A closer look into the affect dynamics of adolescents with depression and the interactions with their parents: An ecological momentary assessment study.

Adolescents with depression tend to perceive behavior of parents as less positive than adolescents without depression, but conclusions are based on retrospective reports assessed once or over long time intervals, with the risk of memory biases affecting the recall. The current study used ecological momentary assessments to examine the link between adolescent affect and the amount of warmth and criticism expressed by both mothers and fathers in families with adolescents with depression versus adolescents without psychopathology in daily life. It also explored the possible bias by assessing parenting on the momentary, daily (EMA), and retrospective level. The sample consisted of 34 adolescents with depression and 58 parents and 80 healthy controls and 151 parents (adolescents: Mage = 15.8, SD = 1.41; 67.5% girls, parents: Mage = 49.3, SD = 5.73; 54.1% mothers). Participants completed retrospective questionnaires and four surveys a day for 14 consecutive days. Preregistered multilevel models showed that momentary parenting reports of adolescents with depression and healthy controls did not differ. The associations between perceived parenting of both mothers and fathers and adolescent affect did also not differ between the two groups. These results illustrate that adolescents generally benefit from supportive parenting, but substantial differences between individuals were found. In contrast to the momentary data, both adolescents with depression and their parents did report more negative parenting on retrospective questionnaires than healthy controls and their parents indicating that adolescents with depression may have a negativity bias in their retrospective recall. These findings are highly relevant for clinical practice and underscore the need for careful assessments on different time scales and including all family members.

A Network Study of Family Affect Systems in Daily Life.

Adolescence is a time period characterized by extremes in affect and increasing prevalence of mental health problems. Prior studies have illustrated how affect states of adolescents are related to interactions with parents. However, it remains unclear how affect states among family triads, that is adolescents and their parents, are related in daily life. This study investigated affect state dynamics (happy, sad, relaxed, and irritated) of 60 family triads, including 60 adolescents (Mage = 15.92, 63.3% females), fathers and mothers (Mage = 49.16). The families participated in the RE-PAIR study, where they reported their affect states in four ecological momentary assessments per day for 14 days. First, we used multilevel vector-autoregressive network models to estimate affect dynamics across all families, and for each family individually. Resulting models elucidated how family affect states were related at the same moment, and over time. We identified relations from parents to adolescents and vice versa, while considering family variation in these relations. Second, we evaluated the statistical performance of the network model via a simulation study, varying the percentage missing data, the number of families, and the number of time points. We conclude with substantive and statistical recommendations for future research on family affect dynamics.

Tracking real-time proximity in daily life: A new tool to examine social interactions.

Social interactions, spending time together, and relationships are important for individuals' well-being, with people feeling happier when they spend more time with others. So far, most information about the frequency and duration of spending time together is based on self-report questionnaires. Although recent technological innovations have stimulated the development of objective approaches for measuring physical proximity in humans in everyday life, these methods still have substantial limitations. Here we present a novel method, using Bluetooth low-energy beacons and a smartphone application, to measure the frequency and duration of dyads being in close proximity in daily life. This method can also be used to link the frequency and duration of proximity to the quality of interactions, by using proximity-triggered questionnaires. We examined the use of this novel method by exploring proximity patterns of family interactions among 233 participants (77 Dutch families, with 77 adolescents [Mage = 15.9] and 145 parents [Mage = 48.9]) for 14 consecutive days. Overall, proximity-based analyses indicated that adolescents were more often and longer in proximity to mothers than to fathers, with large differences between families in frequency and duration. Proximity-triggered evaluations of the interactions and parenting behavior were generally positive for both fathers and mothers. This innovative method is a promising tool that can be broadly used in other social contexts to yield new and more detailed insights into social proximity in daily life.

Adolescents' and parents' affect in relation to discrepant perceptions of parental warmth in daily life.

The current study aimed to evaluate how adolescents' and parents' perceptions of daily parenting-and their discrepancies-relate to daily parent and adolescent affect. Daily parental warmth and affect were assessed using electronic diaries in 150 American adolescent-parent dyads (61.3% females, Mage = 14.6, 83.3% White; 95.3% mothers, Mage = 43.4; 89.3% White) and in 80 Dutch adolescents with 79 mothers and 72 fathers (63.8% females, Mage = 15.9, 91.3% White; Mage = 49.0, 97.4% White). Results of preregistered models indicated that individuals' affect may be more important for perceptions of parenting than discrepancies between parent-adolescent reports of parenting for affect, stressing the need to be aware of this influence of affect on parenting reports in clinical and research settings.

