Arousal Reduction Research Articles

Peritraumatic Reaction Courses During War: Gender, Serious Mental Illness, and Exposure

Objective: We assessed in vivo symptom courses of early psychological responses during war and investigated the influence of exposure, gender, and a prior diagnosis of severe mental illness (SMI). Method: Participants were 181 highly exposed individuals from the general population and community psychiatric rehabilitation centers. A 30-day twice-daily Internet-smartphone-based intensive assessment two weeks into the 2014 Israel–Gaza war estimated peritraumatic symptom clusters, sense of threat, negative emotions and cognitions, and siren exposure during two periods that varied in exposure level. Piecewise growth curve modeling procedures were performed. Results: We found different courses for most variables, gender, and SMI status. Women were more reactive two weeks into the war but reduced their reactivity level at a faster pace than males, reaching lower symptom levels one month later. Women’s courses were characterized by arousal, negative emotionality, sense of threat, and reactivity to siren exposure. No-SMI men had a stable course followed by a significant reduction in arousal, negative emotions, avoidance, and perceived threat during a “return to routine” lower-level intensity period of the war. Individuals with SMI had higher reactivity levels at study onset; but while women with SMI improved over time, men with SMI worsened. SMI reactivity was characterized by negative cognitions, intrusions, and avoidance. Conclusions: Early reactions during prolonged exposure to war are variable, dynamic, and affected by exposure context. Symptoms, emotions, and cognitions develop differentially over time and are affected by gender and mental health status. The identification of various early stress courses should inform primary intervention strategies.

6.5 Cognitive-Behavioral Therapy for Insomnia

CBT for insomnia (CBT-I) in adolescents and young adults is a brief intervention that includes both behavioral and psychological procedures. At the end of this presentation, participants will be able to 1) describe when and for whom CBT-I is an appropriate form of treatment intervention; 2) provide practical guidelines for conducting CBT-I, including stimulus control, sleep restriction, cognitive restructuring, and sleep hygiene; and 3) practice arousal reduction and biofeedback for the treatment of insomnia.

Skin Conductance Reactivity to Standardized Virtual Reality Combat Scenes in Veterans with PTSD.

Interest in virtual reality (VR) as a clinical tool to augment posttraumatic stress (PTSD) treatment has grown substantially in recent years due to advances in VR technology. Moreover, its potential assisted use in the PTSD diagnostic process has been recognized. In this study we examined physiological responding, skin conductance, to a standardized presentation of non-personalized combat-related VR events (e.g. encountering enemy fire; explosions) as compared to non-combat classroom VR events in 19 Veterans with and 24 Veterans without combat-related PTSD who had been deployed to Iraq and Afghanistan. Veterans watched a total of 12 VR scenarios-six combat-related and six non-combat-related-with each scenario gradually increasing in emotional intensity by adding more VR events in addition to repeating prior VR events. Results show that Veterans with PTSD displayed larger skin conductance reactivity across VR combat events, but not for non-combat VR events, as compared to combat Veterans without PTSD. Nevertheless, Veterans with and without PTSD showed a similar reduction of emotional arousal to repeated presentation of the same VR combat events. Within the PTSD sample, the elevated level of VR combat-related arousal correlated marginally with severity of hyperarousal symptoms. This study confirms that the use of a non-personalized and standardized VR presentation successfully distinguishes Veterans with PTSD from those without on a measure of psychophysiological arousal to combat-related VR stimuli. The assessment of physiological reactivity during the repeated presentation of standardized, trauma-related VR events highlights its use for PTSD assessment as well as treatment.

Perceived Stress has a Negative Impact on Variables Related to Exercise Recovery in Adolescent Athletes

