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The Unique Autonomic Signatures of Savoring Meditation for Anxiety Reduction: A Pilot Randomized Controlled Trial
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Anxiety and stress plague populations worldwide. Voluntary regulated breathing practices offer a tool to address this epidemic. We examined peer-reviewed published literature to understand effective approaches to and implementation of these practices. PubMed and ScienceDirect were searched to identify clinical trials evaluating isolated breathing-based interventions with psychometric stress/anxiety outcomes. Two independent reviewers conducted all screening and data extraction. Of 2904 unique articles, 731 abstracts, and 181 full texts screened, 58 met the inclusion criteria. Fifty-four of the studies’ 72 interventions were effective. Components of effective and ineffective interventions were evaluated to develop a conceptual framework of factors associated with stress/anxiety reduction effectiveness. Effective breath practices avoided fast-only breath paces and sessions <5 min, while including human-guided training, multiple sessions, and long-term practice. Population, other breath paces, session duration ≥5 min, and group versus individual or at-home practices were not associated with effectiveness. Analysis of interventions that did not fit this framework revealed that extensive standing, interruptions, involuntary diaphragmatic obstruction, and inadequate training for highly technical practices may render otherwise promising interventions ineffective. Following this evidence-based framework can help maximize the stress/anxiety reduction benefits of breathing practices. Future research is warranted to further refine this easily accessible intervention for stress/anxiety relief.
This secondary analysis of a randomized controlled trial (RCT) examined whether contrast avoidance (CA) in Generalized Anxiety Disorder (GAD) could be reduced through savoring—purposeful engagement with positive emotions. 85 participants were diagnosed with GAD by both clinical interview and questionnaire. They were then randomly assigned to one of two seven-day smartphone-delivered ecological momentary interventions (EMIs). The SkillJoy EMI facilitated in-the-moment practice of savoring positive emotions in participants’ daily lives. The active self-monitoring control (ASM) was nearly identical to SkillJoy in ratings, activities, and language, yet omitted specific attention to positive emotion and savoring. CA was assessed by questionnaire at pre-trial and eighth day post-trial. Savoring was assessed by questionnaire at pre-trial and fifth day mid-trial. Longitudinal linear mixed models and simple slope analyses examined CA change between and within conditions. Bias-corrected boot strapping path analysis with individuals’ CA slopes extracted from a multilevel model examined mediation by savoring. Results showed that SkillJoy led to significant reductions in CA, whereas the ASM control did not. The relation between treatment condition and reductions in CA was mediated by increases in savoring from pre- to mid-trial. It may be possible for treatment to meaningfully reduce CA in GAD, specifically through savoring practices.
Objective: This study sought to determine if upregulating positive emotion both reduces symptoms and increases well-being for those with generalized anxiety disorder (GAD). Method: Eighty-five participants were diagnosed with GAD by both questionnaire and clinical interview. They were then randomly assigned to one of two seven-day smartphone-delivered ecological momentary interventions (EMIs). SkillJoy, a savoring ecological momentary intervention, prompted participants to attend to positive aspects of the present moment, engage in and savor planned enjoyable activities, record and reflect on recent positive experiences, note events that turned out well, and look forward to positive events. The active self-monitoring control (ASM) mirrored SkillJoy’s activities and wording, yet omitted savoring. It included attending to current thoughts and feelings, planning everyday activities, remembering and recording daily events, and anticipating important events. Participants were assessed at pre- and posttreatment with a 30th day follow-up. Linear mixed models and simple slope analyses with multiple imputation examined outcome change between and within conditions. Results: Pretrial to posttrial, SkillJoy (vs. ASM) led to significantly greater reductions in worry and increases in positive emotions and savoring. Depression symptoms significantly decreased for both EMIs. Pretrial to follow-up, SkillJoy (vs. ASM) users showed significantly greater increases in savoring. Both SkillJoy and ASM significantly decreased worry (d = −1.02 vs. −0.51) and depression (d = −1.09 vs. −0.63) pre-to-follow-up, yet SkillJoy had greater effect sizes. SkillJoy significantly increased positive emotions and savoring pre-to-follow-up, yet ASM did not. Conclusion: SkillJoy may strengthen positive emotions and skills for enhancing them, while also reducing worry.
Autonomic nervous system (ANS) activity is a fundamental component of emotional responding. It is not clear, however, whether positive emotional states are associated with differential ANS reactivity. To address this issue, we conducted a meta-analytic review of 120 articles (686 effect sizes, total N = 6,546), measuring ANS activity during 11 elicited positive emotions, namely amusement, attachment love, awe, contentment, craving, excitement, gratitude, joy, nurturant love, pride, and sexual desire. We identified a widely dispersed collection of studies. Univariate results indicated that positive emotions produce no or weak and highly variable increases in ANS reactivity. However, the limitations of work to date – which we discuss – mean that our conclusions should be treated as empirically grounded hypotheses that future research should validate.
Savouring is an emotion regulation strategy and intervention that focuses on the process of attending, intensifying and prolonging positive experiences and positive affect associated with these memories. Personal savouring involves a reflection on positive memories that are specific to the individual and do not involve others. In contrast, relational savouring entails reflecting on instances when people were responsive to the needs of their significant others. Such interventions hold potential benefits in enhancing positive affect (PA) and reducing negative affect (NA) for both parents of children with autism spectrum disorder (ASD) and parents of neurotypical children. Adults with greater symptoms of generalised anxiety have been found to have less PA and more NA. However, no study has investigated the effects of a mother’s anxiety symptoms on the efficacy of savouring in enhancing PA and reducing NA. Thus, this paper combined personal and relational savouring to investigate whether savouring may enhance PA and reduce NA of a pooled sample of mothers of neurotypical children and mothers of children with ASD. 52 mothers of neurotypical children and 26 mothers of children with ASD aged 3–7 years old were given a series of questionnaires and randomly assigned to either relational savouring or personal savouring conditions. In relational savouring, mothers were asked to reflect upon a shared positive experience with their child while in the personal savouring condition, a personal positive experience was recalled. Across mothers of children with ASD and neurotypical children, findings suggest that savouring leads to a decrease in NA (p < 0.01) but not increases in PA. Similarly, mothers with higher levels of anxiety experience a greater decrease in NA (p < 0.001) compared to mothers with lower levels of anxiety post-savouring. This study proposes that a brief savouring intervention may be effective among mothers of preschoolers. As lower levels of negative affect is linked to healthier psychological well-being, mothers might be able to engage in more effective and warm parenting after savouring exercises, which would cultivate positive mother-child relationships that benefit their children in the long-term.
