Publication guidelines for human heart rate and heart rate variability studies in psychophysiology-Part 1: Physiological underpinnings and foundations of measurement.

This Committee Report provides methodological, interpretive, and reporting guidance for researchers who use measures of heart rate (HR) and heart rate variability (HRV) in psychophysiological research. We provide brief summaries of best practices in measuring HR and HRV via electrocardiographic and photoplethysmographic signals in laboratory, field (ambulatory), and brain-imaging contexts to address research questions incorporating measures of HR and HRV. The Report emphasizes evidence for the strengths and weaknesses of different recording and derivation methods for measures of HR and HRV. Along with this guidance, the Report reviews what is known about the origin of the heartbeat and its neural control, including factors that produce and influence HRV metrics. The Report concludes with checklists to guide authors in study design and analysis considerations, as well as guidance on the reporting of key methodological details and characteristics of the samples under study. It is expected that rigorous and transparent recording and reporting of HR and HRV measures will strengthen inferences across the many applications of these metrics in psychophysiology. The prior Committee Reports on HR and HRV are several decades old. Since their appearance, technologies for human cardiac and vascular monitoring in laboratory and daily life (i.e., ambulatory) contexts have greatly expanded. This Committee Report was prepared for the Society for Psychophysiological Research to provide updated methodological and interpretive guidance, as well as to summarize best practices for reporting HR and HRV studies in humans.

Resting parasympathetic activity is associated with malodor-induced change in perceived foreignness of speakers.

INTRODUCTION: To protect against infection, individuals have evolved context-dependent pathogen-avoidant strategies, including selective social behaviors aimed at avoiding foreign individuals who may possess greater risk of infection. Parasympathetic nervous system (PNS) activity is associated with social engagement and regulation of the classical immune system but has not been widely investigated in relation to changes in intergroup perception and the behavioral immune system. METHOD: The current research investigated the relationship between parasympathetic activity and perceived foreignness of in and outgroup speakers during exposure to a pathogen-relevant odor (butyric acid). High-frequency heart rate variability was measured at rest and while participants rated foreignness of speakers with and without the odor present. RESULTS: Findings show that exposure to the odor was associated with higher foreignness perceptions of outgroup speakers and lower foreignness perceptions of ingroup speakers. This effect was especially evident among individuals with higher resting parasympathetic activity. CONCLUSION: These results suggest that the PNS may play a role in changes in social perceptions during a behavioral immune response.

Perceived control, loneliness, early-life stress, and parents' perceptions of stress.

The COVID-19 pandemic has highlighted the importance of understanding what contributes to individual variability in experiences of stress. Increases in stress related to the pandemic have been especially pronounced in parents, indicating a need for research examining what factors contribute to parents' perceptions of stress. Here, we assessed the relationship between parents' perceptions of stress, control, loneliness, and experiences of childhood trauma in two populations of caregivers. In Study 1, we examined the relationship between perceptions of stress, control, loneliness, and history of early stress, along with indices of socioeconomic risk and resting parasympathetic nervous systema activity, which has been linked to variability in perceptions of stress, in caregivers of young children. Perceived control, loneliness, childhood stress, and resting parasympathetic nervous system activity predicted caregivers' stress. In Study 2, we replicated these initial findings in a second sample of caregivers. Additionally, we examined how these processes change over time. Caregivers demonstrated significant changes in perceptions of control, loneliness, and stress, and changes in control and childhood trauma history were associated with changes in perceptions of stress. Together these results indicate the importance of assessing how caregivers perceive their environment when examining what contributes to increased risk for stress. Additionally, they suggest that caregivers' stress-related processes are malleable and provide insight into potential targets for interventions aimed at reducing parents' stress.

Cost-utility of real-time continuous glucose monitoring versus self-monitoring of blood glucose and intermittently scanned continuous glucose monitoring in people with type 1 diabetes receiving multiple daily insulin injections in Denmark.

