Pre-ejection Period Responses Research Articles

Dampened autonomic nervous system responses to stress and substance use in adolescence.

We investigated whether parasympathetic and sympathetic nervous system (SNS) responses to social-evaluative threat at age 14 were related to the number of substances used between ages 14 and 16 among Mexican-origin adolescents (N=243; 70.4% had never used substances by 14). Participants completed the Trier Social Stress Test, while cardiac measures of parasympathetic and SNS activity were measured continuously using respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP), respectively. Participants reported whether they had ever used alcohol, marijuana, and cigarettes, and had ever vaped nicotine in their lifetime at ages 14 and 16. Multilevel models were used to test associations between RSA and PEP responses at age 14 and substance use at 16. Among youth who had not used substances by 14, dampened RSA and PEP responses, and profiles of greater coinhibition and lower reciprocal SNS activation between RSA and PEP, at age 14 were associated with using substances by 16. Among youth who used by 14, exaggerated PEP responses were associated with using more substances by age 16. Taken together, dampened autonomic responses to social-evaluative threat predicted initiation of substance use over two years, and difficulties with coordination of physiological responses may confer risk for substance use in adolescence.

Correlation of sympathetic and parasympathetic nervous system activity during rest and acute stress tasks

Autonomic nervous system (ANS) activity is a core and central component of emotion and motivated action. The myriad social and cognitive challenges faced by humans require flexible modulation of ANS activity for different contexts. In this study, simultaneous activity of the parasympathetic and sympathetic nervous system was measured using respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP), respectively. Samples combined four previous studies (N = 325, 63% female, aged 15–55) in which RSA and PEP were collected continuously during a resting baseline and an acute stressor, the Trier Social Stress Task. The concurrent relation between RSA and PEP responses was modelled in order to determine the extent to which SNS and PNS activity is correlated across the task within and between participants, and whether this correlation was moderated by age, race, sex, or baseline RSA and PEP. Overall, RSA and PEP were reciprocally coupled. However, recovery from a stressor was characterized by coactivation. Individuals also vary in the extent to which their SNS and PNS are reciprocally coupled; women, younger adults, and individuals with higher baseline RSA showed more reciprocal coupling than men, older adults, and those with lower baseline RSA, respectively, reflecting greater coordination of physiological responding in the former groups.

Evidence for decreased parasympathetic response to a novel peer interaction in older children with autism spectrum disorder: a case-control study

BackgroundIndividuals with autism spectrum disorder (ASD) often experience elevated stress during social interactions and may have difficulty forming and maintaining peer relationships. The autonomic nervous system (ANS) directs physiological changes in the body in response to a number of environmental stimuli, including social encounters. Evidence suggests the flexibility of the ANS response is an important driving factor in shaping social behavior. For youth with ASD, increased stress response and/or atypical ANS regulation to benign social encounters may therefore influence social behaviors, and, along with developmental and experiential factors, shape psychological outcomes.MethodsThe current study measured ANS response to a peer-based social interaction paradigm in 50 typically developing (TD) children and 50 children with ASD (ages 10–13). Respiratory sinus arrhythmia (RSA), a cardiac measure of parasympathetic influence on the heart, and pre-ejection period (PEP), a sympathetic indicator, were collected. Participants engaged in a friendly, face-to-face conversation with a novel, same-aged peer, and physiological data were collected continuously before and during the interaction. Participants also reported on state anxiety following the interaction, while parents reported on the child’s social functioning and number of social difficulties.ResultsLinear mixed models revealed that, while there were no diagnostic effects for RSA or PEP, older youth with ASD appeared to demonstrate a blunted parasympathetic (RSA) response. Further, increased severity of parent-reported social symptoms was associated with lower RSA. Youth with ASD reported more anxiety following the interaction; however, symptoms were not related to RSA or PEP response based on linear mixed modeling.ConclusionsPhysiological regulation, age, and social functioning likely influence stress responses to peer interactions for youth with ASD. Parasympathetic functioning, as opposed to sympathetic arousal, may be especially important in behavioral regulation, as older youth with ASD demonstrated atypical regulation and response to the social interaction paradigm. Future studies should help to further elucidate the developmental factors contributing to stress responses in ASD, the impact of physiological response on observable social behavior, and potential long-term consequences of chronic social stress in youth with ASD.

