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Bynum LG, Brindle RC. The relationship between sleep and interoception. J Sleep Res 2024:e14337. [PMID: 39266010 DOI: 10.1111/jsr.14337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 08/23/2024] [Accepted: 08/27/2024] [Indexed: 09/14/2024]
Abstract
The present study aimed to characterise the relationship between sleep and interoception in two independent studies. Theoretical grounds for such a relationship include a weak relationship between subjectively- and objectively-measured sleep, the covariance of sleep with pain, as well as the mass regulation of a number of visceral biological systems. In addition, such a relationship is often reflected in our language (i.e., 'feeling' tired). In both studies (Study 1: N = 118, 73% female, mean age 20.98 years; Study 2: N = 830, 49% female, mean age 38.04 years) sleep over the last month was self-reported. Confidence in interoceptive accuracy, which is the precision with which a person can monitor visceral signals, was measured using the Interoceptive Accuracy Scale, while interoceptive attention, which is the dispositional tendency to attend to bodily signals, was measured using the Body Perception Questionnaire. Study 1 revealed a relationship between long sleep latency and low confidence in interoceptive accuracy (β = -0.222, p = 0.021) and poor sleep quality and less interoceptive attention (β = -0.226, p = 0.016). Study 2 replicated these results as well as made clear a more general pattern whereby poor sleep-characterised by short duration, poor quality, less efficiency, long latency, and more frequent nighttime awakenings-related to an interoceptive phenotype of less confidence in interoceptive accuracy and more interoceptive attention (all β ≥ 0.047, p ≤ 0.17). In conclusion, results from these two independent studies provide robust cross-sectional evidence for associations between various dimensions of poor sleep and greater interoceptive attention, but less confidence in interoceptive accuracy.
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Affiliation(s)
- Louisa G Bynum
- Neuroscience Program, Washington and Lee University, Lexington, Kentucky, USA
| | - Ryan C Brindle
- Neuroscience Program, Washington and Lee University, Lexington, Kentucky, USA
- Department of Cognitive and Behavioral Science, Washington and Lee University, Lexington, Kentucky, USA
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2
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Ranfaing S, De Zorzi L, Ruyffelaere R, Honoré J, Critchley H, Sequeira H. The impact of attention bias modification training on behavioral and physiological responses. Biol Psychol 2024; 186:108753. [PMID: 38244853 DOI: 10.1016/j.biopsycho.2024.108753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 01/15/2024] [Accepted: 01/15/2024] [Indexed: 01/22/2024]
Abstract
Attention bias modification training aims to alter attentional deployment to symptom-relevant emotionally salient stimuli. Such training has therapeutic applications in the management of disorders including anxiety, depression, addiction and chronic pain. In emotional reactions, attentional biases interact with autonomically-mediated changes in bodily arousal putatively underpinning affective feeling states. Here we examined the impact of attention bias modification training on behavioral and autonomic reactivity. Fifty-eight participants were divided into two groups. A training group (TR) received attention bias modification training to enhance attention to pleasant visual information, while a control group (CT) performed a procedure that did not modify attentional bias. After training, participants performed an evaluation task in which pairs of emotional and neutral images (unpleasant-neutral, pleasant-neutral, neutral-neutral) were presented, while behavioral (eye movements) and autonomic (skin conductance; heart rate) responses were recorded. At the behavioral level, trained participants were faster to orientate attention to pleasant images, and slower to orientate to unpleasant images. At the autonomic level, trained participants showed attenuated skin conductance responses to unpleasant images, while stronger skin conductance responses were generally associated with higher anxiety. These data argue for the use of attentional training to address both the attentional and the physiological sides of emotional responses, appropriate for anxious and depressive symptomatology, characterized by atypical attentional deployment and autonomic reactivity.
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Affiliation(s)
- Stéphane Ranfaing
- PSyCOS - ETHICS EA 7446, Université Catholique de Lille, F-59000 Lille, France.
| | - Lucas De Zorzi
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| | - Rémi Ruyffelaere
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| | - Jacques Honoré
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| | - Hugo Critchley
- Psychiatry, Department of Neuroscience, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Henrique Sequeira
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
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Jimeno B, Verhulst S. Meta-analysis reveals glucocorticoid levels reflect variation in metabolic rate, not 'stress'. eLife 2023; 12:RP88205. [PMID: 37889839 PMCID: PMC10611431 DOI: 10.7554/elife.88205] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023] Open
Abstract
Glucocorticoid (GC) variation has long been thought to reflect variation in organismal 'stress,' but associations between GCs and Darwinian fitness components are diverse in magnitude, direction, and highly context-dependent. This paradox reveals our poor understanding of the causes of GC variation, contrasting with the detailed knowledge of the functional consequences of GC variation. Amongst an array of effects in many physiological systems, GCs orchestrate energy availability to anticipate and recover from predictable and unpredictable environmental fluctuations and challenges. Although this is mechanistically well-known, the extent to which GC levels are quantitatively explained by energy metabolism is unresolved. We investigated this association through meta-analysis, selecting studies of endotherms in which (1) an experiment was performed that affected metabolic rate and (2) metabolic rate and GC levels were measured simultaneously. We found that an increase in metabolic rate was associated with an increase in GC levels in 20 out of 21 studies (32 out of 35 effect sizes). More importantly, there was a strong positive correlation between the increases in metabolic rate and GCs (p=0.003). This pattern was similar in birds and mammals, and independent of the nature of the experimental treatment. We conclude that metabolic rate is a major driver of GC variation within individuals. Stressors often affect metabolic rate, leading us to question whether GC levels provide information on 'stress' beyond the stressor's effect on metabolic rate.
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Affiliation(s)
- Blanca Jimeno
- Instituto de Investigación en Recursos Cinegéticos (IREC), CSIC-UCLM-JCC, Ciudad Real, Spain
- Instituto Pirenaico de Ecologia (IPE), CSIC, Avda. Nuestra Señora de la Victoria, Jaca, Spain
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Sedentary behaviour, but not moderate-to-vigorous physical activity, is associated with respiratory responses to acute psychological stress. Biol Psychol 2023; 177:108510. [PMID: 36716988 DOI: 10.1016/j.biopsycho.2023.108510] [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: 02/07/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND Acute psychological stress induces respiratory responses, and stress-induced respiratory changes can be used to non-invasively reflect metabolic regulation. Respiratory and cardiovascular responses to stress are both driven by sympathetic mechanisms. Higher volumes of sedentary behaviour and lower volumes of physical activity are associated with elevated sympathetic tone and larger cardiovascular responses to stress. The aim of this study was to test whether these associations translate to measures of respiratory stress reactivity. METHODS Daily hours of sedentary behaviour (thigh-mounted activPAL) and moderate-to-vigorous physical activity (MVPA; wrist-mounted ActiGraph) were assessed across seven days. Breath-by-breath respiratory (e.g., breathing frequency [BF], end-tidal carbon dioxide partial pressure [PetCO2], carbon dioxide output [V̇CO2] and respiratory exchange ratio [RER]) responses to an 8-min Paced Auditory Serial Addition Test were then measured using a Cortex MetaLyzer3B. RESULTS Healthy participants (N = 61, mean age ± SD = 25.7 ± 8.9 years) recorded high volumes of sedentary behaviour (9.96 ± 1.48 h/day) and MVPA (1.70 ± 0.71 h/day). In adjusted models (with the inclusion of sedentary behaviour, MVPA, and other a priori selected covariates) hours of daily sedentary behaviour were associated with baseline to stress changes in BF (Β = 0.695, 95% CI = 0.281 - 1.109, p = .014), VT (Β = -0.042, 95% CI = -0.058 - -0.026, p = .014), PetCO2 (Β = -0.537, 95% CI = -0.829 - -0.245, p = .014), V̇CO2 (Β = -0.008, 95% CI = -0.014 - -0.003, p = .030), and RER (Β = -0.013, 95% CI = -0.021 - -0.005, p = .022). Daily hours of MVPA were not linked with respiratory responses to stress. DISCUSSION Sedentary behaviour, but not MVPA, is associated with respiratory stress reactivity. Future work should untangle the underlying mechanisms of these findings and explore the consequences for cardiometabolic disease.
