Autonomic Nervous System Arousal Research Articles

81 Test-retest Reliability of the Oral Trail Making Test Administered on the Telephone

Objective:In the aftermath and continuance of the COVID-19 pandemic, the field of neuropsychology has experienced a burgeoning literature base on remote telehealth practices. These practices include both videoconference and telephone modalities. Several studies to date have proposed evidence suggesting that inperson and remote telehealth assessments demonstrate comparable results. One of the major limitations to telehealth practices is the scarcity of measures of processing speed. A widely used measure is the Oral Trail Making Test, which has two trials (A & B). Oral Trails B is often conceptualized as a measure of set-shifting and cognitive flexibility. And validity studies support Oral Trails B having strong test-retest reliability and correlation to its written counterpart. In contrast, there is contention as to whether Oral Trails A can be conceptualized as a measure of basic attention and speed versus simple numerical automaticity. Importantly, to our knowledge, the test-retest reliability of Oral Trails A administered specifically via telephone has never been reported in a healthy sample. The following study presents test-retest reliability for the Oral Trails A and B (in a healthy control group) administered as part of a larger study investigating the effects of deep diaphragmatic breathing on cognitive functioning.Participants and Methods:Eighty healthy young adults with elevated stress levels were recruited from a major metropolitan city at a major university. The subjects had to be between the ages of 18 to 29 and self-reported Perceived Stress Scale score >13. The subjects could not practice any form of meditation, yoga, or breathing exercise regularly. Additionally, they could not have any severe medical or psychiatric disorder, be actively suicidal; have a substance use disorder within the past year, or use of medication with a known negative impact on cognition or autonomic nervous system (ANS) arousal. Participants were randomized to a waitlist control group or an intervention group. Cognitive assessments were administered over the phone to both groups (pre and post-treatment) and self-report measures were completed online due to quarantine restrictions.Results:Among participants in the waitlist control group, the mean difference (MD) between time points on OTMT-A (MD= -0.17, SD= 1.69) was small and not significant (p>0.05). The mean difference for OTMT-B (MD= -13.06, SD=26.99) was large and significant (p=0.01). Bivariate Pearson correlations were computed revealing a significant moderate strength relationship between OTMT-A performance across time points (r=0.6, p<0.001). In contrast, performance on OTMT-B across time points revealed a nonsignificant, weak relationship (r=0.2, p=1.94).Conclusions:These results do not support literature demonstrating strong test-retest reliability for OTMT-B. Furthermore, this is the first study establishing test-retest reliability for the OTMT-A as administered via a novel telephonic modality. Given the novel and non-standardized method of administration, the data should be interpreted with caution. Nonetheless, given the weak relationship in OTMT-B performance and the only moderate relationship of OTMT-A performance across time points, the results suggest that the OTMT may not be highly reliable as administered via a telephonic modality.

79 The Effects of Mobile Based Resonant Frequency Breathing on Cognitive Performance in Healthy Young Adults with Elevated Stress

