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Ortiz A, Park Y, MacLean S, Husain MI, Sanches M, Ravindran A, Mulsant BH. A History of Suicide Attempt Is Associated with Increased Sympathetic Activation in Bipolar Disorder. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024; 69:126-137. [PMID: 37583363 PMCID: PMC10789230 DOI: 10.1177/07067437231194334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
OBJECTIVE Suicide risk in bipolar disorder (BD) is estimated to be up to 20 times higher than in the general population. While there is a large body of evidence suggesting that increased sympathetic activation is associated with disease and death, there is a paucity of research on the role of autonomic nervous system (ANS) dysfunction in patients with BD who have attempted suicide. METHODS Fifty-three participants with BD used a wearable device to assess the association between history of suicide attempt, current suicidal ideation, and ANS dysfunction, including measures of heart rate variability (HRV) and respiratory rate. Data were analyzed in a series of unadjusted and adjusted bivariate models of association controlling for relevant variables. RESULTS A history of suicide attempts was significantly associated with an increase in respiratory rate (p < 0.01). These results remained significant after adjusting for age, BMI, and current mood state. There was no association between current suicidal ideation and heart rate or respiratory rate. In the frequency domain, HRV parameters suggest reduced parasympathetic (i.e., vagal) activity in participants with a history of suicide attempts and in those with current suicidality, suggesting changes in sympathicovagal balance in BD. CONCLUSIONS Our results suggest that changes in the ANS in patients with BD and a history of suicide attempt are not restricted to pure vagally mediated HRV parameters, but rather signal a general ANS dysregulation. This ANS imbalance may be contributing to illness burden and cardiovascular disease. Further research on the relationship between ANS and suicidality in BD is needed.
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Affiliation(s)
- Abigail Ortiz
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Yunkyung Park
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Stephane MacLean
- Institute for Mental Health Research, The Royal Ottawa Hospital, Ottawa, Ontario, Canada
| | - M. Ishrat Husain
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Marcos Sanches
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Arun Ravindran
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Benoit H. Mulsant
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Kaufman EA, Clerke AS, Meddaoui B. Translating core intervention strategies into action: Interpersonal validation among self-injuring adolescents and their mothers. J Clin Psychol 2023; 79:105-125. [PMID: 35611597 DOI: 10.1002/jclp.23393] [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: 07/24/2021] [Revised: 01/27/2022] [Accepted: 05/07/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Most evidence-supported treatments for psychiatric problems teach clients skills to incorporate into their daily lives. Yet little research rigorously examines the extent to which individuals absorb these strategies and can competently apply them outside of the therapeutic relationship. OBJECTIVES The current study examined the degree to which self-injuring adolescents and their mothers (n = 30 dyads) and typical control mother-daughter dyads (n = 30) were able to utilize a multicomponent interpersonal validation-oriented skill from dialectical behavior therapy, after a single teaching. We also aimed to assess whether variance in Gentle, Interested, Validate, and Easy (GIVE) skill practice was associated with a physiological index of emotion regulation (respiratory sinus arrhythmia [RSA]). METHOD An observational coding system was developed to measure skill-related behavior across four key domains (be[ing] gentle, act[ing] interested, validation, and us[ing] an easy manner; GIVE) and applied during two family conflict discussions (pre- and postskills training). Mother and adolescent RSA data were collected at rest and across discussion tasks. RESULTS Behavioral indicators of skill use improved pre-to-post skills training across the entire sample, except in one GIVE domain (easy manner). Self-injuring youth and their mothers demonstrated greater improvements than control dyads with respect to being gentle. RSA reactivity scores predicted behavioral validation, such that higher RSA was associated with higher validation scores. CONCLUSIONS As a field, we currently have a limited understanding of how intervention skills are used, and what factors predict effective skill application. Results suggest self-injuring adolescents and their mothers can learn and improve on most aspects of a core intervention strategy after a single teaching and that better physiological regulation during conflict is associated with more validating behaviors.
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Affiliation(s)
- Erin A Kaufman
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
| | - Alexa S Clerke
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
| | - Brianna Meddaoui
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
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3
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La Marca R, Pallich G, Holtforth MG, Hochstrasser B. Higher Resting Cardiovagal Activity Predicts Larger Decrease of Depressive Symptoms in Inpatients Treated for Stress-Related Depression. J PSYCHOPHYSIOL 2022. [DOI: 10.1027/0269-8803/a000299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Depression is one of the most prevalent mental disorders, with treatment outcomes generally being unsatisfactory. The identification of outcome predictors could contribute to improving diagnosis, treatment, and outcome. Heart rate variability (HRV), an index of cardiovagal activity, has been proposed as a potential correlate of depression as well as a predictor of treatment effectiveness. The aim of the present study was to examine if HRV at baseline could predict the outcome of inpatient treatment for stress-related depressive disorder (SRDD). Depressive symptoms of n = 57 inpatients with an SRDD, who were treated in a specialized burnout ward, were assessed using the Beck Depression Inventory (BDI) at the beginning, the end of treatment, and at 3-month follow-up. HRV (i.e., RMSSD, the root mean square of successive RR interval differences) was determined from a five-minute measurement in the supine position. RMSSD was not significantly associated with the BDI score at the beginning, end, and follow-up. Higher RMSSD was revealed to be a significant predictor of a stronger decrease in depressive severity from the beginning to the end of the treatment. Thereby, the regression model explained 7.6% of the total variance in the BDI decrease. The results revealed initial HRV to predict a larger decrease in depressive severity. Therefore, resting HRV represents a physiological resource and index of successful neurovisceral interaction, which supports inpatients in benefitting from specialized treatment.
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Affiliation(s)
- Roberto La Marca
- Centre for Stress-Related Disorders, Clinica Holistica Engiadina SA, Susch, Switzerland
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland
| | - Gianandrea Pallich
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland
- Clinical Psychology and Psychotherapy, University of Bern, Switzerland
- Private Hospital Meiringen, Switzerland
| | - Martin grosse Holtforth
- Clinical Psychology and Psychotherapy, University of Bern, Switzerland
- Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland
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Psychopathy, the Four Facet Model, and Fearlessness: Testing Sympathetic and Parasympathetic Nervous System Reactivity in a Late Adolescent Sample. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-021-09948-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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5
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Sheridan DC, Baker S, Dehart R, Lin A, Hansen M, Tereshchenko LG, Le N, Newgard CD, Nagel B. Heart Rate Variability and Its Ability to Detect Worsening Suicidality in Adolescents: A Pilot Trial of Wearable Technology. Psychiatry Investig 2021; 18:928-935. [PMID: 34555890 PMCID: PMC8542751 DOI: 10.30773/pi.2021.0057] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/27/2021] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Suicide is the 2nd leading cause of death in adolescence, and acute pediatric mental health emergency department (ED) visits have doubled in the past decade. The objective of this study was to evaluate physiologic parameters relationship to suicide severity. METHODS This was a prospective, observational study from April 2018 thru November 2019 in a tertiary care pediatric emergency department (ED) and inpatient pediatric psychiatric unit enrolling acutely suicidal adolescent patients. Patients wore a wrist device that used photoplethysmography for 7 days during their acute hospitalization to measure heart rate variability (HRV). During that time, Columbia Suicide Severity Scores (CSSRS) were assessed at 3 time points. RESULTS There was complete device data and follow-up for 51 patients. There was an increase in the high frequency (HF) component of HRV in patients that had a 25% or greater decrease in their CSSRS (mean difference 11.89 ms/ Hz ; p-value 0.005). Patients with a CSSRS≥15 on day of enrollment had a lower, although not statistically significant, HF component (mean difference -8.34 ms/ Hz; p-value 0.071). CONCLUSION We found an inverse correlation between parasympathetic activity measured through the HF component and suicidality in an acutely suicidal population of adolescents. Wearable technology may have the ability to improve outpatient monitoring for earlier detection and intervention.
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Affiliation(s)
- David C Sheridan
- Department of Emergency Medicine, Oregon Health & Science University, Oregon, USA.,Center of Policy and Research in Emergency Medicine, Oregon Health & Science University, Oregon, USA
| | - Steven Baker
- Department of Emergency Medicine, Oregon Health & Science University, Oregon, USA.,Alpha Bravo Connectivity, LLC, Oregon, USA
| | - Ryan Dehart
- Department of Emergency Medicine, Oregon Health & Science University, Oregon, USA
| | - Amber Lin
- Department of Emergency Medicine, Oregon Health & Science University, Oregon, USA.,Center of Policy and Research in Emergency Medicine, Oregon Health & Science University, Oregon, USA
| | - Matthew Hansen
- Department of Emergency Medicine, Oregon Health & Science University, Oregon, USA.,Center of Policy and Research in Emergency Medicine, Oregon Health & Science University, Oregon, USA
| | - Larisa G Tereshchenko
- Department of Medicine, Division of Cardiology, Oregon Health & Science University, Oregon, USA
| | - Nancy Le
- Department of Emergency Medicine, Oregon Health & Science University, Oregon, USA.,Center of Policy and Research in Emergency Medicine, Oregon Health & Science University, Oregon, USA
| | - Craig D Newgard
- Department of Emergency Medicine, Oregon Health & Science University, Oregon, USA.,Center of Policy and Research in Emergency Medicine, Oregon Health & Science University, Oregon, USA
| | - Bonnie Nagel
- Department of Psychiatry, Oregon Health & Science University, Oregon, USA.,Department of Behavioral Neuroscience, Oregon Health & Science University, Oregon, USA
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Zhang H, Luo Y, Davis T, Zhang L. Interactive effects of childhood maltreatment and tonic respiratory sinus arrhythmia on young adults' depressive symptoms. Psychophysiology 2021; 58:e13900. [PMID: 34287947 DOI: 10.1111/psyp.13900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 06/21/2021] [Accepted: 06/24/2021] [Indexed: 01/17/2023]
Abstract
The goal of the current study was to investigate the moderating effect of tonic respiratory sinus arrhythmia (RSA) in the relation between childhood maltreatment and depression symptoms among young adults. A total of 98 participants (70 women) aged 17-22 years completed questionnaires on childhood maltreatment and depressive symptoms. RSA data were obtained during a resting condition in the laboratory. Results indicated that childhood maltreatment interacted with tonic RSA to predict depressive symptoms, even after controlling for age and body mass index (BMI) of each participant. Specifically, higher levels of childhood maltreatment were associated with higher levels of depressive symptoms, but only among young adults who exhibited lower tonic RSA. The results indicated that the association between childhood maltreatment and depressive symptoms depends on young adults' physiological functioning/flexibility. Findings suggest that consideration of external environmental factors in combination with internal physiological factors is critical to understand young adults' mental health.
