Gender differences in psychophysiological responses to speech stress among older social phobics:: congruence and incongruence between self-evaluative and cardiovascular reactions

OBJECTIVE: Evidence suggests increased cardiovascular risk and autonomic impairment among individuals with chronic anxiety. Little attention, however, has been paid to the anxiety disorder of social phobia despite its high prevalence. Additionally, gender- and age-related cardiovascular profiles have not been examined in relation to social phobia. This study investigated cardiovascular responses to a socially threatening situation among older men and women with social phobia and control subjects. METHODS: Thirty subjects with social phobia and 30 control subjects (mean age = 65 years) were assessed during baseline, paced breathing, speech preparation, and speech presentation. Electrocardiographic variables, blood pressure, respiration, and emotional state (self-reported) were monitored. Hemodynamic variables included heart rate, blood pressure, cardiac output, and systemic vascular resistance; autonomic measures were respiratory sinus arrhythmia and baroreflex sensitivity, both markers of cardiac vagal control, and 0.10-Hz systolic blood pressure variability, an index of sympathetic vasomotor tone. RESULTS: Subjects with social phobia, in contrast to nonanxious control subjects, manifested more anxiety, embarrassment, and somatic complaints in response to stress; however, physiological measures generally did not distinguish groups. Interaction effects indicated that socially phobic women were hyperresponsive to the stressor with respect to self-reported, hemodynamic, and autonomic parameters. Socially phobic men manifested no physiological differences in comparison with control subjects, but they reported more psychological and somatic complaints. CONCLUSIONS: Gender differences in subjective and physiological responses to a socially threatening situation indicate congruence between perceived social anxiety and physiological responses in older women but not men. We found no evidence of impaired cardiovascular autonomic regulation among socially phobic men despite other reports that phobically anxious men are at greater cardiovascular risk.     

Autonomic and hypothalamic-pituitary-adrenal stress resilience: Impact of cardiac vagal tone

Resilience refers to the ability to cope with stressful events. Variation in the activity of the stress-responsive sympatho-adrenal-medullary and hypothalamic-pituitary-adrenal axes is particularly important for adaptive stress responses and thus may give rise to individual differences in resilience. Here, we investigated whether cardiac vagal tone and adult attachment style are related to psychophysiological stress resilience by exposing a sample of healthy young men and women (n = 68) to a laboratory stress test while monitoring autonomic (heart rate, salivary alpha-amylase), hypothalamic-pituitary-adrenal (salivary cortisol), and psychological stress levels. Our results demonstrate that adult attachment style did not influence autonomic, hypothalamic-pituitary-adrenal, or psychological stress responses. In contrast, higher resting cardiac vagal tone was associated with stress-induced increases in cortisol. This suggests a role for sympathetic influences on heart rate regulation in hypothalamic-pituitary-adrenal stress responses, and extends previous observations of a link between vagal tone and stress resilience.     

Augmented limb blood flow during neurovascular stress in physically fit women

The study examined whether cardiorespiratory fitness modifies cardiovascular responses by normotensive men and women during the Stroop color‐word interference test. Independent of age and an estimate of body fatness, fitness level was positively related (R² = .39 and .51) to increases in limb blood flow and vascular conductance, coherent with cardiac‐vagal withdrawal and a decrease in heart period, among women but not men. Fitness was unrelated to changes in systolic and diastolic blood pressures and muscle sympathetic nerve activity. The augmented hemodynamic responses among fitter women were not consistent with passive vasodilation via withdrawal of sympathetic neural tone. The results encourage further gender comparisons testing whether fitness augments limb blood flow during mental stress by neurohumoral and flow‐mediated vasodilatory mechanisms or by increased cardiac output.     

Respiratory Sinus Arrhythmia and Cardiovascular Responses to Stress

The parasympathetic nervous system provides mechanisms that could attenuate sympathetically mediated heart rate stress responses and might have even more general antagonistic actions on stress reactivity. Individuals characterized by higher levels of parasympathetic tone might, through such mechanisms, be less reactive when stimuli elicit sympathetically mediated responses. Respiratory sinus arrhythmia (RSA) is considered to be a noninvasive index of cardiac parasympathetic (vagal) tone. The present study investigated whether individual differences in RSA level at rest could predict variations among individuals in the magnitude of cardiovascular responses to psychological stress. None of the measures of resting respiratory sinus arrhythmia, derived from spectral analysis of beat-to-beat changes in resting heart rate, predicted the observed variations in cardiovascular task reactivity. However, scores reflecting respiratory sinus arrhythmia as the percentage of total heart rate variability (RSAnorm) were negatively correlated with blood pressure levels, both at rest and during the task. Furthermore, subjects with higher scores for RSAnorm demonstrated a faster adaptation of heart rate responses during stress, which suggests the development of parasympathetic antagonism to ongoing sympathetic arousal. Although a simple relationship between respiratory sinus arrhythmia and reactivity was not observed, these results encourage further investigation of RSA measures as psychophysiological indices of individual differences in parasympathetic (vagal) cardiac tone, or perhaps of general parasympathetic/sympathetic balance, which could modulate the expression of potentially pathogenic stress responses.     