Objective:Finding effective, innovative, and accessible methods of coping with and mitigating stress has been increasingly relevant in the midst of the COVID-19 pandemic. To do so, it is important to understand the impact of acute stress responses on cognition, behavior, and emotional functioning. The young adult population in particular has been known to show higher levels of stress. Studies have shown that deep breathing interventions are associated with improved affect, decreased stress levels, and improved cognitive functioning. The autonomic nervous system, particularly the functioning of the vagus nerve, has been thought to be a key mechanism in the effect of breathing on stress and mood. Most studies to date investigating the efficacy of breathing practices in stress reduction and mood improvement have lacked appropriate methodology, including adequate control groups, randomization, and cross-sectional designs. This single-blind, randomized, waitlist-controlled study investigated the feasibility of using a mobile application to train in resonance frequency breathing and its efficacy in reducing stress and improving cognitive functioning in a non-clinical sample of young adults with elevated stress.Participants and Methods:80 healthy young adults with elevated stress levels were recruited from the NY/NJ community and the Queens College undergraduate research subject pool. Inclusion criteria: ages 18-29, Perceived Stress Scale score >13. Exclusion criteria: regular (at least 3 times per week) practice of any form of meditation, yoga, or breathing exercise; severe medical or psychiatric disorder; active suicidal ideation; drug or alcohol abuse within the past year; use of medication with a known negative impact on cognition or autonomic nervous system (ANS) arousal. Participants were randomized to a waitlist control group or breathing group. Participants in the breathing group were instructed to complete 10-minute breathing sessions using the free mobile application “The Breathing App” twice a day for five days per week for four weeks. Cognitive assessments were administered over the phone (pre and post-treatment) and self-report measures were completed online due to quarantine restrictions.Results:There were no significant main effects of group across any of the neuropsychological variables, including verbal memory, letter fluency, category fluency, cognitive flexibility, processing speed, basic attention span, and working memory. This indicated that breathing training did not significantly impact neuropsychological performance. Mediation analysis also demonstrated that breathing training did not indirectly lead to improvement in basic attention, processing speed, working memory, set-shifting, verbal fluency, category fluency, or cognitive flexibility, through its effects on stress reduction.Conclusions:These results do not support literature suggesting that breathing at resonance frequency is associated with improved cognitive functioning such as greater cognitive flexibility, improved decision-making, stronger response inhibition, faster processing speed, and increased working memory. Future study designs should consider implementing active control groups (e.g., mindfulness meditation) and differential dosages of the breathing treatment.

The Role of the Autonomic Nervous System in the Mediation of the Resolution of Suicidal Ideation With Electroconvulsive Therapy: A Hypothesis and Review of Heart Rate Variability Over a Course of Electroconvulsive Therapy.

Longitudinal observational studies have shown a meaningful decrease in suicidal thinking and suicidal behavior after receipt of electroconvulsive therapy (ECT). The antisuicide effect of ECT may be related to success in the global relief of the presenting syndrome such as depressive or psychotic illness. However, it is possible that the antisuicide effect is specific to ECT per se, over and above the relief of the clinical syndrome. Electroconvulsive therapy is associated with many observable neurochemical and physiologic effects, and some of these may plausibly be specifically linked to an antisuicide effect. The phenomenon of physiologic hyperarousal has been named as a candidate mechanism driving the risk for suicide. Hyperarousal is associated with decreased neuropsychological executive function responsible for response inhibition and can lead to impulsive action. The level of arousal within the autonomic nervous system (ANS) can be assayed with the pupillary light reflex, electrodermal activity, or with heart rate variability (HRV). This article summarizes the literature on the effects of ECT on HRV 24 to 72 hours after a course of ECT and finds evidence for increases in HRV, which indicates lower levels of arousal in the ANS. This finding suggests that ECT-related reductions in ANS arousal, presumably with corresponding improvements in response inhibition, may be one mechanism whereby ECT reduces risk for suicide.

Sympathetic Vagal Balance and Cognitive Performance in Young Adults during the NIH Cognitive Test

Compromised cognitive function is associated with increased mortality and increased healthcare costs. Autonomic nervous system arousal, as measured by an electrocardiogram (ECG), has received recent attention because of its association with the blood perfusion of brain regions involved with cognitive function. The purposes of this study were to determine whether the ECG HR variation, as measured by the standard deviation of the heart rate N-to-N intervals (SDNN), and sympathetic vagal tone, as estimated by the low-frequency/high-frequency ratio (LF/HF), are increased with cognitive performance during the NIH Cognitive Test (Picture Sequence, Dimensional Change Card Sort, Flanker, and List Sorting). A total of 62 young people without cognitive impairment participated in this study. We discovered that the ECG LF/HF ratio was increased in the top 50% of participants who could: (1) inhibit information and stay attentive to a desired task during the Flanker Test; (U = 329, p = 0.03; R2 = 0.76); and (2) promote cognitive function flexibility during the DCCS Test; (U = 55, p = 0.007; R2 = 0.98). Taken together, these findings support that the arousal level influences performance during a cognitive test.

