Arousal Research Articles

Augmenting self-guided virtual-reality exposure therapy for social anxiety with biofeedback: a randomised controlled trial

IntroductionWe previously found that self-guided Virtual Reality Exposure Therapy (VRET) improved Public Speaking Anxiety (PSA) and reduced heartrate. Elevated heartrate characterises social anxiety and the self-guided VRET seemed to reduce heartrate. Thus, receiving continuous biofeedback about physiological arousal during the VRET could help socially anxious individuals to manage their anxiety. The present study aimed to determine whether biofeedback enhances the responsiveness of VRET.MethodsSeventy-two individuals with high self-reported social anxiety were randomly allocated to VRET-plus-biofeedback (n=38; 25 completers) or VRET-alone (n=35; 25 completers). Three hour-long VRET sessions were delivered over two consecutive weeks. During each session, participants delivered a 20-minute public speech in front of a virtual audience.ResultsParticipants in the VRET-plus-biofeedback group received biofeedback on heartrate and frontal alpha asymmetry (FAA) within the virtual environment and were asked to lower their arousal accordingly. Participants in both groups completed psychometric assessments of social anxiety after each session and at one-month follow-up. PSA improved by the end of treatment and overall social anxiety improved one month after the VRET across both groups. The VRET-plus-biofeedback group showed a steadier reduction in FAA in the first VRET session and a greater reduction in self-reported arousal across the two sessions than the VRET-alone group.ConclusionBiofeedback can steady physiological arousal and lower perceived arousal during exposure. The benefits of self-guided VRET for social anxiety are sustained one month after therapy.

Post-traumatic stress disorder and metabolic syndrome: the role of some antioxidants in treatment

The basis for the pathogenesis of cardiovascular, cancer, metabolic diseases, low-grade chronic inflammation (LGCI) and many other disorders is an imbalance between prooxidants and the antioxidant defense system. It is believed that the link between post-traumatic stress disorder (PTSD) and metabolic syndrome (MetS) is based on oxidative stress (OS), increased autonomic nervous system activity, glucocorticoid synthesis activation, or immunological dysregulation. Moreover, pathophysiological changes in the systemic LGCI pathways that result from modifications in glucocorticoid receptor reactivity (secondary to emotional and physiological arousal) may be the basis for inappropriate social behavior consistent with PTSD and MetS manifestations. Recently, evidence has emerged suggesting that a combination of high levels of systemic OS and activation of LGCI plays an important role in the pathogenesis of PTSD. On the other hand, PTSD is a type of recurrent and long-term trauma that exacerbates OS and accele­rates cellular aging. LGCI is accompanied by the release of reactive oxygen and nitrogen species, proinflammatory cytokines, and other biologically active substances that cause OS. The purpose of this review was to discuss the role of individual antioxidants, in particular polyphenols, flavonoids, carotenoids, N-acetylcysteine, melatonin, L-arginine, C and E vitamins, zinc, copper, and selenium, in the prevention/treatment of comorbid pathology of PTSD and MetS, as well as to analyze new trends and directions for future research. The search was conducted in Scopus, Science Direct (from Else­vier) and PubMed, including MEDLINE databases. The keywords used were “post-traumatic stress disorder,” “metabolic syndrome,” and “antioxidants.” To identify research results that could not be found during the online search, a manual search of the bibliography of publications was used.

The effect of social anxiety on social attention in naturalistic situations

ABSTRACT Background and Objectives This multimodal two-phase study investigated the impact of trait social anxiety on exploration, social attention, and autonomic responses in a naturalistic setting. We expected higher avoidance of potentially crowded spaces, reduced visual attention on other people, and heightened physiological arousal in social situations for participants with higher social anxiety levels. Design and Methods Eighty-seven participants, pre-screened for high variance in trait social anxiety, first completed a half-hour walk on a freely chosen route and subsequently had a staged social interaction with a confederate consisting of a non-interactive waiting phase and a short conversation. Results While social anxiety did not modulate the choice of route during the walk phase, socially anxious participants avoided gazing at other individuals in non-interactive situations, i.e., during the walk and the waiting phase. In contrast, during actual interaction, they showed increased visual attention towards the confederate’s face. Across all experimental phases, highly socially anxious individuals showed elevated heart rates, but this effect was independent of the social context. Conclusions This study showed that social anxiety affects social exploration behavior not in a way of general avoidance, but rather in nuanced adaptations depending on the concrete situation, likelihood of interaction and associated socio-evaluative threat.

