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Finseth TT, Smith B, Van Steenis AL, Glahn DC, Johnson M, Ruttle P, Shirtcliff BA, Shirtcliff EA. When virtual reality becomes psychoneuroendocrine reality: A stress(or) review. Psychoneuroendocrinology 2024; 166:107061. [PMID: 38701607 DOI: 10.1016/j.psyneuen.2024.107061] [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: 09/22/2023] [Revised: 04/18/2024] [Accepted: 04/18/2024] [Indexed: 05/05/2024]
Abstract
This review article was awarded the Dirk Hellhammer award from ISPNE in 2023. It explores the dynamic relationship between stressors and stress from a historical view as well as a vision towards the future of stress research via virtual reality (VR). We introduce the concept of a "syncytium," a permeable boundary that blurs the distinction between stress and stressor, in order to understand why the field of stress biology continues to inadequately measure stress alone as a proxy for the force of external stressors. Using Virtual Reality (VR) as an illustrative example to explicate the black box of stressors, we examine the distinction between 'immersion' and 'presence' as analogous terms for stressor and stress, respectively. We argue that the conventional psychological approaches to stress measurement and appraisal theory unfortunately fall short in quantifying the force of the stressor, leading to reverse causality fallacies. Further, the concept of affordances is introduced as an ecological or holistic tool to measure and design a stressor's force, bridging the gap between the external environment and an individual's physiological response to stress. Affordances also serve to ameliorate shortcomings in stress appraisal by integrating ecological interdependencies. By combining VR and psychobiological measures, this paper aims to unravel the complexity of the stressor-stress syncytium, highlighting the necessity of assessing both the internal and external facets to gain a holistic understanding of stress physiology and shift away from reverse causality reasoning. We find that the utility of VR extends beyond presence to include affordance-based measures of immersion, which can effectively model stressor force. Future research should prioritize the development of tools that can measure both immersion and presence, thereby providing a more comprehensive understanding of how external stressors interact with individual psychological states.
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Affiliation(s)
| | - Brandon Smith
- Center for Translational Neuroscience, University of Oregon, USA
| | | | - David C Glahn
- Psychiatry and Behavioral Sciences, Boston Children's Hospital and Harvard Medical School, USA
| | - Megan Johnson
- Center for Translational Neuroscience, University of Oregon, USA
| | - Paula Ruttle
- Center for Translational Neuroscience, University of Oregon, USA
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Javelle F, Bloch W, Borges U, Burberg T, Collins B, Gunasekara N, Hosang TJ, Jacobsen T, Laborde S, Löw A, Schenk A, Schlagheck ML, Schoser D, Vogel A, Walzik D, Zimmer P. Eight weeks of high-intensity interval training versus stretching do not change the psychoneuroendocrine response to a social stress test in emotionally impulsive humans. Eur J Appl Physiol 2024:10.1007/s00421-024-05471-w. [PMID: 38710835 DOI: 10.1007/s00421-024-05471-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 03/19/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE Research supports physical activity as a method to heighten stress resistance and resilience through positive metabolic alterations mostly affecting the neuroendocrine system. High-intensity interval training (HIIT) has been proposed as a highly effective time-saving method to induce those changes. However, existing literature relies heavily on cross-sectional analyses, with few randomised controlled trials highlighting the necessity for more exercise interventions. Thus, this study aims to investigate the effects of HIIT versus an active control group on the stress response to an acute psychosocial stressor in emotionally impulsive humans (suggested as being strong stress responders). METHODS The study protocol was registered online (DRKS00016589) before data collection. Sedentary, emotionally impulsive adults (30.69 ± 8.20 y) were recruited for a supervised intervention of 8 weeks and randomly allocated to either a HIIT (n = 25) or a stretching group (n = 19, acting as active controls). Participants were submitted to a test battery, including saliva samples, questionnaires (self-efficacy- and perceived stress-related), visual analogue scales (physical exercise- and stress-related), and resting electroencephalography and electrocardiography assessing their reaction to an acute psychological stressor (Trier Social Stress Test) before and after the exercise intervention. RESULTS HIIT increased aerobic fitness in all participants, whereas stretching did not. Participants from the HIIT group reported perceiving exercising more intensively than those from the active control group (ƞp2 = 0.108, p = 0.038). No further group differences were detected. Both interventions largely increased levels of joy post-TSST (ƞp2 = 0.209, p = 0.003) whilst decreasing tension (ƞp2 = 0.262, p < 0.001) and worries (ƞp2 = 0.113, p = 0.037). Finally, both interventions largely increased perceived levels of general self-efficacy (ƞp2 = 0.120, p = 0.029). CONCLUSION This study suggests that 8 weeks of HIIT does not change the psychoneuroendocrine response to an acute psychological stress test compared to an active control group in emotionally impulsive humans. Further replications of supervised exercise studies highly powered with active and passive controls are warranted.
