Cardiac complexity and emotional dysregulation in children

Fiskum, Charlotte; Andersen, Tonje Grønning; Aslaksen, Per M.; Svendsen, Birgit; Flaten, Magne Arve; Jacobsen, Karl

doi:10.1016/j.ijpsycho.2017.08.005

Cited by 11 publications

(14 citation statements)

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“…In our study SampEn was not significantly correlated with either RMSSD or PEP, but showed a weak negative relationship to heart rate in the controls. When RMSSD and PEP were modeled together as independent variables affecting SampEn, (as reported in Fiskum et al, 2017 ), lower RMSSD and higher PEP were linked to greater entropy. This indicates that SampEn did not relate to either vagal or SNS influence in a simple one-to-one linear way.…”

Section: Discussionmentioning

confidence: 93%

“… Between group differences was conducted using independent t-tests (t); SD, standard deviation; DFA, detrended fluctuation analysis; HR, mean heart rate; RMSSD, root mean square of successive differences; PEP, pre-ejection period; SampEn, sample entropy; * p ≤ 0.05; ** p ≤ 0.01; *** p ≤ 0.001, a minor portion of this table has been published in Fiskum et al ( 2017 ) …”

Section: Resultsmentioning

confidence: 99%

“…The study was part of a larger study on child psychotherapy (also described in Fiskum et al, 2017 ) and had a between-groups design consisting of a clinical and a control group assessed with electrocardiography (ECG) and impedance cardiography (ICG), along with parental reports of emotional and clinical problems.…”

Section: Methodsmentioning

confidence: 99%

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Non-linear Heart Rate Variability as a Discriminator of Internalizing Psychopathology and Negative Affect in Children With Internalizing Problems and Healthy Controls

et al. 2018

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Background: Internalizing psychopathology and dysregulated negative affect are characterized by dysregulation in the autonomic nervous system and reduced heart rate variability (HRV) due to increases in sympathetic activity alongside reduced vagal tone. The neurovisceral system is however, a complex nonlinear system, and nonlinear indices related to psychopathology are so far less studied in children. Essential nonlinear properties of a system can be found in two main domains: the informational domain and the invariant domain. sample entropy (SampEn) is a much-used method from the informational domain, while detrended fluctuation analysis (DFA) represents a widely-used method from the invariant domain. To see if nonlinear HRV can provide information beyond linear indices of autonomic activation, this study investigated SampEn and DFA as discriminators of internalizing psychopathology and negative affect alongside measures of vagally-mediated HRV and sympathetic activation.Material and Methods: Thirty-Two children with internalizing difficulties and 25 healthy controls (aged 9–13) were assessed with the Child Behavior Checklist and the Early Adolescent Temperament Questionnaire, Revised, giving an estimate of internalizing psychopathology, negative affect and effortful control, a protective factor against psychopathology. Five minute electrocardiogram and impedance cardiography recordings were collected during a resting baseline, giving estimates of SampEn, DFA short-term scaling exponent α1, root mean square of successive differences (RMSSD), and pre-ejection period (PEP). Between-group differences and correlations were assessed with parametric and non-parametric tests, and the relationships between cardiac variables, psychopathology and negative affect were assessed using generalized linear modeling.Results: SampEn and DFA were not significantly different between the groups. SampEn was weakly negatively related to heart rate (HR) in the controls, while DFA was moderately negatively related to RMSSD in both groups, and moderately positively related to HR in the clinical sample. SampEn was significantly associated with internalizing psychopathology and negative affect. DFA was significantly related to internalizing psychopathology.Conclusions: Higher invariant self-similarity was linked to less psychopathology. Higher informational entropy was related to less psychopathology and less negative affect, and may provide an index of the organizational flexibility of the neurovisceral system.