AIMS: To determine the cost-effectiveness of the Dexcom G6 real-time continuous glucose monitoring (rt-CGM) system compared with both the self-monitoring of blood glucose (SMBG) and the Abbott FreeStyle Libre 1 and 2 intermittently scanned CGM (is-CGM) devices in people with type 1 diabetes receiving multiple daily insulin injections in Denmark. MATERIALS AND METHODS: The analysis was performed using the IQVIA Core Diabetes Model, which associates rt-CGM use with glycated haemoglobin reductions of 0.6% and 0.36% based on data from the DIAMOND and ALERTT1 trials, respectively, compared with SMBG and is-CGM use. The analysis was performed from the payer perspective over a 50-year time horizon; future costs and clinical outcomes were discounted at 4% per annum. RESULTS: The use of rt-CGM was associated with an incremental gain of 1.37 quality-adjusted life years (QALYs) versus SMBG. Total mean lifetime costs were Danish Krone (DKK) 894 535 for rt-CGM and DKK 823 474 for SMBG, resulting in an incremental cost-utility ratio of DKK 51 918 per QALY gained versus SMBG. Compared with is-CGM, the use of rt-CGM led to a gain of 0.87 QALYs and higher mean lifetime costs resulting in an incremental cost-utility ratio of DKK 40 879 to DKK 34 367 per QALY gained. CONCLUSIONS: In Denmark, the rt-CGM was projected to be highly cost-effective versus both SMBG and is-CGM, based on a willingness-to-pay threshold of 1× per capita gross domestic product per QALY gained. These findings may help inform future policies to address regional disparities in access to rt-CGM.

Triad multisystem phenotype with high risk for developing temporomandibular disorders-characteristics and potential pathophysiology results from the Orofacial Pain: Prospective Evaluation and Risk Assessment dataset.

ABSTRACT: A multisystem phenotype with the Triad of bodily pain, psychological distress, and sleep disturbance was found to have high risk for developing initial onset of painful temporomandibular disorders (TMDs) in the multicenter Orofacial Pain: Prospective Evaluation and Risk Assessment dataset. In this study, we systemically examined phenotypic characteristics and explored potential pathophysiology in quantitative sensory testing and autonomic nervous system domains in this multisystem Triad phenotype. Secondary analysis was performed on 1199 non-Triad and 154 Triad TMD-free Orofacial Pain: Prospective Evaluation and Risk Assessment enrollees at baseline. Results indicated that before developing TMDs, the Triad phenotype demonstrated both orofacial and systemic signs and symptoms that can only be captured through multisystem assessment. In addition, we found significantly lower resting heart rate variability and higher resting heart rate in the Triad phenotype as compared with the non-Triad group. However, pain sensitivity measured by quantitative sensory testing was not different between groups. These findings highlight the importance of whole-person multisystem assessment at the stage before developing complex pain conditions, such as TMDs, and suggest that, in addition to a "tissue damage monitor," pain should be considered in a broader context, such as a component within a "distress monitoring system" at the whole-person level when multisystem issues copresent. Therefore, the presence or absence of multisystem issues may carry critical information when searching for disease mechanisms and developing mechanism-based intervention and prevention strategies for TMDs and related pain conditions. Cardiovascular autonomic function should be further researched when multisystem issues copresent before developing TMDs.

Impact of stereotype threat on brain activity during memory tasks in older adults.

We report the first neuroimaging experiment to investigate the impact of explicitly activating aging stereotypes (i.e., stereotype threat) on brain activity during cognitive tasks. Cognitively normal older adults read about aging stereotypes or a control passage prior to taking episodic memory, working memory, and a non-demanding control task during fMRI. At the group level, stereotype activation did not impact cognitive performance or measures sensitive to stress and anxiety (physiological or self-report), but like prior work, highly educated and retired adults exhibited greater stereotype effects on episodic memory. At the neural level, stereotype activation did not impact brain activity in executive control or emotional regulation regions previously linked to stereotype threat effects in younger adults, suggesting that stereotype threat operates differently in older adults. Instead, on each task, the stereotype group showed more brain activity than the control group in parietal midline regions (e.g., precuneus, posterior cingulate). Although activity in these regions can arise from many processes, they have previously been associated with self-referential thinking and error-prevention focus, and in our study, brain activity in these regions was associated with slower responses and lower false alarm errors on the episodic memory task. Collectively, these findings are more consistent with the regulatory fit hypothesis than an executive control interference hypothesis of stereotype threat effects in older adults, whereby older adults adopt an error-prevention mindset in response to explicit stereotype threat.

Increases in loneliness during medical school are associated with increases in individuals' likelihood of mislabeling emotions as negative.

