakening cortisol, in remitted medication-free recurrent MDD patients. Furthermore, the relationship between HPA-axis and fatty acids showed significant differences in recurrent MDD patients versus controls. Prospective research is needed to determine the predictive value of this relationship for MDD recurrence.
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Interactions of momentary thought content and subjective stress predict cortisol fluctuations in a daily life experience sampling study. Sci Rep 2018; 8:15462. [PMID: 30337580 PMCID: PMC6193976 DOI: 10.1038/s41598-018-33708-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 10/04/2018] [Indexed: 01/17/2023] Open
Abstract
Daily life stress is an omnipresent phenomenon in modern society. Research has linked prolonged activation of the hypothalamic-pituitary-adrenal axis to psychiatric and somatic diseases. Everyday stressors substantially contribute to these health risks. Despite the notion that the physiological stress response is highly dependent on concurrent psychological processes, investigations associating diurnal cortisol levels with subjective experience have primarily focused on affective states. The impact of everyday cognitive processes including thought content has been largely neglected. To investigate this link, moment-to-moment associations of psychological experience including subjective stress, thought content and affect, and cortisol levels were assessed throughout the daily routines of 289 healthy adult participants. We found that subjective stress interacted with current thought content and affect in predicting cortisol release: more negative and future-directed thoughts were associated with higher cortisol levels after experiencing subjective stress, suggesting an increase in negative future anticipation. Concurrent cortisol rises might reflect proactive coping to adequately prepare for upcoming demands. In the absence of subjective stress, more past-directed thoughts and negative affect were associated with higher cortisol levels. These findings provide evidence for a fundamental link between thought content and daily cortisol activation, and highlight the significant contribution of thought patterns to physiological stress levels.
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Zamoscik VE, Schmidt SNL, Gerchen MF, Samsouris C, Timm C, Kuehner C, Kirsch P. Respiration pattern variability and related default mode network connectivity are altered in remitted depression. Psychol Med 2018; 48:2364-2374. [PMID: 29335031 DOI: 10.1017/s0033291717003890] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Studies with healthy participants and patients with respiratory diseases suggest a relation between respiration and mood. The aim of the present analyses was to investigate whether emotionally challenged remitted depressed participants show higher respiration pattern variability (RPV) and whether this is related to mood, clinical outcome and increased default mode network connectivity. METHODS To challenge participants, sad mood was induced with keywords of personal negative life events in individuals with remitted depression [recurrent major depressive disorder (rMDD), n = 30] and matched healthy controls (HCs, n = 30) during functional magnetic resonance imaging. Respiration was measured by means of a built-in respiration belt. Additionally, questionnaires, a daily life assessment of mood and a 3 years follow-up were applied. For replication, we analysed RPV in an independent sample of 53 rMDD who underwent the same fMRI paradigm. RESULTS During sad mood, rMDD compared with HC showed greater RPV, with higher variability in pause duration and respiration frequency and lower expiration to inspiration ratio. Higher RPV was related to lower daily life mood and predicted higher depression scores as well as relapses during a 3-year follow-up period. Furthermore, in rMDD compared with HC higher main respiration frequency exhibited a more positive association with connectivity of the posterior cingulate cortex and the right parahippocampal gyrus. CONCLUSIONS The results suggest a relation between RPV, mood and depression on the behavioural and neural level. Based on our findings, we propose interventions focusing on respiration to be a promising additional tool in the treatment of depression.