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Bobba-Alves N, Juster RP, Picard M. The energetic cost of allostasis and allostatic load. Psychoneuroendocrinology 2022; 146:105951. [PMID: 36302295 PMCID: PMC10082134 DOI: 10.1016/j.psyneuen.2022.105951] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
Chronic psychosocial stress increases disease risk and mortality, but the underlying mechanisms remain largely unclear. Here we outline an energy-based model for the transduction of chronic stress into disease over time. The energetic model of allostatic load (EMAL) emphasizes the energetic cost of allostasis and allostatic load, where the "load" is the additional energetic burden required to support allostasis and stress-induced energy needs. Living organisms have a limited capacity to consume energy. Overconsumption of energy by allostatic brain-body processes leads to hypermetabolism, defined as excess energy expenditure above the organism's optimum. In turn, hypermetabolism accelerates physiological decline in cells, laboratory animals, and humans, and may drive biological aging. Therefore, we propose that the transition from adaptive allostasis to maladaptive allostatic states, allostatic load, and allostatic overload arises when the added energetic cost of stress competes with longevity-promoting growth, maintenance, and repair. Mechanistically, the energetic restriction of growth, maintenance and repair processes leads to the progressive wear-and-tear of molecular and organ systems. The proposed model makes testable predictions around the physiological, cellular, and sub-cellular energetic mechanisms that transduce chronic stress into disease risk and mortality. We also highlight new avenues to quantify allostatic load and its link to health across the lifespan, via the integration of systemic and cellular energy expenditure measurements together with classic allostatic load biomarkers.
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Affiliation(s)
- Natalia Bobba-Alves
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Robert-Paul Juster
- Center on Sex⁎Gender, Allostasis, and Resilience, Research Center of the Montreal Mental Health University Institute, Montreal, QC, Canada; Department of Psychiatry and Addiction, University of Montreal, Montreal, QC, Canada
| | - Martin Picard
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA; Department of Neurology, H. Houston Merritt Center and Columbia Translational Neuroscience Initiative, Columbia University Irving Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA.
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Love J, Sung W, Francis AL. Psychophysiological responses to potentially annoying heating, ventilation, and air conditioning noise during mentally demanding work. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 150:3149. [PMID: 34717455 DOI: 10.1121/10.0006383] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/29/2021] [Indexed: 06/13/2023]
Abstract
Exposure to noise-or unwanted sound-is considered a major public health issue in the United States and internationally. Previous work has shown that even acute noise exposure can influence physiological response in humans and that individuals differ markedly in their susceptibility to noise. Recent research also suggests that specific acoustic properties of noise may have distinct effects on human physiological response. Much of the existing research on physiological response to noise consists of laboratory studies using very simple acoustic stimuli-like white noise or tone bursts-or field studies of longer-term workplace noise exposure that may neglect acoustic properties of the noise entirely. By using laboratory exposure to realistic heating, ventilation, and air conditioning (HVAC) noise, the current study explores the interaction between acoustic properties of annoying noise and individual response to working in occupational noise. This study assessed autonomic response to two acoustically distinct noises while participants performed cognitively demanding work. Results showed that the two HVAC noises affected physiological arousal in different ways. Individual differences in physiological response to noise as a function of noise sensitivity were also observed. Further research is necessary to link specific acoustic characteristics with differential physiological responses in humans.
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Affiliation(s)
- Jordan Love
- Department of Speech, Language and Hearing Sciences, Purdue University, West Lafayette, Indiana 47907, USA
| | - Weonchan Sung
- Medical Device Research Center, Samsung Electronics, Seoul, South Korea
| | - Alexander L Francis
- Department of Speech, Language and Hearing Sciences, Purdue University, West Lafayette, Indiana 47907, USA
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Salier Eriksson J, Olsson KSE, Rosdahl H, Schantz P. Heart Rate Methods Can Be Valid for Estimating Intensity Spectrums of Oxygen Uptake in Field Exercise. Front Physiol 2021; 12:687566. [PMID: 34295264 PMCID: PMC8290204 DOI: 10.3389/fphys.2021.687566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/24/2021] [Indexed: 11/22/2022] Open
Abstract
Purpose Quantifying intensities of physical activities through measuring oxygen uptake (V̇O2) is of importance for understanding the relation between human movement, health and performance. This can in principle be estimated by the heart rate (HR) method, based on the linear relationship between HR and V̇O2 established in the laboratory. It needs, however, to be explored whether HR methods, based on HR-V̇O2 relationships determined in the laboratory, are valid for estimating spectrums of V̇O2 in field exercise. We hereby initiate such studies, and use cycle commuting as the form of exercise. Methods Ten male and ten female commuter cyclists underwent measurements of HR and V̇O2 while performing ergometer cycling in a laboratory and a normal cycle commute in the metropolitan area of Stockholm County, Sweden. Two models of individual HR-V̇O2 relationships were established in the laboratory through linear regression equations. Model 1 included three submaximal work rates, whereas model 2 also involved a maximal work rate. The HR-V̇O2 regression equations of the two models were then used to estimate V̇O2 at six positions of field HR: five means of quintiles and the mean of the whole commute. The estimations obtained were for both models compared with the measured V̇O2. Results The measured quintile range during commuting cycling was about 45–80% of V̇O2max. Overall, there was a high resemblance between the estimated and measured V̇O2, without any significant absolute differences in either males or females (range of all differences: −0.03–0.20 L⋅min–1). Simultaneously, rather large individual differences were noted. Conclusion The present HR methods are valid at group level for estimating V̇O2 of cycle commuting characterized by relatively wide spectrums of exercise intensities. To further the understanding of the external validity of the HR method, there is a need for studying other forms of field exercises.
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Affiliation(s)
- Jane Salier Eriksson
- The Research Unit for Movement, Health and Environment, Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Karin S E Olsson
- The Research Unit for Movement, Health and Environment, Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Hans Rosdahl
- The Research Unit for Movement, Health and Environment, Department of Physiology, Nutrition and Biomechanics, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Peter Schantz
- The Research Unit for Movement, Health and Environment, Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
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8
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Zawadzki MJ, Gavrilova L. All the lonely people: Comparing the effects of loneliness as a social stressor to non-lonely stress on blood pressure recovery. Int J Psychophysiol 2021; 167:94-101. [PMID: 34228984 DOI: 10.1016/j.ijpsycho.2021.06.016] [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: 02/14/2021] [Revised: 05/06/2021] [Accepted: 06/29/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study examined whether recalling a social stress that evoked lonely feelings produces greater affective and blood pressure responses than recalling non-social stress or a relaxing event. METHODS Young adults (n = 114) underwent one of three inductions: recalling a social stressor in which one felt lonely, recalling a non-social non-lonely stressor, and relaxation. Negative affect was assessed during baseline, induction, and recovery. Blood pressure was assessed continuously using a finger cuff. RESULTS Both the lonely and non-lonely stress conditions reported increased negative affect following the induction, with neither condition having fully recovered to baseline levels by the end of the study. For blood pressure, during recovery, blood pressure increased linearly for the lonely stress condition, but remained steady for the other conditions. CONCLUSIONS Recalling a social stress evoking lonely feelings may be more harmful for cardiovascular health than recalling non-social stressors. Results extend work demonstrating that in vivo stressors involving social evaluation elicit larger stress responses compared to stressors without this component.