The Situation Specific Arousal Analyzer: Innovation in the Physiological Assessment of Foreign Language Education Anxiety

As the most studied affective variable within foreign language education, the emotion of anxiety continues to generate significant research interest. Owing to technological developments in wearable research devices, new opportunities have arisen to expand the research methodologies used in the recording and assessment of foreign language education anxiety. This article contends that foreign language education research has over-emphasized the experiential component of emotion while neglecting the behavioural and physiological components. Attention is first given to the emergence of emotion as a significant focal point in foreign language education. The position of anxiety as an affective variable in foreign language education is then documented along with the methodological limitations of experiential measures. The article then highlights technological innovations in physiological data measurement and analysis in the form of the Empatica E4 wristband and the recent development of the Situation Specific Arousal Analyzer (SSAA) application. The article demonstrates how foreign language education anxiety researchers can use the Empatica E4 and SSAA to document autonomic nervous system arousal in real-time communication situations using high-integrity metrics such as Heart Rate Variability (HRV) and Electrodermal Activity (EDA) under a range of tailored conditions. The article ends with a call to foreign language education anxiety researchers to extend their methodological repertoire beyond experiential self-report measures and to consider the opportunities afforded by physiological data capture and analysis technologies.

Electrodermal Activity and Stress Assessment.

Stress, as a kind of emotion, is inevitable in everyday life. In psychosomatic medicine stress represents a powerful link in the pathophysiological chain of disorder. Having evidence about the power of stress on the body, the interest in medicine was how to measure it in appropriate, fast way and with minimal cost. Electrodermal activity seems to be available for this purpose. The galvanic skin response (GSR) is an objective, transient indication of autonomic nervous system arousal in response to a stimulus. It refers to changes in sweat gland activity that are reflective of the intensity of our emotional arousal. In this article we discuss physiological specifics of skin conductance/resistance and how it is measured in practice. The most used application of GSR is in biofeedback methodology. Biofeedback assessment and training exactly uses skin reaction to different stimuli and aims to gain voluntary control over this autonomic response. The aim of this article is to show effectiveness of this method in paediatric practice.

Widening the map of hypo-states: a methodology to modify muscular hypo-response and support regulation of autonomic nervous system arousal

ABSTRACTThe human muscle system participates in psychological defences related to stress and trauma. Methodologies that work with muscles in a hyperresponsive state using relaxation and releasing held back impulses and emotions have been described. What is often missing, and potently more challenging, is hypo response – giving up, taking energy out of the muscle system. Experiences and impulses involved in being stressed or threatened go unnoticed, unfelt, resulting in the inability to access psychomotor skills necessary for resilience. The therapeutic problem becomes, how do we access what we no longer feel? This article will present two case studies to demonstrate a method of Hypo-Response Muscular Dosing. The method works with small slow muscle activation, allowing the psycho-physical system to habituate to more vitality and with that regain access to impulses and emotions, and support regulation of both hyper- and hypo-arousal in the autonomic nervous system.

Eye Contact Is a Two-Way Street: Arousal Is Elicited by the Sending and Receiving of Eye Gaze Information.

Research shows that arousal is significantly enhanced while participants make eye contact with a live person compared to viewing a picture of direct or averted gaze. Recent research has pointed toward the potential for social interaction as a possible driving force behind the arousal enhancement. That is, eye gaze is not only a signal perceived but also a signal sent out in order to communicate with others. This study aimed to test this by having dyads engage in eye contact and averted gaze naturally, while wearing sunglasses, and while blindfolded; such that the gaze signals were clear, degraded, and blocked, respectively. Autonomic nervous system arousal was measured via skin conductance response and level. The results showed that dyads exhibited the highest degree of arousal (increased skin conductance) while making eye contact (send/receive) compared to send-only or receive-only gaze trials; however, this was only the case if eye contact was clear. Once gaze information became degraded (by sunglasses or blindfold), arousal significantly decreased and was no longer modulated by the sending and receiving of gaze. Therefore, the arousal enhancement observed during eye contact is not only caused by receiving gaze signals (the focus of previous research) and should be more accurately attributed to the subtle interplay between sending and receiving gaze signals.

