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Article Summaries for November–December 2021 Psychosomatic Medicine, Volume 83, Issue 9

doi: 10.1097/PSY.0000000000001035
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Disproportionate exposure to life stress, trauma, and racial discrimination contributes to poorer health outcomes for Black Americans, in part because of the impact of premature biological aging. McKenna et al. examined how anger expression may contribute to the association between stress and premature aging (i.e., epigenetic age acceleration [EAA]). Race-related stress was significantly associated with both internalized and externalized expressions of anger, and internalized anger was found to mediate the association between stress and EAA.

Pages 949–958; http://doi.org/10.1097/PSY.0000000000001007

Beta-adrenergic receptor signaling, a critical mediator of sympathetic nervous system influences on physiology and behavior, has long been proposed as one contributor to emotions and the subjective experience of stress. MacCormack et al. reevaluated the question and examined the effects of beta-blockade on psychophysiological indicators of sympathetic and parasympathetic nervous system reactivity. Results provide updated experimental evidence that beta-adrenergic blockade attenuates negative, high arousal emotions in response to a psychosocial stressor while also blunting sympathetic nervous system reactivity. Together, these findings shed light on the neurophysiological mechanisms by which stressors transform into the subjective experience of stress.

Pages 959–968; https://doi.org/10.1097/PSY.0000000000001009

Posttraumatic stress disorder (PTSD) is a disabling condition, but current treatment options have limitations. Transcutaneous cervical (neck) vagal nerve stimulation (tcVNS) has the potential to mitigate nerve activity that may lead to intrusions and hyperarousal symptoms in PTSD. Wittbrodt et al. studied the effects of tcVNS on neural responses to reminders of PTSD-related traumatic stress. Compared with sham, TcVNS increased anterior cingulate and hippocampus activation during trauma scripts, potentially indicating a reversal of neurobiological changes that coincide with PTSD consistent with improved autonomic control.

Pages 969–977; https://doi.org/10.1097/PSY.0000000000000987

High levels of psychological distress can lead to adverse health outcomes, including kidney disease. Glomerular filtration rate (GFR) is a measure of kidney function, but the association between PTSD and GFR is not well defined. Koraishy et al. studied participants in the World Trade Center responder cohort and compared the association between PTSD with either GFR decline (indicating reduced kidney function) or GFR increase during 2 years follow-up (with stable GFR as reference). PTSD was associated with GFR decline, indicating poorer kidney functioning. Additional evidence suggested that the association between PTSD with changes in GFR may be U-shaped, which can be interpreted to reflect the complex link between psychological factors and kidney disease progression.

Pages 978–986; https://doi.org/10.1097/PSY.0000000000000968

Dupre et al. investigated cumulative exposure to chronic stressors and the incidence of myocardial infarction (MI) in older adults. Risks of MI increased incrementally from one chronic stressor to four or more chronic, compared with those who reported no stressors. The risks associated with multiple chronic stressors were especially high in adults with a previous MI. These risks were only partly reduced after adjustments for demographic, socioeconomic, psychosocial, behavioral, and clinical risk factors. Chronic life stressors are significant independent risk factors for cardiovascular events in older adults

Pages 987–994; https://doi.org/10.1097/PSY.0000000000000976

Hu et al. examined the association of subjective and objective sleep quality with subsequent rebleeding of peptic ulcers (PUB) in older patients. Poor sleep quality was associated with 30-day peptic ulcer rebleeding after successful PUB treatment. Multivariate analyses showed that longer sleep onset latency and more nighttime awakenings increased the risk of ulcer rebleeding, but longer total sleep and better sleep efficiency protected against it. This study might shed light on the etiology of peptic ulcer rebleeding and suggest new treatment pathways for preventing its occurrence.

Pages 995–1003; https://doi.org/10.1097/PSY.0000000000001001

Accumulating evidence suggests bidirectionality between sleep problems and depression, but the underlying mechanism is unclear. Inhibitory control – the ability to resist distractor interference to regulate behavior in line with goals – has been shown to be suboptimal among individuals with depression and may prolong depressive symptoms. Lau et al. assessed the role of sleep and its effect on inhibitory control in the presence of emotional stimuli. Among individuals with depressive disorders, gains in sleep, particularly Stage 2 sleep and related physiology, potentially enhances inhibitory control in response to emotional information.