Background
The COVID-19 pandemic is a worldwide epidemic declared by the world health organization as a public health emergency of concern and consequently inducing huge mental health and psychological reactions.
Aims
This study is aimed to summarize the existing data regarding anxiety, depression, and psychological distress during the covid-19 pandemic among the wider population so that effective intervention strategies will be initiated.
Methods
Pieces of literature that assessed anxiety, depression, and psychological distress among the general population during the COVID pandemic period were systematically gathered. Data extraction in Microsoft excel was done by two independent reviewers using predefined criteria. The analysis was done using a stata-11 and random effect model. A sub-group and sensitivity analysis was done. Besides, the funnel plot and eggers publication bias test was tested.
Results
Sixteen studies that assessed 78,225 participants were included. Nine studies were included in the meta-analysis for anxiety prevalence. The average prevalence of anxiety was found to be 38.12%. A sub-group analysis showed that anxiety was 33.33% in China and 47.70% in other countries (Italy, Turkey, and India). Anxiety prevalence in studies measured with the DASS-21 scale, GAD-7 scale, and other tools (SAS, HADS, and 5-point Likert scale) was 23.4%, 40.73%, and 44.47% respectively. The prevalence of anxiety in studies that assessed a sample size above 2,000 participants was 40.33%. The average prevalence of depression among included studies was 34.31% and a sub-group analysis showed that depression was higher in China (36.32%) than in other countries (28.3%). Moreover, six studies reported psychological distress and the average prevalence was 37.54%.
Conclusion
This study revealed that anxiety, depression, and psychological distress are potential public mental health problems of the global community that suggests the need for early recognition and initiation of interventions during the COVID-19 pandemic period.
Trait dysphoric rumination is a transdiagnostic factor associated with depression and anxiety that has also been linked with blunted respiratory sinus arrhythmia (RSA), an index of reduced emotion regulation capacity. However, the autonomic correlates of state dysphoric rumination remain unclear. We examined the physiological correlates of state dysphoric rumination and the potential repairing effects of savoring on autonomic functioning. To provide a comprehensive assessment of autonomic correlates, we examined changes in parasympathetic (RSA) and sympathetic (cardiac pre-ejection period, PEP; and electrodermal activity, EDA) arousal independently, as well as autonomic coordination among indices. Eighty-two women (ages 18-25) completed laboratory physiological assessments, including rumination and savoring tasks, and self-report measures of trait rumination. Dysphoric rumination was associated with sympathetic activation (i.e., decreases in PEP, increases in EDA), and subsequent Savoring following a recovery period also corresponded with decreases in PEP. Trait rumination did not predict autonomic changes during state rumination. However, higher trait rumination was associated with greater sympathetic coordination (PEP-EDA correspondence) during savoring. In summary, dysphoric rumination co-occurred with sympathetic activation, and subsequent savoring successfully recruited sympathetic activity (PEP) redirected on positive moods and events. Results also emphasize the utility of examining sympathetic and parasympathetic indices, and coordination among autonomic indices to delineate autonomic activity associated with emotion regulation strategies.
Aims and objectives
To examine the effects of the two‐month breathing‐based walking intervention and its follow‐up on anxiety, depression, dyspnoea and quality of life in patients with chronic obstructive pulmonary disease.
Background
Mind–body‐related exercises improve bio‐psychological symptoms and quality of life in chronic diseases, but these improvements are not proven for chronic obstructive pulmonary disease.
Design
This was a randomised controlled study and applied the Consolidated Standards of Reporting Trials (CONSORT) statement.
Methods
Outpatients diagnosed with chronic obstructive pulmonary disease were recruited from a medical centre in Taiwan and randomly assigned to two groups. The walking group (n = 42) received breathing, meditation and walking for two months, and the control group (n = 42) did not. Data from the outcomes of anxiety, depression, dyspnoea and quality of life were collected at baseline and in Month 1, Month 2 and Month 3. Clinical trial registration was done (ClinicalTrials.gov.: NCT03388489).
Findings
The results showed significant changes in anxiety, depression, dyspnoea and quality of life in the walking group across three months, compared to those in the control group and at baseline.
Conclusion
This breathing‐based walking intervention is promising to achieve bio‐psychological well‐being for patients with chronic obstructive pulmonary disease.
Relevance to clinical practice
This breathing‐based walking, as a mind–body exercise, could serve as an evidence‐based nursing care that contributes to improving anxiety, depression, dyspnoea and quality of life in stable chronic obstructive pulmonary disease outpatients. The feasibility and acceptability of the breathing‐based walking were met the requirement of the chronic obstructive pulmonary disease outpatients, which could be considered as home‐based exercise.
Regulation of the parasympathetic nervous system, indexed through high frequency heart rate variability (HF-HRV), is indicative of physical and psychological health. However, little is known about the trainability of this capacity. We investigated the effects of a 9-month mental training program (the ReSource Project; n = 298) on voluntary HF-HRV upregulation, assessed with a novel biofeedback procedure. The program consisted of attentional, interoceptive, socio-affective and socio-cognitive training elements, all of which potentially influence parasympathetic regulation. Based on known links between oxytocin and parasympathetic activity, we also explored the relationship of HF-HRV upregulation to the oxytocin receptor system. We found that HF-HRV during the biofeedback session increased after 3 months of training, concomitant with prolonged respiration cycles. Breathing-controlled changes in HF-HRV upregulation, indicative of improved parasympathetic control, were significantly increased after 6 months of training. Homozygous risk allele carriers (AA) of the oxytocin receptor gene polymorphism rs53576 showed initially lower parasympathetic control, but fully compensated for their initial deficits through the training. No changes were found for HF-HRV at rest. Our data demonstrate that a mental training intervention extending over several months can increase the capacity for voluntary regulation of HF-HRV, with important implications for improving individual and societal health.