Cardiovascular Control in the Milan Strain of Spontaneously Hypertensive Rat (MHS) at “Rest” and during Acute Mental “Stress”

The cardiovascular responses to acute mental “stress” were compared in the Milan strain of spontaneously hypertensive rats (MHS) and in normotensive control rats (NR). Blood pressure and heart rate were followed in pairs of awake MHS and NR, while defence reactions were provoked by alerting stimuli (noise, vibration). No differences were noted between the two groups in response to “stress” although resting heart rate in MHS was lower than in NR. Administration of atropine or propranolol to MHS and NR showed the MHS to have a higher resting vagal tone and lower sympathetic tone than the NR. Subsequent (at least two weeks later) hemodynamic investigation, under nembutal anesthesia, showed no difference in cardiac output between MHS and NR but a higher stroke volume, presumably related to the lower heart rate in MHS. Thus, total peripheral resistance was increased in MHS as was the ratio left ventricular weight/body weight, and in good proportion to the blood pressure rise. Thus MHS differ substantially in both their responses to “stress” and also hemodynamically from the Okamoto strain of spontaneously hypertensive rat (SHR), being the so far most studied and best known model of essential hypertension in man. In MHS the hypertension is more of a systolic type and is of primarily renal origin. As such, MHS provide another model for investigating the polygenic nature of hypertension in man.     

Cardiovascular control in the Milan strain of spontaneously hypertensive rat (MHS) at "rest" and during acute mental "stress"

The cardiovascular responses to acute mental "stress" were compared in the Milan strain of spontaneously hypertensive rats (MHS) and in normotensive control rats (NR). Blood pressure and heart rate were followed in pairs of awake MHS and NR, while defence reactions were provoked by alerting stimuli (noise, vibration). No differences were noted between the two groups in response to "stress" although resting heart rate in MHS was lower than in NR. Administration of atropine or propranolol to MHS and NR showed the MHS to have a higher resting vagal tone and lower sympathetic tone than the NR. Subsequent (at least two weeks later) hemodynamic investigation, under nembutal anesthesia, showed no difference in cardiac output between MHS and NR but a higher stroke volume, presumably related to the lower heart rate in MHS. Thus, total peripheral resistance was increased in MHS as was the ratio left ventricular weight/body weight, and in good proportion to the blood pressure rise. Thus MHS differ substantially in both their responses to "stress" and also hemodynamically from the Okamoto strain of spontaneously hypertensive rat (SHR), being the so far most studied and best known model of essential hypertension in man. In MHS the hypertension is more of a systolic type and is of primarily renal origin. As such, MHS provide another model for investigating the polygenic nature of hypertension in man.     

Autonomic cardiovascular control during submergence and emergence in bullfrogs.

Unanesthetized bullfrogs were involuntarily submerged for 25 min in air-saturated water at 21 degrees C. Significant bradycardia was observed while systemic blood pressure was maintained or slightly elevated. Upon emergence, heart rates immediately returned to presubmergence levels or higher. Similar responses were observed in frogs allowed to make voluntary dives in an experimental tank. Heart rates of vagal-blocked (atropine) frogs did not change during submergence or emergence. beta-Adrenergic blockade (propranolol) had little effect on the magnitude of heart rate decrease during submergence or its increase upon emergence. After alpha-adrenergic blockade (phentolamine), frogs developed diving bradycardia while undergoing a fall in systemic blood pressure. It is concluded that, in bullfrogs, 1) bradycardia during submergence is entirely due to increased vagal activity, 2) the immediate cardiac rate increase upon emergence apparently results from a decrease in vagal tone; and 3) there appears to be no substantial reciprocal sympathetic influence on heart rate during alterations in vagal tone.     

Role of cardiac sympathetics in the tonic circulatory restraint by vagal afferents.

