Single-Session Attention Bias Modification Training in Victims of Work-Related Accidents

Individuals who experienced traumatic work-related accidents frequently show cognitive deficits and biased processing of trauma-relevant information, which, in turn, could increase the risk of further accidents. The attention bias modification training (ABMT) is designed to reduce hypervigilance toward and enhance attentional disengagement from threat stimuli. The aim of the present study was to assess whether it is possible to implicitly reduce the attentional bias toward trauma-related stimuli through a single session of ABMT in individuals who experienced a traumatic occupational accident. Nineteen individuals who had experienced a traumatic work-related accident and 11 workers who never experienced a work accident (control group) underwent a preliminary assessment of cognitive performance (executive functions and sustained attention) and an evaluation of the attentional bias toward accident-related pictures by means of a dot-probe task. The results showed that injured workers performed more poorly than controls in tasks of executive functions and concentration abilities. Also, injured workers showed an attentional bias toward trauma reminders (i.e., faster reaction times to probes replacing trauma-related pictures). Injured workers were then randomly allocated to a single-session of ABMT (N = 10) or to an Attention Control Condition (ACC; N = 9). After the training, the dot-probe task was administered again to assess changes in the attentional bias toward trauma-relevant pictures. Injured workers who underwent the ABMT, but not those who underwent the ACC, showed a significant reduction of the attentional bias from pre- to post-training. Overall, these results support previous findings reporting an association between traumatic occupational accidents and cognitive dysfunctions. More importantly, these preliminary findings add to a growing body of evidence suggesting the effectiveness of a short ABMT in reducing the attentional bias after a traumatic workplace accident

The interaction between depression and autonomic dysregulation in patients undergoing cardiac surgery

In this thesis four studies have been described that were primarily meant to investigate the psychophysiological mechanisms underlying the relationship between depression and increased cardiac risk in patients after first time cardiac surgery, and, secondarily, to test the effectiveness of a cardiorespiratory biofeedback training in reducing cardiac risk in these patients. Findings from the first study confirm and extend previous data on depressed patients with cardiovascular diseases by showing that also depressed patients after first time cardiac surgery had lowered vagal control on the heart, compared to patients without depression. In the second study, this relationship has been shown to be partially mediated by altered emotion regulation as a trait, and, specifically, by excessive use of suppression of emotions. Findings from the third study displayed that patients with postoperative depression had significantly greater stress response, characterized by disproportionate vagal withdrawal, specifically during unpleasant stressors, compared to nondepressed patients after surgery. More importantly, findings from the fourth study provide new evidence supporting the usefulness of a biofeedback of respiratory sinus arrhythmia training, in increasing vagal control on the heart and improving depressive symptoms. In conclusion, the present thesis provides further information on the psychophysiological mechanisms underlying the relationship between depression and increased cardiac risk, and more importantly, yields evidence in support of the effectiveness of biofeedback training in patients after cardiac surgery

Multidimensional components of (state) mathematics anxiety: Behavioral, cognitive, emotional, and psychophysiological consequences

The present study aimed to analyze the different components of state mathematics anxiety that students experienced while solving calculation problems by manipulating their stress levels. A computerized mathematical task was administered to 165 fifth-graders randomly assigned to three different groups: positive, negative, and control conditions, in which positive, negative, or no feedback during the task was given, respectively. Behavioral (task performance), emotional (negative feelings), cognitive (worrisome thoughts and perceived competence), and psychophysiological responses (skin conductance and vagal withdrawal) were analyzed. Behavioral responses did not differ in the positive and negative conditions, while the latter was associated with children's reportedly negative emotional states, worries, and perceived lack of competence. The stress induced in the negative condition led to an increase in skin conductance and cardiac vagal withdrawal in children. Our data suggest the importance of considering students' interpretation of mathematics-related experiences, which might affect their emotional, cognitive, and psychophysiological responses

Not All Competitions Come to Harm! Competitive Biofeedback to Increase Respiratory Sinus Arrhythmia in Managers

