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Facilitated processing of negative information might contribute to the etiopathogenesis and maintenance of depressive symptoms. Cardiac vagal tone, indexed by heart rate variability (HRV), is believed to represent a proxy of the functional integrity of the neural networks implicated in brooding rumination, affective interference and depression. The present study examined whether HRV may moderate the relation between brooding rumination, affective interference and depressive symptoms in a sample of healthy individuals (n = 68) with different degrees of depressed mood. Self-report measures of depression and brooding were collected, whereas the emotional Stroop task was employed to measure affective interference. Three-minute resting-state electrocardiogram was recorded to obtain time- and frequency-domain vagally mediated HRV parameters. Stepwise linear regression analyses revealed that HRV was a significant moderator of the positive association between depression and brooding rumination, but not of the association between depression and affective interference. An integrated model is supported, in which vagally mediated HRV appeared to potentiate the positive link between depressive symptoms and brooding rumination. Considering that HRV and brooding rumination were found to have an interacting role in determining the severity of depressive symptoms, they may represent potential clinical targets in the prevention and treatment of depressive symptoms., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Depression has been associated with poor health-related quality of life (HRQoL) in patients with congestive heart failure (CHF). However, to date, whether somatic-affective and cognitive-depressive symptoms differently contribute to poor HRQoL and behavioral functional capacity in patients with CHF has yet to be investigated., Objective: To examine the differential influence of somatic-affective vs cognitive-depressive symptoms on HRQoL and behavioral functional capacity in CHF patients., Method: Overall, 55 patients with CHF completed a psychologic evaluation, including the Minnesota Living with Heart Failure Questionnaire, the Beck Depression Inventory-II, and the Beck Anxiety Inventory for HRQoL, depressive, and anxiety symptoms, respectively. The patients completed the Instrumental Activities of Daily Living Questionnaire and the 6-minute walk test for behavioral functional capacity. Hierarchical regression analyses were used to predict HRQoL and behavioral functional capacity from Beck Depression Inventory-II and Beck Anxiety Inventory scores., Results: Somatic-affective depressive symptoms were associated with physical (β = 0.37, p = 0.005) and emotional (β = 0.39, p = 0.008) Minnesota Living with Heart Failure Questionnaire subscale scores. Likewise, somatic-affective depressive symptoms predicted Instrumental Activities of Daily Livings Scores (β = 0.43, p = 0.004) and distance ambulated during the 6-minute walk test (β = -0.36, p = 0.029). By contrast, cognitive-depressive symptoms and anxiety were unrelated to HRQoL and behavioral functional capacity (all p > 0.05)., Conclusions: These findings showed that somatic-affective depressive symptoms, but not cognitive-depressive symptoms and anxiety, are associated with poor HRQoL and behavioral functional capacity independent of age, clinical functional status, and medical comorbidities. This study suggests that patients with CHF with somatic-affective rather than cognitive-depressive symptoms or anxiety may be at greater risk of poor HRQoL and behavioral functional capacity., (Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: To examine how impulsiveness influences the emotional modulation of behavioral and neural correlates of response inhibition., Methods: Twenty-nine healthy individuals scoring high (HI, N=16) or low (LI, N=13) on motor impulsiveness performed an emotional Go/Nogo task, including the presentation of pleasant, neutral and unpleasant pictures. Behavioral [reaction times (RTs), accuracy to Go and Nogo trials] and neural (Nogo-N2 and Nogo-P3) correlates of response inhibition were compared between HI and LI groups., Results: Larger Nogo-P3 was found for emotional than neutral stimuli in HI relative to LI group. Faster RTs to Go stimuli and lower accuracy to Nogo stimuli were correlated with larger Nogo-P3 in HI, but not LI, group. No significant interactions between emotion content and impulsiveness for Nogo-N2 and behavioral measures were noted., Conclusions: Impulsiveness influences the emotional modulation of response inhibition by potentiating the response tendencies evoked by the emotional stimuli. Accordingly, high impulsive individuals may need an increased and/or more effortful response inhibition in order to counteract the prepotent tendency to respond elicited by the combination of high trait impulsiveness and high emotional arousal., Significance: The present study suggests the importance to examine how pathological impulsiveness may interact with emotional arousal in modulating response inhibition., (Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)

