The Levels of Emotional Awareness Scale (LEAS) is a well-validated performance measure of trait emotional awareness (EA), which is associated with psychological and physical problems. EA is,... Show moreThe Levels of Emotional Awareness Scale (LEAS) is a well-validated performance measure of trait emotional awareness (EA), which is associated with psychological and physical problems. EA is, however, expected to vary over time and we aimed to adapt the LEAS to permit the measurement of EA in daily life as a function of momentary state. Twenty-five students completed 12 ecological momentary assessments (EMAs) of EA across 2 days. The correlation between the mean EMAs of EA and trait EA, and the change over time in EA, was also examined. Findings revealed a significant positive correlation between state and trait EA. The within-person reliability was substantial, suggesting that EMAs can reliably assess EA over time across individuals. Importantly, latent state-trait analysis showed that about 50% of EA variability was due to state variance whereas only 2% of EA variability was due to trait variance. Preliminary psychometric properties suggest that the developed method allows for the measurement of EA in daily life and supports the claim that EA can be measured using both hypothetical (as in the LEAS) and real-life (using EMAs) scenarios. Show less
Frequent or chronic reduction in heart rate variability (HRV) is a powerful predictor of cardiovascular disease, and psychological stress has been suggested to be a co-determinant of this reduction... Show moreFrequent or chronic reduction in heart rate variability (HRV) is a powerful predictor of cardiovascular disease, and psychological stress has been suggested to be a co-determinant of this reduction. Recently, we evaluated various methods to measure additional HRV reduction in everyday life and to relate these reductions to psychological stress. In the current paper, we thoroughly evaluate these methods and add two new methods in both newly acquired and reanalyzed datasets. All of these methods use a subset of 24 h worth of HRV and movement data to do so: either the first 10 min of every hour, the full 24 h, a combination of 10 min from three consecutive hours, a classification of level of movement, the data from day n to detect episodes in day n + 1, or a range of activities during lab calibration. The method that used the full 24 h worth of data detected the largest percentage of episodes of reduced additional HRV that matched with self-reported stress levels, making this method the most promising, while using the first 10 min from three consecutive hours was a good runner-up. Show less
Stress-related stimuli may be presented outside of awareness and may ultimately influence health by causing repetitive increases in physiological parameters, such as blood pressure (BP). In this... Show moreStress-related stimuli may be presented outside of awareness and may ultimately influence health by causing repetitive increases in physiological parameters, such as blood pressure (BP). In this study, we aimed to corroborate previous studies that demonstrated BP effects of subliminally presented stress-related stimuli. This would add evidence to the hypothesis that unconscious manifestations of stress can affect somatic health. Additionally, we suggest that these findings may be extended by measuring affective changes relating to these physiological changes, using measures for self-reported and implicit positive and negative affectivity. Using a repeated measures between-subject design, we presented either the prime word “angry” (n = 26) or “relax” (n = 28) subliminally (17 ms) for 100 trials to a student sample and measured systolic and diastolic BP, heart rate (HR), and affect. The “angry” prime, compared to the “relax” prime, did not affect any of the outcome variables. During the priming task, a higher level of implicit negative affect (INA) was associated with a lower systolic BP and diastolic BP. No association was found with HR. Self-reported affect and implicit positive affect were not related to the cardiovascular (CV) activity. In sum, anger and relax primes elicited similar CV activity patterns, but implicit measures of affect may provide a new method to examine the relationship between (unconscious) stress and health. Show less
Worry is an important mediator in the relation between stressors and health. This pilot study examined whether a smartphone-based in time worry-reduction training was feasible and improved... Show moreWorry is an important mediator in the relation between stressors and health. This pilot study examined whether a smartphone-based in time worry-reduction training was feasible and improved physiological health (i.e. increased heart rate variability [HRV]). A total of 26 high-worriers were randomised to an experimental or active-control condition (EC and CC respectively). Participants in both conditions registered emotions 5 times daily for a month. The EC additionally received worry-reduction training with mindfulness exercises. Primary outcomes were feasibility and HRV measured at baseline, after 2 weeks (halfway), and at 4 weeks (post-intervention). Both training conditions were feasible and well received. HRV increased in the EC and CC, but this increase did not differ between conditions. Preliminary findings suggest that both training conditions are feasible and might improve HRV, which is an important predictor of cardiovascular disease. This pilot study only provided preliminary evidence, but it laid the groundwork for future randomised controlled trials that ought to include more participants and a waitlist control group in order to get more definitive evidence of the effectiveness of the intervention. Show less
Burger, A.M.; Does, W. van der; Brosschot, J.F.; Verkuil, B. 2020
Fear overgeneralization is thought to be one of the cardinal processes underlying anxiety disorders, and a determinant of the onset, maintenance and recurrence of these disorders. Animal studies... Show moreFear overgeneralization is thought to be one of the cardinal processes underlying anxiety disorders, and a determinant of the onset, maintenance and recurrence of these disorders. Animal studies have shown that stimulating the vagus nerve (VNS) affects neuronal pathways implicated in pattern separation and completion, suggesting it may reduce the generalization of a fear memory to novel situations. In a one-day study, 58 healthy students were subjected to a fear conditioning, fear generalization, and fear extinction paradigm. Participants were randomly assigned to receive either transcutaneous auricular VNS (tVNS; final N = 29) or sham stimulation (final N = 29) during the generalization and extinction phases. tVNS did not affect fear generalization, as reflected by US expectancy ratings and fear potentiated startle responses. However, participants who received tVNS reported lower US expectancy ratings to the CS + during the extinction phase, possibly reflecting a stronger declarative extinction of fear. No effects of tVNS on fear potentiated startle responses during extinction were found. The pattern of findings regarding extinction of declarative fear suggest a facilitating effect of tVNS. Show less
