Positive affect state is a good predictor of movement and stress: combining data from ESM/EMA, mobile HRV measurements and trait questionnaires

Resting vagally-mediated heart rate variability in the laboratory is associated with momentary negative affect and emotion regulation in daily life

Vagally-mediated heart rate variability (vmHRV) is a physiological index reflecting parasympathetic activity that has been linked to emotion regulation (ER) capacity. However, very limited research has examined associations of physiological indices of regulation such as vmHRV with emotional functioning in daily life. The few studies that exist have small samples sizes and typically focus on only a narrow aspect of ER or emotional functioning. In this study, we examined associations between vmHRV assessed in the laboratory and emotional/mental health functioning in daily life using a 7-day ecological momentary assessment design in 303 adult community participants. We hypothesized that higher resting vmHRV would be associated with higher positive affect (PA), lower negative affect (NA), less affective variability, greater well-being, fewer dysphoria symptoms, greater use of engagement ER strategies, and less use of avoidance ER strategies, as assessed in daily life. Results revealed that higher resting vmHRV in the laboratory (as indexed by both high frequency heart rate variability, HF-HRV, and the root mean of successive square deviations between heart beats, RMSSD) was significantly associated with less frequent use of avoidance ER strategies in daily life. Theoretical and clinical implications are discussed, including the association of vmHRV with negatively valenced, rather than positively valenced, daily life experiences.

Characteristics and Influencing Factors of Post-Traumatic Growth: A Cross-Sectional Study of Psychiatric Nurses Suffering from Workplace Violence in Guangdong China

BACKGROUND

Workplace violence (WPV) had become an important issue that endangered the occupational safety of psychiatric nurses. A growing number of studies showed positive post-traumatic growth (PTG) resulting from coping with trauma.

OBJECTIVE

To investigate the characteristics of PTG in psychiatric nurses who experienced violence in the workplace and analyze its influencing factors.

METHODS

A total of 1202 psychiatric nurses participated in the study. From October 2022 to December 2022, this cross-sectional study collected data on psychiatric nurses from five tertiary hospitals in Guangdong Province, China. Twenty-item Chinese version post-traumatic growth inventory (PTGI), Jefferson Scale of Empathy Health Professional (JSE-HP), Confidence in Coping with Patient Aggression Instrument (CCPAI), Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C), and Connor-Davidson Resilience Scale (CD-RISC) measured PTG level, empathy, the confidence in coping with WPV, post-traumatic stress disorder, and resilience, respectively. Bivariate analysis and multiple linear regression explored potential influencing factors of PTG. This study complies with the EQUATOR (STROBE) checklist.

RESULTS

The sample was composed of a total of 1202 psychiatric nurses suffering from WPV. The average score of PTGI in psychiatric nurses was above average (65.75 points; SD = 20.20). Linear regression analyses showed from single-child family (β=0.052,95% CI=0.342,5.409, P<0.05), education background (β=0.108,95% CI=1.833,5.097, P<0.001), the confidence in coping with patient aggression (β=0.106,95% CI=1.385,4.317, P<0.001), empathy (β=0.057,95% CI=0.312,4.374, P<0.05), and resilience (β=0.484,95% CI=7.737,9.575, P<0.001) were associated with PTG level.

CONCLUSION

Psychiatric nurses who were non-single child, had received higher education, had confidence in coping with patient aggression, had good resilience and strong empathy were prone to PTG after experiencing WPV. The study findings could help hospitals and nursing managers identify vulnerable individuals and take early intervention measures against such populations.

Physical activity and specific symptoms of depression: A pooled analysis of six cohort studies

BACKGROUND

The association between physical activity (PA) and depression is well-established, but the details that explain this association remain elusive. We examined whether PA is differentially associated with specific symptoms of depression (e.g., cognitive vs somatic symptoms), and whether these associations follow a dose-response pattern with respect to intensity or frequency of PA.

METHODS

Cross-sectional analyses were based on 6 samples of the continuous U.S. National Health and Nutrition Examination Surveys (NHANES) carried out between 2007 and 2018 (n = 28,520). Depressive symptoms were assessed with Patient Health Questionnaire 9 (PHQ-9). Information about PA (vigorous, moderate, and daily commuting by foot or bike) and covariates was self-reported.

