Linking Daily Stress Processes and Laboratory-Based Heart Rate Variability in a National Sample of Midlife and Older Adults

Negative affective responsivity to daily stressors in young adults: The influence of depressive symptom severity

BACKGROUND

Evidence suggests that adults with major depressive disorder appraise daily stressor events as more severe and report stronger stressor-related negative emotions than non-depressed adults. Despite the growing number of young adults (~18-25 yrs) experiencing depressive symptoms in the absence of a formal clinical diagnosis, limited studies have examined whether current depressive symptom severity influences affective responsivity to daily stressors in young men and women. We tested the hypotheses that greater depressive symptom severity would be related to greater negative stressor appraisal characteristics and greater affective responsivity to daily stressors but not to stressor exposure frequency. We further hypothesized that the relations between depressive symptom severity and daily stress processes would be sensitized in young females compared to males.

METHODS

Depressive symptom severity (Patient Health Questionnaire-9) and daily stress processes (8-day daily dairy) were assessed in 235 young adults (18-30 yrs.; 166 females).

RESULTS

Greater depressive symptom severity was related to greater likelihood of daily stressor exposure, intensity of feelings of anger and shame following a stressor event, and negative and positive affective responsivity to daily stressors. Self-reported biological sex moderated the association between depressive symptom severity and positive (but not negative) affective responsivity to daily stressors.

LIMITATIONS

Causality cannot be established from this daily diary study design.

CONCLUSIONS

These data demonstrate that daily stressors are more pervasively reported and worsen negative affect to a greater extent in young adults currently experiencing more severe symptoms of depression, which may contribute to an increased risk of developing future chronic disease.

Savouring Moderates Affect Reactivity to Daily Events in Old Age

OBJECTIVE

This study investigated savouring as a moderator of affect reactivity to daily events among older adults.

METHOD

A sample of 108 individuals aged 65-92 years (M = 73.11, SD = 5.92; 58% women) completed daily diary questionnaires over 14 days, reporting on daily stressors, positive events, savouring, and positive and negative affect.

RESULTS

Multilevel models showed that on days when a stressor was experienced, negative affect was higher when daily savouring (within-person) was low, but this association was not observed when daily savouring was high. Additionally, on days with positive events, negative affect was lower when trait savouring (between-person) was high, but this effect was not found when trait savouring was low.

DISCUSSION

The findings highlight the importance of savouring as a key factor in managing emotional responses to daily experiences among older adults. Specifically, deliberately engaging with positive experiences might buffer daily negative emotional responses.

Affective Responsivity to Daily Stressors is Amplified in Young Females

Despite mounting evidence that young adults experience greater exposure and affective responsivity to daily stressors than middle-aged and older adults, few studies have examined potential sex differences in these daily stress processes in young adults. We tested the hypotheses that young women would experience (1) a greater percentage of days with at least one daily stressor event and (2) exaggerated negative and positive affective responsivity to daily stressors compared to young men. Young adults ( n = 215) completed a daily web-based interview for eight consecutive days to assess multiple dynamic aspects of daily stress processes. Women experienced a greater frequency of daily stressor days. Further, the magnitude of the difference in both negative and positive affect between stressor-free and stressor days were greater in young women compared to young men. Greater exposure and amplified affective responsivity to daily stressors may potentially contribute to increased susceptibility to adverse psychological outcomes in young women.

Heart rate variability wrist-wearable biomarkers identify adverse posttraumatic neuropsychiatric sequelae after traumatic stress exposure

Adverse posttraumatic neuropsychiatric sequelae (APNS) are common after traumatic events. We examined whether wrist-wearable devices could provide heart rate variability (HRV) biomarkers for recovery after traumatic stress exposure in a large socioeconomically disadvantaged cohort. Participants were enrolled in the emergency department within 72 hours after a traumatic event as part of the AURORA (Advancing Understanding of RecOvery afteR traumA) multicenter prospective observational cohort study and followed over 6 months. HRV biomarkers were derived and validated for associations with specific APNS symptoms at a point in time and changes in symptom severity over time. Sixty-four HRV characteristics were derived and validated as cross-sectional biomarkers of APNS symptoms, including pain (26), re-experiencing (8), somatic (7), avoidance (7), concentration difficulty (6), hyperarousal (5), nightmares (1), anxiety (1), and sleep disturbance (3). Changes in 22 HRV characteristics were derived and validated as biomarkers identifying changes in APNS symptoms, including reexperiencing (11), somatic (3), avoidance (2), concentration difficulty (1), hyperarousal (1), and sleep disturbance (4). Changes in HRV variables over time predicted symptom improvement (PPV 0.68-0.87) and symptom worsening (NPV 0.71-0.90). HRV biomarkers collected from wrist-wearable devices may have utility as screening tools for APNS symptoms that occur after traumatic stress exposure in high-risk populations.

Effects of stress management interventions on heart rate variability in adults with cardiovascular disease: a systematic review and meta-analysis

Meta-analysis was used to investigate the potential benefits of stress management interventions (SMIs) on vagally-mediated heart rate variability (HRV) in adults with cardiovascular disease. Electronic bibliographic databases were searched through August 2022. Randomized controlled trials and quasi-experimental studies assessing effects of SMIs on HRV were included. Methodological quality was assessed with a standardized checklist. A pooled effect size was calculated for vagally-mediated HRV indices (standard deviation of normal-to-normal intervals, root mean square of the successive differences, and high frequency power) using random effects models. Fourteen studies (1202 participants, Mage: 59 ± 6.25 years; 25% ± 16% women; 61% ± 22% White) were included. Ten studies (11 effects) reported short-term HRV assessment; a small between-group difference emerged for vagally-mediated HRV (d+ = .27, 95% confidence interval [CI] 0.01-0.52, k = 11). Most interventions examined biofeedback; these studies yielded a small between-group difference on vagally-mediated HRV (d+ = 0.31, 95% CI 0.09-0.53, k = 7, Q [6] = 3.82, p = .70, I2 = 11%). This is the first systematic examination of the effect of SMIs on HRV in adults with CVD. Findings suggest a small effect of SMIs on vagally-mediated HRV, with biofeedback likely driving the effect. More research is required to fully understand whether this benefit on vagally-mediated HRV applies to other SMIs.

Relationship between heart rate variability and differential patterns of cortisol response to acute stressors in mid-life adults: A data-driven investigation

Cortisol and heart rate variability (HRV) are well-established biomarkers of the human stress response system. While a relationship between cortisol and HRV is assumed, few studies have found evidence of their correlation within single study designs. One complication for isolating such a relationship may lie in individual variability in the cortisol response to stress such that atypical cortisol responding (i.e., elevated or blunted) occurs. To-date, studies on the cortisol response have employed traditional mean-difference-based approaches to examine average magnitude change in cortisol over time. Alternatively, data-driven trajectory modelling, such as latent growth mixture modelling, may be advantageous for quantifying cortisol based on patterns of response over time. Latent growth mixture modelling was used in N = 386 adults to identify subgroups based on trajectories of cortisol responses to stress. The relationship between cortisol and HRV was tested within subgroups. Results revealed a 'prototypical' subgroup characterised by expected rise and fall in cortisol response to stress (n = 309), a 'decline' subgroup (n = 28) that declined in cortisol after stress, and a 'rise' subgroup (n = 49) that increased in cortisol after stress. Within the 'prototypical' subgroup, greater HRV during stress was associated with decline in cortisol after stress from its maximum (r (306) = 0.19, p < 0.001). This relationship failed to emerge in the 'decline' and 'rise' subgroups (p > 0.271). Results document different patterns of cortisol response to stress; among those who exhibit a 'prototypical' response, changes in HRV during stress are related to changes in cortisol after stress.