Spectral Dynamics Prior to Motor Events Differ Between NREM Sleep Parasomnias and Healthy Sleepers.

The umbrella term "Disorders of Arousal" (DoA), encompassing sleepwalking, confusional arousals, and sleep terrors, refers to parasomnias manifesting during non-rapid eye movement (NREM) sleep, commonly thought to arise from an aberrant arousal process. While previous studies have detailed EEG changes linked to DoA episodes, it remains uncertain how these alterations differ from a physiological arousal process. This study directly compared brain activity between DoA episodes and arousals associated with physiological movements (motor arousal) in individuals with DoA and healthy sleepers. Fifty-three adult patients with DoA (25 males, 32.2±15.5years) and 33 control subjects (14 males, 31.4±11.4years) underwent one or more home-EEG recordings. A semiparametric regression model was employed to elucidate the complex relationship between EEG activity across channels, within and across different groups, including motor arousals in DoA (n=169), parasomnia episodes in DoA (n=361), and motor arousals in healthy sleepers (n=137). Parasomnia episodes and motor arousals in both groups were preceded by a diffuse increase in slow-wave activity (SWA) and beta power, and a widespread decrease in sigma power. However, motor arousals in DoA displayed lower beta and central sigma than in healthy sleepers. Within DoA patients, episodes were preceded by lower beta, frontal sigma, and higher SWA than motor arousals. Our findings suggest that the arousal process is altered in DOA patients, and that specific EEG patterns are required for DOA episodes to emerge. These insights will help guide future research into the underlying circuits and objective markers of DOA.

Predictors of Trauma-Related Self-Blame in Male Survivors of Sexual Violence

ABSTRACT Survivors of adult sexual assault and child sexual abuse – together encompassing sexual violence (SV) – experience a number of adverse consequences. High rates of self-blame can lead to increased symptomatology and treatment resistance. There has been a paucity of studies of men who have experienced SV, particularly about self-blame. For this study, 179 cisgender male survivors of SV completed an online survey to explore the relationships among 10 variables, including trauma-related self-blame, rape myth acceptance, tonic immobility, disclosure experiences, sexual arousal, and substance use. Multiple regression analyses and t-tests were used to test the study hypotheses. Results indicate that 93% of the sample reported some level of self-blame. However, only rape myth acceptance was strongly associated with self-blame. Additionally, participants who used substances within 12 hours prior to their SV had higher rates of self-blame, as did participants who had not previously disclosed their abuse. Exploratory analyses also found a significant difference in self-blame between those who experienced SV in childhood and adulthood versus those who only experienced SV in either childhood or adulthood. The findings of this research highlight the high rates of self-blame and how imperative it is to provide psychoeducation about the variables discussed in this study and to normalize these experiences, especially for less well-known phenomena such as physiological sexual arousal and TI.

Distortion of overlapping memories relates to arousal and anxiety.

Everyday experiences often overlap, challenging our ability to maintain distinct episodic memories. One way to resolve such interference is by exaggerating subtle differences between remembered events, a phenomenon known as memory repulsion. Here, we tested whether repulsion is influenced by emotional arousal, when resolving memory interference is perhaps most needed. We adapted an existing paradigm in which participants repeatedly studied object-face associations. Participants studied two different-colored versions of each object: a to-be-tested "target" and its not-to-be-tested "competitor" pair mate. The level of interference between target and competitor pair mates was manipulated by making the object colors either highly similar or less similar, depending on the participant group. To manipulate arousal, the competitor object-face associations were preceded by either a neutral tone or an aversive and arousing burst of white noise. Memory distortion for the color of the target objects was tested after each study round to examine whether memory distortions emerge after learning. We found that participants with greater sound-induced pupil dilations, an index of physiological arousal, showed greater memory attraction of target colors towards highly similar competitor colors. Greater memory attraction was also correlated with greater memory interference in the last round of learning. Additionally, individuals who self-reported higher trait anxiety showed greater memory attraction when one of the overlapping memories was associated with something aversive. Our findings suggest that memories of similar neutral and arousing events may blur together after repeated exposures, especially in individuals who show higher arousal responses and symptoms of anxiety.

