Attentional bias in individuals with depression and adverse childhood experiences: influence of the noradrenergic system?

Abstract Rationale Major depressive disorder (MDD) is a severe mental disorder with affective, cognitive, and somatic symptoms. Mood congruent cognitive biases, including a negative attentional bias, are important for development, maintenance, and recurrence of depressive symptoms. MDD is associated with maladaptive changes in the biological stress systems such as dysregulations of central noradrenergic alpha2-receptors in the locus coeruleus-noradrenergic system, which can affect cognitive processes including attention. Patients with adverse childhood experiences (ACE), representing severe stress experiences in early life, might be particularly affected. Objectives With an experimental design, we aimed to gain further knowledge about the role of noradrenergic activity for attentional bias in MDD patients with and without ACE. Methods We tested the effect of increased noradrenergic activity induced by the alpha2-receptor blocker yohimbine on attentional bias in a placebo-controlled repeated measures design. Four groups were included as follows: MDD patients with and without ACE, and healthy participants with and without ACE (total N = 128, all without antidepressant medication). Results A significant effect of MDD on attentional bias scores of sad face pictures (p = .037) indicated a facilitated attentional processing of sad face pictures in MDD patients (compared to non-MDD individuals). However, we found no such effect of ACE. For attentional bias of happy face pictures, we found no significant effects of MDD and ACE. Even though a higher increase of blood pressure and salivary alpha-amylase following yohimbine compared to placebo indicated successful noradrenergic stimulation, we found no significant effects of yohimbine on attentional bias of happy or sad face pictures. Conclusions Our results are consistent with the hypothesis of a negative attentional bias in MDD patients. However, as we found no effect of ACE or yohimbine, further research is needed to understand the mechanisms by which ACE increases the risk of MDD and to understand the biological basis of the MDD-related negative attentional bias.

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Yohimbine-Induced Reactivity of Heart Rate Variability in Unmedicated Depressed Patients With and Without Adverse Childhood Experience

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.734904 ◽

2021 ◽

Vol 12 ◽

Author(s):

Christian Eric Deuter ◽

Christian Otte ◽

Katja Wingenfeld ◽

Linn Kristina Kuehl

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Repeated Measures ◽

Stressful Life Events ◽

Developmental Stress ◽

Double Blind ◽

Childhood Experiences ◽

Repeated Measures Design ◽

Adverse Childhood ◽

Before And After

Stressful life events play a role in the pathogenesis of major depressive disorder (MDD) and many patients with MDD were exposed to developmental stress due to adverse childhood experiences (ACE). Furthermore, dysregulation of the autonomic nervous system and higher incidence of cardiovascular disease are found in MDD. In MDD, and independently in individuals with ACE, abnormalities in heart rate variability (HRV) have been reported. While these are often confounded, we systematically investigated them with a study which included MDD patients with/without ACE as well as healthy individuals with/without ACE. With this study, we investigated the influence of noradrenergic stimulation on HRV reactivity in unmedicated participants in a randomized, double-blind, repeated measures design. Our sample consisted of men and women with MDD and ACE (n = 25), MDD without ACE (n = 24), healthy participants with ACE (n = 27), and without ACE (n = 48). Participants received a 10 mg single dose of the alpha-2 antagonist yohimbine that increases noradrenergic activity or placebo on 2 separate days, with ECG recordings before and after drug administration at defined intervals. We found lower basal HRV in MDD and ACE: patients with MDD had reduced RMSSD whereas participants with ACE had lower LF-HRV. Contrary to our hypothesis, there was no effect of yohimbine. With this study, we were able to replicate previous findings on HRV differences in MDD and ACE. From the null effect of yohimbine, we conclude that the yohimbine-induced sympathetic activation is not a significant driver of HRV in MDD and ACE.

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A-158 The Effect of Adverse Childhood Experiences on Attentional Bias

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa068.158 ◽

2020 ◽

Vol 35 (6) ◽

pp. 952-952

Author(s):

Owens R ◽

Smith S ◽

Lindsey S ◽

Marker C ◽

Robinson B

Keyword(s):

Attentional Bias ◽

Family Conflict ◽

Adverse Childhood Experiences ◽

Stroop Test ◽

Emotional Stroop ◽

Neighborhood Crime ◽

Childhood Experiences ◽

Bivariate Correlation ◽

Household Dysfunction ◽

Adverse Childhood

Abstract Objective This study aims to investigate the relationship between Adverse Childhood Experiences (ACEs, specifically household dysfunction) and attentional bias. Research has shown that ACEs can induce psychological stress and result in greater risk for neuropsychological difficulties among children who experience them (Raver and Blair., 2016). Therefore, we hypothesize that children with higher levels of ACE exposure will show higher levels of attentional bias overall. Data Selection Data was obtained through the longitudinal Adolescent Brain Cognitive Development Study. The broader dataset was narrowed to include variables related to household dysfunction: Parent Family Environment Scale—Family Conflict Subscale Modified from PhenX and Parent Neighborhood Safety/Crime Modified from PhenX. Attentional bias was measured via the Youth Emotional Stroop Test. Data Synthesis Data was analyzed using a Bivariate correlation between predictor variables and participant latency on incongruent items within the Youth Emotional Stroop Test. Neighborhood crime and response latency were significantly correlated at r(4838) = −.041, p < .001. Neighborhood crime and family conflict were significantly correlated at r(4838) = −.040, p < .001. Additionally, we used linear regression to examine the roles of neighborhood crime and family conflict as predictors of attentional bias (N = 4838). The two variables together significantly predicted attentional bias, F(2, 4835) = 4.50, p = .012, r2 .002. Conclusion Although family conflict was not significantly related to attentional bias, our results support previous research and our hypothesis that higher levels of exposure to ACEs are significantly associated with an increase in attentional bias for environmentally threatening stimuli (Caldwell., Carter., and Minzenberg 2014).

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