Pages 1004–1012; https://doi.org/ 0.1097/PSY.0000000000000996

In a systematic review, Strikweda et al. investigated the association of burnout and vital exhaustion with glycemic control and type 2 diabetes (T2D). Twenty-nine studies were included, which showed two times higher odds of burnout and vital exhaustion with T2D. No statistically significant associations were observed for measures of glycemic control. Although some of the included studies were of low methodological, results show that burnout and vital exhaustion might be associated with a higher risk of T2D but not with glycemic control.

Pages 1013–1030; https://doi.org/10.1097/PSY.0000000000000995

Subjective socioeconomic status (SES) is a well-established psychosocial factor associated with adolescents’ self-reported health. Whether low subjective SES is correlated with stress-related physiological measures remains uncertain. Chen et al. examined the association of subjective SES relative to different reference groups (i.e., perception of family SES relative to other students in the school versus other people in the city) with adolescents’ diurnal cortisol profiles. The measurements highlight the importance of the reference group for subjective SES and provide a further understanding of socioeconomic disparities in adolescents’ stress physiology.

Pages 1031–1040; https://doi.org/10.1097/PSY.0000000000000974

People who are “good” placebo responders are valuable in basic research and in clinical applications of the placebo response. Multiple studies point to direct verbal suggestibility as a potential valuable predictor of individual differences in placebo responsiveness, but previous research has produced conflicting results on this association. Parsons et al. conducted two double-blind studies to assess the extent to which direct verbal suggestibility would account for variability in placebo responsiveness. The results suggest that suggestibility is associated with placebo hypoalgesia responsiveness only in the absence of conditioning.

Pages 1041–1049; https://doi.org/10.1097/PSY.0000000000000977

Perceived stress, lower fruit intake, and comfort eating are all risk factors for chronic disease. Finch et al. aimed to investigate these three risk factors at once by applying Pavlovian conditioning to change the nature of comfort eating. Stressed participants underwent an intervention designed to elicit comforting effects of fruit intake and reduce negative mood. Repeated pairing of fruit intake with a reliable distress-reducing activity was successful. Further refinement of the intervention design is necessary to translate this conditioned association to actual intake of fruit and other foods.

Pages 1050–1057; https://doi.org/10.1097/PSY.0000000000001008

Perseverative cognition (PC) is the repeated or long-term activation of the cognitive representation of psychological stressors and is associated with prolonged distress that includes somatic and mental consequences. Appel et al. explored the significance of PC in different mental and somatic disorders in psychiatric patients. Their data complement previous work linking PC to stress-related mental disorders but question its immediate role in neurodevelopmental and somatic disorders. Targeting PC in the treatment of mood disorders and perhaps also in addiction appears promising.

Pages 1058–1066; https:/doi.org/10.1097/PSY.0000000000001003

There is a well-documented bidirectional relationship between pain and depression in that the presence of both disorders makes it more difficult to treat either one. In an online cognitive behavioral therapy program for anxiety and depression, Marone et al. found that high optimism may buffer against the negative effects of pain interference on treatment response as measured by mental health-related quality of life. Primary care patients who report high pain interference but lack optimism may not receive as much benefit from distance cognitive behavioral therapy as other groups. For depressed and anxious patients with no or little pain interference, the study found an unexpected positive effect of low optimism on treatment response.

Pages 1067–1074; https://doi.org/10.1097/PSY.0000000000000980

In a large, nationally representative study of 9- and 10-year old participants, Lewis-de los Angeles and Liu found that a history of depression was associated with elevated BMI and waist-to-height ratio in girls but not boys. These results suggest that depression is associated with either the development or the persistence of elevated BMI and waist-to-height ratio in pre-adolescent girls. The results of this study provide important clinical context to help pediatricians care for preadolescents with a history of depression, which represented more than 10% of the population in this study.

Pages 1075–1081; https://doi.org/10.1097/PSY.0000000000000982

Few studies have investigated differences between men and women who have schizophrenia and comorbid major depression. To explore the topic, Li et al. recruited 996 patients who were experiencing their first episode of schizophrenia and had not previously used psychotropic drugs. Results showed sex differences in the proportion of severe depression, clinical symptoms, and risk factors of comorbid major depressive episode (MDE). Men and women with schizophrenia were equally likely to have comorbid MDE, but men had more severe psychotic symptoms. These sex differences have clinical implications for the treatment of depression as related to the nature and severity of psychopathological symptoms in patients with schizophrenia.

Pages 1082–1088; http://doi.org/10.1097/PSY.0000000000000998

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