Misophonia and comorbid psychiatric symptoms: a preliminary study of clinical findings

Objective: Misophonia is a neurophysiological disorder, phenotypically characterized by heightened autonomic nervous system arousal which is accompanied by a high magnitude of emotional reactivity to repetitive and pattern-based auditory stimuli. This study identifies the prevalence of psychiatric symptoms in misophonia sufferers, the association between severity of misophonia and psychiatric symptoms, and the association between misophonia severity and gender. Methods: Fifty-two misophonia sufferers, 30 females (mean age = 40.93 ± 15.29) and 22 males (mean age = 51.18 ± 15.91) were recruited in our study and they were diagnosed according the criteria proposed by Schröder et al. The participants were evaluated by the A-MISO-S for the severity of misophonia and the MINI to assess the presence of psychiatric symptoms. Results: The most common comorbid symptoms reported by the misophonia patients were respectively PTSD (N = 8, 15.38%), OCD (N = 6, 11.53%), MDD (N = 5, 9.61%), and anorexia (N = 5, 9.61%). Misophonia severity was associated with the symptoms of MDD, OCD, and PTSD as well as anorexia. There was an indication of a significant difference between men and women in the severity of misophonic symptoms. Conclusion: Our findings highlight the importance of recognizing psychiatric comorbidity among misophonia sufferers. The presence of these varying psychiatric disorders’ features in individuals with misophonia suggests that while misophonia has unique clinical characteristics with an underlying neurophysiological mechanism, may be associated with psychiatric symptoms. Therefore, when assessing individuals with misophonia symptoms, it is important to screen for psychiatric symptoms. This will assist researchers and clinicians to better understand the nature of the symptoms and how they may be interacting and ultimately allocating the most effective therapeutic strategies.

Emotional response to perceived racism and nocturnal heart rate variability in young adult African Americans

BackgroundHeightened autonomic nervous system (ANS) arousal is a well-established contributor to the effect of stress on adverse cardiovascular health outcomes which disproportionately affect African Americans. ANS arousal is normally attenuated during sleep and compromise of this shift is associated with multiple adverse cardiovascular outcomes. Parasympathetic nervous system (PNS) dominance during sleep can be altered by stress. Racism has been recognized to have many negative health consequences in African Americans. Perceived racism has been linked to ANS activity, however, we are not aware of prior research on racism and nocturnal ANS balance. Objective: To examine relationships between perceived racism and nocturnal ANS activity indexed by heart rate variability (HRV) in healthy African American men and women age 18–35. MethodsFifty-four participants completed the Perceived Racism Scale and had 24-hour ambulatory electrocardiogram recordings in their homes. Power spectral analysis was used to derive normalized high frequency (nHF) to index PNS activity which was computed by 5-minute epochs during wake and sleep. ResultsEndorsement of racism and negative emotional reactions during the past year were inversely related to nHF during time in bed. Multiple regression analysis indicated that negative emotional reactions were a significant predictor of nHF during the sleep period F(2,54) = 4.213, p = .020, R2 = 0.135 (adjusted R2 = 0.103). Relationships during wake were not statistically significant. ConclusionFindings suggest that perseverative thoughts triggered by negative emotional reactions to racism influencing nocturnal ANS activity may be a pathway by which perceived racism affects health.Support: 3UL1TR001409-02S1 and R01HL087995 to Dr. Mellman.