Subjective Socioeconomic Status Moderates How Resting Heart Rate Variability Predicts Pain Response

Higher resting heart rate variability (HRV)-an index of more flexible response to environmental stressors, including noxious stimuli-has been linked to reduced perception of experimentally induced pain. However, as stress responses are adapted to one's chronic environments, we propose that chronic exposure to threats captured by one's subjective socioeconomic status (SSS) may shape different adaptations that produce distinct pain responses linked to higher resting HRV. Specifically, lower SSS individuals with more threat exposures may prioritize threat detection by upregulating sensitivity to stressors, such as acute pain. Therefore, higher HRV would predict greater perceived acute pain among lower SSS individuals. In contrast, higher SSS individuals with less threat exposures may instead prioritize affective regulation by downregulating sensitivity to stressors, producing lower pain perception with higher HRV. We examined this stress response moderation by SSS in 164 healthy young adults exposed to experimental pain via the cold pressor test (CPT). Resting HRV, indexed by the root-mean-square of successive differences in heart rate, and self-reported SSS were measured at rest. Pain perception indexed by self-reported pain and pain tolerance indexed by hand-immersion time during the CPT were assessed. Results revealed that among higher SSS individuals, higher resting HRV predicted lower pain reports and subsequently greater pain tolerance during the CPT. Conversely, among lower SSS individuals, higher resting HRV predicted higher pain reports and subsequently lower pain tolerance. These findings provide preliminary evidence that environmental stress exposures linked to one's SSS may shape unique biological adaptations that predict distinct pain responses.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-023-00234-w.

Perceived Parenting Stress Is Related to Cardiac Flexibility in Mothers: Data from the NorBaby Study

Heart rate variability (HRV) is an indicator of autonomic nervous system activity, and high levels of stress and/or depressive symptoms may reduce HRV. Here, we assessed whether (a) parental stress affected HRV in mothers during the perinatal period and whether this is mediated by bonding and (b) whether antenatal maternal mental states, specifically repetitive negative thinking, depressive symptoms, and pregnancy-related anxiety, have an impact on infant HRV, and lastly, we investigated (c) the relationship between maternal HRV and infant HRV. Data are from the Northern Babies Longitudinal Study (NorBaby). In 111 parent-infant pairs, cardiac data were collected 6 months after birth. In the antenatal period, we used the Pregnancy-Related Anxiety Questionnaire-Revised, the Edinburgh Postnatal Depression Scale, and the Perseverative Thinking Questionnaire; in the postnatal period, we used the Parenting Stress Index and the Maternal Postnatal Attachment Scale. Higher levels of perceived parenting stress but not depressive symptoms were associated with lower HRV in mothers (τ = -0.146), and this relationship was not mediated by maternal bonding. Antenatal maternal mental states were not associated with infant HRV. There was no significant correlation between maternal HRV and infant HRV. Our observational data suggest that perceived stress reduces cardiac flexibility. Future studies should measure HRV and parenting stress repeatedly during the perinatal period.

Parent Stress and Trauma, Autonomic Responses, and Negative Child Behaviors

Cumulative stress and trauma in parents may alter autonomic function. Both may negatively impact child behaviors, however these links have not been well established. We tested hypotheses that parent stress and trauma are associated with and interact with altered autonomic function during the toy wait task, an acute parent-child interaction challenge, to predict greater negative child behaviors. Sixty-eight parents and their 2-5 year old children were enrolled. More parent major and traumatic life events, and more parent recent life events coupled with increased heart rate and decreased heart rate variability (HRV), each related to more child disruptive/aggressive behavior. More major life and traumatic life events coupled with greater HRV predicted more child attention seeking behavior. Our novel approach to assessing parental life stress offers a unique perspective. Interventions mitigating parent stress and regulating physiological coping during parent-child interactions may both promote better parent health and improve child behavioral outcomes.

Heart rate variability (HRV) as a way to understand associations between the autonomic nervous system (ANS) and affective states: A critical review of the literature

Evidence suggests affective disorders such as depression and bipolar disorder are characterised by dysregulated autonomic nervous system (ANS) activity. These findings suggest ANS dysregulation may be involved in the pathogenesis of affective disorders. Different affective states are characterised by different ANS activity patterns (i.e., an increase or decrease in sympathetic or parasympathetic activity). To understand how ANS abnormalities are involved in the development of affective disorders, it is important to understand how affective states correlate with ANS activity before their onset. Using heart rate variability (HRV) as a tool to measure ANS activity, this review aimed to look at associations between affective states and HRV in non-clinical populations (i.e., in those without medical and psychiatric disorders). Searches on PubMed and Google Scholar were completed using the following search terms: heart rate variability, autonomic nervous system, sympathetic nervous system, parasympathetic nervous system, affective state, mood and emotion in all possible combinations. All but one of the studies examined (N = 13), demonstrated significant associations between affect and HRV. Findings suggest negative affect, encompassing both diffused longer-term experiences (i.e., mood) as well as more focused short-term experiences (i.e., emotions), may be associated with a reduction in parasympathetic activity as measured through HRV parameters known to quantify parasympathetic activity (e.g., high frequency (HF)-HRV). HRV measures typically linked to reduction in parasympathetic activity appear to be linked to negative affective states in non-clinical populations. However, given the complex and possibly non-linear relationship between HRV and parasympathetic activity, further studies need to clarify specificity of these findings. Future studies should investigate the potential utility of HRV measures as biomarkers for monitoring changes in affective states and for early detection of onset and relapse of depression in patients with affective disorders.

Stress buffering after physical activity engagement: An experience sampling study

OBJECTIVES

While encountering daily hassles is a normative experience, it poses a threat to individuals' daily affective well-being. However, physical activity engagement may help to reduce the current stress-related impact on affective well-being (i.e. stress buffering), which we investigate in this study. Furthermore, we examined the possible moderating role of people's global stress context (i.e. exposure to major life events and chronic stress) on this within-person stress-buffering effect.

DESIGN

We approached these ideas using six-times-a-day experience sampling assessments over a period of 22 days.

METHODS

Drawing on a broad national sample of 156 middle-aged adults from the EE-SOEP-IS study, we aimed to elucidate the naturally occurring within-person dynamics of current stress, physical activity engagement, and momentary affect within individuals' everyday lives. Major life events and chronic stress were measured as between-person variables.

RESULTS

Multilevel analyses revealed significant within-person associations of current stress and physical activity engagement with momentary affect. Stress-related negative affect was lower when individuals engaged in physical activity, in accordance with the idea of a within-person stress-buffering effect of physical activity engagement. For individuals exposed to more severe major life events, the stress-buffering effect of physical activity engagement for negative affect was lower. Chronic stress did not moderate the within-person stress-buffering effect.

CONCLUSIONS

Overall, results add to the existing literature that links physical activity to increased stress resilience and emphasizes the need for taking the global between-person stress context into account.

Daily Sleep-Stress Reactivity and Functional Impairment in World Trade Center Responders

BACKGROUND

How sleep is impacted by stress ("sleep reactivity to stress") and how stress is impacted by sleep ("stress reactivity to sleep") are trait-like characteristics of individuals that predict depression, anxiety, and insomnia. However, pathways between reactivity and functional impairment (e.g., impairment in social relationships and interpersonal functioning) have not been explored, which may be a critical pathway in understanding the link between reactivity and the development of psychological disorders.

PURPOSE

We examined associations between reactivity and changes in functional impairment among a cohort of 9/11 World Trade Center responders.

METHODS

Data from 452 responders (Mage = 55.22 years; 89.4% male) were collected between 2014 and 2016. Four baseline sleep and stress reactivity indices (i.e., sleep duration and efficiency reactivity to stress; stress reactivity to sleep duration and efficiency) were calculated from 14 days of sleep and stress data using random slopes from multilevel models. Functional impairment was assessed approximately 1 year and 2 years after baseline via semi-structured interviews. Latent change score analyses examined associations between baseline reactivity indices and changes in functional impairment.

RESULTS

Greater baseline sleep efficiency reactivity to stress was associated with decreases in functioning (β = -0.05, p = .039). In addition, greater stress reactivity to sleep duration (β = -0.08, p = .017) and sleep efficiency (β = -0.22, p < .001) was associated with lower functioning at timepoint one.

CONCLUSION

People who are more reactive to daily fluctuations in stress and sleep have poorer interpersonal relationships and social functioning. Identifying individuals with high reactivity who could benefit from preventative treatment may foster better social integration.

