The Correlations of Baseline Autonomic Nervous System Function and Hostility Score with Change Ratio of Treatment Response in Generalized Anxiety Disorder ANS index and hostility in GAD
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Published:
Jun 24, 2019
Keywords:
Autonomic nervous system function Generalized anxiety disorder Hostility Predictors Treatment response
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Abstract
The relationship between the autonomic nervous system (ANS) index, hostility scale and generalized anxiety disorder (GAD) in the long-term treatment outcome has been rarely studied. The aim of this study was to explore whether the ANS index and hostility scale at baseline are predictors of long-term outcome in GAD. Nine patients with GAD were recruited. At baseline (week 0), blood pressure (BP), heart rate (HR), and mean heart rate range (MHRR) were measured as ANS index; the Cook–Medley Hostility Scale was assessed as hostility. The Hamilton Anxiety Rating Scale (HAM-A) was administered at baseline, short-term (week 6) and long-term (week 52). The aggressive response subscale of the hostility scale was significantly negatively correlated with the HAM-A change ratio in short-term and long-term, while MHRR were significantly positively correlated with these change ratios. The MHRR and the aggressive response subscale at baseline could be predictors of long-term outcome in GAD.
Article Details
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Lu, T.-H., Lee, L.-T., Hsu, S.-E., Chen, K. C., Lee, I. H., Yeh, T. L., Chen, P. S., & Kuang Yang, Y. (2019). The Correlations of Baseline Autonomic Nervous System Function and Hostility Score with Change Ratio of Treatment Response in Generalized Anxiety Disorder: ANS index and hostility in GAD. International Journal of Child Development and Mental Health, 7(1), 20–17. Retrieved from https://he01.tci-thaijo.org/index.php/cdmh/article/view/130977
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References
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Bereza, B. G., Machado, M., Ravindran, A. V., & Einarson, T. R. (2012). Evidence-Based Review of Clinical Outcomes
of Guideline-Recommended Pharmacotherapies for Generalized Anxiety Disorder. The Canadian Journal of
Psychiatry, 57(8), 470-478.
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of relapse in a study of duloxetine treatment for patients with generalized anxiety disorder. Human
Psychopharmacology: Clinical and Experimental, 26(3), 258-266.
Brotman, D. J., Golden, S. H., & Wittstein, I. S. (2007). The cardiovascular toll of stress. Lancet, 370(9592), 1089-1100.
Canadian Agency for Drugs and Technologies in Health (2014). Neurofeedback and biofeedback for mood and anxiety
disorders: a review of the clinical evidence and guidelines - an update. In Canadian Agency for Drugs and
Technologies in Health (Ed.), CADTH rapid response reports. Ottawa (ON): Canadian Agency for Drugs and
Technologies in Health.
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Psychopharmacology (Berl), 213(2-3), 625-632.
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obsessive-compulsive, and generalized anxiety disorders at baseline and in response to relaxation and
hyperventilation. Int J Psychophysiol, 87(1), 19-27.
Pollack, M. H., Meoni, P., Otto, M. W., Simon, N., & Hackett, D. (2003). Predictors of outcome following venlafaxine
extended-release treatment of DSM-IV generalized anxiety disorder: a pooled analysis of short- and long-term
studies. J Clin Psychopharmacol, 23(3), 250-259.
Ravindran, L. N., & Stein, M. B. (2010). The pharmacologic treatment of anxiety disorders: a review of progress. J Clin
Psychiatry, 71(7), 839-854.
Reeves, J. W., Fisher, A. J., Newman, M. G., & Granger, D. A. (2016). Sympathetic and hypothalamic-pituitary-adrenal
asymmetry in generalized anxiety disorder. Psychophysiology, 53(6), 951-957.
Rynn, M., Khalid-Khan, S., Garcia-Espana, J. F., Etemad, B., & Rickels, K. (2006). Early response and 8-week
treatment outcome in GAD. Depress Anxiety, 23(8), 461-465.
Sarris, J., Moylan, S., Camfield, D. A., Pase, M. P., Mischoulon, D., Berk, M., Jacka, F. N., & Schweitzer, I. (2012).
Complementary medicine, exercise, meditation, diet, and lifestyle modification for anxiety disorders: a review of
current evidence. Evid Based Complement Alternat Med, 2012, 20.
Schoenberg, P. L., & David, A. S. (2014). Biofeedback for psychiatric disorders: a systematic review. Appl
Psychophysiol Biofeedback, 39(2), 109-135.
Seligman, L. D., & Ollendick, T. H. (2011). Cognitive-behavioral therapy for anxiety disorders in youth. Child Adolesc
Psychiatr Clin N Am, 20(2), 217-238.
