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Fowler N, Mikhail ME, Neale M, Keel PK, Katzman DK, Sisk CL, Burt SA, Klump KL. Between- and within-person effects of stress on emotional eating in women: a longitudinal study over 49 days. Psychol Med 2023; 53:5167-5176. [PMID: 37650340 PMCID: PMC10471857 DOI: 10.1017/s0033291722002185] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/24/2022] [Accepted: 06/24/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Stress is associated with binge eating and emotional eating (EE) cross-sectionally. However, few studies have examined stress longitudinally, limiting understanding of how within-person fluctuations in stress influence EE over time and whether stress is a risk factor or consequence of EE. Additionally, little is known regarding how the biological stress response relates to EE. METHODS We used an intensive, longitudinal design to examine between-person and within-person effects of major life stress, daily stress, and cortisol on EE in a population-based sample of women (N = 477; ages 15-30; M = 21.8; s.d. = 3.0) from the Michigan State University Twin Registry. Participants reported past year major life stress, then provided daily ratings of EE and stress for 49 consecutive days. Hair cortisol concentration (HCC) was collected as a longitudinal biological stress measure. RESULTS Women reported greater EE when they experienced greater mean stress across days (between-person effects) or greater stress relative to their own average on a given day (within-person effects). Daily stress was more strongly associated with EE than major life stress. However, the impact of daily stress on EE was amplified in women with greater past year major life stress. Finally, participants with lower HCC had increased EE. CONCLUSIONS Findings confirm longitudinal associations between stress and EE in women, and highlight the importance of within-person shifts in stress in EE risk. Results also highlight HCC as a novel biological stress measure that is significantly associated with EE and may overcome limitations of prior physiological stress response indicators.
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Affiliation(s)
- Natasha Fowler
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, USA
| | - Megan E. Mikhail
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Michael Neale
- Department of Psychiatry, Human Genetics, and Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Pamela K. Keel
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Debra K. Katzman
- Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Cheryl L. Sisk
- Neuroscience Program, Michigan State University, East Lansing, Michigan, USA
| | - S. Alexandra Burt
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, USA
| | - Kelly L. Klump
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, USA
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Kanes SJ, Dennie L, Perera P. Targeting the Arginine Vasopressin V 1b Receptor System and Stress Response in Depression and Other Neuropsychiatric Disorders. Neuropsychiatr Dis Treat 2023; 19:811-828. [PMID: 37077711 PMCID: PMC10106826 DOI: 10.2147/ndt.s402831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/23/2023] [Indexed: 04/21/2023] Open
Abstract
A healthy stress response is critical for good mental and overall health and promotes neuronal growth and adaptation, but the intricately balanced biological mechanisms that facilitate a stress response can also result in predisposition to disease when that equilibrium is disrupted. The hypothalamic-pituitary-adrenal (HPA) axis neuroendocrine system plays a critical role in the body's response and adaptation to stress, and vasopressinergic regulation of the HPA axis is critical to maintaining system responsiveness during chronic stress. However, exposure to repeated or excessive physical or emotional stress or trauma can shift the body's stress response equilibrium to a "new normal" underpinned by enduring changes in HPA axis function. Exposure to early life stress due to adverse childhood experiences can also lead to lasting neurobiological changes, including in HPA axis function. HPA axis impairment in patients with depression is considered among the most reliable findings in biological psychiatry, and chronic stress has been shown to play a major role in the pathogenesis and onset of depression and other neuropsychiatric disorders. Modulating HPA axis activity, for example via targeted antagonism of the vasopressin V1b receptor, is a promising approach for patients with depression and other neuropsychiatric disorders associated with HPA axis impairment. Despite favorable preclinical indications in animal models, demonstration of clinical efficacy for the treatment of depressive disorders by targeting HPA axis dysfunction has been challenging, possibly due to the heterogeneity and syndromal nature of depressive disorders. Measures of HPA axis function, such as elevated cortisol levels, may be useful biomarkers for identifying patients who may benefit from treatments that modulate HPA axis activity. Utilizing clinical biomarkers to identify subsets of patients with impaired HPA axis function who may benefit is a promising next step in fine-tuning HPA axis activity via targeted antagonism of the V1b receptor.