Burger, A.M.; Does, W. van der; Thayer, J.F.; Brosschot, J.F.; Verkuil, B. 2019
Worrying is a central component of anxiety disorders. We tested whether non-invasive vagus nerve stimulation reduces negative thought intrusions in high worriers. Worry was assessed with a... Show moreWorrying is a central component of anxiety disorders. We tested whether non-invasive vagus nerve stimulation reduces negative thought intrusions in high worriers. Worry was assessed with a Breathing Focus Task, which consists of a pre-worry period, a worry induction, and a post-worry period. Ninety-seven high worriers were randomly allocated to receive transcutaneous electrical stimulation of the auricular branch of the vagus nerve at the concha (tVNS), or of the earlobe (sham stimulation) throughout the lab session. Participants who received tVNS reported significantly fewer negative thought intrusions during the pre-worry period, but the effects of tVNS after the worry induction were mixed. An exploratory analysis indicated that participants in the tVNS condition were more likely to report negative thought intrusions shortly after the worry induction, but became less likely to do so as the post-worry period went on. No effects of tVNS on RMSSD were observed. These findings provide preliminary indications that tVNS may decrease the occurrence of worrisome thoughts. Show less
Cardiovascular disease is the leading cause of death in the western world. Frequent or chronic reductions in heart rate variability (HRV) are a powerful predictor of cardiovascular disease.... Show moreCardiovascular disease is the leading cause of death in the western world. Frequent or chronic reductions in heart rate variability (HRV) are a powerful predictor of cardiovascular disease. Psychological stress has been suggested to be an important factor in the development of reduced HRV. Recently, Verkuil et al. (2016) introduced a laboratory-based method to measure additional HRV reduction in everyday life, and reductions in HRV related to psychological stress. In the current paper, we discuss alternative methods to detect additional HRV reductions, in real life data sets without the necessity of laboratory-based calibration, and even in existing data sets. All of these methods use a subset of 24 h' worth of HRV and movement data to do so: either the first 10 min of every hour, the full 24 h, a combination of 10 min from three consecutive hours, or a classification of level of movement. We also present a method to visualize HRV and movement data to be able to detect episodes of reduced additional HRV optically. The method that used the full 24 h' worth of data detected the largest percentage of episodes of reduced additional HRV that actually match with self-reported stress levels, making this method the most promising. Show less
Burger, A.M.; Dies, I. van; Does, W. van der; Hysaj, M.; Thayer, J.F.; Brosschot, J.F.; Verkuil, B. 2018
Objective: Perseverative cognition (e.g. worry) and unconscious stress are suggested to be important mediators in the relation between stressors and physiological health. We examined whether a... Show moreObjective: Perseverative cognition (e.g. worry) and unconscious stress are suggested to be important mediators in the relation between stressors and physiological health. We examined whether a smartphone-based worry-reduction training improved a physiological marker of stress (i.e. increased heart rate variability [HRV]) and unconscious stress.Design: Randomised-controlled trial was conducted with individuals reporting work stress (n = 136). Participants were randomised to the experimental, control or waitlist condition (resp. EC, CC, WL). The EC and CC registered emotions five times daily for four weeks. The EC additionally received a worry-reduction training with mindfulness exercises.Main Outcome Measures: Primary outcome was 24-h assessments of HRV measured at pre-, mid- and post-intervention. Secondary outcomes were implicit affect and stress. Effects on heart rate and other psychological outcomes were explored.Results: A total of 118 participants completed the study. No change from pre- to post-intervention was observed for the primary or secondary outcomes. The change over time was not different between conditions.Conclusion: Findings suggest that the training was ineffective for improving HRV or psychological stress. Future studies may focus on alternative smartphone-based stress interventions, as stress levels are high in society. There is need for easy interventions and smartphones offer possibilities for this. Show less
Self-esteem moderates the relationship between stress and (cardiovascular) health, with low self-esteem potentially exacerbating the impact of stressors. Boosting self-esteem may therefore help to... Show moreSelf-esteem moderates the relationship between stress and (cardiovascular) health, with low self-esteem potentially exacerbating the impact of stressors. Boosting self-esteem may therefore help to buffer against stress. Subliminal evaluative conditioning (SEC), which subliminally couples self-words with positive words, has previously been successfully used to boost self-esteem, but the existing studies are in need of replication. In this article, we aimed to replicate and extend previous SEC studies. The first 2 experiments simultaneously examined whether SEC increased self-esteem (Experiment 1, n=84) and reduced cardiovascular reactivity to a stressor in high worriers (Experiment 2, n=77). On the basis of these results, the 3rd experiment was set up to examine whether an adjusted personalized SEC task increased self-esteem and reduced cardiac activity in high worriers (n=81). Across the 3 experiments, no effects were found of SEC on implicit or explicit self-esteem or affect or on cardiovascular (re)activity compared to a control condition in which the self was coupled with neutral words. The results do not support the use of the subliminal intervention in its current format. As stress is highly prevalent, future studies should focus on developing other cost-effective and evidence-based interventions. Show less