Objective:
Loss of pleasure or interest in activities (i.e., anhedonia) is a risk factor for suicidality, treatment nonresponse, and relapse. Extant treatments that focus on reducing negative affect have limited effects upon positive affect (a core feature of anhedonia). We investigated whether a novel intervention aimed at increasing reward sensitivity was more efficacious for positive affect than a cognitive-behavior treatment aimed at reducing threat sensitivity, in individuals with clinically severe symptoms of depression or anxiety, and functional impairment.
Method:
The Treatment for Affective Dimensions trial was offered in a 2-site randomized study at outpatient treatment centers in Los Angeles and Dallas. Ninety-six patients were randomized to 15 weekly, individual sessions of Positive Affect Treatment (PAT) or Negative Affect Treatment (NAT). The primary outcome was improvement in positive affect (Positive and Negative Affect Schedule-Positive) from pretreatment to 6-month follow-up (6MFU). Secondary outcomes were improvements in negative affect (Positive and Negative Affect Schedule-Negative), suicidal ideation, and symptoms (Depression Anxiety Stress Scales).
Results:
PAT resulted in greater improvements in positive affect, p = .009, d = .52, and higher positive affect at 6MFU, p = .002, d = .67, than NAT. Participants in PAT also reported lower negative affect, p = .033, d = .52, and lower symptoms of depression, p = .035, d = .34, anxiety, p < .018, d = .30, and stress, p = .006, d = .43 at 6MFU. Finally, probability of suicidal ideation at 6MFU was lower in PAT than NAT (1.7% vs. 12.0%), p < .001.
Conclusions:
Compared to NAT, PAT demonstrated better outcomes (at 6MFU) on positive affect, depression, anxiety, stress, and suicidal ideation, for patients with symptomatic pretreatment levels of these outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Mindfulness and savoring the moment both involve presently occurring experiences. However, these scientific constructs are distinct and may play complementary roles when predicting day-to-day positive emotions. Therefore, we examined the unique and interactive roles of dispositional mindfulness and perceived ability to savor the moment for predicting daily positive emotions as well as related psychological health benefits. Participants completed a 9-week longitudinal field study. At baseline, dispositional mindfulness and perceived ability to savor the moment were assessed, along with three indicators of psychological health: depressive symptoms, psychological well-being, and life satisfaction. Each day for the subsequent 9 weeks, participants reported on their emotions. At the end of the study, participants again completed the three psychological health measures. Results showed that baseline dispositional mindfulness and perceived ability to savor the moment interacted to predict mean positive emotion levels over the reporting period and, in turn, residualized changes in psychological health. Specifically, the relation between perceived ability to savor the moment and positive emotions and, in turn, residualized change in psychological health indicators was amplified at greater levels of mindfulness and fell to non-significance at lower levels of mindfulness. Dispositional mindfulness only predicted positive emotions and, in turn, residualized changes in psychological health, for those very high in perceived ability to savor the moment. This research provides preliminary evidence that dispositional mindfulness and perceived ability to savor the moment, though related constructs, may serve unique and synergistic roles in predicting benefits for and through positive emotions.
Trait mindfulness is often conceptualized to comprise multiple facets such as attention to and acceptance of present-moment experiences. State mindfulness however is mostly conceptualized as unidimensional. As research on trait mindfulness indicates that differentiating aspects of mindfulness deepens our understanding of its associations with well-being, we tested the presence of four facets at both, the trait and the state level: acting with awareness, nonjudgmental acceptance, present-moment attention, and nonreactivity. Via an experience-sampling technology, 70 participants (aged 20–30 years, 50% female) reported their state mindfulness six times a day for several days. In multiple multilevel confirmatory factor analyses, three of the four facets were corroborated at both levels of analysis. The final three-factor model including acting with awareness, nonjudgmental acceptance, and present-moment attention was superior to a one-factor model implying that state mindfulness can be conceptualized as multidimensional. A multidimensional state assessment will likely be informative for future research questions.
Aim:
The aim of the present study was to examine whether depression and anxiety disorder manifest different autonomic dysregulations using heart rate variability (HRV) and heart rate (HR) measurements.
Methods:
HRV and HR were recorded both at rest and during task execution (random number generation) in the first-onset drug-naïve patients with major depressive disorder (MDD, n = 14) and generalized anxiety disorder (GAD, n = 11) as well as in healthy controls (n = 41). The patients showed no comorbidity of depression and anxiety disorder. GAD patients did not exhibit panic or phobic symptoms at the time of measurement. Following power spectrum analysis of HR trend, the high and low frequency components (HF and LF), the sum (LF+HF) and the ratio (LF/HF) of LF and HF were compared between the groups.
Results:
In the MDD patients, as previously reported, HF was low and LF/HF was high during the initial rest condition, and that HF was less reactive to the task. In contrast, GAD patients showed significantly high HF, although autonomic reactivity was not impaired.
Conclusion:
The results indicate that not only the baseline autonomic activity but also its reactivity to behavioral changes are different between MDD and GAD in the early stage of illness. High parasympathetic tone in GAD may reflect responses of parasympathetic system to anxiety. MDD is accompanied by an autonomic shift toward sympathetic activation and a reduced reactivity to task.
One of the frequent questions by users of the mixed model function lmer of the lme4 package has been: How can I get p values for the F and t tests for objects returned by lmer? The lmerTest package extends the 'lmerMod' class of the lme4 package, by overloading the anova and summary functions by providing p values for tests for fixed effects. We have implemented the Satterthwaite's method for approximating degrees of freedom for the t and F tests. We have also implemented the construction of Type I - III ANOVA tables. Furthermore, one may also obtain the summary as well as the anova table using the Kenward-Roger approximation for denominator degrees of freedom (based on the KRmodcomp function from the pbkrtest package). Some other convenient mixed model analysis tools such as a step method, that performs backward elimination of nonsignificant effects - both random and fixed, calculation of population means and multiple comparison tests together with plot facilities are provided by the package as well.
This paper describes a five-visit heart rate variability (HRV) biofeedback protocol we have used both clinically and in research. This protocol was refined in a study of biofeedback therapy for treating asthma. Similar, longer methods have been used for treating various conditions involving pain, anxiety, depression, and other psychophysiological disorders.