Does psychological treatment of major depression reduce cardiac risk biomarkers? An exploratory randomized controlled trial

BACKGROUND

Depression is associated with an increased risk for cardiovascular disease (CVD). Biological cardiac risk factors are already elevated in depressed patients without existing CVD. The purpose of this exploratory trial was to examine whether treating Major Depression (MD) with cognitive behavioral therapy (CBT) is associated with improvements in cardiac risk biomarkers and whether depressive symptom severity at baseline moderates treatment effects.

METHODS

Eighty antidepressant-free patients with MD were randomly assigned to CBT or waiting list (WL). Biological outcomes included long-term recordings (24-h, daytime, nighttime) of heart rate, heart rate variability (HRV), and blood pressure, as well as inflammatory markers such as C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-α. A sample of 40 age- and sex-matched non-clinical controls was also involved to verify biological alterations in MD at study entry.

RESULTS

Compared to WL, CBT was associated with a significant increase in overall HRV, as indexed by the 24-h and daytime HRV triangular index, as well as trend improvements in 24-h low-frequency HRV and daytime systolic blood pressure. Self-rated depressive symptom severity moderated (or tended to moderate) improvements in CBT for 24-h and daytime heart rate and several indices of HRV (especially daytime measures). Inflammatory treatment effects were not observed.

CONCLUSIONS

CBT increased overall HRV in patients with MD. Initially more depressed patients showed the most pronounced cardiovascular improvements through CBT. These exploratory findings may provide new insights into the biological effects of psychological treatment against depression and must be confirmed through future research.

Acute and Long-Lasting Effects of Slow-Paced Breathing on Handball Team Coach's Match Stress

Stress was previously defined as a response to any demand for change. These demands are noticeable during sport events, not only in athletes but also in coaches. Therefore, this study aimed to determine the influence of slow-paced breathing (SPB) on acute stress to handball coaches during official matches. One professional handball coach, aged 37 (height, 180 cm; weight, 80 kg), took part in the study. His salivary cortisol (C) concentration and alpha-amylase (AA) activity were measured, and his heart rate (HR) was monitored during six official matches. In the first three matches the SPB training protocol was not followed. From match four to match six, the coach performed SPB training every day and directly before the match. The decrease observed in AA was statistically significant with a large effect size (1.80). The trend of change in HR is visible and similar for matches with and without SPB. However, for SPB matches, there is a lower starting point compared to matches without SPB (89.81 ± 6.26 and 96.62 ± 8.10, respectively). Moreover, values of AA on SPB matches were smaller before the match (93.92 ± 15.89) compared to the same time point in non-SPB matches (115.30 ± 26.00). For AA, there is a significant effect size in the half-time (2.00) and after the match (-2.14). SPB matches showed a lower increase in AA. SPB might be used as one of the possible tools that could help coaches in achieving a desirable mental state during the match.

Mild daily stress, in interaction with NR3C1 DNA methylation levels, is linked to alterations in the HPA axis and ANS response to acute stress in early adolescents

BACKGROUND

Daily Hassles (DH) or daily stress - is a mild type of stressor with unique contributions to psychological distress. Yet, most prior studies that investigate the effects of stressful life experiences focus on childhood trauma or on early life stress and little is known about the effects of DH on epigenetic changes in stress system related genes and on the physiological response to social stressors.

METHODS

In the present study, conducted among 101 early adolescents (mean age = 11.61; SD = 0.64), we investigated whether Autonomic Nervous System (ANS) (namely heart rate and heart rate variability) and Hypothalamic-Pituitary-Adrenal (HPA) axis functioning (measured as cortisol stress reactivity and recovery) are associated with DNA methylation (DNAm) in the glucocorticoid receptor gene (NR3C1), the level of DH and their interaction. To assess the stress system functioning the TSST protocol was used.

RESULTS

Our findings show that higher NR3C1 DNAm in interaction with higher levels of daily hassles, is associated with blunted HPA axis reactivity to psychosocial stress. In addition, higher levels of DH are associated with extended HPA axis stress recovery. In addition, participants with higher NR3C1 DNAm had lower ANS adaptability to stress, specifically lower parasympathetic withdrawal; for heart rate variability this effect was strongest for participants with higher level of DH.

CONCLUSIONS

The observation that interaction effects between NR3C1 DNAm levels and daily stress on the functioning of the stress-systems, are already detectable in young adolescents, highlights the importance of early interventions, not only in the case of trauma, but also daily stress. This might help to prevent stress-induced mental and physical disorders later in life.

Affective Reactions to daily interpersonal stressors: Moderation by family involvement and gender

The goal of this study was to examine whether family involvement and gender moderated daily changes in affect associated with interpersonal stressors. Adults (N = 2022; M _age = 56.25, Median = 56, SD = 12.20, Range = 33-84) from the second wave of the National Study of Daily Experiences participated in eight consecutive daily diaries. Each day they reported whether a daily interpersonal stressor occurred, whether family was involved, and their positive and negative affect. Results from multilevel models indicated that family involvement did not significantly moderate daily interpersonal stressor-affect associations; however, gender was a significant moderator in some instances. Women showed greater increases in negative affective reactivity to arguments and avoided arguments compared to men. Further, compared to men, women reported larger decreases in positive affective reactivity, but only for avoided arguments. Neither family involvement, gender, nor the interaction between family involvement and gender predicted affective residue. Gender differences in daily interpersonal stressors and affective reactivity may be attributable to overarching gender norms and roles that are still salient in the U.S. Our results suggest that daily interpersonal stressors may be detrimental to affective well-being, regardless of family involvement. Future work should explore associations between daily interpersonal stressors and family involvement by specific relationship roles, such as mother or spouse, for a more comprehensive understanding of what stressor characteristics impact daily affective well-being.

Daily reactivity to stress and sleep disturbances: unique risk factors for insomnia

STUDY OBJECTIVES

To naturalistically measure sleep disturbances following stress exposure (i.e. sleep reactivity) and stress responses following sleep disturbances (i.e. stress reactivity) at the daily level and prospectively examine these reactivity measures as individual risk factors for insomnia.

METHODS

The study assessed 392 nurses' sleep and stress for 14 days using daily diaries and actigraphy. Self-reported insomnia symptoms were assessed at the end of the 14 days, as well as 6 and 11 months later.

RESULTS

In multilevel modeling, while negative fixed effects indicated that shorter total sleep time (TST) and lower sleep efficiency led to greater stress and vice versa, significant random effects indicated individual variability in sleep reactivity and stress reactivity. In latent score change modeling, greater sleep reactivity (lower diary-determined sleep efficiency following greater stress) and greater stress reactivity (greater stress following shorter diary-determined TST) at baseline were associated with greater insomnia symptoms at 11 months (b = 10.34, p = .026; b = 7.83, p = .03). Sleep reactivity and stress reactivity also interacted to predict insomnia symptoms, such that sleep reactivity was significantly associated with insomnia symptoms for those with high (+1 SD) stress reactivity (b = 17.23, p = .001), but not for those with low (-1 SD) stress reactivity (b = 5.16, p = .315).

CONCLUSIONS

Baseline stress reactivity and sleep reactivity independently as well as jointly predict greater insomnia symptoms 11 months later. The findings delineate processes underlying the stress-diathesis model of insomnia and highlight the utility of longitudinal and naturalistic measures of sleep and stress reactivity.

"We've Got This": Middle-Aged and Older Couples' Satisfying Relationships and We-Talk Promote Better Physiological, Relational, and Emotional Responses to Conflict

OBJECTIVE

Conflict poses multiple relational and health risks. Dyadic stress theories suggest satisfaction and communication alter cardiovascular and autonomic function, key pathways from troubled relationships to poor health. However, "we-talk," a positive communication pattern, can strengthen relationships and promote health. We examined how each spouse's satisfaction and we-talk were related to conflict's physiological, relational, and emotional toll.

METHODS

Married couples ( n = 107 couples, 214 individuals, ages 40-87 years) who were mostly White, highly educated, and higher-income Americans in different-gender relationships engaged in 20-minute conflict discussions while wearing monitors to assess heart rate variability (HRV). Spouses rated their closeness immediately after conflict and their conflict rumination 2 hours later. Conflict transcriptions measured we-talk, or the proportion of first-person plural pronouns (we, us, our).