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Affiliation(s)
- Matthew J Zawadzki
- Department of Psychological Sciences, University of California, Merced, United States of America.
| | - Larisa Gavrilova
- Department of Psychological Sciences, University of California, Merced, United States of America
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Francis AL, Bent T, Schumaker J, Love J, Silbert N. Listener characteristics differentially affect self-reported and physiological measures of effort associated with two challenging listening conditions. Atten Percept Psychophys 2021; 83:1818-1841. [PMID: 33438149 PMCID: PMC8084824 DOI: 10.3758/s13414-020-02195-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 12/14/2022]
Abstract
Listeners vary in their ability to understand speech in adverse conditions. Differences in both cognitive and linguistic capacities play a role, but increasing evidence suggests that such factors may contribute differentially depending on the listening challenge. Here, we used multilevel modeling to evaluate contributions of individual differences in age, hearing thresholds, vocabulary, selective attention, working memory capacity, personality traits, and noise sensitivity to variability in measures of comprehension and listening effort in two listening conditions. A total of 35 participants completed a battery of cognitive and linguistic tests as well as a spoken story comprehension task using (1) native-accented English speech masked by speech-shaped noise and (2) nonnative accented English speech without masking. Masker levels were adjusted individually to ensure each participant would show (close to) equivalent word recognition performance across the two conditions. Dependent measures included comprehension tests results, self-rated effort, and electrodermal, cardiovascular, and facial electromyographic measures associated with listening effort. Results showed varied patterns of responsivity across different dependent measures as well as across listening conditions. In particular, results suggested that working memory capacity may play a greater role in the comprehension of nonnative accented speech than noise-masked speech, while hearing acuity and personality may have a stronger influence on physiological responses affected by demands of understanding speech in noise. Furthermore, electrodermal measures may be more strongly affected by affective response to noise-related interference while cardiovascular responses may be more strongly affected by demands on working memory and lexical access.
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Affiliation(s)
- Alexander L Francis
- Department of Speech, Language and Hearing Sciences, Purdue University, Lyles-Porter Hall, 715 Clinic Dr., West Lafayette, IN, 47907, USA.
| | - Tessa Bent
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, IN, USA
| | - Jennifer Schumaker
- Department of Speech, Language and Hearing Sciences, Purdue University, Lyles-Porter Hall, 715 Clinic Dr., West Lafayette, IN, 47907, USA
| | - Jordan Love
- Department of Speech, Language and Hearing Sciences, Purdue University, Lyles-Porter Hall, 715 Clinic Dr., West Lafayette, IN, 47907, USA
| | - Noah Silbert
- Applied Research Laboratory for Intelligence and Security, University of Maryland, College Park, MD, USA
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Energy investment and motivation: The additive impact of task demand and reward value on exerted force in hand grip tasks. MOTIVATION AND EMOTION 2021. [DOI: 10.1007/s11031-020-09862-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AbstractAccording to motivational intensity theory, individuals are motivated to conserve energy when pursuing goals. They should invest only the energy required for success and disengage if success is not important enough to justify the required energy. We tested this hypothesis in five experiments assessing exerted muscle force in isometric hand grip tasks as indicator of energy investment. Our results provided mixed evidence for motivational intensity theory. Corroborating its predictions, energy investment was a function of task demand. However, we did not find evidence for the predicted disengagement, and we observed that participants exerted in most conditions more force than required. Furthermore, the data could be better explained by a model that predicted an additive effect of task demand and success importance than by models drawing on motivational intensity theory’s predictions. These results illustrate the strong link between energy investment and task demand but challenge motivational intensity theory’s primacy of energy conservation.
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Cross A, Naughton F, Sheffield D. What is the role of stress cardiovascular reactivity in health behaviour change? A systematic review, meta-analysis and research agenda. Psychol Health 2020; 36:1021-1040. [PMID: 32998581 DOI: 10.1080/08870446.2020.1825714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The stress reactivity hypothesis posits that the extremes of exaggerated and low or blunted cardiovascular reactivity (CVR) to stress may lead to adverse health outcomes via psychophysiological pathways. A potential indirect pathway between CVR and disease outcomes is through health-related behaviour and behaviour change. However, this is a less well understood pathway. Design: A registered systematic review was undertaken to determine the association between cardiovascular reactivity (CVR) and health behaviour change, as well as identify mediators and moderators. Eight papers that met the inclusion criteria, focused on smoking cessation and weight loss, were identified. Results: Pooling data from studies exploring the prospective relationship between CVR (as systolic blood pressure) and smoking cessation found that exaggerated CVR was associated with smoking relapse (Hedges' g = 0.39, SE = 0.00, 95% CI 0.38 - 0.40, p < .001; I2 = 0%; N = 257) but did not find evidence that CVR responses were associated with changes in weight. In order to advance our understanding of reactivity as a modifiable determinant of health behaviour change, our review recommends exploring the association between CVR and other health behaviours, to determine the influence of blunted reactivity versus low motivational effort identify mediators and moderators and determine the focus of interventions.
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Affiliation(s)
- Ainslea Cross
- School of Psychology, University of Derby, Derby, UK
| | - Felix Naughton
- School of Health Sciences, University of East Anglia, Norwich, UK
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Creaven AM, Higgins NM, Ginty AT, Gallagher S. Social support, social participation, and cardiovascular reactivity to stress in the Midlife in the United States (MIDUS) study. Biol Psychol 2020; 155:107921. [PMID: 32598908 DOI: 10.1016/j.biopsycho.2020.107921] [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: 07/09/2019] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 12/21/2022]
Abstract
This study tested two hypotheses of associations between dimensions of social connectedness and cardiovascular reactivity to acute stress: (1) high social support predicts diminished cardiovascular responses to stress (i.e., the stress-buffering model of social support), and (2) diminished cardiovascular responses predict lower social participation, a form of motivated behaviour. Participants (N = 606) in the main Midlife in the United States study completed measures of social support and social participation and underwent psychophysiological stress testing. In unadjusted analyses, social support was positively, rather than inversely, associated with reactivity. Results withstood adjustment for several control variables, but not for depressive symptoms, which was associated with diminished reactivity. Further, diminished reactivity was associated with lower social participation, but not in fully adjusted models. No robust evidence was observed for either the stress-buffering model, or for an association between diminished reactivity and lower social participation. The implications for our understanding of links between social connectedness and cardiovascular reactivity are discussed.
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Affiliation(s)
- Ann-Marie Creaven
- Department of Psychology, Centre for Social Issues Research, & Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland.
| | - Niamh M Higgins
- Department of Psychology, Mary Immaculate College, University of Limerick, South Circular Road, Limerick, Ireland.
| | - Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University, TX, United States.
| | - Stephen Gallagher
- Department of Psychology, Centre for Social Issues Research, & Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland.