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Affiliation(s)
- Stephen J Kanes
- EmbarkNeuro, Oakland, CA, USA
- Correspondence: Stephen J Kanes, EmbarkNeuro, Inc, 1111 Broadway, Suite 1300, Oakland, CA, 94607, USA, Tel +1 610 757 7821, Email
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Norden M, Hofmann AG, Meier M, Balzer F, Wolf OT, Böttinger E, Drimalla H. Inducing and Recording Acute Stress Responses on a Large Scale With the Digital Stress Test (DST): Development and Evaluation Study. J Med Internet Res 2022; 24:e32280. [PMID: 35838765 PMCID: PMC9338415 DOI: 10.2196/32280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 11/29/2022] Open
Abstract
Background Valuable insights into the pathophysiology and consequences of acute psychosocial stress have been gained using standardized stress induction experiments. However, most protocols are limited to laboratory settings, are labor-intensive, and cannot be scaled to larger cohorts or transferred to daily life scenarios. Objective We aimed to provide a scalable digital tool that enables the standardized induction and recording of acute stress responses in outside-the-laboratory settings without any experimenter contact. Methods On the basis of well-described stress protocols, we developed the Digital Stress Test (DST) and evaluated its feasibility and stress induction potential in a large web-based study. A total of 284 participants completed either the DST (n=103; 52/103, 50.5% women; mean age 31.34, SD 9.48 years) or an adapted control version (n=181; 96/181, 53% women; mean age 31.51, SD 11.18 years) with their smartphones via a web application. We compared their affective responses using the international Positive and Negative Affect Schedule Short Form before and after stress induction. In addition, we assessed the participants’ stress-related feelings indicated in visual analogue scales before, during, and after the procedure, and further analyzed the implemented stress-inducing elements. Finally, we compared the DST participants’ stress reactivity with the results obtained in a classic stress test paradigm using data previously collected in 4 independent Trier Social Stress Test studies including 122 participants overall. Results Participants in the DST manifested significantly higher perceived stress indexes than the Control-DST participants at all measurements after the baseline (P<.001). Furthermore, the effect size of the increase in DST participants’ negative affect (d=0.427) lay within the range of effect sizes for the increase in negative affect in the previously conducted Trier Social Stress Test experiments (0.281-1.015). Conclusions We present evidence that a digital stress paradigm administered by smartphone can be used for standardized stress induction and multimodal data collection on a large scale. Further development of the DST prototype and a subsequent validation study including physiological markers are outlined.
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Affiliation(s)
- Matthias Norden
- Faculty of Technology, Bielefeld University, Bielefeld, Germany.,Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany.,Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Amin Gerard Hofmann
- Faculty of Technology, Bielefeld University, Bielefeld, Germany.,Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
| | - Martin Meier
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
| | - Felix Balzer
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Erwin Böttinger
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany.,Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
| | - Hanna Drimalla
- Faculty of Technology, Bielefeld University, Bielefeld, Germany.,Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
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Presseller EK, Patarinski AGG, Fan SC, Lampe EW, Juarascio AS. Sensor technology in eating disorders research: A systematic review. Int J Eat Disord 2022; 55:573-624. [PMID: 35489036 DOI: 10.1002/eat.23715] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 04/02/2022] [Accepted: 04/03/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Sensor technologies offer exciting potential to objectively measure psychopathological correlates of eating pathology and eating disorder (ED) research utilizing sensors has rapidly proliferated in the past several years. The aims of the present review are: (1) characterize the types of sensors that have been utilized in ED research, (2) identify the psychopathological factors relevant to EDs that have been assessed using sensors, (3) describe the data supporting the validity and reliability of these sensors, (4) discuss limitations associated with these sensors, and (5) identify gaps that persist within the ED literature with regard to use of sensor technologies. METHOD A systematic search was conducted of PubMed, PsycINFO, Web of Science, ProQuest, and "gray" literature sources. Eligible publications were empirical studies that utilized sensors to measure at least one psychological variable among clinical ED populations. RESULTS Sensors have been utilized with ED samples to measure eating behaviors, physical activity, sleep, autonomic nervous system activity, eyeblink startle response, visual attention, and visual-haptic object integration. The reliability and validity of these sensors varies widely and there are a number of significant gaps that remain in the literature with regard to the types of sensors utilized, context in which sensors have been used, and populations studied. DISCUSSION The existing literature utilizing sensors within ED research largely support the feasibility and acceptability of these tools. Sensors should continue to be utilized within the field, with a specific focus on examining the reliability and validity of these tools within ED samples and increasing the diversity of samples studied. PUBLIC SIGNIFICANCE STATEMENT Sensor technologies, such as those included in modern smartwatches, offer new opportunities to measure factors that may maintain or contribute to symptoms of eating disorders. This article describes the types of sensors that have been used in eating disorders research, challenges that may arise in using these sensors, and discusses new applications of these sensors that may be pursued in future research.