Reduced professional efficacy is associated with a blunted salivary alpha-amylase awakening response

The job demands-resources model (JD-R) has shown an ability to predict worker engagement and exhaustion, yet to our knowledge, research has not been conducted that assesses the JD-R model with physiological indicators of chronic stress and burnout. Using the JD-R model, we assessed if occupational stress and burnout were related to dysregulated cortisol and salivary alpha-amylase awakening responses (sAA-AR). Professional apprentice jockeys comprising of males (n = 14) and females (n = 18) provided morning saliva samples and completed self-report measures relating to job demands and resources, burnout, and perceived mental and physical health. Data was collected at two time points coinciding with naturally occurring ‘low’ and ‘high’ stress periods during the racing calendar. The jockeys reported good physical and mental health but had elevated levels of the burnout subtypes cynicism and exhaustion. Regression analyses suggested that those jockeys presenting with reduced professional efficacy in the high stress period produced a ‘flattened’ sAA-AR indicative of reduced autonomic nervous system (ANS) arousal, which has been associated with burnout. Further, decreases in professional efficacy explained the relationship between increased workplace stress and decreased ANS activity in the high stress period. Our findings suggest that assessments of psychological stress or physiology in isolation are not as useful as looking at both in combination, and extend previous findings on the sAA-AR.

MISOPHONIA, EMOTIONAL DYSREGULATION AND AFFECTIVE DISORDERS: A PRELIMINARY STUDY

Background Misophonia is characterized by aversive reactivity to repetitive and pattern based auditory (and sometimes visual) stimuli1. When faced with stimuli, misophonia sufferers demonstrate autonomic nervous system arousal, accompanied by heightened emotional reactivity. Sufferers describe extreme irritation, the desire to get away from the stimuli (or flee), anger, feelings of helplessness, being overwhelmed, and aggressive urge with physiological reactions including hypertonia, diaphoresis and tachycardia2. Some studies have found comorbidity with psychiatric disorders. However, most of these studies used small samples and very few experimental methodologies3. Despite the paucity of empirically based and large sample studies it is important to study the relationship between affective disorders and their symptoms because people with misophonia suffer from a high level of emotional distress. The purpose of this study is to identify possible overlapping characteristics between misophonia and affective disorders based on DSM-5 and ICD-10 diagnoses. Despite the idiopathic nature of the disorder the small but emerging body of literature begins to contribute to a better understanding of its underlying mechanisms, illuminate nosology, and translate into appropriate treatment methods. Objective The current study identifies (a) the possible relationship between Misophonia and affective disorders (b) if there is any difference between the severity of misophonia in male and female patients. Methods and materials 86 misophonic patients (female=54, mean age= 46.28, SD=1.57) with no history of active substance abuse within 6 months, no prior treatment of any kind, who were free of hormonal and psychotropic medication were recruited in our study. We evaluated the diagnosis of misophonia with A-MISO-S and diagnosis of affective disorders with the M.I.N.I International Neuropsychiatric Interview. Out of 86 patients, 36 participants were excluded from the study due to incomplete questionnaires or unwillingness to continue. Results Among N=50 misophonic patients (major depression = 11, melancholic depression= 5, dysthymia= 11, suicidality= 10, manic= 3, panic disorder= 8, agoraphobia= 5, social phobia= 7, obsessive compulsive disorder= 14, post traumatic stress disorder= 15). Misophonia was associated with MDD (U= 76, p= .001), Suicidality (U= 67, p=.001), OCD (U= 115, p= .002) and PTSD (U=142.5, p=.008) as well as the positive correlation between severity of misophonia and MDD (rs= .486, p Conclusion Misophonia is associated with major depression, suicidality, OCD and PTSD. Our findings highlight the importance of recognizing affective comorbidity among misophonic patients. The presence of these varying affective disorders features with misophonia suggests that while Misophonia has unique clinical characteristics that suggest an underlying neurophysiological mechanism, the sufferers are at high risk for affective disorders. Conversely, when assessing patients with affective disorders is important screen for misophonia symptoms. This will assist researchers, clinicians and sufferers to better understand the nature of their symptoms and how they may be interacting. In addition, from this small sample, it appears that women experience more severe misophonic symptoms than men.

