Physiological Concomitants Research Articles

Depressive rumination and heart rate variability: A pilot study on the effect of biofeedback on rumination and its physiological concomitants.

ObjectiveRecent studies suggest that lower resting heart rate variability (HRV) is associated with elevated vulnerability to depressive rumination. In this study, we tested whether increases in HRV after HRV-biofeedback training are accompanied by reductions in rumination levels.Materials and methodsSixteen patients suffering from depression completed a 6-week HRV-biofeedback training and fourteen patients completed a control condition in which there was no intervention (waitlist). The training included five sessions per week at home using a smartphone application and an ECG belt. Depressive symptoms and autonomic function at rest and during induced rumination were assessed before and after each of the two conditions. We used a well-established rumination induction task to provoke a state of pervasive rumination while recording various physiological signals simultaneously. Changes in HRV, respiration rate, skin conductance, and pupil diameter were compared between conditions and time points.ResultsA significant correlation was found between resting HRV and rumination levels, both assessed at the first laboratory session (r = -0.43, p < 0.05). Induction of rumination led to an acceleration of heart rate and skin conductance increases. After biofeedback training, resting vagal HRV was increased (p < 0.01) and self-ratings of state anxiety (p < 0.05), rumination (p < 0.05), perceived stress (p < 0.05), and depressive symptoms (QIDS, BDI; both p < 0.05) were decreased. In the control condition, there were no changes in autonomic indices or depressive symptomatology. A significant interaction effect group x time on HRV was observed.ConclusionOur results indicate that a smartphone-based HRV-biofeedback intervention can be applied to improve cardiovagal function and to reduce depressive symptoms including self-rated rumination tendencies.

Disturbance of desire-goal motivational dynamics during different exercise intensity domains.

PurposeThe desire‐goal motivational conflict helps explain endurance performance; however, the physiological concomitants are unknown. The present study examined disturbances in desire to reduce effort and performance goal value across moderate, heavy, and severe exercise intensity domains, demarcated by the first (LT1) and second (LT2) lactate thresholds. In addition, the within‐person relationships among blood lactate concentration, heart rate, and desire‐goal conflict were examined.MethodsThirty participants (53% female, Mage = 21.03 years; SD = 2.06 years) completed an incremental cycling exercise test, in which work rate was increased by 25 watts every four minutes, until voluntary exhaustion or sufficient data from the severe intensity domain had been collected. Desire to reduce effort, performance goal value, blood lactate concentration (for determination of LT1 and LT2), and heart rate were measured at the end of each stage and analyzed using multilevel models.ResultsThe desire to reduce effort increased over the exercise test with additional shifts and accelerations after each lactate threshold. The performance goal did not show general declines, nor did it shift at LT1. However, the performance goal value shifted at LT2, and the rate of change increased at both thresholds. Within‐person variation in blood lactate concentration positively correlated with the desire to reduce effort and negatively correlated with the performance goal. Within‐person variation in heart rate correlated with desire to reduce effort but not the performance goal.ConclusionTransitioning through both lactate thresholds is important phases for motivation during progressive exercise, particularly for the desire to reduce effort. Within‐person variation in blood lactate concentration is more influential for motivation, compared with heart rate.

Evidence for the association between physiological and emotional states in adolescents and young adults without psychopathology under ecologically valid conditions.

Well-powered studies on the physiological concomitants underlying affect and its regulation during emerging adulthood are warranted to provide novel insight into mental health. The association between autonomic nervous system activity and emotional states occurring under natural conditions in daily life was investigated in individuals (N=549, age 14-21, females 45.6%) without any lifetime mental disorder from an epidemiological cohort study in Germany. Using ecological momentary assessment, mood and optimism/pessimism were assessed over 4days simultaneously with continuous heart rate monitoring. Lower vagal activity was found in mood states accompanied by high arousal (wakefulness, mania) and greater vagal activity in mood states with low arousal (calmness, pessimism). Findings illustrate important associations between autonomic nervous system activity and mood in youth under ecologically valid conditions. Vagal activity presents a prominent pathway by which mood may influence physiological function or vice versa. In contrast to commonly performed laboratory assessments, the ambulatory assessment in participants' daily life allows an application of the results to the field.