Circadian mismatch and cardiovascular response to a performance challenge: Larks in morning and evening work sessions

We presented morning chronotype (“Lark”) university undergraduate volunteers a more or less difficult Sternberg-type recognition memory task either in the morning (8–11 am) or in the evening (5–8 pm) with instructions that they could win a prize if they were 85% successful. We established morning chronotype using the Composite Scale for Morningness (Smith et al., 1989), employing a tertile split on a pool of scale scores that ranged from 13 (extreme eveningness) to 55 (extreme morningness). Participants had scores above 37, with most participants identifying as White/Caucasian, Hispanic/Latino, or Black/African-American. Among women (final sample n = 81), systolic blood pressure and mean arterial pressure responses assessed during work formed a crossover pattern, being positively correspondent to difficulty in the morning but negatively correspondent to difficulty in the evening. Heart rate and heart pre-ejection period responses ran parallel in the morning but not the evening. Among men (final sample n = 41), cardiovascular responses differed neither with difficulty nor with time. Findings for women support the extension of a recent analysis of fatigue influence on effort and associated cardiovascular responses to the phenomenon of circadian mismatch. Findings for men do not support the extension but should be interpreted guardedly in light of prohibitively low cell ns and unexpected findings on key subjective measures.

Implicit achievement motive limits the impact of task difficulty on effort-related cardiovascular response

In contrast to the motive literature, motivational intensity theory predicts that the implicit achievement motive (nAch) should only exert an indirect impact on effort by limiting the impact of task difficulty. To contrast these two views, sixty-eight participants with a low or high nAch performed an easy or difficult arithmetic task. Effort was assessed using cardiac pre-ejection period (PEP). Supporting motivational intensity theory’s view, PEP response was low in both easy-task conditions but stronger in the high-nAch group than in the low-nAch group in the difficult task. These findings suggest that nAch exerts an indirect effect on effort investment by setting the maximally justified effort instead of directly determining the amount of effort that is invested to satisfy the motive.

Task difficulty moderates implicit fear and anger effects on effort-related cardiac response

Based on the implicit-affect-primes-effort (IAPE) model (Gendolla, 2012, 2015), the present experiment tested whether objective task difficulty moderates the previously found impact of fear and anger primes on effort-related cardiac response during an arithmetic task. We expected that fear primes would lead to stronger cardiac pre-ejection period (PEP) reactivity than anger primes in an easy task, but that anger primes would lead to a stronger PEP response than fear primes in a difficult task. Results corroborated these predictions. Moreover, there was no evidence that the affect primes induced conscious feelings that could explain the observed cardiac reactivity, suggesting that the primes had the intended implicit effect on effort mobilization. The findings contribute to the accumulating evidence in support of the IAPE model, showing that objective task difficulty is a moderator of implicit affect’s influence on effort-related cardiac response.

Implicit fear and effort-related cardiac response

Based on the Implicit-Affect-Primes-Effort (IAPE) model (Gendolla, 2012, 2015), two experiments tested the impact of fear primes on effort-related cardiac response. The main dependent variable was reactivity of cardiac pre-ejection period (PEP) during the performance of cognitive tasks. The IAPE model predicts that activation of implicit fear and sadness results in stronger PEP responses during task performance than activation of implicit happiness or anger. To test this, Experiment 1 exposed participants to masked facial expressions of fear, anger, or happiness while they performed a cognitive “parity task”. As expected, PEP responses in the implicit fear condition were stronger than in both the implicit anger and happiness conditions. Experiment 2 conceptually replicated the implicit fear effect and revealed, as expected, stronger PEP responses for implicit fear and sadness than implicit anger during a “mental concentration” task. The findings provide the first evidence for the systematic impact of implicit fear on effort-related cardiac response and complete the existing evidence for the IAPE model.

