Psychosomatic Medicine最新文献

Objective: Among younger adults, to determine the associations of actigraph- and self-reported sleep duration with arterial stiffness (AS) assessed in clinic and in ecologically valid contexts, and to examine sex-specific associations.

Methods: Healthy adults ( n = 282, median age = 29 years, 67% women) completed a state-of-the-art assessment of AS at rest (SphygmoCor; carotid femoral pulse wave velocity [cfPWV]; central augmentation index [cAIx]) and 7 days of actigraphy-assessed sleep with concurrent, momentary cAIx assessment for 36 hours (Oscar-2). Multivariable regressions were conducted on the full sample and sex-stratified to examine cross-sectional linear and quadratic associations of average sleep duration with resting PWV and cAIx, average cAIx while awake and asleep, and nocturnal cAIx dipping, adjusted for demographic and health covariates. Exploratory analyses included self-reported sleep duration with AS, and actigraphy and self-reported sleep duration with the ambulatory arterial stiffness index (AASI; Oscar-2).

Results: Overall and by sex, associations of average sleep duration with resting cfPWV, resting cAIx, and awake cAIx were not significant. Sleep duration showed a positive, linear association with sleep cAIx in women (95% confidence interval =1.07 to 5.86, Δ R2 = 0.021). Among women, sleep duration was also inversely associated with cAIx dipping (95% confidence interval = -4.48 to -0.95, Δ R2 = 0.020). Analyses with self-reported sleep duration and AASI as alternate predictors and outcomes were not significant.

Conclusions: Certain sleep duration-AS associations may be sex-specific. Assessing sleep and momentary AS in ecologically valid conditions outside the research laboratory is valuable to understand these relations. Although this investigation should be replicated, findings raise the question of whether interventions to target sleep duration also reduce AS.

Objective: Considering the growing evidence that psychological variables might contribute to fibromyalgia syndrome (FMS), our study aims to understand the impact of psychological factors in quantitative sensory testing (QST) in FMS patients by performing a systematic review with meta-analysis.

Methods: A systematic search was carried out in PubMed/MEDLINE, EMBASE, Web of Science, and PsycINFO databases for records up until January 2024. We included 20 studies ( n = 1623, 16 randomized controlled trials, and 4 nonrandomized controlled trials) with low or moderate risk of bias included.

Results: From nonrandomized evidence, our meta-analysis found a baseline relationship between anxiety, depression, and pain catastrophizing and QST measures in FMS patients. Higher pain catastrophizing levels were associated with less efficient conditioned pain modulation. Higher anxiety and depression were associated with lower pain threshold (PT). Randomized evidence showed a statistically significant increase in PT after fibromyalgia treatments (effect size = 0.29, 95% confidence interval = 0.03-0.56). The effect was not influenced by treatment type. Moreover, we found that only anxiety levels before treatment negatively influenced the PT improvements after treatment.

Conclusion: FMS patients with higher anxiety levels at baseline showed a smaller increase in PT after the intervention. Depression factor was not significant in either changes in anxiety or depression. Baseline anxiety levels should be monitored as possible confounders of QST measurements. Understanding how psychological factors and QST are related in FMS patients is critical for improving the syndrome's management and treatment.Protocol Registration: CRD42023429397.

Objective: Impaired habituation of bodily sensations has been suggested as a contributing factor to chronic pain. We examined in healthy volunteers the influence of fear learning toward a nonpainful sensation in the esophagus on the perceptual habituation of this sensation.

Methods: In a homoreflexive fear learning paradigm, nonpainful electrical sensations in the esophagus were used as a conditioned stimulus (CS). This sensation was presented 42 times before, during, and after fear learning. In the fear learning group ( n = 41), the CS was paired with a painful electrical sensation in the esophagus (unconditioned stimulus [US]). In the control group ( n = 41), the CS was not paired with the US. Ratings for CS intensity, US expectancy, startle electromyogram (EMG), skin conductance responses (SCR), and event-related potentials (ERPs) to the CS were assessed.

Results: Compared to the control group, fear learning was observed in the fear learning group as evidenced by potentiated startle responses after the CS relative to ITI ( t (1327) = 3.231, p = .001) and higher US expectancy ratings ( t (196) = 3.17, p = .002). SCRs did not differ between groups ( F1,817 = 1.241, p = .33). Despite successful fear learning, the fear learning group did not show a distinct pattern of habituation to the visceral CS relative to the control group (intensity ratings: F1,77.731 = 0.532, p = .47; ERPs: F1,520.78 = 0.059, p = .94).

