Mental Stress Task Research Articles

Plasma renin responses to mental stress and carotid intima–media thickness in black Africans: the SABPA study

The renin-angiotensin-aldosterone system can be activated by sympathetic nervous input and is thought to have an important role in the prevalence of hypertension and cardiovascular risk in black Africans. We examined (1) the association between plasma renin responses to mental stress and a marker of sub-clinical atherosclerosis; and (2) associations between resting renin and 24-h ambulatory blood pressure. Participants were 143 urbanized black African men and women (43.1 ± 7.7 years) drawn from a study of Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA). After an overnight fast, participants completed the Stroop mental stress task. Blood samples were drawn during baseline and 10 min after the task to assess the concentration of active renin in plasma. Blood pressure assessments included continuous Finometer measures during the stress testing and 24-h ambulatory monitoring. Carotid intima-media thickness (CIMT) was measured using high-resolution ultrasound. Approximately 50% of the sample responded to the task with an increase in renin concentration. Multiple linear regression analysis revealed an association between the renin stress response and CIMT (β = 0.024, 95% confidence interval, 0.004-0.043), after adjustment for conventional risk factors, blood pressure stress responses and basal levels of renin activity (R(2) for model = 0.37). In addition, resting renin was inversely associated with ambulatory blood pressure. In summary, heightened release of renin during a laboratory mental stressor was associated with a marker of sub-clinical atherosclerosis; thus, it may be a potential mechanism in explaining the increased burden of cardiovascular disease in urbanized black Africans.

Cardiovascular stress reactivity and recovery in bulimia nervosa and binge eating disorder

Objective Stress plays a role in the pathology of bulimia nervosa and binge eating disorders, but it is unclear whether they involve similar disturbances of biological stress responses. Patients and methods We recruited 25 patients with binge eating behavior, 12 with bulimia nervosa (BN) and 13 with binge eating disorder (BED), and compared them with 13 obese non-binge eaters (NBED). We measured heart rate variability in response to mental stress tasks, and concentrations of leptin, glucose and insulin in the blood. Results Heart rate stress reactivity was highest in BN patients. Heart rate variability did not change during mental stress in BN and BED patients, but reduced as expected in the NBED group. During post-stress recovery, heart rate variability decreased in BN, was maintained in BED and increased as expected only in the NBED group. Conclusions BN and BED patients exhibit limitations in autonomic stress reactivity and recovery capacity.

Blunted cardiovascular reactivity relates to depression, obesity, and self-reported health

The reactivity hypothesis implicates exaggerated cardiovascular reactions to acute psychological stress in the development of hypertension and other cardiovascular disease outcomes. However, cardiovascular reactivity has also been suggested as a mediator between a variety of psychosocial and behavioural risk factors and cardiovascular disease. Data from various analyses of the West of Scotland Twenty-07 study are discussed together, and caution against over-stretching the original reactivity hypothesis. Blood pressure and heart rate were assessed at rest and during an acute mental arithmetic stress task. First, depression, though a putative risk factor for cardiovascular disease, does not appear to confer this risk via exaggerated reactivity, as it was negatively related to reactivity. Second, obesity, another risk factor, was also associated with blunted rather than heightened reactivity. Finally, lower reactivity was related to poorer self-reported health. Similar associations emerged from both cross-sectional and prospective analyses. These seemingly paradoxical results are discussed in terms of implications for the reactivity hypothesis.

Effects of Stimuli on Cardiovascular Reactivity Occurring at Regular Intervals During Mental Stress

Studies examining the direct effects of stimuli needed to perform mental stress tasks such as instructor commands at regular intervals during the mental task are limited to date. Because of the comprehensive effects of different stimuli, we studied the effect of short instructor commands occurring at regular intervals on the behavior of the cardiovascular system during two different types of tasks. Continuous beat-to-beat heart rate and blood pressure, respiration, thoracic impedance, skin conductance, and peripheral temperature were measured in 20 healthy females during a cancellation test of attention (stimuli interval of 20 s) and during mental arithmetic tasks (stimuli interval of 120 s). The transient effects of the stimuli on measures in the time domain as well as the effects of stimulus intervals on measures in the frequency domain (using spectral analysis) were examined. Instructor commands caused increases in several cardiovascular variables and in skin conductance. SBP (systolic blood pressure) and DBP (diastolic blood pressure) showed a significant stimulus response only during the mental arithmetic tasks. An effect of instructor commands at regular intervals was seen in the spectral analysis at 0.05 Hz (cancellation test of attention) and 1/120 Hz (mental arithmetic), according to the stimulus intervals of 20 s and 120 s used in these tasks. The findings suggest that even simple instructor commands given during high mental task load had a strong impact and can considerably influence measures of cardiovascular reactivity. The effects of paced stimuli should be considered when interpreting cardiovascular responses to task conditions with constant stimulus intervals.