Social bonding through shared experiences: the role of emotional intensity.

Sharing emotions with other individuals is a widespread phenomenon. Previous research proposed that experiencing intense and similar emotions with other individuals reinforces social bonds. However, several aspects of this phenomenon remain unclear, notably whether social bonding requires the convergence and synchronization of emotions in the group, and whether these effects generalize across positively valenced and negatively valenced emotional contexts. To address these questions, we measured subjective emotional experiences, physiological activity (cardiac, respiratory, electrodermal) and social attitudes in dyads of unacquainted individuals who watched videos in the presence of each other. We manipulated the emotional content of the videos and the type of shared attention between participants, to test for the contribution of interpersonal influence. The results revealed that intense emotions indexed by physiological arousal were associated with the emergence of reciprocal prosocial attitudes within dyads, and that this effect depended on joint attention. We did not observe the convergence and synchronization of emotions within dyads, which suggests that experiencing similar emotions was not necessary for social bonding. We discuss implications of this study for research on collective effervescence and the social consequences of shared experiences.

Physiological, behavioral, and self-report outcomes of acceptance- and regulation-based exposure for intrusive thoughts

Leading theories regarding the mechanisms of exposure for OCD focus on Pavlovian fear reduction more than operant processes. Acceptance-based exposure directly targets operant behavior. Integrating these perspectives could lead to a more robust understanding of mechanisms of change in exposure and more effective and enduring treatments. The current study investigated acceptance and regulation of distress during exposure. Participants with intrusive thoughts were randomized into three groups, Acceptance (n = 23), Regulation (n = 20), and Control (n = 21), and completed two behavioral avoidance tests (BATs) 1 week apart. Active conditions completed a 30-min exposure plus 6 days of 10-min exposures at home; Control participants watched videos of the same durations. Self-report measures were collected at both sessions, and behavioral, subjective, and physiological repeated measures data were collected during both BATs. Compared to Control, active conditions decreased OCD symptom severity, rituals, and skin conductance levels, while Acceptance showed lower skin conductance levels than Regulation and Control. Acceptance showed greater willingness and psychological flexibility than Control, while Regulation did not. Results support theorized mechanisms of change in acceptance-based exposure and suggest willingness to experience distress may paradoxically lead to decreased physiological arousal, which has important implications for treatment and future research.

The complexity of interpersonal physiology during rupture and repair episodes in the treatment of borderline personality disorder: a proof-of-concept multimethod single case study of verbal and non-verbal interactional dynamics.

The aim of this proof-of-concept multimethod exploratory single case study is to increase knowledge of the underlying mechanisms of alliance ruptures and repairs in Borderline Personality Disorder treatment across and within the psychotherapeutic treatment process. The multimethod includes outcome assessment of patient self-reporting questionnaires (the Affect Integration Inventory, the Hopkins Symptom Checklist), observation-based ratings of sessions with the Rupture Resolution Rating System, quantitative analysis of heart rate variability using recurrence quantification analysis, and a qualitative multimodal interaction analysis of within-session dynamics. Results reveal how patterns of heart rate synchrony between patient and therapist reflect periodical patterns of emotional interaction corresponding to key therapeutic alliance processes throughout the treatment process. Particularly, heart rate synchronization and desynchronization correspond with increasing rupture resolution ratings and positive outcome measures in the last part of the therapy process, indicating increased productivity, affectivity, and positive change. The qualitative microanalysis highlights context sensitivity to alliance management within sessions. Physiological arousal is found to underlie important alliance processes, including emotion regulation, relatedness, security, empathic responding, sense-making, and validation in correspondence with different therapist verbal and non-verbal markerbs. Clinical implications and study limitations are discussed. Recommendations are made for future directions in relation to applying multimethod approaches when studying rupture and repair processes in psychotherapy.