Contrasting the effects of suboptimally versus optimally presented affect primes on effort-related cardiac response

Participants worked on an easy versus difficult arithmetic task with integrated happiness versus sadness primes, presented either suboptimally (briefly and masked) or optimally (long and visible). As predicted by the IAPE model (Gendolla in International Journal of Psychophysiology 86:123–135, 2012. doi: 10.1016/j.ijpsycho.2012.05.003 ), the affect primes moderated the task difficulty effect on mental effort in the suboptimal-prime condition: cardiac pre-ejection period response was stronger in the happiness/difficult than in the sadness/difficult condition and tended to be stronger in the sadness-easy than in the happiness-easy condition. These effects were reversed in the optimal-prime-presentation condition, suggesting behavior correction due to controlled prime processing. Moreover, neither suboptimally nor optimally presented affect primes had prime-congruent effects on conscious mood assessed via self-report. The results demonstrate differential effects of implicitly versus explicitly processed affect cues on mental effort and suggest that they can do so without inducing emotional feelings.

Transforming or restraining rumination: The impact of compassionate reappraisal versus emotion suppression on empathy, forgiveness, and affective psychophysiology

We tested the effects of practicing compassionate reappraisal vs. emotional suppression as direct coping responses to victims’ ruminations about a past interpersonal offense. Participants (32 females, 32 males) were randomly assigned to learn one coping strategy which immediately followed three of six offense rumination trials (counterbalanced). For both strategy types, coping (vs. offense ruminating) reduced ratings of negative emotion, decreased the use of negative emotion language, and reduced tension at the brow muscle (corrugator EMG). Only compassionate reappraisal coping (vs. offense rumination) immediately prompted greater empathy and emotional forgiveness toward the offender. Empathy ratings for the first coping trial mediated the relationship between strategy type and empathy ratings for the final rumination trial. Compassionate reappraisal strategy participants increased their empathy toward the offender while ruminating at the end of the study. Compassionate reappraisal participants (vs. emotional suppression) described coping (vs. rumination) with more positive language, and also had calmer cardiac pre-ejection period responses.

Incentive moderates the impact of implicit anger vs. sadness cues on effort-related cardiac response

This experiment investigated the combined effect of implicit affect and monetary success incentive on effort-related cardiac response in a 2 (Affect Prime: anger vs. sadness)×2 (Incentive: low vs. high) between-person design. Sixty-two participants were exposed to affect primes during an objectively difficult short-term memory task. As predicted, by our theorizing about affect primes’ systematic impact on subjectively experienced task demand and corresponding effort mobilization, sadness primes led to a weak cardiac pre-ejection period (PEP) response when incentive was low (disengagement), but to a very strong PEP response when incentive was high (high effort). PEP responses were moderate in the anger-prime conditions (low effort). HR responses largely corresponded to those of PEP. The results demonstrate for the first time that high incentive can compensate the effort mobilization deficit of individuals who process sadness primes during a difficult task.

Hypothalamic pituitary adrenal axis and sympathetic activation: Joint predictors of memory in children, adolescents, and adults

Although the links between physiological arousal and adults’ memory for emotional information are well understood, little is known about these links across development or when memory is examined for the actual event that induced arousal. In the current study, we examined the associations between physiological arousal and memory in children, adolescents, and young adults. Participants completed a laboratory stressor, the Trier Social Stress Test-Modified (TSST-M) during which salivary cortisol, pre-ejection period (PEP), and self-reported distress were measured. Two weeks later, participants completed a surprise memory test about what occurred during the TSST-M. Larger cortisol responses predicted enhanced memory, especially among individuals who also exhibited a PEP response the TSST-M. These associations did not vary with age. Results have implications for understanding how coordinated physiological responses may influence memory for salient, personal experiences across development.