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Affiliation(s)
- Vera Eva Zamoscik
- Department of Clinical Psychology,Central Institute of Mental Health,Mannheim,Medical Faculty Mannheim,Heidelberg University,Heidelberg,Germany
| | - Stephanie Nicole Lyn Schmidt
- Department of Clinical Psychology,Central Institute of Mental Health,Mannheim,Medical Faculty Mannheim,Heidelberg University,Heidelberg,Germany
| | - Martin Fungisai Gerchen
- Department of Clinical Psychology,Central Institute of Mental Health,Mannheim,Medical Faculty Mannheim,Heidelberg University,Heidelberg,Germany
| | - Christos Samsouris
- Department of Clinical Psychology,Central Institute of Mental Health,Mannheim,Medical Faculty Mannheim,Heidelberg University,Heidelberg,Germany
| | - Christina Timm
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy,Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim,Heidelberg University,Heidelberg,Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy,Central Institute of Mental Health, Mannheim, Medical Faculty Mannheim,Heidelberg University,Heidelberg,Germany
| | - Peter Kirsch
- Department of Clinical Psychology,Central Institute of Mental Health,Mannheim,Medical Faculty Mannheim,Heidelberg University,Heidelberg,Germany
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Combining ecological momentary assessment with objective, ambulatory measures of behavior and physiology in substance-use research. Addict Behav 2018; 83:5-17. [PMID: 29174666 DOI: 10.1016/j.addbeh.2017.11.027] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/02/2017] [Accepted: 11/02/2017] [Indexed: 02/06/2023]
Abstract
Whereas substance-use researchers have long combined self-report with objective measures of behavior and physiology inside the laboratory, developments in mobile/wearable electronic technology are increasingly allowing for the collection of both subjective and objective information in participants' daily lives. For self-report, ecological momentary assessment (EMA), as implemented on contemporary smartphones or personal digital assistants, can provide researchers with near-real-time information on participants' behavior and mood in their natural environments. Data from portable/wearable electronic sensors measuring participants' internal and external environments can be combined with EMA (e.g., by timestamps recorded on questionnaires) to provide objective information useful in determining the momentary context of behavior and mood and/or validating participants' self-reports. Here, we review three objective ambulatory monitoring techniques that have been combined with EMA, with a focus on detecting drug use and/or measuring the behavioral or physiological correlates of mental events (i.e., emotions, cognitions): (1) collection and processing of biological samples in the field to measure drug use or participants' physiological activity (e.g., hypothalamic-pituitary-adrenal axis activity); (2) global positioning system (GPS) location information to link environmental characteristics (disorder/disadvantage, retail drug outlets) to drug use and affect; (3) ambulatory electronic physiological monitoring (e.g., electrocardiography) to detect drug use and mental events, as advances in machine learning algorithms make it possible to distinguish target changes from confounds (e.g., physical activity). Finally, we consider several other mobile/wearable technologies that hold promise to be combined with EMA, as well as potential challenges faced by researchers working with multiple mobile/wearable technologies simultaneously in the field.
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Rudolph KD, Troop-Gordon W, Modi HH, Granger DA. An exploratory analysis of the joint contribution of HPA axis activation and motivation to early adolescent depressive symptoms. Dev Psychobiol 2018; 60:303-316. [DOI: 10.1002/dev.21600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 11/15/2017] [Accepted: 11/18/2017] [Indexed: 01/07/2023]
Affiliation(s)
| | | | - Haina H. Modi
- University of Illinois, Urbana-Champaign; Urbana Illinois
| | - Douglas A. Granger
- Institute for Interdisciplinary Salivary Bioscience Research; University of California; Irvine California
- Johns Hopkins University School of Medicine; School of Nursing, and Bloomberg School of Public Health; Baltimore Maryland
- Department of Psychology and Salivary Bioscience Laboratory; University of Nebraska at Lincoln; Lincoln Nebraska
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Zoccola PM, Manigault AW, Figueroa WS, Hollenbeck C, Mendlein A, Woody A, Hamilton K, Scanlin M, Johnson RC. Trait Rumination Predicts Elevated Evening Cortisol in Sexual and Gender Minority Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111365. [PMID: 29120379 PMCID: PMC5708004 DOI: 10.3390/ijerph14111365] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 11/05/2017] [Accepted: 11/07/2017] [Indexed: 11/29/2022]
Abstract
Stress may contribute to illness through the impaired recovery or sustained activity of stress-responsive biological systems. Rumination, or mental rehearsal of past stressors, may alter the body’s stress-responsive systems by amplifying and prolonging exposure to physiological mediators, such as cortisol. The primary aim of the current investigation was to test the extent to which the tendency to ruminate on stress predicts diminished diurnal cortisol recovery (i.e., elevated evening cortisol) in a sample of sexual and gender minority young adults. Participants included 58 lesbian, gay, bisexual, and transgender young adults (Mage = 25.0, SD = 4.1) who completed an initial online survey that assessed trait rumination and current depressed mood. Participants completed daily evening questionnaires and provided salivary cortisol samples at wake, 45 min post-wake, 12 h post-wake, and at bedtime over seven consecutive days. Trait rumination predicted significantly higher cortisol concentrations at bedtime, but was unrelated to other cortisol indices (e.g., morning cortisol, diurnal slope, total output). The association with trait rumination was not accounted for by daily negative affect, and was largely independent of depressed mood. These results have implications for identifying and treating those who may be at risk for impaired diurnal cortisol recovery and associated negative health outcomes.