Functional imaging of sympathetic activation during mental stress

Activation of the sympathetic nervous system (SNS) is essential in adapting to environmental stressors and in maintaining homeostasis. This reaction can also turn into maladaptation, associated with a wide spectrum of stress-related diseases. Up to now, the cortical mechanisms of sympathetic activation in acute mental stress have not been sufficiently characterized. We therefore investigated cerebral activation applying functional magnetic resonance imaging (fMRI) during performance of a mental stress task with graded levels of difficulty, i.e. four versions of a Stroop task (Colour Word Interference Test, CWT) in healthy subjects. To analyze stress-associated sympathetic activation, skin conductance and heart rate were continuously recorded. The results show that sympathetic activation through mental stress is associated with distinct cerebral regions being immediately involved in task performance (visual, motor, and premotor areas). Other activated regions (right insula, dorsolateral superior frontal gyrus, cerebellar regions) are unrelated to task performance. These latter regions have previously been considered to be involved in mediating different stress responses. The results might furthermore serve as a basis for future investigations of the connection between these cortical regions in the generation of stress-related diseases.

Effects of mental stress on autonomic cardiac modulation during weightlessness

Sustained weightlessness affects all body functions, among these also cardiac autonomic control mechanisms. How this may influence neural response to central stimulation by a mental arithmetic task remains an open question. The hypothesis was tested that microgravity alters cardiovascular neural response to standardized cognitive load stimuli. Beat-to-beat heart rate, brachial blood pressure, and respiratory frequency were collected in five astronauts, taking part in three different short-duration (10 to 11 days) space missions to the International Space Station. Data recording was performed in supine position 1 mo before launch; at days 5 or 8 in space; and on days 1, 4, and 25 after landing. Heart rate variability (HRV) parameters were obtained in the frequency domain. Measurements were performed in the control condition for 10 min and during a 5-min mental arithmetic stress task, consisting of deducting 17 from a four-digit number, read by a colleague, and orally announcing the result. Our results show that over all sessions (pre-, in-, and postflight), mental stress induced an average increase in mean heart rate (Delta7 +/- 1 beats/min; P = 0.03) and mean arterial pressure (Delta7 +/- 1 mmHg; P = 0.006). A sympathetic excitation during mental stress was shown from HRV parameters: increase of low frequency expressed in normalized units (Delta8.3 +/- 1.4; P = 0.004) and low frequency/high frequency (Delta1.6 +/- 0.3; P = 0.001) and decrease of high frequency expressed in normalized units (Delta8.9 +/- 1.4; P = 0.004). The total power was not influenced by mental stress. No effect of spaceflight was found on baseline heart rate, mean arterial pressure, and HRV parameters. No differences in response to mental stress were found between pre-, in-, and postflight. Our findings confirm that a mental arithmetic task in astronauts elicits sympathovagal shifts toward enhanced sympathetic modulation and reduced vagal modulation. However, these responses are not changed in space during microgravity or after spaceflight.

Mental stress‐induced haemoconcentration in women: Effects of menstrual cycle phase

In women, variation in the incidence of myocardial infarction (MI) has been reported with phase of the menstrual cycle. Mental stress-induced rheological and haemodynamic perturbations have been implicated in the triggering of MI. This study examined cardiovascular reactions to mental stress across the menstrual cycle, as a factor contributing to the known variation between the menstrual cycle phases in MI incidence. Rheological and haemodynamic activity during rest and a prolonged mental stress task were assessed in 12 women during the follicular and luteal phases of the menstrual cycle. The stress task increased haematocrit, colloid osmotic pressure, blood pressure and heart rate, and decreased heart rate variability and R-wave to pulse interval. However, there were no effects of menstrual phase on rheological or haemodynamic function at rest or in response to mental stress. There were also no moderating menstrual cycle effects for the rheological or haemodynamic reactions over time to this prolonged stress task. Our findings do not support the hypothesis that variations in reactions to mental stress can explain the reported variations in risk for MI across the menstrual cycle.

