Cardiac autonomic functioning and post-traumatic stress: A preliminary study in youth at-risk for PTSD

Cohen, Joseph R.; Thomsen, Kari N.; Tu, Kelly M.; Thakur, Hena; McNeil, Shiesha L.; Menon, Suvarna V.

doi:10.1016/j.psychres.2019.112684

Cited by 19 publications

(21 citation statements)

References 53 publications

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“…Although this is the first study to document on dysregulated PEP parameters among traumatized adolescents, these findings are in line with research in an at-risk, low-income community sample that showed that sympathetically-oriented stress responses could distinguish between adolescents with and without posttraumatic symptoms (Cohen et al, 2020). Interestingly, PEP reactivity analyses showed that healthy controls were able to recover quickly after the stressor disappeared, whereas prolonged sympathetic activation was observed in traumatized adolescents.…”

Section: Key Findingssupporting

confidence: 87%

“…Heightened SNS reactivity increases emotion-driven impulsivity and facilitates vulnerability for at-risk behavior (Peters et al, 2018), which characterizes many traumatized adolescents. The finding that traumatized adolescents exhibit increased PEP reactivity to stress is in line with previous studies on early adversity in community samples (Cohen et al, 2020;Ellis et al, 2005;Oosterman et al, 2010). One study that reported no relation between PEP reactivity and trauma was conducted in a sample that exhibited comorbid externalizing problems .…”

Section: Key Findingssupporting

confidence: 87%

“…The association between trauma and the SNS, or PEP, has not been extensively investigated. Some studies found increased PEP reactivity after traumatic events (Cohen et al, 2020), while others observed no relation . However, these studies were all conducted among non-clinical samples: neither traumatic experiences nor posttraumatic stress were used as inclusion criteria.…”

Section: Introductionmentioning

confidence: 98%

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Alterations of autonomic nervous system and HPA axis basal activity and reactivity to acute stress: a comparison of traumatized adolescents and healthy controls

Schuurmans

Nijhof

Cima

et al. 2021

Stress

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Alterations in neurobiological stress systems such as the autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis contribute to the development and maintenance of psychological and behavioral problems after traumatic experiences. Investigating neurobiological parameters and how these relate to each other may provide insight into the complex mechanisms at play. Whereas the preponderance of studies focuses on either the ANS or the HPA axis separately, the current study is the first to evaluate relations between posttraumatic stress and both basal activity during rest and stress reactivity of the ANS as well as the HPA axis in a sample of traumatized adolescents and healthy controls. The traumatized sample (n ¼ 77), based on clinical levels of posttraumatic stress, was a convenience sample that was recruited within residential institutions, was compared to a healthy control sample (n ¼ 48) recruited within the general community. For the ANS, we expected increased SNS and decreased PNS activity during rest and increased SNS and decreased PNS reactivity to social stress among traumatized adolescents compared to healthy controls. Regarding the HPA axis, we expected increased basal cortisol levels and decreased cortisol reactivity to stress in the traumatized sample. Compared to healthy controls, traumatized adolescents exhibited significantly higher sympathetic and lower parasympathetic activation during rest and increased sympathetic reactivity to acute stress (ANS parameters). Outcomes on the HPA axis (i.e. cortisol) indicated that traumatized adolescents showed increased cortisol levels during rest and blunted cortisol reactivity to acute stress. Implications for clinical relevance and trauma-focused treatment purposes are discussed.

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Section: Key Findingssupporting

confidence: 87%

Section: Key Findingssupporting

confidence: 87%

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Alterations of autonomic nervous system and HPA axis basal activity and reactivity to acute stress: a comparison of traumatized adolescents and healthy controls

Schuurmans

Nijhof

Cima

et al. 2021

Stress

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“…One candidate autonomic measure is the pre‐ejection period (PEP), which is inversely related to myocardial contractility and has been validated as an index of cardiac sympathetic beta‐adrenergic activity (Cacioppo et al, 1994; Mezzacappa et al, 1999; Newlin & Levenson, 1979). Therefore, PEP is an important non‐invasive measure of SNS activity and can help examine a wide range of neuropsychiatric and heart diseases, including post‐traumatic stress disorder (PTSD; Cohen et al, 2020; Peters et al, 2018; Shah et al, 2013). Laboratory‐induced mental stress paradigms help researchers understand the autonomic response to various conditions.…”