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Affiliation(s)
- Peggy M Zoccola
- Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA.
| | - Andrew W Manigault
- Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA.
| | - Wilson S Figueroa
- Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA.
| | - Cari Hollenbeck
- Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA.
- Department of Social and Public Health, Ohio University, Grover Center W324, Athens, OH 45701, USA.
| | - Anna Mendlein
- Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA.
| | - Alex Woody
- Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA.
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, 460 Medical Center Drive, Columbus, OH 43210, USA.
| | - Katrina Hamilton
- Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA.
- Heritage College of Osteopathic Medicine, Ohio University, 35 W. Green Drive, Athens, OH 45701, USA.
| | - Matt Scanlin
- Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA.
- Department of Social and Public Health, Ohio University, Grover Center W324, Athens, OH 45701, USA.
| | - Ryan C Johnson
- Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701, USA.
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Kuehner C, Welz A, Reinhard I, Alpers GW. Lab meets real life: A laboratory assessment of spontaneous thought and its ecological validity. PLoS One 2017; 12:e0184488. [PMID: 28910351 PMCID: PMC5598976 DOI: 10.1371/journal.pone.0184488] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 08/24/2017] [Indexed: 01/28/2023] Open
Abstract
People's minds frequently wander towards self-generated thoughts, which are unrelated to external stimuli or demands. These phenomena, referred to as "spontaneous thought" (ST) and "mind wandering" (MW), have previously been linked with both costs and benefits. Current assessments of ST and MW have predominantly been conducted in the laboratory, whereas studies on the ecological validity of such lab-related constructs and their interrelations are rare. The current study examined the stability of ST dimensions assessed in the lab and their predictive value with respect to MW, repetitive negative thought (uncontrollable rumination, RUM), and affect in daily life. Forty-three university students were assessed with the Amsterdam Resting State Questionnaire (2nd version) to assess ten ST dimensions during the resting state in two laboratory sessions, which were separated by five days of electronic ambulatory assessment (AA). During AA, individuals indicated the intensity of MW and RUM, as well as of positive and negative affect in daily life ten times a day. ST dimensions measured in the lab were moderately stable across one week. Five out of ten ST lab dimensions were predicted by mental health-related symptoms or by dispositional cognitive traits. Hierarchical linear models revealed that a number of ST lab dimensions predicted cognitive and affective states in daily life. Mediation analyses showed that RUM, but not MW per se, accounted for the relationship between specific ST lab dimensions and mood in daily life. By using a simple resting state task, we could demonstrate that a number of lab dimensions of spontaneous thought are moderately stable, are predicted by mental health symptoms and cognitive traits, and show plausible associations with categories of self-generated thought and mood in daily life.
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Affiliation(s)
- Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- * E-mail:
| | - Annett Welz
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Georg W. Alpers
- Department of Psychology, School of Social Sciences, University of Mannheim, and Otto-Selz-Institute, University of Mannheim, Mannheim, Germany
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Timm C, Ubl B, Zamoscik V, Ebner-Priemer U, Reinhard I, Huffziger S, Kirsch P, Kuehner C. Cognitive and affective trait and state factors influencing the long-term symptom course in remitted depressed patients. PLoS One 2017; 12:e0178759. [PMID: 28575049 PMCID: PMC5456349 DOI: 10.1371/journal.pone.0178759] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 05/18/2017] [Indexed: 12/16/2022] Open
Abstract
Background Major depressive disorder (MDD) is characterized by a high risk for relapses and chronic developments. Clinical characteristics such as residual symptoms have been shown to negatively affect the long-term course of MDD. However, it is unclear so far how trait repetitive negative thinking (RNT) as well as cognitive and affective momentary states, the latter experienced during daily-life, affect the long-term course of MDD. Method We followed up 57 remitted depressed (rMDD) individuals six (T2) and 36 (T3) months after baseline. Clinical outcomes were time to relapse, time spent with significant symptoms as a marker of chronicity, and levels of depressive symptoms at T2 and T3. Predictors assessed at baseline included residual symptoms and trait RNT. Furthermore, momentary daily life affect and momentary rumination, and their variation over the day were assessed at baseline using ambulatory assessment (AA). Results In multiple models, residual symptoms and instability of daily-life affect at baseline independently predicted a faster time to relapse, while chronicity was significantly predicted by trait RNT. Multilevel models revealed that depressive symptom levels during follow-up were predicted by baseline residual symptom levels and by instability of daily-life rumination. Both instability features were linked to a higher number of anamnestic MDD episodes. Conclusions Our findings indicate that trait RNT, but also affective and cognitive processes during daily life impact the longer-term course of MDD. Future longitudinal research on the role of respective AA-phenotypes as potential transdiagnostic course-modifiers is warranted.