Depressed Affect is Associated with Poorer Cardiovascular Recovery in Young Women Following a Mental Stressor

Depressed mood has been prospectively associated with hypertension. Altered ANS function, as reflected in poor CV recovery, may be one mechanism that underlies this relationship. The purpose of this study was to investigate the relationship between depressed mood and cardiovascular recovery following a standard mental stress task in healthy young women. Depressed mood was assessed in 63 young women. Cardiovascular data were collected during a 5-min baseline period, 5-min public speaking stress task, and 15-min recovery period. Depressed mood accounted for 9.6% of the variation in HR reactivity (F(1,58) = 6.513, p = 0.013) and 4.5% of DBP recovery (F(1,58) = 4.538, p = 0.037). Greater depressed mood was associated with greater HR reactivity and poorer DBP recovery. This is the first study to directly investigate associations between depressed mood and CV recovery following mental stress.

Cardiovascular activity and the antibody response to vaccination

Objective To examine the relationship between cardiovascular activity in response to acute psychological stress and the antibody response to vaccination. Methods Fifty-seven healthy participants were vaccinated with the trivalent influenza vaccine and meningococcal A+C polysaccharides. Antibody levels were measured at baseline and 5-weeks post-vaccination. Cardiovascular activity was measured at rest, during, and following a mental arithmetic stress task in 54 participants. Results Participants demonstrating a fourfold increase in antibody titre to the A/Panama and B/Shangdong influenza strains and to meningococcal A showed greater blood pressure reactions toward the end of the acute stress task. In addition, there was some evidence of delayed diastolic blood pressure recovery in those who were responders to A/Panama and B/Shangdong influenza strains. Conclusion The present results suggest that heightened cardiovascular reactivity to stress and delayed recovery may not necessarily be detrimental to all aspects of health and may be associated with an enhanced immune response to antigen challenge.

Metabolically exaggerated cardiac reactions to acute psychological stress revisited

The reactivity hypothesis postulates that large magnitude cardiovascular reactions to psychological stress contribute to the development of pathology. A key but little tested assumption is that such reactions are metabolically exaggerated. Cardiac activity, using Doppler echocardiography, and oxygen consumption, using mass spectrometry, were measured at rest and during and after a mental stress task and during graded submaximal cycling exercise. Cardiac activity and oxygen consumption showed the expected orderly association during exercise. However, during stress, large increases in cardiac activity were observed in the context of modest rises in energy expenditure; observed cardiac activity during stress substantially exceeded that predicted on the basis of contemporary levels of oxygen consumption. Thus, psychological stress can provoke increases in cardiac activity difficult to account for in terms of the metabolic demands of the stress task.

Stress and thermoregulation: Different sympathetic responses and different effects on experimental pain

Stress and thermoregulation both activate the sympathetic nervous system (SNS) but might differently affect pain. Studies investigating possible interactions in patients are problematic because of the high prevalence of SNS disturbances in patients. We therefore analyzed the influence of these different sympathetic challenges on experimentally-induced pain in healthy subjects. SNS was activated in two different ways: by mental stress (Stroop task, mental arithmetic task), and by thermoregulatory stimulation using a water-perfused thermal suit (7 °C, 32 °C, or 50 °C). Attentional effects of the mental stress tasks were controlled by using easy control tasks. Both, stress and thermoregulatory stimuli, robustly activated SNS parameters. However, the patterns of activation were different. While stress co-activated heart rate, blood pressure, peripheral vasoconstriction and sweating, thermal stimulation either increased blood pressure (cold) or heart rate and sweating (warm). Only stress was able to induce a significant reduction of pain. The control tasks neither activated the SNS nor altered pain perception. Our results suggest that (1) different patterns of sympathetic activation can be recorded after stress and thermoregulatory challenges and (2) that only stress is able to interfere with sensation of experimental pain. Whether SNS activation is causally responsible for analgesia needs to be further investigated.

