Jennifer F. Buckman

Assessment of women's bodily experiences is used primarily to characterize negative psychological features of menstruation. However, women's somatic states span a full spectrum of valence, emanate from multiple body systems, and affect physical and psychological well-being every day, throughout life and a more complete understanding of these states is important for the advancement of the science of women. This study presents the conception and formative stages of a comprehensive inventory about women's somatic states, bodily experiences, and physical perceptions to be called the Women's Somatic Experience Inventory. Three hundred biologically female university students (ages 18-25) rated the frequency and valence of diverse somatic experiences. An iterative approach was used: a systematic review compiled somatic items, variable clustering techniques reduced items, and confirmatory factor analysis and structural equation modeling guided factor refinement and proof-of-concept. Nine unpleasant latent factors (Kinesthetic Disconnect, Generalized Pain, Gastrointestinal Distress, Illness, Low Energy, Neurological Discomfort, Metabolic Stress, Heat & Urgency Response, and Sympathetic Activation) and four pleasant latent factors (Physical Alignment, Physical Intimacy, Activated & Attractive, and Parasympathetic Activation) were identified. Validated surveys of premenstrual symptoms and body awareness, use of hormonal contraception, and exercise and alcohol use behaviors were associated with pleasant and unpleasant factors, serving as initial proof-of-concept. These results support further refinement of the factors to be included in the inventory. With further testing and validation, the identified 73 somatic items and 13 factors could form the Women's Somatic Experience Inventory, the first comprehensive inventory for understanding women's somatic experiences, how these experiences change across female reproductive life stages, and how they interact with lifestyle behaviors.

Physiological processes such as respiration, while typically automatic, can be brought under volitional control to initiate cascading effects across the autonomic and central nervous systems. Slow breathing paced at approximately six breaths‐per‐minute, termed resonance paced breathing (RPB), activates the 0.1 Hz resonance frequency of the baroreflex. This slow breathing intervention has multiple health benefits, including significant reductions in anxiety, depression, and stress. Positive cardiovascular changes (e.g., reduced blood pressure, increased heart rate variability and baroreflex sensitivity) are observed during RPB, however, little is known about real‐time brain response to RPB. This study examined changes in functional connectivity between 13 a priori selected regions‐of‐interest (ROIs) of the central autonomic brain network during RPB compared to natural breathing. Participants ( N = 147) with depression, a substance use disorder, or no diagnosis were imaged using a 3 T Siemens Trio scanner during brief episodes of natural breathing and RPB. Linear mixed modeling with adaptive false discovery rate correction indicated that compared to natural breathing, RPB led to increased functional connectivity between multiple ROIs of the central autonomic network. Of the 15 ROI pairs with significantly increased connectivity, 10 pairs involved a subdivision of the insula. This pattern supports that the insular cortex may play a key role in integrating afferent viscerosensory information from lower brain areas with cognitive and emotional information relayed from higher cortical areas. Further knowledge about the interdependencies between autonomic and central nervous system processes is important to identify new and accessible intervention targets for physical and mental disorders that involve arousal modulation challenges.

Physiological processes such as respiration, while typically automatic, can be brought under volitional control to initiate cascading effects across the autonomic and central nervous systems. Slow breathing paced at approximately six breaths-per-minute, termed resonance paced breathing (RPB), activates the 0.1 Hz resonance frequency of the baroreflex. This slow breathing intervention has multiple health benefits, including significant reductions in anxiety, depression, and stress. Positive cardiovascular changes (e.g., reduced blood pressure, increased heart rate variability and baroreflex sensitivity) are observed during RPB, however, little is known about real-time brain response to RPB. This study examined changes in functional connectivity between 13 a priori selected regions-of-interest (ROIs) of the central autonomic brain network during RPB compared to natural breathing. Participants (N = 147) with depression, a substance use disorder, or no diagnosis were imaged using a 3 T Siemens Trio scanner during brief episodes of natural breathing and RPB. Linear mixed modeling with adaptive false discovery rate correction indicated that compared to natural breathing, RPB led to increased functional connectivity between multiple ROIs of the central autonomic network. Of the 15 ROI pairs with significantly increased connectivity, 10 pairs involved a subdivision of the insula. This pattern supports that the insular cortex may play a key role in integrating afferent viscerosensory information from lower brain areas with cognitive and emotional information relayed from higher cortical areas. Further knowledge about the interdependencies between autonomic and central nervous system processes is important to identify new and accessible intervention targets for physical and mental disorders that involve arousal modulation challenges.

