Article Summaries for January 2023 Psychosomatic Medicine, Volume 85, Issue 1

Poor emotion regulation is associated with cardiovascular disease (CVD) risk. Using ecological momentary assessment, Tyra et al. explored the associations between emotion regulation and cardiovascular activity in 100 American Indian adults, a community at high risk for CVD. Higher expressive suppression was associated with higher ambulatory blood pressure and pulse rate, whereas higher cognitive reappraisal was associated with lower ambulatory blood pressure and pulse rate and psychological stress. These results highlight a need to include emotion regulation training in health interventions.

Pages 2–7; https://doi.org/10.1097/PSY.0000000000001140

Long et al. conducted a systematic review and meta-analysis of associations between loneliness, social isolation, and living alone and risk of mortality among individuals with established cardiovascular disease (CVD). The narrative synthesis of 35 studies and a meta-analytic evaluation found that loneliness, social isolation, and living alone were associated with higher risk of premature mortality among individuals with established CVD. However, evidence of publication bias and large methodological differences across studies point to the need for more rigorous research.

Pages 8–17; https://doi.org/10.1097/PSY.0000000000001151

Depressive disorders have been associated with a higher prevalence of cardiac arrhythmias. Theofilis et al. evaluated the association between depression and QTc (Q-T corrected) a marker of ventricular repolarization, in a cross-sectional study of midlife (<65 years) and older adults (≥65 years) (n = 1,637). The interrelationship between depression and autonomic dysregulation suggests potential risk factors for cardiovascular disease and sudden cardiac death associated with increased QTc interval, especially in individuals younger than 65 years of age.

Pages 18–25; https://doi.org/10.1097/PSY.0000000000001152

Karlsen et al. examined whether the use of antidepressant medications was associated with a risk of myocardial infarction (MI) in 31,765 adults. Men and women have unique cardiovascular risk factors, and sex differences in depression, as well as the efficacy of antidepressants, are important to consider. Antidepressant use reduced the risk of MI to a larger degree for women than men, though a statistically significant interaction effect was not found.

Pages 26–33; https://doi.org/10.1097/PSY.0000000000001144

The mechanisms through which sleep loss is a major risk factor for cardiovascular disease remain largely unknown. In a study by Krause et al., 66 healthy adults participated in a repeated-measures, cross-over, experimental study involving assessments of cardiovascular function and brain connectivity following a night of sleep and a night of sleep deprivation. The findings established a previously unrecognized embodied framework in which sleep loss confers increased risk of cardiovascular disease through an impact upon brain control of vascular tone, rather than a direct impact on an accelerated heart rate per se.

Pages 89–97; https://doi.org/10.1097/PSY.0000000000001147

The COVID-19 pandemic may affect the mental health of younger adults to a larger degree than older adults. Using data from a nationally representative sample of 2000 individuals aged 18 to 90, Gabarrell-Pascuet et al. found that older age was related to fewer symptoms of mental disorder and less loneliness. Loneliness was associated with more symptoms, but depression, anxiety, and post-traumatic stress disorder symptoms were highest in those who were lonely, younger, and without pre-pandemic mental disorder. Depression and anxiety symptoms were highest in those who were lonely, older, and with pre-pandemic mental disorder.

Pages 42–52; https://doi.org/10.1097/PSY.0000000000001146

Vagedes et al. examined changes in heart rate variability in 114 COVID-19 healthcare providers (HCPs) after an individually tailored, multimodal integrative medicine (IM) intervention. Increased parasympathetic activity was observed in all HCPs, particularly those expressing emotional-spiritual keywords in post-intervention, open-ended responses to questions about the intervention. More research is needed to explore the relationship between subjective effects of the IM intervention and physiological mechanisms of relaxation in HCPs.

Pages 53–60; https://doi.org/10.1097/PSY.0000000000001153

Patients with somatic symptom disorder (SSD) often receive targeted intervention only after a long duration of illness. Reported effect sizes for SSD interventions are small. As preliminary evidence suggests autonomic imbalance (e.g., lower heart rate variability; HRV) in the disorder, Krempel and Martin randomized 50 adults to either HRV-biofeedback (HRV-BF) training or relaxation training. Improvements in somatic symptoms suggest that only four sessions of HRV-BF may be a useful intervention option for SSD.

Pages 61–70; https://doi.org/10.1097/PSY.0000000000001143

In a systematic review and meta-analysis of 154 studies across health domains, Kitselaar et al. examined potential origins of persistent somatic symptoms (PSS). There was strong evidence for biological, psychological, interpersonal, contextual, and health behavioral factors. With risk factors for PSS onset arising from all dynamic biopsychosocial domains, measuring commonality across subtypes could improve clinical treatment.

Pages 71–78; https://doi.org/10.1097/PSY.0000000000001145

Symptom perception in pathological illness anxiety (PIA) may be atypical, with somatic signals overreported. Wolters et al. conducted somatic signal detection tasks (SSDT) in participants with PIA (n = 44) and healthy controls (n = 40). Tactile and light emitting diode (LED) stimuli were presented in half of the trials. Illness-related or neutral words were presented alongside tactile stimuli in an adaptation. Generally altered response bias in PIA was not observed, but an increase in sensitivity from no LED to LED in participants with PIA compared with controls suggested stronger multisensory integration.

Pages 34–41; https://doi.org/10.1097/PSY.000000000000115

Wang et al. investigated associations of optimism with epigenome-wide leukocyte DNA methylation using two population-based cohorts (total n = 4483). Random-effects meta-analyses were used to pool the individual results. Genes related to optimism are involved in psychiatric disorders, cardiovascular disease, cognitive impairment, and cancer. Pathways related to optimism were related to cancer, neurodevelopmental and neurodegenerative disorders. Their findings provide new insights into optimism and the causal pathway for human health and diseases.

Pages 89–97; https://doi.org/10.1097/PSY.0000000000001147

Patients in need of heart, liver, or kidney transplantation face distinct physical and psychological challenges. Gronewald et al. compared the psychosocial characteristics and preferences for additional therapy in transplant candidates (n = 1110). Patients assessed for heart, liver, or kidney transplant suitability differed significantly in depression, anxiety, health-related quality of life, perceived social support, sense of coherence, self-efficacy, and body image. Patients evaluated for heart transplantation showed the highest psychosocial impairment and the highest inclination toward additional supportive therapy. Structures for psycho-cardiological treatment are recommended.

Pages 98–105; https://doi.org/10.1097/PSY.0000000000001142

For this issue of the journal, the review process for articles submitted in 2021 was managed by Willem J. Kop, who is now Editor-in-Chief Emeritus of Psychosomatic Medicine. Review of articles submitted in 2022 was managed by Editor-in-Chief Suzanne C. Segerstrom.

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