Mindfulness and stress reactivity: a preliminary investigation

AbstractA number of measures of mindfulness have been developed to assess one or more facets of mindfulness. However, to date, all of these have been validated by comparing the mindfulness questionnaire with other self‐report measures of theoretically related constructs. Given the problems of demand characteristics and shared method variance, other approaches to validation are warranted. Therefore, we sought to determine whether individuals who describe themselves as more mindful evidence lower levels of stress reactivity. Thirty‐six university students completed the Kentucky Inventory of Mindfulness Skills and the Paced Auditory Serial Addition Test. Results indicated that those individuals who described themselves as more mindful show smaller cardiovascular increases in response to the stress task (heart rate r = −0.38, diastolic blood pressure r = −0.43). This study supports the validity of the Kentucky Inventory of Mindfulness Skills, indicating that people who score more highly on this measure of mindfulness show less marked cardiovascular reactivity to a low‐grade mental stress task. Copyright © 2008 John Wiley & Sons, Ltd.

Sex differences in vascular and endothelial responses to acute mental stress

Our objective was to assess the differences in systemic vascular and endothelial function in response to acute mental stress between men and women. The endothelium plays a pivotal role in vascular homeostasis and the development of atherosclerotic heart disease. The mechanism and presentation of cardiovascular events show a sex-based difference, although the sex difference in the vascular and endothelial response to mental stress is not known. Male (n = 34) and female (n = 53) subjects participated in a series of three different mental stress tasks during which vascular response was measured non-invasively using peripheral arterial tonometry. Endothelial function was assessed using reactive hyperemia peripheral arterial tonometry. Double product (systolic blood pressure x heart rate) was calculated. Males had a greater double product response (27.2 + 3.6% increase in double product vs. 19.2 + 1.7%; P = 0.01), and a greater vascular reactivity to mental stress. Females demonstrated a reduced response to reactive hyperemia (-0.47 vs. 13.74%; P = 0.01). Furthermore, a subgroup of females who showed the least vaso-reactivity to mental stress showed the greatest decline in endothelial function (-10.5 + 4% vs. 17.4 + 6.3%; P < 0.001). This study demonstrates sex-based differences in the vascular and endothelial responses to mental stress. The mental stress-induced reduction in endothelial function and increased double product seen in the females might manifest clinically as contributing to the pathophysiology of mental stress-mediated cardiovascular events in female patients and provide further information regarding the potential mechanism for sex differences in cardiac events.

The cumulative effect of coffee and a mental stress task on heart rate, blood pressure, and mental alertness is similar in caffeine-naïve and caffeine-habituated females

Most North American workers drink coffee throughout their workday, although the cumulative effect of job stress and coffee is not well known. Research has shown that coffee affects the cardiovascular system and mental alertness primarily through the active ingredient caffeine; however, the dose of caffeine used in these studies is greater than a normal cup of coffee. In addition, these changes have been mostly determined in male caffeine-habituated consumers. Therefore, this study examined the effect of a normal cup of coffee on the cardiovascular and mental alertness response both before and after a mental stress task in 10 caffeine-naïve (23 +/- 5.0 years) and 10 caffeine-habituated (25 +/- 6 years) females. Blood pressure, heart rate, and mental alertness were taken at baseline (before coffee), 50 minutes after finishing coffee and immediately after a 9-minute mental stress task. The volume of coffee ingested for a 15-minute period was 350 mL (12 oz), which is equivalent to 140 mg of caffeine. The combined effect of coffee and mental stress significantly decreased diastolic blood pressure (Delta8 mm Hg) and increased heart rate (Delta6 beats per minute) and mental alertness (Delta67.3%) in caffeine-naïve and caffeine-habituated females, whereas systolic blood pressure (Delta10.3 mm Hg) only increased in the caffeine-naïve participants. Our results indicate that a normal cup of coffee can effect changes in blood pressure and mental alertness and that mental stress may alter the magnitude of change; however, the transient increase in systolic blood pressure after drinking coffee in caffeine-naïve participants requires further investigation.