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Affiliation(s)
- F Javelle
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany.
| | - W Bloch
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - U Borges
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
- Department of Health and Social Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - T Burberg
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
| | - B Collins
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - N Gunasekara
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - T J Hosang
- Experimental Psychology Unit, Faculty of Humanities and Social Sciences, Helmut Schmidt University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - T Jacobsen
- Experimental Psychology Unit, Faculty of Humanities and Social Sciences, Helmut Schmidt University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - S Laborde
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - A Löw
- Experimental Psychology Unit, Faculty of Humanities and Social Sciences, Helmut Schmidt University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - A Schenk
- Division of Performance and Health (Sports Medicine), Institute for Sport and Sport Science, Technical University Dortmund, Dortmund, Germany
| | - M L Schlagheck
- Division of Performance and Health (Sports Medicine), Institute for Sport and Sport Science, Technical University Dortmund, Dortmund, Germany
| | - D Schoser
- Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - A Vogel
- University of Cologne, Cologne, Germany
| | - D Walzik
- Division of Performance and Health (Sports Medicine), Institute for Sport and Sport Science, Technical University Dortmund, Dortmund, Germany
| | - P Zimmer
- Division of Performance and Health (Sports Medicine), Institute for Sport and Sport Science, Technical University Dortmund, Dortmund, Germany
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Hantsoo L, Jagodnik KM, Novick AM, Baweja R, di Scalea TL, Ozerdem A, McGlade EC, Simeonova DI, Dekel S, Kornfield SL, Nazareth M, Weiss SJ. The role of the hypothalamic-pituitary-adrenal axis in depression across the female reproductive lifecycle: current knowledge and future directions. Front Endocrinol (Lausanne) 2023; 14:1295261. [PMID: 38149098 PMCID: PMC10750128 DOI: 10.3389/fendo.2023.1295261] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/13/2023] [Indexed: 12/28/2023] Open
Abstract
The aim of this narrative review is to consolidate knowledge on the role of the hypothalamic-pituitary-adrenal (HPA) axis in depression pathophysiology at different reproductive stages across the female lifespan. Despite growing evidence about the impact of gonadal hormones on mood disorders, no previous review has examined the interaction between such hormonal changes and the HPA axis within the context of depressive disorders in women. We will focus on HPA axis function in depressive disorders at different reproductive stages including the menstrual cycle (e.g., premenstrual dysphoric disorder [PMDD]), perinatally (e.g., postpartum depression), and in perimenopausal depression. Each of these reproductive stages is characterized by vast physiological changes and presents major neuroendocrine reorganization. The HPA axis is one of the main targets of such functional alterations, and with its key role in stress response, it is an etiological factor in vulnerable windows for depression across the female lifespan. We begin with an overview of the HPA axis and a brief summary of techniques for measuring HPA axis parameters. We then describe the hormonal milieu of each of these key reproductive stages, and integrate information about HPA axis function in depression across these reproductive stages, describing similarities and differences. The role of a history of stress and trauma exposure as a contributor to female depression in the context of HPA axis involvement across the reproductive stages is also presented. This review advances the pursuit of understanding common biological mechanisms across depressive disorders among women. Our overarching goal is to identify unmet needs in characterizing stress-related markers of depression in women in the context of hormonal changes across the lifespan, and to support future research in women's mental health as it pertains to pathophysiology, early diagnosis, and treatment targets.