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Affiliation(s)
- Christina Timm
- Research Group Longitudinal and Intervention Research, Department of Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Bettina Ubl
- Research Group Longitudinal and Intervention Research, Department of Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Vera Zamoscik
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ulrich Ebner-Priemer
- Karlsruhe Institute of Technology, Institut für Sport und Sportwissenschaften, University of Karlsruhe, Karlsruhe, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Silke Huffziger
- Research Group Longitudinal and Intervention Research, Department of Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Peter Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Hilt LM, Sladek MR, Doane LD, Stroud CB. Daily and trait rumination: diurnal cortisol patterns in adolescent girls. Cogn Emot 2016; 31:1757-1767. [PMID: 27922343 DOI: 10.1080/02699931.2016.1262332] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Rumination is a maladaptive form of emotion regulation associated with psychopathology. Research with adults suggests that rumination covaries with diurnal cortisol rhythms, yet this has not been examined among adolescents. Here, we examine the day-to-day covariation between rumination and cortisol, and explore whether trait rumination is associated with alterations in diurnal cortisol rhythms among adolescent girls. Participants (N = 122) provided saliva samples 3 times per day over 3 days, along with daily reports of stress and rumination, questionnaires assessing trait rumination related to peer stress, and diagnostic interviews assessing depression and anxiety. Greater rumination than usual during the day was associated with lower cortisol awakening responses the following morning, but this effect was not significant after accounting for wake time and an objective measure of adherence to the saliva sampling protocol. Trait rumination was associated with lower average cortisol levels at waking and flatter diurnal slopes, accounting for wake time, protocol compliance, and other factors. These patterns may help to explain why rumination is related to the development of psychopathology.
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Affiliation(s)
- Lori M Hilt
- a Department of Psychology , Lawrence University , Appleton , WI , USA
| | - Michael R Sladek
- b Department of Psychology , Arizona State University , Tempe , AZ , USA
| | - Leah D Doane
- b Department of Psychology , Arizona State University , Tempe , AZ , USA
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Kokonyei G, Szabo E, Kocsel N, Edes A, Eszlari N, Pap D, Magyar M, Kovacs D, Zsombok T, Elliott R, Anderson IM, William Deakin JF, Bagdy G, Juhasz G. Rumination in migraine: Mediating effects of brooding and reflection between migraine and psychological distress. Psychol Health 2016; 31:1481-1497. [PMID: 27616579 PMCID: PMC5062042 DOI: 10.1080/08870446.2016.1235166] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 09/05/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The relationship between migraine and psychological distress has been consistently reported in cross-sectional and longitudinal studies. We hypothesised that a stable tendency to perseverative thoughts such as rumination would mediate the relationship between migraine and psychological distress. Design and Main Outcomes Measures: Self-report questionnaires measuring depressive rumination, current psychological distress and migraine symptoms in two independent European population cohorts, recruited from Budapest (N = 1139) and Manchester (N = 2004), were used. Structural regression analysis within structural equation modelling was applied to test the mediational role of brooding and reflection, the components of rumination, between migraine and psychological distress. Sex, age and lifetime depression were controlled for in the analysis. RESULTS Migraine predicted higher brooding and reflection scores, and brooding proved to be a mediator between migraine and psychological distress in both samples, while reflection mediated the relationship significantly only in the Budapest sample. CONCLUSIONS Elevated psychological distress in migraine is partially attributed to ruminative response style. Further studies are needed to expand our findings to clinical samples and to examine how rumination links to the adjustment to migraine.
