The baroreflex consists of a negative feedback loop adjusting heart activity to blood pressure fluctuations. This review is concerned with interactions between baroreflex function and behavior. In ...addition to changes in baroreflex cardiac control subject to behavioral manipulations, interindividual differences in reflex function predicted psychological and central nervous features. The sensitivity of the reflex was inversely related to cognitive performance, evoked potential amplitudes, experimental pain sensitivity, and the severity of clinical pain. Possible variables moderating the strength of the associations are tonic blood pressure, gender, and psychiatric disease. It is suggested that these observations reflect inhibition of higher brain function by baroreceptor afferents. While in many cases increased baroreflex function implies stronger inhibition, individual and situational factors modulate the behavioral impact of cardiac regulation.
•We tested the relationship between cardiac interoceptive awareness and neural responses preceding decision-making.•Cardiac interoceptive awareness was associated with activity in the right anterior ...insula and the left postcentral gyrus.•Right anterior insula activity was related to decision-making performance in accurate cardiac interoceptive awareness.•These findings support a relationship between body feedback and decision-making.
The current study examined the relationship between conscious perception of somatic feedback (interoceptive awareness) and neural responses preceding decision-making. Previous research has suggested that decision-making is influenced by body signals from the periphery or the central representation of the periphery. Using event-related fMRI, participants whose interoceptive awareness was assessed using a heartbeat perception paradigm performed the Iowa Gambling Task. The results show a positive relationship between the degree of interoceptive awareness and selection related activity in the right anterior insula and the left postcentral gyrus. Neural activity within the right anterior insula was associated with decision-making performance only in individuals with accurate but not in those with non-accurate interoceptive awareness. These findings support the role of somatic feedback in decision-making processes. They indicate that the right anterior insula holds a representation of somatic markers and that these are more strongly processed with increased interoceptive awareness.
In the present study we provide the first empirical evidence that viscero‐sensory feedback from an internal organ is associated with decision‐making processes. Participants with accurate vs. poor ...perception of their heart activity were compared with regard to their performance in the Iowa Gambling Task. During this task, participants have to choose between four card decks. Decks A and B yield high gains and high losses, and if played continuously, result in net loss. In contrast, decks C and D yield small gains and also small losses, but result in net profit if they are selected continuously. Accordingly, participants have to learn to avoid the net loss options in favor of the net gain options. In our study, participants with good cardiac perception chose significantly more of the net gain and fewer of the net loss options. Our findings document the substantial role of visceral feedback in decision‐making processes in complex situations.
Occupational stress, dissatisfaction, higher risk for chronical and psychological disorders impairs the well-being of care nurses staff and maintaining the quality of elderly and disabled care. ...However, few studies have compared the psychological and physical stress in nurses working in inpatient and outpatient care settings.
The aim of the present study was to compare perceived stress, workload and psychosomatic complaints in nurses working in inpatient and outpatient care settings.
158 care nurses working in geriatric and disabled care participated in the quantitative cross-sectional survey study. Comparisons of stress, workload and psychosomatic complaints were made between the inpatient and outpatient care group.
Nurses working in the outpatient care reported more subjective experience of stress and more workload compared to nurses working in inpatient care. Additionally, nurses working in outpatient care reported more psychosomatic complaints compared to nurses in inpatient care.
Our results suggest that inpatient and outpatient nurses experience their nursing activities differently stressful. In future research the differential stress factors need to be explored to provide adequate job training and develop stress prevention programs.
Background: Occupational stress, dissatisfaction, higher risk for chronical and psychological disorders impairs the well-being of care nurses staff and maintaining the quality of elderly and disabled ...care. However, few studies have compared the psychological and physical stress in nurses working in inpatient and outpatient care settings. Aim: The aim of the present study was to compare perceived stress, workload and psychosomatic complaints in nurses working in inpatient and outpatient care settings. Methods: 158 care nurses working in geriatric and disabled care participated in the quantitative cross-sectional survey study. Comparisons of stress, workload and psychosomatic complaints were made between the inpatient and outpatient care group. Results: Nurses working in the outpatient care reported more subjective experience of stress and more workload compared to nurses working in inpatient care. Additionally, nurses working in outpatient care reported more psychosomatic complaints compared to nurses in inpatient care. Conclusions: Our results suggest that inpatient and outpatient nurses experience their nursing activities differently stressful. In future research the differential stress factors need to be explored to provide adequate job training and develop stress prevention programs.
Objective
In addition to central nervous sensitization, affect dysregulation constitutes an important factor in the pathogenesis of fibromyalgia syndrome (FMS). The present study is concerned with ...emotional influences on information processing in FMS. The hypothesis of attentional bias, i.e., selective processing of negatively connoted stimuli, was tested.
