1
|
Dell’Acqua C, Mura F, Messerotti Benvenuti S, Patron E, Palomba D. Reduced heart rate variability and expressive suppression interact to prospectively predict COVID-19 pandemic-related post-traumatic stress symptoms. Sci Rep 2022; 12:21311. [PMID: 36494439 PMCID: PMC9734110 DOI: 10.1038/s41598-022-25915-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
The COVID-19 pandemic is a unique period of stress that, in some cases, led to post-traumatic stress symptoms (PTSSs). Emotion regulation strategies are known to modulate the emotional response to stressful events. Expressive suppression (ES) is a maladaptive strategy related to the exacerbation of the physiological stress response. Heart rate variability (HRV), an index of cardiac autonomic balance strictly related to ES, was also shown to predict PTSSs. This was the first study to investigate whether the pre-pandemic ES use and resting-state HRV predicted pandemic-related PTSSs. Before the pandemic, 83 (58 females) university students completed the Emotion Regulation Questionnaire (ERQ), self-report measures of anxiety and depressive symptoms, and a three-minute resting-state electrocardiogram recording. After 12 months, 61 (45 females) participants completed a self-report measure of pandemic-related PTSSs and repeated the self-report psychological measures. Pre-pandemic anxiety symptoms prospectively predicted greater PTSSs. Moreover, a significant interaction between HRV and ES in predicting PTSSs emerged, whereby those who had higher levels of ES and reduced HRV showed higher PTSSs. These findings suggest that an integrated assessment of HRV and ES might be useful for identifying individuals who are more vulnerable to the development of PTSSs during crises.
Collapse
Affiliation(s)
- Carola Dell’Acqua
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Francesca Mura
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Simone Messerotti Benvenuti
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy ,grid.411474.30000 0004 1760 2630Hospital Psychology Unit, Padua University Hospital, Padua, Italy
| | - Elisabetta Patron
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy
| | - Daniela Palomba
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| |
Collapse
|
2
|
Brown RL, Chen MA, Paoletti J, Dicker EE, Wu-Chung EL, LeRoy AS, Majd M, Suchting R, Thayer JF, Fagundes CP. Emotion Regulation, Parasympathetic Function, and Psychological Well-Being. Front Psychol 2022; 13:879166. [PMID: 35992409 PMCID: PMC9381823 DOI: 10.3389/fpsyg.2022.879166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
The negative emotions generated following stressful life events can increase one’s risk of depressive symptoms and promote higher levels of perceived stress. The process model of emotion regulation can help distinguish between adaptive and maladaptive emotion regulation strategies to determine who may be at the greatest risk of worse psychological health across the lifespan. Heart rate variability (HRV) may affect these relationships as it indexes aspects of self-regulation, including emotion and behavioral regulation, that enable an individual to dynamically adapt to the changing demands of both internal and external environments. In this study, we expected individual differences in resting vagally mediated HRV to moderate the influence of emotion regulatory strategies among our sample of 267 adults. We found support for the hypothesis that higher vagally mediated HRV buffers against the typical adverse effects of expressive suppression when evaluating depressive symptoms and found weak support when considering perceived stress. There was no evidence for an interaction between cognitive reappraisal and vagally mediated HRV but there was a significant, negative association between cognitive reappraisal and depressive symptoms and perceived stress. Future work may determine if intervening on either emotion regulation strategies or HRV may change these within-persons over time.