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Affiliation(s)
- Hui Zhang
- Jiangsu Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Nanjing Normal University, Nanjing, China
| | - Yun Luo
- School of Education, Zhaoqing University, Zhaoqing, China
| | - Toshanna Davis
- Jiangsu Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Nanjing Normal University, Nanjing, China
| | - Linlin Zhang
- School of Psychology, Capital Normal University, Beijing, China
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7
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Positive emotions have different impacts on mood and sympathetic changes in crying from negative emotions. MOTIVATION AND EMOTION 2021. [DOI: 10.1007/s11031-021-09887-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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Park SM, Jung HY. Respiratory sinus arrhythmia biofeedback alters heart rate variability and default mode network connectivity in major depressive disorder: A preliminary study. Int J Psychophysiol 2020; 158:225-237. [DOI: 10.1016/j.ijpsycho.2020.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 10/06/2020] [Accepted: 10/20/2020] [Indexed: 12/12/2022]
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9
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Skoranski AM, Lunkenheimer E. Person-centered profiles of parasympathetic physiology, anxiety symptoms, and depressive symptoms in mothers and fathers of young children. Dev Psychobiol 2020; 63:753-767. [PMID: 32979242 DOI: 10.1002/dev.22043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/27/2020] [Accepted: 09/06/2020] [Indexed: 01/11/2023]
Abstract
Respiratory sinus arrhythmia (RSA) is a biomarker of mental health, but RSA-symptom relations in parents of young children are understudied. We examined how anxiety symptoms, depressive symptoms, resting RSA, and RSA reactivity during challenging parent-child interactions clustered in a community sample of mothers (N = 126) and fathers (N = 87) of 3-year-olds and whether profiles predicted child emotional and behavioral dysregulation at age 4. Mothers fit four profiles (Typical, Mild Risk, Moderate Risk/Withdrawal, and Moderate Risk/Augmentation), suggesting that RSA reactivity was distinct by predominant symptom type at higher levels of risk: specifically, heightened RSA withdrawal was associated with a higher probability of anxiety symptoms and RSA augmentation was associated with a higher probability of depressive symptoms. Fathers fit three profiles (Typical, Mild Risk, and Moderate Risk) where Moderate Risk was characterized by RSA augmentation and a higher probability of both anxiety and depressive symptoms. Mild risk profiles showed heightened resting RSA for mothers and fathers but no differences in RSA reactivity. Both mild and moderate risk profiles predicted higher child dysregulation 1 year later compared to typical profiles. Findings offer preliminary evidence that parasympathetic physiology covaries with symptoms differently for mothers and fathers and that parental profiles of physiology and symptoms inform children's developmental psychopathology.
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10
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Gray JM, Tully EC. Cognitive reappraisal moderates the quadratic association between heart rate variability and negative affectivity. Psychophysiology 2020; 57:e13584. [DOI: 10.1111/psyp.13584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 01/06/2023]
Affiliation(s)
- Jackson M. Gray
- Department of Psychology Georgia State University Atlanta GA USA
| | - Erin C. Tully
- Department of Psychology Georgia State University Atlanta GA USA
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11
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Choi KW, Jeon HJ. Heart Rate Variability for the Prediction of Treatment Response in Major Depressive Disorder. Front Psychiatry 2020; 11:607. [PMID: 32695031 PMCID: PMC7339656 DOI: 10.3389/fpsyt.2020.00607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/11/2020] [Indexed: 11/13/2022] Open
Abstract
Major depressive disorder (MDD) is one of the disabling diseases in the world-wide, and known to increase cardiac morbidity and mortality. Therefore, previous studies related heart rate variability (HRV) have been conducted to evaluate and diagnose MDD, and to predict treatment outcomes in patient with MDD. We reviewed extensively on the previous peer-reviewed publications associated with this issue, using Pub-Med. In this review article, we introduce the basic concept of HRV and HRV measures, and present several important findings associated with diagnosis and treatment prediction in MDD with using HRV parameters. Furthermore, we discuss the possible underlying mechanism of this phenomenon, and suggest several considerations for the future research.
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Affiliation(s)
- Kwan Woo Choi
- Department of Psychiatry, Korea University College of Medicine, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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12
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Chesin M, Cascardi M, Tsang W, Smith S. Blunted Arousal in Response to Psychological Stress is Associated with Current Suicide Ideation. Arch Suicide Res 2020; 24:S381-S390. [PMID: 30955451 DOI: 10.1080/13811118.2019.1592041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose of this study was to test the association between arousal in response to psychological stress, as measured by standardized maximum decrease in high-frequency heart rate variability (HF HRV) during a stressful laboratory task, and current suicide ideation (SI). 81 emerging adult college students completed a stressful laboratory task consisting of the computerized Stroop and Cyberball while having their heart activity recorded. Spectral analysis and Fast Fourier transformations were used to decompose and transform the recording into the high (0.15 Hz-0.4 Hz) frequency component. After the task, participants completed the Beck Scale for Suicide Ideation to measure current SI, the Beck Depression Inventory-II to assess depressive symptom severity, and a brief medical history. Multivariate negative binomial regression analysis showed that the negative association between SI and arousal in response to psychological stress remained statistically significant when suicide attempt history, depressive symptom severity, female gender, and current smoking behavior were controlled. Identification of potential biomarkers for SI is important for suicide behavior prevention given limits to self-report SI assessment. Our results suggest arousal in response to psychological stress merits further consideration as a biomarker for current SI.
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Affiliation(s)
- Megan Chesin
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| | - Michele Cascardi
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| | - William Tsang
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| | - Samantha Smith
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
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Danböck SK, Werner GG. Cardiac Vagal Control, Regulatory Processes and Depressive Symptoms: Re-Investigating the Moderating Role of Sleep Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214067. [PMID: 31652709 PMCID: PMC6862518 DOI: 10.3390/ijerph16214067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/10/2019] [Accepted: 10/19/2019] [Indexed: 12/12/2022]
Abstract
Lower cardiac vagal control (CVC), which is often understood as an indicator for impaired regulatory processes, is assumed to predict the development of depressive symptoms. As this link has not been consistently demonstrated, sleep quality has been proposed as a moderating factor. However, previous studies were limited by non-representative samples, cross-sectional data, and focused on CVC as a physiological indicator for impaired regulatory processes, but neglected corresponding subjective measures. Therefore, we investigated whether sleep quality moderates the effects of CVC (quantified by high-frequency heart rate variability) and self-reported regulatory processes (self- and emotion-regulation) on concurrent depressive symptoms and on depressive symptoms after three months in a representative sample (N = 125). Significant interactions between CVC and sleep quality (in women only), as well as self-/emotion-regulation and sleep quality emerged, whereby higher sleep quality attenuated the relation between all risk factors and current depressive symptoms (cross-sectional data). However, there were no significant interactions between those variables in predicting depressive symptoms three months later (longitudinal data). Our cross-sectional findings extend previous findings on sleep quality as a protective factor against depressive symptoms in the presence of lower CVC and subjective indices of impaired regulatory processes. In contrast, our conflicting longitudinal results stress the need for further investigations.
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Affiliation(s)
- Sarah K Danböck
- Division of Clinical Psychology and Psychological Treatment, Department of Psychology, Ludwig-Maximilians-University Munich, Leopoldstr. 13, 80802 Munich, Germany.
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology and Psychopathology, Department of Psychology, University of Salzburg, Hellbrunner Str. 34, 5020 Salzburg, Austria.
| | - Gabriela G Werner
- Division of Clinical Psychology and Psychological Treatment, Department of Psychology, Ludwig-Maximilians-University Munich, Leopoldstr. 13, 80802 Munich, Germany.
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Thomson ND, Beauchaine TP. Respiratory Sinus Arrhythmia Mediates Links Between Borderline Personality Disorder Symptoms and Both Aggressive and Violent Behavior. J Pers Disord 2019; 33:544-559. [PMID: 30307825 DOI: 10.1521/pedi_2018_32_358] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Although emotion dysregulation (ED) is a core symptom of borderline personality disorder (BPD), tests of associations between ED and aggression and violence-which are common to BPD-are sparse. The authors evaluated mediating effects of an autonomic vulnerability to ED on links between BPD symptoms and (a) reactive aggression, (b) proactive aggression, and (c) histories of interpersonal violence in a sample of young adults (N = 104), ages 18-22 years. Low baseline respiratory sinus arrhythmia (RSA) mediated the association between BPD symptoms and reactive aggression. In contrast, although BPD symptoms were correlated with proactive aggression, no mediational effect was found. In addition, low RSA mediated the association between BPD symptoms and histories of interpersonal violence. Collectively, these findings add evidence that neurobiological vulnerability to ED contributes to aggressive and violent behavior among those with BPD.
