Motivational orientation mediates the association between depression and cardiovascular reactivity to acute psychological stress

Social participation is associated with a habituated blood pressure response to recurrent stress

Lower cardiovascular reactivity is a proposed marker of motivational dysregulation and is related to a range of adverse behavioural and health outcomes. Social participation is a form of motivated behaviour and represents the frequency in which an individual engages in social activities. Low social participation has recently been linked to lower cardiovascular responses to acute psychological stress. With recent work emphasizing the importance of assessing adaptation of the cardiovascular response to recurrent stress, the aim of the current study is to build on previous work by examining the relationship between social participation and cardiovascular stress response adaptation. This study utilised data from the Pittsburgh Cold Study 3 (PCS 3). Two hundred and thirteen participants (M = 30.13; SD = 10.85) completed a social participation measure and had their systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) monitored across two separate standardized stress testing sessions. The testing sessions consisted of a 20-minute baseline and a 15-minute stress task. Results indicated that higher levels of social participation were associated with greater blood pressure habituation to recurrent stress, extending previous work identifying that social participation was associated with higher cardiovascular responses to stress. The present study identifies that those reporting greater levels of social participation may show enhanced stress tolerance when exposed to recurrent stress.

Type D personality is associated with lower cardiovascular reactivity to stress in women

OBJECTIVE

This study examines if Type D personality is (1) associated with cardiovascular reactivity to acute stress in a healthy sample, and (2) has predictive utility for cardiovascular reactivity above its individual subcomponents (negative affect; NA, social inhibition; SI), as well as anxiety and depression.

DESIGN

Undergraduate students (n = 173) competed a standardised cardiovascular reactivity experimental protocol consisting of resting baseline and stressor phase (mental arithmetic), with systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) monitored throughout.

MAIN OUTCOME MEASURES

The main outcome measures were cardiovascular reactivity to the stressor, which was operationalised as the difference between resting baseline and the stressor phase for SBP, DBP and HR.

RESULTS

The continuous Type D interaction term (NA × SI) significantly predicted lower SBP reactivity to the mental arithmetic stressor amongst women, independent of NA, SI and confounding variables. Moreover, this remained significant after adjustment for anxiety and depressive symptoms. Depression, NA and SI were also significant independent predictors of SBP reactivity amongst women.

CONCLUSION

Type D personality is associated with lower SBP reactivity to acute stress in women, which may be indicative of blunted cardiovascular reactivity. This association was independent of NA, SI, Anxiety and Depression.

Physiological reactivity and habituation to acute psychological stress: The influence of trait extraversion

BACKGROUND AND AIMS

Adaptive physiological responses to stress have been suggested as a potential mechanism facilitating the association between extraversion and positive health outcomes. The present study examined the influence of extraversion on physiological reactivity and habituation to a standardized psychological stress task presented as two separate laboratory sessions approximately 48 days apart.

METHODS

The present study utilized data from the Pittsburgh Cold Study 3. Participants in the study (N = 213, mean age = 30.13, SD = 10.85 years; female = 42.3 %) completed a standardized stress testing protocol twice, at two separate laboratory sessions. The stress protocol consisted of a speech preparation period (5-minutes), a public specking task (5-minutes), and a mental arithmetic task with observation (5-minutes). Trait extraversion was assessed using 10-items from the international personality item pool (IPIP). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and salivary cortisol (SC) were assessed throughout a baseline phase and the stress task phase.

RESULTS

Extraversion was statistically significantly associated with larger DBP and HR reactivity in response to the initial stress exposure, as well as greater habituation of DBP, MAP and HR on repeated stress exposure. No statistically significant associations emerged between extraversion and SBP responses, SC responses or self-reported state affective responses.

CONCLUSION

Extraversion is associated with greater cardiovascular reactivity, as well as pronounced cardiovascular habituation to acute social stress. These findings may indicate an adaptive response pattern amongst highly extraverted individuals and a potential mechanism leading to positive health outcomes.

Disordered eating is associated with blunted blood pressure reactivity and poorer habituation to acute psychological stress

Psychological stress has been shown to influence the development and progression of disordered eating. Psychophysiological studies have reported that individuals with disordered eating behavior exhibit atypical cardiovascular reactions to acute psychological stress. However, prior studies have been limited by small sample sizes and have examined cardiovascular responses to a singular stress exposure. The current study examined the association between disordered eating and cardiovascular reactivity, as well as cardiovascular habituation to acute psychological stress. A mixed-sex sample (N = 450) of undergraduate students were categorized into a disordered eating or non-disordered eating group using a validated disordered eating screening questionnaire and attended a laboratory stress testing session. The testing session included two identical stress-testing protocols, each consisting of a 10-minute baseline and 4-minute stress task. Cardiovascular parameters including heart rate, systolic/diastolic blood pressure and mean arterial pressure (MAP) were recorded throughout the testing session. Post task measures of self-reported stress, as well as positive affect and negative affect (NA) reactivity were used to assess psychological reactions to stress. The disordered eating group exhibited greater increases in NA reactivity in response to both stress exposures. Additionally, in comparison to the control group, those in the disordered eating group exhibited blunted MAP reactivity to the initial stress exposure and less MAP habituation across both stress exposures. These findings indicate that disordered eating is characterized by dysregulated hemodynamic stress responsivity, which may constitute a physiological mechanism leading to poor physical health outcomes.