Expressions of emotion represent an important and unique source of information about the states of others. Being able to effectively understand expressions of emotions to make inferences about others' internal mental states and use these inferences to guide decision-making and behavior is critical to navigating social relationships. Loneliness, the perception that one lacks social connection, has important functional consequences for how individuals attend to signals of emotions in others. However, it is less clear whether loneliness changes how individuals recognize emotions in others. In medical practitioners, being able to accurately recognize emotional cues from patients is critical to effectively diagnosing and reacting with care to those patients. The current study examines the relationship between changes in loneliness during medical school and students' recognition of emotion in others. Measures of loneliness and emotion recognition were collected from 122 medical students during their first 3 years of medical school at the beginning and end of each academic year. Changes in loneliness were related to changes in emotion detection, with increases in loneliness being associated with decreases in the probability of accurately discriminating sad and angry faces from other expressions, decreases in the probability of mislabeling emotion expressions as happy, and increases in the probability of mislabeling other emotional expressions as pained and angry. This study suggests that changes in loneliness during medical school are associated with increases in students' labeling emotional expressions as negative, possibly by shifting attention to cues of negative emotion and away from cues of positive emotion. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Acute effects of oral delta-9-tetrahydrocannabinol (THC) on autonomic cardiac activity and their relation to subjective and anxiogenic effects.

Cannabis is the most commonly used psychotropic drug in the United States, after alcohol. Despite its apparent sedative and calming effects, cannabis and its main psychoactive constituent, ∆9 -tetrahydrocannabinol (THC) can produce serious adverse effects including tachycardia and anxiety. These effects can be especially pronounced in women, who remain underrepresented in clinical cannabinoid research. The present study is one of the first to characterize the effects of single doses of oral THC on autonomic nervous system function in healthy adult women. Occasional female cannabis users participated in three laboratory sessions in which they received oral THC (7.5 and 15 mg) and placebo. Autonomic measures included heart rate (HR), blood pressure (BP), pre-ejection period (PEP) a measure of cardiac sympathetic functioning, and high frequency heart rate variability (HF-HRV) a measure of parasympathetic cardiac control. Autonomic responses were examined in relation to subjective drug effects. THC dose-dependently increased HR, decreased HF-HRV, and increased ratings of feeling a drug effect, cannabis-like intoxication, and anxiety. Although the drug did not significantly affect BP or PEP, HR was negatively related to both PEP and HF-HRV. HF-HRV, the measure of parasympathetic activity, was significantly negatively related to subjective measures of cannabis intoxication (but not anxiety) at the 15 mg dose only. PEP was not significantly related to any subjective measure. These results extend our knowledge of the autonomic effects of THC in relation to subjective drug experience. This and future studies will help us to understand risk factors related to cannabis use.

Multilevel analysis: Integrating multiple levels of neurobehavioral systems.

Traditional disciplines have frequently dealt with complex phenomena from a given level of analysis, be that molecular, cellular, organ system, or organismic level. This can yield highly valuable information on biological and psychological processes. There is an explanatory value added, however, by an integrative multilevel approach, in which different levels of analysis and different levels of the neural organization are considered in the models and theories of psychological functions. This is the essence of the emerging discipline of social neuroscience, promoted by John Cacioppo and Gary Berntson, which seeks to inform the interactions between social psychological and biological processes.

Medical students' empathy positively predicts charitable donation behavior.

Empathy is known to motivate prosocial behavior. This relationship, however is complex and influenced by the social context and the type of prosocial behavior. Additionally, empathy is a complex psychological capacity, making it important to examine how different components of empathy influence different prosocial behaviors. The current study uses a unique longitudinal sample to assess how changes in cognitive and affective components of empathy relate to charitable giving. Measures of empathy were collected from medical students in the fall and spring of students' first three years of medical school. After this time, students had the opportunity to donate to charity. Positive changes in students' cognitive empathy predicted their charitable giving, with students who demonstrated greater increases in cognitive empathy giving more money. This study points to an important role for cognitive empathy in certain prosocial behaviors, and suggests that long term changes in empathy influence individual differences in prosocial behavior.

Third-party punishment following observed social rejection.