The Link between Parental Support and Adolescent Negative Mood in Daily Life: between-Person Heterogeneity in within-Person Processes.

Lack of parental support is related to more adolescent negative mood. However, little is known about how fluctuations of parental support relate to fluctuations of negative mood within adolescents in daily life. The current study aimed to elucidate these processes at a day to day micro-level and examined to which extent adolescents would differ in the association between perceived parental support and adolescent negative mood. The sample consisted of 242 Dutch adolescents (Mage = 13.82, 63.2% female) who completed ecological momentary assessments of 3 weeks 3 months apart. Results from the multilevel regression analyses showed that, on average, adolescents experienced higher levels of negative mood on days when they perceived their parents to be less supportive. Substantial individual differences were found in this association, however, these were partially explained by the level of depressive symptoms and perceived parental intrusiveness. These findings suggest that advice on parental support should be tailored to the unique characteristics of the adolescent.

Perceptions of Parenting in Daily Life: Adolescent-Parent Differences and Associations with Adolescent Affect.

Adolescents can perceive parenting quite differently than parents themselves and these discrepancies may relate to adolescent well-being. The current study aimed to explore how adolescents and parents perceive daily parental warmth and criticism and whether these perceptions and discrepancies relate to adolescents' daily positive and negative affect. The sample consisted of 80 adolescents (Mage = 15.9; 63.8% girls) and 151 parents (Mage = 49.4; 52.3% women) who completed four ecological momentary assessments per day for 14 consecutive days. In addition to adolescents' perception, not parents' perception by itself, but the extent to which this perception differed or overlapped with adolescents' perception was related to adolescent affect. These findings highlight the importance of including combined adolescents' and parents' perspectives when studying dynamic parenting processes.

Noradrenergic Regulation of Cognitive Flexibility: No Effects of Stress, Transcutaneous Vagus Nerve Stimulation, and Atomoxetine on Task-switching in Humans.

Cognitive flexibility allows us to adaptively switch between different responsibilities in important domains of our daily life. Previous work has elucidated the neurochemical basis underlying the ability to switch responses to a previously nonreinforced exemplar and to switch between attentional sets. However, the role of neuromodulators in task switching, the ability to rapidly switch between two or more cognitive tasks afforded by the same stimuli, is still poorly understood. We attempted to fill this gap by manipulating norepinephrine levels using stress manipulation (Study 1a, n = 48; between-group design), transcutaneous vagus nerve stimulation at two different intensities (Study 1b, n = 48; sham-controlled between-group design), and pharmacological manipulation (Study 2, n = 24; double-blind crossover design), all of which increased salivary cortisol measures. Participants repeatedly switched between two cognitive tasks (classifying a digit as high/low [Task 1] or as odd/even [Task 2]), depending on the preceding cue. On each trial, a cue indicated the task to be performed. The cue-stimulus interval was varied to manipulate the time to prepare for the switch. Participants showed typical switch costs, which decreased with the time available for preparation. None of the manipulations modulated the size of the switch costs or the preparation effect, as supported by frequentist and Bayesian model comparisons. Task-switching performance reflects a complex mix of cognitive control and bottom-up dynamics of task-set representations. Our findings suggest that norepinephrine does not affect either of these aspects of cognitive flexibility.

The effects of transcutaneous vagus nerve stimulation on conditioned fear extinction in humans.

A critical component of the treatment for anxiety disorders is the extinction of fear via repeated exposure to the feared stimulus. This process is strongly dependent on successful memory formation and consolidation. Stimulation of the vagus nerve enhances memory formation in both animals and humans. The objective of this study was to assess whether transcutaneous stimulation of the vagus nerve (tVNS) can accelerate extinction memory formation and retention in fear conditioned humans. To assess fear conditioning and subsequent fear extinction, we assessed US expectancy ratings, fear potentiated startle responses and phasic heart rate responses. We conducted a randomized controlled trial in thirty-one healthy participants. After fear conditioning participants were randomly assigned to receive tVNS or sham stimulation during the extinction phase. Retention of extinction memory was tested 24h later. tVNS accelerated explicit fear extinction learning (US expectancy ratings), but did not lead to better retention of extinction memory 24h later. We did not find a differential physiological conditioning response during the acquisition of fear and thus were unable to assess potential effects of tVNS on the extinction of physiological indices of fear. These findings complement recent studies that suggest vagus nerve stimulation could be a promising tool to improve memory consolidation and fear extinction.