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Affiliation(s)
- Emily K Presseller
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA.,Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Stephanie C Fan
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Elizabeth W Lampe
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA.,Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne S Juarascio
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA.,Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, Pennsylvania, USA
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Chang RS, Cerit H, Hye T, Durham EL, Aizley H, Boukezzi S, Haimovici F, Goldstein JM, Dillon DG, Pizzagalli DA, Holsen LM. Stress-induced alterations in HPA-axis reactivity and mesolimbic reward activation in individuals with emotional eating. Appetite 2022; 168:105707. [PMID: 34562531 PMCID: PMC8671188 DOI: 10.1016/j.appet.2021.105707] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Emotional eating has emerged as a contributing factor to overeating, potentially leading to obesity or disordered eating behaviors. However, the underlying biological mechanisms related to emotional eating remain unclear. The present study examined emotional, hormonal, and neural alterations elicited by an acute laboratory stressor in individuals with and without emotional eating. METHODS Emotional (n = 13) and non-emotional eaters (n = 15) completed two main study visits, one week apart: one visit included a Stress version and the other a No-stress version of the Maastricht Acute Stress Task (MAST). Immediately pre- and post-MAST, blood was drawn for serum cortisol and participants rated their anxiety level. After the MAST, participants completed a Food Incentive Delay (FID) task during functional magnetic resonance imaging (fMRI), followed by an ad libitum snack period. RESULTS Emotional eaters exhibited elevated anxiety (p = 0.037) and cortisol (p = 0.001) in response to the Stress MAST. There were no changes in anxiety or cortisol among non-emotional eaters in response to the Stress MAST or in either group in response to the No-stress MAST. In response to the Stress MAST, emotional eaters exhibited reduced activation during anticipation of food reward in mesolimbic reward regions (caudate: p = 0.014, nucleus accumbens: p = 0.022, putamen: p = 0.013), compared to non-emotional eaters. Groups did not differ in snack consumption. CONCLUSIONS These data indicate disrupted neuroendocrine and neural responsivity to psychosocial stress amongst otherwise-healthy emotional eaters, who demonstrated hyperactive HPA-axis response coupled with hypoactivation in reward circuitry. Differential responsivity to stress may represent a risk factor in the development of maladaptive eating behaviors.
