Juvenile onset depression alters cardiac autonomic balance in response to psychological and physical challenges

Abstract

Cardiac autonomic balance (CAB) indexes the ratio of parasympathetic to sympathetic activation (Berntson, Norman, Hawkley, & Cacioppo, 2008), and is believed to reflect overall autonomic flexibility in the face of environmental challenges. However, CAB has not been examined in depression. We examined changes in CAB and other physiological variables in 179 youth with a history of juvenile onset depression (JOD) and 161 healthy controls, in response to two psychological (unsolvable puzzle, sad film) and two physical (handgrip, and forehead cold pressor) challenges. In repeated measures analyses, controls showed expected reductions in CAB for both the handgrip and unsolvable puzzle, reflecting a shift to sympathetic relative to parasympathetic activation. By contrast, JOD youth showed increased CAB from baseline for both tasks (ps<.05). No effects were found for the forehead cold pressor or sad film tasks, suggesting that CAB differences may arise under conditions requiring greater attentional control or sustained effort.

Cross system autonomic balance and regulation: Associations with depression and anxiety symptoms

“…ANS assessments that examine relative PNS and SNS control within the cardiovascular system have been proposed, including cardiac autonomic balance (CAB) and cardiac autonomic regulation (CAR) (Berntson, Norman, Hawkley, & Cacioppo, 2008). However, only a handful of studies have applied CAB and CAR to understanding emotional functioning in the context of psychopathology (Brush et al, 2019;Bylsma et al, 2015). Another limitation of prior work in this area is that most SNS assessments have been limited to single indices and have largely been atheoretical regarding neurotransmitter systems.…”

“…Low resting PNS control (i.e., reduced RSA levels) is theorized to reflect limited, rigid capacity to respond to external stressors, whereas high PNS control has been interpreted to reflect greater conservation of resources, allowing for more flexible range of response (Porges, 2007), including greater emotion regulation capacity (Balzarotti, Biassoni, Colombo, & Ciceri, 2017;Beauchaine, 2015;Pace-Schott et al, 2019;Thayer & Lane, 2000). As problems in emotion regulation are associated with a range of psychopathology including depression and anxiety disorders (Amstadter, 2008;Gotlib & Joormann, 2010), it is not surprising that meta-analytic and qualitative reviews support a modest association between low resting RSA and depressive disorders (Kemp et al, 2010;Koenig, Kemp, Beauchaine, Thayer, & Kaess, 2016;Rottenberg, 2007), but other studies have also failed to find an association (Bylsma et al, 2015;Guinjoan, Bernabó, & Cardinali, 1995;Hughes & Stoney, 2000;Lehofer et al, 1997;Sheffield et al, 1998;Yeragani et al, 1991). Similarly, most studies support a link between low resting RSA and anxiety disorders (Chalmers et al, 2014;Friedman, 2007;Friedman & Thayer, 1998), but there are also exceptions (Fisher & Newman, 2013;Schmitz, Tuschen-Caffier, Wilhelm, & Blechert, 2013;Tulen et al, 1996;Yeragani et al, 1991).…”

Atypical reactivity of heart rate variability to stress and depression across development: Systematic review of the literature and directions for future research

“…Indeed, meta-analyses indicate that depression increases the risk for coronary heart disease among adults (Rugulies, 2002; Wulsin & Singal, 2003) and adolescents (Bylsma et al, 2015), and may be a more important risk factor for cardiovascular disease than smoking or diabetes (Van der Kooy et al, 2007). Specifically, abnormalities in the autonomic nervous system (ANS) related to cardiac activity, especially in response to stress, have been identified as potential mechanisms linking depression and poor cardiovascular health (Grippo & Johnson, 2009).…”

The implications of sympathetic and parasympathetic regulatory coordination for understanding child adjustment

“…Although there are a number of approaches for considering the coordination of sympathetic and parasympathetic activation (e.g., the aforementioned profile approaches and cardiac autonomic balance/regulation; Bylsma et al, 2015), interactive models are particularly well suited to assess sympathetic and parasympathetic influences along the full continuum of activation and inhibition. For example, using skin conductance and RSA as sympathetic and parasympathetic indicators, respectively, El-Sheikh et al (2008) found that a coordinated pattern of sympathetic inhibition and parasympathetic activation at rest (i.e., low skin conductance and high RSA)…”

“…Although there are a number of approaches for considering the coordination of sympathetic and parasympathetic activation (e.g., the aforementioned profile approaches and cardiac autonomic balance/regulation; Bylsma et al, ), interactive models are particularly well suited to assess sympathetic and parasympathetic influences along the full continuum of activation and inhibition. For example, using skin conductance and RSA as sympathetic and parasympathetic indicators, respectively, El‐Sheikh et al () found that a coordinated pattern of sympathetic inhibition and parasympathetic activation at rest (i.e., low skin conductance and high RSA) was associated with fewer concurrent delinquency problems among 8‐year‐olds drawn from homes that were high in marital conflict, whereas a discoordinated resting pattern of sympathetic activation (i.e., high skin conductance) and parasympathetic activation (i.e., high baseline RSA) was associated with higher levels of delinquency.…”