Prolonged Non-metabolic Heart Rate Variability Reduction as a Physiological Marker of Psychological Stress in Daily Life.

BACKGROUND: Prolonged cardiac activity that exceeds metabolic needs can be detrimental for somatic health. Psychological stress could result in such "additional cardiac activity." PURPOSE: In this study, we examined whether prolonged additional reductions in heart rate variability (AddHRVr) can be measured in daily life with an algorithm that filters out changes in HRV that are purely due to metabolic demand, as indexed by movement, using a brief calibration procedure. We tested whether these AddHRVr periods were related to worry, stress, and negative emotions. METHODS: Movement and the root of the mean square of successive differences (RMSSD) in heart rate were measured during a calibration phase and the subsequent 24 h in 32 participants. Worry, stress, explicit and implicit emotions were assessed hourly using smartphones. The Levels of Emotional Awareness Scale and resting HRV were used to account for individual differences. During calibration, person-specific relations between movement and RMSSD were determined. The 24-h data were used to detect prolonged periods (i.e., 7.5 min) of AddHRVr. RESULTS: AddHRVr periods were associated with worrying, with decreased explicit positive affect, and with increased tension, but not with the frequency of stressful events or implicit emotions. Only in people high in emotional awareness and high in resting HRV did changes in AddHRVr covary with changes in explicit emotions. CONCLUSIONS: The algorithm can be used to capture prolonged reductions in HRV that are not due to metabolic needs. This enables the real-time assessment of episodes of potentially detrimental cardiac activity and its psychological determinants in daily life.

Changing Mental Health and Positive Psychological Well-Being Using Ecological Momentary Interventions: A Systematic Review and Meta-analysis.

BACKGROUND: Mental health problems are highly prevalent, and there is need for the self-management of (mental) health. Ecological momentary interventions (EMIs) can be used to deliver interventions in the daily life of individuals using mobile devices. OBJECTIVES: The aim of this study was to systematically assess and meta-analyze the effect of EMI on 3 highly prevalent mental health outcomes (anxiety, depression, and perceived stress) and positive psychological outcomes (eg, acceptance). METHODS: PsycINFO and Web of Science were searched for relevant publications, and the last search was done in September 2015. Three concepts were used to find publications: (1) mental health, (2) mobile phones, and (3) interventions. A total of 33 studies (using either a within- or between-subject design) including 43 samples that received an EMI were identified (n=1301), and relevant study characteristics were coded using a standardized form. Quality assessment was done with the Cochrane Collaboration tool. RESULTS: Most of the EMIs focused on a clinical sample, used an active intervention (that offered exercises), and in over half of the studies, additional support by a mental health professional (MHP) was given. The EMI lasted on average 7.48 weeks (SD=6.46), with 2.80 training episodes per day (SD=2.12) and 108.25 total training episodes (SD=123.00). Overall, 27 studies were included in the meta-analysis, and after removing 6 outliers, a medium effect was found on mental health in the within-subject analyses (n=1008), with g=0.57 and 95% CI (0.45-0.70). This effect did not differ as function of outcome type (ie, anxiety, depression, perceived stress, acceptance, relaxation, and quality of life). The only moderator for which the effect varied significantly was additional support by an MHP (MHP-supported EMI, g=0.73, 95% CI: 0.57-0.88; stand-alone EMI, g=0.45, 95% CI: 0.22-0.69; stand-alone EMI with access to care as usual, g=0.38, 95% CI: 0.11-0.64). In the between-subject studies, 13 studies were included, and a small to medium effect was found (g=0.40, 95% CI: 0.22-0.57). Yet, these between-subject analyses were at risk for publication bias and were not suited for moderator analyses. Furthermore, the overall quality of the studies was relatively low. CONCLUSIONS: Results showed that there was a small to medium effect of EMIs on mental health and positive psychological well-being and that the effect was not different between outcome types. Moreover, the effect was larger with additional support by an MHP. Future randomized controlled trials are needed to further strengthen the results and to determine potential moderator variables. Overall, EMIs offer great potential for providing easy and cost-effective interventions to improve mental health and increase positive psychological well-being.