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Affiliation(s)
- Rose Seoyoung Chang
- Division of Women’s Health, Department of Medicine, 75 Francis St., Boston, Massachusetts, 02115, USA
| | - Hilâl Cerit
- Division of Women’s Health, Department of Medicine, 75 Francis St., Boston, Massachusetts, 02115, USA,Harvard Medical School, 25 Shattuck St., Boston, Massachusetts, 02115, USA
| | - Taryn Hye
- Division of Women’s Health, Department of Medicine, 75 Francis St., Boston, Massachusetts, 02115, USA
| | - E. Leighton Durham
- Division of Women’s Health, Department of Medicine, 75 Francis St., Boston, Massachusetts, 02115, USA
| | - Harlyn Aizley
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA
| | - Sarah Boukezzi
- Division of Women’s Health, Department of Medicine, 75 Francis St., Boston, Massachusetts, 02115, USA,Harvard Medical School, 25 Shattuck St., Boston, Massachusetts, 02115, USA
| | - Florina Haimovici
- Department of Psychiatry, Brigham and Women’s Hospital, 75 Francis St., Boston, Massachusetts, 02115, USA,Harvard Medical School, 25 Shattuck St., Boston, Massachusetts, 02115, USA
| | - Jill M. Goldstein
- Division of Women’s Health, Department of Medicine, 75 Francis St., Boston, Massachusetts, 02115, USA,Harvard Medical School, 25 Shattuck St., Boston, Massachusetts, 02115, USA,Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA,Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA,Innovation Center on Sex Differences in Medicine, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA
| | - Daniel G. Dillon
- Harvard Medical School, 25 Shattuck St., Boston, Massachusetts, 02115, USA,Center for Depression, Anxiety and Stress Research, McLean Hospital, 115 Mill St., Belmont, Massachusetts, 02478, USA
| | - Diego A. Pizzagalli
- Harvard Medical School, 25 Shattuck St., Boston, Massachusetts, 02115, USA,Center for Depression, Anxiety and Stress Research, McLean Hospital, 115 Mill St., Belmont, Massachusetts, 02478, USA,McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, Massachusetts, 02478, USA
| | - Laura M. Holsen
- Division of Women’s Health, Department of Medicine, 75 Francis St., Boston, Massachusetts, 02115, USA,Department of Psychiatry, Brigham and Women’s Hospital, 75 Francis St., Boston, Massachusetts, 02115, USA,Harvard Medical School, 25 Shattuck St., Boston, Massachusetts, 02115, USA,Innovation Center on Sex Differences in Medicine, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA,Corresponding author: Laura Holsen, Ph.D., Division of Women’s Health, 1620 Tremont St., BC-3, Brigham and Women’s Hospital, Boston, MA 02120,
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6
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Monteleone P. Eating Disorders in the Era of the COVID-19 Pandemic: What Have We Learned? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312381. [PMID: 34886107 PMCID: PMC8657195 DOI: 10.3390/ijerph182312381] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 11/23/2021] [Indexed: 01/23/2023]
Affiliation(s)
- Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081 Baronissi, Italy
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7
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Kexel AK, Kluwe-Schiavon B, Visentini M, Soravia LM, Kirschbaum C, Quednow BB. Stability and test-retest reliability of different hormonal stress markers upon exposure to psychosocial stress at a 4-month interval. Psychoneuroendocrinology 2021; 132:105342. [PMID: 34225185 DOI: 10.1016/j.psyneuen.2021.105342] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/21/2021] [Accepted: 06/21/2021] [Indexed: 11/26/2022]
Abstract
The Trier Social Stress Test (TSST) has been shown to reliably induce physiological stress responses in the hypothalamus-pituitary-adrenal (HPA) and in the sympathetic-adrenal-medullary (SAM) axis in cross-sectional studies. However, it was also reported that repeated exposure to the TSST might be associated with habituation, mainly of the HPA axis responsivity. Thus, in all longitudinal stress studies involving repeated TSST administration, potential habituation of the HPA axis response complicates the interpretation of results. The goal of the present study was therefore to assess stability and test-retest reliability of a number of different endocrinological stress markers as well as subjective stress responses after two exposures to the TSST four months apart. We assessed salivary and plasma cortisol profiles, plasma ACTH and noradrenaline profiles, as well as subjective stress ratings in healthy volunteers before, during, and after the TSST at six time-points both at test-day 1 (TSST_1, n = 42) and test-day 2 (TSST_2, n = 34) 4-months later. Half of the participants received the TSST in the early, the other half in the late afternoon. Discontinuous growth models were applied to model three phases of the stress response (preTSST, reactivity, recovery) for each marker. Subsequently, the stability of these phases was analyzed. Stability and test-retest reliability of standard physiological stress markers such as Area-under-the-Curve (AUCG, AUCI), Absolute Peak Change, and Relative Peak Change (RPC) were analyzed as well. We did not observe strong test-retest effects in any of the endocrinological measures. In contrast, test-retest effects in subjective stress were characterized by a faster drop directly after the second TSST, whereas the initial increase before the test period was the same for both test-days. Regarding test-retest-reliability, AUCG was the most reliable measure across all endocrinological and subjective stress markers (range: r = .606 to .858), while AUCI and RPC (range: r = - .146 to .548) were least reliable. A 4-month interval is a sufficient time interval between two repeated TSST exposures to largely reinstate the physiological stress response, which was also true for the initial psychological stress response. Thus, the TSST is well applicable in longitudinal studies.
