School of Psychology, University of Southern Mississippi, USA.
Department of Human Development & Family Studies, Purdue University, USA.
Psychoneuroendocrinology. 2022 Jan;135:105575. doi: 10.1016/j.psyneuen.2021.105575. Epub 2021 Oct 26.
Breast cancer survivors face a number of physical health threats including cardiovascular disease, the leading cause of death among breast cancer survivors. Low heart rate variability (HRV) represents one well-established risk factor for poor cardiovascular health. Among physically healthy adults and breast cancer survivors, distress disorders may contribute to lower HRV, enhancing morbidity and mortality. This study examined how a distress disorder history altered survivors' HRV trajectories during and after an experimental stressor.
Breast cancer survivors (n = 178; mean age = 51.22) who finished treatment for stages 0-IIIa cancer within the past two years completed a diagnostic interview assessing lifetime presence of psychological disorders. They also participated in a Trier Social Stress Test (TSST). HRV data provided information on survivors' cardiovascular responses at baseline, during the TSST, and during recovery. HRV recovery data at 45 min and 120 min post-TSST was also collected. Survivors also completed questionnaires before and after the TSST assessing task performance, stress levels, ability to cope, and hopelessness. Covariates included body mass index, age, cancer stage, cardiovascular medications, exercise, menopause status, fatigue, current depressive and anxiety symptoms, and physical comorbidities.
Women with a distress disorder history had significantly lower HRV before, during, and after the TSST compared to women without such a history. Survivors with distress disorders found the TSST to be more threatening, and reported feeling less control over their performance than those without distress disorders.
Breast cancer survivors with a distress disorder history may have lower autonomic flexibility before, during, and after stress exposure. Distress disorder histories also heighten several stress-related risk perceptions leading up to and following the TSST. These findings highlight distress disorder histories as a unique correlate of poorer cardiovascular function among survivors.
乳腺癌幸存者面临许多身体健康威胁，包括心血管疾病，这是乳腺癌幸存者的主要死因。心率变异性（HRV）低表示心血管健康不良的一个已确立的风险因素。在身体健康的成年人和乳腺癌幸存者中，精神障碍可能导致 HRV 降低，增加发病率和死亡率。本研究探讨了在经历实验性应激源期间和之后，精神障碍病史如何改变幸存者的 HRV 轨迹。
在过去两年内完成 0-IIIa 期癌症治疗的乳腺癌幸存者（n=178；平均年龄=51.22 岁）完成了一项诊断性访谈，评估一生中是否存在心理障碍。他们还参加了特里尔社会应激测试（TSST）。HRV 数据提供了幸存者在基线、TSST 期间和恢复期间心血管反应的信息。还收集了 TSST 后 45 分钟和 120 分钟的 HRV 恢复数据。幸存者还在 TSST 前后完成了评估任务表现、压力水平、应对能力和绝望感的问卷。协变量包括体重指数、年龄、癌症分期、心血管药物、运动、绝经状态、疲劳、当前抑郁和焦虑症状以及身体合并症。
与没有此类病史的女性相比，有精神障碍病史的女性在 TSST 之前、期间和之后的 HRV 明显较低。有精神障碍的幸存者认为 TSST 更具威胁性，并且报告在 TSST 期间感觉对自己的表现缺乏控制感，而没有精神障碍的幸存者则没有。
有精神障碍病史的乳腺癌幸存者在暴露于压力之前、期间和之后可能自主神经灵活性较低。精神障碍病史还增加了 TSST 前后与压力相关的几种风险认知。这些发现突出了精神障碍病史作为幸存者心血管功能较差的独特相关因素。