Transcutaneous Vagus Nerve Stimulation Enhances Post-error Slowing.

People tend to slow down after they commit an error, a phenomenon known as post-error slowing (PES). It has been proposed that slowing after negative feedback or unforeseen errors is linked to the activity of the locus coeruleus-norepinephrine (LC-NE) system, but there is little direct evidence for this hypothesis. Here, we assessed the causal role of the noradrenergic system in modulating PES by applying transcutaneous vagus nerve stimulation (tVNS), a new noninvasive and safe method to stimulate the vagus nerve and to increase NE concentrations in the brain. A single-blind, sham-controlled, between-group design was used to assess the effect of tVNS in healthy young volunteers (n = 40) during two cognitive tasks designed to measure PES. Results showed increased PES during active tVNS, as compared with sham stimulation. This effect was of similar magnitude for the two tasks. These findings provide evidence for an important role of the noradrenergic system in PES.

Goal linking and everyday worries in clinical work stress: A daily diary study.

OBJECTIVES: In this study, we tested whether high levels of daily worrying are associated with linking, a tendency to overvalue the attainment of specific lower level goals for attaining higher level goals, and more specifically the attainment of experiencing happiness. METHODS: Thirty-two patients suffering from work stress complaints and awaiting a stress management treatment and 31 healthy adults, who formed the comparison group, filled in a goal linking questionnaire and two widely used trait worry questionnaires. Subsequently, they reported the frequency and duration of worry during 14 consecutive days and nights. RESULTS: The patients suffering from work stress complaints scored higher on the linking questionnaire and worried almost twice as much as the healthy comparison group, especially during the night-time. Furthermore, goal linking was a stronger predictor of the frequency and duration of worry in daily life than the trait worry questionnaires and this was independent of the observed group differences in daily worry. CONCLUSIONS: These findings provide evidence that people who believe that their happiness is strongly dependent on the attainment of specific lower level goals worry frequently in daily life. Linking seems to be at least partly responsible for the excessive worry found in high work stress. PRACTITIONER POINTS: Worry is elevated in patients seeking professional help for work stress complaints, compared to healthy controls The higher levels of worry in the patient group were related to elevated tendencies to overvalue the attainment of specific lower level goals as a means to attain higher level goals ('linking'). It could be beneficial for high worriers to learn how to reduce linking tendencies. No strong inferences on the direction of the association between worry and linking can be made, as we relied on correlational data in which a linking questionnaire predicted worry in daily life.

EEG theta/beta ratio as a potential biomarker for attentional control and resilience against deleterious effects of stress on attention.

Anxious stress compromises cognitive executive performance. This occurs, for instance, in cognitive performance anxiety (CPA), in which anxiety about one's cognitive performance causes that performance to actually deteriorate (e.g., test anxiety). This is thought to result from a prefrontal cortically (PFC) mediated failure of top-down attentional control over stress-induced automatic processing of threat-related information. In addition, stress-induced increased catecholamine influx into the PFC may directly compromise attentional function. Previous research has suggested that the ratio between resting state electroencephalographic (EEG) low- and high-frequency power (the theta/beta ratio) is related to trait attentional control, which might moderate these effects of stress on attentional function. The goals of the present study were to test the novel prediction that theta/beta ratio moderates the deleterious effects of CPA-like anxious stress on state attentional control and to replicate a previous finding that the theta/beta ratio is related to self-reported trait attentional control. After recording of baseline frontal EEG signals, 77 participants performed a stress induction or a control procedure. Trait attentional control was assessed with the Attentional Control Scale, whereas stress-induced changes in attentional control and anxiety were measured with self-report visual analogue scales. The hypothesized moderating influence of theta/beta ratio on the effects of stress on state attentional control was confirmed. Theta/beta ratio explained 28% of the variance in stress-induced deterioration of self-reported attentional control. The negative relationship between theta/beta ratio and trait attentional control was replicated (r = -.33). The theta/beta ratio reflects, likely prefrontally mediated, attentional control, and should be a useful biomarker for the study of CPA and other anxiety-cognition interactions.