Studies on electroencephalographic (EEG) alpha band asymmetry at rest have reported that, compared to healthy controls, dysphoric and clinically depressed individuals often display relatively less left- than right-sided cortical activity at anterior scalp sites, and the opposite pattern at posterior scalp sites. It has also been shown that depression-related differences in alpha lateralization at anterior and posterior sites are more likely to emerge during emotional tasks and during visuospatial tasks, respectively, rather than during resting conditions. However, although it is the well-established that posterior cortical activity plays a key role also in emotional processing in healthy individuals, the influence of dysphoria on posterior alpha asymmetry sites during an emotional task has yet to be examined. To this end, dysphoric (n=23) and nondysphoric (n=24) individuals performed an emotional imagery task including pleasant, neutral, and unpleasant narratives. The group with, but not without, dysphoria showed reduced left relative to right cortical activity at anterior sites, irrespective of emotional condition. By contrast, at posterior sites, individuals with dysphoria showed reduced right relative to left parietal activity during unpleasant, but not pleasant and neutral, imagery condition compared to nondysphoric individuals. Results at anterior scalp sites provide further evidence for the presence of a stable pattern of reduced approach motivation in dysphoric individuals. The association between dysphoria and right relative to left parietal hypoactivation in response to unpleasant imagery suggests that dysphoric individuals are more likely to use state-dependent dysfunctional strategies to regulate negative emotions compared to nondysphoric individuals., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: The aim of this study was to examine the influence of depression on heart rate and heart rate variability (HRV) during emotional imagery in patients after cardiac surgery., Methods: Based on the scores of the Center for Epidemiological Studies of Depression (CES-D) scale, 28 patients after cardiac surgery were assigned either to the group with depression (CES-D scores ≥ 16; N = 14) or the one without depression (CES-D scores<16; N = 14). Each patient completed a rest period and an emotional imagery including pleasant, neutral and unpleasant scripts. Inter-beat intervals (IBIs) and HRV were measured during the entire protocol., Results: Compared to nondepressed patients, those with depression had greater reductions in high frequency expressed in normalized units (HF n.u.) during the imaging of the unpleasant script (p = .003, Cohen's d = 1.34). Moreover, HF n.u. were lower during the imaging of the unpleasant script than the pleasant one in depressed patients only (p = .020, Cohen's d = 0.55). CES-D scores were also inversely correlated with residualized changes in IBIs (r = -.38, p = .045) and HF n.u. (r = -.49, p = .008) from rest to the imaging of the unpleasant script., Conclusions: The relationship between depression and increased vagal withdrawal during unpleasant emotional imagery extends to patients after cardiac surgery. The present study suggests that increased vagal withdrawal to negative emotions in patients after cardiac surgery may mediate the conferral of cardiac risk by depression., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: Depression is commonly reported in patients after cardiac surgery and increases the risk of postoperative cardiac morbidity or mortality or both. Although preoperative depression has been implicated as the strongest predictor of depression after surgery, the characteristics thought to influence reactive or persistent depression have been poorly investigated in cardiac surgery patients., Objective: Therefore, the main aim of this study was to examine whether pre-existing depression rather than perioperative variables may predict postoperative reactive or persistent depression., Methods: Overall, 96 patients completed a psychologic evaluation, including the Center for Epidemiologic Studies of Depression scale and the State and Trait Anxiety Inventory for depression and anxiety, respectively, before surgery and at 3-month follow-up., Results: A total of 27 (28%) and 24 (25%) patients had depression preoperatively and at 3-month follow-up, respectively. Postoperative depression was predicted by preoperative scores in Center for Epidemiologic Studies of Depression scale (β = 0.29, p < 0.05) and European System for Cardiac Operative Risk Evaluation (β = 0.22, p < 0.04), but not by procedure-related variables (p > 0.75). Specifically, patients with reactive depression showed greater European System for Cardiac Operative Risk Evaluation than those without depression (p < 0.05), whereas patients with persistent depression had greater preoperative Center for Epidemiologic Studies of Depression scores than those whose depression improved after surgery (p < 0.01)., Conclusions: The severity of pre-existing depression and biomedical risk factors can be markers of depression-related risk 3 months after cardiac surgery in patients with persistent and reactive depression, respectively. An integrated psychologic and biomedical evaluation is essential to anticipate which patients are likely to show depression after cardiac surgery., (Copyright © 2014 Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Heart rate variability (HRV), as an index of autonomic nervous system (ANS) functioning, is reduced by depression after cardiac surgery, but the underlying mechanisms of this relationship are poorly understood. Poor emotion regulation as a core symptom of depression has also been associated with altered ANS functioning. The present study aimed to examine whether emotion dysregulation could be a mediator of the depression-reduced HRV relationship observed after cardiac surgery., Methods: Self-reported emotion regulation and four-minute HRV were measured in 25 depressed and 43 nondepressed patients after cardiac surgery. Mediation analysis was conducted to evaluate emotion regulation as a mediator of the depression-reduced HRV relationship., Results: Compared to nondepressed patients, those with depression showed lower standard deviation of normal-to-normal (NN) intervals (p<.05), root mean square successive difference of NN intervals (p<.004), and number of interval differences of successive NN intervals greater than 50ms (NN50) (p<.05). Increased low frequency (LF) in normalized units (n.u.) and reduced high frequency (HF) n.u. were also found in depressed compared to nondepressed patients (p's<.01). Mediation analysis revealed that suppression of emotion-expressive behavior partially mediated the effect of depression on LF n.u. and HF n.u., Conclusions: Results confirmed previous findings showing that depression is associated with reduced HRV, especially a reduced vagal tone and a sympathovagal imbalance, after cardiac surgery. This study also provides preliminary evidence that increased trait levels of suppression of emotion-expressive behavior may mediate the depression-related sympathovagal imbalance after cardiac surgery., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Objective: To investigate whether the electrocortical activity underlying the anticipation and processing of emotional stimuli is enhanced in individuals with recurrent episodes of vasovagal syncope (VVS)., Methods: Fifteen fainters and 15 age-matched healthy controls were presented a S1-S2 task, where the content of high-arousal pleasant and unpleasant, and neutral pictures (S2) was forecasted by word cues (S1). Stimulus Preceding Negativity (SPN) amplitude during the S1-S2 interval was computed as a measure of affective anticipation. The event-related potentials (ERPs) to S1 and S2 were measured to assess the processing of emotional warning stimuli and pictures., Results: Relative to controls, fainters showed smaller P300 to warning cues anticipating emotional (and, particularly, unpleasant) pictures, and smaller SPN during anticipation of unpleasant pictures. No differences between groups were found with regard to ERP amplitudes during picture processing., Conclusions: These results suggest that the anticipation, rather than the processing, of aversive stimuli is altered in syncopal patients., Significance: The reduced cortical anticipation in fainters might reflect the use of non-adaptive emotion regulation strategies for reducing the impact of upcoming highly arousing (and, particularly, of unpleasant) events., (Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)

