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Article Summaries for July–August 2018 Psychosomatic Medicine, Volume 80, Issue 6

doi: 10.1097/PSY.0000000000000617

The long-term consequences of cardiovascular disease (CVD) risk factors for future major depressive disorder (MDD) are not well understood. Patel et al. report that CVD risk factors predict new-onset MDD in a large study of 22,915 adults. Specifically, hypertension (protective factor), former tobacco use (risk factor), and body mass index (risk factor) are particularly strong predictors of incident atypical MDD. This evidence could provide insight into MDD subtype etiologies and inform patient-tailored interventions.

Pages 508–514;

In an accompanying editorial Drs. Christoph Herrmann-Lingen and Mustafa al’Absi highlight the implications of the research findings on the link between cardiovascular disease risk factors and future development of depression. They discuss the findings in light of research linking blood pressure to emotion regulation, as previous research has indicated that there is a positive association between blood pressure with reduced expression of negative emotions and pain.

Pages 504–507;

The brain-heart mechanisms of coronary artery disease (CAD) remains an important topic. Bremner et al. assessed the effects of stress—public speaking and mental arithmetic challenges—on brain and cardiac function in patients with CAD. Patients with mental stress–induced myocardial ischemia (MSMI) showed increased activation in areas relevant to emotions, particularly the anterior cingulate, inferior frontal gyrus, and parietal cortex. Arithmetic stress was associated with left insula activation, and public speaking with right pre/post-central gyrus and middle temporal gyrus activation. Altered brain reactivity to stress may represent a mechanism through which stress leads to increased risk of CAD-related morbidity and mortality.

Pages 515–525;

Psychological well-being is linked to health behavior adherence following acute coronary syndrome (ACS). Positive psychological (PP) interventions, therefore, may hold promise in improving post-ACS adherence to a healthy lifestyle. Celano et al. report on a factorial trial in 128 post-ACS patients to identify components of a positive psychological intervention associated with the greatest improvement in cardiac health behaviors. They found weekly completion of positive psychological exercises, combined with motivational interviewing and booster sessions, to be associated with the greatest benefit.

Pages 526–534;

In a systematic review, Kube et al. examined expectation-focused psychological interventions (EFPI) in patients with medical conditions that included coronary heart disease, cancer, and chronic pain. In qualitative synthesis, expectation-optimization or expectation-violation approaches revealed positive effects of EFPI on clinical outcome variables in randomized trials. In optimizing EFPI treatment, it is important to consider disease-specific aspects and personality traits of patients.

Pages 535–543;

Elevated resting blood pressure (BP) is associated with risk for later development of clinical hypertension and with dampened responses to emotionally meaningful stimuli. If this cardiovascular emotional dampening reduces threat appraisal, then high resting BP may be associated with increased risk behavior. McCubbin et al. found that individuals with elevated resting BP report increased risk behaviors, possibly reflecting brain integration of both visceral and emotional responsivity and the relationship of emotional dampening to hypertension development.

Pages 544–550;

Among socially marginalized populations such as sexual minorities, experiences with stigma, prejudice, and discrimination are thought to result in the accumulation of adverse biological processes such as allostatic load (AL). Using data from the National Health and Nutrition Examination Survey, Mays et al. examined the association between sexual orientation with AL. Elevated AL was more common in bisexual men compared to all other men. No significant sexual orientation-related differences in AL were observed in women. Further study of AL in sexual minorities is important to elucidate the sociocultural pathways that may contribute to distinct AL profiles and subsequent adverse health outcomes.

Pages 551–563;

Behavioral and psychosocial factors have been associated with decline in semen quality. The relationship of depression and physical activity (PA) to semen quality remains unclear. In otherwise healthy young men, Zou et al. found depression was associated with decreased sperm concentration and total sperm count, and the lack of PA was associated with the decline of total sperm count. In addition, interaction effects were detected between depression and PA on sperm concentration.

Pages 564–572;

De la Coba et al. examined the diagnostic accuracy and test-retest reliability of a novel dynamic evoked pain protocol (slowly repeated evoked pain: SREP) compared to temporal summation of pain (TSP) as a standard index of central sensitization. In comparison to TSP, SREP demonstrated higher accuracy in discriminating between fibromyalgia and rheumatoid arthritis patients (87.7% vs. 64.6%), and slightly larger test-retest reliability (intraclass correlation: 0.80 vs. 0.73). Additional research is needed to study mechanisms underlying SREP and its potential clinical utility.

Pages 573–580;

Yogic breathing techniques are hypothesized to confer health benefits by increasing cardiac vagal control, but observed increases in low frequency HRV power do not unambiguously differentiate sympathetic from parasympathetic contributions. In an autonomic blockade study, Kromenacker et al. found that changes in low-frequency heart rate variability that occur during slow-paced breathing are vagally mediated and not sympathetically mediated. These findings suggest that slow-paced breathing is an effective tool for cardiac vagal activation.

Pages 581–587;

Copyright © 2018 by American Psychosomatic Society