In this article, we draw from Conservation of Resources Theory to advance and test a framework which predicts that emotional exhaustion plays an explanatory role underlying the relation between workplace anxiety and job performance. Further, we draw from social exchange theories to predict that leader-member exchange and coworker exchange will mitigate the harmful effects of anxiety on job performance. Findings across a 3-wave study of police officers supported our model. Emotional exhaustion mediated the link between workplace anxiety and job performance, over and above the effect of cognitive interference. Further, coworker exchange mitigated the positive relation between anxiety and emotional exhaustion, while leader-member exchange mitigated the negative relation between emotional exhaustion and job performance. This study elucidates the effects of workplace anxiety on resource depletion via emotional exhaustion and highlights the value of drawing on social resources to offset the potentially harmful effects of workplace anxiety on job performance. (PsycINFO Database Record
Anxiety is an unpleasant physiological state in which an overreaction to a situation occurs. It has been suggested that different brain regions are involved in the modulation and expression of anxiety, including the amygdala, hippocampus, and frontal cortex. Dysfunction of neurotransmitters and their receptors can lead to many mood disorders like anxiety. There are evidences that dopamine plays an important role in anxiety modulation in different parts of the brain. Some evidence has shown that the mesolimbic, mesocortical and nigrostriatal dopaminergic system are involved in anxiety. Both dopamine D1 and D2 receptor mechanisms are important in mediating anxiety. The activity of dopaminergic system is modulated by several neurotransmitters, including glutamatergic neurons from the medial prefrontal cortex (mPFC), GABAergic fibers from the nucleus accumbens (NAc) as well as the ventral pallidum and cholinergic fibers from the pedunculopontine nucleus and the laterodorsal tegmental nucleus. Thus, changes in the glutamatergic, and GABAergic, as well as mediated transmission in the mesolimbic, mesocortical and nigrostriatal dopaminergic system may influence anxiety-like behavior.
The rapid growth of the literature on positive interventions to increase “happiness” suggests the need for an overarching conceptual framework to integrate the many and apparently disparate findings. In this review, we use the process model of emotion regulation (Gross, 1998) to organize the existing literature on positive interventions and to advance theory by clarifying the mechanisms underlying their effectiveness. We propose that positive emotions can be increased both in the short- and longer-term through five families of emotion regulation strategies (i.e., situation selection, situation modification, attentional deployment, cognitive change, and response modulation), and we show how these emotion regulation strategies can be applied before, during, and after positive emotional events. Regarding short-term increases in positive emotions, our review indicates that attentional deployment, cognitive change, and response modulation strategies have received the most empirical support, whereas more work is needed to establish the effectiveness of situation selection and situation modification strategies. Regarding longer-term increases in positive emotions, strategies such as situation selection during an event and attentional deployment before, during, and after an event have received strong empirical support and are at the center of many positive interventions. However, more work is needed to establish the specific benefits of the other strategies, especially situation modification. We argue that our emotion regulation framework clarifies existing interventions and points the way for new interventions that might be used to increase positive emotions in both non-clinical and clinical populations.
Reminders of happy memories can bring back pleasant feelings tied to the original experience, suggesting an intrinsic value in reminiscing about the positive past. However, the neural circuitry underlying the rewarding aspects of autobiographical memory is poorly understood. Using fMRI, we observed enhanced activity during the recall of positive relative to neutral autobiographical memories in corticostriatal circuits that also responded to monetary reward. Enhanced activity in the striatum and medial prefrontal cortex was associated with increases in positive emotion during recall, and striatal engagement further correlated with individual measures of resiliency. Striatal response to the recall of positive memories was greater in individuals whose mood improved after the task. Notably, participants were willing to sacrifice a more tangible reward, money, in order to reminisce about positive past experiences. Our findings suggest that recalling positive autobiographical memories is intrinsically valuable, which may be adaptive for regulating positive emotion and promoting better well-being.
Copyright © 2014 Elsevier Inc. All rights reserved.
The mind and body are intrinsically and dynamically coupled. Perceptions, thoughts and feelings change, and respond to, the state of the body. This chapter describes the integration of cognitive and affective processes with the autonomic control of bodily arousal, focusing on reciprocal effects of autonomic responses on decision making, error detection, memory and emotions. Neuroimaging techniques are beginning to detail the neuronal substrates mediating these interactions between mental and physiological states, implicating cortical regions (specifically insular and cingulate cortices) alongside subcortical (amygdala) and brainstem (notably dorsal pons) in these mechanisms. The extent to which bodily states influence mental processes is determined in part by "interoceptive sensitivity," an index of individual differences in the ability to detect one's own bodily sensations. Moreover, the misidentification or misattribution of interoceptive responses is implicated in a number of pathologies such as depersonalization, schizophrenia, and anxiety. Increasing knowledge of the mechanisms of body-mind interactions has wide ranging implications, from decision making to empathy, and may serve elucidate potential avenues of intervention for stress-sensitive conditions in which psychological, cognitive, and emotional factors impact on the expression of physical symptoms.
This study employed simultaneous neuroimaging with positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) to demonstrate the relationship between changes in receptor occupancy measured by PET and changes in brain activity inferred by fMRI. By administering the D2/D3 dopamine receptor antagonist [(11)C]raclopride at varying specific activities to anesthetized nonhuman primates, we mapped associations between changes in receptor occupancy and hemodynamics [cerebral blood volume (CBV)] in the domains of space, time, and dose. Mass doses of raclopride above tracer levels caused increases in CBV and reductions in binding potential that were localized to the dopamine-rich striatum. Moreover, similar temporal profiles were observed for specific binding estimates and changes in CBV. Injection of graded raclopride mass doses revealed a monotonic coupling between neurovascular responses and receptor occupancies. The distinct CBV magnitudes between putamen and caudate at matched occupancies approximately matched literature differences in basal dopamine levels, suggesting that the relative fMRI measurements reflect basal D2/D3 dopamine receptor occupancy. These results can provide a basis for models that relate dopaminergic occupancies to hemodynamic changes in the basal ganglia. Overall, these data demonstrate the utility of simultaneous PET/fMRI for investigations of neurovascular coupling that correlate neurochemistry with hemodynamic changes in vivo for any receptor system with an available PET tracer.
