Affective Responsivity and Cardiovascular Stress Reactivity in Depression

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Abstract
BACKGROUND: Profound stress system dysfunction is a hallmark pathological feature of major depressive disorder (MDD), including altered affective dynamics in response to stress. However, no studies have directly assessed the link between negative affective responsivity (NA-R) to daily stressors and sympathetic-cardiovascular stress reactivity in young adults with MDD. We tested the hypotheses that (1) greater NA-R to daily stressors would be positively related to the magnitude of acute stress–induced sympathetic-cardiovascular reactivity in young adults (18–30 years) and (2) the slope of these relations would be steeper in young adults with MDD (unmedicated) compared with nondepressed healthy adults. METHODS: Daily stress processes and affective dynamics were assessed during routine everyday life for 8 consecutive days in 42 nondepressed healthy adults and 39 adults with MDD (daily diary). On the last day of the daily assessments, heart rate (ECG), beat-to-beat blood pressure (finger photoplethysmography), and muscle sympathetic nerve activity (peroneal microneurography) were measured during the cold pressor test, a standard laboratory stressor. RESULTS: NA-R to daily stressors was amplified in MDD adults ( P =0.01). Greater NA-R was related to larger acute stress–induced increases in heart rate only in MDD adults ( b =48.61 [95% CI, 22.48–74.74]) but not in nondepressed healthy adults ( b =−6.81 [95% CI, −41.95 to 28.33]). NA-R to daily stressors was not related to blood pressure or muscle sympathetic nerve activity reactivity in either group (all P >0.05). CONCLUSIONS: These data suggest that the association between NA-R to daily stressors and cardiovascular reactivity to stress is sensitized in young adults with MDD, potentially contributing to future cardiovascular disease risk.

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