Humans routinely punish others for violating social norms. This behavior is referred to as third-party punishment. Much of the research on this topic has been done in the context of group cooperation and unjust economic interactions. However, little is known about punishment in response to other types of more personal transgressions. In the present study, we sought to determine whether adults would punish an individual after viewing them undeservingly reject a stranger. We experimentally demonstrate that after observing an individual socially reject an unknown victim, individuals will engage in third-party punishment. Individuals who reported feeling upset with the rejecter were most likely to punish, while feeling sorry for the victim was not predictive of punishment behavior. These findings highlight the motivational role of empathic anger in punishing social norm transgressors. Notably, individuals who reported having been bullied in their own pasts were the most likely to punish the rejecter. These results demonstrate how a history of being bullied may make one more attuned to the social rejection of others and in turn may make one more likely to take retributive action on behalf of another. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Corrigendum: Positive Effects of Nature on Cognitive Performance Across Multiple Experiments: Test Order but Not Affect Modulates the Cognitive Effects.

[This corrects the article DOI: 10.3389/fpsyg.2019.01413.].

Text messaging and brief phone calls for weight loss in overweight and obese English- and Spanish-speaking adults: A 1-year, parallel-group, randomized controlled trial.

BACKGROUND: Weight loss interventions based solely on text messaging (short message service [SMS]) have been shown to be modestly effective for short periods of time and in some populations, but limited evidence is available for positive longer-term outcomes and for efficacy in Hispanic populations. Also, little is known about the comparative efficacy of weight loss interventions that use SMS coupled with brief, technology-mediated contact with health coaches, an important issue when considering the scalability and cost of interventions. We examined the efficacy of a 1-year intervention designed to reduce weight among overweight and obese English- and Spanish-speaking adults via SMS alone (ConTxt) or in combination with brief, monthly health-coaching calls. ConTxt offered 2-4 SMS/day that were personalized, tailored, and interactive. Content was theory- and evidence-based and focused on reducing energy intake and increasing energy expenditure. Monthly health-coaching calls (5-10 minutes' duration) focused on goal-setting, identifying barriers to achieving goals, and self-monitoring. METHODS AND FINDINGS: English- and Spanish-speaking adults were recruited from October 2011 to March 2013. A total of 298 overweight (body mass index [BMI] 27.0 to 39.9 kg/m2) adults (aged 21-60 years; 77% female; 41% Hispanic; 21% primarily Spanish speaking; 44% college graduates or higher; 22% unemployed) were randomly assigned (1:1) to receive either ConTxt only (n = 101), ConTxt plus health-coaching calls (n = 96), or standard print materials on weight reduction (control group, n = 101). We used computer-based permuted-block randomization with block sizes of three or six, stratified by sex and Spanish-speaking status. Participants, study staff, and investigators were masked until the intervention was assigned. The primary outcome was objectively measured percent of weight loss from baseline at 12 months. Differences between groups were evaluated using linear mixed-effects regression within an intention-to-treat framework. A total of 261 (87.2%) and 253 (84.9%) participants completed 6- and 12-month visits, respectively. Loss to follow-up did not differ by study group. Mean (95% confidence intervals [CIs]) percent weight loss at 12 months was -0.61 (-1.99 to 0.77) in the control group, -1.68 (-3.08 to -0.27) in ConTxt only, and -3.63 (-5.05 to -2.81) in ConTxt plus health-coaching calls. At 12 months, mean (95% CI) percent weight loss, adjusted for baseline BMI, was significantly different between ConTxt plus health-coaching calls and the control group (-3.0 [-4.99 to -1.04], p = 0.003) but not between the ConTxt-only and the control group (-1.07 [-3.05 to 0.92], p = 0.291). Differences between ConTxt plus health-coaching calls and ConTxt only were not significant (-1.95 [-3.96 to 0.06], p = 0.057). These findings were consistent across other weight-related secondary outcomes, including changes in absolute weight, BMI, and percent body fat at 12 months. Exploratory subgroup analyses suggested that Spanish speakers responded more favorably to ConTxt plus health-coaching calls than English speakers (Spanish contrast: -7.90 [-11.94 to -3.86], p < 0.001; English contrast: -1.82 [-4.03 to 0.39], p = 0.107). Limitations include the unblinded delivery of the intervention and recruitment of a predominantly female sample from a single site. CONCLUSIONS: A 1-year intervention that delivered theory- and evidence-based weight loss content via daily personalized, tailored, and interactive SMS was most effective when combined with brief, monthly phone calls. TRIAL REGISTRATION: ClinicalTrials.gov NCT01171586.

