Do deficits in subjective stress recovery predict subsequent stress sensitivity and symptoms in schizophrenia spectrum disorders?

High levels of stress play a crucial role in the development of psychotic symptoms, such as paranoia, and may stem in part from recovery deficits after stress exposure. However, it remains unclear whether deficient recovery causes a build-up of heightened stress levels that increases stress sensitivity and symptoms when exposed to another stressor. To test this, we investigated the effect of subjective stress recovery on the response to a subsequent stressor and paranoia.

Are paranoid ideation and hallucination spectrum experiences differently associated with affect dynamics? A continuous-time modeling approach.

Psychotic experiences have been associated with distortions in affective functioning, including aberrancies in affect dynamics. However, it remains unclear whether the two principal symptom dimensions of psychosis, namely paranoid ideation and hallucination spectrum experiences, are differently associated with affect dynamics, and whether associations hold after statistically controlling for depressive symptoms. We investigate this by using a novel statistical approach, the hierarchical Ornstein-Uhlenbeck (OU) process model.

Recovery After Stress-Autonomic and Subjective Arousal in Individuals With Psychosis Compared to Healthy Controls.

Background And Hypothesis: Heightened stress levels in individuals with psychosis (PSY) are associated with psychotic symptom occurrence and may be partially attributed to well-established deficits in resting-state heart rate variability (HRV) and emotion regulation. In healthy participants, resting-state HRV and self-reported emotion regulation skills have been linked to recovery after a stressor; however, it is unclear whether stress recovery is altered in PSY. Thus, we compared the autonomic and subjective recovery of PSY to healthy controls (HC) and investigated the predictive value of resting-state HRV and emotion regulation skills.

How you think about an emotion predicts how you regulate: an experience-sampling study.

Emotion evaluations are assumed to play a crucial role in the emotion regulation process. We tested a postulate from our framework of emotion dysregulation (Nowak, U., Wittkamp, M.

Using the Ball-in-Bowl Metaphor to Outline an Integrative Framework for Understanding Dysregulated Emotion.

Dysregulated emotion plays an important role for mental health problems. To elucidate the underlying mechanisms, researchers have focused on the domains of strategy-based emotion regulation, psychophysiological self-regulation, emotion evaluations, and resulting emotion dynamics. So far, these four domains have been looked at in relative isolation from each other, and their reciprocal influences and interactive effects have seldom been considered.

Heart rate variability as an index of emotion (dys)regulation in psychosis?

The vagally-mediated heart rate variability (HRV), an indicator of the autonomic nervous system (ANS), has been proposed as a transdiagnostic marker for emotion regulation (ER). In people with psychotic disorders (PSY), HRV is profoundly reduced compared to healthy controls (HC). Similarly, questionnaire-based assessments of adaptive ER point to a deficit in PSY.

Linking psychophysiological adaptation, emotion regulation, and subjective stress to the occurrence of paranoia in daily life.

As stress is relevant to the formation of paranoia, maladaptive behavioral and physiological stress regulation is discussed as a crucial indicator of vulnerability. This is supported by research linking psychosis to the tendency to make less use of functional and more use of dysfunctional emotion regulation strategies (ER) and with a lower vagally-mediated heart rate variability (HRV). However, it remains unclear whether ER serves as a mediator between resting-state HRV on the one hand and subjective stress levels and paranoia on the other and whether this is specific to paranoia as compared to depression.

Emotions and persecutory ideation in daily life: On the trail of the "chicken and egg" problem.

Etiological models highlight the importance of emotions for the emergence of persecutory ideation. To increase our understanding of their exacerbation, we tested whether this process can be explained by a vicious cycle of negative emotions and persecutory ideation in daily life. Furthermore, we examined whether this process differs in people with and without a psychotic disorder by testing a sample of 34 individuals with elevated psychotic experiences without a diagnosis (subclinical sample) and a sample of 33 individuals diagnosed with schizophrenia spectrum disorder (clinical sample).

Hair cortisol concentrations as an indicator of potential HPA axis hyperactivation in risk for psychosis.

A chronic hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis is assumed to be an important indicator of vulnerability for psychosis. Despite the considerable research on this topic, putative social origins of HPA axis hyperactivation have received little attention in the literature so far. Also, the inconsistency of previous findings calls for new and reliable methods in the assessment of HPA axis activation.

Autonomic arousal during psychosis spectrum experiences: Results from a high resolution ambulatory assessment study over the course of symptom on- and offset.

Introduction: Ecological momentary assessment (EMA) studies show that stressors trigger the onset or increase of psychotic symptoms. These studies, however, predominantly rely on large sampling intervals and self-report assessment. This study aims to identify the autonomic stress-response to psychosis-spectrum experiences by using a one-day high-resolution EMA with continuous skin conductance and heart rate monitoring in a sample with attenuated positive symptoms.

Specificity of resting-state heart rate variability in psychosis: A comparison with clinical high risk, anxiety, and healthy controls.