The development of sources of self‐efficacy in self‐regulation during one primary school year: the role of gender, special educational needs, and individual strengths

AbstractThe study investigated the development of sources of self‐efficacy in self‐regulation in 9–12 year old (N = 317, primary school) students during one school year. We used latent growth curve modeling to determine (1) how the different sources of self‐efficacy for self‐regulation (i.e., mastery experience, vicarious experience, social persuasion, physiological and emotional arousal) change over one school year, and (2) how students' gender, special educational needs, and behavioral and emotional strengths relate to these changes. These results indicated that, on average, mastery experiences decreased and physiological and emotional arousal increased, whereas vicarious experience and social persuasion remained stable. Girls had higher initial levels of physiological and emotional arousal than boys, and experienced a steeper decline in mastery experiences compared to boys. Students with special educational needs had lower initial levels of mastery experience and higher physiological and emotional arousal than students without special educational needs. In addition, students with higher individual strengths presented higher initial levels of mastery and vicarious experiences, and lower physiological and emotional arousal. The results contribute to current research and practice by indicating that sources of self‐efficacy for self‐regulation change over time and are thus malleable in the school context.

Network analyses of emotion components: an exploratory application to the component process model of emotion

Emotion is an episode involving changes in multiple components, specifically subjective feelings, physiological arousal, expressivity, and action tendencies, all these driven by appraisal processes. However, very few attempts have been made to comprehensively model emotion episodes from this full componential perspective, given the statistical and methodological complexity involved. Recently, network analyses have been proposed in the field of emotion and cognition as an innovative theoretical and statistical framework able to integrate several properties of emotions. We therefore addressed the call for more multi-componential evidence by modeling the network of a comprehensive list of emotion components drawn from the Component Process Model of Emotion. Five-hundred students were confronted with mildly ambiguous scenarios from everyday life, and reported on their situational appraisals and emotion responses. Network analyses were applied to the emotion components related to a positive and a negative scenario to explore 1) how the components organize themselves into networks and dimensions; 2) which components are the most central within networks and dimensions; and 3) the patterns of components relation between and within dimensions. A three-dimensional solution emerged in both scenarios. Additionally, some appraisals and responses appeared to be differentially relevant and related to each other in both scenarios, highlighting the importance of context in shaping the strength of emotion component relations. Overall, we enriched the field of affective science by exploring the connections between emotion components in three novel ways: by using network analyses, by integrating them into a multi-componential framework, and by providing context to our emotion components. Our results can also potentially inform applied research, where understanding the interconnections and the centrality of components could aid the personalization of interventions.

"It's Different for Girls!" The Role of Anxiety, Physiological Arousal, and Subject Preferences in Primary School Children's Math and Mental Rotation Performance.

(1) Background: This study examines the role of subjective anxiety (mathematics and spatial anxiety), along with physiological responses, in mathematics or math and mental rotation performance in 131 German primary school students (65 girls, 66 boys; Mean age = 8.73 years). (2) Method: Students' preference for math vs. German and their subjective anxiety were assessed using standardized questionnaires. Emotional reactivity was measured using the Galvanic Skin Response (GSR). Math performance was evaluated via percentage scored and completion times on number line estimation, word problems, and missing terms tasks. Spatial skills were assessed using a novel mental rotation task (nMRT) incorporating gender-congruent and -neutral stimuli. (3) Results: Girls outperformed boys on percentage scored on the math task but took longer to complete this. No gender differences were found in performance on the nMRT. Girls demonstrated higher math anxiety and were less likely to prefer math over German. Math anxiety predicted math scores and accuracy on the nMRT while gender predicted math performance and mental rotation response time. Subject preference was associated with longer completion times and emotional reactivity with longer response times. Girls' preference for math and lower emotional reactivity was linked to shorter completion times, while lower math anxiety predicted higher scores. In contrast, these factors did not affect boys' math performance. Additionally, subjective anxiety, emotional reactivity, or subject preference did not impact spatial performance for either gender. (4) Conclusions: Supporting mathematical self-efficacy and emotional regulation, especially in girls, is crucial for enhancing STEM outcomes in primary education. Gender-fair assessment in mental rotation reveals equitable spatial performance and reduces the impact of anxiety.