Mental processes and their neural substrates are intimately linked to the homeostatic control of internal bodily state. There are a set of distinct interoceptive pathways that directly and indirectly influence brain functions. The anatomical organization of these pathways and the psychological/behavioral expressions of their influence appear along discrete, evolutionarily conserved dimensions that are tractable to a mechanistic understanding. Here, we review the role of these pathways as sources of biases to perception, cognition, emotion, and behavior and arguably the dynamic basis to the concept of self.
Internalizing and externalizing disorders are often, though inconsistently in studies of young children, associated with low baseline levels of respiratory sinus arrhythmia (RSA). RSA is thus considered to reflect the capacity for flexible and regulated affective reactivity and a general propensity for psychopathology. However, studies assessing RSA reactivity to emotional challenges tend to report more consistent associations with internalizing than with externalizing disorders, although it is unclear whether this is a function of the type of emotion challenges used. In the present study, we examined whether baseline RSA was associated with internalizing and/or externalizing severity in a sample of 273 young children (ages 5-6) with elevated symptoms of psychopathology. Following motivation-based models of emotion, we also tested whether RSA reactivity during withdrawal-based (fear, sadness) and approach-based (happiness, anger) emotion inductions was differentially associated with internalizing and externalizing symptoms, respectively. Baseline RSA was not associated with externalizing or internalizing symptom severity. However, RSA reactivity to specific emotional challenges was associated differentially with each symptom domain. As expected, internalizing symptom severity was associated with greater RSA withdrawal (increased arousal) during fearful and sad film segments. Conversely, externalizing symptom severity was related to blunted RSA withdrawal during a happy film segment. The use of theoretically derived stimuli may be important in characterizing the nature of the deficits in emotion processing that differentiate the internalizing and externalizing domains of psychopathology.
Argues that evolutionary heritage underlies humans' consistent preference for stimuli from the natural environment and that research on affective and aesthetic responses is needed to understand human interaction with the environment. It is noted that the rapidly expanding empirical record concerning aesthetic and affective responses to natural environments is in need of a well-developed theoretical foundation. An integrated conceptual framework to address this theoretical lack, drawing on recent theory and research on emotion, is proposed. This framework explains how affects arise in the natural environment; postulates their functions; and links them to cognition, activity in physiological systems, and behavior. The present author, in developing the framework, questions the view that feelings result from cognitive processes, asserting that feelings (not thoughts) are the initial response in environmental encounters. The observer's initial feeling reaction shapes subsequent cognitive events. The relative sequence of feeling and thinking in environmental encounters represents a fundamental issue in understanding human interaction with the environment. (98 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Writing about traumatic, stressful or emotional events has been found to result in improvements in both physical and psychological health, in non-clinical and clinical populations. In the expressive writing paradigm, participants are asked to write about such events for 15-20 minutes on 3-5 occasions. Those who do so generally have significantly better physical and psychological outcomes compared with those who write about neutral topics. Here we present an overview of the expressive writing paradigm, outline populations for which it has been found to be beneficial and discuss possible mechanisms underlying the observed health benefits. In addition, we suggest how expressive writing can be used as a therapeutic tool for survivors of trauma and in psychiatric settings.
Background: Research has shown that beliefs about one's capacity to savour positive outcomes, a form of perceived control over positive emotions, are largely independent of beliefs about coping, a form of perceived control over negative emotions. Aim: To describe a new measure of savouring beliefs, the Savoring Beliefs Inventory (SBI). Method: Six studies validating the SBI that is designed to assess individuals' perceptions of their ability to derive pleasure through anticipating upcoming positive events, savouring positive moments, and reminiscing about past positive experiences. Results: SBI scores were found to be: (a) positively correlated with affect intensity, extraversion, optimism, internal locus of control, reported self-control behaviours, life satisfaction, value fulfilment, self-esteem, and intensity and frequency of happiness; (b) negatively correlated with neuroticism, guilt, physical and social anhedonia, hopelessness, depression, and the frequency of unhappy and neutral affect; and (c) uncorrelated with socially desirable responding. SBI was validated prospec-tively by first measuring college students' savouring beliefs and then later assessing their behaviours and affects in looking forward to, enjoying the actual experience of, and looking back on their Christmas vacation. Within each of the three time frames, the relevant SBI subscale generally predicted behaviours and affects more strongly than did the subscales associated with the other two temporal orientations. Finally, SBI was cross-validated in a sample of older adults. Conclusion: These results provide strong evidence that the SBI is a valid and reliable measure of individuals' beliefs about their capacity to savour positive experiences through anticipation, present enjoyment, and reminiscence.
Music, an abstract stimulus, can arouse feelings of euphoria and craving, similar to tangible rewards that involve the striatal dopaminergic system. Using the neurochemical specificity of [(11)C]raclopride positron emission tomography scanning, combined with psychophysiological measures of autonomic nervous system activity, we found endogenous dopamine release in the striatum at peak emotional arousal during music listening. To examine the time course of dopamine release, we used functional magnetic resonance imaging with the same stimuli and listeners, and found a functional dissociation: the caudate was more involved during the anticipation and the nucleus accumbens was more involved during the experience of peak emotional responses to music. These results indicate that intense pleasure in response to music can lead to dopamine release in the striatal system. Notably, the anticipation of an abstract reward can result in dopamine release in an anatomical pathway distinct from that associated with the peak pleasure itself. Our results help to explain why music is of such high value across all human societies.
The present study examined the effect of worry versus relaxation and neutral thought activity on both physiological and subjective responding to positive and negative emotional stimuli. Thirty-eight participants with generalized anxiety disorder (GAD) and 35 nonanxious control participants were randomly assigned to engage in worry, relaxation, or neutral inductions prior to sequential exposure to each of four emotion-inducing film clips. The clips were designed to elicit fear, sadness, happiness, and calm emotions. Self reported negative and positive affect was assessed following each induction and exposure, and vagal activity was measured throughout. Results indicate that worry (vs. relaxation) led to reduced vagal tone for the GAD group, as well as higher negative affect levels for both groups. Additionally, prior worry resulted in less physiological and subjective responding to the fearful film clip, and reduced negative affect in response to the sad clip. This suggests that worry may facilitate avoidance of processing negative emotions by way of preventing a negative emotional contrast. Implications for the role of worry in emotion avoidance are discussed.