Editor's Highlight: Formulation and Toxicology Evaluation of the Intrathecal AYX1 DNA-Decoy in Sprague Dawley Rats.

The longevity of pain after surgery is debilitating and limits the recovery of patients. AYX1 is a double-stranded, unprotected, 23 base-pair oligonucleotide designed to reduce acute post-surgical pain and prevent its chronification with a single intrathecal perioperative dose. AYX1 mimics the DNA sequence normally bound by EGR1 on chromosomes, a transcription factor transiently induced in the dorsal root ganglia-spinal cord network following a noxious input. AYX1 binds to EGR1 and prevents it from launching waves of gene regulation that are necessary to maintain pain over time. A formulation suitable for an intrathecal injection of AYX1 was developed, including a specific ratio of AYX1 and calcium so the ionic homeostasis of the cerebrospinal fluid is maintained and no impact on neuromuscular control is produced upon injection. A GLP toxicology study in naïve Sprague Dawley rats was conducted using 3 dose levels up to the maximum feasible dose. Clinical observations, neurobehavioral observations, clinical pathology and histopathology of the nervous system and peripheral tissues were conducted. An additional nonGLP study was conducted in the spared nerve injury model of chronic neuropathic pain in which EGR1 is induced in the dorsal root ganglia and spinal cord. Similar testing was performed, including a modified Irwin test to assess a potential impact of AYX1 on autonomic nervous system responses, locomotion, activity, arousal, sensorimotor, and neuromuscular function. No AYX1-related adverse events were observed in any of the studies and the no-observed-adverse-effect-level was judged to be the maximum feasible dose.

Misophonia and affective disorders: The relationship and clinical perspective

Misophonia is characterized by aversive reactivity to repetitive and pattern based auditory stimuli [1]. Misophonic sufferers demonstrate autonomic nervous system arousal, accompanied by heightened emotional distress. Sufferers describe extreme irritation, anger, and aggressive urge with physiological reactions including hypertonia, diaphoresis and tachycardia [2]. Some studies have found comorbidity with psychiatric disorders. However, most of these studies used small samples and few experimental methodologies [3]. This study identifies the possible relationship between misophonia and affective disorders, and any difference between the severity of misophonia in male and female patients. Fifty misophonic patients (female = 25, mean age = 46.28) were evaluated with Amsterdam Misophonia Scale (A-MISO-S) for the diagnosis of misophonia and with the M.I.N.I International Neuropsychiatric Interview for the diagnosis of affective disorders. Among n = 50 misophonic patients, we found major depression (MDD) = 11, melancholic depression = 5, dysthymia = 11, suicidality = 10, manic = 3, panic disorder = 8, agoraphobia = , social phobia = , obsessive compulsive disorder (OCD) = 14, post-traumatic stress disorder (PTSD) = 15. Misophonia was associated with MDD (U = 76, P = .001), suicidality (U = 67, P = .001), OCD (U = 115, P = .002) and PTSD (U = 142.5, P = .008). There was an indication of a significant difference between men and women in severity of misophonia (U = 160.5, P = .002). The presence of these varying affective disorders suggests that the sufferers are at high risk for affective disorders. Investigation of the co-morbidity will assist researchers to better understand the nature of the symptoms and how they may be interacting.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Emotions in a repeated Cournot duopoly game: A psychophysiological experiment.

