Effect of childhood maltreatment on cardiovascular response habitation to repeated psychosocial stress

History of COVID-19 infection is associated with disrupted cardiovascular stress response habituation in physically active people

OBJECTIVE

Coronavirus disease 2019 (COVID-19) is characterized by multiple effects on cardiovascular and autonomic functioning. As moment-to-moment cardiovascular function is highly susceptible to mental stress, this has spurred concerns regarding the potential long-term consequences of COVID-19 on sufferers' resilience to psychological stress and stress-related cardiovascular complications. However, the long-term after-effects of COVID-19 on cardiovascular stress reactivity profiles remain relatively unexplored. To address this gap, we investigated dynamic changes in cardiovascular function during and after successive stress exposures as a function of participants' COVID-19 histories.

METHOD

Our sample comprised 60 adult members of running clubs (mean age ± SD = 44.85 ± 9.64 yrs; 50 % male; 50 % female), who were classified into one of three groups based on self-reported history of COVID-19 (never had COVID-19; had COVID-19 once; had COVID-19 multiple times). Participants underwent a laboratory-based stress-induction protocol, during which a mental arithmetic challenge was presented twice. Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured before and during both stress exposures, which facilitated an assessment of habituation of cardiovascular stress responses.

RESULTS

History of COVID-19 was associated with disrupted cardiovascular stress response habituation. Specifically, persons classified as having never been infected with COVID-19 exhibited lower DBP responses to the second stress exposure compared to the first, indicative of ordinary habituation as observed in previous research. Furthermore, history of COVID-19 was associated with significantly elevated average HR throughout the procedure.

CONCLUSIONS

Response habituation is an ordinary mechanism that protects an organism from the rigors of recurring daily stress. If COVID-19 disrupts habituation of cardiovascular system responses, then individuals who have experienced COVID-19 in the past may be left with lingering effects that increase their susceptibility to future stress-related cardiovascular ill-health. Given the substantial number of people worldwide who have been affected by COVID-19, this potential long-lasting impact merits comprehensive investigation.

Rumination and Cardiovascular Adaptation to Repeated Psychological Stress

Rumination, that is mentally dwelling on past-centred negative, unwanted, and persistent thoughts, has been reliably linked to exaggerated cardiovascular responses to, and prolonged cardiovascular recovery from, a single psychological stressor. Although cardiovascular adaptation to multiple stress exposures is also an important indicator of a healthful stress response, only one study has examined the association between trait rumination and adaptation to repeated stress, employing a protocol administered across two separate testing sessions, 1 week apart. The aim of this study was to examine the influence of trait rumination on cardiovascular adaptation to repeated psychological stress within the same testing session. In a single laboratory visit, 146 participants completed a standardised stress testing protocol where they were exposed to the same stress task twice, separated by an inter-task interval. Trait rumination was assessed using the revised Emotion Control Questionnaire. Participants' cardiovascular parameters were monitored throughout using a Finometer. Habituation was operationalised as significant differences between reactivity scores from task 1 to reactivity scores from task 2. Repeated measures ANCOVA's found that lower levels of trait rumination were associated with greater systolic blood pressure adaptation in comparison to those reporting a higher tendency to ruminate, who showed less of a decrease in reactivity from the first to the second stress exposure, indicating poorer adaptation. Rumination did not affect cardiovascular habituation for other parameters, however it is worth noting that individuals in this sample failed to habituate regardless of trait rumination. Our results present some evidence implicating rumination as a possible mechanism compromising an individual's capacity to adequately adapt to repeated stress, which over time may play a role in the aetiology of disease. However, more research is needed to replicate this effect.

Childhood trauma and social anxiety in adolescents: Mediating role of cardiovascular response to social stress

Adolescents exposed to childhood trauma are at an elevated risk for social anxiety. However, the physiological mechanisms linking childhood trauma and adolescents' social anxiety remain poorly understood. This study examined whether cardiovascular reactivity to acute social stress was a mechanism underlying this association. Participants were Chinese adolescents (N = 172; Mage = 12.95). They first reported their childhood trauma and social anxiety using the Childhood Trauma Questionnaire and the Social Interaction Anxiety Scale. They then participated in a social stress task, during which their cardiovascular data [heart rate (HR) and systolic and diastolic blood pressure (SBP, DBP)] were monitored. The results showed that high levels of childhood trauma were associated with blunted HR, SBP, and DBP reactivity, which in turn were associated with high levels of social anxiety. Mediation analysis indicated that childhood trauma was indirectly associated with social anxiety via blunted cardiovascular reactivity. The findings suggest that blunted cardiovascular reactivity may serve as a physiological pathway linking childhood trauma and adolescents' social anxiety.