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Affiliation(s)
- Liisa Hantsoo
- Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kathleen M. Jagodnik
- Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, MA, United States
| | - Andrew M. Novick
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ritika Baweja
- Department of Psychiatry and Behavioral Health, Penn State Health, Hershey, PA, United States
- Department of Obstetrics and Gynecology, Penn State Health, Hershey, PA, United States
| | - Teresa Lanza di Scalea
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Department of Women’s Health, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Aysegul Ozerdem
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Erin C. McGlade
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake, UT, United States
- Department of Veterans Affairs, Mental Illness Research, Education, and Clinical Center (MIRECC), Salt Lake, UT, United States
| | - Diana I. Simeonova
- Department of Psychiatry and Behavioral Sciences, Brain Health Center, Emory University School of Medicine, Atlanta, GA, United States
- Goizueta Business School, Emory University, Atlanta, GA, United States
| | - Sharon Dekel
- Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, MA, United States
| | - Sara L. Kornfield
- Center for Women’s Behavioral Wellness, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michelle Nazareth
- Department of Neuroscience, The Johns Hopkins University, Baltimore, MD, United States
| | - Sandra J. Weiss
- Department of Community Health Systems, University of California, San Francisco, San Francisco, CA, United States
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Quagebeur R, Dalile B, Raes J, Van Oudenhove L, Verbeke K, Vrieze E. The role of short-chain fatty acids (SCFAs) in regulating stress responses, eating behavior, and nutritional state in anorexia nervosa: protocol for a randomized controlled trial. J Eat Disord 2023; 11:191. [PMID: 37884972 PMCID: PMC10605799 DOI: 10.1186/s40337-023-00917-6] [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: 08/04/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE This protocol proposes investigating the effects of short-chain fatty acids (SCFAs)-namely acetate, propionate, and butyrate-as mediators of microbiota-gut-brain interactions on the acute stress response, eating behavior, and nutritional state in malnourished patients with anorexia nervosa (AN). SCFAs are produced by bacterial fermentation of dietary fiber in the gut and have recently been proposed as crucial mediators of the gut microbiota's effects on the host. Emerging evidence suggests that SCFAs impact human psychobiology through endocrine, neural, and immune pathways and may regulate stress responses and eating behavior. METHOD We will conduct a randomized, triple-blind, placebo-controlled trial in 92 patients with AN. Patients will receive either a placebo or a mixture of SCFAs (acetate propionate, butyrate) using pH-dependent colon-delivery capsules for six weeks. This clinical trial is an add-on to the standard inpatient psychotherapeutic program focusing on nutritional rehabilitation. HYPOTHESES We hypothesize that colonic SCFAs delivery will modulate neuroendocrine, cardiovascular, and subjective responses to an acute laboratory psychosocial stress task. As secondary outcome measures, we will assess alterations in restrictive eating behavior and nutritional status, as reflected by changes in body mass index. Additionally, we will explore changes in microbiota composition, gastrointestinal symptoms, eating disorder psychopathology, and related comorbidities. DISCUSSION The findings of this study would enhance our understanding of how gut microbiota-affiliated metabolites, particularly SCFAs, impact the stress response and eating behavior of individuals with AN. It has the potential to provide essential insights into the complex interplay between the gut, stress system, and eating behavior and facilitate new therapeutic targets for stress-related psychiatric disorders. This protocol is prospectively registered with ClinicalTrials.gov, with trial registration number NCT06064201.
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Affiliation(s)
- Robin Quagebeur
- Mind-Body Research, Department of Neurosciences, KU Leuven, Leuven, Belgium.