In anesthetized cats with aortic nerves sectioned and carotid arteries occluded, we determined the role of cardiac sympathetic nerves on the tonic inhibitory restraint by cardiac vagal afferents on the cardiovascular system. The effect of afferent vagal blockade on mean arterial pressure and cardiac contractility was determined when sympathetic tone to the heart was altered. Bilateral cardiac sympathectomy produced a significant decrease in left ventricular dP/dt and attenuated the arterial pressure response to afferent vagal cold block to less than 40% of the control. The increase in dP/dt normally observed with vagal blockade was also reduced significantly. Increasing dP/dt by efferent stimulation of cardiac sympathetic nerves restored the arterial pressure response to vagal blockade to near control levels. While the vagal inhibitory activity appeared to be dependent on the resting dP/dt, left ventricular peak pressure did not seem to be contributing to the reflex. Thus, the inhibitory effects of vagally mediated reflexes from the heart which contribute to arterial pressure regulation appear to be influenced by changes in cardiac contractility induced by cardiac sympathetic nerve stimulation.     

Maternal postpartum behavior and the emergence of infant-mother and infant-father synchrony in preterm and full-term infants: the role of neonatal vagal tone

Relations between maternal postpartum behavior and the emergence of parent-infant relatedness as a function of infant autonomic maturity were examined in 56 premature infants (birthweight = 1000-1500 g) and 52 full-term infants. Maternal behavior, mother depressive symptoms, and infant cardiac vagal tone were assessed in the neonatal period. Infant-mother and infant-father synchrony, maternal and paternal affectionate touch, and the home environment were observed at 3 months. Premature birth was associated with higher maternal depression, less maternal behaviors, decreased infant alertness, and lower coordination of maternal behavior with infant alertness in the neonatal period. At 3 months, interactions between premature infants with their mothers and fathers were less synchronous. Interaction effects of premature birth and autonomic maturity indicated that preterm infants with low vagal tone received the lowest amounts of maternal behavior in the postpartum and the least maternal touch at 3 months. Infant-mother and infant-father synchrony were each predicted by cardiac vagal tone and maternal postpartum behavior in both the preterm and full-term groups. Among preterm infants, additional predictors of parent-infant synchrony were maternal depression (mother only) and the home environment (mother and father). Findings are consistent with evolutionary perspectives on the higher susceptibility of dysregulated infants to rearing contexts and underscore the compensatory mechanisms required for social-emotional growth under risk conditions for parent-infant bonding.     

Neonatal sympathectomy by 6-hydroxydopamine: cardiovascular responses in the paralyzed rat

Rats who had been neonatally sympathectomized by peripheral injections of 6-hydroxydopamine or vehicle were paralyzed by succinylcholine and received either atropine or saline injection. Heart rate and blood pressure responses to foot shocks and to a conditioned stimulus (CS) for shock were continuously recorded. Sympathectomized rats showed lower basal systolic blood pressure, less second to second blood pressure variability and attenuated pressor responses to the shock and the CS. Basal heart rate and the heart rate response to shock were were unaffected by sympathectomy, but cardiac rate deceleration to the CS was ablished. Atropine increased basal heart rate, decreased heart rate variability and abolished the cardiac deceleration to the CS. These data were interpreted as suggesting that conditioned cardiac deceleration in the rat is a vagal mediated response compensatory to prior blood pressure increases. Sympathectomized rats also showed higher core temperatures under paralysis.     

Cardiovascular,hormonal, and emotional responses to the TSST in relation to sex and menstrual cycle phase

The prevalence of stress disorders differs between men and women. An understanding of how men and women vary in acute stress responses may help to understand these sex differences. We compared responses to the TSST and a control task in healthy men (N=28) and women tested in two phases (Follicular N=29, Luteal N=23) of the menstrual cycle. Men exhibited greater cortisol responses to stress than women in either phase. Luteal women exhibited the greatest subjective and allopregnanolone responses to stress, whereas follicular women exhibited blunted noradrenaline responses. Partial correlations controlling for group differences revealed that individuals who were most sensitive to the subjective effects of stress exhibited the largest salivary cortisol, noradrenaline, and allopregnanolone responses and the smallest progesterone responses to stress. We discuss our findings in the context of sex differences in the prevalence of stress‐linked disorders.     