Objective: No specific and sensitive method is available in routine clinical practice to detect pain in anaesthetised patients during surgery. The main aim of the present study was to investigate whether intraoperative somatosensory evoked potentials, the bispectral index, electroencephalogram, blood pressure and heart rate change during painful stimulation in cardiac surgery patients., Methods: After induction of anaesthesia, 37 cardiac surgery patients were subjected to increasing electrical stimulation of both the median nerves and subsequent intravenous infusion of remifentanil to suppress this painful stimulation., Results: The higher intensities of electrical stimulation significantly modified the cortical evoked potentials, the electroencephalogram spectral edge frequency and blood pressure. We also observed the appearance of a middle-latency component in the somatosensory evoked cortical potentials between 60 and 70 ms. These neurophysiological and clinical responses were significantly reduced by remifentanil administration., Conclusions: The data suggest that somatosensory evoked potentials might be used to detect and monitor painful stimulation during surgery, unlike the bispectral index, which does not seem to be highly sensitive to intraoperative pain., Significance: Measurement of intraoperative somatosensory evoked potentials provides a specific and sensitive method to monitor the afferent pain pathway in anaesthetised patients., (Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)

The investigation of cognitive functions in individuals who developed post-traumatic symptoms after occupational accidents has been overlooked in the relevant literature. The present study was aimed at assessing attention, memory and executive functions in individuals with post-traumatic symptoms after a workplace accident. Moreover, possible presence of emotional interference from trauma-related cues on attentional performance was evaluated. Results showed that injured workers exhibited deficits in perceptual-psychomotor skills, executive functions, attention and concentration abilities, and memory as compared with healthy controls. With regards to emotional interference on attention, injured workers were found to perform significantly worse than controls specifically when exposed to trauma-related pictures. Overall, these findings suggest that post-traumatic symptoms following a workplace accident are associated with several cognitive and emotional dysfunctions, that should be carefully evaluated to help reduce the frequency and the adverse consequences of occupational accidents., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

The aim of the present study was to investigate the affective modulation of the Stimulus-Preceding Negativity (SPN) and heart rate changes in anticipation of visual stimuli differing in emotional content. A S1-S2 task was employed with a word (S1) indicating the content of a subsequent emotional picture (S2). Both valence and arousal dimensions were manipulated by presenting positive and negative pictures, high and low in arousal. Irrespective of valence, the amplitude of the SPN resulted to be significantly larger preceding high rather than low arousal pictures, indicating that the SPN does reflect the intensity of the motivational engagement ascribed to affective stimuli. Heart rate responses showed a deceleration preceding S2, which was larger preceding high arousal stimuli in comparison with neutral stimuli. Results suggest a coherent response pattern in both cortical and peripheral measures during affective anticipation.

The major goal of the present functional magnetic resonance imaging study was to investigate the influence of disgust sensitivity on hemodynamic responses during disgust induction. Fifteen subjects viewed three different film excerpts (duration: 135 s each) with disgust-evoking, threatening and neutral content. The films were presented in a block design with four repetitions of each condition. Afterwards, subjects gave affective ratings for the films and answered the questionnaire for the assessment of disgust sensitivity (QADS, []). The subjects' overall disgust sensitivity was positively related to their experienced disgust, as well as to their prefrontal cortex activation during the disgust condition. Further, there was a positive correlation between subjects' scores on the QADS subscale spoilage/decay and their amygdala activation (r=0.76). This was reasonable since the disgust film clip depicted a cockroach-invasion and the subscale spoilage/decay contains, among others, an item asking for disgust towards cockroaches. The study stresses, in accordance to previous studies, the importance of considering personality traits when studying affective responses in fMRI studies.