Attenuated Pre‐ejection Period Response to Tyramine in Patients with Cardiac Sympathetic Denervation

Stress is a well-known factor affecting cardiac contractility through the cardiac sympathetic nerves. A positive inotropic effect of the cardiac sympathetic nerves on the myocardium is reflected by pre-ejection period (PEP) shortening. Patients with Parkinson disease (PD) and neurogenic orthostatic hypotension (NOH) (PD + NOH) or with pure autonomic failure (PAF) have markedly decreased myocardial 6-[(18)F]Fluorodopamine-derived radioactivity, reflecting cardiac sympathetic denervation. The functional effects of the cardiac sympathetic denervation have been unknown. We measured PEP and heart rate-corrected PEP (PEPI) responses to i.v. tyramine (1 mg/min) in 13 patients (9 PD + NOH and 4 PAF) with low 6-[(18)F]Fluorodopamine-derived radioactivity and in subjects with normal radioactivity (15 multiple system atrophy with NOS patients (MSA + NOS). Baseline PEP and PEPI did not differ between the groups. By 10 min after initiation of tyramine infusion, PEP and PEPI were significantly lower (P < 0.01) in MSA + NOS, compared to base line, whereas PEP and PEPI remained unchanged in the PD + NOH/PAF group. The PEP and PEPI decrease was larger in the MSA + NOS group than in the PD + NOH/PAF group (P < 0.05). One of the functional consequences of cardiac sympathetic denervation is failure to increase contractility in response to stimuli that depend on endogenous norepinephrine release.

Autonomic Reactivity of Children to Separation and Reunion With Foster Parents

To determine whether foster children showed different autonomic nervous system activity on separation and reunion than control children. Autonomic nervous system activity in foster children was examined in relation to time in placement and disinhibited attachment. The sample included 60 foster and 50 control children between 2 and 7 years of age who participated with their caregivers in a modified Strange Situation. Heart rate, respiratory sinus arrhythmia (RSA), and pre-ejection period were monitored continuously. Foster caregivers reported disinhibited symptoms on the Disturbances of Attachment Interview. The Strange Situation elicited less RSA reactivity in foster children. Differences in RSA, heart rate, and pre-ejection period responses on the specific separation and reunion episodes were not significant. RSA responses on separation from the stranger and on reunion with the foster caregiver were partly explained by time in placement and disinhibited attachment. Early experiences of relationship disruptions in foster children as well as short placements may have an impact on children's adaptation to environmental and relational challenges. Stable placement may facilitate adaptive affect regulation, except for children with disinhibited symptoms.

Interactive relation of insulin and gender to cardiovascular reactivity in healthy young adults.

High levels of insulin may promote hypertension pathogenesis, in part, via enhanced sympathetic nervous system (SNS) activity. This study examined potential interactive relations of fasting insulin levels, gender, and race to cardiovascular reactivity-a correlate of SNS activation. Hemodynamic responses to 4 laboratory challenges were determined by impedance cardiography in 64 healthy young adults (ages 18-26; 48% male; 50% White, 50% African American). Also examined were lipoprotein lipids, central and total adiposity, self-reported dietary factors, and physical activity. High-insulin (>10.2 mU/ml) men showed greater total peripheral resistance and longer pre-ejection period responses than low-insulin ( pound 10.2 mU/ml) men. High-insulin women displayed greater cardiac index responses than high-insulin men. High insulin levels were related to greater percentage body fat, dietary carbohydrate and fat intake, lower high-density lipoprotein (HDL) cholesterol (in men), higher total cholesterol (in women), and a trend toward higher triglycerides. Cardiovascular reactivity findings were unchanged after statistical adjustment for total and HDL cholesterol, triglycerides, percentage body fat, dietary carbohydrates, and fat. The Gender x Insulin (continuous scores) interaction accounted for 7% and 9% of the variance in cardiac index and total peripheral resistance responses, respectively. These results indicate that high insulin levels are associated with greater vascular reactivity in young men and cardiac reactivity in young women. Enhanced cardiovascular reactivity may constitute a biobehavioral dimension of the metabolic syndrome.

