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Article Summaries for November–December 2014 Psychosomatic Medicine, Volume 76, Issue 9

doi: 10.1097/PSY.0000000000000132
In This Issue

Posttraumatic stress disorder (PTSD) is characterized by specific emotional and physiological arousal patterns. PTSD symptoms can significantly impair function even when criteria for a full PTSD diagnosis are not fully met. Costanzo et al. used a virtual reality combat environment to evaluate service members who had recently returned from deployment. The results suggest that virtual reality exposure elicits a physiologic response relevant to subthreshold PTSD. Specifically, heart rate responses were associated with symptom clusters of re-experiencing, hyperarousal, as well as global PTSD symptoms. Physiologic monitoring of subthreshold PTSD symptoms may help identify people who may benefit from interventions that improve functional status and prevent progression to full PTSD.

Pages 670–677; Web:

Urbanization can adversely influence mental and physical health, with city dwellers experiencing higher levels of mood and anxiety than inhabitants of rural areas. Steinheuser et al. tested the hypothesis that urban upbringing may alter the activity of the hypothalamus-pituitary-adrenal axis, one of the major stress response systems. Results showed that participants raised in cities had increased cortisol responses to laboratory stressors and a reduced cortisol awakening response compared to participants raised in more rural areas. These findings suggest that an urban upbringing may result in a dysregulated stress response system.

Pages 678–685; Web:

Workers involved in the cleanup after the attack on the World Trade Center (WTC) in New York City on September 11, 2001, have high rates of psychological distress and physical disorders, including upper gastrointestinal (GI) symptoms. Litcher-Kelly et al. examined the concurrent and longitudinal associations of psychological distress with the development of new-onset upper GI symptoms in a large sample of WTC responders. Among both police and nontraditional responders, psychological distress symptoms measured 3 years after 9/11 were significantly related to the later development of GI symptoms.

Pages 686–693; Web:

Pathological buying is a clinical phenomenon with severe negative consequences, which may include bankrupty and legal challenges, for the individuals affected. Trotzke et al. evaluated physiologic measures and craving responses ("cues") elicited by shopping-related photos in people with pathological buying and compared them with control participants. The pathological shopping group had higher skin conductance responses to the cue photos and also reported a greater urge to buy specific items and cravings to purchase. The results suggest that physiological and psychological cue-reactivity and craving are mechanisms contributing to the maintenance of the pathological behavior. These findings suggest similarity between pathological buying and addictive behaviors.

Pages 694–700; Web:

Hirokawa et al. investigated whether menopausal status is associated with higher cardiovascular reactivity to mental stress in healthy Japanese women. The researchers compared premenopausal women, postmenopausal women, and men aged 16 to 82 years. Postmenopausal women were more reactive to stress than men and premenopausal women. These findings are consistent with cardiovascular hyperreactivity in postmenopausal women, which may contribute to an elevated risk of cardiovascular diseases.

Pages 701–708; Web:

The role of psychological factors in osteoporosis has not been extensively studied. Rauma et al. examined whether life satisfaction is associated with bone mineral density and bone loss in postmenopausal women. Results based on cross-sectional and longitudinal data showed that better self-reported life satisfaction was longitudinally associated with a lower level of bone loss. Promoting life satisfaction may therefore be one approach that could be considered to decrease the adverse effects of aging on bone biology.

Pages 709–715; Web:

Adverse inflammatory processes in asthma are exacerbated by psychological distress. Fractional exhaled nitric oxide (FeNO) is commonly interpreted as an indicator of airway inflammatory status in respiratory disease, and increases in FeNO levels have been observed after acute laboratory stress. Ritz et al. explored whether depressed mood, anxiety, and perceived stress were associated with the FeNO response to laboratory speech and arithmetic tasks performed by patients with asthma and healthy controls. The results showed that depressive mood was associated with a decreased FeNO response to the stressors in the expected direction, whereas perceived stress was associated with an increased FeNO response. Understanding how stress affects nitric oxide may provide insights into psychosocial influences on immunity and inflammation in health and chronic disease.

Pages 716–725; Web:

Immune system dysregulation may be one mechanism leading to a poorer prognosis for heart failure (HF) patients with depression compared with HF patients without depression. Redwine et al. investigated the relationship of depressive symptoms with leukocyte β-adrenergic receptor (AR) sensitivity. Heart failure patients with major depressive disorder had significantly higher β-AR sensitivity than patients who were not depressed. Results based on the Beck Depression Inventory, however, revealed a more complex relationship: Mild depressive symptoms were associated with reduced β-AR sensitivity, and moderate-to-severe symptoms with higher β-AR sensitivity compared with patients with minimal depressive symptoms. These findings may indicate that the relationship between depression and immune system dysregulation may not be linear or influenced by specific depressive symptom profiles.

Pages 726–731; Web:

Meier et al. examined whether depression and anxiety symptoms were associated with retinal vessel caliber, an indicator of cardiovascular risk, in a sample of adolescents and young adults. Results showed that depression and anxiety symptoms were associated with wider arteriolar caliber, even after controlling for standard cardiovascular risk factors. Findings add to a growing literature suggesting that pathophysiological mechanisms linking depression and anxiety with cardiovascular disease may already operate at a young age, possibly at the level of the microvasculature.

Pages 732–738; Web:

Depression after myocardial infarction (MI) has consistently been associated with adverse outcomes, but less is known about the role of anxiety. Larsen et al. examined the association between anxiety symptoms measured 3 months after first-time MI and new cardiovascular events or death during follow-up, taking into account depression and other established risk factors. In this study, depressive symptoms were an independent prognostic risk factor for death, whereas anxiety symptoms were not independently associated with an elevated a risk for new cardiovascular events or for death.

Pages 739–746; Web:

Goldschmidt et al. examined emotional, physiologic, and environmental correlates of pathological and nonpathological eating episodes in obese adults. Data were collected via ecological momentary assessments during the course of 2 weeks. Binge eating episodes and loss of control eating episodes were associated with negative emotional and physiological hunger cues. Most environmental variables, such as location, did not differ among eating episode types. Ambulatory monitoring identified a substantial number of individuals with binge eating episodes who did not meet standard diagnostic criteria. Results may indicate the potential importance of ambulatory monitoring that may guide future research in behavioral interventions for obesity and other eating pathologies.

Pages 747–752; Web:

Copyright © 2014 by American Psychosomatic Society