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Schantz P, Salier Eriksson J, Rosdahl H. Perspectives on Exercise Intensity, Volume and Energy Expenditure in Habitual Cycle Commuting. Front Sports Act Living 2020; 2:65. [PMID: 33345056 PMCID: PMC7739755 DOI: 10.3389/fspor.2020.00065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 05/11/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Knowledge about exercise intensity and energy expenditure combined with trip frequency and duration is necessary for interpreting the character and potential influencing capacity of habitual cycle commuting on e.g., health outcomes. It needs to be investigated with validated methods, which is the purpose of this study. Methods: Ten male and 10 female middle-aged habitual commuter cyclists were studied at rest and with maximal exercise tests on a cycle ergometer and a treadmill in the laboratory. During their normal commute in the Stockholm County, Sweden, their oxygen uptake, heart rate, energy expenditure, ventilation, blood lactate, rated perceived exertion, number of stops, durations, route distances and cycling velocities were monitored with validated methods. The frequency of trips was self-reported. Results: The relative exercise intensity was 65% of maximal oxygen uptake, and the energy expenditure was 0.46 kcal per km and kg body weight for both sexes. Sex differences in MET-values (men, 8.7; women 7.4) mirrored higher levels of cycling speed (20%), body weight (29%), oxygen uptake (54%) and ventilation (51%) in men compared to women. The number of METhours per week during peak cycling season averaged 40 for the men and 28 for the women. It corresponded to a total energy expenditure of about 3,500 and 1,880 kcal for men and women, respectively. The number of trips per year was about 370, and the annual distance cycled was on average 3,500 km for men and 2,300 for women. Conclusion: Cycle commuting is characterized by equal relative aerobic intensity levels and energy requirements for a given distance cycled by men and women. Based on an overall evaluation, it represents a lower range within the vigorous intensity category. The combined levels of oxygen uptake, durations and trip frequencies lead to high levels of METhours and energy expenditure in both men and women during both peak cycling season as well as over the year. Overall, the study presents a novel basis for interpreting cycle commuting in relation to various health outcomes.
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Affiliation(s)
- Peter Schantz
- Research Unit for Movement, Health and Environment, The Åstrand Laboratory and Laboratory of Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Jane Salier Eriksson
- Research Unit for Movement, Health and Environment, The Åstrand Laboratory and Laboratory of Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Hans Rosdahl
- Research Unit for Movement, Health and Environment, The Åstrand Laboratory and Laboratory of Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
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Jennings JR, Muldoon MF, Sved AF. Is the Brain an Early or Late Component of Essential Hypertension? Am J Hypertens 2020; 33:482-490. [PMID: 32170317 DOI: 10.1093/ajh/hpaa038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/17/2020] [Accepted: 03/11/2020] [Indexed: 11/13/2022] Open
Abstract
The brain's relationship to essential hypertension is primarily understood to be that of an end-organ, damaged late in life by stroke or dementia. Emerging evidence, however, shows that heightened blood pressure (BP) early in life and prior to traditionally defined hypertension, relates to altered brain structure, cerebrovascular function, and cognitive processing. Deficits in cognitive function, cerebral blood flow responsivity, volumes of brain areas, and white matter integrity all relate to increased but prehypertensive levels of BP. Such relationships may be observed as early as childhood. In this review, we consider the basis of these relationships by examining the emergence of putative causative factors for hypertension that would impact or involve brain function/structure, e.g., sympathetic nervous system activation and related endocrine and inflammatory activation. Currently, however, available evidence is not sufficient to fully explain the specific pattern of brain deficits related to heightened BP. Despite this uncertainty, the evidence reviewed suggests the value that early intervention may have, not only for reducing BP, but also for maintaining brain function.
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Affiliation(s)
- John Richard Jennings
- Department of Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Matthew F Muldoon
- Division of Cardiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Heart and Vascular Institute, Hypertension Center, UPMC Medical Center, Pittsburgh, Pennsylvania, USA
| | - Alan F Sved
- Center for Neuroscience, University of Pittsburgh, Pennsylvania, USA
- Department of Neuroscience, University of Pittsburgh, Pennsylvania, USA
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John-Henderson NA, Gruman HE, Counts CJ, Ginty AT. American Indian young adults display diminished cardiovascular and cortisol responses to acute psychological stress. Psychoneuroendocrinology 2020; 114:104583. [PMID: 32000056 PMCID: PMC7096252 DOI: 10.1016/j.psyneuen.2020.104583] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/29/2019] [Accepted: 01/07/2020] [Indexed: 12/18/2022]
Abstract
American Indian adults are at an increased risk for cardiovascular disease compared with non-Hispanic white adults. Scant research exists examining the underlying physiological and psychological mechanisms associated with these risks. This study aimed to examine possible psychological and physiological stress-related mechanisms related to cardiovascular disease risk in healthy American Indian and non-Hispanic white adults. Forty American Indian (60% female, Mean age = 19.93, SD = 2.08 years) and 45 non-Hispanic white (70% female, Mean age = 20.18, SD = 2.22 years) participants attended an in-person laboratory session. Salivary cortisol and cardiovascular activity were measured before (baseline), during, and after exposure to a 10-minute mental arithmetic task. Compared to non-Hispanic white participants, American Indian had diminished salivary cortisol (p < .001), blood pressure (p's < .001), and heart rate (p = .041) responses to acute psychological stress. These effects could not be accounted for by differences in task performance or self-reported engagement. Previous research has shown that exaggerated responses to stress are associated with increased risk of cardiovascular disease. However, diminished responses to stress are associated with early childhood stress and future adverse behaviors (e.g., addiction, obesity). Diminished reactivity may influence behaviors that can impact future development of cardiovascular disease in American Indian populations.
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Affiliation(s)
| | | | | | - Annie T. Ginty
- Department of Psychology & Neuroscience, Baylor University
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16
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Schantz P, Salier Eriksson J, Rosdahl H. The heart rate method for estimating oxygen uptake: analyses of reproducibility using a range of heart rates from commuter walking. Eur J Appl Physiol 2019; 119:2655-2671. [PMID: 31628539 PMCID: PMC6858472 DOI: 10.1007/s00421-019-04236-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 09/21/2019] [Indexed: 12/02/2022]
Abstract
Background The heart rate method, based on the linear relation between heart rate and oxygen uptake, is potentially valuable to monitor intensity levels of physical activities. However, this depends not least on its reproducibility under standard conditions. This study aims, therefore, to evaluate the reproducibility of the heart rate method in the laboratory using a range of heart rates associated with walking commuting. Methods On two different days, heart rate and oxygen uptake measurements were made during three submaximal (model 1) and a maximal exercise intensity (model 2) on a cycle ergometer in the laboratory. 14 habitual walking commuters participated. The reproducibility, based on the regression equations from test and retest and using three levels of heart rate from the walking commuting, was analyzed. Differences between the two models were also analyzed. Results For both models, there were no significant differences between test and retest in the constituents of the regression equations (y intercept, slope and r value). Neither were there any systematic differences in estimated absolute levels of VO2 between test and retest for either model. However, some rather large individual differences were seen in both models. Furthermore, no significant differences were seen between the two models in slopes, intercepts and r values of the regression equations or in the estimated VO2. Conclusion The heart rate method shows good reproducibility on the group level in estimating oxygen consumption from heart rate–oxygen uptake relations in the laboratory, and based on three levels of heart rate which are representative for walking commuting.