Maternal childhood emotional abuse increases cardiovascular responses to children's emotional facial expressions

Parents with a history of childhood maltreatment may be more likely to respond inadequately to their child's emotional cues, such as crying or screaming, due to previous exposure to prolonged stress. While studies have investigated parents' physiological reactions to their children's vocal expressions of emotions, less attention has been given to their responses when perceiving children's facial expressions of emotions. The present study aimed to determine if viewing facial expressions of emotions in children induces cardiovascular changes in mothers (hypo- or hyper-arousal) and whether these differ as a function of childhood maltreatment. A total of 104 mothers took part in this study. Their experiences of childhood maltreatment were measured using the Childhood Trauma Questionnaire (CTQ). Participants' electrocardiogram signals were recorded during a task in which they viewed a landscape video (baseline) and images of children's faces expressing different intensities of emotion. Heart rate variability (HRV) was extracted from the recordings as an indicator of parasympathetic reactivity. Participants presented two profiles: one group of mothers had a decreased HRV when presented with images of children's facial expressions of emotions, while the other group's HRV increased. However, HRV change was not significantly different between the two groups. The interaction between HRV groups and the severity of maltreatment experienced was marginal. Results suggested that experiences of childhood emotional abuse were more common in mothers whose HRV increased during the task. Therefore, more severe childhood experiences of emotional abuse could be associated with mothers' cardiovascular hyperreactivity. Maladaptive cardiovascular responses could have a ripple effect, influencing how mothers react to their children's facial expressions of emotions. That reaction could affect the quality of their interaction with their child. Providing interventions that help parents regulate their physiological and behavioral responses to stress might be helpful, especially if they have experienced childhood maltreatment.

Bridging childhood to adulthood: the impact of early life stress on acute stress responses

Background

Childhood trauma exerts enduring impacts on the physical and psychological well-being of individuals in adulthood, influencing their daily functioning. This study aims to investigate the impact of childhood trauma on stress recovery in adults, concentrating on heart rate variations during acute stress exposure.

Methods

A cohort of 126 participants completed the Childhood Trauma Questionnaire (CTQ) and underwent the Trier Social Stress Test (TSST) to elicit acute stress, with continuous heart rate (HR) monitoring for stress recovery assessment.

Results

The results revealed a negative correlation between childhood trauma and stress recovery, prominently observed in instances of emotional neglect and abuse. Individuals with heightened childhood trauma exhibited protracted stress recovery following acute stress exposure.

Conclusion

Childhood traumatic experiences were associated with the recovery from acute stress, as indicated by heart rate indices. These findings contribute to the foundational framework for psychological interventions tailored to individuals with a history of childhood trauma.

NR3C1 and NR3C2 Genes Increase the Risk of Suicide Attempt in Psychiatric Disorder Patients with History of Childhood Trauma

Background

Hypothalamic-pituitary-adrenal axis gene variants and childhood trauma (CT) are considered risk factors for suicide attempt (SA). The aim of the present study was analyzed gene x environment (GxE) interaction of NR3C1, NR3C2, and CT, and NR3C1 and NR3C2 gene expression in the development of SA with CT.

Participants and Methods

A total of 516 psychiatric Mexican patients from Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz. Among them, 274 had SA at least once and 242 had not SA. Genetic variants of NR3C1 and NR3C2 were genotyped in all the patients, of which were obtained the CT information from medical records. Additionally, the gene expression of NR3C1 and NR3C2 was also analyzed for a subsample of 96 patients, obtaining the TC information from Childhood Trauma Questionnaire (CTQ).

Results

The analysis showed a GxE interaction of NR3C1, NR3C2, and CT (OR=2.8, 95% CI [1.9-3.9], p<0.0001). Interactions were also observed with neglect (OR=2.1, 95% CI [1.4-3.1], p<0.0001), emotional abuse (OR=2.1, 95% CI [1.5-3], p<0.0001), and sexual abuse (OR=2.4, 95% CI [1.4-2.9], p<0.0001) in the prediction of SA. The analysis of gene expression identified an overexpression of NR3C1 in SA patients with high scores for physical and sexual abuse (p<0.0001; p<0.0006, respectively) and emotional neglect (p=0.014). An underexpression was observed of NR3C2, associated with high scores of trauma subtypes (p<0.0001) except physical neglect. Additionally, we observed an overexpression of NR3C1 gene in patients with SA carriers of A allele of rs6191 (p=0.0015). Also, overexpression of NR3C1 gene in carriers of G allele of rs6198 and underexpression of NR3C2 gene in carriers of G allele of rs5522 (p<0.0001).

Conclusion

Our findings suggest that genetic variants of NR3C1 and NR3C2 differentially affect expression levels, increasing the susceptibility to SA in psychiatric patients with a history of CT.

Early life adversity and cardiovascular responses to repeated stress among adolescents: Moderating role of COMT gene rs4680 polymorphism

BACKGROUND

Early life adversity (ELA) increases the risk of cardiovascular diseases through dysregulation of cardiovascular stress responses manifested by either exaggerated or blunted reactivity. The catechol-O-methyltransferase (COMT) gene rs4680 polymorphism has been identified in gene-environment interaction (G×E) studies to explain individual differences in the effects of ELA on physiological stress responses. However, little is known about whether ELA interacts with COMT gene rs4680 polymorphism to affect cardiovascular responses to repeated stress exposures.

OBJECTIVE

The current study examined the associations between ELA and cardiovascular responses to repeated stress exposures, and the moderating role of COMT rs4680 polymorphism in these associations.

