Are Large Physiological Reactions to Acute Psychological Stress Always Bad for Health?

How we react physiologically to stress has long been considered to have implications for our health. There is now persuasive evidence that individuals who show large cardiovascular reactions to stress are at increased risk of developing cardiovascular disease, particularly hypertension. By implication, low reactivity is protective or benign. However, there is recent evidence that low reactivity may predict elevated risk for a range of adverse health outcomes, such as depression, obesity, poor self-reported health, and compromised immunity. In addition, low cortisol and cardiovascular reactivity may be a characteristic of individuals with addictions to tobacco and alcohol, as well as those at risk of addiction and those who relapse from abstinence. Our ideas about reactivity may have to be revised in the light of such findings

Biological correlates of moral decision making

Recently an association between parasympathetic activity at rest (assessed via heart rate variability; HRV; RMSSD) and utilitarian judgements was reported (Park et al., 2016). One aim of the project is to replicate these findings and to extend them by including an indicator of sympathetic activity. To this end, electrodermal activity (EDA) will be recorded as well. Furthermore, previous findings suggest a connection between testosterone and utilitarian judgement tendencies. The role of testosterone and the CAG polymorphism in the androgen receptor gene are thus investigated as are the influence of sex, menstrual cycle phase and the use of oral contraceptives. Update 01/30/2020: Data collection was completed in December 2019 (N=157). Preprocessing of electrophysiological data and hormone analysis are underway. Genotyping for the CAG polymorphism in the AR gene will be done in February / March 2020. Update 02/14/2020: Hormone analyses are complete. Update 03/2020: Due to COVID-19, genotyping is unfortunately delayed. Update 08/2020: A preprint of the first paper of the study is available: https://psyarxiv.com/7vy5u

Deficits in emotion regulation partly mediate the relation between sleep problems and depressive symptoms in adolescent inpatients with depression

Sleep problems are a risk factor for the development of depressive disorders and influence the severity and treatment of depressive symptoms negatively. To enhance treatment for depression in young people, it is important to advance the understanding of the relationship between sleep problems and depressive symptoms. Since deficits in emotion regulation are discussed as possible underlying mechanisms, the present study investigated the mediating effect of maladaptive and adaptive strategies for emotion regulation on the association between sleep problems and depressive symptoms. Emotion regulation strategies, depression and sleep quality were assessed via self-report in a large clinical sample of 602 adolescents (age 13–18 years) who reported clinically relevant symptoms of depression. The questionnaires were assessed at admission for inpatient psychiatric treatment. Correlation and mediation analyses were performed. There was a significant partial mediation effect ($\beta$ = 0.554, $\it p$ < 0.001, $R_2$ = 0.527), indicating that sleep problems influenced depressive symptoms via the decreased use of adaptive strategies and the increased use of maladaptive strategies. Additionally, a direct effect of sleep problems on depressive symptoms emerged ($\beta$ = 0.251, $\it p$ < 0.001, $R_2$ = 0.364). This cross-sectional study provides first indications that additional treatment modules focusing on sleep and ER skills in prevention and treatment programs for adolescents would be important steps. Longitudinal studies are needed to substantiate these results

Adolescent depression: Study protocol for a randomized, controlled, double-blind multicenter parallel group trial of Bright Light Therapy in a naturalistic inpatient setting (DeLight)

Abstract Background Depressive disorders are among the most prominent health problems in youth. Even with the best available pharmacological and non-pharmacological treatments, remission rates are low. Without early treatment, depression in youth is associated with a high risk of symptom progression, chronicity, co-morbidity, and suicidal behavior. Thus, adolescent depression is a prime candidate for innovation in treatment. In depressive adults, meta-analytic evidence has proven that bright light therapy (BLT) is a potent low-threshold intervention, promising due to easy application, low side effects, and optimized compliance. In adolescents, studies with small samples show promising effects. This randomized controlled trial will examine the effectiveness of BLT in youth inpatients. Methods/design In this randomized, controlled, double-blind multicenter parallel group trial, morning BLT is applied for four weeks in addition to treatment as usual (TAU) for depressed youth inpatients (daily morning exposure to bright light via light-emitting glasses, 10,000 lx, for 30 min) and will be compared to a control condition (placebo light treatment, red light, identical light glasses). The primary objective is to assess whether BLT reduces symptoms of depression in youth with greater effect compared to placebo light therapy. Secondary objectives are to examine the impact of BLT on responder status, application of antidepressant medication, and further depression-related symptoms (sleep, activity, quality of life, satisfaction with health, general psychopathology, alertness, and circadian function). N = 224 patients will be recruited in a naturalistic inpatient setting. A follow-up will be carried out after three and six months. Discussion The study aims to discuss and evaluate BLT as an additive method supporting standardized clinical procedures dealing with severe to moderate depressive symptoms in youth. Trial registration German Clinical Trials Register, DRKS00013188. Registered on November 30, 2017