Early adversity and emotional awareness: A partial confirmation and extension of their relationship.

Early adversity has been consistently linked to mental health outcomes, but the underlying pathways remain unclear. One previous study found an association between early adversity and trait emotional awareness (EA), which has itself been linked to health outcomes, but links to mental health were not explicitly examined. The aim of the current study was to test the hypothesis that the association between early adversity and health can be partially accounted for by differences in EA within a large student sample (n = 196). Participants completed measures of early adversity, EA, and current emotional functioning (i.e., depression, anxiety, somatization, positive/negative affect). Bayesian analyses found the most evidence for models with an interaction between sex and early adversity in predicting emotional functioning - revealing the expected negative relationship between early adversity and EA in females, but a positive relationship in males. Early adversity, but not EA, was associated with depression, anxiety, and implicit negative affect. Only explicit positive affect was associated with both early adversity and EA, and EA partially mediated the negative association between early adversity and positive affect. These results provide limited support for EA as a mediating pathway for the effects of early adversity on mental health.

The effect of subliminal evaluative conditioning of cognitive self-schema and illness schema on pain tolerance.

BACKGROUND: Cognitive models explaining medically unexplained complaints propose that activating illness-related memory causes increased complaints such as pain. However, our previous studies showed conflicting support for this theory. PURPOSE: Illness-related memory is more likely to influence reporting of complaints when its activation is enmeshed with that of self-related memory. We, therefore, investigated whether inducing this association would cause a stronger decrease in pain tolerance. In addition, we examined whether SFA acted as a moderator of this effect. METHODS: We used subliminal evaluative conditioning (SEC) to induce an association between activated self-related and illness-related memory. Seventy-six participants were randomly assigned to four combinations of two priming factors: (1) the self-referent word "I" versus the nonself-referent "X" to manipulate activated self-related memory and (2) health complaint (HC) words versus neutral words to manipulate activated illness-related memory. Pain tolerance was assessed using a cold pressor task (CPT). RESULTS: Participants primed with the self-referent "I" and HC words did not demonstrate the expected lower pain tolerance. However, SFA acted as a moderator of the main effect of the self-prime: priming with "I" resulted in increased pain tolerance in participants with low SFA. CONCLUSIONS: The current study did not support the hypothesis that associations between activated self-related memory and illness-related memory cause increased reporting of complaints. Instead, activating self-related memory increased pain tolerance in participants with low SFA. This seems to indicate that the self-prime might cause an increase in SFA and suggests possible new ways to promote adaptive coping with pain.

Effects of non-invasive vagus nerve stimulation on cognitive and autonomic correlates of perseverative cognition.

Perseverative cognitions can provoke psychophysiological stress in the absence of an actual stressor and are considered important transdiagnostic vulnerability factors for several (mental) health issues. These stress-related cognitive processes are reflected by both cognitive (assessed by self-reports) and autonomic inflexibility (assessed by heart rate variability; HRV), with a key role attributed to the vagus nerve. Interestingly, modulation of the afferent branches of the vagus can be achieved with transcutaneous auricular vagus nerve stimulation (taVNS), a non-invasive technique that employs a low-intensity electrical current applied to the ear. In a sample of healthy individuals, we investigated the effects of taVNS of the left concha, compared to sham (earlobe) stimulation, on the cognitive and autonomic correlates of perseverative cognition following a psychosocial stress task. Interestingly, taVNS significantly reduced cognitive rigidity, reflected by reduced subjective perseverative thinking after psychosocial stress. Although there were no direct effects on autonomic correlates of perseverative cognition, individual differences in perseverative thinking after the stressor significantly affected the effects of taVNS on HRV. Specifically, more autonomic inflexibility during the stress task (i.e., reduced HRV) was associated with increases in perseverative thinking afterward for the sham condition, but not the active taVNS condition. Additional exploratory analyses revealed no significant moderation of stimulation intensity. Overall, the study findings endorse the association between perseverative cognitions and vagus nerve functioning.

High-frequency variability in heart rate is related to COVID-19-associated worries six years later.