PURPOSE: Psychological stress has been shown to impair recovery in laboratory settings, but no study has done so in field settings. This study was designed to test the impact of perceived stress on variables related to recovery in an adolescent athlete population who were participating in a 6-wk Summer training program. METHODS: Participants included 100 high school athletes (M age = 15.1; 78% Male; 46% African American). Data were collected during 4 consecutive days in the middle of the training program. Recovery was indicated by measures of feeling states and arousal, fatigue, and soreness. These were collected prior to each day’s training. The Perceived Stress Scale was used to assess stress. Growth curve analysis was used to examine change in these variables throughout the week. We hypothesized stress to be associated with greater soreness to begin the week, and greater decrements in all variables throughout the week. RESULTS: Stress had a significant (p < .05) impact on the reference value of the feeling scale (β00 = 1.2) and soreness (β00 = 1.4). As stress increases by 1 SD, there was a .7 decrease in average feeling scale response and a .4 increase in reported soreness. In addition, stress had a significant impact the change in both felt arousal (β10 = -.1) and soreness (β10 = .3) during the week, with each 1 SD increase in stress associated with a daily .14 drop in felt arousal, and a daily increase of.16 in soreness. CONCLUSION: Stress appears to be associated with reduced recovery during a week of intense, Summer training in high school athletes. Not only was stress associated with reduced mood and increased soreness overall, it was also associated with a greater increase in soreness and reduction in felt arousal across the week. It may be important to help athletes better cope with stress to enhance their response to training. Research reported in this publication was supported by Dairy MAX: UTA16-000534.

Individual Differences in Mood Changes

The study explores the influence of individual tendencies toward mood improvement/deterioration and the Big Five personality traits on mood changes. Participants (218 students) completed NEO-FFI and The Mood Regulation Scales. Based on the within-person structure of individual tendencies toward mood improvement/deterioration four mood regulative types were distinguished (increasing, decreasing, hot and cool type). In the experimental stage participants were randomly assigned to one of four group conditions created by experimental factors: (1) induced mood (positive/negative), and (2) the level of cognitive loading (easy/hard condition). Direct (Mood Adjective Check List) and indirect (emotional version of Lexical Decision Task) measurements were used to assess mood changes. The results showed different patterns of mood changes for increasing and decreasing regulative types. Those differences were visible especially in the positive mood regulation. While the decreasing type decreased the induced positive mood, the increasing type was characterized by mood changes manifested in energetic arousal increase and tense reduction. Moreover, high Neuroticism and low Extraversion in the decreasing type contributed to a negative mood increment manifested in reduction of energetic arousal. The same effect was revealed for high Conscientiousness for the increasing type. The results are discussed in the context of psychological status of mood regulation strategies (automatic/controlled) and with reference to previous research in this area.

How oncologists’ communication improves (analogue) patients’ recall of information. A randomized video-vignettes study

ObjectiveCancer patients need information provision to cope with their disease. However, only 20–60% of information provided during consultations is remembered. This study aimed to investigate whether oncologists’ use of trust-conveying communication, characterized by communicating competence, honesty and caring, enhances patients’ memory. Moreover, we aimed to investigate if this hypothetical relationship is mediated by a reduction in psychophysiological arousal during the consultation. MethodsAn experimental design was used, allowing for conclusion about causality. Two versions of a scripted video-taped consultation were used in which the oncologist adopted either a standard or a trust-conveying communication style. 97 cancer-naive individuals acted as analogue patients and were randomly assigned to watch one of the consultations. ResultsFree recall, assessed 24–28h after viewing, was higher (p=0.039) in the trust-conveying condition (65.3% versus 59.5%). Recognition did not differ (p=0.502). Psychophysiological assessment during watching showed a smaller heart rate response in the trust-conveying condition (p=0.037). No mediation effect nor an effect on electrodermal activity was found. ConclusionThese results suggest that oncologists’ use of trust-conveying communication could increase patients’ free recall of information and diminish their cardiovascular response. Practice implicationsThe underlying mechanisms by which oncologists’ communication influences information recall warrants further investigation.

Distinct Cortical Signatures Associated with Sedation and Respiratory Rate Depression by Morphine in a Pediatric Population.