METHODS

The childhood trauma questionnaire (CTQ) was administered to 359 junior school students who underwent a two-successive stress exposures protocol with continuous cardiovascular monitoring [heart rate (HR) and systolic and diastolic blood pressure (SBP, DBP)] across four laboratory phases, and their saliva samples for deoxyribonucleic acid (DNA) genotyping were collected.

RESULTS

ELA was associated with blunted HR reactivity to the first and second stress exposures, blunted SBP reactivity to the first stress exposure, and attenuated SBP habituation to repeated stress exposures. Moreover, COMT rs4680 moderated these associations, such that the associations between ELA and blunted HR, SBP, and DBP reactivity to the first stress and disrupted DBP habituation to repeated stress exposures only existed in GA/AA genotype carriers but not in GG genotype carriers.

CONCLUSIONS

These findings suggest that the A allele of COMT rs4680 is vulnerable to the negative effects of ELA on the developmental dysregulation of stress physiological systems.

Early Life Stress, Coping, and Cardiovascular Reactivity to Acute Social Stress

OBJECTIVE

Early life stress (ELS) occurring during childhood and adolescence is an established risk factor for later cardiovascular disease and dysregulated reactivity to acute social stress. This study examined whether ELS associations with baseline cardiovascular functioning, cardiovascular stress reactivity and recovery, and emotional stress reactivity vary across levels of emotion-oriented, task-oriented, and avoidant coping styles.

METHODS

The sample included 1027 adolescents and young adults (mean age = 19.29 years; 50% female; 64% Black, 34% non-Hispanic White) who reported on their ELS exposure and coping styles. Participants completed a standardized acute social stress test (the Trier Social Stress Test [TSST]), with heart rate (HR) and blood pressure (BP) measured before, during, and after the TSST. Self-reports of negative emotions during the TSST indexed emotional stress reactivity.

RESULTS

Multiple regression models adjusting for demographic factors and body mass index showed that ELS was associated with lower HR stress reactivity, avoidant coping was related to lower systolic BP and diastolic BP during stress and lower systolic BP during recovery, and higher emotion-oriented coping and lower task-oriented coping predicted greater emotional stress reactivity. A consistent pattern emerged where emotion-oriented coping amplified the associations between ELS and maladaptive stress responses (blunted cardiovascular stress reactivity and recovery; enhanced emotional stress reactivity), whereas lower levels of emotion-oriented coping were associated with resilient profiles among those who experienced ELS (lower resting HR, lower emotional stress reactivity, average HR and BP stress reactivity and recovery). However, low levels of emotion-oriented coping also conferred a risk of higher BP during recovery for those with high levels of ELS.

CONCLUSIONS

These results suggest that low to moderate levels of emotion-oriented coping promote optimal cardiovascular and emotional reactivity to acute stress among individuals exposed to ELS.

Association of Heart Rate Variability with the Psychosocial Stress Level in Men 41-44 Years Old Living in Moscow

Aim. Research of the association of heart rate variability (HRV) with the level of psychosocial stress (PS) and other indicators of the risk of cardiovascular diseases in a sample of 41-44-year-old men living in Moscow.

Material and methods. A total of 299 men aged 41-44 years were examined. The study included a clinical examination and a survey using a standard questionnaire. The categorization of risk factors (RF) for cardiovascular diseases (CVD) was carried out in accordance with generally accepted criteria The psychosocial stress was assessed using the Reeder scale. Depending on the psychosocial stress level, all surveyed men were divided into 3 groups by terciles: group 1 (3,28-4,0 points) – mild stress, group 2 (2,71-3,14) – moderate stress, group 3 (1,28-2,57) – severe stress. The analysis of HRV was performed on the basis of a short recording of an electrocardiogram using the original software package.

Results. Nonparametric ANOVA showed that the mean [M (95% CI)] values of the HRV time domain (SDNN, rMSSD and the state of regulatory reserves) were lower in the group of men with high PS compared with the group with low PS [25.3 ms (20.9-29.7) versus 40.5 ms (30.7-50.3), p=0.007; 29.5 ms (24.6-34.3) versus 49.5 ms (36.7-62.3), p=0.030; and 46.7 (44.7-48.6) versus 49.7 (48.1-51.4), p=0.019; respectively]. On the contrary, the mean values [M (95% CI)] of the integral indicators of HRV (SI and IVR) were higher in the group of men with high PS [635.8 c.u. (556.2-715.4) versus 488.9 (423.8-554.1), p=0.005; 1172.6 (1045.1-1300.1) versus 904.7 (790.0-1019.4), p=0.003; respectively]. The results of correlation and multiple regression analysis confirmed that these HRV indicators are statistically significantly associated not only with PS, but also with other indicators (age, waist / hip ratio, diastolic blood pressure). However, their predictive value turned out to be low, and the proportion of the explained variance of HRV indices ranged from 2.5 to 13.1%.

Conclusion. The weakening of the autonomous regulation of the heart rate with a decrease in the activity of the parasympathetic link, the activation of the central circuit of regulation with the prevalence of sympathetic influences, a decrease in the functional reserves of the heart rate regulation system are associated with an increase in the level of PS and other indicators of the risk of cardiovascular diseases.