Shaffer, F., & Ginsberg, J. P. (2017). An overview of heart rate variability metrics and norms. Front Public Health, 5,
258.
Shields, R. W., Jr. (2009). Heart rate variability with deep breathing as a clinical test of cardiovagal function. Cleve Clin
J Med, 76 (2), 37-40.
Virtanen, R., Jula, A., Salminen, J. K., Voipio-Pulkki, L. M., Helenius, H., Kuusela, T., & Airaksinen, J. (2003). Anxiety
and hostility are associated with reduced baroreflex sensitivity and increased beat-to-beat blood pressure variability.
Psychosom Med, 65(5), 751-756.
Weisberg, R. B. (2009). Overview of generalized anxiety disorder: epidemiology, presentation, and course. J Clin
Psychiatry, 70 (2), 4-9.
Yang, Y. K., Yao, W. J., Yeh, T. L., Lee, I. H., Chen, K. C., & Lu, R. B. (2007). Association between serotonin transporter
availability and hostility scores in healthy volunteers - a single photon emission computed tomography study with
[(123)I] ADAM. Psychiatry Res, 154(3), 281-284.
Reduced Heart Rate Variability in Social Anxiety Disorder: Associations with Gender and Symptom Severity. PLoS
ONE, 8(7), e70468.
Aysin, B., & Aysin, E. (2006). Effect of Respiration in Heart Rate Variability (HRV) Analysis. 2006 International
Conference of the IEEE Engineering in Medicine and Biology Society. 1. 1776-1779.
Barefoot, J. C., Larsen, S., Von der Lieth, L., & Schroll, M. (1995). Hostility, Incidence of Acute Myocardial Infarction,
and Mortality in a Sample of Older Danish Men and Women. American Journal of Epidemiology, 142(5), 477-484.
Barefoot, J. C. a. I. M. L. (1994). Anger, hostility, and the heart. NJ, USA: Lawrence Erlbaum Associates, Hillsdale.
Bereza, B. G., Machado, M., Ravindran, A. V., & Einarson, T. R. (2012). Evidence-Based Review of Clinical Outcomes
of Guideline-Recommended Pharmacotherapies for Generalized Anxiety Disorder. The Canadian Journal of
Psychiatry, 57(8), 470-478.
Bodkin, J. A., Allgulander, C., Llorca, P. M., Spann, M. E., Walker, D. J., Russell, J. M., & Ball, S. G. (2011). Predictors
of relapse in a study of duloxetine treatment for patients with generalized anxiety disorder. Human
Psychopharmacology: Clinical and Experimental, 26(3), 258-266.
Brotman, D. J., Golden, S. H., & Wittstein, I. S. (2007). The cardiovascular toll of stress. Lancet, 370(9592), 1089-1100.
Canadian Agency for Drugs and Technologies in Health (2014). Neurofeedback and biofeedback for mood and anxiety
disorders: a review of the clinical evidence and guidelines - an update. In Canadian Agency for Drugs and
Technologies in Health (Ed.), CADTH rapid response reports. Ottawa (ON): Canadian Agency for Drugs and
Technologies in Health.
Chalmers, J. A., Quintana, D. S., Abbott, M. J., & Kemp, A. H. (2014). Anxiety Disorders are Associated with Reduced
Heart Rate Variability: A Meta-Analysis. Frontiers in Psychiatry, 5, 80.
Connor, K. M., & Davidson, J. R. (1998). Generalized anxiety disorder: neurobiological and pharmacotherapeutic
perspectives. Biological Psychiatry, 44(12), 1286-1294.
Contrada, R. J., & Jussim, L. (1992). What Does the Cook-Medley Hostility Scale Measure? In Search of an Adequate
Measurement Model1. Journal of Applied Social Psychology, 22(8), 615-627
Cook, W. W., & Medley, D. M. (1954). Proposed hostility and Pharisaic-virtue scales for the MMPI. Journal of Applied
Psychology, 38(6), 414-418.
Fisher, A. J., & Newman, M. G. (2013). Heart rate and autonomic response to stress after experimental induction of
worry versus relaxation in healthy, high-worry, and generalized anxiety disorder individuals. Biological Psychology,
93(1), 65-74.
Fracalanza, K., Koerner, N., Deschenes, S. S., & Dugas, M. J. (2014). Intolerance of uncertainty mediates the relation
between generalized anxiety disorder symptoms and anger. Cogn Behav Ther, 43(2), 122-132.
Howorka, K., Pumprla, J., Jirkovska, A., Lacigova, S., & Nolan, J. (2010). Modified orthostatic load for spectral analysis
of short-term heart rate variability improves the sensitivity of autonomic dysfunction assessment. J Diabetes
Complications, 24(1), 48-54.