Neural correlates of heart rate variability during emotion

The vagal (high frequency [HF]) component of heart rate variability (HRV) predicts survival in post-myocardial infarction patients and is considered to reflect vagal antagonism of sympathetic influences. Previous studies of the neural correlates of vagal tone involved mental stress tasks that included cognitive and emotional elements. To differentiate the neural substrates of vagal tone due to emotion, we correlated HF-HRV with measures of regional cerebral blood flow (rCBF) derived from positron emission tomography (PET) and 15O-water in 12 healthy women during different emotional states. Happiness, sadness, disgust and three neutral conditions were each induced by film clips and recall of personal experiences (12 conditions). Inter-beat intervals derived from electrocardiographic recordings during the 60-second scans were spectrally-analyzed, generating 12 separate measures of HF-HRV in each subject. The six emotion and six neutral conditions were grouped together and contrasted. We observed substantial overlap between emotion-specific rCBF and the correlation between emotion-specific rCBF and HF-HRV, particularly in the medial prefrontal cortex. Emotion-specific rCBF also correlated with HF-HRV in the caudate nucleus, periacqueductal gray and left mid-insula. We also observed that the elements of cognitive control inherent in this experiment (that involved focusing on the target mental state) had definable neural substrates that correlated with HF-HRV and to a large extent differed from the emotion-specific correlates of HF-HRV. No statistically significant asymmetries were observed. Our findings are consistent with the view that the medial visceromotor network is a final common pathway by which emotional and cognitive functions recruit autonomic support.

Self-esteem levels and cardiovascular and inflammatory responses to acute stress

Acute mental stress tests have helped to clarify the pathways through which psychosocial factors are linked to disease risk. This methodology is now being used to investigate potentially protective psychosocial factors. We investigated whether global self-esteem might buffer cardiovascular and inflammatory responses to acute stress. One hundred and one students completed the Rosenberg Self-Esteem Scale. Heart rate and heart rate variability (HRV) were recorded for 5 min periods at baseline, during two mental stress tasks, (a speech and a color-word task) and 10, 25 and 40 min into a recovery period. Plasma levels of tumor-necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1 receptor antagonist (IL-1Ra) were assessed at baseline, immediately post-stress and after 45 min recovery. Repeated measures analysis of variance demonstrated that heart rate levels were lower across all time points in those with high self-esteem, although heart rate reactivity to stress was not related to self-esteem. There were no differences in baseline HRV, TNF-α, IL-6 or IL-1Ra. Multiple linear regressions revealed that greater self-esteem was associated with a smaller reduction in heart rate variability during the speech task, but not the color-word task. Greater self-esteem was associated with smaller TNF-α and IL-1Ra responses immediately following acute stress and smaller IL-1Ra responses at 45 min post-stress. In conclusion, global self-esteem is associated with lower heart rate and attenuated HRV and inflammatory responses to acute stress. These responses could be processes through which self-esteem protects against the development of disease.

Complement Cascade Activation After an Acute Psychological Stress Task

To examine complement cascade activation after an acute psychological stress task. Psychological stress has been implicated in the exacerbation of inflammatory disorders. Although the complement cascade is a key component of these inflammatory processes, there has been little research regarding its susceptibility to stress. In experiment 1, 38 healthy participants completed an 8-minute psychological stress task. Complement components were assessed from blood samples taken by venipuncture, at rest and immediately post task. In experiment 2, 40 participants undertook a similar task; blood samples were collected from a cannula at rest, immediately post task, and after 30 and 60 minutes of recovery. In experiment 3, 40 participants were exposed to both a stress and a control session. Session order was counterbalanced and, on both occasions, we received blood samples from half the participants via a cannula and the other half by repeated venipuncture. In experiment 1, C3a levels increased significantly from rest to task, indicating complement cascade activation. In experiment 2, we found that both C3a and Factor Bb increased significantly from rest to task and recovered by 30 and 60 minutes. C5a rose significantly 30 minutes after completion of the stress task. In experiment 3, C3a increased in response to the mental stress task, whereas it decreased slightly during the control session. There was no significant effect of blood taking method. These experiments demonstrate that the complement cascade is susceptible to acute psychological stress and suggest a potential mechanism for stress-induced inflammatory activation in individuals with inflammatory disorders.