Despite the positive impact on achievement, competition has been associated with elevated psychophysiological activation, potentially leading to a greater risk of cardiovascular diseases. Competitive biofeedback (BF) can be used to highlight the effects of competition on the same physiological responses that are going to be controlled through BF. However, it is still unknown whether competition could enhance the effects of respiratory sinus arrhythmia (RSA)-BF training in improving cardiac vagal control. The present study explored whether competitive RSA-BF could be more effective than non-competitive RSA-BF in increasing RSA in executive managers, who are at higher cardiovascular risk of being commonly exposed to highly competitive conditions. Thirty managers leading outstanding private or public companies were randomly assigned to either a Competition (n = 14) or a Control (n = 16) RSA-BF training lasting five weekly sessions. Managers in the Competition group underwent the RSA-BF in couples and each participant was requested to produce a better performance (i.e., higher RSA) than the paired challenger. After the training, results showed that managers in the Competition group succeeded in increasing cardiac vagal control, as supported by the specific increase in RSA (p < 0.001), the standard deviation of R-R wave intervals (SDNN; p < 0.001), and root mean square of the successive differences between adjacent heartbeats (rMSSD; p < 0.001). A significant increase in the percentage of successive normal sinus beat to beat intervals more than 50 ms (pNN50; p = 0.023; partial eta squared = 0.17), low frequency (p < 0.001; partial eta squared = 0.44), and high frequency power (p = 0.005; partial eta squared = 0.25) emerged independently from the competitive condition. Intriguingly, managers who compete showed the same reduction in resting heart rate (HR; p = 0.003, partial eta squared = 0.28), systolic blood pressure (SBP; p = 0.013, partial eta squared = 0.20), respiration rate (p < 0.001; partial eta squared = 0.46), and skin conductance level (SCL; p = 0.001, partial eta squared = 0.32) as non-competitive participants. Also, the same reduction in social anxiety (p = 0.005; partial eta squared = 0.25), state (p = 0.038, partial eta squared = 0.14) and trait anxiety (p = 0.001, partial eta squared = 0.31), and depressive symptoms (p = 0.023, partial eta squared = 0.17) emerged in the two groups. The present results showed that managers competing for increasing RSA showed a greater improvement in their parasympathetic modulation than non-competing managers. Most importantly, competition did not lead to the classic pattern of increased psychophysiological activation under competitive RSA-BF. Therefore, competition could facilitate the use of self-regulation strategies, especially in highly competitive individuals, to promote adaptive responses to psychological stress

The moderating role of depressive symptoms in the association between heart rate variability and cognitive performance in cardiac patients

Introduction: Coronary heart disease (CHD) is strongly associated with cognitive impairment, which is a core feature of depression, highly prevalent in patients with CHD. Interestingly, patients with CHD and individuals with depression display reduced heart rate variability (HRV), which proxies a complex network integrating autonomic and attentional systems. This study investigated the moderating role of depressive symptoms in the relation between reduced HRV and cognitive performance in patients with CHD. Method: The sample included 274 patients with CHD (mean [standard deviation] age = 62 [9.5] years; 13 % women) admitted to cardiac rehabilitation units. Visual attention and task switching were assessed through the Trail Making Test (TMT). Depressive symptoms were assessed with the Beck Depression Inventory-II (BDI-II). Resting electrocardiographic recordings were collected to compute HRV indices. Results: Patients with more severe depressive symptoms displayed an inverse association between HRV and cognitive performance (TMT-A: b = -0.08, p = .022; TMTB: b = -0.07, p = .042), whereas patients with milder depressive symptoms showed no significant association (TMT-A: b = -0.00, p = .90; TMTB: b = -0.02, p = .44). Conclusions: Depressive symptoms may strengthen the relation between reduced HRV and poorer cognitive performance in cardiac patients. The presence of depressive symptoms may signal the dysfunction of a network subserving autonomic and cognitive function

The interaction between depression and autonomic dysregulation in patients undergoing cardiac surgery