Sighing generates a reliable sympathetic cardiovascular response that, like exercise, could be leveraged in a graded “stress test” to reveal preclinical changes in cardiovascular health and stress reactivity. This study presents the fixed‐interval volitional sighing (FIVS) protocol, which rhythmically paces sighs at different frequencies to systematically load the cardiovascular system. Cardiovascular and autonomic responses during the FIVS protocol were statistically dissected to independently characterize physiological responses. Sex differences were explored as a preliminary step toward characterizing factors that affect sigh reactivity. Healthy college students ( n = 250, 65% female) completed a baseline task and two sighing tasks: a longer inter‐sigh interval task (1 sigh per 30 s, long interval), followed by a shorter inter‐sigh interval task (1 sigh per 15 s, short interval). Heart rate (HR), blood pressure, and respiration were continuously measured. Mixed models with a priori cardiorespiratory assumptions isolated HR, low‐frequency heart rate variability (LF‐HRV), high‐frequency HRV (HF‐HRV), pulse transit time variability (PTTv), mean arterial pressure (MAP), low‐frequency blood pressure variability (LF‐BPV), and high‐frequency BPV (HF‐BPV) responses to the sighing tasks. HR, LF‐HRV, PTTv, MAP, and LF‐BPV increased significantly from baseline to both sighing tasks, with greater changes observed during short‐interval sighing. HF‐BPV increased similarly from baseline to both sighing tasks. HF‐HRV decreased only during the short‐interval sighing task. Males exhibited greater increases than females in HR, LF‐HRV, LF‐BPV, HF‐BPV, and PTTv but smaller decreases in HF‐HRV in response to sighing. Volitional sighing elicits cardiac, vascular, and autonomic responses consistent with sympathetic activation. As time under load and loading intensity increased, greater responses were observed in several vascular and sympathetic indices. Sex differences suggest that the FIVS protocol can detect person‐specific differences in cardiovascular responding. Sighing is physically accessible for most people, and the FIVS protocol may be useful as a stress test to detect early‐stage cardiovascular or autonomic dysfunction.

Background: Sighing is integral to psychophysiological regulation. Volitional sighing tasks have been developed to overcome methodological issues of studying naturalistic sighing and advance research on sigh physiology. This study uses fixed-interval volitional sighing (FIVS), which rhythmically paces sighs at different frequencies, to dissect cardiovascular and autonomic responses during FIVS and explore potential sex differences in cardiovascular response dynamics. Methods: Healthy college students (n=250, 65% female) completed a baseline task and two FIVS tasks (0.033Hz and 0.066Hz) while continuous HR, BP, and respiration were measured. Using a mixed model and a priori cardiorespiratory assumptions, we isolated HR, low-frequency heart rate variability (LF-HRV), high-frequency HRV (HF-HRV), pulse transit time variability (PTTv), and mean arterial pressure (MAP) responses to sighing. Results: FIVS produced non-habituating cardiovascular responses with spectral peaks corresponding to sighing frequency. HR, LF-HRV, PTTv, and MAP increased significantly from baseline to both FIVS tasks, with greater changes observed during 0.066Hz FIVS. HF-HRV decreased only during the 0.066Hz task. Males exhibited greater increases than females in HR and PTTv, but smaller decreases in HF-HRV, from baseline to the FIVS tasks. Conclusions: Volitional sighing directly elicits graded cardiac, vascular, and autonomic responses in a frequency-dependent manner. These responses support sighing as a sympathetic challenge, which, like strenuous physical activity, may lead to longer-term improvements in autonomic balance. Sex differences in cardiovascular mobilization processes indicate potentially distinct regulatory mechanisms. This research advances our understanding of sigh physiology and suggests FIVS may serve as a valuable tool for assessing subtle variations in cardiovascular function.

Sleep disturbances are common during pregnancy. This study determined whether meeting physical activity or dietary guidelines during pregnancy was associated with improved sleep. Third trimester pregnant women (n = 49, 31.9 ± 4.1 years) completed physical activity and sleep questionnaires and then wore a wrist actigraph 24 h/day and completed three 24 h dietary recalls across two weeks. Participants who reported meeting physical activity guidelines (>150 min moderate-to-vigorous physical activity [MVPA]/week, n = 23) or dietary guidelines (≥1.1 g protein/kg body weight/day, n = 26 or ≥25 g fiber/day, n = 16) were compared to those who were physically inactive ( 0.05); however, the active group reported better sleep quality (p = 0.049). Those who met protein guidelines exhibited longer sleep duration and less wake-after-sleep-onset (ps < 0.05). Across all participants, higher weekly MET mins/week of MVPA associated with better sleep quality (p = 0.02), and a diet higher in fat and lower in carbohydrates associated with longer sleep duration (ps < 0.05). Meeting physical activity and nutrition guidelines positively associates with improved sleep, with protein associated with objective measures and physical activity with subjective measures.