Early life adversity and cardiovascular responses to repeated stress among adolescents: Moderating role of COMT gene rs4680 polymorphism

BACKGROUND

Early life adversity (ELA) increases the risk of cardiovascular diseases through dysregulation of cardiovascular stress responses manifested by either exaggerated or blunted reactivity. The catechol-O-methyltransferase (COMT) gene rs4680 polymorphism has been identified in gene-environment interaction (G×E) studies to explain individual differences in the effects of ELA on physiological stress responses. However, little is known about whether ELA interacts with COMT gene rs4680 polymorphism to affect cardiovascular responses to repeated stress exposures.

OBJECTIVE

The current study examined the associations between ELA and cardiovascular responses to repeated stress exposures, and the moderating role of COMT rs4680 polymorphism in these associations.

METHODS

The childhood trauma questionnaire (CTQ) was administered to 359 junior school students who underwent a two-successive stress exposures protocol with continuous cardiovascular monitoring [heart rate (HR) and systolic and diastolic blood pressure (SBP, DBP)] across four laboratory phases, and their saliva samples for deoxyribonucleic acid (DNA) genotyping were collected.

RESULTS

ELA was associated with blunted HR reactivity to the first and second stress exposures, blunted SBP reactivity to the first stress exposure, and attenuated SBP habituation to repeated stress exposures. Moreover, COMT rs4680 moderated these associations, such that the associations between ELA and blunted HR, SBP, and DBP reactivity to the first stress and disrupted DBP habituation to repeated stress exposures only existed in GA/AA genotype carriers but not in GG genotype carriers.

CONCLUSIONS

These findings suggest that the A allele of COMT rs4680 is vulnerable to the negative effects of ELA on the developmental dysregulation of stress physiological systems.

Behavioural clusters characteristic of cardiovascular reactivity profiles relate to poorer health outcomes

OBJECTIVES

Blunted cardiovascular reactivity is associated with a distinct behavioural profile of greater exposure to early life adversity, coupled with higher levels of behavioural disengagement and symptoms of depression. The present study sought to extend on this work by investigating if behavioural clusters with distinct patterns of reactivity were related to health and behavioural outcomes at baseline and at a 4-year follow-up.

METHODS

Hierarchical cluster analyses were conducted using longitudinal data drawn from the Midlife Development in the United States (MIDUS 2) Biomarker Project and the MIDUS 3 follow-up 4 years later. During MIDUS, 2 participants (N = 513) underwent a standardized stress testing protocol and had their blood pressure and heart rate monitored throughout. In addition, hierarchical cluster analyses were conducted on responses from measures of early life adversity, behavioural disengagement and depression. Binary logistic regressions were conducted to determine whether cluster membership was related to health and behavioural outcomes which were taken at both time points.

RESULTS

Three behavioural clusters emerged with statistically different blood pressure reactivity patterns. The cluster characterized by greater exposure to early life adversity, higher levels of behavioural disengagement and depressive symptoms, had relatively lower blood pressure reactivity patterns compared with both the exaggerated reactivity cluster and the cluster similar to the sample mean. In fully adjusted models, this cluster was associated with hypertension (p = .050) and depressed affect (p = .033), while Cluster 1 characteristic of an exaggerated blood pressure reactivity profile was associated with depressed affect (p < .001). Cluster membership did not significantly predict future health status.

CONCLUSION

This study extends research on behavioural clusters characteristic of reactivity profiles to demonstrate how they relate to health and behavioural outcomes during MIDUS 2.

State level income inequality affects cardiovascular stress responses: Evidence from the Midlife in the United States (MIDUS) study

RATIONALE

The slow and insidious effects of income inequality on health means that their effects can be difficult to reveal, taking many years to become apparent. These effects can also be experienced differently according to subjective status and ethnicity making the relation between income inequality and health difficult to understand. Cardiovascular reactions to acute stress are indicative of future health outcomes.

OBJECTIVE

To examine whether short to medium term income inequality affected cardiovascular responses to acute stress whilst accounting for ethnic groups and subjective status.

METHOD

Participants state of residence was available for 1155 people who participated in the MIDUS biomarker data project. This detail was used to merge the relevant US state level inequality data 1, 5, 10 and 15 years prior to the MIDUS biomarker data project which assessed cardiovascular responses to acute stress.

RESULTS

Our analysis demonstrated an association between inequality 5, 10 and 15 year prior and cardiovascular reactions to acute stress. Subjective community status and Black and minority ethnic group membership interacted to affect the association between inequality and cardiovascular reactions.