Furthering the Focus on Translational Sleep Science in Behavioral Medicine

Translational sleep science has become a critical and fundamental focus in the field of behavioral medicine. This is the second issue in the special series of the International Journal of Behavioral Medicine focused on the physiological, psychological, social, and environmental concomitants of sleep and human health. The articles included in this issue draw further attention to the range and significance of sleep as a marker of health status and as a target of behavioral intervention. The research included in this series highlights the pervasive manner in which sleep health is intrinsically connected to health risk, behavior, and outcomes. The next decade promises to further behavioral medicine approaches to improving the provision of care and the overall public health through the implementation of translational sleep science research.

Improving biobehavioral outcomes with progressive muscle relaxation in patients with advanced lung cancer.

292 Background: Advanced lung cancer involves severe and distressing symptoms, especially anxiety, breathlessness, insomnia, and pain. Progressive muscle relaxation (PMR) is an empirically supported treatment for reducing stress and the emotional, cognitive, and physiological concomitants of anxiety. Methods: A quality improvement effort involved enhancing standard of care (SOC) by offering patients with newly diagnosed lung cancer one brief (20-minute) PMR session during a clinic visit for treatment determination. A static group comparison design was used. The PMR group ( n= 40) received PMR with pre (initial visit) and post (3-4 week follow-up) assessments of anxiety (Generalized Anxiety Disorder-7 Scale), breathlessness (American Thoracic Society for the Division of Lung Diseases Questionnaire), insomnia (Medical Outcomes Study Sleep Scale), and pain (Brief Pain Inventory). The static group ( n= 32) was assessed on one occasion only, during the 3-4 week follow-up visit. Pre/post analyses for the PMR group used paired samples t-tests. Linear regressions compared post data between the two groups. An alpha of .10 determined significance. Results: Analyses showed pre- to post-PMR differences in pain ( p= .036, d= .309) and breathlessness ( p= .084, d= .663), with null effects for anxiety ( p= .149, d= .178) and insomnia ( p= .811, d= .067). Controlling for performance status, smoking history, and toxicities, regression showed that the PMR group reported significantly less pain ( p= .046, b= 2.48). Conclusions: PMR effectively reduced symptoms of breathlessness and pain among patients with advanced lung cancer. Interventions based on the education and training of PMR may provide an improvement to SOC lung cancer treatment.

Sense of Smell as the Central Driver of Pavlovian Appetite Behavior in Mammals.

The seminal experiments of Ivan Petrovich Pavlov set the stage for an understanding of the physiological concomitants of appetite and feeding behavior. His findings, from careful and creative experimentation, have been uncontested for over a century. One of Pavlov’s most fundamental observations was that activation of salivary, gastric and pancreatic secretions during feeding and sham-feeding, precedes entry of food into the mouth, generating signals to the brain from various sensory pathways. Pavlov referred to this as the “psychic” phase of digestion. However, quite surprisingly, he did not attempt to isolate any single sensory system as the main driver of this phenomenon. Herein we revisit Pavlov’s findings and hypothesize that the evolutionarily-important sense of smell is the pathway most-likely determinant of feeding behavior in mammals. Substantial understandings of olfactory receptors and their neural pathways in the central nervous system have emerged over the past decade. Neurogenic signals, working in concert with hormonal inputs are described, illustrating the ways in which sense of smell determines food-seeking and food-preference. Additionally, we describe how sense of smell affects metabolic pathways relevant to energy metabolism, hunger and satiety as well as a broad range of human behaviors, thereby reinforcing its central biological role in mammals. Intriguing possibilities for future research, based upon this hypothesis, are raised.