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Affiliation(s)
- Nicholas D Thomson
- Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University Health, Richmond, Virginia, and University of Durham, Durham, UK
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15
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Emotion dysregulation, temperamental vulnerability, and parental depression in adolescents: Correspondence between physiological and informant-report measures. Dev Psychopathol 2019; 31:1023-1035. [PMID: 31046860 DOI: 10.1017/s0954579419000567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
AbstractAlthough numerous studies reveal altered respiratory sinus arrhythmia (RSA) among children, adolescents, and adults who exhibit emotion dysregulation, effects of temperamental vulnerability and parental mental health on RSA remain unclear. We evaluated the relationship among emotion regulation, RSA, and RSA reactivity in a pooled sample of 24 vulnerable and 31 resilient adolescents (mean age = 13.69 years; 60% girls), including associations with temperamental vulnerability and parental depressive symptoms. Participants watched a neutral film clip while their resting RSA was recorded, and then completed a reward and frustration task, using an affective Posner paradigm. Temperament and emotion regulation were assessed via self-report and parent report, and parents reported on their own depressive symptoms. Low resting RSA was associated with temperamental negative emotionality, whereas greater RSA reactivity to frustration was associated with maladaptive emotion regulation strategies. No significant relations were found between RSA and parental depressive symptoms. This study elucidates the role of RSA as a biomarker of individual differences in emotion dysregulation and temperamental vulnerability and stresses the importance of considering multiple units of analyses, as well as functional domains, when studying emotional responding and regulation in adolescents.
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Yang X, Daches S, George CJ, Kiss E, Kapornai K, Baji I, Kovacs M. Autonomic correlates of lifetime suicidal thoughts and behaviors among adolescents with a history of depression. Psychophysiology 2019; 56:e13378. [PMID: 31002191 DOI: 10.1111/psyp.13378] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 03/27/2019] [Accepted: 03/31/2019] [Indexed: 12/23/2022]
Abstract
Suicidal thoughts and behaviors (STBs) have been associated with emotion dysregulation and atypical responses to affective and stressful stimuli. To investigate the psychophysiology involved, we measured changes in respiratory sinus arrhythmia (RSA) and cardiac pre-ejection period (PEP; indexing parasympathetic and sympathetic functioning, respectively) in response to stressful- and sadness-eliciting laboratory probes. Our sample included adolescents with a history of depression and STBs (n = 177), adolescents with a history of depression but no history of STBs (n = 47), and healthy controls (n = 175). The outcome of interest was the most severe form of clinician-rated STBs across the subject's lifetime. In partial support of our hypotheses, during the stressful task, adolescents with a history of depression and STBs did not evidence the RSA decrease that was exhibited by controls and displayed greater PEP shortening compared to ever-depressed adolescents with no lifetime STBs. No group differences were found in either RSA or PEP reactivity to the sadness-eliciting stimulus. As expected, severity of STBs was positively correlated with the extent of PEP shortening during the stressful task. The results suggest that adolescents with a history of depression and STBs experience blunted parasympathetic responses to stress along with compensatory efforts. Our findings contribute to a better understanding of STBs among youths and underscore that future studies should examine physiological risk factors for these psychopathological outcomes.
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Affiliation(s)
- Xiao Yang
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Shimrit Daches
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Charles J George
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Enikő Kiss
- Department of Child and Adolescent Psychiatry, University of Szeged, Szeged, Hungary
| | - Krisztina Kapornai
- Department of Child and Adolescent Psychiatry, University of Szeged, Szeged, Hungary
| | - Ildikó Baji
- Department of Child and Adolescent Psychiatry, University of Szeged, Szeged, Hungary
| | - Maria Kovacs
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Heart rate variability for treatment response between patients with major depressive disorder versus panic disorder: A 12-week follow-up study. J Affect Disord 2019; 246:157-165. [PMID: 30583140 DOI: 10.1016/j.jad.2018.12.048] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 11/08/2018] [Accepted: 12/16/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Heart Rate Variability (HRV) parameters have been used to evaluate the autonomic nervous system. We hypothesized that patients with major depressive disorder (MDD) and panic disorder (PD) showed different HRV profiles compared to healthy controls. We also hypothesized that we could predict the responder groups in the MDD and PD patients, using differences in HRV indices between the stress and rest phases. METHODS 28 MDD patients and 29 PD patients were followed for 12 weeks, and we also followed 39 healthy control subjects. We measured HRV parameters at the rest, stress, and recovery phases. RESULTS Patients with MDD and PD demonstrated lower pNN50 than controls during the stress (F = 7.49, p = 0.001), and recovery phases (F = 9.43, p = 0.0001). Patients with MDD and PD also showed higher LF/HF ratio than controls during the stress phase (F = 6.15, p = 0.002). Responders in the PD group presented a lower level of LF/HF ratio during the stress phase compared to non-responders (F = 10.14, p = 0.002), while responders in the MDD group showed a lower level of heart rate during all three phases, compared to non-responders. Additionally, we could predict treatment response in patients with MDD using ΔLF/HF ratio (OR: 1.33, 95% CI = 1.07-1.65, p = 0.011) and ΔpNN50 (OR: 1.49, 95% CI 1.09-1.77, p = 0.014). CONCLUSION The changes of HRV parameters of pNN50 and LF/HF ratio between the stress and recovery phase may be clinical markers of predictors of treatment responsiveness in MDD and PD patients.
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Abstract
Suicide is the second leading cause of death worldwide for adolescents. Despite decades of research on correlates and risk factors for adolescent suicide, we know little about why suicidal ideation and behavior frequently emerge in adolescence and how to predict, and ultimately prevent, suicidal behavior among youths. In this review, we first discuss knowledge regarding correlates, risk factors, and theories of suicide. We then review why adolescence is a period of unique vulnerability, given changing biology and social network reorganization. Next, we present a conceptual model through which to interpret emerging findings in adolescent suicide research. We suggest that a promising area for future research is to examine adolescent suicide as a failure of biological responses to acute stress in the proximal moments of a suicidal crisis. After reviewing initial evidence for this conceptualization, we review future directions for studies on adolescent suicide.
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Affiliation(s)
- Adam Bryant Miller
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA; ,
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA; ,
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Fox AR, Hammond LE, Mezulis AH. Respiratory sinus arrhythmia and adaptive emotion regulation as predictors of nonsuicidal self-injury in young adults. Int J Psychophysiol 2018; 133:1-11. [DOI: 10.1016/j.ijpsycho.2018.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 08/23/2018] [Accepted: 09/19/2018] [Indexed: 11/24/2022]
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Adolph D, Teismann T, Forkmann T, Wannemüller A, Margraf J. High frequency heart rate variability: Evidence for a transdiagnostic association with suicide ideation. Biol Psychol 2018; 138:165-171. [PMID: 30253232 DOI: 10.1016/j.biopsycho.2018.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 09/12/2018] [Accepted: 09/15/2018] [Indexed: 10/28/2022]
Abstract
Low levels of high frequency heart rate variability (HF-HRV) have been shown to be associated with suicidal ideation and behavior in students and depressed patients. The goal of the present study was to examine associations between suicide ideation and resting HF-HRV as well as HF-HRV reactivity in a diagnostically heterogeneous sample of adult outpatients with or without concurrent suicide ideation. Participants were N = 85 outpatients (67.1% female; age: M = 38.8, SD = 13.72). HF-HRV reactivity was assessed using a sad film induction method. Associations between resting HF-HRV, HF-HRV reactivity and suicide ideation were analyzed using linear regression modeling - controlling for depression, anxiety and stress. HF-HRV reactivity towards the sad film, but not low resting HF-HRV baseline, was predictive of higher scores on suicidal ideation within the whole sample. In women, lower resting as well as perturbed HF-HRV reactivity was associated with higher scores on suicidal ideation. Results suggest that suicide ideators have a reduced capacity to regulate their response to stress.
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Affiliation(s)
- Dirk Adolph
- Mental Health Research and Treatment Center, Ruhr-Universität, Bochum, Germany.
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-Universität, Bochum, Germany
| | - Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Germany
| | - Andre Wannemüller
- Mental Health Research and Treatment Center, Ruhr-Universität, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr-Universität, Bochum, Germany
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21
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Hartmann R, Schmidt FM, Sander C, Hegerl U. Heart Rate Variability as Indicator of Clinical State in Depression. Front Psychiatry 2018; 9:735. [PMID: 30705641 PMCID: PMC6344433 DOI: 10.3389/fpsyt.2018.00735] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 12/13/2018] [Indexed: 12/24/2022] Open
Abstract
Background: Depression is a severe disease with great burdens for the affected individuals and public health care systems. Autonomic nervous system (ANS) dysfunction indexed by measures of heart rate variability (HRV) has repeatedly been associated with depression. However, HRV parameters are subject to a wide range of multi-factorial influences and underlying mechanisms in depression are still unclear. HRV parameters have been proposed to be promising candidates for diagnostic or predictive bio-markers for depression but necessary longitudinal design studies investigating the relationship between HRV and depression are scarce. Methods: The sample in this study consisted of 62 depressive individuals without antidepressant medication prior to assessment and 65 healthy controls. Fifteen minute blocks of resting ECGs were recorded 1-2 days before onset of antidepressant treatment and 2 weeks thereafter. The ECGs were pre-processed to extract inter-beat-intervals. Linear and non-linear methods were used to extract HRV parameters. ANOVAS were performed to investigate group differences between depressive patients and healthy controls. Associations between the change in severity of depression and HRV parameters were assessed in a repeated measurements design. Results: Analyses revealed HRV parameter differences between the groups of depressive patients and healthy controls at baseline. Further results show differences in HRV parameters within subjects after 2 weeks of antidepressant treatment. Change in HRV parameter values correlated with changes in symptom severity of depression. Discussion: The current results provide further insight into the relationship between HRV parameters and depression. This may help to underpin utilization of HRV parameters are bio-maker for disease state in depression. Results are discussed within a theoretical framework to link arousal and ANS regulation in depression.