Respiratory sinus arrhythmia, cardiac vagal tone, and respiration: Within- and between-individual relations

Respiratory sinus arrhythmia (RSA) is frequently employed as an intra- and interindividual index of cardiac parasympathetic tone, although the relationship of RSA to interindividual differences in cardiac vagal tone remains questionable. Our study examined between- and within-subject relations among RSA, cardiac vagal tone, and respiratory parameters. Twenty-nine young adults performed two sessions of tasks under no medication and single and double autonomic blockade (intravenously administered propranolol and atropine). Parasympathetic tone was determined from heart period responses to complete vagal blockade. Results indicated the following. Resting RSA does not accurately predict individual differences in cardiac vagal tone. However, RSA and heart period together do predict such individual differences reasonably well. The relationship between individual variations in RSA and vagal tone is not improved by controlling respiratory parameters. Substantial cardiac vagal activity occurs during inspiration, and intraindividual variations in respiratory measures confound the association between RSA and cardiac vagal tone.     

Differential effects of active versus passive coping on secretory immunity

This study examined the acute immunological effects of two laboratory stressors, expected to evoke distinct patterns of cardiac autonomic activity; namely an "active coping" time-paced memory test, and a "passive coping" stressful video showing surgical operations. We measured salivary S-IgA, IgA-subclasses (IgA1, IgA2), and secretory component (SC). SC is responsible for the transport of S-IgA across the epithelium, and thus a rate-determining step in S-IgA secretion. Thirty-two male undergraduates were subjected to both stressors and a control video (a didactic television program). The memory test induced a typical "fight-flight" response, characterized by increases in heart rate and blood pressure in association with a decrease in cardiac preejection period (PEP) and vagal tone. The surgical video produced a "conservation-withdrawal"-like response, characterized by an enhanced vagal tone, a decrease in heart rate, and a moderate sympathetic coactivation (as indicated by a shortened PEP and an increased systolic pressure). The memory test induced an increase in the concentration and, to a lesser extent, in the output of S-IgA, IgA], and SC. The output of IgA2 was not significantly affected. For the surgical video, a different pattern emerged: During stressor exposure S-IgA remained unaffected, against the background of a small increase in SC output. However, 10 min after the surgical video S-IgA levels had decreased. This decrease in S-IgA was paralleled by a decrease in IgA1, but not IgA2. We conclude that acute stress can have both enhancing and suppressive effects on secretory immunity, the IgA1 subclass in particular. The mechanisms that underlie these divergent responses may include stressor-specific patterns of autonomic activation.     

The Inhibition of Cardiovascular Responses to Mental Stress Following Aerobic Exercise

The effects of exercise on subsequent psychophysiological responses to mental stress were assessed in a study of 30 normotensive male volunteers. Participants were randomly allocated to three experimental conditions--20-min exercise at 100 Watts (high exercise), 20-min exercise at 25 Watts (low exercise), or 20-min no exercise (control). After a recovery period of 20 min, all subjects performed a mental arithmetic task for four 5-min trials. Blood pressure and heart rate were monitored continuously using a Finapres, and respiration and electrodermal activity were also recorded. Baroreceptor reflex control of heart rate was assessed using power spectrum analysis. Exercise produced consistent increases in systolic blood pressure, heart rate, and subjective tension, together with reductions in systemic resistance and baroreflex sensitivity. The systolic and diastolic blood pressure and heart rate reactions to mental arithmetic were significantly blunted in the high exercise compared with control conditions, with the low exercise group showing an intermediate pattern. Subjective responses to mental stress were unaffected by prior exercise. The pattern of hemodynamic response was not a result of changes in baroreflex sensitivity. The mechanisms underlying this result are discussed in relation to the discrepancies between subjective and physiological responses to mental stress, and the implications for the use of exercise in stress management.     

The Effects of Cognitive and Physical Stress on Cardiovascular Reactivity Among Smokers and Oral Contraceptive Users

Blood pressure and heart rate responses to cognitive (mental arithmetic) and physical (cold pressor) stress were monitored in four groups of women: 1) smokers/non oral contraceptive (OC) users, 2) non-smokers/OC users, 3) smokers/OC users, and 4) non-smokers/non-OC users (control). All subjects were reactive to both types of stress. The results suggest that oral contraceptive use among smokers may enhance systolic blood pressure reactivity to cognitive stress when compared to smokers/non-OC users. Also, OC use among women with a parental history of heart disease was marginally associated with elevated systolic and diastolic blood pressure responses to the cold pressor test. These findings suggest that oral contraceptive use may interact with smoking and parental history of heart disease and warrant further investigation.     

