Swipe om te navigeren naar een ander artikel
Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) are highly comorbid; we know little, however, about the shared physiological features of these disorders. In the present study, we examined whether aberrant parasympathetic stress responsivity represents a transdiagnostic process in MDD, GAD, and co-occurring MDD-GAD. Adult women diagnosed with MDD only, GAD only, and co-occurring MDD-GAD and never-disordered controls (CTLs) completed a standardized laboratory task that involved anticipating, confronting, and recovering from a social stressor. Participants’ levels of respiratory sinus arrhythmia (RSA) were measured to index parasympathetic responses. The three clinical groups combined (participants with MDD only, GAD only, and co-occurring MDD-GAD) exhibited a similar pattern of RSA responsivity that differed significantly from that of the CTL group. Specifically, whereas CTL participants exhibited a sharp decrease in RSA when confronting the stressor and a sharp increase in RSA when recovering immediately following the stressor, the clinical participants exhibited a blunted response pattern that involved weaker fluctuations in RSA when confronting and recovering from the stressor. There were no significant differences among the three clinical groups in RSA responses. Interestingly, clinical and CTL participants did not differ in self-reported fluctuations in negative emotional arousal. Finally, for clinical participants patterns of RSA reactivity to the acute stressor were associated differentially with trait rumination and worry as maladaptive forms of emotion regulation. These findings support the formulation that aberrant parasympathetic stress responsivity is a shared feature of MDD, GAD, and co-occurring MDD-GAD that is characterized by diminished reactivity to and recovery from stress.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV-TR). American Psychiatric Publishing.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). American Psychiatric Publishing.
Ballenger, J. C., Davidson, J. R., Lecrubier, Y., Nutt, D. J., Borkovec, T. D., Rickels, K., & Wittchen, H. U. (2001). Consensus statement on generalized anxiety disorder from the international consensus group on depression and anxiety. The Journal of Clinical Psychiatry, 62(Suppl 11), 53–58. PubMed
Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35(2), 205–230. CrossRef
Barr, D. J., Levy, R., Scheepers, C., & Tily, H. J. (2013). Random effects structure for confirmatory hypothesis testing: keep it maximal. Journal of Memory and Language, 68(3), 255–278. CrossRef
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the beck depression inventory-II. San Antonio: Psychological Corporation.
Dozois, D. J. A., Dobson, K. S., & Ahnberg, J. L. (1998). A psychometric evaluation of the beck depression inventory-II. Psychological Assessment, 10(2), 83–89. CrossRef
Ehring, T., & Watkins, E. R. (2008). Repetitive negative thinking as a transdiagnostic process. International Journal of Cognitive Therapy, 1(3), 192–205. CrossRef
First, M. B., Spitzer, R., Gibbon, M., & Williams, J. (1996). Structured clinical interview for DSM-IV axis I disorders-clinician version (SCID-CV). Washington: American Psychiatric Press.
Insel, T. (2013). Transforming diagnosis. USA: National Institute of Mental Health.
Kemp, A. H., Quintana, D. S., Felmingham, K. L., Matthews, S., & Jelinek, H. F. (2012). Depression, comorbid anxiety disorders, and heart rate variability in physically healthy, unmedicated patients: Implications for cardiovascular risk. PLoS ONE, 7(2).
Kessler, R. C., DuPont, R. L., Berglund, P., & Wittchen, H. U. (1999). Impairment in pure and comorbid generalized anxiety disorder and major depression at 12 months in two national surveys. The American Journal of Psychiatry, 156(12), 1915–1923. PubMed
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., & National Comorbidity Survey Replication. (2003). The epidemiology of major depressive disorder: results from the national comorbidity survey replication (NCS-R). JAMA, the Journal of the American Medical Association, 289(23), 3095–3105. PubMedCrossRef
Licht, C. M. M., de Geus, E. J. C., Zitman, F. G., Hoogendijk, W. J. G., van Dyck, R., & Penninx, B. W. J. H. (2008). Association between major depressive disorder and heart rate variability in the Netherlands study of depression and anxiety (NESDA). Archives of General Psychiatry, 65(12), 1358–1367. PubMedCrossRef
Lyonfields, J. D., Borkovec, T. D., & Thayer, J. F. (1995). Vagal tone in generalized anxiety disorder and the effects of aversive imagery and worrisome thinking. Behavior Therapy, 26(3), 457–466. CrossRef
Newman, M. G., Zuellig, A. R., Kachin, K. E., Constantino, M. J., Przeworski, A., Erickson, T., & Cashman-McGrath, L. (2002). Preliminary reliability and validity of the generalized anxiety disorder questionnaire-IV: a revised self-report diagnostic measure of generalized anxiety disorder. Behavior Therapy, 33(2), 215–233. CrossRef
Pittig, A., Arch, J. J., Lam, C. W. R., & Craske, M. G. (2013). Heart rate and heart rate variability in panic, social anxiety, obsessive-compulsive, and generalized anxiety disorders at baseline and in response to relaxation and hyperventilation. International Journal of Psychophysiology, 87(1), 19–27. PubMedCrossRef
Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: Applications and data analysis methods (Vol. 1). Thousand Oaks: Sage Publications.
Raudenbush, S. W., Bryk, A. S., & Congdon, R. (2004). HLM (Version 6) [Computer software].
Salomon, K. (2005). Respiratory sinus arrhythmia during stress predicts resting respiratory sinus arrhythmia 3 years later in a pediatric sample. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 24(1), 68–76. CrossRef
Snijders, T. A. B. (2005). Power and sample size in multilevel modeling. In B. S. Everitt & D. C. Howell (Eds.), Encyclopedia of statistics in behavioral science (Vol. 3, pp. 1570–1573). Chichester: Wiley.
Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: a psychometric analysis. Cognitive Therapy and Research, 27(3), 247–259. CrossRef
Wilhelm, F. H., Grossman, P., & Roth, W. T. (1999). Analysis of cardiovascular regulation. Biomedical Sciences Instrumentation, 35, 135–140. PubMed
- Aberrant Parasympathetic Stress Responsivity in Pure and Co-Occurring Major Depressive Disorder and Generalized Anxiety Disorder
Christian E. Waugh
M. Catalina Camacho
Ian H. Gotlib
- Springer US
Journal of Psychopathology and Behavioral Assessment
Print ISSN: 0882-2689
Elektronisch ISSN: 1573-3505