Maladaptability, particularly of autonomic activity, is described as a central component of vulnerability-stress-models for the pathogenesis of psychotic symptoms. Investigating heart rate variability (HRV) as an index of autonomic adaptability is thus likely to improve our understanding of psychosis. In clinically vulnerable groups for psychosis, it is unclear whether maladaptability is already evident.

Stress levels in psychosis: Do body and mind diverge?

Discrepancies between subjective and physiological stress levels may help to explain why stress leads to psychosis. We examined self-reported and physiological stress levels (heart rate, skin conductance level, cortisol level) during two conditions (noise stressor, no stressor) in patients with psychotic disorders (n = 35), patients with depression (n = 30), and healthy controls (n = 28), expecting larger discrepancies between self-reported and physiological stress levels in patients with psychosis than in controls. Difference values were calculated from standardized stress levels.

Emotion regulation as a predictor of the endocrine, autonomic, affective, and symptomatic stress response and recovery.

Stress is associated with the development of mental disorders such as depression and psychosis. The ability to regulate emotions is likely to influence how individuals respond to and recover from acute stress, and may thus be relevant to symptom development. To test this, we investigated whether self-reported emotion regulation predicts the endocrine, autonomic, affective, and symptomatic response to and recovery from a stressor.

A randomized-controlled trial of heart rate variability biofeedback for psychotic symptoms.

Arousal and the way it is coped with are relevant to the emergence of psychotic symptoms. Heart rate variability (HRV) stems from autonomic responses to environmental demands such as stress and is an index of physiological arousal, adaptability, and homeostatic reflexes forming autonomic balance. A randomized-controlled between-subjects trial that compared HRV-biofeedback (BF) to an active relaxation and to a waiting control condition was conducted in a sample with attenuated subclinical psychotic symptoms (N = 84).

The association of resting state heart rate variability and 24-hour blood pressure variability in spinal cord injury.

Patients with high cervical complete spinal cord injuries (tetraplegia) sustain damage to the autonomic neural pathways that influence cardiovascular functioning and produce variability in the heart rate (HR) and blood pressure (BP). In non-injured individuals, an inverse relationship exists between resting autonomic control of the heart (as evidenced by HR variability (HRV)) and BP variability (BPV). This study examined the relationship between HRV, BP and BPV in individuals with tetraplegic (n=10) and paraplegic (n=10) spinal cord injuries, and a group of healthy controls (n=14).

Pneumogastric (Vagus) Nerve Activity Indexed by Heart Rate Variability in Chronic Pain Patients Compared to Healthy Controls: A Systematic Review and Meta-Analysis.

Background: A large body of scientific literature derived from experimental studies emphasizes the vital role of vagal-nociceptive networks in acute pain processing. However, research on vagal activity, indexed by vagally-mediated heart rate variability (vmHRV) in chronic pain patients (CPPs), has not yet been summarized.

Objectives: To systematically investigate differences in vagus nerve activity indexed by time- and frequency-domain measures of vmHRV in CPPs compared to healthy controls (HCs).

Resting vagal activity in schizophrenia: meta-analysis of heart rate variability as a potential endophenotype.

Background: Cardiac vagal tone, indexed by heart rate variability (HRV), is a proxy for the functional integrity of feedback mechanisms integrating central and peripheral physiology.

Aims: To quantify differences in HRV in individuals with schizophrenia compared with healthy controls.

Method: Databases were systematically searched for studies eligible for inclusion.

Bridging psychophysiological and phenomenological characteristics of psychosis--Preliminary evidence for the relevance of emotion regulation.

In psychosis, the alleged increased subjective stress-sensitivity is reflected in abnormal physiological arousal such as higher heart rate, elevated skin conductance levels, decreased vagal activity, and unusual cortisol levels. Despite ongoing research, possible mechanisms that explain the interplay between the phenomenological (i.e.

Arousal Predisposition as a Vulnerability Indicator for Psychosis: A General Population Online Stress Induction Study.

Explanatory models ascribe to arousability a central role for the development of psychotic symptoms. Thus, a disposition to hyperarousal (i.e.

Altered autonomic arousal in psychosis: an analysis of vulnerability and specificity.

Vulnerability-stress models implicate that alterations of the autonomous nervous system contribute to the development of psychosis. Previous research has found autonomic arousal alterations in psychotic disorders and at-risk individuals that are not explained by medication alone. To test whether these alterations are associated with the extent of an individual's vulnerability and whether they are specific to psychosis, we compared participants with psychosis (n=23), first-degree relatives of individuals with psychosis (n=21), and healthy participants with attenuated positive symptoms (n=23) to participants with depression (n=24) and healthy controls (n=24).

Effects of medical and psychological treatment of depression in patients with COPD--a review.

Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease characterized by progressive and only partially reversible symptoms and by considerable negative consequences such as reductions in functional status and quality of life. Comorbid depression is highly prevalent in patients with COPD and related to a worse course of the disease. Despite its negative impact, depression often remains unrecognized and untreated in COPD patients.