Developmental and contextual influences on autonomic reactivity in young children.

Studies of cardiovascular reactivity in young children have generally employed integrated, physiologically complex measures, such as heart rate and blood pressure, which are subject to the multiple influences of factors such as blood volume, hematologic status, thermoregulation, and autonomic nervous system (ANS) tone. Reactivity studies in children have rarely employed more differentiated, proximal measures of autonomic function capable of discerning the independent effects of sympathetic and parasympathetic responses. We describe 1) the development, validity, and reliability of a psychobiology protocol assessing autonomic reactivity to challenge in 3- to 8-year-old children; 2) the influences of age, gender, and study context on autonomic measures; and 3) the distributions of reactivity measures in a normative sample of children and the prevalences of discrete autonomic profiles. Preejection period (PEP) and respiratory sinus arrythmia (RSA) were measured as indices of sympathetic and parasympathetic nervous system reactivity, respectively, and autonomic profiles were created to offer summative indices of PEP and RSA response. Results confirmed the protocol's validity and reliability, and showed differences in autonomic reactivity by age and study context, but not by gender. The studies' findings offer guidelines for future research on autonomic reactivity in middle childhood and support the feasibility of examining sympathetic and parasympathetic responses to challenge in 3- to 8-year-old children.

Bupropion and paroxetine differentially influence cardiovascular and neuroendocrine responses to stress in depressed patients

Background: There exists a need to identify safe and effective treatments for depression in patients with coronary heart disease (CHD). Methods: Using a cross-sectional design, 17 depressed patients being treated with bupropion (200–450 mg/day) were compared with 17 depressed patients being treated with paroxetine (10–50 mg/day) and with a group of 15 unmedicated, non-depressed controls for cardiovascular, neuroendocrine and heart rate variability (HRV) measures at rest and in response to mental and physical stressors. Results: Regardless of treatment, both treated groups exhibited blunted plasma cortisol, plasma epinephrine, systolic blood pressure, cardiac output, and pre-ejection period responses to mental stressors relative to controls. Bupropion treated individuals exhibited greater total peripheral resistance (TPR) increases than either the paroxetine or control groups, and greater plasma norepinephrine (NE) increases to mental stressors than the paroxetine group. The bupropion group also displayed reduced HRV at rest relative to the controls and during orthostatic challenge relative to both the control and paroxetine groups. Limitations: Despite the fact that the treated groups were well matched for depression and other psychiatric histories, lack of randomization into treatment arms may be associated with a selection bias in the two treated groups. Conclusions: Although both pharmacological treatments were associated with a blunting of some cardiovascular and neuroendocrine responses to stress relative to controls, which may be reflective of their therapeutic mechanisms of action, the results of our study also suggest that bupropion is associated with a more detrimental autonomic profile than paroxetine, as reflected in increased TPR and NE, and reduced HRV. The results of this study may have implications for the pharmacological treatment of depression in CHD patients.

Blunted cardiovascular and catecholamine stress reactivity in women with bulimia nervosa

Cardiovascular and catecholamine responses to mental stressors were investigated in women with bulimia nervosa (BN) and in healthy control subjects. Fifteen women with BN and 15 control subjects completed psychosocial questionnaires before laboratory testing, where they were exposed to an interpersonally based speech stressor and a serial math task. Blood pressure, heart rate, epinephrine, norepinephrine and, via impedance cardiography, systolic time intervals, cardiac output and total peripheral resistance were measured at rest and during stress. Results indicated that BN was associated with blunted sympathetic activation in response to mental stress, indicated by increased pre-ejection period responses and blunted systolic blood pressure, heart rate and epinephrine responses. In contrast, women with BN had elevated cortisol levels when compared with control women. In addition, despite equivalent performance between groups, bulimic women reported feeling significantly more confused, frustrated, inadequate and dissatisfied with their performance during tasks. Psychosocial questionnaires also indicated that women with BN perceived more stress, had worse coping skills, lower self-esteem and sense of mastery, reported less social support, had worse mood, had greater anxiety and were more depressed when compared with control women. These results are interpreted as reflecting physiological and psychological profiles indicative of distress vs. active effort coping in BN. © 1998 Elsevier Science Ireland Ltd. All rights reserved.