RESULTS

Satisfied spouses or those in mutually satisfying relationships had higher HRV during conflict ( b = 0.0001, p = .049), felt closer immediately after conflict ( b = 0.07, p < .001), and ruminated less about the conflict 2 hours later ( b = -0.26, p = .026). Spouses' HRV was highest ( b = 0.0002, p = .002) and rumination was lowest ( b = -0.49, p = .019) when they or their partners were satisfied and used we-talk more often. Women's HRV ( b = 0.0001, p = .035) and rumination ( b = -0.01, p = .02) benefited when both spouses were satisfied, as did closeness when women were satisfied ( b = 0.10, p < .001). Men's closeness benefited when they ( b = 0.04, p = .003) or their wives ( b = 0.04, p = .002) were satisfied.

CONCLUSIONS

The combination of mutually satisfying relationships and we-talk was associated with better relational and health outcomes after conflict. These findings are important for middle-aged and older couples whose relationships are central to their health.

Role of peer learning and self-efficacy in parasympathetic activity during the simulation learning process in nursing students

AIMS

This study aimed to investigate the stress level, including parasympathetic nervous activity, of students engaged in peer learning during simulations and the role of self-efficacy.

DESIGN

Observational-comparative study.

METHODS

The participants were 76 nursing students who were asked to evaluate a stable postoperative patient in Scene 1 and the same patient bleeding in Scene 2. In each scene, the students engaged in phases of repeated individual observations of the patient and discussions with peers. We compared each participant's parasympathetic activity during each observation in Scenes 1 and 2. Furthermore, the self-efficacy score before the simulation was used to divide the participants into 3 groups, and the self-efficacy and parasympathetic activity during the simulation were analysed.

RESULTS

The participants' parasympathetic activity decreased in both scenes with each phase of repeated observation. Two-way repeated-measures analysis of variance showed no statistically significant difference in parasympathetic activity during simulations among the three self-efficacy groups.

Daily Stress and Microvascular Dysfunction: The Buffering Effect of Physical Activity

Although often short-lived, emotional responsiveness to daily stressors ( i.e. , routine and sometimes unexpected everyday hassles) is associated with increased cardiovascular disease (CVD), morbidity, and mortality. Here, we present the novel hypothesis that a disruption of microvascular homeostasis is a key antecedent. In addition, we postulate that physical activity may mitigate the psychobiological consequences of daily stress, thereby limiting pathophysiological CVD-related sequelae.

Alignment Between Heart Rate Variability From Fitness Trackers and Perceived Stress: Perspectives From a Large-Scale In Situ Longitudinal Study of Information Workers

BACKGROUND

Stress can have adverse effects on health and well-being. Informed by laboratory findings that heart rate variability (HRV) decreases in response to an induced stress response, recent efforts to monitor perceived stress in the wild have focused on HRV measured using wearable devices. However, it is not clear that the well-established association between perceived stress and HRV replicates in naturalistic settings without explicit stress inductions and research-grade sensors.

OBJECTIVE

This study aims to quantify the strength of the associations between HRV and perceived daily stress using wearable devices in real-world settings.

METHODS

In the main study, 657 participants wore a fitness tracker and completed 14,695 ecological momentary assessments (EMAs) assessing perceived stress, anxiety, positive affect, and negative affect across 8 weeks. In the follow-up study, approximately a year later, 49.8% (327/657) of the same participants wore the same fitness tracker and completed 1373 EMAs assessing perceived stress at the most stressful time of the day over a 1-week period. We used mixed-effects generalized linear models to predict EMA responses from HRV features calculated over varying time windows from 5 minutes to 24 hours.

RESULTS

Across all time windows, the models explained an average of 1% (SD 0.5%; marginal R2) of the variance. Models using HRV features computed from an 8 AM to 6 PM time window (namely work hours) outperformed other time windows using HRV features calculated closer to the survey response time but still explained a small amount (2.2%) of the variance. HRV features that were associated with perceived stress were the low frequency to high frequency ratio, very low frequency power, triangular index, and SD of the averages of normal-to-normal intervals. In addition, we found that although HRV was also predictive of other related measures, namely, anxiety, negative affect, and positive affect, it was a significant predictor of stress after controlling for these other constructs. In the follow-up study, calculating HRV when participants reported their most stressful time of the day was less predictive and provided a worse fit (R2=0.022) than the work hours time window (R2=0.032).

CONCLUSIONS

A significant but small relationship between perceived stress and HRV was found. Thus, although HRV is associated with perceived stress in laboratory settings, the strength of that association diminishes in real-life settings. HRV might be more reflective of perceived stress in the presence of specific and isolated stressors and research-grade sensing. Relying on wearable-derived HRV alone might not be sufficient to detect stress in naturalistic settings and should not be considered a proxy for perceived stress but rather a component of a complex phenomenon.

Is Silence Golden? Chronic Stress and Psychophysiological Indicators’ Changes over Time in International Students: A Pilot Study

Most people assume studying or working abroad would be stressful - but would one ever think that it could be detrimental to the health? Stress literature relates cross-cultural transactions to the chances of gaining higher levels of chronic stress. This paper reports the results of two studies on international students in Moscow in 2018. Specifically, Study 1 assessed how cross-cultural transactions perceived to affect health state during the first 6 months of their relocation. Study 2 aimed to investigate if the psychological stress linked to relocation to a different country can possibly lead to psychobiological effects of chronic stress. In Study 1, qualitative methods were applied to conduct 21 interviews with international students. In Study 2, a longitudinal pilot study was conducted for 10 foreign students during the first 2-5 (M = 3.6) months of their relocation. Stress related to cross-cultural transactions was expected to affect subjective well-being and health variables. The health state was a relatively silent topic in the interview participants of Study 1. The results of Study 2 showed that the participants had changes in the resting heart rate (RHR) baseline. Perceived chronic stress related to cross-cultural transactions may affect psychophysiological state; however, the affect varies depending on a person. Further research is required for the data consistency and for identifying non-invasive objective risk markers and individual stress pathways, with the goal of identifying at-risk students and providing treatment options before any serious harm is done to their health.

Correlation of Circadian Rhythms of Heart Rate Variability Indices with Stress, Mood, and Sleep Status in Female Medical Workers with Night Shifts

PURPOSE

Heart rate variability (HRV) indices have been used as stress indicators. Rare studies investigated the associations of circadian rhythms of the HRV indices with the stress, mood, and sleep conditions in populations under stress.

METHODS

In total 257 female participants (203 shift workers and 54 non-shift workers) were included. All the participants completed a structured questionnaire to assess the stress, mood, and sleep conditions and performed 24-hour Holter electrocardiogram monitoring on the day away from shifts. Using epochs of 1-min or 5-min beat-to-beat intervals, the HRV indices (SDNN, RMSSD, LF, HF, LF/HF, and LFnu, SD1, SD2, SD1/SD2) were plotted as a function of time and fitted into cosine periodic curves, respectively. Three mathematical parameters based on the cosine periodic curves were extracted, MESOR (M, overall averages of the cosine curve), amplitude (A, amplitude of the peak of the cosine curve), and acrophase (θ, latency to the peak) to quantify the circadian rhythms of the HRV indices. Multivariable linear regression models were used to reveal the associations of these parameters with the clinical assessments of stress, mood, or sleep conditions, as well as with the 24-h averages of the HRV indices.

RESULTS

The parameters M and A of SDNN, RMSSD, LF, and HF, and θ of LF/HF and LFnu significantly differ between shift and non-shift workers. The parameter θ of LF/HF positively correlates with the severity of stress and anxiety. The parameter A of LF/HF and LFnu also positively correlates with daytime sleepiness and sleep fragmentation. In addition, the parameters M and A instead of θ of SDNN, RMSSD, LF, LF/HF, and LFnu significantly correlate with the 24-h averages of HRV indices.

CONCLUSION

The circadian rhythms of the HRV indices over 24 hours can, to some extent, predict the severity of stress, emotion and sleep conditions in female populations under stress.

Daily Stressors, Emotion Dynamics, and Inflammation in the MIDUS Cohort

BACKGROUND

The current study (1) examined links between daily stressors and inflammation and (2) tested whether negative emotion dynamics (emotional variability) is one pathway through which stressors are linked to inflammation.