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Affiliation(s)
- Ralf Hartmann
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Frank M Schmidt
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
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22
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Chang CC, Tzeng NS, Kao YC, Yeh CB, Chang HA. The relationships of current suicidal ideation with inflammatory markers and heart rate variability in unmedicated patients with major depressive disorder. Psychiatry Res 2017; 258:449-456. [PMID: 28886903 DOI: 10.1016/j.psychres.2017.08.076] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 07/11/2017] [Accepted: 08/27/2017] [Indexed: 10/19/2022]
Abstract
Studies investigating inflammatory status and autonomic functioning simultaneously in depressed patients with current suicidal ideation (SI) are lacking. We recruited 58 unmedicated depressed patients with current SI but without lifetime history of suicidal behavior, as well as 61 equally depressed patients without lifetime history of SI or suicidal behavior. We measured serum cortisol, high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and autonomic functioning evaluated by frequency-domain measures of heart rate variability (HRV). The intensity of current SI was rated with the Columbia Suicide Severity Rating Scale. Chronic psychological stress was assessed using the Chinese version of the Perceived Stress Scale (PSS). Patients with current SI showed higher hs-CRP and ESR but lower variance (total HRV), low frequency (LF), and high frequency (HF) HRV than those without lifetime history of SI. We found no differences in cortisol levels and PSS scores. The intensity of current SI was negatively correlated with variance, LF, and HF but positively correlated with hs-CRP. Our results help improve the understanding of the relationships among current SI, inflammation, and autonomic functioning in depressed patients. The combined use of inflammatory markers and HRV indices may one day be applied in predicting and monitoring patients' suicide risk.
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Affiliation(s)
- Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan
| | - Chin-Bin Yeh
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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23
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Werner GG, Ford BQ, Mauss IB, Schabus M, Blechert J, Wilhelm FH. Cardiac Vagal Control and Depressive Symptoms: The Moderating Role of Sleep Quality. Behav Sleep Med 2017; 15:451-465. [PMID: 27149648 PMCID: PMC5679343 DOI: 10.1080/15402002.2016.1150280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Lower cardiac vagal control (CVC) has been linked to greater depression. However, this link has not been consistently demonstrated, suggesting the presence of key moderators. Sleep plausibly is one such factor. Therefore, we investigated whether sleep quality moderates the link between CVC (quantified by high-frequency heart rate variability, HF-HRV) and depressive symptoms (assessed using established questionnaires) in 29 healthy women. Results revealed a significant interaction between HF-HRV and sleep quality in predicting depressive symptoms: participants with lower HF-HRV reported elevated depressive symptoms only when sleep quality was also low. In contrast, HF-HRV was not associated with depressive symptoms when sleep quality was high, suggesting a protective function of high sleep quality in the context of lower CVC.
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Affiliation(s)
- Gabriela G. Werner
- Department of Psychology, University of Salzburg, Salzburg, Austria,Correspondence should be addressed to Gabriela G. Werner, Department of Psychology, LMU Munich, Leopoldstr.13, 80802Munich, Germany. E-mail:
| | - Brett Q. Ford
- Department of Psychology, University of California, Berkeley, California
| | - Iris B. Mauss
- Department of Psychology, University of California, Berkeley, California
| | - Manuel Schabus
- Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Jens Blechert
- Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Frank H. Wilhelm
- Department of Psychology, University of Salzburg, Salzburg, Austria
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24
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Sanders AFP, Hobbs DA, Stephenson DD, Laird RD, Beaton EA. Working Memory Impairments in Chromosome 22q11.2 Deletion Syndrome: The Roles of Anxiety and Stress Physiology. J Autism Dev Disord 2017; 47:992-1005. [PMID: 28083777 DOI: 10.1007/s10803-016-3011-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Stress and anxiety have a negative impact on working memory systems by competing for executive resources and attention. Broad memory deficits, anxiety, and elevated stress have been reported in individuals with chromosome 22q11.2 deletion syndrome (22q11.2DS). We investigated anxiety and physiological stress reactivity in relation to visuospatial working memory impairments in 20 children with 22q11.2DS and 32 typically developing (TD) children ages 7 to 16. Children with 22q11.2DS demonstrated poorer working memory, reduced post-stress respiratory sinus arrhythmia recovery, and overall increased levels of cortisol in comparison to TD children. Anxiety, but not physiological stress responsivity, mediated the relationship between 22q11.2DS diagnosis and visuospatial working memory impairment. Findings indicate that anxiety exacerbates impaired working memory in children with 22q11.2DS.
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Affiliation(s)
- Ashley F P Sanders
- Department of Psychology, University of New Orleans, 2000 Lakeshore Drive, New Orleans, LA, 70148, USA
| | - Diana A Hobbs
- Department of Psychology, University of New Orleans, 2000 Lakeshore Drive, New Orleans, LA, 70148, USA
| | - David D Stephenson
- Department of Psychology, University of New Orleans, 2000 Lakeshore Drive, New Orleans, LA, 70148, USA
| | - Robert D Laird
- Department of Psychology, University of New Orleans, 2000 Lakeshore Drive, New Orleans, LA, 70148, USA
| | - Elliott A Beaton
- Department of Psychology, University of New Orleans, 2000 Lakeshore Drive, New Orleans, LA, 70148, USA.
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25
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James KM, Woody ML, Feurer C, Kudinova AY, Gibb BE. Disrupted physiological reactivity among children with a history of suicidal ideation: Moderation by parental expressed emotion-criticism. Biol Psychol 2017; 130:22-29. [PMID: 29030216 DOI: 10.1016/j.biopsycho.2017.10.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 10/09/2017] [Accepted: 10/09/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The goal of this study was to examine physiological reactivity during parent-child interactions in children with and without a history of suicidal ideation (SI), a group known to be at increased risk for suicidal thoughts and behaviors in the future. We also examined the potential moderating role of parental expressed emotion-criticism (EE-Crit) to determine whether the presence of parental criticism may help to identify a subgroup of children with a history of SI most at risk for physiological dysregulation. METHOD Participants were 396 children (age 7-11; 54% male, 71.7% Caucasian) and their biological parent. Children's levels of high frequency heart rate variability (HF-HRV) were assessed during a resting baseline period followed by a positive and negative discussion with their parent. Additionally, parents completed the Five-Minute Speech Sample to determine levels of EE-Crit toward their child, and children completed an interview assessing their history of SI. RESULTS Consistent with our hypothesis, we found that exposure to parental criticism moderated the relation between a child's history of SI and their HF-HRV reactivity to the discussions. Specifically, while most children exhibited the typical pattern of HF-HRV suppression from baseline to both interactions, the highest risk children (i.e., children with a history of SI who also had highly critical parents) did not display any change in HF-HRV across the tasks, suggesting a failure to engage a typical psychophysiological response during emotional contexts. CONCLUSIONS These results suggest a specific physiological mechanism that may place these children at risk for suicidal thoughts and behaviors in the future.
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Affiliation(s)
- Kiera M James
- Center for Affective Science, Binghamton University (SUNY), USA.
| | - Mary L Woody
- Center for Affective Science, Binghamton University (SUNY), USA
| | - Cope Feurer
- Center for Affective Science, Binghamton University (SUNY), USA
| | | | - Brandon E Gibb
- Center for Affective Science, Binghamton University (SUNY), USA
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26
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Tsypes A, James KM, Woody ML, Feurer C, Kudinova AY, Gibb BE. Resting respiratory sinus arrhythmia in suicide attempters. Psychophysiology 2017; 55. [PMID: 28792621 DOI: 10.1111/psyp.12978] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/24/2017] [Accepted: 07/20/2017] [Indexed: 11/26/2022]
Abstract
Although suicide attempts (SA) occur across a broad range of diagnoses as well as in the absence of a diagnosable disorder, most studies to date have focused on them within a single, specific disorder. Consistent with the NIMH RDoC initiative to identify biobehavioral vulnerabilities that cut across diagnoses, the goal of the present study was to examine potential differences in resting respiratory sinus arrhythmia (RSA) levels in a large, diagnostically heterogeneous sample of women with and without a history of SA who were matched on a broad range of demographic and clinical variables. Participants were 112 women with (n = 56) and without (n = 56) a history of SA recruited from the community. The two groups were equated on approximate age, race, household income, and lifetime histories of psychiatric diagnoses. Resting electrocardiogram was recorded during a 2-min rest period. RSA was calculated via spectral power analyses with a fast Fourier transform. We found that women with a history of SA exhibited significantly lower resting RSA levels than women with no history of SA, and this difference was maintained even after statistically controlling for the potential influence of women's history of psychiatric diagnoses and their current symptoms of depression and anxiety. These findings suggest the presence of a link between resting RSA and SA history.
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Affiliation(s)
- Aliona Tsypes
- Center for Affective Science, Binghamton University (SUNY), Binghamton, New York, USA
| | - Kiera M James
- Center for Affective Science, Binghamton University (SUNY), Binghamton, New York, USA
| | - Mary L Woody
- Center for Affective Science, Binghamton University (SUNY), Binghamton, New York, USA
| | - Cope Feurer
- Center for Affective Science, Binghamton University (SUNY), Binghamton, New York, USA
| | - Anastacia Y Kudinova
- Center for Affective Science, Binghamton University (SUNY), Binghamton, New York, USA
| | - Brandon E Gibb
- Center for Affective Science, Binghamton University (SUNY), Binghamton, New York, USA
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27
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Kobayashi M, Shinba T, Matsui T, Kirimoto T. Simple and objective screening of major depressive disorder by heart rate variability analysis during paced respiration and mental task conditions. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:1316-1319. [PMID: 29060118 DOI: 10.1109/embc.2017.8037074] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Since objective biomarkers for major depressive disorder (MDD) are not readily available, clinical psychiatrists diagnose patients with MDD subjectively based on clinical interviews and diagnostic criteria. It often raises various concerns, including false responses by patients, subjective factors, and inexperience of the attendants leading to incorrect diagnosis. Here, we developed a self-monitoring system for simple and objective screening of MDD using a photoplethysmography (PPG) sensor and a 24-GHz microwave radar, which was based on the analysis of heart rate variability (HRV) during paced respiration and mental task conditions. In our previous study, we assessed the reactivity of HRV measurements during a mental task (random number generation) condition in patients with MDD and healthy control subjects. The HRV indices are less reactive in patients with MDD compared to healthy subjects during the mental task, which enabled us to identify the patients at risk for depression. In this study, the reactivity of HRV was measured not only in the mental task but also during paced respiration (i.e., 5-s inhalation and 5-s exhalation) conditions, thereby assessing more detailed autonomic nervous system (ANS) activity via HRV indices. To investigate the effect of paced respiration on MDD screening, we compared the ANS activity via HRV indices in with/without paced respiration conditions in 28 drug-naïve patients with MDD and 27 healthy control subjects. The result showed that ANS significantly activated during the paced respiration condition (p<;0.05). The sensitivity in detecting patients with MDD was 86% under paced respiration and mental task conditions, which was higher than the sensitivity (68%) under mental task condition alone.