The reason why cooperation occurs in repeated games has remained a puzzle. Earlier literature has maintained that reciprocal behavior that gives rise to cooperation can be entirely self-regarding. However, experimental evidence shows that reciprocal behavior is other-regarding in many one-shot games. This other-regarding behavior is believed to have an emotional foundation. We hypothesized that emotions play a role in reciprocal behavior in repeated games as well. We tested this hypothesis by measuring the psychophysiological correlates of emotions from pairs of subjects as they played a repeated Cournot duopoly game. The players, who were in different rooms and remained anonymous to each other, made adjustment decisions to their production quantities that determined their payoffs in each round. Autonomic nervous system arousal was activated when the payoffs of both players decreased in a round, whereas positive affect was expressed when the payoffs of both players increased in a round. The disgust expression was related to a player's own one-sided increase in the payoff. Anger was expressed occasionally but less frequently when the outcome was the player's ideal outcome. An upwards adjustment of the production quantity was observed when the other player did not cooperate. This had the effect of decreasing the payoffs of both players and this was also related to an increase in the level of arousal. Our results provide evidence on how emotions are present in reciprocal behavior in a repeated social dilemma game. The results challenge recent behavioral research that advocates self-regarded motivations of cooperation in repeated games.

The impact of posttraumatic stress disorder versus resilience on nocturnal autonomic nervous system activity as functions of sleep stage and time of sleep

Posttraumatic stress disorder (PTSD) has been associated with sleep disturbances including alterations in sleep stages and recently, elevated nocturnal autonomic nervous system (ANS) arousal (i.e., dominance of the sympathetic nervous system over the parasympathetic nervous system). Data suggest that sleep contributes to the regulation of ANS activity. In our previous ambulatory heart rate variability (HRV) monitoring study, strong relationships between sleep and nocturnal ANS activity in resilient participants (i.e., individuals who had never had PTSD despite exposure to high-impact trauma) were not seen with PTSD. In this study, we examined the impact of PTSD vs. resilience on ANS activity as a function of sleep stage and time of sleep. Participants (age 18–35) with current PTSD (n=38) and resilience (n=33) completed two overnight polysomnography recordings in a lab setting. The second night electrocardiogram was analyzed for frequency domain HRV parameters and heart rate within rapid-eye-movement (REM) and non-REM (NREM) sleep periods. Results indicated that ANS arousal indexed by HRV was greater during REM compared with NREM sleep and that the REM–NREM difference was greater in the PTSD than in the resilient participants. This effect of PTSD was reduced to non-significance when analyses controlled for REM sleep percentage, which was lower with PTSD. Exploratory analyses revealed that the REM–NREM difference in HRV was correlated with REM sleep percentage in resilient participants, but not with PTSD. In contrast with our data from home settings, the present study did not find increased overall nocturnal ANS arousal with PTSD. Analyses did reveal higher heart rate during initial NREM sleep with more rapid decline over the course of NREM sleep with PTSD compared with resilience. Findings suggest that elevated ANS arousal indexed by heart rate with PTSD is specific to the early part of sleep and possible impairment in regulating ANS activity with PTSD related to REM sleep.

Hypothalamic pituitary adrenal activity and autonomic nervous system arousal predict developmental trajectories of children's comorbid behavior problems.

The combined effects of hypothalamic-pituitary-adrenal (HPA) axis activity and autonomic nervous system (ANS) arousal were examined on developmental trajectories of children's comorbid internalizing and externalizing problems. Participants were 394 urban dwelling, primarily African American, youth (50% male, age 11-12 years). Parent-reported child behavior problems were obtained initially, 3, 6, and 12 months later. Saliva samples (collected at the initial assessment) were assayed for cortisol (HPA) and alpha-amylase (ANS). Cross-domain latent class growth analysis identified a stable comorbid trajectory and four other distinct short-term developmental trajectories of internalizing and externalizing behavior problems. ANS arousal was negatively associated with the probability of stable comorbidity, but only among youth who also had high levels of HPA axis activity. Findings underscore the predictive value of the interaction of HPA axis activity and ANS arousal in differentiating children with stable comorbidity and have important implications for etiological theories and treatment outcome research.

