{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:36:03Z","timestamp":1792805763708,"version":"4.5.0"},"reference-count":83,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T00:00:00Z","timestamp":1650240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003132","name":"Agentschap voor Innovatie door Wetenschap en Technologie","doi-asserted-by":"publisher","award":["140745"],"award-info":[{"award-number":["140745"]}],"id":[{"id":"10.13039\/501100003132","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:p>Past research links depression and blunted cardiac vagal reactivity to chronic stress. Yet, to our knowledge no experiment investigates heart rate (variability) responses to a repeated laboratory stressor in patients with depression. Repeated exposure may provide valuable information on stress reactivity in depression. Fifty-nine women (30 inpatients diagnosed with depression and 29 matched controls) underwent two consecutive runs of a mental arithmetic stress paradigm consisting of one baseline and two exposures to control, stress, and recovery phases of 5 min each, in a case-control design. Subjective stress and electrocardiography were recorded. Variance of heart rate (HR) and root mean square of successive RR interval differences (RMSSD) were analyzed using linear mixed models. Overall, physiological parameters (HR and RMSSD) and subjective stress showed a strong group effect (all <jats:italic>p<\/jats:italic> &amp;lt; 0.001). In both groups, subjective stress and HR increased in response to stress, but the subjective stress levels of patients with depression did not return to baseline levels after the first stressor and for the remainder of the experiment (all <jats:italic>p<\/jats:italic> &amp;lt; 0.004 compared to baseline). Patients\u2019 HR reactivity responded oppositely: while HR recovered after the first stress exposure, no reactivity was observed in response to the second exposure. These findings may suggest that the often-reported blunted HR\/HRV response to stressors results from exhaustion rather than an incapacity to react to stress. The altered HR reactivity could indicate allostatic (over-) load in depression.<\/jats:p>","DOI":"10.3389\/fpsyt.2022.869608","type":"journal-article","created":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T04:47:10Z","timestamp":1650257230000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Exhausted Heart Rate Responses to Repeated Psychological Stress in Women With Major Depressive Disorder"],"prefix":"10.3389","volume":"13","author":[{"given":"Carmen","family":"Schiweck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Gholamrezaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxim","family":"Hellyn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Vaessen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elske","family":"Vrieze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Claes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,18]]},"reference":[{"key":"B1","year":"2017","journal-title":"Depression and other Common Mental Disorders: Global Health Estimates."},{"key":"B2","doi-asserted-by":"publisher","first-page":"155","DOI":"10.4088\/jcp.14m09298","article-title":"The economic burden of adults with major depressive disorder in the United States (2005 and 2010).","volume":"76","author":"Greenberg","year":"2015","journal-title":"J Clin Psychiatry."},{"key":"B3","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1146\/annurev.clinpsy.1.102803.143938","article-title":"Stress and Depression.","volume":"1","author":"Hammen","year":"2004","journal-title":"Annu Rev Clin Psychol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1111\/j.1468-2850.1998.tb00151.x","article-title":"Life Stressors as Risk Factors in Depression.","volume":"5","author":"Mazure","year":"1998","journal-title":"Clin Psychol Sci Pract."},{"key":"B5","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1037\/\/0021-843x.100.4.555","article-title":"Generation of stress in the course of unipolar depression.","volume":"100","author":"Hammen","year":"1991","journal-title":"J Abnorm Psychol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1016\/j.cpr.2010.04.010","article-title":"Stress generation in depression: a systematic review of the empirical literature and recommendations for future study.","volume":"30","author":"Liu","year":"2010","journal-title":"Clincal Psychol Rev."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1016\/S0140-6736(07)61305-1","article-title":"The cardiovascular toll of stress.","volume":"370","author":"Brotman","year":"2007","journal-title":"Lancet."},{"key":"B8","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1192\/bjp.164.3.365","article-title":"Glucocorticoids and the genesis of depressive illness a psychobiological model.","volume":"164","author":"Dinan","year":"1994","journal-title":"Br J Psychiatry."},{"key":"B9","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1016\/j.tins.2008.06.006","article-title":"The HPA axis in major depression: classical theories and new developments.","volume":"31","author":"Pariante","year":"2008","journal-title":"Trends Neurosci."},{"key":"B10","doi-asserted-by":"crossref","DOI":"10.1038\/nrn.2016.69","article-title":"Integrating neuroimmune systems in the neurobiology of depression.","volume":"17","author":"Wohleb","year":"2016","journal-title":"Nat Rev Neurosci."},{"key":"B11","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.ijpsycho.2013.06.003","article-title":"Is the association between depression and blunted cardiovascular stress reactions mediated by perceptions of stress?","volume":"90","author":"Brindle","year":"2013","journal-title":"Int J Psychophysiol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1097\/psy.0000000000000019","article-title":"Respiratory sinus arrhythmia reactivity in current and remitted major depressive disorder.","volume":"76","author":"Bylsma","year":"2014","journal-title":"Psychosom Med."},{"key":"B13","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1097\/PSY.0000000000000313","article-title":"Differential Autonomic Nervous System Reactivity in Depression and Anxiety During Stress Depending on Type of Stressor.","volume":"78","author":"Hu","year":"2016","journal-title":"Psychosom Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1001\/archpsyc.1980.01780180055005","article-title":"Life events and depressive disorder reviewed. 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