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28
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Quantifying respiratory sinus arrhythmia: Effects of misspecifying breathing frequencies across development. Dev Psychopathol 2017; 30:351-366. [DOI: 10.1017/s0954579417000669] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
AbstractLow resting respiratory sinus arrhythmia (RSA), and to a lesser extent excessive RSA reactivity to emotion evocation, are observed in many psychiatric disorders characterized by emotion dysregulation, including syndromes spanning the internalizing and externalizing spectra, and other conditions such as nonsuicidal self-injury. Nevertheless, some inconsistencies exist. For example, null outcomes in studies of RSA–emotion dysregulation relations are sometimes observed among younger participants. Such findings may derive from use of age inappropriate frequency bands in calculating RSA. We combine data from five published samples (N = 559) spanning ages 4 to 17 years, and reanalyze RSA data using age-appropriate respiratory frequencies. Misspecifying respiratory frequencies results in overestimates of resting RSA and underestimates of RSA reactivity, particularly among young children. Underestimates of developmental shifts in RSA and RSA reactivity from preschool to adolescence were also observed. Although correlational analyses revealed weak negative associations between resting RSA and aggression, those with clinical levels of externalizing exhibited lower resting RSA than their peers. No associations between RSA reactivity and externalizing were observed. Results confirm that age-corrected frequency bands should be used when estimating RSA, and that literature-wide overestimates of resting RSA, underestimates of RSA reactivity, and underestimates of developmental shifts in RSA and RSA reactivity may exist.
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Ellis AJ, Shumake J, Beevers CG. The effects of respiratory sinus arrhythmia on anger reactivity and persistence in major depression. Psychophysiology 2016; 53:1587-99. [PMID: 27401801 DOI: 10.1111/psyp.12722] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 06/14/2016] [Indexed: 11/28/2022]
Abstract
The experience of anger during a depressive episode has recently been identified as a poor prognostic indicator of illness course. Given the clinical implications of anger in major depressive disorder (MDD), understanding the mechanisms involved in anger reactivity and persistence is critical for improved intervention. Biological processes involved in emotion regulation during stress, such as respiratory sinus arrhythmia (RSA), may play a role in maintaining negative moods. Clinically depressed (MDD; n = 49) and nondepressed (non-MDD; n = 50) individuals were challenged with a stressful computer task shown to increase anger, while RSA (high frequency range 0.15-0.4 Hz) was collected. RSA predicted future anger, but was unrelated to current anger. That is, across participants, low baseline RSA predicted anger reactivity during the task, and in depressed individuals, those with low RSA during the task had a greater likelihood of anger persistence during a recovery period. These results suggest that low RSA may be a psychophysiological process involved in anger regulation in depression. Low RSA may contribute to sustained illness course by diminishing the repair of angry moods.
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Affiliation(s)
- Alissa J Ellis
- Semel Institute of Neuroscience and Human Behavior, Department of Psychiatry, University of California-Los Angeles, Los Angeles, California, USA.
| | - Jason Shumake
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Christopher G Beevers
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
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30
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Wielgus MD, Aldrich JT, Mezulis AH, Crowell SE. Respiratory sinus arrhythmia as a predictor of self-injurious thoughts and behaviors among adolescents. Int J Psychophysiol 2016; 106:127-34. [PMID: 27212441 DOI: 10.1016/j.ijpsycho.2016.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 05/16/2016] [Accepted: 05/17/2016] [Indexed: 01/31/2023]
Abstract
Research suggests that self-injurious thoughts and behaviors (SITBs) may function as maladaptive emotion regulation strategies. One psychophysiological index of emotion regulatory capacity is respiratory sinus arrhythmia (RSA). The temporal course of RSA responsivity to a stressor may be characterized by basal RSA, RSA reactivity to stressor, and RSA recovery post-stressor. RSA has been linked to both internalizing and externalizing symptoms in adolescents, but little is known about the relation between RSA and SITBs. Initial research has shown a cross-sectional relation between lower basal RSA and greater RSA reactivity to a sad mood induction and self-injury. To date no prospective research on the relation between RSA and SITBs exists. The current study aims to investigate the prospective relation between RSA and SITBs in a community sample of 108 adolescents (Mage=12.82, SDage=0.82, 53.70% female). At the initial laboratory visit (T1), participants completed an unsolvable anagram stressor task, during which RSA (basal, reactivity, and recovery) was measured. SITBs were assessed at T1 and at the 6-month follow-up (T2). Results indicated basal RSA and RSA reactivity did not significantly predict engagement in SITBs between T1 and T2. Poorer RSA recovery from the stressor task at T1 did significantly predict engagement in SITBs between T1 and T2, over and above depressive symptoms and lifetime history of SITBs. This suggests that adolescents with poor ability to regulate physiologically following a stressor may turn to maladaptive emotion regulation strategies like SITBs.
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Affiliation(s)
- Madeline D Wielgus
- Department of Clinical Psychology, Seattle Pacific University, United States.
| | - Jaclyn T Aldrich
- Department of Clinical Psychology, Seattle Pacific University, United States
| | - Amy H Mezulis
- Department of Clinical Psychology, Seattle Pacific University, United States
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Lin Y, Lin C, Sun IW, Hsu CC, Fang CK, Lo MT, Huang HC, Liu SI. Resting respiratory sinus arrhythmia is related to longer hospitalization in mood-disordered repetitive suicide attempters. World J Biol Psychiatry 2016; 16:323-33. [PMID: 25839729 DOI: 10.3109/15622975.2015.1017603] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Our aims were (1) to measure respiratory sinus arrhythmia (RSA), a high-frequency spectrum component of heart rate variability (HRV) in mood-disordered suicide attempters and (2) to investigate the relationship of RSA to symptoms and length of hospitalization. METHODS Forty-nine female repetitive-suicide attempters with depressive disorder or bipolar disorder were recruited in a general hospital setting. Manic or psychotic patients were excluded. Resting RSA values were calculated from electrocardiogram data, and severity of clinical presentation shortly after admission and length of hospital stay were assessed. RESULTS RSA was positively associated with a higher Beck Scale for Suicidal Ideation score (r = 0.33 P = 0.019). Stepwise multiple regression analysis showed a significant correlation between RSA and hospitalization length after adjusting other variables (beta coefficient = 3.00; P = 0.030). Patients with a higher resting RSA had more prolonged hospitalizations (hospitalization beyond 30 days) after controlling for other variables (odds ratio = 5.08, P = 0.017). CONCLUSIONS Interaction between the environment and the autonomic nervous system is complex. Further and more comprehensive research is needed.
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Affiliation(s)
- Ying Lin
- Department of Psychiatry, Mackay Memorial Hospital , Taipei , Taiwan
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32
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Dennis PA, Weinberg JB, Calhoun PS, Watkins LL, Sherwood A, Dennis MF, Beckham JC. An investigation of vago-regulatory and health-behavior accounts for increased inflammation in posttraumatic stress disorder. J Psychosom Res 2016; 83:33-9. [PMID: 27020074 PMCID: PMC4813329 DOI: 10.1016/j.jpsychores.2016.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 02/18/2016] [Accepted: 02/24/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) has been linked to chronic inflammation, a condition that poses a risk for cardiovascular disease. Attenuated vagal activity has been proposed as a potential mediator of PTSD and inflammation, although associated behavioral health risks-namely cigarette smoking and alcohol dependence-might also account for that link. METHODS Inflammation was quantified by fasting serum concentrations of C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-10, and thymus- and activation-regulated chemokine (TARC)/CCL17 collected from 85 participants with PTSD and 82 without PTSD. Latent variable modeling was used to assess the relationship between PTSD symptom severity and inflammation along with potential mediators vagal activity (respiratory sinus arrhythmia; RSA), smoking status, and lifetime alcohol dependence. RESULTS PTSD symptom severity was associated with increased inflammation (β=.18, p=.02). However, this association was reduced in models that adjusted for RSA, smoking status, and lifetime alcohol dependence. Independent mediation effects were deemed significant via bootstrapping analyses. Together, RSA, smoking status, and lifetime alcohol dependence accounted for 95% of the effect of PTSD symptom severity on inflammation. CONCLUSION Although RSA accounted for a modest proportion of the association between posttraumatic stress and pro-inflammatory responses, behavioral factors-specifically cigarette smoking and alcohol dependence-proved to be larger mediators. The benefits of PTSD treatment may be enhanced by additional interventions aimed at modifying these health behaviors.
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Affiliation(s)
- Paul A. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - J. B. Weinberg
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Medicine, Duke University Medical Center, Durham, NC 27705, USA
| | - Patrick S. Calhoun
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA,Veterans Affairs Center for Health Services Research in Primary Care, Durham, NC, 27705, USA
| | - Lana L. Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Michelle F. Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Jean C. Beckham
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
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Rouleau CR, Tomfohr-Madsen LM, Campbell TS, Letourneau N, O'Beirne M, Giesbrecht GF. The role of maternal cardiac vagal control in the association between depressive symptoms and gestational hypertension. Biol Psychol 2016; 117:32-42. [PMID: 26868182 DOI: 10.1016/j.biopsycho.2016.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 01/20/2023]
Abstract
Reduced cardiac vagal control, indexed by relatively lower high-frequency heart rate variability (HF-HRV), is implicated in depressed mood and hypertensive disorders among non-pregnant adults whereas research in pregnancy is limited. This study examined whether maternal HF-HRV during pregnancy mediates the association between depressed mood and gestational hypertension. Depressive symptoms (Edinburgh Depression Scale) and HF-HRV were measured during early (M=14.9 weeks) and late (M=32.4 weeks) pregnancy in 287 women. Gestational hypertension was determined by chart review. Depressive symptoms were associated with less HF-HRV (b=-0.02, p=.001). There was an indirect effect of depressed mood on gestational hypertension through late pregnancy HF-HRV (b=0.04, 95% CI 0.0038, 0.1028) after accounting for heart rate. These findings suggest cardiac vagal control is a possible pathway through which prenatal depressed mood is associated with gestational hypertension, though causal ordering remains uncertain.