Positive Effects of Nature on Cognitive Performance Across Multiple Experiments: Test Order but Not Affect Modulates the Cognitive Effects.

Interactions with natural environments and nature-related stimuli have been found to be beneficial to cognitive performance, in particular on executive cognitive tasks with high demands on directed attention processes. However, results vary across different studies. The aim of the present paper was to evaluate the effects of nature vs. urban environments on cognitive performance across all of our published and new/unpublished studies testing the effects of different interactions with nature vs. urban/built control environments, on an executive-functioning test with high demands on directed attention-the backwards digit span (BDS) task. Specific aims in this study were to: (1) evaluate the effect of nature vs. urban environment interactions on BDS across different exposure types (e.g., real-world vs. artificial environments/stimuli); (2) disentangle the effects of testing order (i.e., effects caused by the order in which experimental conditions are administered) from the effects of the environment interactions, and (3) test the (mediating) role of affective changes on BDS performance. To this end, data from 13 experiments are presented, and pooled data-analyses are performed. Results from the pooled data-analyses (N = 528 participants) showed significant time-by-environment interactions with beneficial effects of nature compared to urban environments on BDS performance. There were also clear interactions with the order in which environment conditions were tested. Specifically, there were practice effects across environment conditions in first sessions. Importantly, after parceling out initial practice effects, the positive effects of nature compared to urban interactions on BDS performance were magnified. Changes in positive or negative affect did not mediate the beneficial effects of nature on BDS performance. These results are discussed in relation to the findings of other studies identified in the literature. Uncontrolled and confounding order effects (i.e., effects due to the order of experimental conditions, rather than the treatment conditions) may explain some of the inconsistent findings across studies in the literature on nature effects on cognitive performance. In all, these results highlight the robustness of the effects of natural environments on cognition, particularly when confounding order effects have been considered, and provide a more nuanced account of when a nature intervention will be most effective.

Visual cues to fertility are in the eye (movements) of the beholder.

Past work demonstrates that humans behave differently towards women across their menstrual cycles, even after exclusively visual exposure to women's faces. People may look at women's faces differently as a function of women's menstrual cycles. Analyses of participants' scanpaths (eye movement patterns) while they looked at women at different phases of their menstrual cycles revealed that observers exhibit more consistent scanpaths when examining women's faces when women are in a menstrual cycle phase that typically corresponds with peak fertility, whereas they exhibit more variable patterns when looking at women's faces when they are in phases that do not correspond with fertility. A multivariate classifier on participants' scanpaths predicted whether they were looking at the face of a woman in a more typically fertile- versus non-fertile-phase of her menstrual cycle with above-chance accuracy. These findings demonstrate that people look at women's faces differently as a function of women's menstrual cycles, and suggest that people are sensitive to fluctuating visual cues associated with women's menstrual cycle phase.

Where is the love? A double-blind, randomized study of the effects of intranasal oxytocin on stress regulation and aggression.

Previous studies reveal that oxytocin (OT) encourages prosocial behavior in humans; however, animal studies and recent work in humans suggest that OT may also play a role in aggressive behavior and feelings. The present study investigated these competing predictions in the context of a competitive task among 85 healthy human participants (males and females). Using a randomized double-blind design, participants were assigned to an experimental (intranasal OT) or control (intranasal placebo) group. Hostility (Aggression Questionnaire) was measured at home (T1) and in the lab after intranasal administration (T2). Behavioral aggression was assessed post-intranasal administration. There was a significant difference between the OT and the placebo group on hostility scores (p = 0.03) and a significant time by group interaction for behavioral aggression (p < 0.05). Self-reported hostility was significantly higher at T2 compared to T1 (p < 0.001) among participants in the oxytocin group while no significant change was found in hostility among the placebo group. Behavioral aggression was slightly higher in the OT group (compared to the placebo group) directly after OT administration, however, the opposite relationship was found as the study period progressed. Both hostility and behavioral aggression findings were consistent across gender.

Effects of opioid- and non-opioid analgesics on responses to psychosocial stress in humans.