METHOD

A cross-sectional sample of 986 adults (aged 35-86 years, 57% female) from MIDUS reported daily stressor frequency and severity and negative emotions on 8 consecutive nights. Negative emotion variability (intraindividual standard deviation), controlling for overall mean level (intraindividual mean), was the focus of the current study. Interleukin-6 (IL-6) and C-reactive protein (CRP) were assayed from blood drawn at a clinic visit. Regression models adjusted for demographics, health factors, and the time between assessments.

RESULTS

More severe daily stressors were associated with higher CRP, but this effect was accounted for by covariates. More frequent daily stressors were associated with lower IL-6 and CRP. In follow-up analyses, significant interactions between stressor severity and frequency suggested that participants with lower stressor severity and higher stressor frequency had the lowest levels of IL-6 and CRP, whereas those with higher stressor severity had the highest levels of IL-6 and CRP, regardless of frequency. Daily stressor frequency and severity were positively associated with negative emotion variability, but variability was not linearly associated with inflammation and did not operate as a mediator.

CONCLUSION

Among midlife and older adults, daily stressor frequency and severity may interact and synergistically associate with inflammatory markers, potentially due to these adults being advantaged in other ways related to lower inflammation, or in a pattern aligning with hormetic stress, where frequent but manageable stressors may yield physiological benefits, or both. Negative emotion variability does not operate as a mediator. Additional work is needed to reliably measure and test other emotion dynamic metrics that may contribute to inflammation.

COVID-19-Related Daily Stress Processes in College-Aged Adults: Examining the Role of Depressive Symptom Severity

Exposure to daily stressors specific to the COVID-19 pandemic (e.g., threat of infection) is associated with emotional distress, heightened stress reactivity, and increased depressive symptomology. Herein, we examined whether current depressive symptomology modulates the association between COVID-19-related daily stressor exposure and negative affective reactivity in young, otherwise healthy, college-aged adults. Fifty-eight adults (21 men; 22±3years) completed a daily web-based interview for eight consecutive days to assess COVID-19-related daily stress exposure and emotional responsiveness (September–November 2020). Depressive symptom severity was assessed using the Patient Health Questionnaire-9 (PHQ-9), and a score of ≥10 (range: 0–27) was used to define adults with a depressive episode (n=20). Participants reported at least one COVID-19-related stressor on 35.8% of interview days. Depressive symptomology did not predict the likelihood of exposure to a COVID-19-related stressor (p=0.46; OR=1.52; 95% CI: 0.492–4.718). However, negative affect (NA) was greater on days with an exposure to any COVID-19-specific daily stressor in adults with moderate-to-severe depressive symptoms (b=0.28, SE=0.093, p=0.003) but not in those without (b=0.009, SE=0.074, p=0.90), such that negative affective reactivity to COVID-19-related stressors was amplified in adults with a current depressive episode (p=0.019). Depressive symptomology did not moderate positive affective reactivity (p=0.686). Taken together, these data suggest that exposure to daily stressors related to COVID-19 further worsens NA in adults with a current depressive episode, potentially rendering them more susceptible to adverse mental health outcomes during the pandemic.

Is the Association Between Education and Sympathovagal Balance Mediated by Chronic Stressors?

Background

This study investigated whether raised chronic stress in low education groups contributes to education differences in cardiovascular disease by altering sympathovagal balance.

Methods

This study included cross-sectional data of 10,202 participants from the multi-ethnic, population-based HELIUS-study. Sympathovagal balance was measured by baroreflex sensitivity (BRS), the standard deviation of the inter-beat interval (SDNN) and the root mean square of successive differences between normal heartbeats (RMSSD). The associations between chronic stressors (work, home, psychiatric, financial, negative life events, lack of job control and perceived discrimination) in a variety of domains and BRS, SDNN and RMSSD were assessed using linear regression, adjusted for age, ethnicity, waist-to-hip ratio and pack-years smoked. Mediation analysis was used to assess the contribution of chronic stress to the association between education and sympathovagal balance.

Results

Modest but significant associations were observed between financial stress and BRS and SDNN in women, but not in RMSSD nor for any outcome measure in men. Women with the highest category of financial stress had 0.55% lower BRS (ms/mmHg; β = -0.055; CI = -0.098, -0.011) and 0.61% lower SDNN (ms; β = -0.061; CI = -0.099, -0.024) than those in the lowest category. Financial stress in women contributed 7.1% to the association between education and BRS, and 13.8% to the association between education and SDNN.

Conclusion

No evidence was found for the hypothesized pathway in which sympathovagal balance is altered by chronic stress, except for a small contribution of financial stress in women.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12529-021-10027-9.

Notification alert! Effects of auditory text alerts on attention and heart rate variability across three developmental periods

In a modern world saturated with cellphone-related stimuli, surprisingly little is known about their psychological effects. A small number of previous studies have found global distracting effects of cellphone rings on cognitive performance in undergraduate students. However, moment-to-moment reactions to cellphone sounds have not been investigated, nor have physiological changes that might accompany the cognitive effects. Developmental variations also remain unexamined. Thus, two experiments were conducted to examine the effects of cellphone notification sounds on cognitive performance (i.e., reaction time and accuracy on math problems) and heart rate variability in three age groups: adolescents (mean age: 15 years); young adults (mean age: 20 years); and mid-life adults (mean age: 48 years). Effects were most pronounced in the adolescent group, whose math problem accuracy and reaction time was compromised in response to notification sounds. These compromises were accompanied by increases in heart rate variability.

The Effect of Stress Management Programs on Physiological and Psychological Components of Stress: The Influence of Baseline Physiological State

Military personnel are particularly exposed to stressful events, and overexposure to stress is both physically and mentally unhealthy. While stress management programs, such as the Tactics of Optimized Potential (TOP) and Heart Coherence (HC) have been implemented, their efficiency remains to be evaluated. The objective of this randomized control trial was to evaluate the effectiveness of the two programs among a young male population of 180 military fire fighter recruits. Based on two psychological, and one physiological measurement, namely heart rate variability (HRV), we found that both TOP and HC programs significantly increased HRV. This is promising as we know that higher HRV is consistent with better health, in most cases. Moreover, the TOP program significantly reduced perceived stress and negative mood, unlike the HC program. Combining these results, we conclude that while both TOP and HC programs influence physiological measurements, only the TOP modifies psychological evaluations. Finally, we distinguished the effects of the programs on two samples characterized by their HRV level. For the low HRV group, both programs tended to increase their HRV level, while for the high HRV group neither program had a significant effect.

Purposefulness and daily life in a pandemic: Predicting daily affect and physical symptoms during the first weeks of the COVID-19 response

OBJECTIVE

Sense of purpose has been associated with greater health and well-being, even in daily contexts. However, it is unclear whether effects would hold in daily life during COVID-19, when people may have difficulty seeing a path towards their life goals.

DESIGN

The current study investigated whether purposefulness predicted daily positive affect, negative affect, and physical symptoms. Participants (n = 831) reported on these variables during the first weeks of the COVID-19 response in North America.

MAIN OUTCOME MEASURES

Participants completed daily surveys asking them for daily positive events, stressors, positive affect, negative affect, physical symptoms, and purposefulness.

RESULTS

Purposefulness at between- and within-person levels predicted less negative affect and physical symptoms, but more positive affect at the daily level. Between-person purposefulness interacted with positive events when predicting negative and positive affect, suggesting that purposeful people may be less reactive to positive events. However, between-person purposefulness also interacted with daily stressors, insofar that stressors predicted greater declines in positive affect for purposeful people.

CONCLUSION

Being a purposeful person holds positive implications for daily health and well-being, even during the pandemic context. However, purposefulness may hold some consequences unique to the COVID-19 context, which merit attention in future research.

Emotional Vulnerability to Short Sleep Predicts Increases in Chronic Health Conditions Across 8 Years

BACKGROUND

Sleep is a robust determinant of next-day emotions, but people vary in the extent that their emotions fluctuate on days following short sleep duration. These individual differences in day-to-day sleep and emotion dynamics may have long-term health implications.