RESULTS

After adjusting for education, health behaviors, body-mass index, physical functioning, and all the other depressive symptoms, lower PA was specifically associated with four depressive symptoms: loss of interest/pleasure, feeling down/hopeless, fatigue, and changes in appetite (odds ratios from 0.94 to 0.59). A monotonic dose-response pattern on PA amount was observed only for interest/pleasure and fatigue, and these associations were independent of PA intensity.

LIMITATIONS

Cross-sectional data did not allow us to assess temporal ordering. Both depressive symptoms and PA were self-reported, which may induce bias.

CONCLUSION

Low PA may be linked to depressive symptoms particularly through the symptoms of anhedonia and fatigue. Given that their association with PA amount follows a dose-response pattern and is independent of PA intensity, we hypothesize that behavioral activation and exposure to rewarding experiences might help to explain why PA alleviates depression.

Comparison of the Perceived Stress Reactivity Scale with physiological and self-reported stress responses during ecological momentary assessment and during participation in a virtual reality version of the Trier Social Stress Test

Valid approaches to conveniently measure stress reactivity are needed due to the growing evidence of its health-impairing effects. This study examined whether the Perceived Stress Reactivity Scale (PSRS) predicts cardiovascular and psychological responses to psychosocial stressors during daily life and during a virtual reality (VR) Trier Social Stress Test (TSST). Medical students answered a standardized baseline questionnaire to assess perceived stress reactivity by the PSRS. The PSRS asks participants to rate the intensity of their typical affective responses to common stressors during daily life. They were further asked to participate in a VR-TSST and in an ecological momentary assessment (EMA) over a period of three consecutive workdays during daily life. Blood pressure and self-reported stress were repeatedly, heart rate variability (HRV) continuously measured during the VR-TSST and EMA. Furthermore, participants repeatedly assessed task demands, task control and social conflict during the EMA. Data was analysed using multilevel analysis and multiple linear regression. Results indicate that the PSRS moderates associations between blood pressure (but not HRV) and demands and control during daily life. Furthermore, the PSRS directly predicted self-reported stress, but did not moderate associations between self-reported stress and demands, control and social conflict. The PSRS did not predict physiological and self-reported stress responses to the VR-TSST. This study partly confirmed convergent validity of the PSRS to stress reactivity in daily life. Furthermore, the lack of association between the PSRS and stress responses to the VR-TSST calls for future studies to search for reliable and valid ways to assess stress reactivity.

Investigation of different ML approaches in classification of emotions induced by acute stress

Background

Machine learning is becoming a common tool in monitoring emotion. However, methodological studies of the processing pipeline are scarce, especially ones using subjective appraisals as ground truth.

New method

A novel protocol was used to induce cognitive load and physical discomfort, and emotional dimensions (arousal, valence, and dominance) were reported after each task. The performance of five common ML models with a versatile set of features (physiological features, task performance data, and personality trait) was compared in binary classification of subjectively assessed emotions.

Results

The psychophysiological responses proved the protocol was successful in changing the mental state from baseline, also the cognitive and physical tasks were different. The optimization and performance of ML models used for emotion detection were evaluated. Additionally, methods to account for imbalanced classes were applied and shown to improve the classification performance.

Comparison with existing methods

Classification of human emotional states often assumes the states are determined by the stimuli. However, individual appraisals vary. None of the past studies have classified subjective emotional dimensions with a set of features including biosignals, personality and behavior.

Conclusion

Our data represent a typical setup in affective computing utilizing psychophysiological monitoring: N is low compared to number of features, inter-individual variability is high, and class imbalance cannot be avoided. Our observations are a) if possible, include features representing physiology, behavior and personality, b) use simple models and limited number of features to improve interpretability, c) address the possible imbalance, d) if the data size allows, use nested cross-validation.

Greater Ecologically Assessed Positive Experiences Predict Heightened Sex Hormone Concentrations Across Two Weeks in Older Adults

OBJECTIVES

Sex hormones are important components of healthy aging, with beneficial effects on physical and mental health. Positive experiences such as elevated mood, lowered stress, and higher well-being also contribute to health outcomes and, in younger adults, may be associated with elevated sex hormone levels. However, little is known about the association between positive experiences and sex hormones in older adults.

