Vagal influence during worry and cognitive challenge

Abstract

The primary foci of the study were exploration of the linkage between cognitive and autonomic inflexibility of worry and generalized anxiety disorder (GAD) and examination of the effects of an analog cognitive restructuring task on this relationship. Cardiac responses of GAD and non-GAD participants were measured to examine the sympathetic and parasympathetic effects of worry and cognitive challenge. Diagnostic groups of undergraduate students were determined via administration of a structured interview, yielding a GAD group (n=16) and a control group (n=19) of individuals without GAD, depression, or panic disorder diagnoses. Cardiac autonomic responses were acquired via electrocardiogram during rest, worry, and cognitive challenge conditions by an experimenter blind to diagnosis. Metrics were compared between the two groups and across the three conditions. Individuals diagnosed with GAD did not differ significantly from controls on autonomic indices. Worry was associated with significantly decreased parasympathetic influence and increased sympathetic activity. Cognitive challenge did not result in significant increased cardiac responsivity. The results indicate that worry behavior is associated with decreased vagal activity, suggest a linkage between autonomic and cognitive inflexibility, and provide further suggestions for improving protocols to assess the autonomic effects of cognitive therapy techniques.

Does stress affect the joints? Daily stressors, stress vulnerability, immune and HPA axis activity, and short-term disease and symptom fluctuations in rheumatoid arthritis

“…Of course, we cannot conclude by our study that worrying impacts RA disease and symptom fluctuations independently of physiological pathways, because we only studied a specific selection of immune and HPA axis indicators. For instance, the associations could potentially be explained by increasing activity of the sympathetic nervous system,34 35 which in turn has been shown to be overly active in active RA 36 37. Moreover, daily stressors and worrying independently also contributed to different parameters of RA disease fluctuations and also showed no interaction effects, showing that individual stress vulnerability patterns and other coping capacities can act independently from the occurrence of external stressors 20 33 38…”

Worry and Generalized Anxiety Disorder: A Review and Theoretical Synthesis of Evidence on Nature, Etiology, Mechanisms, and Treatment

“…Also, trait worry is associated with increased sympathetic nervous system (SNS) activity, such as heightened cardiovascular activity, and decreased parasympathetic nervous system (PNS) activity, such as lower heart rate variability (Brosschot et al 2007, Pieper et al 2010). Similarly, experimentally induced worry results in increased SNS activity and decreased PNS activity relative to baseline and relaxation periods (e.g., Llera & Newman 2010, 2011), even above and beyond a cognitive challenge task (Hammel et al 2011). Likewise, in a small sample of GAD patients, listening to personally relevant worry statements induced activation of the prefrontal and thalamostriatal brain regions, which are associated with response to threat (Hoehn-Saric et al 2004); citalopram treatment for eight weeks decreased these activation patterns and self-reported worry, implicating worry specifically (not just GAD status) in activation of key brain regions.…”

A BRIEF ECOLOGICAL MOMENTARY INTERVENTION FOR GENERALIZED ANXIETY DISORDER: A RANDOMIZED CONTROLLED TRIAL OF THEWORRY OUTCOME JOURNAL

“…In addition to being generally inaccurate, worry creates undesirable distress and interference. When worry is induced in the laboratory, those with GAD experience increased sympathetic and decreased parasympathetic nervous system activation relative to baseline, relaxation periods, and a challenging cognitive task . They also report heightened negative emotions during worry .…”