PURPOSE

To evaluate emotional vulnerability to short sleep (within-person associations between sleep duration and next-day emotions) as a risk factor for future chronic conditions.

METHODS

Adults aged 33-84 (N = 1,426; 57% female) in the Midlife in the United States Study reported sleep duration and emotions by telephone for eight consecutive days. Chronic conditions were assessed via checklist at baseline and at a median follow-up of eight years (range: 5-10 years). Short sleep was examined in three ways: person-centered continuous variable, ≤6 hr, and <7 hr; long sleep was defined as ≥9 hr.

RESULTS

Multilevel structural equation models revealed that people with greater negative emotions following nights of sleep ≤6 hr (vs. their negative emotions after longer sleep) had increased chronic conditions at follow-up, compared to people who were less emotionally vulnerable to short sleep (Est. = 1.04, SE = .51, p < .028). Smaller declines in positive emotions following ≤6 hr of sleep were marginally predictive of lower risk for chronic conditions (Est. = -.77, SE = .44, p = .054). Emotional vulnerability to <7, ≥9, and continuous sleep hours were not associated with subsequent chronic conditions.

CONCLUSIONS

Emotional vulnerability to short sleep is a unique risk factor for the development of chronic conditions, independent of mean-level sleep duration and emotions.

Stress and anxiety in nursing students between individual and peer simulations

BACKGROUND

The use of high-fidelity simulation practice as an educational tool is becoming increasingly prevalent in nursing education. Despite the learning effects of simulation practice, students have been shown to experience high levels of stress and anxiety during simulation. In recent years, peer learning has been defined as an acquisition of knowledge and skills through active support and support among equal or equal peers and has been shown to be an effective educational intervention for clinical health science students.

AIM

The purpose of this study was to incorporate peer learning into simulation learning and to clarify the differences between stress and anxiety during personal and peer simulations.

METHOD

Third-grade undergraduate students in a four-year course at two nursing universities participated in this study. In this study, the simulated patient was a 53-year-old man who had undergone gastrectomy for the treatment of gastric cancer. The scenario was that the patient had completely recovered consciousness in the operating room, and his tracheal tube had been removed one hour before the students examined him. Stress while simulation training was evaluated with heart rate variability. Anxiety was evaluated by the STAI after the simulations were complete.

RESULTS

Personal simulation practice (personal group; n = 50) and peer simulation practice (peer group, n = 59) was conducted. The personal group included 7 male students, and the peer group included 12 male students; the difference in male proportion was not significant. At the first patient assessment phase, stress of heart rate variability components at the peer group significantly increased relative to that of the personal. In addition, the personal had a significantly higher state anxiety score after simulation than the peer.

CONCLUSION

This study shows that in the face-to-face scene involving vital sign measurements, the presence of peers did not objectively alleviate stress.

Individual Differences in Cross-System Physiological Activity at Rest and in Response to Acute Social Stress

OBJECTIVE

Individual differences in long-term cardiovascular disease risk are related to physiological responses to psychological stress. However, little is known about specific physiological response profiles in young adults that may set the stage for long-term increased cardiovascular disease risk. We investigated individual differences in profiles of resting cardiovascular physiology and stress reactivity, combining parasympathetic, sympathetic, and hemodynamic measures.

METHODS

Participants (n = 744, 71% women, mean [standard deviation] age = 20.1 [2.4] years) underwent the Trier Social Stress Test, while blood pressure (systolic blood pressure, diastolic blood pressure), electrocardiograms (interbeat interval), and impedance cardiograms (preejection period, left ventricular ejection time) were recorded. Respiratory sinus arrhythmia was derived from the combination of the electrocardiogram and the impedance cardiogram. A three-step latent profile analysis (LPA) was performed on resting and reactivity values to derive clusters of individual physiological profiles. We also explored demographic and health behavioral correlates of the observed latent clusters.

RESULTS

For resting physiology, LPA revealed five different resting physiology profiles, which were related to sex, usual physical activity levels, and body mass index. Five cardiovascular stress reactivity profiles were identified: a reciprocal/moderate stress response (Cr1; 29%), and clusters characterized by high blood pressure reactivity (Cr2: 22%), high vagal withdrawal (Cr3; 22%), autonomic coactivation (parasympathetic nervous system and sympathetic nervous system; Cr4; 13%), and overall high reactivity (Cr5; 12%). Men were more likely to belong to the high reactivity (Cr5) cluster, whereas women were more likely to have autonomic coactivation (Cr4).

CONCLUSIONS

We identified five cardiovascular physiological reactivity profiles, with individuals displaying generalized hyperreactivity, predominant vagal withdrawal, autonomic coactivation, or blood pressure-specific hyperreactivity. Longitudinal studies are needed to determine whether these profiles are useful in early detection of individuals at high risk for cardiovascular disease.

Taking context to heart: Momentary emotions, menstrual cycle phase, and cardiac autonomic regulation

Emotions have long been discussed in conjunction with the autonomic nervous system. Most research on emotion-autonomic linkages does not consider sex differences or an evident underlying mechanism for sex differences: menstrual cycle phase. Further, most research is limited to cross-sectional and laboratory studies. The degree to which emotion-autonomic associations manifest in everyday life may be different and may vary by sex and, for women, by menstrual cycle phase. This study employs the ambulatory monitoring of cardiovascular measures (e.g., heart rate and heart rate variability; HRV) and concurrent emotional states (e.g., sadness, stress, anxiety, anger, and happiness) in everyday life to better characterize emotion-autonomic associations as a function of sex and menstrual cycle phase. Participants (N = 174; 87 female) ages 18 to 46 (31.23 ± 6.49) were monitored over a 5-day observation period (one 2- and one 3-day session), using an ambulatory 24-hour electrocardiogram to monitor heart rate and ecological momentary assessment to record emotions every ~30 min. Women were monitored in both the early to mid-follicular and -luteal phases and men in two comparably distanced sessions. Multilevel models indicated that across sex, negative emotions and happiness were associated with elevated heart rate. Relative to men, women exhibited an elevated heart rate and reduced HRV during reports of anger. For women, during the luteal phase, but not follicular phase, momentary sadness, stress, and anxiety predicted increased heart rate and reduced HRV. These findings demonstrate the importance of considering sex and menstrual cycle phase in research investigating emotion-autonomic linkages.

Sleep duration and affective reactivity to stressors and positive events in daily life

OBJECTIVE

Experimental evidence suggests that inadequate sleep disrupts next-day affective processing and evokes greater stress reactivity. However, less research has focused on whether sleep predicts next-day affective reactivity to naturally occurring stressors and positive events in daily life, as well as the reversed direction of association (i.e., affective reactivity to daily events as predictors of subsequent sleep). The purpose of this study was to evaluate the within-person, bidirectional associations between nightly sleep duration and day-to-day fluctuations in affect related to stressors and positive events.

METHOD

Adults ages 33-84 (N = 1,982, 57% female) in the U.S. National Study of Daily Experiences II reported sociodemographics and chronic conditions at baseline, then completed telephone interviews for 8 consecutive days about their sleep duration, daily stressors, positive events, and affect.

RESULTS

Prior-night sleep duration moderated the link between current-day events and positive affect, but not negative affect. Specifically, nights of shorter-than-usual sleep duration predicted more pronounced decreases in positive affect in response to daily stressors, as well as smaller increases in positive affect in response to daily positive events. Results for the reversed direction of association showed no evidence for affective reactivity to daily events as predictors of subsequent sleep duration. People with more chronic conditions were more reactive to positive events, particularly after nights of longer sleep.