METHODS

In this study, older men and women (N = 224, 70+ years of age) provided blood samples before and after a 2-week period of ecological momentary assessment (EMA) of positive and negative experiences (assessed based on self-reporting items related to affect, stress, and well-being). Concentrations of a panel of steroid sex hormones and glucocorticoids were determined in blood.

RESULTS

Higher levels of positive experiences reported in daily life across 2 weeks were associated with increases in free (biologically active) levels of testosterone (B = 0.353 [0.106, 0.601], t(221.3) = 2.801, p = .006), estradiol (B = 0.373 [0.097, 0.649], t(225.1) = 2.645, p = .009), and estrone (B = 0.468 [0.208, 0.727], t(224.3) = 3.535, p < .001) between the start and the end of the 2-week EMA period.

DISCUSSION

These findings suggest that sex hormones may be a pathway linking positive experiences to health in older adults.

Zoom-Based Mindfulness-Oriented Recovery Enhancement Plus Just-in-Time Mindfulness Practice Triggered by Wearable Sensors for Opioid Craving and Chronic Pain

Objective

The opioid crisis in the USA remains severe during the COVID-19 pandemic, which has reduced access to evidence-based interventions. This Stage 1 randomized controlled trial (RCT) assessed the preliminary efficacy of Zoom-based Mindfulness-Oriented Recovery Enhancement (MORE) plus Just-in-Time Adaptive Intervention (JITAI) prompts to practice mindfulness triggered by wearable sensors (MORE + JITAI).

Method

Opioid-treated chronic pain patients (n = 63) were randomized to MORE + JITAI or a Zoom-based supportive group (SG) psychotherapy control. Participants completed ecological momentary assessments (EMA) of craving and pain (co-primary outcomes), as well as positive affect, and stress at one random probe per day for 90 days. EMA probes were also triggered when a wearable sensor detected the presence of physiological stress, as indicated by changes in heart rate variability (HRV), at which time participants in MORE + JITAI were prompted by an app to engage in audio-guided mindfulness practice.

Results

EMA showed significantly greater reductions in craving, pain, and stress, and increased positive affect over time for participants in MORE + JITAI than for participants in SG. JITAI-initiated mindfulness practice was associated with significant improvements in these variables, as well as increases in HRV. Machine learning predicted JITAI-initiated mindfulness practice effectiveness with reasonable sensitivity and specificity.

Conclusions

In this pilot trial, MORE + JITAI demonstrated preliminary efficacy for reducing opioid craving and pain, two factors implicated in opioid misuse. MORE + JITAI is a promising intervention that warrants investigation in a fully powered RCT.

Preregistration

This study is registered on ClinicalTrials.gov (NCT04567043).

Capturing the Dynamics of the Social Environment Through Experience Sampling Methods, Passive Sensing, and Egocentric Networks: Scoping Review

BACKGROUND

Social interactions are important for well-being, and therefore, researchers are increasingly attempting to capture people's social environment. Many different disciplines have developed tools to measure the social environment, which can be highly variable over time. The experience sampling method (ESM) is often used in psychology to study the dynamics within a person and the social environment. In addition, passive sensing is often used to capture social behavior via sensors from smartphones or other wearable devices. Furthermore, sociologists use egocentric networks to track how social relationships are changing. Each of these methods is likely to tap into different but important parts of people's social environment. Thus far, the development and implementation of these methods have occurred mostly separately from each other.

OBJECTIVE

Our aim was to synthesize the literature on how these methods are currently used to capture the changing social environment in relation to well-being and assess how to best combine these methods to study well-being.

METHODS

We conducted a scoping review according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.

RESULTS

We included 275 studies. In total, 3 important points follow from our review. First, each method captures a different but important part of the social environment at a different temporal resolution. Second, measures are rarely validated (>70% of ESM studies and 50% of passive sensing studies were not validated), which undermines the robustness of the conclusions drawn. Third, a combination of methods is currently lacking (only 15/275, 5.5% of the studies combined ESM and passive sensing, and no studies combined all 3 methods) but is essential in understanding well-being.

CONCLUSIONS

We highlight that the practice of using poorly validated measures hampers progress in understanding the relationship between the changing social environment and well-being. We conclude that different methods should be combined more often to reduce the participants' burden and form a holistic perspective on the social environment.