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Affiliation(s)
- Codie R Rouleau
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Lianne M Tomfohr-Madsen
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Tavis S Campbell
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Nicole Letourneau
- Alberta Children's Hospital Research Institute for Child and Maternal Health, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; Department of Paediatrics, University of Calgary, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada
| | - Maeve O'Beirne
- Department of Family Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Gerald F Giesbrecht
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada; Alberta Children's Hospital Research Institute for Child and Maternal Health, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; Department of Paediatrics, University of Calgary, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada.
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Panaite V, Hindash AC, Bylsma LM, Small BJ, Salomon K, Rottenberg J. Respiratory sinus arrhythmia reactivity to a sad film predicts depression symptom improvement and symptomatic trajectory. Int J Psychophysiol 2015; 99:108-13. [PMID: 26681648 DOI: 10.1016/j.ijpsycho.2015.12.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 11/07/2015] [Accepted: 12/06/2015] [Indexed: 10/22/2022]
Abstract
Respiratory sinus arrhythmia (RSA) reactivity, an index of cardiac vagal tone, has been linked to self-regulation and the severity and course of depression (Rottenberg, 2007). Although initial data supports the proposition that RSA withdrawal during a sad film is a specific predictor of depression course (Fraguas, 2007; Rottenberg, 2005), the robustness and specificity of this finding are unclear. To provide a stronger test, RSA reactivity to three emotion films (happy, sad, fear) and to a more robust stressor, a speech task, were examined in currently depressed individuals (n=37), who were assessed for their degree of symptomatic improvement over 30weeks. Robust RSA reactivity to the sad film uniquely predicted overall symptom improvement over 30weeks. RSA reactivity to both sad and stressful stimuli predicted the speed and maintenance of symptomatic improvement. The current analyses provide the most robust support to date that RSA withdrawal to sad stimuli (but not stressful) has specificity in predicting the overall symptomatic improvement. In contrast, RSA reactivity to negative stimuli (both sad and stressful) predicted the trajectory of depression course. Patients' engagement with sad stimuli may be an important sign to attend to in therapeutic settings.
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Affiliation(s)
- Vanessa Panaite
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | | | - Lauren M Bylsma
- Psychiatry Department, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Kristen Salomon
- Department of Psychology, University of South Florida, Tampa, FL, USA
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Mezulis AH, Crystal SI, Ahles JJ, Crowell SE. Examining biological vulnerability in environmental context: Parenting moderates effects of low resting respiratory sinus arrhythmia on adolescent depressive symptoms. Dev Psychobiol 2015; 57:974-83. [PMID: 26290213 DOI: 10.1002/dev.21347] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 08/07/2015] [Indexed: 11/10/2022]
Abstract
Polyvagal theory suggests that parasympathetic regulation of cardiac function, indexed by resting respiratory sinus arrhythmia (RSA), may be a marker of emotion regulatory capacity and associated with youth psychopathology. Contemporary models of psychopathology suggest that the effects of biological vulnerability may be moderated by developmental context. The aim of the present study was to examine whether parenting, particularly parental responses to youth's negative emotions, moderated the effects of resting RSA on depressive symptoms among early adolescents. We examined resting RSA, depressive symptoms, and parental responses to youth negative emotions among 120 adolescents aged 11-14 years (M = 12.86, SD = .85; 52.5% female). Resting RSA and lack of supportive parenting interacted to predict youth depressive symptoms, such that low resting RSA predicted more depressive symptoms only in the context of low levels of supportive parental responses to youth's negative emotions. By contrast, high resting RSA buffered the effects of low supportive parenting on youth depressive symptoms. These findings highlight the importance of understanding joint contributions of biological vulnerability and developmental context on youth depression outcomes.
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Affiliation(s)
- Amy H Mezulis
- Department of Clinical Psychology, Seattle Pacific University, Seattle, WA.
| | - Sarah I Crystal
- Department of Clinical Psychology, Seattle Pacific University, Seattle, WA
| | - Joshua J Ahles
- Department of Clinical Psychology, Seattle Pacific University, Seattle, WA
| | - Sheila E Crowell
- Department of Psychology, University of Utah, Salt Lake City, UT
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Gruber J, Mennin DS, Fields A, Purcell A, Murray G. Heart rate variability as a potential indicator of positive valence system disturbance: A proof of concept investigation. Int J Psychophysiol 2015; 98:240-248. [PMID: 26281850 DOI: 10.1016/j.ijpsycho.2015.08.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 08/10/2015] [Accepted: 08/10/2015] [Indexed: 12/16/2022]
Abstract
One promising avenue toward a better understanding of the pathophysiology of positive emotional disturbances is to examine high-frequency heart rate variability (HRV-HF), which has been implicated as a potential physiological index of disturbances in positive emotional functioning. To date, only a few psychopathology relevant studies have systematically quantified HRV-HF profiles using more ecologically valid methods in everyday life. Using an experience-sampling approach, the present study examined both mean levels and intra-individual variability of HRV-HF - as well as comparison measures of cardiovascular arousal, sympathetic activity, and gross somatic movement - in everyday life, using ambulatory psychophysiological measurement across a six-day consecutive period among a spectrum of community adult participants with varying degrees of positive valence system disturbance, including adults with bipolar I disorder (BD; n=21), major depressive disorder (MDD; n=17), and healthy non-psychiatric controls (CTL; n=28). Groups did not differ in mean HRV-HF, but greater HRV-HF instability (i.e., intra-individual variation in HRV-HF) was found in the BD compared to both MDD and CTL groups. Subsequent analyses suggested that group differences in HRV-HF variability were largely accounted for by variations in clinician-rated manic symptoms. However, no association was found between HRV-HF variability and dimensional measures of positive affectivity. This work provides evidence consistent with a quadratic relationship between HRV-HF and positive emotional disturbance and represents a valuable step toward developing a more ecologically valid model of positive valence system disturbances and their underlying psychophysiological mechanisms within an RDoC framework.
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Affiliation(s)
- June Gruber
- University of Colorado Boulder, Boulder, CO, USA.
| | | | - Adam Fields
- Mount Sinai School of Medicine, New York, NY, USA
| | | | - Greg Murray
- Swinburne University of Technology, Melbourne, Australia
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Beauchaine TP, Thayer JF. Heart rate variability as a transdiagnostic biomarker of psychopathology. Int J Psychophysiol 2015; 98:338-350. [PMID: 26272488 DOI: 10.1016/j.ijpsycho.2015.08.004] [Citation(s) in RCA: 495] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 08/01/2015] [Accepted: 08/03/2015] [Indexed: 02/06/2023]
Abstract
The Research Domain Criteria (RDoC), developed by the National Institute of Mental Health as a neuroscience-informed alternative to traditional psychiatric nosology, is an explicitly dimensional system in which classification of psychopathology is derived inductively (i.e., from basic science), across multiple levels of analysis (e.g., genetic, neural, psychophysiological, and behavioral). Although RDoC is often presented as paradigmatically revolutionary, a review of the history of psychophysiology suggests that roots of RDoC thinking extend at least as far back as the mid-20th Century. In this paper, we briefly and selectively review the historical emergence of neurobiologically-informed dimensional trait models of psychopathology, and we summarize our thinking regarding high frequency heart rate variability (HF-HRV) as a transdiagnostic biomarker of self-regulation and cognitive control. When functional interactions between HF-HRV and systems of behavioral approach and avoidance are considered, diverse patterns of behavioral maladjustment can be subsumed into a single model. This model accommodates the general bifactor structure of psychopathology, and suggests that HF-HRV can be viewed as an autonomic, transdiagnostic biomarker of mental illness.
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Yaptangco M, Crowell SE, Baucom BR, Bride DL, Hansen EJ. Examining the relation between respiratory sinus arrhythmia and depressive symptoms in emerging adults: A longitudinal study. Biol Psychol 2015; 110:34-41. [PMID: 26118360 DOI: 10.1016/j.biopsycho.2015.06.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 06/08/2015] [Accepted: 06/12/2015] [Indexed: 02/05/2023]
Abstract
Major depressive disorder (MDD) is a debilitating and prevalent disorder associated with lower quality of life and substantial economic burden. Recently, there has been strong interest in respiratory sinus arrhythmia (RSA) as a biological predictor of later depression. Theoretical work suggests that higher resting RSA indexes physiological flexibility and better emotion regulation whereas lower RSA may mark vulnerability for psychopathology. However, empirical findings have varied. This study examined whether lower resting RSA predicted later depressive symptoms in a sample of healthy young adults across one year (n=185). Results indicate that year one (Y1) resting RSA predicted Y2 depressive symptoms. This finding remained significant when accounting for the stability of RSA and depressive symptoms across both time points and when including trait anxiety, body mass index, and medication use in statistical models. Findings provide further support for RSA as a promising biological marker for understanding and predicting depressive symptoms.