Opioid analgesia is an essential component of perioperative care, but effective analgesia can be limited by excessive sedation and respiratory depression. The cortical signatures associated with sedation by opioids and the relationship between changes in cortical activity and respiratory function are not well understood. The objectives of this study were to identify the electroencephalogram signatures of sedation and respiratory changes induced by morphine in a pediatric population after elective surgery. After otologic surgery, patients (14.8 ± 2.8 yr, n = 10) stayed overnight for pain relief with morphine (3 to 10 mg), hydration, and clinical observation. Electroencephalogram activity and polysomnography were performed before and after morphine, and electroencephalogram spectral properties and cardiorespiratory activities were analyzed. Compared to wakefulness and non-rapid eye movement sleep, morphine reduced high-frequency β1 (13.5 to 20 Hz) and β2 (20 to 30Hz) electroencephalogram powers (n = 10) and decreased coherence between frontal and occipital β2 electroencephalogram activities (n = 9), therefore indicating that morphine induced a deep sedative state. Morphine also reduced respiratory rate by 8.3% (n = 10). Interestingly, there was a significant correlation between the reduction in β1 electroencephalogram activity and the depression in respiratory rate induced by morphine (R = 0.715, n = 10). With significant reduction in β1 power, respiratory rate was decreased by more than 25%, suggesting that reduction in cortical arousal is associated with the severity of respiratory rate depression. Analgesic doses of morphine are associated with reduction in respiratory rate when accompanied by reduction in β1 electroencephalogram power, indicating a powerful effect of cortical arousal state per se in respiratory rate depression by morphine.

Pupillometry reveals changes in physiological arousal during a sustained listening task.

Hearing loss is associated with anecdotal reports of fatigue during periods of sustained listening. However, few studies have attempted to measure changes in arousal, as a potential marker of fatigue, over the course of a sustained listening task. The present study aimed to examine subjective, behavioral, and physiological indices of listening-related fatigue. Twenty-four normal-hearing young adults performed a speech-picture verification task in different signal-to-noise ratios (SNRs) while their pupil size was monitored and response times recorded. Growth curve analysis revealed a significantly steeper linear decrease in pupil size in the more challenging SNR, but only in the second half of the trial block. Changes in pupil dynamics over the course of the more challenging listening condition block suggest a reduction in physiological arousal. Behavioral and self-report measures did not reveal any differences between listening conditions. This is the first study to show reduced physiological arousal during a sustained listening task, with changes over time consistent with the onset of fatigue.

Emotional Modulation of the Late Positive Potential during Picture Free Viewing in Older and Young Adults.

Hedonic bias during free viewing of novel emotional and neutral scenes was investigated in older adults and college students. A neurophysiological index of emotional picture processing–the amplitude of the centroparietal late positive potential (LPP)–was recorded from the scalp using a dense sensor array while participants (29 older adults; 21 college students) viewed emotionally engaging or mundane natural scenes that varied in specific content. Both students and older adults showed LPP enhancement when viewing affective, compared to neutral, scenes, and there was no difference in LPP amplitude between older individuals and college students when viewing neutral everyday scenes. However, compared to the college students, older individuals showed attenuated LPP amplitude when viewing emotional scenes, regardless of hedonic valence or specific content. Age related differences could be mediated by a reduction in reactive emotional arousal with age, possible mediated by repeated life exposure to emotional stimuli.

The Potential Benefits of Targeted Attentional Bias Modification on Cognitive Arousal and Sleep Quality in Worry-Related Sleep Disturbance

Attentional bias for sleep-related negative information is believed to contribute to symptoms of insomnia by elevating arousal during the presleep period. In the present study, we examined whether the delivery of an attentional bias modification (ABM) procedure in the presleep period could produce transient benefits for sleep-disturbed individuals by reducing presleep cognitive arousal and improving ease of sleep onset. In a counterbalanced repeated A-B design, participants alternated completing an ABM training task and a nontraining control task across six nights and reported on presleep cognitive arousal and sleep onset latency. Significant reductions in presleep cognitive arousal and sleep onset latency were observed on nights where the ABM task was completed relative to nights where the control task was completed. These results suggest that delivery of ABM can attenuate cognitive arousal and sleep onset latency and highlights the possibility that targeted delivery of ABM could deliver real-world benefits for sleep-disturbed individuals.

The Relationship Between Exercise Intensity and Sleep Quality in People Hospitalised Due to Affective Disorders: A Pilot Study

Individuals with mental illness experience poorer sleep quality compared to the general population. Exercise may improve sleep quality through a reduction in arousal, however the association between perceived exercise intensity and sleep quality for this population is largely unknown. Forty inpatient mental health consumers reported perceived exertion prior to, and immediately following, a morning session of combined aerobic and strengthening exercise. Self-reported sleep quality was reported immediately upon waking the day following the acute exercise session. Pearson's correlations examined the relationship between exercise intensity and sleep quality. A significant negative correlation was observed between post-exercise exertion and sleep quality (r = –0.32, p = 0.045). A reduction in arousal may explain the observed effects for people with anxiety disorders.

