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      Autonomic and Brain Morphological Predictors of Stress Resilience

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          Abstract

          Stressful life events are an important cause of psychopathology. Humans exposed to aversive or stressful experiences show considerable inter-individual heterogeneity in their responses. However, the majority does not develop stress-related psychiatric disorders. The dynamic processes encompassing positive and functional adaptation in the face of significant adversity have been broadly defined as resilience. Traditionally, the assessment of resilience has been confined to self-report measures, both within the general community and putative high-risk populations. Although this approach has value, it is highly susceptible to subjective bias and may not capture the dynamic nature of resilience, as underlying construct. Recognizing the obvious benefits of more objective measures of resilience, research in the field has just started investigating the predictive value of several potential biological markers. This review provides an overview of theoretical views and empirical evidence suggesting that individual differences in heart rate variability (HRV), a surrogate index of resting cardiac vagal outflow, may underlie different levels of resilience toward the development of stress-related psychiatric disorders. Following this line of thought, recent studies describing associations between regional brain morphometric characteristics and resting state vagally-mediated HRV are summarized. Existing studies suggest that the structural morphology of the anterior cingulated cortex (ACC), particularly its cortical thickness, is implicated in the expression of individual differences in HRV. These findings are discussed in light of emerging structural neuroimaging research, linking morphological characteristics of the ACC to psychological traits ascribed to a high-resilient profile and abnormal structural integrity of the ACC to the psychophysiological expression of stress-related mental health consequences. We conclude that a multidisciplinary approach integrating brain structural imaging with HRV monitoring could offer novel perspectives about brain-body pathways in resilience and adaptation to psychological stress.

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          Psychological Resilience

          The purpose of this paper is to review and critique the variety of definitions, concepts, and theories of psychological resilience. To this end, the narrative is divided into three main sections. The first considers how resilience has been defined in the psychology research literature. Despite the construct being operationalized in a variety of ways, most definitions are based around two core concepts: adversity and positive adaptation. A substantial body of evidence suggests that resilience is required in response to different adversities, ranging from ongoing daily hassles to major life events, and that positive adaptation must be conceptually appropriate to the adversity examined in terms of the domains assessed and the stringency of criteria used. The second section examines the conceptualization of resilience as either a trait or a process, and explores how it is distinct from a number of related terms. Resilience is conceptualized as the interactive influence of psychological characteristics within the context of the stress process. The final section reviews the theories of resilience and critically examines one theory in particular that is commonly cited in the resilience literature. Future theories in this area should take into account the multiple demands individuals encounter, the meta-cognitive and -emotive processes that affect the resilience-stress relationship, and the conceptual distinction between resilience and coping. The review concludes with implications for policy, practice, and research including the need to carefully manage individuals’ immediate environment, and to develop the protective and promotive factors that individuals can proactively use to build resilience.
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            Psychobiological mechanisms of resilience and vulnerability: implications for successful adaptation to extreme stress.

            Most research on the effects of severe psychological stress has focused on stress-related psychopathology. Here, the author develops psychobiological models of resilience to extreme stress. An integrative model of resilience and vulnerability that encompasses the neurochemical response patterns to acute stress and the neural mechanisms mediating reward, fear conditioning and extinction, and social behavior is proposed. Eleven possible neurochemical, neuropeptide, and hormonal mediators of the psychobiological response to extreme stress were identified and related to resilience or vulnerability. The neural mechanisms of reward and motivation (hedonia, optimism, and learned helpfulness), fear responsiveness (effective behaviors despite fear), and adaptive social behavior (altruism, bonding, and teamwork) were found to be relevant to the character traits associated with resilience. The opportunity now exists to bring to bear the full power of advances in our understanding of the neurobiological basis of behavior to facilitate the discoveries needed to predict, prevent, and treat stress-related psychopathology.
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              The subgenual anterior cingulate cortex in mood disorders.

              The anterior cingulate cortex (ACC) ventral to the genu of the corpus callosum has been implicated in the modulation of emotional behavior on the basis of neuroimaging studies in humans and lesion analyses in experimental animals. In a combined positron emission tomography/magnetic resonance imaging study of mood disorders, we demonstrated that the mean gray matter volume of this "subgenual" ACC (sgACC) cortex is abnormally reduced in subjects with major depressive disorder (MDD) and bipolar disorder, irrespective of mood state. Neuropathological assessments of sgACC tissue acquired postmortem from subjects with MDD or bipolar disorder confirmed the decrement in gray matter volume, and revealed that this abnormality was associated with a reduction in glia, with no equivalent loss of neurons. In positron emission tomography studies, the metabolic activity was elevated in this region in the depressed relative to the remitted phases of the same MDD subjects, and effective antidepressant treatment was associated with a reduction in sgACC activity. Other laboratories replicated and extended these findings, and the clinical importance of this treatment effect was underscored by a study showing that deep brain stimulation of the sgACC ameliorates depressive symptoms in treatment-resistant MDD. This article discusses the functional significance of these findings within the context of the preclinical literature that implicates the putative homologue of this region in the regulation of emotional behavior and stress response. In experimental animals, this region participates in an extended "visceromotor network" of structures that modulates autonomic/neuroendocrine responses and neurotransmitter transmission during the neural processing of reward, fear, and stress. These data thus hold important implications for the development of neural models of depression that can account for the abnormal motivational, neuroendocrine, autonomic, and emotional manifestations evident in human mood disorders.
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                Author and article information

                Contributors
                Journal
                Front Neurosci
                Front Neurosci
                Front. Neurosci.
                Frontiers in Neuroscience
                Frontiers Media S.A.
                1662-4548
                1662-453X
                06 April 2018
                2018
                : 12
                : 228
                Affiliations
                [1] 1Neuroimaging Laboratory, Santa Lucia Foundation , Rome, Italy
                [2] 2Stress Physiology Lab, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma , Parma, Italy
                [3] 3Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg , Heidelberg, Germany
                [4] 4University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern , Bern, Switzerland
                [5] 5Department of Psychology, Sapienza University of Rome , Rome, Italy
                Author notes

                Edited by: Vaughan G. Macefield, Baker Heart and Diabetes Institute, Australia

                Reviewed by: Beverley Greenwood-VanMeerveld, University of Oklahoma Health Sciences Center, United States; Bruno Bonaz, Centre Hospitalier Universitaire de Grenoble, France

                *Correspondence: Luca Carnevali luca.carnevali@ 123456nemo.unipr.it

                This article was submitted to Autonomic Neuroscience, a section of the journal Frontiers in Neuroscience

                Article
                10.3389/fnins.2018.00228
                5897537
                29681793
                adf1e1e2-1316-4d08-92c7-fbbd08ee300c
                Copyright © 2018 Carnevali, Koenig, Sgoifo and Ottaviani.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 16 January 2018
                : 22 March 2018
                Page count
                Figures: 1, Tables: 0, Equations: 0, References: 139, Pages: 13, Words: 11497
                Funding
                Funded by: Ministry of Health 10.13039/501100003196
                Award ID: GR2011-02348232
                Categories
                Neuroscience
                Review

                Neurosciences
                anterior cingulate cortex,cortical thickness,depression,heart rate variability,ptsd,resilience,stress

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