In this thesis four studies have been described that were primarily meant to investigate the psychophysiological mechanisms underlying the relationship between depression and increased cardiac risk in patients after first time cardiac surgery, and, secondarily, to test the effectiveness of a cardiorespiratory biofeedback training in reducing cardiac risk in these patients. Findings from the first study confirm and extend previous data on depressed patients with cardiovascular diseases by showing that also depressed patients after first time cardiac surgery had lowered vagal control on the heart, compared to patients without depression. In the second study, this relationship has been shown to be partially mediated by altered emotion regulation as a trait, and, specifically, by excessive use of suppression of emotions. Findings from the third study displayed that patients with postoperative depression had significantly greater stress response, characterized by disproportionate vagal withdrawal, specifically during unpleasant stressors, compared to nondepressed patients after surgery. More importantly, findings from the fourth study provide new evidence supporting the usefulness of a biofeedback of respiratory sinus arrhythmia training, in increasing vagal control on the heart and improving depressive symptoms. In conclusion, the present thesis provides further information on the psychophysiological mechanisms underlying the relationship between depression and increased cardiac risk, and more importantly, yields evidence in support of the effectiveness of biofeedback training in patients after cardiac surgery.Nel presente lavoro di tesi sono riportati quattro studi volti ad indagare, in primo luogo, i meccanismi psicofisiologici coinvolti nell’associazione tra depressione ed incrementato rischio cardiovascolare e, in secondo luogo, a valutare l’efficacia di un training di biofeedback cardiorespiratorio in pazienti sottoposti al primo intervento i cardiochirurgia. I risultati emersi dal primo studio hanno confermato ed esteso i dati sulla depressione in pazienti cardiopatici, mostrando che la depressione si associa ad un ridotto tono vagale sul cuore anche in pazienti postcardiochirugici. I dati emersi dal secondo studio hanno mostrato che tale relazione viene parzialmente mediata da un tratto particolare di regolazione emozionale, ovvero, da un eccessivo utilizzo della soppressione delle emozioni. Il terzo studio ha rilevato che pazienti depressi a seguito di cardiochirurgia mostrano una maggiore risposta da stress, caratterizzata da un eccessiva diminuzione del controllo vagale sul cuore, specificamente durante situazioni spiacevoli. Infine, il quarto studio, ha fornito dati a supporto dell’efficacia del biofeedback dell’aritmia sinusale respiratoria nell’incrementare il tono vagale sul cuore e nel ridurre la sintomatologia depressiva in pazienti sottoposti a cardiochirurgia. Concludendo, il presente lavoro di tesi fornisce utili informazioni che vanno ad aggiungersi alla letteratura sui meccanismi psicofisiologici che sottendono la relazione tra depressione ed incrementato rischio cardiovascolare, e, soprattutto, fornisce dati a supporto dell’efficacia di un training tramite biofeedback in pazienti sottoposti a cardiochirurgia

Direct Gaze Holds Attention, but Not in Individuals with Obsessive-Compulsive Disorder

: The attentional response to eye-gaze stimuli is still largely unexplored in individuals with obsessive-compulsive disorder (OCD). Here, we focused on an attentional phenomenon according to which a direct-gaze face can hold attention in a perceiver. Individuals with OCD and a group of matched healthy controls were asked to discriminate, through a speeded manual response, a peripheral target. Meanwhile, a task-irrelevant face displaying either direct gaze (in the eye-contact condition) or averted gaze (in the no-eye-contact condition) was also presented at the centre of the screen. Overall, the latencies were slower for faces with direct gaze than for faces with averted gaze; however, this difference was reliable in the healthy control group but not in the OCD group. This suggests the presence of an unusual attentional response to direct gaze in this clinical population

Improving Managers\u2019 Psychophysical Well-Being: Effectiveness of Respiratory Sinus Arrhythmia Biofeedback

High work stress has been consistently associated with disturbed autonomic balance, specifically, lowered vagal cardiac control and increased sympathetic activity, which may lead to increased cardiovascular risk. Stress management procedures have been proposed to reduce autonomic dysfunctions related to work stress in different categories of workers exposed to heightened work demands, while a limited number of studies addressed this issue in managers. The present study was aimed at evaluating the effectiveness of a respiratory sinus arrhythmia (RSA) biofeedback (BF) intervention on psychological and physiological outcomes, in managers with high-level work responsibilities. Thirty-one managers leading outstanding private or public companies were randomly assigned to either a RSA-BF training (RSA-BF; N = 16) or a control group (N = 15). The RSA-BF training consisted of five weekly 45 min sessions, designed to increase RSA, whereas controls had to provide a daily stress diary once a week. After the training, managers in both groups reported reduced heart rate at rest, lower anxiety levels and improvement in health-related quality of life. More importantly, managers in the RSA-BF group showed increased vagal control (as indexed by increased RSA), decreased sympathetic arousal (as indexed by reduced skin conductance and systolic blood pressure) and lower emotional interferences, compared to managers in the control group. Results from this study showed that RSA-BF training was effective in improving cardiac autonomic balance at rest. Moreover, findings from this study underline the effectiveness of biofeedback in reducing psychophysiological negative outcomes associated with stress in managers