Collapse
Affiliation(s)
- Ryan L. Brown
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Michelle A. Chen
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Jensine Paoletti
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Eva E. Dicker
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - E. Lydia Wu-Chung
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Angie S. LeRoy
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Marzieh Majd
- Department of Psychological Sciences, Rice University, Houston, TX, United States
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School at UTHealth, Houston, TX, United States
| | - Julian F. Thayer
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
| | - Christopher P. Fagundes
- Department of Psychological Sciences, Rice University, Houston, TX, United States
- Department of Behavioral Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- *Correspondence: Christopher P. Fagundes,
| |
Collapse
|
3
|
Fitzgerald JM, Timmer-Murillo S, Sheeran C, Begg H, Christoph M, deRoon-Cassini TA, Larson CL. Psychophysiological predictors of change in emotion dysregulation 6 months after traumatic injury. Int J Psychophysiol 2022; 173:29-37. [PMID: 35007667 DOI: 10.1016/j.ijpsycho.2022.01.005] [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: 08/31/2021] [Revised: 12/10/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
Emotion dysregulation that occurs after trauma conveys risk for multiple disorders, including posttraumatic stress disorder, depression, and anxiety. Psychophysiological data (e.g., skin conductance level [SCL]) may be a useful biomarker for quantifying emotion dysregulation given that autonomic nervous system (ANS)-mediated arousal may underlie this feature. In this longitudinal study, we tested whether SCL collected following a single-incident traumatic injury could predict changes in emotion dysregulation over 6 months. Sixty-six adults were recruited from the emergency department; SCL was quantified during an active trauma narrative, in which participants re-told their traumatic event to a research staff member, as well as a neutral narrative for a control condition. Change in SCL (ΔSCL) was calculated using a maximum activation - minimum activation difference score. Multilevel linear modeling was used to test ΔSCL as a predictor of emotion dysregulation using the Emotion Dysregulation Scale (EDS) over time (3 timepoints over 6 months). Results showed that greater ΔSCL - indicative of increasing arousal- during both the trauma (p = 0.037) and neutral (p = 0.013) narratives was a significant predictor of greater emotion dysregulation at each subsequent timepoint. Further, we found a ΔSCL by time interaction, such that less ΔSCL during the neutral narrative predicted decreased emotion dysregulation over time (b = -1.26, SE = 0.43, t = -2.91, p = 0.004). Results validate the use of lab-based assessments of arousal to study emotion dysregulation in trauma survivors. That recovery from emotion dysregulation was predicted by less arousal during a neutral event underscores the importance of clinically targeting response to safety in trauma survivors.
Collapse
Affiliation(s)
| | - Sydney Timmer-Murillo
- Medical College of Wisconsin, Department of Surgery, Division of Trauma & Acute Care Surgery, Milwaukee, WI, USA
| | - Claire Sheeran
- Marquette University, Department of Psychology, Milwaukee, WI, USA
| | - Hailey Begg
- Marquette University, Department of Psychology, Milwaukee, WI, USA
| | - Morgan Christoph
- Marquette University, Department of Psychology, Milwaukee, WI, USA
| | - Terri A deRoon-Cassini
- Medical College of Wisconsin, Department of Surgery, Division of Trauma & Acute Care Surgery, Milwaukee, WI, USA
| | - Christine L Larson
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| |
Collapse
|
4
|
Kocsel N, Köteles F, Galambos A, Kökönyei G. The interplay of self-critical rumination and resting heart rate variability on subjective well-being and somatic symptom distress: A prospective study. J Psychosom Res 2021; 152:110676. [PMID: 34823115 DOI: 10.1016/j.jpsychores.2021.110676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 10/25/2021] [Accepted: 11/11/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this prospective study was to investigate the association of self-critical rumination, autonomic function (indexed by a time domain metric of resting heart rate variability-RMSSD), subjective well-being and somatic symptom distress. METHOD 84 healthy participants (73 females; mean age = 23.56, SD = 3.35 years) completed the Somatic Symptom Severity Scale of the Patient Health Questionnaire and Mental Health Continuum Short Form at two timepoints (at baseline and six months later). Resting heart rate variability (HRV) was assessed at baseline, along with content specific rumination using the Self-Critical Rumination Scale. Four moderation analyses were performed to test these associations. RESULTS The interaction between resting HRV and self-critical rumination significantly explained somatic symptom distress at baseline. For those participants who had high resting HRV, somatic symptom distress was basically independent from the level of self-critical rumination. At the same time, lower resting HRV was associated with higher somatic symptom distress, especially in the presence of more ruminative thoughts. Prospectively, however, the interaction between rumination and resting HRV was not a significant predictor of somatic symptom distress. The association between resting HRV and self-critical rumination did not explain the variance on subjective well-being, but subjective well-being was negatively related to self-critical rumination. CONCLUSION Our findings potentially indicate that self-critical rumination could have a long-term negative impact on psychological functioning, even in a non-clinical sample, and highlight that a lower level of parasympathetic activation, assessed with RMSSD, might be an important factor in the relationship of self-critical rumination and somatic symptom distress.