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Affiliation(s)
- Peter Schantz
- The Research Unit for Movement, Health and Environment, The Åstrand Laboratory and Laboratory for Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden.
| | - Jane Salier Eriksson
- The Research Unit for Movement, Health and Environment, The Åstrand Laboratory and Laboratory for Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Hans Rosdahl
- The Research Unit for Movement, Health and Environment, The Åstrand Laboratory and Laboratory for Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
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17
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Ginty AT, Kraynak TE, Kuan DC, Gianaros PJ. Ventromedial prefrontal cortex connectivity during and after psychological stress in women. Psychophysiology 2019; 56:e13445. [PMID: 31376163 DOI: 10.1111/psyp.13445] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 05/25/2019] [Accepted: 06/28/2019] [Indexed: 01/14/2023]
Abstract
The ventromedial prefrontal cortex (vmPFC) integrates sensory, affective, memory-related, and social information from diverse brain systems to coordinate behavioral and peripheral physiological responses according to contextual demands that are appraised as stressful. However, the functionality of the vmPFC during stressful experiences is not fully understood. Among 40 female participants, the present study evaluated (a) functional connectivity of the vmPFC during exposure to and recovery following an acute psychological stressor, (b) associations among vmPFC functional connectivity, heart rate, and subjective reports of stress across individuals, and (c) whether patterns of vmPFC functional connectivity were associated with distributed brain networks. Results showed that psychological stress increased vmPFC functional connectivity with individual brain areas implicated in stressor processing (e.g., insula, amygdala, anterior cingulate cortex) and decreased connectivity with the posterior cingulate cortex and thalamus. There were no statistical differences in vmPFC connectivity to individual brain areas during recovery, as compared with baseline. Spatial similarity analyses revealed stressor-evoked increased connectivity of the vmPFC with the so-called dorsal attention, ventral attention, and frontoparietal networks, as well as decreased connectivity with the default mode network. During recovery, vmPFC connectivity increased with the frontoparietal network. Finally, individual differences in heart rate and perceived stress were associated with vmPFC connectivity to the ventral attention, frontoparietal, and default mode networks. Psychological stress appears to alter network-level functional connectivity of the vmPFC in a manner that further relates to individual differences in stressor-evoked cardiovascular and affective reactivity.
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Affiliation(s)
- Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas
| | - Thomas E Kraynak
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Dora C Kuan
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Peter J Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania
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18
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Schantz P, Salier Eriksson J, Rosdahl H. The heart rate method for estimating oxygen uptake: Analyses of reproducibility using a range of heart rates from cycle commuting. PLoS One 2019; 14:e0219741. [PMID: 31339909 PMCID: PMC6655643 DOI: 10.1371/journal.pone.0219741] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 07/01/2019] [Indexed: 11/23/2022] Open
Abstract
Monitoring aerobic exercise intensities of free-living physical activities is valuable for purposes such as education and research. The heart rate (HR) method, based on the linear relation between HR and oxygen uptake (VO2), is potentially valuable for this purpose. Three prerequisites are that the method is reproducible, and valid for the specific form of physical activity executed as well as under field conditions. The aim of this study is to evaluate reproducibility of the heart rate method in the laboratory. VO2 and HR measurements were made on two different occasions during three submaximal (model 1) plus a maximal exercise intensity (model 2) on a cycle ergometer in the laboratory. 19 habitual commuter cyclists (9 males and 10 females), aged 44 ± 3 years, were measured. The reproducibility of the estimated VO2, based on three levels of HR from commuting cycling and the regression equations from test and retest were analyzed. Differences between the two models were also studied. For both models, there were no significant differences between test and retest in the constituents of the regression equations (y-intercept, slope and r-value). Neither were there any systematic differences in estimated absolute levels of VO2 between test and retest. The relative differences between test and retest, based on estimations from three different levels of HR, were 0.99 ± 11.0 (n.s.), 2.67 ± 6.48 (n.s.) and 3.57 ± 6.24% (p<0.05) for model 1, and 1.09 ± 10.6, 1.75 ± 6.43 and 2.12 ± 5.92% (all n.s.) for model 2. However, some large individual differences were seen in both models. There were no significant differences between the two models in the slopes, intercepts or r-values of the regression equations or in the estimated levels of VO2. The heart rate method shows good reproducibility on the group level in estimating oxygen consumption from HR-VO2 relations in the laboratory, and based on three levels of HR which are representative for cycle commuting. However, on the individual level, some large variations were seen.
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Affiliation(s)
- Peter Schantz
- The Research Unit for Movement, Health and Environment, The Åstrand Laboratory & Laboratory for Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
- * E-mail:
| | - Jane Salier Eriksson
- The Research Unit for Movement, Health and Environment, The Åstrand Laboratory & Laboratory for Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Hans Rosdahl
- The Research Unit for Movement, Health and Environment, The Åstrand Laboratory & Laboratory for Applied Sport Science, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
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19
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Cardiovascular stress-response adaptation: Conceptual basis, empirical findings, and implications for disease processes. Int J Psychophysiol 2018; 131:4-12. [DOI: 10.1016/j.ijpsycho.2018.02.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 01/30/2018] [Accepted: 02/02/2018] [Indexed: 11/21/2022]
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20
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Dal Lin C, Tona F, Osto E. The Heart as a Psychoneuroendocrine and Immunoregulatory Organ. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1065:225-239. [PMID: 30051388 DOI: 10.1007/978-3-319-77932-4_15] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The heart can be viewed not just as muscle pump but also as an important checkpoint for a complex network of nervous, endocrine, and immune signals. The heart is able to process neurological signals independently from the brain and to crosstalk with the endocrine and immune systems. The heart communicates with the psyche through the neuro-endocrine-immune system in a highly integrated way, in order to maintain the homeostasis of the whole body with peculiarities specific to males and females.
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Affiliation(s)
- Carlo Dal Lin
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Francesco Tona
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Elena Osto
- Laboratory of Translational Nutrition Biology, Federal Institute of Technology Zurich ETHZ, Zurich, Switzerland. .,Center for Molecular Cardiology, University of Zurich and University Heart Center, Cardiology, University Hospital Zurich, Zurich, Switzerland.
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21
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(Too) Anxious to help? Social support provider anxiety and cardiovascular function. Int J Psychophysiol 2018; 123:171-178. [DOI: 10.1016/j.ijpsycho.2017.09.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/31/2017] [Accepted: 09/20/2017] [Indexed: 11/22/2022]
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Verkuil B, Brosschot JF, Tollenaar MS, Lane RD, Thayer JF. Prolonged Non-metabolic Heart Rate Variability Reduction as a Physiological Marker of Psychological Stress in Daily Life. Ann Behav Med 2017; 50:704-714. [PMID: 27150960 PMCID: PMC5054058 DOI: 10.1007/s12160-016-9795-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Prolonged cardiac activity that exceeds metabolic needs can be detrimental for somatic health. Psychological stress could result in such “additional cardiac activity.” Purpose In this study, we examined whether prolonged additional reductions in heart rate variability (AddHRVr) can be measured in daily life with an algorithm that filters out changes in HRV that are purely due to metabolic demand, as indexed by movement, using a brief calibration procedure. We tested whether these AddHRVr periods were related to worry, stress, and negative emotions. Methods Movement and the root of the mean square of successive differences (RMSSD) in heart rate were measured during a calibration phase and the subsequent 24 h in 32 participants. Worry, stress, explicit and implicit emotions were assessed hourly using smartphones. The Levels of Emotional Awareness Scale and resting HRV were used to account for individual differences. During calibration, person-specific relations between movement and RMSSD were determined. The 24-h data were used to detect prolonged periods (i.e., 7.5 min) of AddHRVr. Results AddHRVr periods were associated with worrying, with decreased explicit positive affect, and with increased tension, but not with the frequency of stressful events or implicit emotions. Only in people high in emotional awareness and high in resting HRV did changes in AddHRVr covary with changes in explicit emotions. Conclusions The algorithm can be used to capture prolonged reductions in HRV that are not due to metabolic needs. This enables the real-time assessment of episodes of potentially detrimental cardiac activity and its psychological determinants in daily life.