Psychological Interventions in the Treatment of Chronic Itch.

Patients with chronic itch suffer from higher levels of depression and anxiety than their healthy counterparts. Furthermore, psychological factors, such as stress, are known to aggravate itch. The mere act of thinking about itching can induce the sensation. Interventions like habit reversal training and arousal reduction have been shown to have positive effects on itch relief. Yet, there is still limited data on the psychological management to control the itch scratch cycle and a description of methods suitable to address itch. In this review, we describe different psychological interventions shown to be effective in the treatment of chronic itch. We also provide suggestions based on our experience of suitable interventions for patients with different types of itch.

Commentary: Yawning, acute stressors, and arousal reduction in Nazca booby adults and nestlings.

Commentary: Yawning, acute stressors, and arousal reduction in Nazca booby adults and nestlings.

Mechanisms of Change in Written Exposure Treatment of Posttraumatic Stress Disorder

Although the effectiveness of exposure therapy for PTSD is recognized, treatment mechanisms are not well understood. Emotional processing theory (EPT) posits that fear reduction within and between sessions creates new learning, but evidence is limited by self-report assessments and inclusion of treatment components other than exposure. We examined trajectories of physiological arousal and their relation to PTSD treatment outcome in a randomized controlled trial of written exposure treatment, a protocol focused on exposure to trauma memories. Hierarchical linear modeling was used to model reduction in Clinician Administered PTSD Scale score as a predictor of initial activation and within- and between-session change in physiological arousal. Treatment gains were significantly associated with initial physiological activation, but not with within- or between-session changes in physiological arousal. Treatment gains were associated with larger between-session reductions in self-reported arousal. These findings highlight the importance of multimethod arousal assessment and add to a growing literature suggesting refinements of EPT.

Does successful smoking cessation reduce anxious arousal among treatment-seeking smokers?

IntroductionThere is limited work that has examined the effect of quitting smoking on anxious arousal, an underlying dimension of anxiety symptoms and psychopathology. MethodSmokers (n=185, 54.1% female) enrolled in a smoking cessation treatment trial were monitored post-cessation in terms of abstinence status (biochemically verified; at Weeks 1, 2, and Month 1 post-quit) and severity of panic-relevant symptoms (self-reported; at Month 1 and 3 post-quit). Structural equation models were conducted, adjusting for participant sex, age, treatment condition, and pre-cessation nicotine dependence, presence of depressive/anxiety disorders, anxious arousal, and anxiety sensitivity. ResultsAfter adjusting for covariates, participants who remained abstinent for one month (n=80; 43.2%) relative to those who did not (n=105; 56.8%) demonstrated significant reductions in anxious arousal at Month 1 (β=−.26, p=.04) and Month 3 post-quit (β=−.36, p=.006); abstinence status had a non-significant effect on anxious arousal severity at Month 3 after controlling for Month 1 anxious arousal (β=−.18, p=.09). DiscussionFindings align with theoretical models of smoking-anxiety interplay and suggest that smoking cessation can result in reductions in anxious arousal.

Behaviorally-based couple therapies reduce emotional arousal during couple conflict

Emotional arousal during relationship conflict is a major target for intervention in couple therapies. The current study examines changes in conflict-related emotional arousal in 104 couples that participated in a randomized clinical trial of two behaviorally-based couple therapies. Emotional arousal is measured using mean fundamental frequency of spouse's speech, and changes in emotional arousal from pre-to post-therapy are examined using multilevel models. Overall emotional arousal, the rate of increase in emotional arousal at the beginning of conflict, and the duration of emotional arousal declined for all couples. Reductions in overall arousal were stronger for TBCT wives than for IBCT wives but not significantly different for IBCT and TBCT husbands. Reductions in the rate of initial arousal were larger for TBCT couples than IBCT couples. Reductions in duration were larger for IBCT couples than TBCT couples. These findings suggest that both therapies can reduce emotional arousal, but that the two therapies create different kinds of change in emotional arousal.

