Early Life Adversity and Blunted Cardiovascular Reactivity to Acute Psychological Stress: The Role of Current Depressive Symptoms

Abstract

ObjectiveThe pathways underlying the early life adversity and cardiovascular reactivity association remain unclear. The current study examined the role of current depressive symptoms on this relationship.MethodsMediation analyses were conducted using data from 639 participants drawn from the Midlife Development in the United States 2 Biomarker Project. Responses were derived from the Childhood Trauma Questionnaire and Center for Epidemiologic Studies Depression Scale. Participants had their systolic and diastolic blood pressure (SBP, DBP) and heart rate monitored throughout a standardized stress testing protocol.ResultsThe association between early life adversity and reactivity was mediated by current depressive symptoms; all adversity factors were linked to higher levels of current depressive symptoms, which, in turn, were associated with lower cardiovascular reactivity. For emotional abuse, this was noted for SBP (β = −0.06 [95% confidence interval {CI}, −0.13 to −0.01]) and DBP (β = −0.04 [−0.07 to −0.01]), physical abuse (SBP: β = −0.05 [−0.11 to −0.01]; DBP: β = −0.03 [−0.06 to −0.01]), sexual abuse (SBP: β = −0.04 [−0.09 to −0.01]; DBP: β = −0.02 [−0.05 to −0.01]), emotional neglect (SBP: β = −0.04 [−0.09 to −0.01]; DBP: β = −0.02 [−0.05 to −0.01]), physical neglect (SBP: β = −0.09 [−0.17 to −0.02]; DBP: β = −0.05 [−0.09 to −0.02]), and total Childhood Trauma Questionnaire score (SBP: β = −0.02 [−0.03 to −0.00]; DBP: β = −0.01 [−0.02 to −0.00]).ConclusionsThe present findings extend research and demonstrate that depression is an underlying mechanism linking early life adversity and blunted cardiovascular reactivity.

Lifespan psychosocial stressors, optimism, and hemodynamic acute stress response in a national sample.

“…Alternatively, some researchers have wondered if reduced acute stress response may confer short-term cognitive and emotional benefits in the immediate aftermath of stressors (Phillips et al, 2013). Others suggest depression (Keogh et al, 2022) and cognitive function (Bourassa et al, 2021) may be intermediaries linking early adversity with adult stress physiology, but evidence for associations of stressor exposure, neuropsychiatric processes, stress physiology, and health outcomes is often cross-sectional, which may yield biased estimates of longitudinal processes. Research clarifying directionality among these complex developmental processes is needed.…”

“…Fourth, in light of ongoing debate regarding the dimensionality of dispositional optimism and evidence suggesting a stronger association of pessimism than optimism with physical health outcomes (Scheier et al, 2021), we re-estimated the main effects of lifespan stressor exposure and optimism by replacing the LOT-R total score with optimism and pessimism subscale scores (Cronbach's αs: .70 and .80, respectively). Fifth, given Keogh et al's (2022) findings suggesting depressive affect mediated the association between early adversity and reduced cardiovascular reactivity (Keogh et al, 2022), we re-estimated the indirect effects via optimism in the path models while further adjusting for an indirect path via depressive affect.…”

“…Bourassa et al (2021) considered linkages among early adversity (abuse, neglect, SES), BP and HR acute stress reactivity, and health-related outcomes. Keogh et al (2022) tested depression as a mediator of the association between childhood abuse and neglect and cardiovascular (BP and HR) acute stress reactivity. Our study extends prior work by: (a) broadening the conceptualization of childhood stressors to include negative life events beyond abuse, neglect, and SES; (b) testing synergistic effects of childhood and adulthood stressor exposure; (c) considering acute stress recovery as well as reactivity; (d) adding BRS as a novel marker of acute stress response; and (e) testing the role of optimism in the association between lifespan stressor exposure and adulthood acute stress response.…”

“…Covariates included age at the Biomarker Project visit, sex (1 = female, 0 = male), race (White, Black and/or African American, Native American/Alaskan natives/Asians/native Hawaiian or Pacific Islanders/others), highest education level (0 = no school to some high school, 1 = GED or high school graduate, 2 = some college, 3 = college graduate or equivalent, 4 = postgraduate education), current use of BP-altering medications at the Biomarker Project (yes/no; see Document S1 in the online supplemental materials), and lifetime chronic diseases (count score based on yes/no response to 13 conditions, top-coded at 5 due to skewness). Following prior work in this sample (Keogh et al, 2022), depression status was assessed at the Biomarker Project with the depressive affect subscale of the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977). Our manipulation check for the psychophysiology protocol considered participant stress ratings "at the moment" on a scale from 1 (not at all) to 10 (extremely) during each protocol period.…”

The Neurobiology of Infant Attachment-Trauma and Disruption of Parent–Infant Interactions

“…At PN16, fear learning resembles "adult-like," odor learning and amygdala plasticity is engaged regardless of maternal presence and CORT level (Sullivan et al, 2000;Barr et al, 2009). Chen et al, 2021;Claflin et al, 2021;Hilberdink et al, 2021;Keogh et al, 2021).…”