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Affiliation(s)
- Mona Yaptangco
- University of Utah, Department of Psychology, 380 South 1530 East, Room 502 Salt Lake City, UT 84112, USA
| | - Sheila E Crowell
- University of Utah, Department of Psychology, 380 South 1530 East, Room 502 Salt Lake City, UT 84112, USA; University of Utah, Department of Psychiatry, 501 Chipeta Way Salt Lake City, UT 84108, USA.
| | - Brian R Baucom
- University of Utah, Department of Psychology, 380 South 1530 East, Room 502 Salt Lake City, UT 84112, USA
| | - Daniel L Bride
- University of Utah, Department of Psychology, 380 South 1530 East, Room 502 Salt Lake City, UT 84112, USA
| | - Erik J Hansen
- University of Utah, Department of Psychology, 380 South 1530 East, Room 502 Salt Lake City, UT 84112, USA
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Beauchaine TP. Future Directions in Emotion Dysregulation and Youth Psychopathology. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2015; 44:875-96. [DOI: 10.1080/15374416.2015.1038827] [Citation(s) in RCA: 169] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Keen L, Turner AD, Mwendwa D, Callender C, Campbell A. Depressive symptomatology and respiratory sinus arrhythmia in a non-clinical sample of middle-aged African Americans. Biol Psychol 2015; 108:56-61. [PMID: 25796340 DOI: 10.1016/j.biopsycho.2015.03.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 03/07/2015] [Accepted: 03/09/2015] [Indexed: 12/25/2022]
Abstract
Decreased heart rate variability and depression are both independent risk factors for cardiac mortality in clinical and non-clinical samples. The purpose of the current study is to examine the hypothesis that severity of depressive symptomatology is inversely associated with respiratory sinus arrhythmia (RSA) in a non-clinical sample of African Americans. The sample included 77 African Americans with a mean age of 48.4 (SD = 11.7). Participants completed the Beck Depression Inventory-II (BDI-II) and a 5-min resting baseline measurement of RSA was collected. The BDI-II total score was positively associated with RSA (β = .334, p = .008). Given the unexpected direction of the association, we separated the BDI-II into cognitive and somatic affective subscales to identify which construct was driving the relationship. The somatic affective, was related to RSA (β = .328, p = .010), but not the cognitive subscale. Given this unexpected positive result, future research should further examine the nature of the relationship between depressive symptomatology and RSA in African Americans, as the relationship may vary based on levels of depressive symptomatology.
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Affiliation(s)
- Larry Keen
- Virginia State University, Department of Psychology, Petersburg, VA, United States.
| | - Arlener D Turner
- Center of Excellence on Disparities in HIV and Aging, Rush Alzheimer's Disease Center, Chicago, IL, United States.
| | - Denee Mwendwa
- Howard University, Department of Psychology, Washington, DC, United States.
| | - Clive Callender
- Howard University, School of Medicine, Washington, DC, United States; National Minority Organ and Tissue Transplant Program, Washington, DC, United States.
| | - Alfonso Campbell
- Howard University, Department of Psychology, Washington, DC, United States.
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Mechanisms Underlying Motivational Deficits in Psychopathology: Similarities and Differences in Depression and Schizophrenia. Curr Top Behav Neurosci 2015; 27:411-49. [PMID: 26026289 DOI: 10.1007/7854_2015_376] [Citation(s) in RCA: 140] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Motivational and hedonic impairments are core aspects of a variety of types of psychopathology. These impairments cut across diagnostic categories and may be critical to understanding major aspects of the functional impairments accompanying psychopathology. Given the centrality of motivational and hedonic systems to psychopathology, the Research Domain Criteria (RDoC) initiative includes a "positive valence" systems domain that outlines a number of constructs that may be key to understanding the nature and mechanisms of motivational and hedonic impairments in psychopathology. These component constructs include initial responsiveness to reward, reward anticipation or expectancy, incentive or reinforcement learning, effort valuation, and action selection. Here, we review behavioral and neuroimaging studies providing evidence for impairments in these constructs in individuals with psychosis versus in individuals with depressive pathology. There are important differences in the nature of reward-related and hedonic deficits associated with psychosis versus depression that have major implications for our understanding of etiology and treatment development. In particular, the literature strongly suggests the presence of impairments in in-the-moment hedonics or "liking" in individuals with depressive pathology, particularly among those who experience anhedonia. Such deficits may propagate forward and contribute to impairments in other constructs that are dependent on hedonic responses, such as anticipation, learning, effort, and action selection. Such hedonic impairments could reflect alterations in dopamine and/or opioid signaling in the striatum related to depression or specifically to anhedonia in depressed populations. In contrast, the literature points to relatively intact in-the-moment hedonic processing in psychosis, but provides much evidence for impairments in other components involved in translating reward to action selection. Particularly, individuals with schizophrenia exhibit altered reward prediction and associated striatal and prefrontal activation, impaired reward learning, and impaired reward-modulated action selection.
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Levy B. Illness severity, trait anxiety, cognitive impairment and heart rate variability in bipolar disorder. Psychiatry Res 2014; 220:890-5. [PMID: 25219620 DOI: 10.1016/j.psychres.2014.07.059] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 06/28/2014] [Accepted: 07/24/2014] [Indexed: 11/29/2022]
Abstract
Numerous studies have documented a significant association between symptom severity and cognitive functioning in bipolar disorder (BD). These findings advanced speculations about a potential link between the physiological stress associated with illness severity and cognitive dysfunction. To explore this hypothesis, the current study employed heart rate variability (HRV) as a physiological measure that is sensitive to the effects of chronic stress, and a scale of trait anxiety for assessing a psychological condition that is correlated with hyper sympathetic arousal. Analyses indicated that BD patients with High Illness Severity reported more symptoms of trait-anxiety (i.e., State Trait Anxiety Inventory), performed more poorly on a computerized neuropsychological battery (i.e., CNS Vital Signs), and exhibited a more constricted HRV profile (i.e., lower SDNN with elevated LF/HF ratio) than patients with Low Illness Severity. Illness severity was determined by a history of psychosis, illness duration, and number of mood episodes. A third group of healthy controls (n=22) performed better on the neuropsychological battery and exhibited a healthier HRV profile than the BD groups. This study provides preliminary evidence that illness severity and cognitive impairment in BD may be associated with state anxiety and neuro-cardiac alterations that are sensitive to physiological stress.
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Affiliation(s)
- Boaz Levy
- Department of Counseling and School Psychology, University of Massachusetts Boston, Wheatley Building, Second Floor, Room 143-9, 100 Morriseey Boulevard, Boston, MA 02125, USA.
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43
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Ablow JC, Marks AK, Feldman SS, Huffman LC. Associations between first-time expectant women's representations of attachment and their physiological reactivity to infant cry. Child Dev 2013; 84:1373-91. [PMID: 23786152 DOI: 10.1111/cdev.12135] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Associations among 53 primiparous women's Adult Attachment Interview classifications (secure-autonomous vs. insecure-dismissing) and physiological and self-reported responses to infant crying were explored. Heart rate, skin conductance levels, and respiratory sinus arrhythmia (RSA) were recorded continuously. In response to the cry, secure-autonomous women demonstrated RSA declines, consistent with approach-oriented responses. Insecure-dismissing women displayed RSA and electrodermal increases, consistent with behavioral inhibition. Furthermore, insecure-dismissing women rated the cries as more aversive than secure-autonomous women. Nine months postpartum, secure-autonomous women, who prenatally manifested an approach-oriented response to the unfamiliar cry stimulus, were observed as more sensitive when responding to their own distressed infant, whereas women classified prenatally as insecure-dismissing were observed as less sensitive with their own infants.
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Affiliation(s)
- Jennifer C Ablow
- Department of Psychology, University of Oregon, OR 97403-1227, USA.
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Beauchaine TP, Gatzke-Kopp L, Neuhaus E, Chipman J, Reid MJ, Webster-Stratton C. Sympathetic- and parasympathetic-linked cardiac function and prediction of externalizing behavior, emotion regulation, and prosocial behavior among preschoolers treated for ADHD. J Consult Clin Psychol 2013; 81:481-493. [PMID: 23544677 PMCID: PMC3952490 DOI: 10.1037/a0032302] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate measures of cardiac activity and reactivity as prospective biomarkers of treatment response to an empirically supported behavioral intervention for attention-deficit/hyperactivity disorder (ADHD). METHOD Cardiac preejection period (PEP), an index of sympathetic-linked cardiac activity, and respiratory sinus arrhythmia (RSA), an index of parasympathetic-linked cardiac activity, were assessed among 99 preschool children (ages 4-6 years) with ADHD both at rest and in response to behavioral challenge, before participants and their parents completed 1 of 2 versions of the Incredible Years parent and child interventions. RESULTS Main effects of PEP activity and reactivity and of RSA activity and reactivity were found. Although samplewide improvements in behavior were observed at posttreatment, those who exhibited lengthened cardiac PEP at rest and reduced PEP reactivity to incentives scored higher on measures of conduct problems and aggression both before and after treatment. In contrast, children who exhibited lower baseline RSA and greater RSA withdrawal scored lower on prosocial behavior before and after treatment. Finally, children who exhibited greater RSA withdrawal scored lower on emotion regulation before and after treatment. CONCLUSIONS We discuss these findings in terms of (a) individual differences in underlying neurobiological systems subserving appetitive (i.e., approach) motivation, emotion regulation, and social affiliation and (b) the need to develop more intensive interventions targeting neurobiologically vulnerable children.