CONCLUSION

Affective reactivity to daily stressors and positive events vary based upon sleep duration, such that sleep loss may amplify loss of positive affect on days with stressors, as well as reduce positive affective responsiveness to positive events. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Charting adult development through (historically changing) daily stress processes

This article views adult development through the lens of daily life experiences and recent historical changes in these experiences. In particular, it examines whether theories that postulate general linear increases in well-being throughout adulthood still hold during times of less prosperity and more uncertainty. Descriptive analyses of the National Study of Daily Experiences chart show how stress in the daily lives of Americans may have changed from the 1990s (N = 1,499) to the 2010s (N = 782). Results revealed that adults in the 2010s reported experiencing stressors on 2% more days than in the 1990s, which translates to an additional week of stressors across a year. Participants in the 2010s also reported that stressors were more severe and posed more risks to future plans and finances and that they experienced more distress. These historical changes were particularly pronounced among middle-aged adults (e.g., proportion of stressor days increased by 19%, and perceived risks to finances and to future plans rose by 61% and 52%, respectively). As a consequence, age-related linear increases in well-being observed from young adulthood to midlife in the 1990s were no longer observed in the 2010s. If further studies continue to replicate our findings, traditional theories of adult well-being that were developed and empirically tested during times of relative economic prosperity may need to be reevaluated in light of the changes in middle adulthood currently observed in this historic period. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Greater Daily Psychosocial Stress Exposure is Associated With Increased Norepinephrine-Induced Vasoconstriction in Young Adults

Background Epidemiological data suggest a link between psychological stress and increased cardiovascular disease risk; however, the underlying mechanisms remain incompletely understood. The purpose of this investigation was to directly examine the influence of daily psychosocial stress on microvascular adrenergic vasoconstrictor responsiveness in healthy adults. We hypothesized increased daily psychosocial stress would be positively related to increased norepinephrine-induced vasoconstriction. Methods and Results Eighteen healthy adults (19-36 years; 10 women) completed a daily psychosocial experiences telephone interview for 8 consecutive evenings in order to document their exposure and emotional responsiveness to common stressors (eg, arguments, work stress) over the preceding 24 hrs. On the last interview day, red cell flux (laser Doppler flowmetry) was measured during graded intradermal microdialysis perfusion of norepinephrine (10^-12 to 10^-2 mol/L) and expressed as a percentage of baseline vascular conductance. Exogenous norepinephrine elicited progressive and robust vasoconstriction in all individuals (maximal vasoconstriction: 71±4%_base; cumulative vasoconstriction [area under the curve]: 118±102 arbitrary units). Participants experienced a stressor on 51±5% of days and a total of 5.2±0.9 stressors over the 8-day time frame. Increased daily frequency of stressor exposure was positively related to both maximal (R²=0.26; P=0.03) and cumulative (R²=0.31; P=0.02) vasoconstrictor responsiveness. Likewise, the total number of stressors was associated with increased maximal (R²=0.40; P<0.01) and cumulative (R²=0.27; P=0.03) norepinephrine-induced vasoconstriction. Neither stressor severity nor stress-related emotions were related to vasoconstrictor responsiveness. Conclusions Collectively, these data suggest that daily psychosocial stressor exposure by itself is sufficient to adversely influence microvascular vasoconstrictor function, regardless of the perceived severity or emotional consequences of the stressor exposure.

The Influence of Leisure Engagement on Daily Emotional Well-being

Leisure engagement is believed to offer emotional benefits. However, relatively few studies have examined how leisure engagement influences emotional well-being in the context of individuals' everyday lives. The current study examined the associations between leisure engagement and daily emotional well-being, as measured by participants' mean levels of positive affect (PA), PA variability, and PA reactivity to stressors. Using smartphones, participants (n = 176) completed ecological momentary assessments (EMAs) 5 times per day for 14 consecutive days. The Pearson correlations indicated that the participants who engaged in leisure more frequently experienced higher mean levels of PA and lower PA variability in daily life compared to those with less frequent leisure engagement. However, multilevel models indicated that individuals' differences in frequency of leisure engagement did not influence their emotional reactivity in response to daily stressors. The findings extend the importance of leisure engagement to consider the dynamics of daily emotional well-being.

Affective reactivity, resting heart rate variability, and marital quality: A 10-year longitudinal study of U.S. adults

Increasing evidence suggests that heightened affective reactivity to daily stressors has implications for mental and physical health, yet little is known about the long-term repercussions of day-to-day stress reactivity for marital quality. This study examined associations between affective reactivity and two indicators of marital well-being (marital satisfaction and marital risk) over a 10-year period. An additional aim was to investigate the potential role of resting high-frequency heart rate variability (HF-HRV), an index of cardiac vagal regulation, in moderating the association between affective reactivity and marital quality. These relationships were examined using data from 344 married adults in the Midlife in the United States (MIDUS II and III) study. Respondents completed daily telephone interviews and longitudinal reports of stressors, affect, and marital quality. HF-HRV was measured at rest. Greater affective reactivity to daily stressors predicted lower marital satisfaction and higher marital risk 10 years later. These associations remained after adjustments for potential confounders, including demographics, physical and behavioral factors, and psychological characteristics. In addition, HF-HRV moderated the associations between affective reactivity and marital quality. Results are consistent with a buffering effect, in which high levels of HF-HRV offset the inverse association between affective reactivity and marital quality. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Development and validation of a Burden Transfer Inventory for predicting veterinarian stress related to client behavior

OBJECTIVE To develop and validate a Burden Transfer Inventory (BTI) of stressful client behaviors and to evaluate whether those behaviors are associated with client caregiver burden and contribute to veterinarian stress and burnout. DESIGN 3-stage cross-sectional psychometric validation study. SAMPLE 1,151 small animal veterinarians and 372 dog and cat owners. PROCEDURES During stage 1, a pool of 34 items representing stressful client behaviors was created through open-ended surveys of practicing veterinarians and 3 phases of pilot testing. During stage 2, 1,151 veterinarians recruited through the Veterinary Information Network completed a survey including those behavior items and validated measures of stress and burnout. Completed surveys were randomly assigned to either a measure development or validation database for factor and item analyses. Data were then combined to determine whether the BTI was correlated with measures of stress and burnout. During stage 3, owners of dogs and cats with a serious illness completed an online survey to assess how frequently they engaged in each BTI item as well as a validated measure of caregiver burden. RESULTS For dog and cat owners, there was a significant positive correlation between caregiver burden and the frequency that those owners reported engaging in BTI items. The frequency that veterinarians reported encountering BTI items was positively correlated with measures of stress and burnout, which suggested burden transfer from owners to veterinarians. The extent to which veterinarians reported being bothered by BTI items was a more robust predictor of stress and burnout than the frequency with which those items occurred. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated the BTI can be used to understand how client behaviors associated with caregiver burden affect veterinarian stress and burnout. The BTI may be useful to identify specific stressors affecting individual veterinarians and how they react to those stressors.

dynr.mi: An R Program for Multiple Imputation in Dynamic Modeling

Assessing several individuals intensively over time yields intensive longitudinal data (ILD). Even though ILD provide rich information, they also bring other data analytic challenges. One of these is the increased occurrence of missingness with increased study length, possibly under non-ignorable missingness scenarios. Multiple imputation (MI) handles missing data by creating several imputed data sets, and pooling the estimation results across imputed data sets to yield final estimates for inferential purposes. In this article, we introduce dynr.mi(), a function in the R package, Dynamic Modeling in R (dynr). The package dynr provides a suite of fast and accessible functions for estimating and visualizing the results from fitting linear and nonlinear dynamic systems models in discrete as well as continuous time. By integrating the estimation functions in dynr and the MI procedures available from the R package, Multivariate Imputation by Chained Equations (MICE), the dynr.mi() routine is designed to handle possibly non-ignorable missingness in the dependent variables and/or covariates in a user-specified dynamic systems model via MI, with convergence diagnostic check. We utilized dynr.mi() to examine, in the context of a vector autoregressive model, the relationships among individuals' ambulatory physiological measures, and self-report affect valence and arousal. The results from MI were compared to those from listwise deletion of entries with missingness in the covariates. When we determined the number of iterations based on the convergence diagnostics available from dynr.mi(), differences in the statistical significance of the covariate parameters were observed between the listwise deletion and MI approaches. These results underscore the importance of considering diagnostic information in the implementation of MI procedures.