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Affiliation(s)
- Ann-Kathrin Kexel
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
| | - Bruno Kluwe-Schiavon
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Monika Visentini
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Leila M Soravia
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Clemens Kirschbaum
- Department of Biopsychology, Technical University Dresden, Zellescher Weg 19, 01069 Dresden, Germany
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland.
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8
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Schmalbach I, Herhaus B, Pässler S, Runst S, Berth H, Wolff S, Schmalbach B, Petrowski K. Autonomic Nervous System Response to Psychosocial Stress in Anorexia Nervosa: A Cross-Sectional and Controlled Study. Front Psychol 2021; 12:649848. [PMID: 33815232 PMCID: PMC8011538 DOI: 10.3389/fpsyg.2021.649848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/11/2021] [Indexed: 11/13/2022] Open
Abstract
To foster understanding in the psychopathology of patients with anorexia nervosa (PAN) at the psychological and physiological level, standardized experimental studies on reliable biomarkers are needed, especially due to the lack of disorder-specific samples. To this end, the autonomic nervous system (ANS) response to a psychosocial stressor was investigated in n = 19 PAN (BMI: 18.7 ± 3.3 kg/m2), age, and gender-matched to n = 19 healthy controls (HC; BMI: 24.23 ± 3.0 kg/m2). For this purpose, heart rate (HR) and heart rate variability (HRV) parameters were assessed in a cross-sectional study design under two experimental conditions: (1) rest and (2) stress (Trier Social Stress Test). In addition, psychological indicators of stress were assessed. An 2 × 2 × 8 ANOVA demonstrated similar HR and HRV patterns (except LF-HRV) between PAN and HC at rest. Under stress, PAN (vs. HC) demonstrated a blunted HR [condition*time*group: F(2.91, 104.98) = 9.326, p = 0.000, η2 = 0.206] and an attenuated HRV response (reduced SNS/PNS reactivity). Significant effects of stress appraisal (SA) and BMI on HRV-reactivity were revealed. SA on SDNN = Condition*time*SA = F(4.12, 140.15) = 2.676, p = 0.033, η2 = 0.073. BMI on LF/HF-Ratio = Condition*time*BMI = F(3.53, 60.16) = 3.339, p = 0.019, η2 = 0.164. Psychological indices suggested higher levels of chronic and appraised stress in PAN relative to HC. Additional analyses demonstrated that ED-symptoms are highly correlated with the latter constructs, as well as with psychological burden, but not with weight. Further, it was shown that abnormalities in reactivity persisted despite normalized ANS activity. Overall, we suggested that besides weight recovery, improvement in stress appraisal could be beneficial for cardiac health. In this light, a combination of therapy (e.g., development and activation of coping skills, cognitive reappraisal) and biofeedback training may improve treatment outcomes and regulate stress reactivity.