Methods
Twenty‐seven female FMS patients and 34 healthy women undertook an emotional modification of the Stroop task. Subjects had to decide whether the colors of positive, negative, and neutral adjectives accorded with color words presented in black. Attentional bias was defined as delay in color naming of emotional words relative to neutral words. Affective and anxiety disorders, pain severity, as well as medication were considered as possible factors mediating the expected interference.
Results
Patients showed marked attentional bias, manifested in a greater response delay due to negative words compared with the control group. Among the clinical features, pain severity was most closely associated with the extent of the interference. While depression played only a subordinate role, anxiety and medication were without effect.
Conclusions
The study provides evidence of emotionally driven selective attention in FMS. Attentional bias to negative information may play an important role in the vicious circle between negative affective state and pain augmentation. In the management of FMS pain, strategies aiming at conscious direction of attention may be helpful, e.g., imagery techniques or mindfulness training.
The study investigated relationships between autonomic cardiovascular control and attentional performance. In 60 healthy subjects R-wave to pulse interval (RPI), respiratory sinus arrhythmia (RSA), ...heart rate variability in the mid-frequency (MF) band and sensitivity of the cardiac baroreflex (BRS) were assessed at rest and during a visual attention test. All parameters decreased markedly during test execution. Lower values of resting BRS predicted increased performance. On-task RPI, RSA, MF power and BRS were inversely related to attentional functioning, with RSA accounting for the largest portion of test score variance. The inverse association between resting BRS and performance is discussed as reflecting the bottom-up modulation of cerebral function by baroreceptor activity. The results concerning the on-task measures suggest that a pattern of cardiovascular adjustment including enhanced sympathetic and reduced vagal cardiovascular influences, as well as baroreflex inhibition may induce an adaptive state associated with improved cognitive-attentional functioning.
The study investigated relationships between affective states and decision-making performance using the Iowa Gambling Task. Playing the task involves making decisions between four card decks. Two ...decks yield high gains and high losses, and if chosen continuously these decks lead to net loss. In contrast, the other two decks yield small gains and small losses, but lead to net profit if they are selected continuously. Correlation and regression analyses revealed a positive relationship between trait-anxiety and decision-making performance and a negative relationship between self-reported emotion regulation and decision-making performance. In addition, anticipatory skin conductance responses were related positively to trait-anxiety and negatively to self-reported emotion regulation. These findings support the somatic marker hypothesis suggesting that emotions facilitate decision-making in complex situations that have uncertain future outcomes.
Increased cerebral blood flow during processing of acute pain has repeatedly been observed in fibromyalgia syndrome. The study investigated the time dynamics of the pain-related hemodynamic response ...in fibromyalgia using transcranial Doppler sonography.
In 25 women with fibromyalgia and 25 healthy participants, blood flow velocities in the anterior and middle cerebral arteries of both hemispheres were recorded, while heat stimuli of 45°C were applied to their forearms. Thermal pain threshold and subjective pain experience during stimulation were assessed, and the participants completed the McGill Pain Inventory, Beck Depression Inventory, and State-Trait Anxiety Inventory.
The early component of the blood flow response in both anterior cerebral arteries, that is, the steep flow increase during the initial stimulation period, was more pronounced in the patients than in the controls (mean standard deviation = 1.28% 1.85% versus 0.24% 1.58%, p = .04). The patients showed lower pain threshold (p = .018), stronger sensory and affective pain experience (p < .001), and increased values on all questionnaire scales (all p values < .001). Although higher scores on each of the scales were associated with a stronger early blood flow response (r values ranging from 0.17 to 0.36), clinical pain severity proved to be the best predictor (β = .33, p = .02).
The increased blood flow response in the anterior cerebral arteries reflects hyperactivity of medial structures of the neuromatrix of nociception, structures involved in the processing of affective and cognitive aspects of pain. Aberrances in cerebral blood flow related to fibromyalgia and its clinical characteristics become particularly apparent in the enhancement of the initial component of the hemodynamic response.
▶ Cardiac perception is associated with a superior completion of emotional wordstems. ▶ Completion of neutral wordstems is not moderated by cardiac perception. ▶ Arousal and affective states do not ...modulate wordstem completion. ▶ Perception of visceral feedback facilitates cognitive processing.
In the present study we investigated the impact of viscero-sensory feedback on memory performance. Participants with good and poor perception of their heart activity were presented with positive, negative and neutral words while heart rate and skin conductance were measured. After a distractor task, participants were asked to complete primed and unprimed wordstems. Implicit memory performance was assessed in terms of accuracy of completion. In our study, participants with good cardiac perception completed significantly more wordstems of previously presented positive and negative words, whereas no group differences were found for wordstems of neutral words and physiological measures during encoding. Our findings document a substantial role of visceral feedback in implicit memory processes. They are in line with Damasio's somatic marker hypothesis stating that access to information about somatic processes facilitates cognitive processing.
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