Autonomic nervous system (ANS) activity is viewed as a major component of the emotion response in many recent theories of emotion. Positions on the degree of specificity of ANS activation in emotion, however, greatly diverge, ranging from undifferentiated arousal, over acknowledgment of strong response idiosyncrasies, to highly specific predictions of autonomic response patterns for certain emotions. A review of 134 publications that report experimental investigations of emotional effects on peripheral physiological responding in healthy individuals suggests considerable ANS response specificity in emotion when considering subtypes of distinct emotions. The importance of sound terminology of investigated affective states as well as of choice of physiological measures in assessing ANS reactivity is discussed.
The powers of the low-frequency (LF) and high-frequency (HF) oscillations characterizing heart rate variability (HRV) appear to reflect, in their reciprocal relationship, changes in the state of the sympathovagal balance occurring during numerous physiological and pathophysiological conditions. However, no adequate information is available on the quantitative resolution of this methodology.
We studied 22 healthy volunteers (median age, 46.5 years) who were subjected after a rest period to a series of passive head-up tilt steps randomly chosen from the following angles: 15 degrees, 30 degrees, 45 degrees, 60 degrees, and 90 degrees. From the continuous ECG, after appropriate analog-to-digital conversion, a personal computer was used to compute, with an autoregressive methodology, time and frequency domain indexes of RR interval variability. Spectral and cross-spectral analysis with the simultaneously recorded respiratory signal excluded its contribution to LF. Age was significantly correlated to variance and to the absolute values in milliseconds squared of very-low-frequency (VLF), LF, and HF components. The tilt angle was correlated to both LF and HF (expressed in normalized units [nu]) and to the LF-to-HF ratio (r = .78, -.72, and .68; respectively). Lower levels of correlation were found with HF (in ms2) and RR interval. No correlation was present between tilt angle and variance, VLF, or LF (in ms2). Individual analysis confirmed that the use of nu provided the greatest consistency of results.
Spectral analysis of HRV, using nu or LF-to-HF ratio, appears to be capable of providing a noninvasive quantitative evaluation of graded changes in the state of the sympathovagal balance.
Previous work demonstrated that oxytocinergic projections to the solitary vagal complex are involved in the restraint of exercise-induced tachycardia (2). In the present study, we tested the idea that oxytocin (OT) terminals in the solitary vagal complex [nucleus of the solitary tract (NTS)/dorsal motor nucleus of the vagus (DMV)] are involved in baroreceptor reflex control of heart rate (HR). Studies were conducted in male rats instrumented for chronic cardiovascular monitoring with a cannula in the NTS/DMV for brain injections. Basal mean arterial pressure and HR and reflex HR responses during loading and unloading of the baroreceptors (phenylephrine/sodium nitroprusside intravenously) were recorded after administration of a selective OT antagonist (OT(ant)) or OT into the NTS/DMV. The NTS/DMV was selected for study because this region contains such a specific and dense concentration of OT-immunoreactive terminals. Vehicle injections served as a control. OT and OT(ant) changed baroreflex control of HR in opposite directions. OT (20 pmol) increased the maximal bradycardic response (from -56 +/- 9 to -75 +/- 11 beats/min), whereas receptor blockade decreased the bradycardia (from -61 +/- 13 to -35 +/- 2 beats/min). OT(ant) also reduced the operating range of the reflex, thus decreasing baroreflex gain (from -5.68 +/- 1.62 to -2.83 +/- 1.05 beats x min(-1) x mmHg(-1)). OT injected into the NTS/DMV of atenolol-treated rats still potentiated the bradycardic responses to pressor challenges, whereas OT injections had no effect in atropine-treated rats. The brain stem effect was specific because neither vehicle administration nor injection of OT or OT(ant) into the fourth cerebral ventricle had any effect. Our data suggest that OT terminals in the solitary vagal complex modulate reflex control of the heart, acting to facilitate vagal outflow and the slowdown of the heart.
In this study, we determined the projections of oxytocin-containing neurons of the paraventricular nucleus (PVN) to phrenic nuclei and to the rostral ventrolateral medullary (RVLM) region, which is known to be involved in respiratory rhythm generation. Studies were also designed to determine oxytocin-receptor expression within the RVLM and the physiological effects of their activation on respiratory drive and arterial blood pressure. Oxytocin immunohistochemistry combined with cholera toxin B, a retrograde tracer, showed that a subpopulation of oxytocin-containing parvocellular neurons in the dorsal and medial ventral regions of the PVN projects to phrenic nuclei. Similarly, a subpopulation of pseudorabies virus-labeled neurons in the PVN coexpressed oxytocin after injection of pseudorabies virus, a transynaptic retrograde marker, into the costal region of the diaphragm. A subpopulation of oxytocin expressing neurons was also found to project to the RVLM. Activation of this site by microinjection of oxytocin into the RVLM (0.2 nmol/200 nl) significantly increased diaphragm electromyographic activity and frequency discharge (P < 0.05). In addition, oxytocin increased blood pressure and heart rate (P < 0.05). These data indicate that oxytocin participates in the regulation of respiratory and cardiovascular activity, partly via projections to the RVLM and phrenic nuclei.
Background:
Intentional attempts to savor positive emotions may be infrequent in Generalized Anxiety Disorder (GAD) due to avoidance of emotional contrasts. Yet purposeful enjoyment may help reduce worry and increase wellbeing in GAD. We sought to explore 1) the frequency, intensity, and duration of positive emotions from savoring in GAD and 2) its effect on pre-existing worry.
Method:
The same 139 participants participated in two studies. They first took baseline measures. After, they were explicitly taught about savoring practices. In study 1, all participants were instructed to savor a photograph and video, timing and rating their emotion. Then in study 2, participants underwent a worry induction followed by an interventional experiment. In a savoring condition, participants were instructed to savor a personally-chosen enjoyable video. In a control condition, participants watched an emotionally neutral video.
Results:
Participants who met DSM-5 criteria for GAD had significantly lower scores on naturalistic savoring via self-report than those without GAD. Yet when explicitly taught and directed to savor in study 1, there were no differences between those with and without GAD in positive emotion duration and intensity. In study 2, longitudinal linear mixed models demonstrated that savoring after a worry induction significantly decreased worry, decreased anxiety, and increased positive emotions to greater degrees than the control task. These changes did not differ between diagnostic groups. All analyses controlled for depression symptoms.