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Affiliation(s)
- Bart Verkuil
- Clinical Psychology and the Leiden Institute of Brain and Cognition, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.
| | - Jos F Brosschot
- Clinical Psychology and the Leiden Institute of Brain and Cognition, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - Marieke S Tollenaar
- Clinical Psychology and the Leiden Institute of Brain and Cognition, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
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New methods to optimally detect episodes of non-metabolic heart rate variability reduction as an indicator of psychological stress in everyday life. Int J Psychophysiol 2017; 131:30-36. [PMID: 29055696 DOI: 10.1016/j.ijpsycho.2017.10.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 08/15/2017] [Accepted: 10/18/2017] [Indexed: 11/24/2022]
Abstract
Cardiovascular disease is the leading cause of death in the western world. Frequent or chronic reductions in heart rate variability (HRV) are a powerful predictor of cardiovascular disease. Psychological stress has been suggested to be an important factor in the development of reduced HRV. Recently, Verkuil et al. (2016) introduced a laboratory-based method to measure additional HRV reduction in everyday life, and reductions in HRV related to psychological stress. In the current paper, we discuss alternative methods to detect additional HRV reductions, in real life data sets without the necessity of laboratory-based calibration, and even in existing data sets. All of these methods use a subset of 24h' worth of HRV and movement data to do so: either the first 10min of every hour, the full 24h, a combination of 10min from three consecutive hours, or a classification of level of movement. We also present a method to visualize HRV and movement data to be able to detect episodes of reduced additional HRV optically. The method that used the full 24h' worth of data detected the largest percentage of episodes of reduced additional HRV that actually match with self-reported stress levels, making this method the most promising.
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Ginty AT, Kraynak TE, Fisher JP, Gianaros PJ. Cardiovascular and autonomic reactivity to psychological stress: Neurophysiological substrates and links to cardiovascular disease. Auton Neurosci 2017; 207:2-9. [PMID: 28391987 DOI: 10.1016/j.autneu.2017.03.003] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/15/2017] [Accepted: 03/15/2017] [Indexed: 12/30/2022]
Abstract
Psychologically stressful experiences evoke changes in cardiovascular physiology that may influence risk for cardiovascular disease (CVD). But what are the neural circuits and intermediate physiological pathways that link stressful experiences to cardiovascular changes that might in turn confer disease risk? This question is important because it has broader implications for our understanding of the neurophysiological pathways that link stressful and other psychological experiences to physical health. This review highlights selected findings from brain imaging studies of stressor-evoked cardiovascular reactivity and CVD risk. Converging evidence across these studies complements animal models and patient lesion studies to suggest that a network of cortical, limbic, and brainstem areas for central autonomic and physiological control are important for generating and regulating stressor-evoked cardiovascular reactivity via visceromotor and viscerosensory mechanisms. Emerging evidence further suggests that these brain areas may play a role in stress-related CVD risk, specifically by their involvement in mediating metabolically-dysregulated or extreme stressor-evoked cardiovascular reactions. Contextually, the research reviewed here offers an example of how brain imaging and health neuroscience methods can be integrated to address open and mechanistic questions about the neurophysiological pathways linking psychological stress and physical health.
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Affiliation(s)
- Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA.
| | - Thomas E Kraynak
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - James P Fisher
- School of Sport, Exercise, and Rehabiliation Sciences, University of Birmingham, Birmingham, West Midlands, UK
| | - Peter J Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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25
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Ginty AT, Masters NA, Nelson EB, Kaye KT, Conklin SM. Cardiovascular reactions to psychological stress and abuse history: the role of occurrence, frequency, and type of abuse. ANXIETY STRESS AND COPING 2016; 30:155-162. [PMID: 27425575 DOI: 10.1080/10615806.2016.1210791] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Extreme cardiovascular reactions to psychological stress have been associated with traumatic life experiences. Previous studies have focused on the occurrence or frequency of abuse rather than type of abuse. We examined how occurrence, frequency, and the type of abuse history are related to cardiovascular reactivity (CVR) to acute psychological stress. DESIGN The study consisted of between group and continuous analyses to examine the association between occurrence, type, and frequency of abuse with cardiovascular reactions to acute psychological stress. METHODS Data from 64 participants were collected. Heart rate, systolic blood pressure, and diastolic blood pressure were measured at baseline and during a standard mental arithmetic stress task. RESULTS Individuals who experienced abuse showed diminished CVR to acute psychological stress; this was driven specifically by the history of sexual abuse. Frequency of abuse did not relate to stress reactions. CONCLUSIONS These findings accord with previous work suggesting a relationship between traumatic life experience and hypoarousal in physiological reactivity and extend previous findings by suggesting the relationship may be driven by sexual abuse.
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Affiliation(s)
- Annie T Ginty
- a Department of Psychiatry , University of Pittsburgh , Pittsburgh , PA , USA
| | - Nicole A Masters
- b Neuroscience Program , Allegheny College , Meadville , PA , USA
| | - Eliza B Nelson
- c Schools of Medicine & Psychology and Neuroscience , University of St Andrews , St Andrews , UK
| | - Karen T Kaye
- d Department of Psychology , Brandeis University , Waltham , MA , USA
| | - Sarah M Conklin
- b Neuroscience Program , Allegheny College , Meadville , PA , USA.,e Department of Psychology , Allegheny College , Meadville , PA , USA.,f Global Health Studies Program , Allegheny College , Meadville , PA , USA
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26
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Tyagi A, Cohen M, Reece J, Telles S, Jones L. Heart Rate Variability, Flow, Mood and Mental Stress During Yoga Practices in Yoga Practitioners, Non-yoga Practitioners and People with Metabolic Syndrome. Appl Psychophysiol Biofeedback 2016; 41:381-393. [DOI: 10.1007/s10484-016-9340-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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27
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Ginty AT, Brindle RC, Carroll D. Cardiac stress reactions and perseverance: Diminished reactivity is associated with study non-completion. Biol Psychol 2015; 109:200-5. [DOI: 10.1016/j.biopsycho.2015.06.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 05/28/2015] [Accepted: 06/01/2015] [Indexed: 12/30/2022]
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28
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Roemmich JN, Lambiase MJ, Balantekin KN, Feda DM, Dorn J. Stress, behavior, and biology: risk factors for cardiovascular diseases in youth. Exerc Sport Sci Rev 2015; 42:145-52. [PMID: 25061998 DOI: 10.1249/jes.0000000000000027] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Psychological stress reactivity is associated with atherogenesis in youth. The novel hypothesis is that stress promotes atherogenic behaviors, including snacking on energy-dense food and reducing physical activity, and increases adiposity. Stress also increases systolic blood pressure cardiovascular reactivity, which also may be atherogenic. Exercise dampens stress reactivity and may be one mechanism by which it protects against the development of cardiovascular diseases.