Collapse
Affiliation(s)
- Natália Kocsel
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Ferenc Köteles
- Institution of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Attila Galambos
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Gyöngyi Kökönyei
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; SE-NAP2 Genetic Brain Imaging Migraine Research Group, Semmelweis University, Budapest, Hungary; Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary.
| |
Collapse
|
5
|
de Vries H, Kamphuis W, Oldenhuis H, van der Schans C, Sanderman R. Moderation of the Stressor-Strain Process in Interns by Heart Rate Variability Measured with a Wearable and Smartphone App: a Within-Subject Design Using Continuous Monitoring. JMIR Cardio 2021; 5:e28731. [PMID: 34319877 PMCID: PMC8524333 DOI: 10.2196/28731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/14/2021] [Accepted: 07/27/2021] [Indexed: 12/11/2022] Open
Abstract
Background The emergence of smartphones and wearable sensor technologies enables easy and unobtrusive monitoring of physiological and psychological data related to an individual’s resilience. Heart rate variability (HRV) is a promising biomarker for resilience based on between-subject population studies, but observational studies that apply a within-subject design and use wearable sensors in order to observe HRV in a naturalistic real-life context are needed. Objective This study aims to explore whether resting HRV and total sleep time (TST) are indicative and predictive of the within-day accumulation of the negative consequences of stress and mental exhaustion. The tested hypotheses are that demands are positively associated with stress and resting HRV buffers against this association, stress is positively associated with mental exhaustion and resting HRV buffers against this association, stress negatively impacts subsequent-night TST, and previous-evening mental exhaustion negatively impacts resting HRV, while previous-night TST buffers against this association. Methods In total, 26 interns used consumer-available wearables (Fitbit Charge 2 and Polar H7), a consumer-available smartphone app (Elite HRV), and an ecological momentary assessment smartphone app to collect resilience-related data on resting HRV, TST, and perceived demands, stress, and mental exhaustion on a daily basis for 15 weeks. Results Multiple linear regression analysis of within-subject standardized data collected on 2379 unique person-days showed that having a high resting HRV buffered against the positive association between demands and stress (hypothesis 1) and between stress and mental exhaustion (hypothesis 2). Stress did not affect TST (hypothesis 3). Finally, mental exhaustion negatively predicted resting HRV in the subsequent morning but TST did not buffer against this (hypothesis 4). Conclusions To our knowledge, this study provides first evidence that having a low within-subject resting HRV may be both indicative and predictive of the short-term accumulation of the negative effects of stress and mental exhaustion, potentially forming a negative feedback loop. If these findings can be replicated and expanded upon in future studies, they may contribute to the development of automated resilience interventions that monitor daily resting HRV and aim to provide users with an early warning signal when a negative feedback loop forms, to prevent the negative impact of stress on long-term health outcomes.
Collapse
Affiliation(s)
- Herman de Vries
- Professorship Personalized Digital Health, Hanze University of Applied Sciences, Zernikeplein 11, Groningen, NL.,Department of Human Behaviour & Training, TNO, Soesterberg, NL.,Department of Health Psychology, University Medical Center Groningen, Groningen, NL
| | - Wim Kamphuis
- Department of Human Behaviour & Training, TNO, Soesterberg, NL
| | - Hilbrand Oldenhuis
- Professorship Personalized Digital Health, Hanze University of Applied Sciences, Zernikeplein 11, Groningen, NL
| | - Cees van der Schans
- Department of Health Psychology, University Medical Center Groningen, Groningen, NL.,Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, NL.,Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, NL
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, Groningen, NL.,Department of Psychology, Health and Technology, University of Twente, Enschede, NL
| |
Collapse
|