Active Coping and Cardiovascular Reactivity

Active coping enhances cardiovascular response presumably by beta-adrenergically mediated myocardial activation. This study examined impedance-derived hemodynamic parameters underlying blood pressure response to two laboratory tasks requiring active coping, performed either with or without an appetitive (i.e., monetary) incentive. Forty-eight healthy, young men completed the Stroop Color-Word Test and Mirror Tracing. Half received no incentive, whereas half were provided with a monetary incentive as an active coping manipulation. Task-related changes in blood pressure, heart rate, systolic time intervals, and hemodynamic parameters were monitored. Psychological responses to the tasks were also obtained. On average, incentive virtually doubled blood pressure response to both Stroop and Mirror Tracing. The change in blood pressure was explained predominantly by a concomitant increase in total peripheral resistance. Heart rate response was also enhanced substantially with incentive. Individuals in the incentive condition reported greater interest in the task, but less perceived control, than persons in the no-incentive condition. The incentive-related increase in total peripheral resistance, combined with an absence of enhanced stroke volume, cardiac output, or preejection period response, indicates that active coping may, under certain conditions, elevate blood pressure via increased systemic resistance, presumably reflecting alpha-adrenergic activation. Furthermore, the enhanced heart rate associated with incentive may reflect a withdrawal of parasympathetic influence.

Left Ventricular Dysfunction during Dynamic Exercise in Noninsulin-Dependent Diabetic Patients with Retinopathy

Systolic time intervals were obtained from 19 middle-aged noninsulin-dependent diabetic patients without clinically evident cardiovascular disease (8 patients had and 11 did not have retinopathy) and 14 normal subjects using ear densitography. All subjects had neither ischemic electrocardiographic response nor chest pain during maximal treadmill exercise. Although left ventricular ejection time (LVET) and preejection period (PEP) did not differ significantly at rest between the three groups, a prolongation of LVET with a nearly identical PEP response was observed during exercise in diabetic patients with retinopathy. These data indicate that the diabetic patients with retinopathy relied on the enhanced ventricular filling in maintaining stroke volume during exercise. Thus, retinopathy is associated with impaired left ventricular systolic function in noninsulin-dependent diabetic patients.

Cardiac response during uninterrupted treadmill exercise and recovery: measurement by systolic time intervals.

In 12 normal subjects, use of ear densitography permitted measurement of systolic time intervals (STI) during uninterrupted treadmill exercise to over 90 percent maximal heart rate on a modified Bruce protocol. Results for control (sitting leads to standing) leads to end-exercise at 18 minutes leads to 10 minutes' sitting recovery were--heart rate (HR): (77 leads to 861 leads to 171 leads to 98 beats per minute; preejection period (PEP): (106 leads to 111) leads to 49 leads to 110 msec; ejection time index (ETI) (351 leads to 330) leads to 380 leads to 366 msec; PEP/LVET (0.42 leads to 0.49) leads to 0.29 leads to 0.45. Heart rate increased steadily to 18 minutes. In contrast, the PEP/LVET decrease was almost complete by three minutes and both ETI and PEP responses were bimodal with respective plateaus between three and six minutes and three and nine minutes. All STI and HR curves showed rapid restitution during early recovery. The changes during treadmill exercise were numerically comparable to those during bicycle exercise at a common heart rate. The results indicate that it is technically feasible to measure systolic time intervals with precision during uninterrupted treadmill exercise; responses to treadmill exercise were in the direction expected and quantitatively comparable to bicycle exercise at comparable stress level. These obervations provide the technical and physiologic bases for applying this method in clinical treadmill exercise testing.