- Leuven Brain Institute, KU Leuven, Leuven, Belgium.
| | - Boushra Dalile
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Jeroen Raes
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium
- Center for Microbiology, Vlaams Instituut Voor Biotechnologie (VIB), Leuven, Belgium
| | - Lukas Van Oudenhove
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
- Cognitive and Affective Neuroscience Lab (CANlab), Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Kristin Verbeke
- Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Elske Vrieze
- Mind-Body Research, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
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von Känel R, Princip M, Holzgang SA, Sivakumar S, Pazhenkottil AP, Gomez Vieito D, Zuccarella-Hackl C. Sympathetic nervous system responses to acute psychosocial stress in male physicians with clinical burnout. Biol Psychol 2023; 183:108687. [PMID: 37716520 DOI: 10.1016/j.biopsycho.2023.108687] [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: 05/07/2023] [Revised: 08/31/2023] [Accepted: 09/11/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Occupational burnout has been associated with an increased risk of cardiovascular disease, with sympathetic nervous system (SNS) dysfunction as one explanation. This study examined the effects of burnout on responses of SNS activity measures to acute psychosocial stress in male physicians, a population at risk for burnout. METHODS Study participants were 60 male physicians, 30 with clinical burnout, assessed with the Maslach Burnout Inventory, and 30 without burnout (controls). All participants underwent the 15-min Trier Social Stress Test. Heart rate, blood pressure, salivary alpha-amylase, and plasma levels of epinephrine (EPI) and norepinephrine were assessed pre-stress, immediately post-stress, and 15 min and 45 min post-stress. RESULTS Physicians with burnout and controls differed in EPI changes over time, controlling for age, job stress and anxiety symptoms (F (3,147) = 5.18, p = .002 for 'Time by Group' interaction; η2p = .096). Burnout was associated with a smaller increase in EPI from pre-stress to immediately post-stress (r(54) = -.40, p = .004). The emotional exhaustion dimension of burnout was a significant driver of this effect. The area under the curve with respect to increase in EPI was also smaller in the burnout group (F (1,49) = 6.06, p = .017, η2p = .110). Group differences were not significant for the other SNS activity measures. CONCLUSIONS Burnout may be linked to dysfunction of the sympathoadrenal medullary (SAM) system, when exposed to acute psychosocial stress. In keeping with the allostatic load concept, an insufficient SAM stress response in burnout could potentially contribute to cardiovascular disease.
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Affiliation(s)
- Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Mary Princip
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sarah A Holzgang
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sinthujan Sivakumar
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Diego Gomez Vieito
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Institute of Molecular Cancer Research, University of Zurich, Zurich, Switzerland
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Borráz-León JI, Spreitzer A, Scrivner C, Landers M, Lee R, Maestripieri D. Cortisol reactivity to psychosocial stress in vulnerable and grandiose narcissists: An exploratory study. Front Psychol 2023; 13:1067456. [PMID: 36687967 PMCID: PMC9852882 DOI: 10.3389/fpsyg.2022.1067456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/14/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction Narcissistic personality manifests itself in at least two different forms: grandiose and vulnerable. In the present study, we compared cortisol and emotional responses to psychosocial stress between subjects high in vulnerable and grandiose narcissism scores, and examined possible associations between narcissism, other personality traits, and stress responses. We hypothesized that subjects with higher scores of vulnerable narcissism would show stronger emotional and physiological reactivity than those with high scores of grandiose narcissism. Methods A final sample of forty-seven participants underwent a Trier Social Stress Test (TSST), provided saliva samples to assess cortisol levels, and completed several personality questionnaires. Results Consistent with our hypothesis, subjects with higher scores of vulnerable narcissism had a stronger cortisol and emotional response than those with high scores of grandiose narcissism. Vulnerable narcissism was positively correlated with schizotypal traits, while grandiose narcissism was positively correlated with psychopathic traits. Participants with a mixed-type of narcissism were also discussed. Discussion This study provides the first evidence of differential physiological and emotional reactivity to social evaluation threat according to scores of vulnerable and grandiose narcissism. Since this is an exploratory study, the results must be interpreted with caution. However, the results will be informative for future confirmatory research with larger and more heterogeneous samples.