Imholz, B. (1998). Fifteen years experience with finger arterial pressure monitoring: assessment of the technology.
Cardiovascular Research, 38(3), 605-616.
Low, P. A. , & Benarroch, E.E. (1977). Clinical autonomic disorders. Philadelphia, PA: Lippincott Williams & Wilkins.
Makovac, E., Meeten, F., Watson, D. R., Herman, A., Garfinkel, S. N., H, D. C., & Ottaviani, C. (2016). Alterations in
Amygdala-Prefrontal Functional Connectivity Account for Excessive Worry and Autonomic Dysregulation in
Generalized Anxiety Disorder. Biol Psychiatry, 80(10), 786-795.
Mankus, A. M., Aldao, A., Kerns, C., Mayville, E. W., & Mennin, D. S. (2013). Mindfulness and heart rate variability in
individuals with high and low generalized anxiety symptoms. Behav Res Ther, 51(7), 386-391.
Mantella, R. C., Butters, M. A., Amico, J. A., Mazumdar, S., Rollman, B. L., Begley, A. E., Reynolds, C. F., & Lenze, E.
J. (2008). Salivary cortisol is associated with diagnosis and severity of late-life generalized anxiety disorder.
Psychoneuroendocrinology, 33(6), 773-781.
Park, Y. M., Kim, D. W., Kim, S., Im, C. H., & Lee, S. H. (2011). The loudness dependence of the auditory evoked
potential (LDAEP) as a predictor of the response to escitalopram in patients with generalized anxiety disorder.
Psychopharmacology (Berl), 213(2-3), 625-632.
Pittig, A., Arch, J. J., Lam, C. W., & Craske, M. G. (2013). Heart rate and heart rate variability in panic, social anxiety,
obsessive-compulsive, and generalized anxiety disorders at baseline and in response to relaxation and
hyperventilation. Int J Psychophysiol, 87(1), 19-27.
Pollack, M. H., Meoni, P., Otto, M. W., Simon, N., & Hackett, D. (2003). Predictors of outcome following venlafaxine
extended-release treatment of DSM-IV generalized anxiety disorder: a pooled analysis of short- and long-term
studies. J Clin Psychopharmacol, 23(3), 250-259.
Ravindran, L. N., & Stein, M. B. (2010). The pharmacologic treatment of anxiety disorders: a review of progress. J Clin
Psychiatry, 71(7), 839-854.
Reeves, J. W., Fisher, A. J., Newman, M. G., & Granger, D. A. (2016). Sympathetic and hypothalamic-pituitary-adrenal
asymmetry in generalized anxiety disorder. Psychophysiology, 53(6), 951-957.
Rynn, M., Khalid-Khan, S., Garcia-Espana, J. F., Etemad, B., & Rickels, K. (2006). Early response and 8-week
treatment outcome in GAD. Depress Anxiety, 23(8), 461-465.
Sarris, J., Moylan, S., Camfield, D. A., Pase, M. P., Mischoulon, D., Berk, M., Jacka, F. N., & Schweitzer, I. (2012).
Complementary medicine, exercise, meditation, diet, and lifestyle modification for anxiety disorders: a review of
current evidence. Evid Based Complement Alternat Med, 2012, 20.
Schoenberg, P. L., & David, A. S. (2014). Biofeedback for psychiatric disorders: a systematic review. Appl
Psychophysiol Biofeedback, 39(2), 109-135.
Seligman, L. D., & Ollendick, T. H. (2011). Cognitive-behavioral therapy for anxiety disorders in youth. Child Adolesc
Psychiatr Clin N Am, 20(2), 217-238.
Shaffer, F., & Ginsberg, J. P. (2017). An overview of heart rate variability metrics and norms. Front Public Health, 5,
258.
Shields, R. W., Jr. (2009). Heart rate variability with deep breathing as a clinical test of cardiovagal function. Cleve Clin
J Med, 76 (2), 37-40.
Virtanen, R., Jula, A., Salminen, J. K., Voipio-Pulkki, L. M., Helenius, H., Kuusela, T., & Airaksinen, J. (2003). Anxiety
and hostility are associated with reduced baroreflex sensitivity and increased beat-to-beat blood pressure variability.
Psychosom Med, 65(5), 751-756.
Weisberg, R. B. (2009). Overview of generalized anxiety disorder: epidemiology, presentation, and course. J Clin
Psychiatry, 70 (2), 4-9.
Yang, Y. K., Yao, W. J., Yeh, T. L., Lee, I. H., Chen, K. C., & Lu, R. B. (2007). Association between serotonin transporter
availability and hostility scores in healthy volunteers - a single photon emission computed tomography study with
[(123)I] ADAM. Psychiatry Res, 154(3), 281-284.