Gratitude, affect balance, and stress buffering: A growth curve examination of cardiovascular responses to a laboratory stress task

Previous research has indicated that gratitude and affect-balance play key stress-buffering roles. However, to date there is limited research on the impact of gratitude and affect balance on cardiovascular recovery from acute psychological stress, and whether affect balance moderates the relationship between gratitude and cardiovascular reactions to acute psychological stress. In this study, 68 adults completed measures of state gratitude, positive and negative affect, and completed a laboratory-based cardiovascular stress-testing protocol. This incorporated a 20-minute acclimatization period, a 10-minute baseline, a 6-minute arithmetic stress task, and an 8-minute recovery period. Mixed-effects growth curve models were fit and the results indicated that state gratitude predicted lower systolic blood pressure responses throughout the stress-testing period. Affect balance was found to moderate the association between state gratitude and diastolic blood pressure responses to stress, amplifying the effects of state gratitude. These findings suggest that state gratitude has a unique stress-buffering effect on both reactions to and recovery from acute psychological stress.

Is daily-life stress reactivity a measure of stress recovery? An investigation of laboratory and daily-life stress

Typical measures of laboratory reactivity (i.e. difference between control and stress) and recovery (i.e. difference between stress and post-stress) were compared with a conventional measure of daily-life reactivity, best known as event-related stress. Fifty-three healthy individuals between 19 and 35 years of age took part in a laboratory session where stress was induced using the repeated Montreal Imaging Stress Task and 8 days of experience sampling method. Measures of negative affect, heart rate (HR), HR variability, and skin conductance level were collected. Findings show no strong associations between laboratory and daily life measures with the exception of laboratory affective recovery and daily life reactivity. Findings and their implications are discussed.

GD «L.T. Malaya named National Institute of Therapy of NAMS of Ukraine», Kharkіv, Ukraine, Samokhina L, Rudyk I, GD «L.T. Malaya named National Institute of Therapy of NAMS of Ukraine», Kharkіv, Ukraine. FEATURES OF HEART FAILURE IN PATIENTS WHO HAVE CONTRACTED A CORONAVIRUS INFECTION

An analysis of primary and secondary myocardial lesions under the conditions of transmission of the COVID-19 infection, causative factors and consequences of the progression of the pathological condition was carried out. Some possibilities of protection against infection and its consequences are noted. Among the first problems with the spread of SARS-CoV-2 in patients with heart failure is the need to distinguish viral lung disease from acute edema. Particular attention is paid to disorders of immune regulation and inflammation, which can exacerbate the imbalance between oxygen supply and myocardial energy needs. At the same time, the importance of troponin I, natriuretic peptide type B and C-reactive protein and creatinine, hypokalemia are highlighted. The central role is played by angiotensin-converting enzyme 2, the suppression of which enhances the local inflammatory response and fibrosis. Progression of infection is associated with stress cardiomyopathy and acute decompensation of chronic heart failure. They note the possibility of reducing infection, protecting the heart from systolic dysfunction, and correcting stress-induced biological reactions of the body, in particular, by the action of low temperatures.

Physiological reactions to acute stressors and subjective stress during daily life: A systematic review on ecological momentary assessment (EMA) studies

OBJECTIVE

This review aims to provide an overview of ecological momentary assessment (EMA) studies analyzing stress reactivity during daily life in terms of direct and moderated influence of acute stress on physiological responses.

MATERIALS AND METHODS

A systematic literature search was performed on November 29, 2021 using Web of Science, MEDLINE and PsycINFO to identify prospective EMA studies targeting acute stressors or stress under naturalistic conditions, without restrictions of publication date or population. Study quality was assessed for multiple EMA-specific sources of bias.

RESULTS

Out of 4285 non-duplicate records, 107 publications involving 104 unique studies were included. The majority of studies assessed acute physiological stress responses primarily through salivary cortisol (n = 59) and cardiovascular outcomes (n = 32). Most studies performed at least three measurements per day (n = 59), and had a moderate risk of recall bias (n = 68) and confounding (n = 85). Fifty-four studies reported a compliance of ≥80%. Direct, non-moderated positive associations were observed between acute stress exposure and concurrent cortisol levels (44%, n = 11/25), systolic (44%, 8/18) and diastolic blood pressure (53%, 8/15) and heart rate (53%, 9/17). Several inter- and intra-individual moderators were identified, such as age, gender, health status, chronic stress, work-related resources, physical activity and stress coping indicators.