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Affiliation(s)
- Javier I. Borráz-León
- Institute for Mind and Biology, The University of Chicago, Chicago, IL, United States,*Correspondence: Javier I. Borráz-León,
| | - Alena Spreitzer
- Institute for Mind and Biology, The University of Chicago, Chicago, IL, United States
| | - Coltan Scrivner
- Institute for Mind and Biology, The University of Chicago, Chicago, IL, United States,Department of Comparative Human Development, The University of Chicago, Chicago, IL, United States
| | - Mitchell Landers
- Institute for Mind and Biology, The University of Chicago, Chicago, IL, United States,Department of Psychology, The University of Chicago, Chicago, IL, United States
| | - Royce Lee
- Institute for Mind and Biology, The University of Chicago, Chicago, IL, United States,Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, United States
| | - Dario Maestripieri
- Institute for Mind and Biology, The University of Chicago, Chicago, IL, United States,Department of Comparative Human Development, The University of Chicago, Chicago, IL, United States
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Kexel AK, Kluwe-Schiavon B, Baumgartner MR, Engeli EJE, Visentini M, Kirschbaum C, Seifritz E, Ditzen B, Soravia LM, Quednow BB. Cue-induced cocaine craving enhances psychosocial stress and vice versa in chronic cocaine users. Transl Psychiatry 2022; 12:443. [PMID: 36220809 PMCID: PMC9554190 DOI: 10.1038/s41398-022-02204-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 09/16/2022] [Accepted: 09/23/2022] [Indexed: 11/30/2022] Open
Abstract
Stress and craving, it has been found, contribute to the development and maintenance of and relapse in cocaine use disorder. Chronic cocaine users (CU), previous research has shown, display altered physiological responses to psychosocial stress and increased vegetative responding to substance-related cues. However, how psychosocial stress and cue-induced craving interact in relation to the CU's physiological responses remains largely unknown. We thus investigated the interaction between acute psychosocial stress and cocaine-cue-related reactivity in 47 CU and 38 controls. In a crossed and balanced design, the participants were randomly exposed to a video-based cocaine-cue paradigm and the Trier Social Stress Test (TSST) or vice versa to investigate possible mutually augmenting effects of both stressors on physiological stress responses. Over the course of the experimental procedure, plasma cortisol, ACTH, noradrenaline, subjective stress, and craving were assessed repeatedly. To estimate the responses during the cocaine-cue paradigm and TSST, growth models and discontinuous growth models were used. Overall, though both groups did not differ in their endocrinological responses to the TSST, CU displayed lower ACTH levels at baseline. The TSST did not elevate craving in CU, but when the cocaine-cue video was shown first, CU displayed an enhanced cortisol response to the subsequent TSST. In CU, cocaine-cues robustly evoked craving but no physiological stress response, while cue-induced craving was intensified after the TSST. Taken together, though CU did not show an altered acute stress response during the TSST, stress and craving together seemed to have mutually augmenting effects on their stress response.
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Affiliation(s)
- Ann-Kathrin Kexel
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland.
| | - Bruno Kluwe-Schiavon
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland
- Cognition in Context, Research Center for Psychological Science, University of Lisbon, Alameda da Universidade, 1649-013, Lisbon, Portugal
| | - Markus R Baumgartner
- Centre for Forensic Hair Analytics, Institute of Forensic Medicine, University of Zurich, Kurvenstrasse 17, 8006, Zurich, Switzerland
| | - Etna J E Engeli
- Centre for Addictive Disorders, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zurich, Selnaustrasse 9, 8001, Zurich, Switzerland
| | - Monika Visentini
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland
| | - Clemens Kirschbaum
- Department of Biopsychology, Technical University Dresden, Zellescher Weg 19, 01069, Dresden, Germany
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland
| | - Beate Ditzen
- Institute for Medical Psychology, Heidelberg University Hospital, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Bergheimer Str. 20, 69115, Heidelberg, Germany
| | - Leila M Soravia
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000, Bern 60, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland.
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland.