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Affiliation(s)
- James N Roemmich
- 1Department of Pediatrics, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY; 2USDA, ARS, Grand Forks Human Nutrition Center, Grand Forks, ND; and 3Departments of Exercise and Nutrition Sciences and Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
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29
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Tyagi A, Cohen M, Reece J, Telles S. An explorative study of metabolic responses to mental stress and yoga practices in yoga practitioners, non-yoga practitioners and individuals with metabolic syndrome. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:445. [PMID: 25398263 PMCID: PMC4247158 DOI: 10.1186/1472-6882-14-445] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 10/14/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Stress places a metabolic burden on homeostasis and is linked to heightened sympathetic activity, increased energy expenditure and pathology. The yogic state is a hypometabolic state that corresponds with mind-body coherence and reduced stress. This study aimed to investigate metabolic responses to stress and different yoga practices in regular yoga practitioners (YP), non-yoga practitioners (NY) and metabolic syndrome patients (MS). METHODS YP (n = 16), NY (n = 15) and MS (n = 15) subjects underwent an experimental protocol that comprised of different 5-minute interventions including mental arithmetic stress test (MAST), alternate nostril breathing (ANB), Kapabhati breathing (KB) and meditation (Med) interspersed with 5 minutes of quiet resting (neutral condition (NC)). During the intervention periods continuous body weight adjusted oxygen consumption (VO2ml/min/kg) was measured using open circuit indirect calorimetry with a canopy hood. RESULTS This is the first study to report oxygen consumption (OC) in yoga practitioners during and after MAST and the first to report both within and between different populations. The results were analysed with SPSS 16 using 3X9 mixed factorial ANOVAs. The single between-subject factor was group (YP, NY and MS), the single within-subject factor was made up of the nine intervention phases (NC1, MAST, NC2, ANB, NC3, KB, NC4, Med, NC5). The results demonstrated that the regular YP group had significantly less OC and greater variability in their OC across all phases compared to the MS group (p = .003) and NY group (p = .01). All groups significantly raised their OC during the mental arithmetic stress, however the MS group had a significantly blunted post-stress recovery whereas the YP group rapidly recovered back to baseline levels with post stress recovery being greater than either the NY group or MS group. CONCLUSIONS Yoga practitioners have greater metabolic variability compared to non-yoga practitioners and metabolic syndrome patients with reduced oxygen requirements during resting conditions and more rapid post-stress recovery. OC in metabolic syndrome patients displays significantly blunted post-stress recovery demonstrating reduced metabolic resilience. Our results support the findings of previous randomised trials that suggest regular yoga practice may mitigate against the effects of metabolic syndrome. CLINICAL TRIAL NUMBER ACTRN12614001075673; Date of Registration: 07/10/2014.
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Affiliation(s)
- Anupama Tyagi
- />RMIT, West Campus, Building 201, Level 4, Bundoora, Vic 3083 Australia
| | - Marc Cohen
- />RMIT, West Campus, Building 201, Level 4, Bundoora, Vic 3083 Australia
- />PO Box 71, Bundoora, Vic 3083 Australia
| | - John Reece
- />PO Box 71, Bundoora, Vic 3083 Australia
| | - Shirley Telles
- />Patanjali Research Foundation, Bahdrabad, Haridwar, Uttrakhand 249402 India
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30
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Enlow MB, King L, Schreier H, Howard JM, Rosenfield D, Ritz T, Wright RJ. Maternal sensitivity and infant autonomic and endocrine stress responses. Early Hum Dev 2014; 90:377-85. [PMID: 24794304 PMCID: PMC4065189 DOI: 10.1016/j.earlhumdev.2014.04.007] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 03/04/2014] [Accepted: 04/04/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Early environmental exposures may help shape the development of the autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis, influencing vulnerability for health problems across the lifespan. Little is known about the role of maternal sensitivity in influencing the development of the ANS in early life. AIMS To examine associations among maternal sensitivity and infant behavioral distress and ANS and HPA axis reactivity to the Repeated Still-Face Paradigm (SFP-R), a dyadic stress task. STUDY DESIGN Observational repeated measures study. SUBJECTS Thirty-five urban, sociodemographically diverse mothers and their 6-month-old infants. OUTCOME MEASURES Changes in infant affective distress, heart rate, respiratory sinus arrhythmia (RSA), and T-wave amplitude (TWA) across episodes of the SFP-R were assessed. A measure of cortisol output (area under the curve) in the hour following cessation of the SFP-R was also obtained. RESULTS Greater maternal insensitivity was associated with greater infant sympathetic activation (TWA) during periods of stress and tended to be associated with greater cortisol output following the SFP-R. There was also evidence for greater affective distress and less parasympathetic activation (RSA) during the SFP-R among infants of predominantly insensitive mothers. CONCLUSIONS Caregiving quality in early life may influence the responsiveness of the sympathetic and parasympathetic branches of the ANS as well as the HPA axis. Consideration of the ANS and HPA axis systems together provides a fuller representation of adaptive versus maladaptive stress responses. The findings highlight the importance of supporting high quality caregiving in the early years of life, which is likely to promote later health.
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Affiliation(s)
- Michelle Bosquet Enlow
- Department of Psychiatry, Boston Children’s Hospital, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Lucy King
- Department of Psychiatry, Boston Children’s Hospital, Boston, MA
| | - Hannah Schreier
- Department of Pediatrics, Kravis Children’s Hospital and the Icahn School of Medicine at Mount Sinai, New York City, NY
| | - Jamie M. Howard
- Anxiety and Mood Disorders Center, Child Mind Institute, New York City, NY
| | - David Rosenfield
- Department of Psychology, Southern Methodist University, Dallas, TX
| | - Thomas Ritz
- Department of Psychology, Southern Methodist University, Dallas, TX
| | - Rosalind J. Wright
- Department of Pediatrics, Kravis Children’s Hospital and the Icahn School of Medicine at Mount Sinai, New York City, NY,Mindich Child Health & Development Institute, Icahn School of Medicine at Mount Sinai, New York City, NY
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Integrative commentary: implications of blunted reactivity. Int J Psychophysiol 2013; 90:95-8. [PMID: 23954516 DOI: 10.1016/j.ijpsycho.2013.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 07/30/2013] [Indexed: 11/21/2022]
Abstract
The previous issue of the International Journal of Psychophysiology was a special issue that collected some of the latest emerging evidence on blunted reactivity and its relationships with a variety of negative health outcomes. This commentary on the special issue briefly reviews each of the contributions and then provides some thoughts on the general themes that run through these papers. The findings from the special issue suggest that both lower and higher than expected cardiovascular and neuroendocrine responses to active psychological challenges may be maladaptive and differentially associated with adverse health sequelae.
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Abstract
Oxygen consumption varies with physical and mental activity as well as pathological conditions. Although there is a strong relationship between yoga and metabolic parameters, the relationship between yoga and oxygen consumption has not yet been formally reviewed. This systematic review attempted to include all studies of yoga that also measured oxygen consumption or metabolic rate as an outcome. A total of 58 studies were located involving between 1 and 104 subjects (average 21). The studies were generally of poor methodological quality and demonstrated great heterogeneity with different experimental designs, yoga practices, time periods, and small sample sizes. Studies report yoga practices to have profound metabolic effects producing both increase and decrease in oxygen consumption, ranging from 383% increase with cobra pose to 40% decrease with meditation. Compared to nonpractitioners, basal oxygen consumption is reported to be up to 15% less in regular yoga practitioners, and regular yoga practice is reported to have a training effect with oxygen consumption during submaximal exercise decreasing by 36% after 3 months. Yoga breathing practices emphasize breathing patterns and retention ratios as well as unilateral nostril breathing, and these factors appear critical in influencing oxygen consumption. A number of studies report extraordinary volitional control over metabolism in advanced yoga practitioners who appear to be able to survive extended periods in airtight pits and to exceed the limits of normal human endurance. More rigorous research with standardized practices is required to determine the mechanisms of yoga’s metabolic effects and the relevance of yoga practices in different clinical populations.