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Affiliation(s)
- Ileana Schmalbach
- Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany.,Division of Psychological and Social Medicine and Developmental Neurosciences, Research Group Applied Medical Psychology and Medical Sociology, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Benedict Herhaus
- Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany
| | - Sebastian Pässler
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Sarah Runst
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Hendrik Berth
- Division of Psychological and Social Medicine and Developmental Neurosciences, Research Group Applied Medical Psychology and Medical Sociology, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Silvia Wolff
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Bjarne Schmalbach
- Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany
| | - Katja Petrowski
- Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany.,Abteilung für Innere Medizin III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
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9
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Peters EMJ, Schedlowski M, Watzl C, Gimsa U. [Can Stress Interact with SARS-CoV-2? A Narrative Review with a Focus on Stress-Reducing Interventions that may Improve Defence against COVID-19]. Psychother Psychosom Med Psychol 2021; 71:61-71. [PMID: 33440452 DOI: 10.1055/a-1322-3205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The COVID-19 pandemic is on the rise and causes many concerns and fears in the population as well as among medical care givers. This raises the question as to how psychosocial stress associated with the pandemic can be managed, and also if certain forms of stress can contribute to an increase in infections and critical illnesses. METHODS Against the background of the current state of research on stress and the immune response, we provide a narrative review of studies addressing the question as to how stress can influence the immune defence against viral diseases. RESULTS Excessive stress can compromise the barrier function of the airways and alter neuroendocrine control of immune function, which can create a virus-permissive immune response. DISCUSSION Because certain forms of stress can play a role in the successful immune defence against viral respiratory disease, it is important to identify people with high psychosocial stress and to help them manage their stress. Conclusion Psychosocial measures that contribute to improved stress management may have a positive effect on the immune response against viral respiratory infections.
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Affiliation(s)
- Eva Milena Johanne Peters
- Klinik für Psychosomatik und Psychotherapie, Psychoneuroimmunologie Labor, Justus-Liebig Universität Gießen, Deutschland.,Medizinische Klinik mit Schwerpunkt Psychosomatik und Psychotherapie, CharitéCentrum 12 (CC12) für Innere Medizin und Dermatologie, Berlin, Deutschland
| | - Manfred Schedlowski
- Institut für Medizinische Psychologie und Verhaltensimmunbiologie, Universitätsklinik Essen, Deutschland.,Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Carsten Watzl
- Fachbereich Immunologie, Leibniz-Institut für Arbeitsforschung an der TU Dortmund, Deutschland
| | - Ulrike Gimsa
- Institut für Verhaltensphysiologie, Leibniz-Institut für Nutztierbiologie, Dummerstorf, Deutschland
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10
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Role of Neuroendocrine, Immune, and Autonomic Nervous System in Anorexia Nervosa-Linked Cardiovascular Diseases. Int J Mol Sci 2020; 21:ijms21197302. [PMID: 33023273 PMCID: PMC7582625 DOI: 10.3390/ijms21197302] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 12/19/2022] Open
Abstract
Anorexia nervosa represents a severe mental disorder associated with food avoidance and malnutrition. In patients suffering from anorexia nervosa, cardiovascular complications are the main reason leading to morbidity and mortality. However, the origin and pathological mechanisms leading to higher cardiovascular risk in anorexia nervosa are still unclear. In this aspect, the issue of exact pathological mechanisms as well as sensitive biomarkers for detection of anorexia nervosa-linked cardiovascular risk are discussed. Therefore, this review synthesised recent evidence of dysfunction in multiple neuroendocrine axes and alterations in the immune system that may represent anorexia nervosa-linked pathological mechanisms contributing to complex cardiovascular dysregulation. Further, this review is focused on identification of non-invasive biomarkers for the assessment of increased cardiovascular risk in anorexia nervosa that can be linked to a clinical application. Complex non-invasive assessment of cardiovascular autonomic regulation—cardiac vagal control (heart rate variability), sympathetic vascular activity (blood pressure variability), and cardiovascular reflex control (baroreflex sensitivity)—could represent a promising tool for early diagnosis, personalized therapy, and monitoring of therapeutic interventions in anorexia nervosa particularly at a vulnerable adolescent age.
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