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8
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Meier M, Haub K, Schramm ML, Hamma M, Bentele UU, Dimitroff SJ, Gärtner R, Denk BF, Benz ABE, Unternaehrer E, Pruessner JC. Validation of an online version of the trier social stress test in adult men and women. Psychoneuroendocrinology 2022; 142:105818. [PMID: 35662007 DOI: 10.1016/j.psyneuen.2022.105818] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022]
Abstract
The Trier Social Stress Test (TSST) is a reliable and efficient protocol to induce acute psychosocial stress in the laboratory. If circumstances do not allow in-person assessments, an online version of the TSST could create more flexible research opportunities. To date, studies have confirmed subjective and autonomic stress responses to online TSST protocols. In this preregistered study (https://osf.io/u57aj), we focused on the effect of a TSST online for adults (TSST-OA) on cortisol and alpha amylase levels, and pleasure and arousal ratings. As cortisol stress reactivity is mediated by sex, we further compared men and women. We hypothesized significant increases in cortisol, alpha amylase and arousal, and a decrease in pleasure in response to the TSST-OA. Also, we expected stronger cortisol responses in males as compared with females, as in the laboratory TSST. N = 48 adults (56% female, meanage=23.02 years, SD=3.19) participated in the study. Saliva sampling devices were sent to participants' home before testing sessions, during which the experimenter, a mixed-sex panel, and the participant joined a video call. Participants underwent the TSST-OA and overall provided five saliva samples for cortisol and alpha amylase detection. Pleasure and arousal ratings and psychometric questionnaires were also completed online. As hypothesized, the TSST-OA significantly increased cortisol, alpha amylase, and arousal levels, while it decreased pleasure. Moreover, cortisol responses were significantly stronger in males as compared to females. 64% of subjects were classified as responders (cortisol rise>1.5nmol/l). The TSST-OA successfully induced psychophysiological stress in adults. Our protocol offers new possibilities to study stress outside of the laboratory.
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Affiliation(s)
- Maria Meier
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Constance, Germany.
| | - Kristina Haub
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Constance, Germany
| | - Marie-Luise Schramm
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Constance, Germany
| | - Marc Hamma
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Constance, Germany
| | - Ulrike U Bentele
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Constance, Germany
| | - Stephanie J Dimitroff
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Constance, Germany
| | - Raphaela Gärtner
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Constance, Germany
| | - Bernadette F Denk
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Constance, Germany
| | - Annika B E Benz
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Constance, Germany
| | - Eva Unternaehrer
- Child and Adolescent Research Department, University Psychiatric Clinics Basel (UPK), University of Basel, Switzerland
| | - Jens C Pruessner
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Constance, Germany
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Double the dose, double the impact? Effects of iTBS on salivary cortisol in stressed healthy volunteers. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 10:100127. [PMID: 35755208 PMCID: PMC9216409 DOI: 10.1016/j.cpnec.2022.100127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/22/2021] [Accepted: 02/14/2022] [Indexed: 11/24/2022] Open
Abstract
There is a growing interest in applying double-dose repetitive transcranial Magnetic Stimulation (rTMS) as a therapeutic tool for stress-related psychiatric disorders. Such stimulation protocols may shorten the treatment duration and may result in faster symptom improvement. Currently, theta-burst stimulation (TBS) protocols have gained attention because of their significantly reduced treatment duration, compared to conventional rTMS. However, the effect of one or twice daily rTMS sessions remains unclear in relation to stress. Using a two-period cross-over design, we examined the impact of double-dosed intermittent (TBS) over the left dorsolateral prefrontal cortex on stress responses (salivary cortisol) in thirty-eight healthy participants after being stressed by a validated psychosocial stress task: the Trier Social Stress Test. After the first active iTBS session, as contrasted to sham, no differential effects on salivary output were observed. However, after the second active session, there was a significantly smaller decrease of salivary cortisol concentrations in the active iTBS condition compared to sham. Our results suggest that double-dosed iTBS after being stressed might differently affect stress recovery compared to a single session of iTBS. Double-dosed iTBS (after being stressed) might differently affect stress-responses compared to a single session of iTBS One session of iTBS in healthy volunteers might not be enough to alter psychophysiological stress-responses Stimulation protocols applying iTBS twice daily with only a short time of intersession interval may produce rather inhibitory effects on stress regulation instead of a facilitation.
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