Differential Effects of Lowered Arousal on Covert and Overt Shifts of Attention.

Based on previous studies demonstrating detrimental effects of reduced alertness on attentional orienting our study seeks to examine covert and overt attentional orienting in different arousal states. We hypothesized an attentional asymmetry with increasing reaction times to stimuli presented to the left visual field in a state of maximally reduced arousal. Eleven healthy participants underwent sleep deprivation and were examined repeatedly every 4 hr over 28 hr in total with two tasks measuring covert and overt orienting of attention. Contrary to our hypothesis, a reduction of arousal did not induce any asymmetry of overt orienting. Even in participants with profound and significant attentional asymmetries in covert orienting no substantial reaction time differences between left- and right-sided targets in the overt orienting task could be observed. This result is not in agreement with assumptions of a tight coupling of covert and overt attentional processes. In conclusion, we found differential effects of lowered arousal induced by sleep deprivation on covert and overt orienting of attention. This pattern of results points to a neuronal non-overlap of brain structures subserving these functions and a differential influence of the norepinephrine system on these modes of spatial attention.

Integrating electrodermal biofeedback into pharmacologic treatment of grand mal seizures.

Electrodermal activity (EDA) and electrodermal biofeedback, when integrated with pharmacologic treatments, indicate promising methods for the treatment of grand mal seizures. They can be used to monitor patient arousal and help patients learn new strategies to better cope with stress and anxiety. Our proposed method can possibly reduce the number of crises for patients who are dependent on pharmacologic therapy and can improve their quality of life. This article describes the scientific background of electrodermal monitoring and electrodermal biofeedback for patients affected by grand mal seizures. In this study, we have reported a clinical case study. The patient was treated for 2 years with electrodermal biofeedback to augment pharmacologic treatments. The trial has been designed in accordance with “n = 1 case study research”. Our results have shown that our methods could achieve a significant reduction in grand mal seizures and sympathetic arousal when applied. The patient under consideration was also relaxed and exhibited greater competency to cope with stress. Additionally, the patient’s sense of mastery and self-efficacy was enhanced.

Attachment insecurity as a moderator of cardiovascular arousal effects following dyadic support

We examine the cardiovascular arousal effects of emotional support receipt, and the moderation of these by the support recipient’s and provider’s attachment. Seventy couples engaged in a laboratory dyadic supportive interaction, while their ECG was monitored. With more emotional support, men with high attachment anxiety showed greater arousal reduction during the dyadic interaction, whereas men with low attachment anxiety showed less reduction; additionally, women coupled with partners with high attachment anxiety showed greater arousal reduction, whereas women coupled with partners with low attachment anxiety showed less reduction. Men and women with high attachment avoidance showed less arousal reduction, whereas those with low attachment avoidance showed greater reduction. These results highlight the differential ways in which support gets under the skin.

Occlusions congénitales du côlon et du rectum ; l’exclusion des malformations anorectales – questions

There is limited work that has examined the effect of quitting smoking on anxious arousal, an underlying dimension of anxiety symptoms and psychopathology.Smokers (n = 185, 54.1% female) enrolled in a smoking cessation treatment trial were monitored post-cessation in terms of abstinence status (biochemically verified; at Weeks 1, 2, and Month 1 post-quit) and severity of panic-relevant symptoms (self-reported; at Month 1 and 3 post-quit). Structural equation models were conducted, adjusting for participant sex, age, treatment condition, and pre-cessation nicotine dependence, presence of depressive/anxiety disorders, anxious arousal, and anxiety sensitivity.After adjusting for covariates, participants who remained abstinent for one month (n = 80; 43.2%) relative to those who did not (n = 105; 56.8%) demonstrated significant reductions in anxious arousal at Month 1 (β = −.26, p = .04) and Month 3 post-quit (β = −.36, p = .006); abstinence status had a non-significant effect on anxious arousal severity at Month 3 after controlling for Month 1 anxious arousal (β = −.18, p = .09).Findings align with theoretical models of smoking-anxiety interplay and suggest that smoking cessation can result in reductions in anxious arousal.