Inflammatory and metabolic disturbances are associated with more severe trajectories of late-life depression

Late-life depression is a highly prevalent mental health condition with devastating consequences even from its earliest stages. Alterations in physiological functions, such as inflammatory and metabolic, have been described in patients with depression. However, little is known on the association between depression symptom course and metabolic and inflammation dysregulation. This study aimed to depict the course of depression symptoms while ageing, taking into consideration inter-individual heterogeneity. Moreover, it intended to study the associations between inflammatory and metabolic risk profiles and symptom trajectories. To do so, data from 13,203 adults aged 50–90 years (52.75% women; mean age at baseline = 65.07, SD = 10.00) were used. Blood sample and blood pressure measures were taken from 1536 participants (56.58% women; mean age at baseline = 61.73 years, sd = 7.64). Depression symptoms were assessed every two years across a 10-year follow-up. Trajectories were identified by means of latent class mixed modelling. Inflammation and metabolic risk profile scores were obtained from plasma and diagnostic-based indicators in the follow-up, using a robust latent-factor approach. Multigroup modelling was used to study the associations between the profiles and symptom trajectories. As a result, three heterogeneous trajectories of symptoms were identified (low-symptom, moderate-symptom and high-symptom trajectory). Participants depicting a high-symptom trajectory showed the greatest inflammation profile score and high metabolic risk. Moderate-symptom trajectory was also related to high inflammation and metabolic risk. To sum up, at-risk trajectories of symptoms were associated with high inflammation and risk of metabolic diseases. This study provides valuable evidence to advance personalised medicine and mental health precision, considering person-specific profiles and physiological concomitants.

Evidence-Based Psychosocial Treatments for Pediatric Elimination Disorders

Pediatric elimination disorders are common in childhood, yet psychosocial correlates are generally unclear. Given the physiological concomitants of both enuresis and encopresis, and the fact that many children with elimination disorders are initially brought to their primary care physician for treatment, medical evaluation and management are crucial and may serve as the first-line treatment approach. Scientific investigation on psychological and behavioral interventions has progressed over the past couple of decades, resulting in the identification of effective treatments for enuresis and encopresis. However, the body of literature has inherent challenges, particularly given the multicomponent nature of many of the treatment packages. This review identified 25 intervention studies—18 for nocturnal enuresis and 7 for encopresis—over the past 15 years and classified them according to the guidelines set forth by the Task Force on the Promotion and Dissemination of Psychological Procedures. For nocturnal enuresis, the urine alarm and dry-bed training were identified as well-established treatments, Full Spectrum Home Therapy was probably efficacious, lifting was possibly efficacious, and hypnotherapy and retention control training were classified as treatments of questionable efficacy. For encopresis, only two probably efficacious treatments were identified: biofeedback and enhanced toilet training (ETT). Best practice recommendations and suggestions for future research are provided to address existing limitations, including heterogeneity and the multicomponent nature of many of the interventions for pediatric elimination disorders.

Different effects of prenatal stress on ERK2/CREB/Bcl-2 expression in the hippocampus and the prefrontal cortex of adult offspring rats.

It has become increasingly evident that prenatal stress and its psychological and physiological concomitants are associated with the pathophysiology of mood disorders. However, the mechanisms underlying the prenatal stress-induced offspring's anxiety disorders remain unknown. We recently reported that prenatal stress enhanced anxiety-like behavior in adult offspring rat, and involved N-methyl-D-aspartate receptor subunits, including NR1 and NR2A. In the present research, using the same prenatal stress model, we measured the ERK2/CREB/Bcl-2 mRNA levels by real-time PCR. Our findings indicated that prenatal stress decreased ERK2 and CREB mRNA levels in the hippocampus and the prefrontal cortex and Bcl-2 mRNA levels in the hippocampus of offspring rat. The results showed that the abnormal ERK2, CREB, and Bcl-2 mRNA levels may be involved in the anxiety-like behavior of adult rats with prenatal stress.

Physiological concomitants of perseverative cognition: A systematic review and meta-analysis.