Conclusion: Acquired fear to nonpainful esophageal sensations does not affect their perceptual habituation patterns.

Objective: In healthy volunteers, a positive association has previously been observed between emotional awareness (EA), the ability to identify and describe emotional experiences in oneself and others, and resting heart rate variability (HRV), which is dominated by vagus nerve activity. The current study aimed to investigate the EA-HRV association across multiple assessments in a "real-world" ambulatory context in patients with long QT syndrome (LQTS) who are at genetic risk for sudden cardiac death.

Methods: Participants (157 LQTS patients; Mean Age = 35.1, SD Age = 10.4; 115 women) completed the levels of emotional awareness scale (LEAS) on one occasion, which served as our measure of EA. In an ecological momentary assessment study involving 10 assessments per day over 3 days, multiple 5-minute ECG assessments (mean = 24.6, SD = 5.1) were obtained in each patient using a Holter monitor, from which high-frequency HRV (HF-HRV) was computed on each occasion.

Results: There was a significant positive association between LEAS scores and HF-HRV controlling for biobehavioral covariates. We also detected a similar inverse relation between EA and mean heart rate.

Conclusion: These findings suggest that, in patients with a well-defined genetic risk for ventricular arrhythmia and sudden death, the ability to experience emotions in a complex and differentiated way covaries with greater parasympathetic influences on the heart. These findings are consistent with the overlapping neural substrates of EA and HRV and their common contribution to adaptive emotional responding, consistent with the Neurovisceral Integration Model.

Objective: Recent theoretical work suggests that the expression of emotions may differ among Black and White Americans, such that Black Americans engage more frequently in expressive suppression to regulate emotions and avoid conflict. Prior work has linked expressive suppression usage with increases in cardiovascular disease risk, suggesting that racialized differences in expressive suppression usage may be one mechanism by which racism "gets under the skin" and creates health disparities.

Method: To examine racialized differences in expressive suppression and blood pressure (a measure of cardiovascular disease risk), we used self-report and facial electromyography (fEMG) data from two cohorts of Black and White Americans from the Midlife in the United States (MIDUS) longitudinal study (MIDUS 2, n = 271, 34.7% Black, collected from 2004 to 2009; MIDUS Refresher 1, n = 114, 31.6% Black, collected from 2012 to 2016; total N = 385, 33.9% Black).

Results: Black Americans reported engaging in expressive suppression more frequently than White Americans ( t (260.95) = 2.18, p = .002) and showed less corrugator fEMG activity during negative images ( t (969) = 2.38, pFDR = .026). Less corrugator activity during negative images was associated with higher systolic blood pressure only for Black Americans ( b = -4.63, t (375) = 2.67, p = .008).

Conclusion: Overall, results are consistent with theoretical accounts that Black Americans engage more frequently in expressive suppression, which in turn is related to higher cardiovascular risk. Additional research is needed to further test this claim, particularly in real-world contexts and self-reports of in-the-moment usage of expressive suppression.

Objective: Sexual orientation can be measured across identity, attraction, and behavior. Sexual minorities are at increased risk of cardiovascular disease (CVD) and diabetes; however, it is not known whether cardiometabolic disease risk varies across these dimensions.

Methods: We analyzed cross-sectional data from 36,309 adults who participated in the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III; 2012-2013). Participants were categorized as heterosexual (reference), lesbian/gay, or bisexual across identity, attraction, and behavior using structured clinical interview data. Prevalent CVD (myocardial infarction, stroke, angina, or arteriosclerosis) and diabetes were assessed by self-report.

Results: Demographics (age, sex, race/ethnicity, education, and income) adjusted logistic regression models revealed bisexual behavior (i.e., people reporting sexual activity with both man- and woman-identifying individuals), but not lesbian/gay behavior (i.e., people reporting sexual activity exclusively with same-sex individuals), was associated with an increased odds of prevalent CVD (OR = 1.44, 95% CI = 1.08-1.91, p = .013) and prevalent diabetes (OR = 1.39, 95% CI = 1.09-1.77, p = .007). Contrastingly, sexual minority identity (i.e., self-concept) and attraction (i.e., one's sexual/romantic feelings) were not associated with prevalent CVD or diabetes.

Conclusions: Our results in a nationally representative sample indicate that the sexual orientation dimension of behavior is linked with prevalent CVD and diabetes. This finding suggests that assessing multiple sexual orientation dimensions may aid in identifying sexual minority subgroups in greatest need of cardiometabolic disease prevention efforts. Although mechanisms such as stigma and minority stress have been proposed, future studies are required to elucidate mechanisms underlying the bisexual behavior-cardiometabolic disease relationship.