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Section: Discussionmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

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Non-linear Heart Rate Variability as a Discriminator of Internalizing Psychopathology and Negative Affect in Children With Internalizing Problems and Healthy Controls

et al. 2018

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“…This is in accordance with growing evidence supporting the importance of measuring HR entropy: SampEn was a significant predictor of internalizing psychopathology and negative affect in a study with children with internalizing problems and healthy controls (Fiskum et al, ). A previous study (Fiskum et al, ) concluded that SampEn was a potential marker of dysregulation in the underlying neurovisceral processes vital for emotion regulation. In young adults, a recent study showed that HR entropy revealed the most significant difference between male and female cardiac responses to mental stress (Adjei, Xue, & Mandic, ).…”

Section: Discussionmentioning

confidence: 99%

Sex differences in adolescents’ cardiac reactivity and recovery under acute stress: The importance of nonlinear measures

et al. 2019

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How well adolescents can self‐regulate in the face of stressors has considerable implications for long‐term well‐being and risk of psychopathology. This study investigated sex differences in adolescents’ cardiac reactivity and recovery during a stressful task. Measures of cardiac variability (linear) and complexity (nonlinear) were obtained from N = 92 adolescents, 41 males (M age = 13.28, SD = 0.69; BMI = 21.9) and 51 females (M age = 13.36, SD = 0.67; BMI = 21.5). The adolescents underwent the Trier Social Stress Test, consisting of five conditions: baseline, anticipation, social exposure, math task, and recovery. Repeated measures ANOVAs revealed that female in comparison to male adolescents showed lower cardiac complexity revealed by higher short‐term scaling exponent at baseline (p = .006) and math (p = .013) and lower entropy at exposure (p = .013) and math (p = .012). A marginal between‐groups effect was found for Higuchi's fractal dimension, F(1, 90) = 3.67, p = .059, ηp2 = .041, with females showing lower fractal dimension than males in math (p = .037). Linear measures did not reveal sex‐related differences. Results suggest that adolescent females show lower cardiac complexity during stress. These findings support the importance of nonlinear cardiac measures for understanding cardiac reactivity during stress. Further research is needed to test the hypothesis that cardiac complexity is useful to detect an increased risk of emotional disorders, disorders that are more prevalent in women.

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“…Cardiothoracic impedance is a measurement that is often used to acquire data for calculation of the PEP and measured PEP values around 75–134 ms [ 14 , 23 , 24 ]. However, echocardiography is the gold standard for measuring the PEP [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Small intra-individual variability of the pre-ejection period justifies the use of pulse transit time as approximation of the vascular transit

Kortekaas¹,

Velzen²,

Grüne³

et al. 2018

PLoS ONE

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BackgroundVascular transit time (VTT) is the propagation time of a pulse wave through an artery; it is a measure for arterial stiffness. Because reliable non-invasive VTT measurements are difficult, as an alternative we measure pulse transit time (PTT). PTT is defined as the time between the R-wave on electrocardiogram and arrival of the resulting pulse wave in a distal location measured with photoplethysmography (PPG). The time between electrical activation of the ventricles and the resulting pulse wave after opening of the aortic valve is called the pre-ejection period (PEP), a component of PTT. The aim of this study was to estimate the variability of PEP at rest, to establish how accurate PTT is as approximation of VTT.MethodsPTT was measured and PEP was assessed with echocardiography (gold standard) in three groups of 20 volunteers: 1) a control group without cardiovascular disease aged <50 years and 2) aged >50 years, and 3) a group with cardiovascular risk factors, defined as arterial hypertension, dyslipidemia, kidney failure and diabetes mellitus.ResultsPer group, the mean PEP was: 1) 58.5 ± 13.0 ms, 2) 52.4 ± 11.9 ms, and 3) 57.6 ± 11.6 ms. However, per individual the standard deviation was much smaller, i.e. 1) 2.0–5.9 ms, 2) 2.8–5.1 ms, and 3) 1.6–12.0 ms, respectively. There was no significant difference in the mean PEP of the 3 groups (p = 0.236).ConclusionIn conclusion, the intra-individual variability of PEP is small. A change in PTT in a person at rest is most probably the result of a change in VTT rather than of PEP. Thus, PTT at rest is an easy, non-invasive and accurate approximation of VTT for monitoring arterial stiffness.

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Cardiac complexity and emotional dysregulation in children

Cited by 11 publications

References 50 publications

Non-linear Heart Rate Variability as a Discriminator of Internalizing Psychopathology and Negative Affect in Children With Internalizing Problems and Healthy Controls

Non-linear Heart Rate Variability as a Discriminator of Internalizing Psychopathology and Negative Affect in Children With Internalizing Problems and Healthy Controls

Sex differences in adolescents’ cardiac reactivity and recovery under acute stress: The importance of nonlinear measures

Small intra-individual variability of the pre-ejection period justifies the use of pulse transit time as approximation of the vascular transit

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