Salt-sensitive men show reduced heart rate variability, lower norepinephrine and enhanced cortisol during mental stress

Salt sensitivity (SS) represents a risk factor for essential hypertension, which has been related to enhanced cardiovascular stress reactivity possibly mediated by increased noradrenergic susceptibility. We investigated biophysiological responses to mental stress in salt-sensitive (ss) and salt-resistant (sr) subjects, hypothesizing lower heart rate variability (HRV) and higher cortisol in the ss. A total of 48 healthy normotensive Caucasian men (age 25.6+/-2.6, body mass index 22.9+/-2.3) were phenotyped for SS (defined as significant drop in mean arterial pressure>3 mm Hg under the low-salt diet) by a 2-week high- versus low-salt diet. Subjects underwent a standardized mental stress task with continuous cardiovascular monitoring before, during and after the test (Finapres; Ohmeda, Louisville, CO, USA). Blood samples were drawn to examine cortisol and catecholamines before, after and 20 min after stress. The task elicited significant increases of systolic blood pressure (SBP), diastolic BP (DBP) and heart rate (HR) and a significant decrease of HRV (all time effects P<0.0001). The ss subjects showed lower norepinephrine (NE) and higher cortisol, indicated by significant group effects (P=0.009 and 0.025, respectively). HR increased and HRV decreased more in the ss under the stress, shown by significant time by group interactions (P=0.045 and 0.003, respectively). The observation of a more pronounced HR rise coupled with a greater decrease of HRV in healthy ss men under the influence of brief mental stress confirms their enhanced physiological stress reactivity. The lower peripheral NE may represent an effort to compensate for increased noradrenergic receptor sensitivity. The enhanced cortisol levels are backed by recent genetic findings on HSD11B2 polymorphisms and may promote hypertension.

Relation between mental stress-induced prefrontal cortex activity and skin conditions: A near-infrared spectroscopy study

Although psychological stress affects skin condition, the neurophysiological mechanism involved is unclear. In this study, we evaluated the relationship between skin condition and left/right asymmetry in prefrontal cortex (PFC) activity during mental stress tasks since recent studies have suggested that the right PFC dominates the regulation of the stress response system, including the hypothalamic-pituitary-adrenal (HPA) axis. Using near-infrared spectroscopy, we measured hemoglobin concentration changes in the bilateral PFC during a mental arithmetic task in normal adults and evaluated the laterality scores (i.e., [(right-left)/(right+left)]) of oxyhemoglobin concentration changes. Elicitation of stress was verified by the State-Trait Anxiety Inventory (STAI) and heart rate. The sebum levels and Propionibacterium acnes populations in the facial skin were measured before the task. The task significantly increased the STAI-II scores (p=0.00079) and heart rate (p=0.0000049). The oxyhemoglobin concentration increased in the bilateral PFC during the task, associated with a decrease in deoxyhemoglobin concentration. The laterality scores of oxyhemoglobin concentration changes were positively correlated with sebum levels (r=+0.50, p=0.026) and P. acnes populations (r=+0.49, p=0.029) in the facial skin before the task. There was a significant positive correlation between heart rate changes and the laterality scores of oxyhemoglobin concentration changes (r=+0.54, p=0.015). These results demonstrate that the subjects with higher sebum levels and higher P. acnes populations in the facial skin have a right dominant PFC activity during a mental stress task and suggest that such subjects are sensitive to mental stress associated with hyperactivity of the stress response system, including the HPA axis system.

The shape of stress: the use of frequent sampling to measure temporal variation in S‐IgA levels during acute stress

AbstractPrevious studies have indicated that statistically significant increases in Secretory immunoglobulin A (S‐IgA) can be achieved in as little as 5min as a result of mental stress. However, the temporal resolution of these changes is low and therefore the rate and pattern of changes during the stress task and during subsequent recovery is unclear. A within‐subjects design was used to examine levels of S‐IgA before, during and after a short (8 min) mental stress task. S‐IgA was measured from saliva samples obtained every 2 min during the entire 30‐min session. Significant increases in S‐IgA concentration were observed as early as the task instruction period, with additional increases during the stress task itself. The data also show a rapid recovery of S‐IgA, with a return to baseline levels within 6 min. Results suggest that S‐IgA changes can occur very rapidly and that the observed increases are short‐lived. Copyright © 2007 John Wiley &amp; Sons, Ltd.