CONCLUSIONS

About half of the reviewed EMA studies demonstrated direct associations between everyday acute stress exposure and physiological responses, including increased cortisol levels, blood pressure and heart rate. Results further suggested various moderator variables that could help develop tailored prevention strategies and identify groups at higher risk for dysfunctional stress responses.

REGISTRATION

PROSPERO-Reg.-No.: PROSPERO 2020 CRD42020163178.

How Stable, Really? Traditional and Nonlinear Dynamics Approaches to Studying Temporal Fluctuations in Personality and Affect

A pair of quantitative case studies is presented to demonstrate how different approaches to quantifying temporal variability in ratings of traits and affect can provide rich information for personality researchers. Data are presented and analyzed from two college students who completed an Ecological Momentary Assessment protocol sampling ratings of affect and traits up to 24 times daily for one week. Both classical and nonlinear data analytic techniques were applied to the data to summarize and examine the temporal dynamics of both traits and affect. For the purposes of exposition, one Big Five trait rating, extraversion, and the PANAS positive and negative affects, are discussed. The results support previous research demonstrating a high degree of variability in ratings of both traits and affect over time. Analyses using nonlinear and complexity expand on these findings and suggest temporal patterning as well as disorder; implications of phase portraits for understanding variability are discussed. The findings are discussed in light of a processing dynamics approach to resolving the role of variability in understanding personality.

A Longitudinal Examination of Real-World Sedentary Behavior in Adults with Schizophrenia-Spectrum Disorders in a Clinical Trial of Combined Oxytocin and Cognitive Behavioral Social Skills Training

Sedentary behavior contributes to a shortened life expectancy in individuals with schizophrenia-spectrum disorders (SSDs), highlighting the need for effective interventions to improve health. This study examined whether reduced ecological momentary assessment (EMA) measures of sedentary activities were observed in individuals with SSDs who participated in a 24-week randomized trial of cognitive behavioral social skills training (CBSST) and either intranasal oxytocin or placebo (NCT01752712). Participants (n = 57) were prompted with EMA surveys seven times per day for seven days during the baseline, 12-week, and 24-week timepoints to sample sedentary behavior ratings, positive and negative affect, interpersonal interactions, and interpersonal interaction appraisals. Results revealed that sedentary behavior and social interactions did not significantly change over the 24-week clinical trial; however, positive and negative affect and defeatist interaction appraisals improved with treatment, and oxytocin produced modest additional improvements in these EMA outcomes. Greater momentary positive affect was significantly associated with greater activity and greater frequency of interactions. Overall, CBSST was effective at improving functioning, momentary affect, and defeatist interaction appraisals, although it did not reduce sedentary behavior; therefore, targeting these factors is not sufficient to reduce sedentary behavior, and adjunct interventions are needed.

The role of personality traits and social support in relations of health-related behaviours and depressive symptoms

BACKGROUND

Previous evidence has suggested that physically inactive individuals and extensive media users are at high risk for experiencing depressive symptoms. We examined personality traits and perceived social support as potential moderators of this association. Personality and perceived social support were included as two of the most frequently considered variables when determining predispositioning factors for media use phenomena also discussed in relation to physical activity.

METHODS

We analysed cross-sectional data from 1402 adults (18-31 years old) who participated in a national health survey in Germany (KiGGS, Study on the health of children and adolescents in Germany, wave 2). The data included one-week accelerometer assessments as objective indicators of physical activity, self-reported media use, depressive symptoms, perceived social support and Big 5 personality traits. An elastic net regression model was fit with depressive symptoms as outcome. Ten-fold cross-validation was implemented.

RESULTS

Amongst the main effects, we found that high media use was positively correlated with depressive symptoms, whereas physical activity was not correlated. Looking at support and individual differences as moderators, revealed that PC use was more strongly correlated with depressive symptoms in cases of low levels of perceived social support. Positive associations of social media use with depressive symptoms were more pronounced, whereas negative associations of moderate to vigorous physical activity with depressive symptoms were less pronounced in extraverts than they were in introverts.

CONCLUSIONS

Results highlight the importance of considering individual factors for deriving more valid recommendations on protective health behaviours.