Mild hunger elicits attentional desensitization to visual food cues in healthy, non-obese individuals.

Food is a vital human need, and the human visual system is finely tuned to detect and respond to food cues in the environment. The omnipresence of food cues across various settings has been linked to the prevalence of obesity in susceptible populations. However, the influence of the post-prandial state on visual attention to food stimuli remains poorly understood. This study aimed to elucidate how a 12 hour fast affects visual attention to food and non-food stimuli in healthy, non-obese individuals. Visual attention was assessed by measuring the total duration of visual fixations on stimuli presented on a computer screen, using a screen-based eye tracker (Tobii X2-60). Participants were divided into two groups: those who had fasted for 12 hours and those tested within two hours after consuming breakfast (satiated state). Additionally, performance on the Food Stroop task and electrodermal activity (EDA) responses were measured to evaluate attentional interference and physiological arousal, respectively. Salivary samples were also collected to assess levels of alpha-amylase and cortisol. Fasted participants exhibited a progressive decline in visual attention toward food stimuli compared to satiated individuals, reflecting a satiated state. This effect was independent of the palatability of the depicted food items and was not observed with stimuli representing non-food items. The Food Stroop task revealed no differences between fasting and satiated participants, indicating that the presence of food-related stimuli does not differentially impact attentional interference under varying hunger states. Moreover, no significant variations were observed in EDA responses across participant groups and stimulus types, suggesting that the modulation of visual attention to food cues by hunger is independent of physiological arousal. Interestingly, satiated subjects exhibited higher levels of salivary alpha-amylase, which was inversely related to their subjective hunger ratings. No differences in salivary cortisol levels were found between groups. The findings indicate a novel influence of mild hunger on the processing of visual food cues, independent of physiological arousal. The decline in visual attention to food stimuli in fasted individuals suggests that satiety modulates visual processing. The lack of differences in attentional interference and physiological arousal between fasting and satiated states further supports the notion that visual attention to food cues is primarily driven by hunger-related mechanisms rather than stress. Additionally, the inverse relationship between salivary alpha-amylase levels and hunger ratings implies that alpha-amylase may serve as a marker of satiety rather than stress.

Feeling tired versus feeling relaxed: Two faces of low physiological arousal.

Human well-being and functioning depend on two fundamental mental states: Relaxation and sleepiness. Relaxation and sleepiness are both assumed to be states of low physiological arousal and negatively correlated. However, it is still unclear how consistent this negative relationship is across different settings and whether it changes before and after an intervention. Here we investigated this intricate relationship between subjective momentary sleepiness and relaxation states by meta-analytically analyzing several data sets from studies using the Relaxation State Questionnaire. We discovered that subjective sleepiness and relaxation were in fact anti-correlated pre-intervention. This anti-correlation provides a quantitative dissociation between sleepiness and relaxation. Thus, even though sleepiness and relaxation both implicate a low arousal level, the two mental states are subjectively experienced in a qualitatively different fashion, and thus reflect distinct underlying constructs. For the post-intervention relationship, this negative correlation could not be consistently found. This indicates that there are aspects of the experimental setting or intervention that introduce changes in the dynamics of the relationship of the two constructs.

Eye, Heart, the Brain: The Psychophysiology of Trust in AVs

Automation misuse and acceptance, influenced by trust, environmental conditions, and confidence, have hindered drivers from fully benefiting from partially automated vehicles. This study investigates how driver trust changes with AV reliance, differences in mental and physiological states, and continuous measures’ effectiveness. The takeover drivers reported lower trust than the non-takeover drivers in all scenarios. Nontakeover drivers’ elevated DLPFC activation aligns with trust networks and emotion regulation. The groups also differed in neural activation preand during scenarios with the takeover group showed more PFC, V2V3, and IFC engagement pre-scenario. Gaze revealed the takeover group fixated more on the AV button or dashboard, indicating readiness to take over, while non-takeover drivers focused on the rearview mirror, reflecting situational awareness. HRV responses showed higher physiological arousal in the takeover group pre-scenario. In summary, our multimodal approach reveals takeover behavior is associated with lower trust, cognitive unloading, increased stress, and anticipatory visual attention.