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Affiliation(s)
- Gyongyi Kokonyei
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Edina Szabo
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Natalia Kocsel
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Andrea Edes
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - Nora Eszlari
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - Dorottya Pap
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - Mate Magyar
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Medicine, Department of Neurology, Semmelweis University, Budapest, Hungary
| | - David Kovacs
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - Terezia Zsombok
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Medicine, Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Rebecca Elliott
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Ian Muir Anderson
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - John Francis William Deakin
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Gyorgy Bagdy
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
| | - Gabriella Juhasz
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Faculty of Pharmacy, Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
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Eatough E, Shockley K, Yu P. A Review of Ambulatory Health Data Collection Methods for Employee Experience Sampling Research. APPLIED PSYCHOLOGY-AN INTERNATIONAL REVIEW-PSYCHOLOGIE APPLIQUEE-REVUE INTERNATIONALE 2016. [DOI: 10.1111/apps.12068] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Erin Eatough
- Baruch College & The Graduate Center, The City University of New York; USA
| | - Kristen Shockley
- Baruch College & The Graduate Center, The City University of New York; USA
| | - Peter Yu
- Baruch College & The Graduate Center, The City University of New York; USA
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Ubl B, Kuehner C, Kirsch P, Ruttorf M, Flor H, Diener C. Neural reward processing in individuals remitted from major depression. Psychol Med 2015; 45:3549-3558. [PMID: 26315103 DOI: 10.1017/s0033291715001452] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Dysfunctional behavioural and neural processing of reward has been found in currently depressed individuals. However, little is known about altered reward processing in remitted depressed individuals. METHOD A total of 23 medication-free individuals with remitted major depressive disorder (rMDD) and 23 matched healthy controls (HCs) performed a reward task during functional magnetic resonance imaging. We also investigated reward dependence, novelty seeking and harm avoidance using the Tridimensional Personality Questionnaire and their association with neural responses of reward processing. RESULTS Compared to HCs, individuals with rMDD exhibited enhanced responses to reward-predicting cues in the hippocampus, amygdala and superior frontal gyrus. When reward was delivered, rMDD subjects did not significantly differ from HCs. In both groups neural activity during reward anticipation was negatively correlated with harm avoidance. CONCLUSIONS Our results show that rMDD is characterized by hyperactivation in fronto-limbic regions during reward anticipation. Alterations in neural activation during reward processing might reflect an increased effort in remitted depressed individuals to allocate neural activity for executive and evaluative processes during anticipatory reward processing.
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Affiliation(s)
- B Ubl
- Department of Cognitive and Clinical Neuroscience,Central Institute of Mental Health,Medical Faculty Mannheim,Heidelberg University,Mannheim,Germany
| | - C Kuehner
- Research Group Longitudinal and Intervention Research,Department of Psychiatry and Psychotherapy,Central Institute of Mental Health,Medical Faculty Mannheim,Heidelberg University,Mannheim,Germany
| | - P Kirsch
- Department of Clinical Psychology,Central Institute of Mental Health,Medical Faculty Mannheim,Heidelberg University,Mannheim,Germany
| | - M Ruttorf
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim,Heidelberg University,Mannheim,Germany
| | - H Flor
- Department of Cognitive and Clinical Neuroscience,Central Institute of Mental Health,Medical Faculty Mannheim,Heidelberg University,Mannheim,Germany
| | - C Diener
- School of Applied Psychology,SRH University of Applied Science,Heidelberg,Germany
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Dixon-Gordon KL, Weiss NH, Tull MT, DiLillo D, Messman-Moore T, Gratz KL. Characterizing emotional dysfunction in borderline personality, major depression, and their co-occurrence. Compr Psychiatry 2015; 62:187-203. [PMID: 26343484 PMCID: PMC4561853 DOI: 10.1016/j.comppsych.2015.07.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 07/14/2015] [Accepted: 07/22/2015] [Indexed: 12/21/2022] Open
Abstract
This research aimed to characterize patterns of emotional reactivity and dysregulation in borderline personality, depression, and their co-occurrence. In study 1, 488 young adult women from the community were categorized into four groups based on self-reported major depressive disorder (MDD) and borderline personality disorder (BPD) symptoms (Low BPD/Low MDD; Low BPD/High MDD; High BPD/Low MDD; High BPD/High MDD). Immediate and prolonged subjective emotional reactivity to a laboratory stressor were assessed, and participants completed self-report and behavioral measures of emotion dysregulation. Study 2 extended these findings, examining emotional reactivity and dysregulation in a clinical population of 176 substance dependent patients with diagnoses of BPD and MDD and including a biological index of emotional reactivity. Results revealed greater prolonged fear reactivity in the High BPD/High MDD (vs. Low BPD/Low MDD) group in study 1, and greater prolonged anxiety and negative affect reactivity in both High BPD groups (vs. Low BPD/Low MDD and Low BPD/High MDD groups) in study 2 (but no differences in cortisol reactivity). Results also demonstrated greater subjective (but not behavioral) emotion dysregulation in the High BPD/High MDD (vs. Low BPD/Low MDD) group in study 1 and both High BPD groups (vs. both Low BPD groups) in study 2. Finally, the High BPD/High MDD group reported greater difficulties controlling impulsive behaviors compared with all other groups in study 1 and the Low BPD groups in study 2. Findings suggest that BPD pathology (but not MDD pathology alone) is characterized by greater prolonged emotional (especially anxiety/fear-related) reactivity and heightened emotion dysregulation.