Craving for alcohol and other drugs is often described as a momentary hyperarousal state that interferes with one's ability to use top-down strategies. As such, it may be best interrupted ‘in the moment' through bottom-up modulation. We recently reported that episodic resonance paced breathing (eRPB) delivered via mobile phone app as an add-on to outpatient treatment for substance use disorder (SUD) was effective at dampening craving over the course of an 8-week intervention (NCT#02579317). However, not all participants engaged with the eRPB app and there was high intra- and inter-individual variability in weekly ratings of usefulness. Here we examined baseline demographic, physiological, and psychiatric measures as well as time-varying exposure to positive, negative, and temptation craving triggers as predictors of frequency of eRPB app use and ratings of usefulness. Seventy-seven outpatient women were randomized to an eRPB (0.1 Hz) or a faster paced breathing sham (0.23 Hz) condition. Baseline measures were assessed within the first 3 weeks of treatment entry prior to randomization. App use frequency, ratings of usefulness, and trigger exposure were measured weekly throughout the intervention. Variables were entered into marginal means models with forward stepwise model selection and examined as predictors of use and usefulness. Frequent app use was associated with a lifetime alcohol use disorder (AUD) diagnosis (p = 0.026), higher ratings of usefulness (p < 0.001), and fewer exposures to positive triggers (e.g., celebration, socialization; p < 0.001). There was a trend-level association between frequency of app use and greater cardiovascular capacity at baseline (p = 0.088). Higher ratings of usefulness were associated with greater exposure to negative triggers (e.g,. loneliness, frustration; p < 0.001) and parasympathetic dysregulation at baseline (p = 0.05). A positive relationship between app use frequency and ratings of usefulness was present only in the eRPB group (p = 0.045). Matching ideal candidates and moments to an arousal modulation anti-craving intervention can help streamline screening and implementation of eRPB in the treatment of SUD.Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT02579317, identifier NCT02579317.

Background: Measures of postural stability are useful in assisting the diagnosing and managing of athlete concussion. Error counting using the Balance Error Scoring System (BESS) is the clinical standard, but has notable limitations. New technologies offer the potential to increase precision and optimize testing protocols; however, whether these devices enhance clinical assessment remains unclear. Purpose: To examine the relationships between metrics of balance performance using different measurement systems in uninjured, healthy collegiate athletes. Study Design: Cross-sectional. Methods: Five hundred and thirty uninjured collegiate athletes were tested using the C3Logix app, which computes ellipsoid volume as a measure of postural stability during the six standard BESS conditions, while concurrently, errors were manually counted during each condition per standard BESS protocols. The association between concurrently measured ellipsoid volumes and error counts were examined with Spearman’s correlations. From this sample, 177 participants also performed two double-leg conditions on the Biodex BioSway force plate system on the same day. This system computes Sway Index as a measure of postural stability. The association of ellipsoid volume (C3Logix) and Sway Index (Biodex) was examined with Spearman’s correlations. Individual-level data were plotted to visually depict the relationships. Results: C3Logix ellipsoid volume and concurrently recorded error counts were significantly correlated in five of the six BESS conditions (rs:.22-.62; p< 0.0001). C3Logix ellipsoid volume and Biodex Sway Index were significantly correlated in both conditions (rs=.22-.27, p< 0.004). However, substantial variability was shown in postural stability across all three measurement approaches. Conclusion: Modest correlation coefficients between simultaneous and same-day balance assessments in uninjured collegiate athletes suggest a need to further optimize clinical protocols for concussion diagnosis. Level of Evidence: 2b

Digital neuropsychological test batteries are popular in college athletics; however, well-validated digital tests that are short and portable are needed to expand the feasibility of performing cognitive testing quickly, reliably, and outside standard clinical settings. This study assessed performance on digital versions of Trail Making Test (dTMT) and a modified Symbol Digit Modalities Test (dSDMT) in uninjured collegiate athletes (n = 537; 47% female) using the C3Logix baseline assessment module. Time to complete (dTMT) and the number of correct responses (dSDMT) were computed, transformed into z scores, and compared to age-matched normative data from analogous paper-and-pencil tests. Overall sample performance was compared to normative sample performance using Cohen’s d. Sample averages on the dTMT, Part A, and dSDMT were similar to published norms; 97 and 92% of z scores fell within 2 standard deviations of normative means, respectively. The sample averaged faster completion times on dTMT, Part B than published norms, although 98% of z scores were within 2 standard deviations of the normative means. Brief, digitized tests may be useful in populations and testing environments when longer cognitive test batteries are impractical. Future studies should assess the ability of these tests to detect clinically relevant changes following a suspected head injury.