Conclusion:
Although persons with GAD tend to savor less in daily life than those without GAD, intentional savoring may decrease worry and increase positive emotion for both groups.
Voluntary slow breathing (VSB) is used as a prevention technique to support physical and mental health, given it is suggested to influence the parasympathetic nervous system. However, to date, no comprehensive quantitative review exists to support or refute this claim. We address this through a systematic review and meta-analysis of the effects of VSB on heart rate variability (HRV). Specifically, we focus on HRV parameters indexing parasympathetic nervous system (PNS) activity regulating cardiac functioning, referred to as vagally-mediated (vm)HRV: 1) during the breathing session (i.e., DURING), 2) immediately after one training session (i.e., IM-AFTER1), as well as 3) after a multi-session intervention (i.e., AFTER-INT). From the 1842 selected abstracts, 223 studies were suitable for inclusion (172 DURING, 16 IM-AFTER1, and 49 AFTER-INT). Results indicate increases in vmHRV with VSB, DURING, IM-AFTER1, and AFTER-INT. Given the involvement of the PNS in a large range of health-related outcomes and conditions, VSB exercises could be advised as a low-tech and low-cost technique to use in prevention and adjunct treatment purposes, with few adverse effects expected.
Aims:
Patients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was inconsistent. Furthermore, the influence of distinct diagnoses, study design, and demographic factors on the results was not comprehensively examined.
Methods:
We gathered studies comparing HRV in patients with AD and in healthy controls. The parasympathetic activity in the hierarchical order principle was adopted in the main analysis. We adopted the random effects model to calculate the standardized mean difference.
Results:
Of the 7805 screened studies, 99 were included in the quantitative analysis, with a total of 4897 AD patients and 5559 controls finally entered the meta-analysis. AD patients had a significantly lower resting-state HRV for parasympathetic activity compared to control (Hedges' g=-0.3897). For the diagnostic subgroup analysis relative to the controls, resting-state HRV was significantly lower in post-traumatic stress disorder, panic disorder, generalized anxiety disorder, and social anxiety disorder patients. HRV reactivity (all reactivity data, data on physiological challenge, and psychological challenge) did not show significant inter-group differences between AD patients and healthy subjects.
Conclusions:
The results supported that patients with AD had significantly lower resting-state HRV than the healthy population, but no alterations were found for HRV reactivity. This article is protected by copyright. All rights reserved.
Chronic stress has dramatically increased over the last years and is one of the major health concerns of the 21st century. Targeted interventions are traditionally based on inducing cognitive changes and enhancing control with the aim to promote adaptive emotion regulation, ultimately enhancing stress resilience. Crucially, bodily functions have received little attention in this quest, despite increasing evidence on the impact of mind-body interactions on resilience. An exemplary model is constituted by accumulating empirical support on the vagus nerve, which enables two-way communication between heart and brain, allowing to engage in an adaptive stress response in a context-appropriate manner. Yet, research on such bidirectional communication is mainly corre-lational. We propose to consider resonance breathing (bottom-up approach, heart > brain), and neuro-modulation (top-down approach, brain > heart) as evidence-based ways to increase vagal nerve inhibitory control and hence increase stress resilience. These promising, likely cost-effective and easily employable techniques can be used alone or in combination, harnessing neurobiological scientific advances to select treatment options with the greatest likelihood of success.
Infection-triggered perturbation of the immune system could induce psychopathology, and psychiatric sequelae were observed after previous coronavirus outbreaks. The spreading of the Severe Acute Respiratory Syndrome Coronavirus (COVID-19) pandemic could be associated with psychiatric implications. We investigated the psychopathological impact of COVID-19 in survivors, also considering the effect of clinical and inflammatory predictors.
We screened for psychiatric symptoms 402 adults surviving COVID-19 (265male,meanage58), at one month follow-up after hospital treatment. A clinical interview and a battery of self-report questionnaires were used to investigate post-traumatic stress disorder (PTSD), depression, anxiety, insomnia, and obsessive-compulsive (OC) symptomatology. We collected sociodemographic information, clinical data, baseline inflammatory markers and follow-up oxygen saturation levels.
A significant proportion of patients self-rated in the psychopathological range: 28% for PTSD, 31% for depression, 42% for anxiety, 20% for OC symptoms, and 40% for insomnia. Overall, 56% scored in the pathological range in at least one clinical dimension. Despite significantly lower levels of baseline inflammatory markers, females suffered more for both anxiety and depression. Patients with a positive previous psychiatric diagnosis showed increased scores on most psychopathological measures, with similar baseline inflammation. Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil and platelet counts, positively associated with scores of depression and anxiety at follow-up.
PTSD, major depression, and anxiety, are all high-burden non-communicable conditions associated with years of life lived with disability. Considering the alarming impact of COVID-19 infection on mental health, the current insights on inflammation in psychiatry, and the present obervation of worse inflammation leading to worse depression, we recommend to assess psychopathology of COVID-19 survivors and to deepen research on inflammatory biomarkers, in order to diagnose and treat emergent psychiatric conditions.
BACKGROUND: Anxiety and worry are central symptoms of Generalized Anxiety Disorder (GAD) that have been theorized to negatively impact cognitive functions. However, most of the research has focused on threat-related or emotionally-charged stimuli, and a surprisingly small number of investigations examined 'cold' cognitive functions using classic neuropsychological tests. Such investigations are particularly important given that some theoretical models suggest compensatory mechanisms associated with anxiety that in certain circumstances may result in intact performance. The aim of the present study is to assess the neuropsychological profile associated with GAD, using a comprehensive neuropsychological battery.
METHODS:
A sample of 23 college students meeting criteria for DSM-5 GAD and 20 control participants completed a psychometrically valid comprehensive computerized neuropsychological battery and clinical questionnaires.
RESULTS:
The GAD sample presented with significantly elevated symptomatic rates of anxiety, worry, depression and stress. However, no significant differences were found on any neuropsychological outcome measures or domain indexes. Effect sizes were small, some of which favored the GAD sample.