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Affiliation(s)
| | - Marc Cohen
- RMIT University, Bundoora, Victoria, Australia
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Carroll D, Ginty AT, Der G, Hunt K, Benzeval M, Phillips AC. Increased blood pressure reactions to acute mental stress are associated with 16-year cardiovascular disease mortality. Psychophysiology 2012; 49:1444-8. [DOI: 10.1111/j.1469-8986.2012.01463.x] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Accepted: 07/19/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Douglas Carroll
- School of Sport and Exercise Sciences; University of Birmingham; Birmingham; England
| | - Annie T. Ginty
- School of Sport and Exercise Sciences; University of Birmingham; Birmingham; England
| | - Geoff Der
- Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit; University of Glasgow; Glasgow; Scotland
| | - Kate Hunt
- Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit; University of Glasgow; Glasgow; Scotland
| | - Michaela Benzeval
- Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit; University of Glasgow; Glasgow; Scotland
| | - Anna C. Phillips
- School of Sport and Exercise Sciences; University of Birmingham; Birmingham; England
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Lambiase MJ, Dorn J, Chernega NJ, McCarthy TF, Roemmich JN. Excess heart rate and systolic blood pressure during psychological stress in relation to metabolic demand in adolescents. Biol Psychol 2012; 91:42-7. [PMID: 22634388 DOI: 10.1016/j.biopsycho.2012.05.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 03/22/2012] [Accepted: 05/15/2012] [Indexed: 11/17/2022]
Abstract
Cardiovascular responses during exercise are matched to the increased metabolic demand, but this may not be the case during psychological stress. No studies to date have tested this hypothesis in youth. Fifty-four youth, ages 13-16 years completed two visits. Heart rate (HR), systolic blood pressure (SBP), and oxygen (O(2)) consumption were measured during a graded exercise test on one day and during psychological stress reactivity (star tracing, speech) on another day. Predicted HR and SBP values during psychological stress were calculated based on HR-O(2) and SBP-O(2) relationships calculated during graded exercise. At a given O(2) consumption, actual HR was greater (p<0.02) than predicted for all stress tasks. Actual SBP was greater (p<0.001) than predicted for all stress tasks. This was the first study to demonstrate that cardiovascular responses were in excess of what would be expected based on metabolic demand in youth.
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Affiliation(s)
- Maya J Lambiase
- Department of Exercise and Nutrition Sciences, School of Public Health, University at Buffalo, Buffalo, New York 14214, United States.
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35
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Smith TW, Uchino BN, MacKenzie J, Hicks AM, Campo RA, Reblin M, Grewen KM, Amico JA, Light KC. Effects of couple interactions and relationship quality on plasma oxytocin and cardiovascular reactivity: empirical findings and methodological considerations. Int J Psychophysiol 2012; 88:271-81. [PMID: 22543270 DOI: 10.1016/j.ijpsycho.2012.04.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 03/26/2012] [Accepted: 04/18/2012] [Indexed: 11/25/2022]
Abstract
Cardiovascular reactivity is a potential mechanism underlying associations of close relationship quality with cardiovascular disease. Two models describe oxytocin as another mechanism. The "calm and connect" model posits an association between positive relationship experiences and oxytocin levels and responses, whereas the "tend and befriend" model emphasizes the effects of negative relationship experiences in evoking oxytocin release. In this study of 180 younger couples, relationship quality had a small, marginally significant inverse association with plasma oxytocin levels, and neither positive nor negative couple interactions evoked change in plasma oxytocin. Negative couple interactions evoked significant cardiovascular reactivity, especially among women. Hence, in the largest study of these issues to date, there was little support for key tenets of the "calm and connect" model, and only very modest support for the "tend and befriend" model. However, findings were consistent with the view that CVR contributes to the effects of relationship difficulties on health.
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36
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Metabolic and cardiovascular adjustments during psychological stress and carotid artery intima-media thickness in youth. Physiol Behav 2012; 105:1140-7. [DOI: 10.1016/j.physbeh.2011.12.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Revised: 11/23/2011] [Accepted: 12/14/2011] [Indexed: 11/19/2022]
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Blood pressure reactions to acute mental stress and future blood pressure status: data from the 12-year follow-up of the West of Scotland Study. Psychosom Med 2011; 73:737-42. [PMID: 22021460 DOI: 10.1097/psy.0b013e3182359808] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To test the reactivity hypothesis using blood pressure data collected 12 years after baseline. This study examined whether blood pressure reactions to acute mental stress predicted future blood pressure resting levels, as well as the temporal drift in resting blood pressure, and whether the prediction was affected by sex, age, and socioeconomic status. METHODS Resting blood pressure was recorded at an initial baseline and in response to a mental stress task. Twelve years later, resting blood pressure was again assessed. Data were available for 1196 participants (645 women, 551 men), comprising, at the time of stress testing, 439 who were aged 24 years; 503, aged 44; and 254, aged 63. The participants included 531 who were from manual occupational households and 661 from nonmanual occupational households. RESULTS In multivariate linear regression models, adjusting for a number of potential confounders, systolic blood pressure (SBP) reactivity positively predicted future resting SBP, as well as the upward drift in SBP over the 12 years (β = 0.10, p < .001 in both cases). The effect sizes were smaller than those reported from an earlier 5-year follow-up. The analogous associations for diastolic blood pressure reactivity were not statistically significant. In multivariate logistic regression, high SBP reactivity was associated with an increased risk of being hypertensive 12 years later (odds ratio = 1.03, 95% confidence interval = 1.01-1.04, p < .001). CONCLUSIONS The present findings that greater reactivity is associated with higher future resting blood pressure, more upward drift in resting blood pressure, and future hypertension provide support for the reactivity hypothesis.
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Heart rate reactivity is associated with future cognitive ability and cognitive change in a large community sample. Int J Psychophysiol 2011; 82:167-74. [DOI: 10.1016/j.ijpsycho.2011.08.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Revised: 08/05/2011] [Accepted: 08/11/2011] [Indexed: 01/01/2023]
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Johnson MJ, Chahal T, Stinchcombe A, Mullen N, Weaver B, Bédard M. Physiological responses to simulated and on-road driving. Int J Psychophysiol 2011; 81:203-8. [DOI: 10.1016/j.ijpsycho.2011.06.012] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2010] [Revised: 06/16/2011] [Accepted: 06/20/2011] [Indexed: 11/28/2022]
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40
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Allen MT, Bocek CM, Burch AE. Gender differences and the relationships of perceived background stress and psychological distress with cardiovascular responses to laboratory stressors. Int J Psychophysiol 2011; 81:209-17. [DOI: 10.1016/j.ijpsycho.2011.06.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 06/17/2011] [Accepted: 06/20/2011] [Indexed: 11/16/2022]
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41
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A brief commentary on cardiovascular reactivity at a crossroads. Biol Psychol 2011; 86:149-51. [DOI: 10.1016/j.biopsycho.2010.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 07/05/2010] [Accepted: 07/07/2010] [Indexed: 11/21/2022]
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42
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Ginty AT, Phillips AC, Der G, Deary IJ, Carroll D. Cognitive ability and simple reaction time predict cardiac reactivity in the West of Scotland Twenty-07 Study. Psychophysiology 2010; 48:1022-7. [DOI: 10.1111/j.1469-8986.2010.01164.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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43
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Balanos GM, Phillips AC, Frenneaux MP, McIntyre D, Lykidis C, Griffin HS, Carroll D. Metabolically exaggerated cardiac reactions to acute psychological stress: The effects of resting blood pressure status and possible underlying mechanisms. Biol Psychol 2010; 85:104-11. [DOI: 10.1016/j.biopsycho.2010.06.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Revised: 06/01/2010] [Accepted: 06/01/2010] [Indexed: 11/15/2022]
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44
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Schallmayer S, Hughes BM. Impact of oral contraception and neuroticism on cardiovascular stress reactivity across the menstrual cycle. PSYCHOL HEALTH MED 2010; 15:105-15. [DOI: 10.1080/13548500903499391] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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