Both preclinical and clinical evidence suggests that the endogenous opioid system is involved in responses to stress. For example, in animal models opioid agonists reduce isolation distress whereas opioid antagonists increase isolation distress. We recently reported that the mixed mu agonist and kappa antagonist buprenorphine dampened responses to acute psychosocial stress in humans. Now we extend this to study the effects of a pure mu-opioid agonist, hydromorphone, and a non-opioid analgesic, acetaminophen, on response to social stress. We compared the effect of hydromorphone (2 and 4 mg), acetaminophen (1000 mg) to a placebo using a between subject design. Healthy adult volunteers were randomly assigned to receive placebo (N = 13), 2 mg hydromorphone (N = 12), 4 mg hydromorphone (N = 12), or 1000 mg acetaminophen (paracetamol; N = 13) under double-blind conditions before undergoing a stress task or a control task on two separate sessions. The stress task, consisting of a standardized speaking task and the non-stressful control task were presented in counterbalanced order. Dependent measures included mood ratings, subjective appraisal of the stress (or no-stress) task, salivary cortisol, pupil diameter, heart rate, and blood pressure. The stress task produced its expected increase in heart rate, blood pressure, salivary cortisol, pupil diameter, and subjective ratings of anxiety and negative mood. Hydromorphone dose-dependently dampened cortisol responses to stress, and decreased ratings of how "challenging" participants found the task. Acetaminophen did not affect physiological responses, but, like hydromorphone, decreased ratings of how "challenging" the task was. The hydromorphone results support the idea that the mu-opioid system is involved in physiological responses to acute stress in humans, in line with results from preclinical studies. The non-opioid analgesic acetaminophen did not dampen physiological responses, but did reduce some components of psychological stress. It remains to be determined how both opioid and non-opioid systems mediate the complex physiological and psychological responses to social stress.

The complexity of empathy during medical school training: evidence for positive changes.

CONTEXT: Empathy is an essential aspect of clinical care, associated with improved patient satisfaction, increased adherence to treatment, and fewer malpractice complaints. Previous studies suggest that empathy declines during medical training. However, past research relied on a single narrowly operationalised, self-report measure of empathy. As empathy is a complex socio-emotional construct, it is critical to assess changes across its distinct components using multiple measures in order to better understand how it is influenced by medical training. METHODS: In a longitudinal study, medical students completed a series of self-report and behavioural measures twice per year during the first 3 years of their study (2012-2015). These included the previously used Jefferson Scale of Physician Empathy (JSPE), designed to assess empathy in the clinical context, the Questionnaire of Cognitive and Affective Empathy (QCAE), designed to assess overall empathy and its main components, and behavioural measures of sensitivity to others' pain and understanding of others' emotions, both of which are important aspects of empathy. The employment of multiple measures allowed for a more complete assessment of medical students' empathy and related processes. RESULTS: In reflection of findings in previous work, students' empathy assessed by the JSPE decreased over training. However, on the QCAE, aspects of students' empathy, specifically overall cognitive empathy and its subcomponent perspective taking, and the emotion contagion subcomponent of affective empathy improved, whereas the remaining subcomponents remained stable. During medical school, students also exhibited comparable growth in their understanding of others' emotions and increased sensitivity to others' pain. CONCLUSIONS: Changes in empathy during medical school cannot be simply characterised as representing an overall decline. Indeed, aspects of empathy thought to be valuable in positive physician-patient interactions improve during training. Overall, this study points to the importance of assessing the distinct components of empathy using multiple forms of measurement in order to better understand the mechanisms involved in empathy changes in medical practice.

Physiological dynamics of stress contagion.

Can viewing others experiencing stress create a "contagious" physiological stress response in the observer? To investigate second-hand stress, we first created a stimulus set of videos, which featured participants speaking under either minimal stress, high stress, or while recovering from stress. We then recruited a second set of participants to watch these videos. All participants (speakers and observers) were monitored via electrocardiogram. Cardiac activity of the observers while watching the videos was then analyzed and compared to that of the speakers. Furthermore, we assessed dispositional levels of empathy in observers to determine how empathy might be related to the degree of stress contagion. Results revealed that depending on the video being viewed, observers experienced differential changes in cardiac activity that were based on the speaker's stress level. Additionally, this is the first demonstration that individuals high in dispositional empathy experience these physiological changes more quickly.