Physiological and communicative emotional disconcordance in children on the autism spectrum

BackgroundIndividuals on the autism spectrum commonly have differences from non-autistic people in expressing their emotions using communicative behaviors, such as facial expressions. However, it is not yet clear if this reduced expressivity stems from reduced physiological reactivity in emotional contexts or if individuals react internally, but do not show these reactions externally to others. We hypothesized that autism is characterized by a discordance between in-the-moment internal psychophysiological arousal and external communicative expressions of emotion.MethodsForty-one children on the autism spectrum and 39 non-autistic, typically developing (TD) children of two age groups (2–4 and 8–12 years) participated in a low-level stress task whilst wearing a wireless electrocardiogram. Children’s negative emotional expressions (facial, vocal, bodily) were coded following standardized protocols. Alexithymia traits were assessed using the Children’s Alexithymia Measure with school-aged children only. Data analyses involved ANOVAs, correlations, and sensitivity analyses.ResultsThere were no group differences in physiological arousal (heart rate) or in communicative expressions of stress to the stress task. For TD preschoolers, physiological arousal during the stress task was associated with vocal expressions and for TD school-aged children, they were associated with facial and bodily expressions. By contrast, for children on the autism spectrum, physiological arousal during the stress tasks was not associated with communicative expressions across age groups.ConclusionsOur findings suggest that children on the autism spectrum might experience emotional disconcordance, in that their physiological arousal does not align with their communicative expressions. Therefore, the internally experienced stress of children on the autism spectrum may be inadvertently missed by teachers and caregivers and, consequently, learning opportunities for teaching emotional communication and regulation may be also missed. Our results support the use of wearable biosensors to facilitate such interventions in children on the autism spectrum.

Pupillary Responses to Dynamic Negative Versus Positive Facial Expressions of Emotion in Children and Parents: Links to Depression and Anxiety.

Witnessing emotional expressions in others triggers physiological arousal in humans. The current study focused on pupil responses to emotional expressions in a community sample as a physiologicalindex of arousal and attention. We explored the associations between parents' and offspring's responses to dynamic facial expressions of emotion, as well as the links between pupil responses and anxiety/depression. Children (N=90, MAge=10.13, range=7.21-12.94, 47 girls) participated in this lab study with one of their parents (47 mothers). Pupil responses were assessed in a computer task with dynamic happy, angry, fearful, and sad expressions, while participants verbally labeled the emotion displayed on the screen as quickly as possible. Parents and children reported anxiety and depression symptoms in questionnaires. Both parents and children showed stronger pupillary responses to negative versus positive expressions, and children's responses were overall stronger than those of parents. We also found links between the pupil responses of parents and children to negative, especially to angry faces. Child pupil responses were related to their own and their parents' anxiety levels and to their parents' (but not their own) depression. We conclude that child pupils are sensitive to individual differences in parents' pupils and emotional dispositions in community samples.

Exercise and Acute Cognitive Enhancement.

Substantial research has explored the effects of a single session of exercise on cognitive performance. Meta-analytic reviews provide summary statistics relative to these effects when the cognitive task is performed while exercising and when performed after exercise. When performed concomitantly the effects of exercise are typically small or negative with the exception of moderate effects for speed of cognitive performance during moderate intensity exercise. When cognitive performance is assessed following the cessation of exercise, the effects are typically positive. When considering the effects following exercise, most studies have focused on executive function and episodic memory as the cognitive outcomes of interest with meta-analyses supporting small-to-moderate benefits. When potential moderators related to exercise parameters or participants characteristics are examined, results suggest that 20 minutes of moderate to vigorous intensity exercise consistently benefits performance with larger effects evident for executive function tasks with higher cognitive demands, for long-term memory tasks when exercise is performed prior to information encoding, and when considering individuals with lower initial cognitive performance levels. These observed benefits are likely due to the impacts acute exercise can have on physiological arousal, brain function, and brain neurotrophic factors. Advancements in our understanding of the potential of a single session of exercise to benefit cognitive performance are important for exercise prescription and to inform chronic exercise programs designed to benefit cognition.