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Affiliation(s)
- Katherine L. Dixon-Gordon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Nicole H. Weiss
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Matthew T. Tull
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - David DiLillo
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | | | - Kim L. Gratz
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA,Correspondence concerning this article should be addressed to Kim L. Gratz, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216; Phone: (601) 815-6450;
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Kökönyei G, Józan A, Morgan A, Szemenyei E, Urbán R, Reinhardt M, Demetrovics Z. Perseverative thoughts and subjective health complaints in adolescence: Mediating effects of perceived stress and negative affects. Psychol Health 2015; 30:969-86. [PMID: 25599581 DOI: 10.1080/08870446.2015.1007982] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Stable tendency to perseverative thoughts such as trait rumination and worry can influence somatic health. The purpose of the study was to investigate the relationship between perseverative thoughts and somatic complaints, and the possible mediating effects of perceived stress, negative and positive affectivity in adolescence. Having an acute or a chronic condition was also assessed to be controlled for and to reveal their effects on symptom reporting. Three hundred and six adolescents from 7th to 12th grade with mean age of 16.33 (SD = 1.29) participated in the study. Mediation analysis suggested that impact of trait-like perseverative thoughts on complaints were mediated by perceived stress and negative affectivity. Having an acute condition had also an effect on symptom reporting through increased negative affectivity. Our results highlight that ruminations or worry as stable intrapersonal characteristics are relevant processes in health and can be potential targets in prevention programmes in adolescence.
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Affiliation(s)
- Gyöngyi Kökönyei
- a Institute of Psychology , Eötvös Loránd University , Budapest , Hungary
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Ottaviani C, Shahabi L, Tarvainen M, Cook I, Abrams M, Shapiro D. Cognitive, behavioral, and autonomic correlates of mind wandering and perseverative cognition in major depression. Front Neurosci 2015; 8:433. [PMID: 25601824 PMCID: PMC4283544 DOI: 10.3389/fnins.2014.00433] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 12/10/2014] [Indexed: 12/16/2022] Open
Abstract
Autonomic dysregulation has been hypothesized to play a role in the relationships between psychopathology and cardiovascular risk. An important transdiagnostic factor that has been associated with autonomic dysfunction is perseverative cognition (PC), mainly present in Major Depressive Disorder (MDD) in the form of rumination. As the ability to adaptively let our mind wander without ruminating is critical to mental health, this study aimed to examine the autonomic concomitants of functional vs. dysfunctional intrusive thoughts in MDD. Ambulatory heart rate (HR) and variability (HRV) of 18 MDD subjects and 18 healthy controls were recorded for 24 h. Approximately every 30 min during waking hours subjects reported their ongoing thoughts and moods using electronic diaries. Random regression models were performed. Compared to controls, MDD subjects were more often caught during episodes of PC. In both groups, PC required more effort to be inhibited and interfered more with ongoing activities compared to mind wandering (MW) (ps < 0.0001). This cognitive rigidity was mirrored by autonomic inflexibility, as PC was characterized by lower HRV (p < 0.0001) compared to MW. A worse mood was reported by MDD patients compared to controls, independently of their ongoing cognitive process. Controls, however, showed the highest mood worsening during PC compared to being on task and MW. HRV during rumination correlated with self-reported somatic symptoms on the same day and several dispositional traits. MDD subjects showed lower HRV during sleep, which correlated with hopelessness rumination. Results show that PC is associated with autonomic dysfunctions in both healthy and MDD subjects. Understanding when spontaneous thought is adaptive and when it is not may clarify its role in the etiology of mood disorders, shedding light on the still unexplained association between psychopathology, chronic stress, and risk for health.