Cardiac autonomic profile during rest and working memory load in essential hypotensive women

To our knowledge, no previous study has provided reliable data supporting a different modulation of the Neurovegetative system in essential hypotension. Our purpose was to provide, in essential hypotensive women compared to normotensives, evidence of a distinct sympathetic and parasympathetic cardiac control. Cardiovascular and autonomic indexes derived by impedance cardiography (heart rate, HR; pre-ejection period, PEP), photoplethysmographic technique (blood pressure, BP) and heart rate variability analysis (high and low frequencies power, HF and LF) were continuously collected during rest and mental stress condition. Hypotensives, compared to normotensives, exhibited prolonged PEP (low sympathetic tone) and elevated HF (high vagal involvement) during rest. In addition, they showed cardiovascular (reduced increases in BP and HR) and sympathetic (lower reductions of PEP) hypo-reactivity to the task. Furthermore, a lower sympathetic reactivity in hypotensives was associated to a poorer task performance. Essential hypotension was characterized by a low sympathetic and high parasympathetic tone. In addition, a reduced sympathetic nervous system reactivity suggests the main role of the Neurovegetative system in mediating the relationship between blood pressure and cognitive performance in hypotensives.     

Cardiopulmonary Adjustments During Operant Heart Rate Control

Twenty-three healthy men and women participated in a 5-session experiment in which they attempted to increase and decrease their heart rate with the assistance of visual analogue biofeedback. As a group subjects did successfully raise and lower heart rate from resting baseline. These changes in heart rate were closely paralleled by changes in V, a measure of cardiac vagal tone. Heart rate slowing was associated with increases in V, and heart rate speeding was associated with decreases in V. Respiration rate and amplitude did not differ significantly between heart rate slowing and speeding trials, and covariance analysis indicated that respiratory changes did not account for the heart rate or V effects. The weighted coherence between respiration and heart rate showed that cardiopulmonary coupling increased during heart rate slowing and decreased during heart rate speeding. Individual differences in cardiac vagal tone and cardiopulmonary coupling were unrelated to heart rate speeding and slowing performance.     

Influences of sex and age on cardiovascular responses during stress

The present investigation examined the influence of sex and age on blood pressure and heart rate responses in 125 women, 93 men, 121 girls, and 96 boys to three standardized stressors: serial subtraction, mirror-image tracing, and isometric handgrip. With baseline measures and body mass index controlled for, analyses of covariance showed that adults had greater systolic blood pressure responses than did children; men had greater blood pressure responses to all stressors than did women; and high school boys had greater systolic blood pressure responses than did high school girls. In addition, adults had smaller heart rate responses during isometric handgrip than did children, and high school students had smaller heart rate responses during all tasks than did the remaining, younger students. These results show that sex and age are important determinants of the magnitude of cardiovascular adjustments during stressors. The implications of these results are discussed in light of sex differences in coronary heart disease morbidity and mortality.     

Estimated cardiac vagal tone predicts fetal responses to mother's and stranger's voices

Heart rate responses of 84 near-term fetuses to recorded female voices were examined in 166 trials of auditory stimulation. Each fetus was presented with a 2-min recording of their mother's voice and a 2-min recording of a female stranger's voice, in counterbalanced order, with a 10-min rest period between trials. High frequency heart rate variability during a 2-min baseline period was used to estimate cardiac vagal tone for each trial. Differential heart rate responses to familiar and unfamiliar voice recordings were observed during a 2-min poststimulus period, only when estimated cardiac vagal tone was high. This finding suggests that vagal tone plays a moderating role in the cardiac responses of term fetuses to familiar and unfamiliar stimuli.     

Plasma oxytocin is related to lower cardiovascular and sympathetic reactivity to stress

In addition to known reproductive and social affiliation functions, oxytocin (OT) has been identified as a cardiovascular hormone. OT synthesis and receptors are found in cardiac and vascular tissue. Animal studies suggest that OT activates an ‘anti-stress’ response that reduces cardiovascular and neuroendocrine stress reactivity. We tested 28 early postpartum mothers, obtaining multiple blood samples for OT, the sympathetic marker, norepinephrine (NE), and the lactation hormone, prolactin, while monitoring their cardiovascular responses to two stressors: public speaking and forehead cold pressor. Although plasma OT did not increase reliably from pre-stress levels during stressors, greater overall OT level was related to greater vasodilation and cardiac stroke volume responses to both tasks, to reduction in heart rate to the cold pressor, as well as to lower plasma NE and higher prolactin levels. In contrast, higher NE was linked to increases in heart rate and decreases in stroke volume. These data support a cardioprotective role for OT, which may influence the magnitude and hemodynamic determinants of cardiovascular stress responses.