Can transcutaneous auricular vagus nerve stimulation mitigate vigilance loss? Examining the effects of stimulation at individualized versus constant current intensity.

According to the arousal model of vigilance, the locus coeruleus-norepinephrine (LC-NE) system modulates sustained attention over long periods by regulating physiological arousal. Recent research has proposed that transcutaneous auricular vagus nerve stimulation (taVNS) modulates indirect physiological markers of LC-NE activity, although its effects on vigilance have not yet been examined. Aiming to develop a safe and noninvasive procedure to prevent vigilance failures in prolonged tasks, the present study examined whether taVNS can mitigate vigilance loss while modulating indirect markers of LC-NE activity. Following a preregistered protocol (https://osf.io/tu2xy/), 50 participants completed three repeated sessions in a randomized order, in which either active taVNS at individualized intensity set by participant, active taVNS set at 0.5 mA for all participants, or sham taVNS, was delivered while performing an attentional and vigilance task (i.e., ANTI-Vea). Changes in salivary alpha-amylase and cortisol concentrations were measured as markers of LC-NE activity. Self-reports of feelings associated with stimulation and guessing rate of active/sham conditions supported the efficacy of the single-blind procedure. Contrary to our predictions, the observed vigilance decrement was not modulated by active taVNS. Pairwise comparisons showed a mitigation by active taVNS on cortisol reduction across time. Interestingly, Spearman's correlational analyses showed some interindividual effects of taVNS on indirect markers of LC-NE, evidenced by positive associations between changes in salivary alpha-amylase and cortisol in active but not sham taVNS. We highlight the relevance of replicating and extending the present outcomes, investigating further parameters of stimulation and its effects on other indirect markers of LC-NE activity.

The Effect of a Self-Efficacy-Based Dietary Intervention on Weight Gain Control in Obese and Overweight Pregnant Women: A Quasi-Experimental Pretest-Posttest Design Study

Background: The increasing incidence of obesity among women of childbearing age has raised concerns regarding the associated maternal and neonatal complications. Excessive gestational weight gain in overweight and obese pregnant women is related to various perinatal complications, including hypertensive disorders, gestational diabetes mellitus, and cesarean deliveries. Objectives: The aim of this study was to investigate the impact of self-efficacy-based psychological training on controlling excessive weight gain in overweight and obese pregnant women. Methods: A quasi-experimental pretest-posttest design was employed, involving 141 pregnant women with a gestational age range of 16 - 24 weeks, who were attending healthcare centers in Dezful city, Iran. Participants were randomly assigned to either the intervention (n = 69) or control group (n = 71), with the intervention group receiving one month of psychological training in self-efficacy as an educational intervention. The intervention incorporated self-efficacy strategies, including step-by-step progression, learning from vicarious experience, using verbal persuasion, physiological arousal, and mindfulness training to improve self-efficacy regarding eating behaviors. Results: The intervention group demonstrated a significant improvement in weight gain control within the recommended range compared to the control group. Self-efficacy scores increased from 54.43 ± 11.28 to 62.54 ± 7.49 in the intervention group. Additionally, the study found that the intervention group exhibited improved self-efficacy in eating behaviors, particularly in the sub-scales of availability, social pressure, negative emotion, positive emotion, and physical discomfort. Conclusions: This study highlights the effectiveness of using self-efficacy strategies in managing weight gain during pregnancy among overweight and obese women. The findings suggest the potential benefits of mindfulness-based eating awareness training for pregnant women. The study emphasizes the need for tailored interventions to empower pregnant women in managing gestational weight gain, particularly those with pre-pregnancy obesity.