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Affiliation(s)
| | | | | | - Jane Chipman
- Department of Psychology, University of British Columbia
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45
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Chang HA, Chang CC, Chen CL, Kuo TBJ, Lu RB, Huang SY. Major depression is associated with cardiac autonomic dysregulation. Acta Neuropsychiatr 2012; 24:318-27. [PMID: 25287173 DOI: 10.1111/j.1601-5215.2011.00647.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Chang H-A, Chang C-C, Chen C-L, Kuo TBJ, Lu R-B, Huang S-Y. Major depression is associated with cardiac autonomic dysregulation.Objective: Altered cardiac autonomic function has been proposed in patients with major depression (MD), but the results are mixed. Therefore, analyses with larger sample sizes and better methodology are needed.Methods: To examine whether cardiac autonomic dysfunction is associated with MD, 498 unmedicated patients with MD and 462 healthy volunteers, aged 18–65 years, were recruited for a case-control analysis. We used the Hamilton Depression Rating Scale (HAM-D) and the Beck Depression Inventory (BDI) to assess depression severity. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV) parameters. Frequency-domain indices of HRV were obtained.Results: Patients with MD exhibited reduced cardiac vagal control compared to healthy volunteers, and depression severity was negatively correlated with cardiac vagal control. Stratified analyses by suicide ideation revealed more pronounced cardiac vagal withdrawal among MD patients with suicide ideation.Conclusion: This study shows that MD is associated with cardiac autonomic dysregulation, highlighting the importance of assessing HRV in currently depressed patients, given the higher risk for cardiac complications in these individuals. Taking into account that suicidal depressed patients had more adverse patterns of HRV, one might consider the treatment to restore the autonomic function for the patient population having increased susceptibility to autonomic dysregulation.
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Affiliation(s)
- Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
| | - Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
| | - Chih-Lun Chen
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Ru-Band Lu
- Institute of Behavioral Medicine and Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
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Stapelberg NJ, Hamilton-Craig I, Neumann DL, Shum DHK, McConnell H. Mind and heart: heart rate variability in major depressive disorder and coronary heart disease - a review and recommendations. Aust N Z J Psychiatry 2012; 46:946-57. [PMID: 22528974 DOI: 10.1177/0004867412444624] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE There is a reciprocal association between major depressive disorder (MDD) and coronary heart disease (CHD). These conditions are linked by a causal network of mechanisms. This causal network should be quantitatively studied and it is hypothesised that the investigation of vagal function represents a promising starting point. Heart rate variability (HRV) has been used to investigate cardiac vagal control in the context of MDD and CHD. This review aims to examine the relationship of HRV to both MDD and CHD in the context of vagal function and to make recommendations for clinical practice and research. METHODS The search terms 'heart rate variability', 'depression' and 'heart disease' were entered into an electronic multiple database search engine. Abstracts were screened for their relevance and articles were individually selected and collated. RESULTS Decreased HRV is found in both MDD and CHD. Both diseases are theorized to disrupt autonomic control feedback loops on the heart and are linked to vagal function. Existing theories link vagal function to both mood and emotion as well as cardiac function. However, several factors can potentially confound HRV measures and would thus impact on a complete understanding of vagal mechanisms in the link between MDD and CHD. CONCLUSIONS The quantitative investigation of vagal function using HRV represents a reasonable starting point in the study of the relationship between MDD and CHD. Many psychotropic and cardiac medications have effects on HRV, which may have clinical importance. Future studies of HRV in MDD and CHD should consider antidepressant medication, as well as anxiety, as potential confounders.
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Affiliation(s)
- Nicolas J Stapelberg
- Behavioural Basis of Health, Griffith Health Institute and School of Applied Psychology, Griffith University, Southport, Australia.
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47
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Beauchaine TP, Gatzke-Kopp LM. Instantiating the multiple levels of analysis perspective in a program of study on externalizing behavior. Dev Psychopathol 2012; 24:1003-18. [PMID: 22781868 PMCID: PMC4008966 DOI: 10.1017/s0954579412000508] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
During the last quarter century, developmental psychopathology has become increasingly inclusive and now spans disciplines ranging from psychiatric genetics to primary prevention. As a result, developmental psychopathologists have extended traditional diathesis-stress and transactional models to include causal processes at and across all relevant levels of analysis. Such research is embodied in what is known as the multiple levels of analysis perspective. We describe how multiple levels of analysis research has informed our current thinking about antisocial and borderline personality development among trait impulsive and therefore vulnerable individuals. Our approach extends the multiple levels of analysis perspective beyond simple Biology × Environment interactions by evaluating impulsivity across physiological systems (genetic, autonomic, hormonal, neural), psychological constructs (social, affective, motivational), developmental epochs (preschool, middle childhood, adolescence, adulthood), sexes (male, female), and methods of inquiry (self-report, informant report, treatment outcome, cardiovascular, electrophysiological, neuroimaging). By conducting our research using any and all available methods across these levels of analysis, we have arrived at a developmental model of trait impulsivity that we believe confers a greater understanding of this highly heritable trait and captures at least some heterogeneity in key behavioral outcomes, including delinquency and suicide.
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Affiliation(s)
- Theodore P Beauchaine
- Department of Psychology, Washington State University, PO Box 644820, Pullman, WA 99164, USA.
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Chen HC, Yang CCH, Kuo TBJ, Su TP, Chou P. Cardiac vagal control and theoretical models of co-occurring depression and anxiety: a cross-sectional psychophysiological study of community elderly. BMC Psychiatry 2012; 12:93. [PMID: 22846457 PMCID: PMC3499166 DOI: 10.1186/1471-244x-12-93] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2011] [Accepted: 07/20/2012] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND In order to elucidate the complex relationship between co-occurring depression and anxiety with cardiac autonomic function in the elderly, this study examined the correlation between cardiac vagal control (CVC) and pre-defined, theoretical factors from the Hospital Anxiety and Depression Scale (HADS). METHODS Three hundred fifty-four randomly selected Chinese male subjects aged ≥ 65 years and living in the community were enrolled. CVC was measured using a frequency-domain index of heart rate variability. RESULTS Confirmatory factor analysis showed that the flat tripartite model of HADS provided a modest advantage in model fit when compared with other theoretical factor solutions. In the flat tripartite model, there was a significant negative association between anhedonic depression and CVC. In contrast, autonomic anxiety showed a significant positive correlation with CVC. In the hierarchical tripartite model, negative affectivity was not directly associated with CVC; instead, it had positive and negative indirect effects on CVC via autonomic anxiety and anhedonic depression, respectively. As scores for negative affectivity increased, these specific indirect effects diminished. CONCLUSIONS Among competing models of co-occurring depression and anxiety, constructs from tripartite models demonstrate fair conformity with the data but unique and distinct correlations with CVC. Negative affectivity may determine the relationship of anhedonic depression and autonomic anxiety with CVC. Separating affective symptoms under the constructs of the tripartite models helps disentangle complex associations between co-occurring depression and anxiety with CVC.
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Affiliation(s)
- Hsi-Chung Chen
- Department of Psychiatry and Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan,Community Medicine Research Center & Institute of Public Health, National Yang-Ming University, Shih-Pai, Taipei, 112, Taiwan
| | - Cheryl C H Yang
- Institution of Brain Science and Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Terry B J Kuo
- Institution of Brain Science and Sleep Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Division of Psychiatry, National Yang-Ming University, Taipei, Taiwan,Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Pesus Chou
- Community Medicine Research Center & Institute of Public Health, National Yang-Ming University, Shih-Pai, Taipei, 112, Taiwan
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Berger S, Kliem A, Yeragani V, Bär KJ. Cardio-respiratory coupling in untreated patients with major depression. J Affect Disord 2012; 139:166-71. [PMID: 22386048 DOI: 10.1016/j.jad.2012.01.035] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 01/30/2012] [Accepted: 01/30/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Depressive disorders are known to be associated with higher risks of cardiovascular diseases. Several studies have reported an imbalance within the autonomic nervous system (ANS) as one putative cause. Previous investigations showed decreased cardio-respiratory coupling in depressive patients that were treated with nortriptyline. We aimed to compare parameters of heart rate variability and cardio-respiratory coupling between unmedicated patients suffering from major depressive disorder (MDD) and healthy controls in order to further understand autonomic dysfunction in the disease. METHODS We investigated eighteen unmedicated patients with major depressive disorder and eighteen matched healthy controls. Electrocardiogram and respiratory signals were obtained during a twenty minute resting period. Time- and frequency based parameters of HRV, respiratory sinus arrhythmia (RSA), approximate entropy of heart rate (ApEn(RR)) and respiratory rate (ApEn(Resp)) were calculated. Additionally, cross-ApEn between RR-intervals and respiration time series was determined, reflecting coupling of both signals. RESULTS Patients showed an increased heart rate and LF/HF-ratio. Respiratory sinus arrhythmia (RSA) and ApEn(RR) were reduced in patients in comparison to controls. Breathing rate, ApEn(Resp) and cross-ApEn did not differ between the two groups. DISCUSSION Increased heart rate, increased LF/HF-ratio, reduced RSA and reduced ApEn(RR) indicate a decrease of cardiac vagal modulation in depressive patients. No difference of cardio-respiratory coupling was observed. Respiratory parameters and cross-ApEn did not differ between both groups, and thus we conclude that diminished vagal modulation is mainly limited to cardiac modulation.
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Affiliation(s)
- Sandy Berger
- Pain & Autonomics - Integrative Research (PAIR), Department of Psychiatry and Psychotherapy, University Hospital Jena, Germany
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Musser ED, Ablow JC, Measelle JR. Predicting maternal sensitivity: The roles of postnatal depressive symptoms and parasympathetic dysregulation. Infant Ment Health J 2012; 33:350-359. [PMID: 28520177 DOI: 10.1002/imhj.21310] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Previous research has established that maternal depression is a risk factor for a variety of negative developmental outcomes among infants and children. Although low levels of maternal sensitivity have been hypothesized to explain this risk, the biological mechanisms underlying the association between maternal depressive symptoms and low levels of maternal sensitivity have been largely underexplored. This study examined the roles of postnatal depressive symptoms and parasympathetic nervous system functioning as predictors of low levels of maternal sensitivity, during a stressful mother-infant interaction-the reunion phase of the Still-Face Paradigm. Depressive symptoms and traitlike predispositions toward parasympathetic dysregulation, as indexed by low resting levels of respiratory sinus arrhythmia, were associated independently with less sensitive parenting. Discussion considers that during stressful mother-infant interactions, both mothers with depressive symptoms and mothers predisposed to parasympathetic dysregulation may have fewer emotional, physiological, and psychological resources with which to respond sensitively to their infants' cues.
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Affiliation(s)
- Erica D Musser
- University of Oregon and Oregon Health and Science University
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