The age-dependent relationship between resting heart rate variability and functional brain connectivity

Resting heart rate variability (HRV), an index of parasympathetic cardioregulation and an individual trait marker related to mental and physical health, decreases with age. Previous studies have associated resting HRV with structural and functional properties of the brain - mainly in cortical midline and limbic structures. We hypothesized that aging affects the relationship between resting HRV and brain structure and function. In 388 healthy subjects of three age groups (140 younger: 26.0 ± 4.2 years, 119 middle-aged: 46.3 ± 6.2 years, 129 older: 66.9 ± 4.7 years), gray matter volume (GMV, voxel-based morphometry) and resting state functional connectivity (eigenvector centrality mapping and exploratory seed-based functional connectivity) were related to resting HRV, measured as the root mean square of successive differences (RMSSD). Confirming previous findings, resting HRV decreased with age. For HRV-related GMV, there were no statistically significant differences between the age groups, nor similarities across all age groups. In whole-brain functional connectivity analyses, we found an age-dependent association between resting HRV and eigenvector centrality in the bilateral ventromedial prefrontal cortex (vmPFC), driven by the younger adults. Across all age groups, HRV was positively correlated with network centrality in the bilateral posterior cingulate cortex. Seed-based functional connectivity analysis using the vmPFC cluster revealed an HRV-related cortico-cerebellar network in younger but not in middle-aged or older adults. Our results indicate that the decrease of HRV with age is accompanied by changes in functional connectivity along the cortical midline. This extends our knowledge of brain-body interactions and their changes over the lifespan.

Sense of Purpose Moderates the Associations Between Daily Stressors and Daily Well-being

Background

Having a sense of purpose in life has been consistently demonstrated as a predictor of positive health outcomes, including less perceived stress, yet, little is known about the role of sense of purpose on stressful days.

Purpose

The current study investigated the sense of purpose as a moderator of stressor-related changes in daily physical symptoms, positive affect, and negative affect.

Methods

A subset of the Midlife in the United States study (n = 1949, mage: 56.4 years) reported their sense of purpose, along with up to eight daily assessments of stressors, affect, and physical symptoms. Multilevel models evaluated whether sense of purpose was associated with deviations in affect or physical symptom reporting on days when participants reported a stressor versus days when stressors did not occur.

Results

Sense of purpose was associated with higher daily positive affect, lower daily negative affect, and fewer daily physical symptoms. Compared with individuals who reported lower levels of purpose, those reporting higher levels encountered the same number of daily stressors, yet showed less of an increase in negative affect and physical symptoms on stressor days than on stressor-free days. Purpose did not predict changes in positive affect in response to daily stressors.

Conclusions

Findings provide evidence that a purposeful life may be characterized by lower negative affect and physical symptom reporting on stressful days.

StressHacker: Towards Practical Stress Monitoring in the Wild with Smartwatches

In modern life, the nonstop and pervasive stress tends to keep us on long-lasting high alert, which over time, could lead to a broad range of health problems from depression, metabolic disorders to heart diseases. However, there is a stunning lack of practical tools for effective stress management that can help people navigate through their daily stress. This paper presents the feasibility evaluation of StressHacker, a smartwatch-based system designed to continuously and passively monitor one's stress level using bio-signals obtained from the on-board sensors. With the proliferation of smartwatches, StressHacker is highly accessible and suited for daily use. Our preliminary evaluation is based on 300 hours of data collected in a real-life setting (12 subjects, 29 days). The result suggests that StressHacker is capable of reliably capturing daily stress dynamics (precision = 86.1%, recall = 91.2%), thus with great potential to enable seamless and personalized stress management.

Stress and Heart Rate Variability: A Meta-Analysis and Review of the Literature

OBJECTIVE

Physical or mental imbalance caused by harmful stimuli can induce stress to maintain homeostasis. During chronic stress, the sympathetic nervous system is hyperactivated, causing physical, psychological, and behavioral abnormalities. At present, there is no accepted standard for stress evaluation. This review aimed to survey studies providing a rationale for selecting heart rate variability (HRV) as a psychological stress indicator.

METHODS

Term searches in the Web of Science^®, National Library of Medicine (PubMed), and Google Scholar databases yielded 37 publications meeting our criteria. The inclusion criteria were involvement of human participants, HRV as an objective psychological stress measure, and measured HRV reactivity.

RESULTS

In most studies, HRV variables changed in response to stress induced by various methods. The most frequently reported factor associated with variation in HRV variables was low parasympathetic activity, which is characterized by a decrease in the high-frequency band and an increase in the low-frequency band. Neuroimaging studies suggested that HRV may be linked to cortical regions (e.g., the ventromedial prefrontal cortex) that are involved in stressful situation appraisal.

CONCLUSION

In conclusion, the current neurobiological evidence suggests that HRV is impacted by stress and supports its use for the objective assessment of psychological health and stress.

Affective reactivity to daily stress and 20-year mortality risk in adults with chronic illness: Findings from the National Study of Daily Experiences

OBJECTIVE

Daily stress processes have been previously linked to health-related outcomes, but implications for longevity remain unclear. The present study examined whether daily stress exposure and/or affective responses to daily stressors predicted mortality risk over a 20-year period. Based on the hypothesis that chronic illness confers vulnerability to deleterious effects of stress, we also examined whether its presence accentuated the association between daily stress processes and later mortality risk.

METHOD

Participants were 1,346 middle-aged adults from the survey of Midlife Development in the United States who also completed the National Study of Daily Experiences. Participants reported on their experiences of stress and affect for 8 consecutive evenings, and mortality data were collected over the next 20 years, using the National Death Index and other methods.

RESULTS

There was a positive association between total number of stressors experienced across days and mortality risk. There was also a positive association between increases in negative affect on stressor days relative to nonstressor days and risk for mortality. The presence of a chronic illness moderated this association such that negative affective reactivity predicted mortality risk among individuals with at least one chronic illness but not among otherwise healthy individuals. This association was independent of sociodemographic characteristics, typical levels of negative affect on nonstressor days, and total number of endorsed stressors.

CONCLUSION

These results suggest that greater increases in negative affect in response to stress in everyday life may have long-term consequences for longevity, particularly for individuals with chronic illness. (PsycINFO Database Record

Daily positive events and diurnal cortisol rhythms: Examination of between-person differences and within-person variation

Growing evidence from field studies has linked daily stressors to dysregulated patterns of diurnal cortisol. Less is known about whether naturally-occurring positive events in everyday life are associated with diurnal cortisol. The objectives of this study were to evaluate daily positive events as predictors of between-person differences and within-person (day-to-day) variations in diurnal cortisol parameters, in addition to daily positive events as buffers against the associations between daily stressors and cortisol. In the National Study of Daily Experiences, 1657 adults ages 33-84 (57% female) reported daily experiences during telephone interviews on 8 consecutive evenings. Saliva samples were collected 4 times per day on 4 interview days and assayed for cortisol. Multilevel models were used to estimate associations of daily positive events with cortisol awakening response (CAR), diurnal cortisol slope, and area under the curve (AUC). At the between-person level, people who experienced more frequent positive events exhibited a steeper diurnal cortisol slope, controlling for daily stressors, daily affect, and other covariates. At the within-person level, positive events in the morning (but not prior-night or afternoon/evening events) predicted steeper decline in cortisol across that day; positive events were also marginally associated with lower same-day AUC. Associations were not mediated by daily positive affect, and positive events did not buffer against stressor-related cortisol alterations. These findings indicate that individual differences and day-to-day variations in daily positive events are associated with diurnal cortisol patterns, independent of stressors and affect.

The Cardiac Sympathetic Nerve Activity in the Elderly Is Attenuated in the Right Lateral Decubitus Position

Objectives: The aim of this study was to evaluate the effect of the supine, left lateral decubitus, and right lateral decubitus positions on autonomic nervous activity in elderly adults by using spectral analysis of heart rate variability (HRV). Method: Forty-five adults aged 73.6 ± 5.7 years were enrolled. After lying in the supine position, all participants moved to the lateral decubitus positions in a random order and maintained the positions for 10 min, while electrocardiographic data were recorded to measure HRV. Results: The lowest heart rate continued for 10 min when participants were in the left lateral decubitus position compared with the other two positions (p < .001), while the HRV indexes remained unchanged. The low-frequency HRV to high-frequency HRV ratio (LF/HF) for the right lateral decubitus position was significantly lower than that for the other positions. Discussion: The right lateral decubitus position may attenuate sympathetic nerve activity in elderly adults.