Rumination about the past and worries about the future (perseverative cognition) are extremely common, although pervasive and distressing, dysfunctional cognitive processes. Perseverative cognition is not only implicated in psychological health, contributing to mood worsening and psychopathology but, due to its ability to elicit prolonged physiological activity, is also considered to play a role in somatic health. Although there is emerging evidence that such negative and persistent thoughts have consequences on the body, this association has not yet been quantified. The aim of this study was to meta-analyze available studies on the physiological concomitants of perseverative cognition in healthy subjects. Separate meta-analyses were performed on each examined physiological parameter. Sixty studies were eligible for the analyses. Associations emerged between perseverative cognition and higher systolic blood pressure (SBP) (g = .45) and diastolic blood pressure (DBP) (g = .51) in experimental studies, and higher heart rate (HR) (g = .28 and g = .20) and cortisol (g = .36 and g = .32), and lower heart rate variability (HRV) (g = .15 and g = .27) in experimental and correlational studies, respectively. Significant moderators were sex, ethnicity, type of induction used to elicit perseverative cognition, assessment of state versus trait perseverative cognition, focus on worry or rumination, duration of physiological assessment, and quality of the studies. With the exception of blood pressure, results were not influenced by publication bias. Results show that perseverative cognition affects cardiovascular, autonomic, and endocrine nervous system activity, suggesting a pathogenic pathway to long-term disease outcomes and clarifying the still unexplained relationship between chronic stress and health vulnerability.

Macroscopic Self-Organized Electrochemical Patterns in Excitable Tissue and Irreversible Thermodynamics

In this paper we make the assertion that the key to understand the emergent properties of excitable tissue (brain and heart) lies in the application of irreversible thermodynamics. We support this assertion by pointing out where symmetry break, phase transitions both in structure of membranes as well as in the dynamic of interactions between membranes occur in excitable tissue and how they create emergent low dimensional electrochemical patterns. These patterns are expressed as physiological or physiopathological concomitants of the organ or organism behavior. We propose that a set of beliefs about the nature of biological membranes and their interactions are hampering progress in the physiology of excitable tissue. We will argue that while there is no direct evidence to justify the belief that quantum mechanics has anything to do with macroscopic patterns expressed in excitable tissue, there is plenty of evidence in favor of irreversible thermodynamics. Some key predictions have been fulfilled long time ago and they have been ignored by the mainstream literature. Dissipative structures and phase transitions appear to be a better conceptual context to discuss biological self-organization. The central role of time as a global coupling agent is emphasized in the interpretation of the presented results.

Supplemental Material for Physiological Concomitants of Perseverative Cognition: A Systematic Review and Meta-Analysis

Supplemental Material for Physiological Concomitants of Perseverative Cognition: A Systematic Review and Meta-Analysis

The down-regulation of disgust by implementation intentions: experiential and physiological concomitants.

Emotion regulation plays a key role in mental health and psychopathology. Therefore, it seems important to develop effective forms of emotion regulation. Implementation intentions are if-then plans that help people attain their self-regulatory goals. Perspective-taking and response-focused implementation intentions have been shown to reduce feelings of unpleasantness and arousal, respectively, in response to briefly presented disgusting pictures. The present study addressed the open research questions whether forming these types of implementation intentions is effective in regulating affect during prolonged presentation of disgusting pictures, and whether it is associated with changes in physiological arousal. Eighty-one participants viewed disgusting, neutral, and pleasant pictures of 6 s duration under four instructions: the goal intention to not get disgusted, this goal intention furnished with a perspective-taking or a response-focused implementation intention, and no emotion regulation instructions. The dependent variables were ratings of disgust, valence, arousal, and electrodermal activity. Only perspective-taking implementation intention participants significantly reduced their disgust and unpleasantness as compared to goal-intention and control participants. Arousal and skin conductance did not significantly differ between conditions. The effectiveness of response-focused but not perspective-taking implementation intentions seems to be substantially reduced during sustained exposure duration.

Stress, Perseverative Negative Thinking, and Sleep in University Students

Introduction The perception of stress does not automatically lead to prolonged activation. The cognitive representations of stressors need to be prolonged in order to extend their physiological concomitants (Brosschot, Gerin, & Trayer, 2006). It is shown that elevated levels of repetitive negative thinking appear to be causally involved in the maintenance of emotional problems (Ehring & Watkins, 2008). Aims To analyze the associations between Perceived Stress (PS), Perseverative NegativeThinking (PNT) and Sleep difficulties. Methods 549 students from two Portuguese Universities filled in the Portuguese version of Perceived Stress Scale (Cohen et al., 1983; Amaral et al., 2014), PerseverativeThinking Questionnaire (Ehring et al., 2011; Chaves et al., 2013), and three questions were used to access sleep difficulties (initiating sleep, sleepmaintenance, and early morning awakening). Results In the present sample the prevalence on difficulty initiating sleep was 29,8%, of maintaining sleep was 27,9% and of early morning awakening was 30,9%. The strongest correlations were observed between PS and PNT (from r=.338 to r=.520; p Conclusions The PS was strongly associated with PNT and both of these variables were associated with sleep difficulties (particularly initiating and maintaining sleep).