Elevated resting heart rate variability (HRV) in the high frequency range has been proposed to be protective against worrying when facing environmental stressors. Yet, prospective studies using real-life stressors are still scarce. The present study set out to replicate the previous finding of reduced resting HRV predicting COVID-19-associated worries in a larger, more homogenous sample over a longer period of time (N = 123; age: 42.32 [SD:10.72]; 65.9 % female; average time lag: six years). In addition, we were interested in investigating the specificity of this effect with respect to worry content, other physiological markers of autonomic functions, and additional potentially relevant covariates with a special focus on a potential moderating effect of sex on this association. In regression analyses adjusting for age, sex, BMI and smoking status, the interaction between HRV and sex was significant, with women depicting a stronger association between HRV and COVID-19 associated worries. Further sensitivity analyses revealed the specificity of the effect for HRV as distinct from mean heart rate, as well as its dependence on previous COVID-19 infection, but not COVID-19 vaccination status and chronic stress level. These data are in line with theories that propose that higher HRV levels can be protective against the deleterious effects of real-life environmental stressors. However, our results also point to the specificity of this effect, especially with respect to worry content and sex.

Effects of the physical work environment on physiological measures of stress.

AIMS: In this study we investigated the effects of the physical work environment on two physiological measures of the stress response. METHODS AND RESULTS: Circadian variations in vagally mediated heart rate variability (HRV) and the morning rise in cortisol were evaluated in 60 participants working in a government building either in a traditional (individual offices and old cubicles; n=40) or a modern workspace (individualized cubicles with improved views and lighting; n=20). Results revealed significant linear (B=-1.03; confidence interval: -1.05 to -1.01, P<0.05) and quadratic (B=1.001; confidence interval: 1.0004-1.002, P<0.05) trends by office type interactions for indices of vagally mediated HRV. Individuals in the old office space had flatter slopes and thus less circadian variation including less HRV at night, and a larger rise in cortisol upon awakening compared with those in the new office space. CONCLUSION: These results indicate that physical features of the work environment may affect two aspects of the physiological stress response: circadian variations in HRV and the morning rise in cortisol. These findings have important social, economic, and public health implications for work environment risk factors on health.

Moving beyond belief: A narrative review of potential biomarkers for transcutaneous vagus nerve stimulation.

Transcutaneous vagus nerve stimulation (tVNS) is a non-invasive neurostimulation technique that is currently being tested as a potential treatment for a myriad of neurological and psychiatric disorders. However, the working mechanisms underlying tVNS are poorly understood and it remains unclear whether stimulation activates the vagus nerve for every participant. Finding a biological marker of tVNS is imperative, as it can help guide research on clinical applications and can inform researchers on optimal stimulation sites and parameters to further optimize treatment efficacy. In this narrative review, we discuss five potential biomarkers for tVNS and review currently available evidence for these markers for both invasive and tVNS. While some of these biomarkers hold promise from a theoretical perspective, none of the potential biomarkers provide clear and definitive indications that tVNS increases the vagal activity or augments activity in the locus coeruleus-noradrenaline network. We conclude the review by providing several recommendations for how to tackle the challenges and opportunities when researching potential biomarkers for the effects of tVNS.

Assessing New Methods to Optimally Detect Episodes of Non-metabolic Heart Rate Variability Reduction as an Indicator of Psychological Stress in Everyday Life: A Thorough Evaluation of Six Methods.

Frequent or chronic reduction in heart rate variability (HRV) is a powerful predictor of cardiovascular disease, and psychological stress has been suggested to be a co-determinant of this reduction. Recently, we evaluated various methods to measure additional HRV reduction in everyday life and to relate these reductions to psychological stress. In the current paper, we thoroughly evaluate these methods and add two new methods in both newly acquired and reanalyzed datasets. All of these methods use a subset of 24 h worth of HRV and movement data to do so: either the first 10 min of every hour, the full 24 h, a combination of 10 min from three consecutive hours, a classification of level of movement, the data from day n to detect episodes in day n + 1, or a range of activities during lab calibration. The method that used the full 24 h worth of data detected the largest percentage of episodes of reduced additional HRV that matched with self-reported stress levels, making this method the most promising, while using the first 10 min from three consecutive hours was a good runner-up.