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Affiliation(s)
- Cristina Ottaviani
- IRCCS Santa Lucia Foundation Rome, Italy ; ENPlab, Department of Psychology, Sapienza University of Rome Rome, Italy
| | - Leila Shahabi
- Department of Medicine, University of California, Los Angeles Los Angeles, CA, USA
| | - Mika Tarvainen
- Department of Applied Physics, University of Eastern Finland Kuopio, Finland ; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital Kuopio, Finland
| | - Ian Cook
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles Los Angeles CA, USA
| | - Michelle Abrams
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles Los Angeles CA, USA
| | - David Shapiro
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles Los Angeles CA, USA
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Trull TJ, Ebner-Priemer U. The Role of Ambulatory Assessment in Psychological Science. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2014; 23:466-470. [PMID: 25530686 DOI: 10.1177/0963721414550706] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We describe the current use and future promise of an innovative methodology, ambulatory assessment (AA), that can be used to investigate psychological, emotional, behavioral, and biological processes of individuals in their daily life. The term AA encompasses a wide range of methods used to study people in their natural environment, including momentary self-report, observational, and physiological. We emphasize applications of AA that integrate two or more of these methods, discuss the smart phone as a hub or access point for AA, and discuss future applications of AA methodology to the science of psychology. We pay particular attention to the development and application of Wireless Body Area Networks (WBANs) that can be implemented with smart phones and wireless physiological monitoring devices, and we close by discussing future applications of this approach to matters relevant to psychological science.
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Affiliation(s)
| | - Ulrich Ebner-Priemer
- Karlsruhe Institute of Technology & Central Institute of Mental Health, Mannheim; Germany
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Zamoscik V, Huffziger S, Ebner-Priemer U, Kuehner C, Kirsch P. Increased involvement of the parahippocampal gyri in a sad mood predicts future depressive symptoms. Soc Cogn Affect Neurosci 2014; 9:2034-40. [PMID: 24493842 PMCID: PMC4249476 DOI: 10.1093/scan/nsu006] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 12/17/2013] [Accepted: 01/10/2014] [Indexed: 11/14/2022] Open
Abstract
Behavioral studies suggest a relationship between autobiographical memory, rumination and depression. The objective of this study was to determine whether remitted depressed patients show alterations in connectivity of the posterior cingulate cortex (PCC, a node in the default mode network) with the parahippocampal gyri (PHG, a region associated with autobiographical memory) while intensively recalling negative memories and whether this is related to daily life symptoms and to the further course of depression. Sad mood was induced with keywords of personal negative life events in participants with remitted depression (n = 29) and matched healthy controls (n = 29) during functional magnetic resonance imaging. Additionally, daily life assessments of mood and rumination and a 6-month follow-up were conducted. Remitted depressed participants showed greater connectivity than healthy controls of the PCC with the PHG, which was even stronger in patients with more previous episodes. Furthermore, patients with increased PCC-PHG connectivity showed a sadder mood and more rumination in daily life and a worsening of rumination and depression scores during follow-up. A relationship of negative autobiographical memory processing, rumination, sad mood and depression on a neural level seems likely. The identified increased connectivity probably indicates a 'scar' of recurrent depression and may represent a prognostic factor for future depression.
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Affiliation(s)
- Vera Zamoscik
- Department of Clinical Psychology, Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim and Medical Faculty Mannheim, Heidelberg University, and Chair of Applied Psychology, Department of Sport and Sport Science and House of Competence, Karlsruhe Institute of Technology, Germany
| | - Silke Huffziger
- Department of Clinical Psychology, Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim and Medical Faculty Mannheim, Heidelberg University, and Chair of Applied Psychology, Department of Sport and Sport Science and House of Competence, Karlsruhe Institute of Technology, Germany
| | - Ulrich Ebner-Priemer
- Department of Clinical Psychology, Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim and Medical Faculty Mannheim, Heidelberg University, and Chair of Applied Psychology, Department of Sport and Sport Science and House of Competence, Karlsruhe Institute of Technology, Germany
| | - Christine Kuehner
- Department of Clinical Psychology, Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim and Medical Faculty Mannheim, Heidelberg University, and Chair of Applied Psychology, Department of Sport and Sport Science and House of Competence, Karlsruhe Institute of Technology, Germany
| | - Peter Kirsch
- Department of Clinical Psychology, Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim and Medical Faculty Mannheim, Heidelberg University, and Chair of Applied Psychology, Department of Sport and Sport Science and House of Competence, Karlsruhe Institute of Technology, Germany
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