Making Memories Matter

This article reviews some of the neuroendocrine bases by which emotional events regulate brain mechanisms of learning and memory. In laboratory rodents, there is extensive evidence that epinephrine influences memory processing through an inverted-U relationship, at which moderate levels enhance and high levels impair memory. These effects are, in large part, mediated by increases in blood glucose levels subsequent to epinephrine release, which then provide support for the brain processes engaged by learning and memory. These brain processes include augmentation of neurotransmitter release and of energy metabolism, the latter apparently including a key role for astrocytic glycogen. In addition to up- and down-regulation of learning and memory in general, physiological concomitants of emotion and arousal can also switch the neural system that controls learning at a particular time, at once improving some attributes of learning and impairing others in a manner that results in a change in the strategy used to solve a problem.

The Pulse of Thought: Hemodynamics of the Brain and Mind

Back to table of contents Previous article Next article PerspectivesFull AccessThe Pulse of Thought: Hemodynamics of the Brain and MindAndrea Raballo, M.D., Ph.D., Matteo Cella, Ph.D., and Antonio Preti, M.D.Andrea RaballoSearch for more papers by this author, M.D., Ph.D., Matteo CellaSearch for more papers by this author, Ph.D., and Antonio PretiSearch for more papers by this author, M.D.Published Online:1 Nov 2011https://doi.org/10.1176/appi.ajp.2011.11060913AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail The mapping of the human brain through regional changes in blood flow has provided psychiatry and allied neurosciences with extraordinary opportunities to explore the relation between mind and brain. This paradigm lies at the core of contemporary functional neuroanatomy and retains unprecedented potential for refining our understanding of neuropsychiatric diseases. However, the first intuition of the principle that has proved foundational for the entire field of brain imaging was almost serendipitous and dates back to 130 years ago. Angelo Mosso (1846–1910), an Italian physiologist working in Turin, explicitly formulated it in 1881 in his monograph Ueber den Kreislauf des Blutes im menschlichen Gehirn (About the Circulation of the Blood in the Human Brain) (1).Mosso was studying the physiological concomitants of various mental states; in particular, he had started recording changes in blood circulation during laboratory-generated emotions. One of his patients, Michele Bertino, was a 37-year-old man who experienced a traumatic injury and was left with only a thin layer of skin covering a gap in his skull. While assessing Bertino with a special sphygmograph (a registering apparatus measuring in vivo brain volume changes, which were interpreted as measurements of brain circulation; see figure), Mosso noticed a sudden increase in pulsations over the cortex when the church bells rang at noon. He then asked Bertino if he felt that he should have said his midday prayers, and when Bertino answered in the positive, the pulsations increased again. Intrigued by that, almost performing a cognitive activation task ante litteram, Mosso asked him to multiply 8 by 12. Once again the sphygmograph recorded an increase in the pulsations, both when the question was asked and when Bertino replied, “96.” From this observation Mosso concluded that changes in circulation of the brain were related to mental activity.The topicality of such intuition was acknowledged a decade later by William James, in his two-volume classic on the principles of psychology (2), published in 1890:The best proof of the immediate afflux of blood to the brain during mental activity is due to Mosso's observations…. By means of apparatus described in his book, this physiologist was enabled to let the brain-pulse record itself directly by a tracing. The intracranial blood-pressure rose immediately whenever the subject was spoken to, or when he began to think actively, as in solving a problem in mental arithmetic. Mosso gives in his work a large number of reproductions of tracings which show the instantaneity of the change of blood-supply, whenever the mental activity was quickened by any cause whatever, intellectual or emotional. (2, vol I, pp. 97–99)In the same year, Charles Roy and Charles Sherrington reformulated Mosso's original observation as an intrinsic homeostatic mechanism: “The brain possesses an intrinsic mechanism by which its vascular supply can be varied locally in correspondence with local variations of functional activity” (3).Address correspondence to Dr. Raballo ([email protected]ku.dk or andrea.[email protected]it).Photographed pages are shown with the permission of the Max Planck Institute for the History of Science.Image accepted for publication June 2011.The authors thank Torinoscienza (http://www.torinoscienza.it) and European Cultural Heritage Online (http://echo.mpiwg-berlin.mpg.de/home) for support in retrieving the iconographic sources.

