Suzanne Pieper

Expanding stress theory: Prolonged activation and perseverative cognition

Several theories of the stress-disease link have now incorporated prolonged activation. This article argues that these theories still lack an important element, that is, the cognitive nature of the mechanism that causes stress responses to be sustained. The perception of stress and the initial response to it do not automatically lead to prolonged activation. The active cognitive representations of stressors need to be prolonged in order to extend their physiological concomitants. We call this mediating process perseverative cognition, and it is manifested in phenomena such as worry, rumination, and anticipatory stress. We summarize evidence suggesting that these phenomena are indeed associated with physiological activation, including cardiovascular, endocrinological and immunological parameters. This evidence is still far from sufficient, due to the many methodological insufficiencies in the studies involved. Nevertheless, it makes clear that cognitive phenomena characterized by perseverative cognition may be likely candidates to mediate the effects of stress sources on somatic disease. We also argue that there is a dearth of evidence supporting the role of prolonged activation. There are a limited number of studies demonstrating prolonged activity related to stressors and emotional episodes, and their methodologies often do not allow unambiguous conclusions. Even more important, the crucial assumption that prolonged activation actually leads to pathogenic states and disease has received hardly any attention yet and therefore is still largely unsupported. There are only a few studies that showed that anticipatory responses and slow recovery from stress predicted disease states.

Cardiac effects of momentary assessed worry episodes and stressful events.

Objective: To hypothesize that increased heart rate (HR) and decreased heart rate variability (HRV) occurs not only during stressful events but also during episodes in which stress is cognitively represented, but not necessarily present, i.e., during worry. Methods: Ambulatory HR and HRV of 73 female and male teachers were recorded for 4 days, during which they reported, on an hourly basis using computerized diaries, the number and characteristics of worry episodes and stressful events. Multilevel regression models were used, controlling for biobehavioral variables. Results: Compared with neutral periods, worry episodes and stressful events had independent effects on HR (2.00 beats/min and 2.75 beats/min, respectively) and HRV (−1.07ms and −1.05, respectively). Neither psychological traits nor biobehavioral variables influenced these results. Effects were most pronounced for work-related worry on HR (9.16 beats/min) and HRV (−1.19 ms), and for worry about anticipated future stress on HR (4.79 beats/min). Conclusions: Worry in daily life might have substantial cardiac effects in addition to the effects of stressful events, especially in the form of work-related and anticipatory stress, the latter being a type of stress that has been largely neglected in stress research. CV = cardiovascular; HR = heart rate; HRV = heart rate variability; BP = blood pressure; BMI = body mass index; PSWQ = Penn State Worry Questionnaire; WDQ = Worry Domain Questionnaire; BDI = Beck Depression Inventory; STAI = Spielberger Trait Anxiety; CM = Cook-Medley hostility scale; IHAT = Interpersonal Hostility Assessment Technique.

Prolonged Cardiac Effects of Momentary Assessed Stressful Events and Worry Episodes

Objectives: To test the hypothesize that increased heart rate (HR) and decreased heart rate variability (HRV) are not only due to concurrent stressful events and worries but also to stressors and worries occurring in the preceding hours or stressors anticipated to occur in the next hour. Worry was expected to mediate at least part of the prolonged effects of stressors. Methods: Ambulatory HR and HRV of 73 teachers were recorded for 4 days, during which the participants reported occurrence and duration of worry episodes and stressful events on an hourly basis, using computerized diaries. Multilevel regression models were used, accounting for effects of several biobehavioral variables. Results: Stressful events were not associated with changes in HR or HRV. However, worry episodes had effects on concurrent HR and HRV (2.55 beats/minute; −5.76 milliseconds) and HR and HRV in the succeeding hour (3.05 beats/minute; −5.80 milliseconds) and 2 hours later (1.52 beats/minute; −3.14 milliseconds). These findings were independent of emotions, physical activity, posture, and other biobehavioral factors. Conclusion: Worry has effects on cardiac activity, and these effects were still visible after 2 hours. The latter finding suggests that a considerable part of prolonged activation may be induced by unconscious stress-related cognition. CV = cardiovascular disease; HR = heart rate; HRV = heart rate variability; BP = blood pressure; BMI = body mass index; ECG = electrocardiogram.

Oxytocin receptor gene and depressive symptoms associated with physiological reactivity to infant crying

Both the oxytocin receptor (OXTR) gene and depressive symptoms have been associated with parenting behaviour. The OXTR GG genotype has been suggested to be related to more sensitive parenting, whereas depressive symptoms may affect sensitivity negatively. We examined the role of OXTR and the influence of depressive symptoms in explaining differences in physiological reactivity to infant crying. Heart rate responses of 40 healthy females without children (age 19-47 years, randomly selected half of twin pairs) were measured during the presentation of three episodes of infant cry sounds. Participants with the presumably more efficient variant of the oxytonergic system gene (OXTR GG) had more pronounced physiological reactivity to repeated cry sounds, except when they showed more symptoms of depression. Results were replicated in the second half of the twin sample. This is the first study to suggest effects of OXTR genotype on physiological reactivity to infant crying. Depressive symptoms may however suppress the effect of the OXTR GG genotype.

Bilingual toddlers reap the language they sow: ethnic minority toddlers' childcare attendance increases maternal host language use

Abstract This study investigated the development and correlates of language use in bilingual Turkish-Dutch immigrant mothers and their toddlers. In this short-term longitudinal study 87 mothers completed questionnaires on their Dutch and Turkish language use, ethnic identity and use of childcare. Observational data were obtained for maternal supportive presence and observed language use with the child. We found evidence that mothers who felt more strongly connected to the Turkish culture spoke more Turkish and less Dutch with their toddlers. The amount of Dutch that was used in mother–toddler communication increased significantly between the ages of two and three years. Mothers of children who started visiting childcare or who lived in a neighbourhood with a low percentage of non-western immigrants showed a larger increase in use of the Dutch language with their toddlers. Our findings emphasise the importance of contextual factors in determining language use in ethnic minority families.

Behavioral and molecular genetics of dissociation: the role of the serotonin transporter gene promoter polymorphism (5-HTTLPR).

We evaluated the role of the serotonin transporter gene promoter polymorphism (5-HTTLPR) in the etiology of dissociation. Adult twin pairs (N = 184 pairs; mean age 33.0 years, SD = 10.8) completed measures for dissociation and trauma. The DNA samples were genotyped for 5-HTTLPR adjusted for rs25531 alleles. Behavioral genetic analyses showed that genetic factors explained 45% of the variance in dissociative symptoms, while 55% of the variance was explained by unique environment and measurement error. Participants with the SS genotype of 5-HTTLPR reported more dissociative symptoms compared to participants with the other genotypes (p = .02), and they showed more pathological dissociative symptoms than the other participants (p = .04) when they reported more depressive symptoms and when they had experienced trauma.