Venlafaxine versus applied relaxation for generalized anxiety disorder: a randomized controlled study on clinical and electrophysiological outcomes.

Some components of generalized anxiety disorder, such as physical symptoms, are thought to reflect autonomic nervous system arousal. This study primarily assessed the relationships between psychophysiological and clinical measures using venlafaxine extended release or applied relaxation, and secondarily, the impact of combination treatment in patients not remitting after 8 weeks. Fifty-eight patients were randomly assigned to 8 weeks of treatment with either venlafaxine or applied relaxation (Phase I). Non-remitted patients received combination treatment for an additional 8 weeks (Phase II). Assessments included the Hamilton Anxiety Scale (HAM-A), Beck Depression Inventory, Penn State Worry Questionnaire and the Stroop Color-Word Task coupled with electrophysiological measures (skin conductance and frontalis electromyography (EMG)). In Phase 1, a time effect was found for the clinical and skin conductance measures. Thirteen patients from each group were in remission. In Phase 2, seven additional patients remitted. Baseline psychophysiological measures were not associated with baseline clinical variables or with clinical outcomes. Independently of treatment allocation, a reduction in frontal EMG values at week 4 was significantly associated with a decrease in HAM-A scores at week 8. At week 4, responders from the applied relaxation group had lower electrophysiological activity than the venlafaxine group. Baseline psychophysiological measures were not linked with clinical measures at study inclusion or with treatment response. Frontal EMG response at week 4 is a possible predictor of treatment response. Treatment combination enhances treatment response after initial failure.

Nocturnal autonomic balance and sleep in PTSD and resilience.

Posttraumatic stress disorder (PTSD) has been associated with heightened nocturnal autonomic nervous system (ANS) arousal and sleep disturbances. It has been suggested that relationships between sleep and nocturnal ANS activity are influenced by insomnia; however, investigation of this relationship has been limited in PTSD. This study examined nocturnal ANS activity and its relationship to sleep in PTSD and resilience. Physically healthy young adult African Americans with current PTSD (n = 20) or who had never had PTSD despite exposure to a high-impact traumatic event (resilient, n = 18) were monitored with ambulatory electrocardiograms and actigraphy for 24-hr periods. Frequency-domain heart-rate variability measures, that is, low-frequency to high-frequency ratios (LF/HF), which index sympathetic nervous system activity, and normalized HF (nHF), which indexes parasympathetic nervous system activity were examined. Normalized HF during the time-in-bed period was lower for those with PTSD than those with resilience (p = .041). Total sleep time was strongly correlated with time-in-bed LF/HF (r = -.72) and nHF (r = .75) in the resilient group, but these were not correlated in the PTSD group. The results suggest elevated nocturnal ANS arousal and dissociation between ANS activity and total sleep time in PTSD.

Harsh discipline and behavior problems: The moderating effects of cortisol and alpha-amylase

Numerous studies link harsh discipline to adjustment problems in youth, yet not all individuals exposed to harsh discipline develop behavior problems. Contemporary theory suggests that this relationship could be moderated by individual differences in environmentally sensitive biological systems. This study investigated whether the interaction between hypothalamic-pituitary-adrenal (HPA) activity and autonomic nervous system (ANS) arousal moderated the link between harsh discipline and behavior problems. Three saliva samples were collected on a single day from 425 inner city youth (50% male, age 11–12 years, 80% African American) and were later assayed for cortisol (HPA) and alpha-amylase (ANS). Problem behavior was assessed by self- and parent-report using the Child Behavior Checklist. Youth also reported the level of harsh discipline that they experienced. Harsh discipline was positively associated with externalizing and internalizing problems only when there were asymmetrical profiles of HPA activity and ANS arousal. This pattern was evident for boys but not girls. Findings are discussed in relation to prevailing theories suggesting that biological susceptibility translates adversity into risk for behavior problems.