Clinical and autonomic functions: a study of childhood anxiety disorders

BACKGROUND AND OBJECTIVES:Childhood and adolescent anxiety is generally associated with a varied somatic symptom pattern thought to reflect autonomic system activity. Few studies have examined the autonomic characteristics of generalized anxiety disorder (GAD). This omission is at odds with contemporary models of autonomic cardiovascular control. The current study aimed to find differences in autonomic functions between children with a diagnosis of childhood anxiety disorder and a control group using a case-control design.DESIGN AND SETTING:A cross sectional experimental study conducted in the years 2004-2005 in the psycho-physiology lab of a tertiary care multi-speciality teaching hospital.METHODS:Assessments were carried out using a semistructured interview, K-SADS (Schedule for Affective Disorders and Schizophrenia for Children and Adolescents); STAIC (State and Trait Anxiety Inventory for Children); CDRS (Childhood Depression Rating Scales); SCARED (Self-Report for Childhood Anxiety–Related Disorders). Autonomic reactivity was tested using the standard battery of tests.RESULTS:There were differences between 34 children and adolescents (age range, 8-18 years) with a diagnosis of childhood anxiety disorder and a control group of 30 age- and sex-matched subjects from a nearby school in autonomic activity and reactivity between individuals with anxiety disorder and non-anxious control subjects. Our finding is suggestive of autonomic rigidity or diminished physiologic flexibility in children with anxiety disorderCONCLUSIONS:The study is probably the first of its kind to look into the issue in detail using a detailed battery of the autonomic function tests, and the results are of help in better understanding the condition. The result of the present experiment supports differences in autonomic activity and reactivity between individuals with anxiety disorder and non-anxious control subjects.

Clinical assessment applications of ambulatory biosensors.

Ambulatory biosensor assessment includes a diverse set of rapidly developing and increasingly technologically sophisticated strategies to acquire minimally disruptive measures of physiological and motor variables of persons in their natural environments. Numerous studies have measured cardiovascular variables, physical activity, and biochemicals such as cortisol in psychopathology and treatment research. The physiological concomitants of many behavior and medical disorders and the benefits of a multimethod assessment strategy provide strong rationales for clinical applications of ambulatory biosensor measurement. A number of psychometric dimensions of evaluation are important in clinical applications of biosensor measurement, including accuracy and validity, reliability and consistency, clinical utility, incremental validity and utility, sensitivity to change, generalizability, cost benefits, and the conditional nature of dimensions of biomeasure evaluation. The authors review ambulatory biosensor methods and make recommendations for use of the technology.

Sigmund Freud and Emil Kraepelin: 150 Years Old

Sigmund Freud and Emil Kraepelin: 150 Years Old

Comparisons Between High and Low Peritraumatic Dissociators in Cardiovascular and Emotional Activity While Remembering Trauma

ABSTRACT Peritraumatic dissociation (PD) is one of the best predictors of posttraumatic stress disorder (PTSD). In this pilot study, we examined cardiovascular psychophysiology and negative emotions in 19 adults who, retrospectively, reported experiencing high or low levels of PD during the worst trauma of their lives. In a contiguous series of ten-minute phases, they rested, thought about, talked about, and recovered from talking about their index trauma. We hypothesized that greater PD would be associated with more negative emotion, lower cardiovascular activity, and greater discordance between negative emotions and cardiovascular activity. Our main findings were that PD was associated with lower blood pressure prior to talking about the trauma, greater negative emotion while talking about the trauma, and greater emotional and cardiovascular discordance throughout the experiment. These findings add to the very limited empirical data on physiological concomitants of peritraumatic dissociation and may aid in developing preventive interventions for PTSD.