Cardiac stability at differing levels of temporal analysis in panic disorder, post‐traumatic stress disorder, and healthy controls

Fisher, Aaron J.; Woodward, Steven H.

doi:10.1111/psyp.12148

Cited by 26 publications

(35 citation statements)

References 50 publications

(77 reference statements)

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“…A previous study reported that anxiety disorders are associated with significantly lower HRV but that the association is mainly driven by the effects of antidepressants, such as tricyclic antidepressants and selective serotonin reuptake inhibitors,43,57 which decrease vagal activity and alter vagal outflow 19,57,58. Previous studies have also shown that benzodiazepines can influence autonomic neurocardiac regulation, reducing central vagal tone, possibly through their interaction with the gamma-aminobutyric acid-A receptor chloride ion channel complex 59.…”

Section: Discussionmentioning

confidence: 99%

Diminished autonomic neurocardiac function in patients with generalized anxiety disorder

Kim¹,

Lee²,

Kim³

2016

NDT

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BackgroundGeneralized anxiety disorder (GAD) is a chronic and highly prevalent disorder that is characterized by a number of autonomic nervous system symptoms. The purpose of this study was to investigate the linear and nonlinear complexity measures of heart rate variability (HRV), measuring autonomic regulation, and to evaluate the relationship between HRV parameters and the severity of anxiety, in medication-free patients with GAD.MethodsAssessments of linear and nonlinear complexity measures of HRV were performed in 42 medication-free patients with GAD and 50 healthy control subjects. In addition, the severity of anxiety symptoms was assessed using the State-Trait Anxiety Inventory and Beck Anxiety Inventory. The values of the HRV measures of the groups were compared, and the correlations between the HRV measures and the severity of anxiety symptoms were assessed.ResultsThe GAD group showed significantly lower standard deviation of RR intervals and the square root of the mean squared differences of successive normal sinus intervals values compared to the control group (P<0.01). The approximate entropy value, which is a nonlinear complexity indicator, was also significantly lower in the patient group than in the control group (P<0.01). In correlation analysis, there were no significant correlations between HRV parameters and the severity of anxiety symptoms.ConclusionThe present study indicates that GAD is significantly associated with reduced HRV, suggesting that autonomic neurocardiac integrity is substantially impaired in patients with GAD. Future prospective studies are required to investigate the effects of pharmacological or non-pharmacological treatment on neuroautonomic modulation in patients with GAD.

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Section: Discussionmentioning

confidence: 99%

Diminished autonomic neurocardiac function in patients with generalized anxiety disorder

Kim¹,

Lee²,

Kim³

2016

NDT

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“…The present study only uses the data on heart rate (HR) and respiratory sinus arrhythmia (RSA). Complete details regarding recruitment procedures, screening, diagnostic interviewing, and physiological data collection and methodology (including electrocardiography signal cleaning and preparation) are published in the study by Fisher and Woodward (22). The present sample comprised 69 individuals, 16 healthy controls, 23 individuals with PTSD, 14 individuals with panic disorder, and 16 individuals with co-occurring PTSD and panic disorders.…”

Section: Methodsmentioning

confidence: 99%

Lack of group-to-individual generalizability is a threat to human subjects research

Fisher

Medaglia

Jeronimus

2018

Proc. Natl. Acad. Sci. U.S.A.

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810

688

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Only for ergodic processes will inferences based on group-level data generalize to individual experience or behavior. Because human social and psychological processes typically have an individually variable and time-varying nature, they are unlikely to be ergodic. In this paper, six studies with a repeated-measure design were used for symmetric comparisons of interindividual and intraindividual variation. Our results delineate the potential scope and impact of nonergodic data in human subjects research. Analyses across six samples (with 87-94 participants and an equal number of assessments per participant) showed some degree of agreement in central tendency estimates (mean) between groups and individuals across constructs and data collection paradigms. However, the variance around the expected value was two to four times larger within individuals than within groups. This suggests that literatures in social and medical sciences may overestimate the accuracy of aggregated statistical estimates. This observation could have serious consequences for how we understand the consistency between group and individual correlations, and the generalizability of conclusions between domains. Researchers should explicitly test for equivalence of processes at the individual and group level across the social and medical sciences.

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“…Moreover, the sampling rate of the measurements and the temporal scale of the data analysis will come to bear on the conclusions (c.f. Fisher & Woodward, 2014). …”

Section: Rigidity Flexibility and Instabilitymentioning

confidence: 99%

“…Flexibility, rigidity, and stability are popular constructs that have been employed across various psychological research domains, including psychotherapy (Newman & Fisher, 2013), psychophysiology (Fisher & Woodward, 2014; Hoehn-Saric, McLeod, Funderburk, & Kowalski, 2004), personality (Wright, Pincus, & Lenzenweger, 2012), and emotion regulation (Gruber, Kogan, Quoidbach, & Mauss, 2013). Yet, inconsistencies remain in the operationalization and quantitation of these constructs, and it is not always clear where the distinctions lie between instability and flexibility, or stability and rigidity.…”

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confidence: 99%

Reductions in the diurnal rigidity of anxiety predict treatment outcome in cognitive behavioral therapy for generalized anxiety disorder

Fisher

Newman

2016

Behaviour Research and Therapy

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Generalized anxiety disorder (GAD) is a chronic and disabling disorder which is characterized by worrisome mentation about future outcomes. Because the evocative stimuli in GAD are largely internally derived, the feared outcomes contained in worry episodes can be invoked – and responded to – regardless of external context. We hypothesized that individuals with GAD would be entrained to internally-regulated, fixed patterns of anxiety on a day-to-day basis and that successful therapeutic intervention would serve to mitigate this entrainment. Thus, the present study examined the constructs of flexibility and rigidity as they apply to the daily fluctuation of anxious symptoms in individuals with GAD. We aimed to demonstrate that an apparently variable system can be conceptualized as rigid when the variability maps onto stable and predictable periodic oscillations. Sixty-nine individuals completed cognitive-behavioral treatment for GAD. Average age was 36.62 years (SD = 11.56), and participants were mostly Caucasian (89.5%) and female (68.4%). Daily-diary data indicating level of anxiety on a 0 to 100-point scale and collected four times per day were subjected to spectral analysis in order to determine the spectral power attributable to daily oscillations – which was related to the degree of rigidity in daily anxiety. Diurnal rigidity decreased throughout therapy and the degree to which rigidity was reduced significantly predicted reliable change at post-treatment. Thus, symptom rigidity can be conceptualized as stable periodic fluctuation and is discernible from other metrics of volatility in repeated measures data. Moreover, diurnal rigidity is significantly reduced during treatment, facilitating flexible responding to environmental demands.

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Cardiac stability at differing levels of temporal analysis in panic disorder, post‐traumatic stress disorder, and healthy controls

Cited by 26 publications

References 50 publications

Diminished autonomic neurocardiac function in patients with generalized anxiety disorder

Diminished autonomic neurocardiac function in patients with generalized anxiety disorder

Lack of group-to-individual generalizability is a threat to human subjects research

Reductions in the diurnal rigidity of anxiety predict treatment outcome in cognitive behavioral therapy for generalized anxiety disorder

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