CONCLUSION:
Despite substantial psychopathological burden, GAD exhibited intact cognitive functioning. These results support the Cognitive Control Theory of Anxiety, suggesting that elevated primary anxiety may not impact 'cold' cognitive functions in the absence of threat or substantial cognitive load. Given that this is one of the only studies employing a comprehensive neuropsychological battery in GAD, more research is needed in this population to replicate these results and to examine the impact of anxiety on cognitive functions at varying degrees of cognitive load in this population.
Generalized anxiety disorder (GAD) is characterized by difficulties in inhibiting both perseverative thoughts (worry and rumination) and autonomic arousal. We investigated the neurobiological substrates of such abnormal inhibitory processes, hypothesizing aberrant functional coupling within ‘default mode’ (DMN) and autonomic brain networks. Functional imaging and heart rate variability (HRV) data were acquired from GAD patients and controls during performance of three tracking tasks interspersed with a perseverative cognition (PC) induction. After detection of infrequent target stimuli, activity within putative DMN hubs was suppressed, consistent with a redirection of attentional resources from internal to external focus. This magnitude of activity change was attenuated in patients and individuals with higher trait PC, but was predicted by individual differences in HRV. Following the induction of PC in controls, this pattern of neural reactivity became closer to that of GAD patients. Results support, at a neural level, the association between cognitive inflexibility and autonomic rigidity.
Recent research suggests that sleep disturbance may be a transdiagnostic process, and there is increasing interest in examining how sleep disturbance may contribute to anxiety and related disorders. The current review summarizes and synthesizes the extant research assessing sleep in anxiety and related disorders. The findings suggest that sleep disturbance exacerbates symptom severity in the majority of anxiety and related disorders. However, the nature of sleep disturbance often varies as a function of objective versus subjective assessment. Although sleep disturbance is a correlate of most anxiety and related disorders, a causal role for sleep disturbance is less clear. A model of potential mechanisms by which sleep disturbance may confer risk for the development of anxiety and related disorders is discussed. Future research integrating findings from basic sleep research with current knowledge of anxiety and related disorders may facilitate the development of novel treatments for comorbid sleep disturbance and clinical anxiety.
There is a well-known link between stress and depression, but diathesis-stress models suggest that not all individuals are equally susceptible to stress. The current study examined if brooding rumination, a known risk factor for depression, influences cardiovascular reactivity to a laboratory-based interpersonal stressor. Sixty-five women watched a baseline video and were exposed to an interpersonal stressor while high frequency heart rate variability (HRV) was collected. We found that women who endorsed higher levels of brooding rumination exhibited greater HRV withdrawal from baseline to stressor, an effect that was maintained when we controlled for levels of depression. This physiological vulnerability, when combined with high levels of stress, may be one mechanism underlying how brooding rumination increases depression risk.
G*Power (Erdfelder, Faul, & Buchner, 1996) was designed as a general stand-alone power analysis program for statistical tests commonly used in social and behavioral research. G*Power 3 is a major extension of, and improvement over, the previous versions. It runs on widely used computer platforms (i.e., Windows XP, Windows Vista, and Mac OS X 10.4) and covers many different statistical tests of the t, F, and chi2 test families. In addition, it includes power analyses for z tests and some exact tests. G*Power 3 provides improved effect size calculators and graphic options, supports both distribution-based and design-based input modes, and offers all types of power analyses in which users might be interested. Like its predecessors, G*Power 3 is free.
Eta squared measures the proportion of the total variance in a dependent variable that is associated with the membership of different groups defined by an independent variable. Partial eta squared is a similar measure in which the effects of other independent variables and interactions are partialled out. The development of these measures is described and their characteristics compared. In the past, the two measures have been confused in the research literature, partly because of a labelling error in the output produced by certain versions of the statistical package SPSS. Nowadays, partial eta squared is overwhelmingly cited as a measure of effect size in the educational research literature. Although there are good reasons for this, the interpretation of both measures needs to be undertaken with care. The paper concludes with a summary of the key characteristics of eta squared and partial eta squared.
The intimate connection between the brain and the heart was enunciated by Claude Bernard over 150 years ago. In our neurovisceral integration model we have tried to build on this pioneering work. In the present paper we further elaborate our model. Specifically we review recent neuroanatomical studies that implicate inhibitory GABAergic pathways from the prefrontal cortex to the amygdala and additional inhibitory pathways between the amygdala and the sympathetic and parasympathetic medullary output neurons that modulate heart rate and thus heart rate variability. We propose that the default response to uncertainty is the threat response and may be related to the well known negativity bias. We next review the evidence on the role of vagally mediated heart rate variability (HRV) in the regulation of physiological, affective, and cognitive processes. Low HRV is a risk factor for pathophysiology and psychopathology. Finally we review recent work on the genetics of HRV and suggest that low HRV may be an endophenotype for a broad range of dysfunctions.
Scholars spanning a variety of disciplines have studied the ways in which contact with natural environments may impact human well-being. We review the effects of such nature experience on human cognitive function and mental health, synthesizing work from environmental psychology, urban planning, the medical literature, and landscape aesthetics. We provide an overview of the prevailing explanatory theories of these effects, the ways in which exposure to nature has been considered, and the role that individuals' preferences for nature may play in the impact of the environment on psychological functioning. Drawing from the highly productive but disparate programs of research in this area, we conclude by proposing a system of categorization for different types of nature experience. We also outline key questions for future work, including further inquiry into which elements of the natural environment may have impacts on cognitive function and mental health; what the most effective type, duration, and frequency of contact may be; and what the possible neural mechanisms are that could be responsible for the documented effects.
Three studies provide preliminary support for an emotion dysregulation model of generalized anxiety disorder (GAD). In study 1, students with GAD reported heightened intensity of emotions, poorer understanding of emotions, greater negative reactivity to emotional experience, and less ability to self-soothe after negative emotions than controls. A composite emotion regulation score significantly predicted the presence of GAD, after controlling for worry, anxiety, and depressive symptoms. In study 2, these findings were largely replicated with a clinical sample. In study 3, students with GAD, but not controls, displayed greater increases in self-reported physiological symptoms after listening to emotion-inducing music than after neutral mood induction. Further, GAD participants had more difficulty managing their emotional reactions. Implications for GAD and psychopathology in general are discussed.