Section: Introductionmentioning

confidence: 99%

Validation of a new impedance cardiography analysis algorithm for clinical classification of stress states

et al. 2022

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Pre‐ejection period (PEP) is an index of sympathetic nervous system activity that can be computed from electrocardiogram (ECG) and impedance cardiogram (ICG) signals, but sensitive to speech/motion artifact. We sought to validate an ICG noise removal method, three‐stage ensemble‐average algorithm (TEA), in data acquired from a clinical trial comparing active versus sham non‐invasive vagal nerve stimulation (tcVNS) after standardized speech stress. We first compared TEA's performance versus the standard conventional ensemble‐average algorithm (CEA) approach to classify noisy ICG segments. We then analyzed ECG and ICG data to measure PEP and compared group‐level differences in stress states with each approach. We evaluated 45 individuals, of whom 23 had post‐traumatic stress disorder (PTSD). We found that the TEA approach identified artifact‐corrupted beats with intraclass correlation coefficient > 0.99 compared to expert adjudication. TEA also resulted in higher group‐level differences in PEP between stress states than CEA. PEP values were lower in the speech stress (vs. baseline rest) group using both techniques, but the differences were greater using TEA (12.1 ms) than CEA (8.0 ms). PEP differences in groups divided by PTSD status and tcVNS (active vs. sham) were also greater when using the TEA versus CEA method, although the magnitude of the differences was lower. In conclusion, TEA helps to accurately identify noisy ICG beats during speaking stress, and this increased accuracy improves sensitivity to group‐level differences in stress states compared to CEA, suggesting greater clinical utility.

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“…CAB can be calculated from simultaneous recordings of PNS and SNS modulation of the heart, providing a measure of the relative contribution of each ANS branch to autonomic regulation of cardiac activity (Berntson et al, 2008). In youth samples, differential CAB has been linked to psychopathology, such as post‐traumatic stress (Cohen et al, 2020) and depression (Bylsma et al, 2015). However, we are not aware of any past research into the relation between CAB and altruism in children.…”

Section: Introductionmentioning

confidence: 99%

Children’s altruism following acute stress: The role of autonomic nervous system activity and social support

Alen

Deer

Karimi

et al. 2021

Developmental Science

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Altruistic behavior after stress exposure may have important health and psychological benefits, in addition to broader societal consequences. However, so far experimental research on altruism following acute stress has been limited to adult populations. The current study utilized an experimental design to investigate how altruistic donation behavior among children may be influenced by (a) exposure to an acute social stressor, the Trier Social Stress Test modified for use with children (TSST‐M), (b) individual differences in stress physiology, and (c) social support from a parent. The sample consisted of 180 children (54.9% male, 45.1% female; mean age = 9.92 years, SD = 0.56 years) randomly assigned to one of three conditions involving the TSST‐M: (a) prepare for the TSST‐M alone, (b) prepare for the TSST‐M with a parent, and (c) no‐stress control group. Results revealed that children made larger donations post‐stressor if they were alone before the acute stressor, if they had moderate cardiac autonomic balance, reflecting both parasympathetic and sympathetic influence, and if they were older. Children who prepared for the TSST‐M with social support from a parent made comparable donations as children in the no‐stress control group, in accord with stress buffering models. Increased altruism following acute stress among children suggests that a comprehensive understanding of the human stress response needs to incorporate “tend‐and‐befriend” behavior—the tendency for humans to show increased altruistic behavior during times of distress.

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Cardiac autonomic functioning and post-traumatic stress: A preliminary study in youth at-risk for PTSD

Cited by 19 publications

References 53 publications

Alterations of autonomic nervous system and HPA axis basal activity and reactivity to acute stress: a comparison of traumatized adolescents and healthy controls

Alterations of autonomic nervous system and HPA axis basal activity and reactivity to acute stress: a comparison of traumatized adolescents and healthy controls

Validation of a new impedance cardiography analysis algorithm for clinical classification of stress states

Children’s altruism following acute stress: The role of autonomic nervous system activity and social support

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