CONCLUSIONS

In states where income inequality was high, less healthy cardiovascular responses were evident. However lower subjective community status and Black and Ethnic minority group members interacted with income inequality such that their impact was variable contingent on state level inequality. These findings extend the literature on income inequality and health and particularly highlights a psychophysiology pathway linking income inequality and health.

Cluster analysis reveals distinct patterns of childhood adversity, behavioral disengagement, and depression that predict blunted heart rate reactivity to acute psychological stress

BACKGROUND

There is considerable evidence documenting associations between early life adversity, behavioral disengagement, and depression with blunted cardiovascular reactivity to acute psychological stress. However, while often examined as independent predictors, it is also likely that a combination of these factors uniquely relate to cardiovascular reactivity.

PURPOSE

The present study employed multivariate cluster analysis to examine if distinct combinations of these outcomes relate to cardiovascular stress reactivity.

METHODS

Participants (N = 467) were predominantly female (60.6%) with a mean age of 19.30 years (SD = 0.82). Measures of early life adversity, behavioral disengagement, and depression were completed; in addition, participants had their blood pressure and heart rate monitored throughout a standardized stress testing session. Cardiovascular reactivity was calculated as the difference between mean stress and mean baseline cardiovascular values.

RESULTS

Analyses revealed two clusters with distinct patterns of exposure to early life adversity, levels of behavioral disengagement and depression, uniquely related to cardiovascular reactivity. In unadjusted models, Cluster 1 that was characterized by greater exposure to early life adversity, higher levels of behavioral disengagement and depression, was associated with lower systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) reactivity. Cluster 2 was characterized by reactivity values similar to the sample means. In fully adjusted models, Cluster 1 predicted heart rate reactivity to stress.

CONCLUSIONS

The present study identifies a behavioral cluster that is characteristic of a blunted heart rate reactivity profile, significantly extending the research in this area.

The cumulative effect of chronic stress and depressive symptoms affects heart rate in a working population

BACKGROUND

Chronic stress and depressive symptoms have both been linked to increased heart rate (HR) and reduced HR variability. However, up to date, it is not clear whether chronic stress, the mechanisms intrinsic to depression or a combination of both cause these alterations. Subclinical cases may help to answer these questions. In a healthy working population, we aimed to investigate whether the effect of chronic stress on HR circadian rhythm depends on the presence of depressive symptoms and whether chronic stress and depressive symptoms have differential effects on HR reactivity to an acute stressor.

METHODS

1,002 individuals of the SWEET study completed baseline questionnaires, including psychological information, and 5 days of electrocardiogram (ECG) measurements. Complete datasets were available for 516 individuals. In addition, a subset (n = 194) of these participants completed a stress task on a mobile device. Participants were grouped according to their scores for the Depression Anxiety Stress Scale (DASS) and Perceived Stress Scale (PSS). We explored the resulting groups for differences in HR circadian rhythm and stress reactivity using linear mixed effect models. Additionally, we explored the effect of stress and depressive symptoms on night-time HR variability [root mean square of successive differences (RMSSD)].

RESULTS

High and extreme stress alone did not alter HR circadian rhythm, apart from a limited increase in basal HR. Yet, if depressive symptoms were present, extreme chronic stress levels did lead to a blunted circadian rhythm and a lower basal HR. Furthermore, blunted stress reactivity was associated with depressive symptoms, but not chronic stress. Night-time RMSSD data was not influenced by chronic stress, depressive symptoms or their interaction.

CONCLUSION

The combination of stress and depressive symptoms, but not chronic stress by itself leads to a blunted HR circadian rhythm. Furthermore, blunted HR reactivity is associated with depressive symptoms and not chronic stress.

Eveningness, depression and cardiovascular reactivity to acute psychological stress: A mediation model

The psychological pathways linking depression to blunted cardiovascular reactivity (CVR) are still being elucidated. The purpose of the present study was to test whether the association between eveningness, a diurnal/sleep-wake preference and CVR would be mediated by depressive symptoms. One hundred and eighty-two healthy young adults completed measures of morningness/eveningness (the Morningness-Eveningness Questionnaire; MEQ-SA), depressive symptoms (Hospital Anxiety and Depression Scale; HADS) and had their blood pressure and heart rate monitored throughout a standardised stress testing protocol. Results indicated that depressive symptoms were negatively associated with systolic blood pressure (SBP) but not diastolic blood pressure (DBP) or heart rate (HR) reactions to the stress task. Eveningness was also negatively associated with both SBP and DBP, but not HR. As such, those who reported increased depressive symptomology, and higher scores on eveningness displayed a more blunted cardiovascular response. Furthermore, the latter relationship was mediated by depressive symptoms such that those reporting higher scores on eveningness also reported increased depressive symptomology and this resulted in blunted CVR for SBP. These findings withstood adjustment for several confounding factors including time of testing. In conclusion, the present findings highlight the importance of considering eveningness when looking at the depression-blunted CVR relationship.