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Heart rate variability and its neural correlates during emotional face processing in social anxiety disorder
... High TCVT is related to better coping in stressful conditions (Brosschot et al., 2007) and influences the level of efficacious adaptation to short-term demands (Appelhans and Luecken, 2006;Lane et al., 2013;Porges, 1991;Lane, 2000, 2009;Park et al., 2014). High TCVT is associated with higher dynamic capacity of vagal tone to respond to a stress condition (PCVT reactivity) which is represented by more vagal withdrawal under stress in adults (Aldao and Mennin, 2012;Gaebler et al., 2013;Park et al., 2014). TCVT is further positively related to PCVT recovery. ...
... To our knowledge, there are only two studies who have focused on this relationship of TCVT and PCVT dynamics. McLaughlin et al. (2014) investigated adolescents and found that high vagal tone at baseline was related to high vagal recovery corresponding with the idea of higher dynamic capacities in high TCVT of adults (Aldao and Mennin, 2012;Gaebler et al., 2013;Park et al., 2014). In contrast, high TCVT was related to less stress reactivity in children aged 4-7 years (Santucci et al., 2008), which is in contrast to expectations. ...
... We aimed to investigate the potential impact of TCVT on PCVT dynamics as this had been found in adults in previous work (Aldao and Mennin, 2012;Gaebler et al., 2013;Park et al., 2014). We found that even in children at preschool age of 2-6 years, TCVT influenced PCVT reactivity and PCVT early recovery, but not late PCVT recovery. ...
Introduction
Cardiac vagal tone has been understood as the biological correlate of emotion regulation and can be divided into emotion regulation (tonic cardiac vagal tone (TCVT)) and the flexibility to adapt to changing conditions (phasic cardiac vagal tone (PCVT)). There is evidence that TCVT influences PCVT dynamics in adults and that stress exposure impacts on cardiac vagal tone in adults and older children. The aim of the study was to investigate the impact of TCVT on PCVT dynamics in preschoolers and to identify the influence of stress exposures on cardiac vagal tone.
Method
Measures of heart rate variability including baseline (TCVT), during an age-adapted stress task (PCVT stress reactivity) and during recovery (PCVT recovery) were assessed in 222 children aged 2–6 years of the SPLASHY study. Further, parents were asked to complete questionnaires on early stress exposure (including pregnancy, birth and early life) and current stress exposure (including family stress and parenting).
Results
Preschool children with high TCVT showed less PCVT reactivity (p < 0.001) and more increase of vagal tone (PCVT) during early recovery (p = 0.016). Further only child's low birth weight was a relevant stress exposure impacting on early and late PCVT recovery (p = 0.03/p = 0.005). None of the other early or late stress exposure conditions, nor the accumulation of stress exposures influenced TCVT or PCVT dynamics in these healthy preschoolers.
Discussion
TCVT impacts on PCVT dynamics in a lab-based stress task in healthy preschool children and only low birth weight is related to more change during early and to less late PCVT recovery.
... Indeed, resting vmHRV is closely related to the effective engagement of prefrontal-subcortical inhibitory circuits implicated in the self-regulatory effort of emotional and cognitive processes 37-39 . Empirical evidence suggests that individuals with high resting vmHRV are more efficient in regulating both emotional and cognitive processes during simulation and interpretation of the respective states 40-44 , moreover, irrespectively from the resting vmHRV level, emotion suppression and reappraisal have been associated with vmHRV enhancement 43,[45][46][47] . In spite of the well-documented link between vmHRV and cognitive and emotion regulation, only a few studies have investigated the association between vmHRV and the empathy for pain 48-50 , however, to date it has never been explored whether the vmHRV responses detected during empathic conditions can be moderated by social factors such as the in-group/out-group dichotomy. ...
... Participants and behavioral scales. Male and female participants were matched both for age [t (46) = 0.218, p = 0.8283; see Table 1] and, for the Body Mass Index [t (46) = 1.893, p = 0.0646; see Table 1]. A series of further Student's t-test also revealed no differences between male and female participants in Resting Root Mean square of Successive Differences -RMMSD [t (46) = 0.261, p = 0.7949; see Table 1], Resting natural Log transformed High-Frequency power -Log-HF-HRV [t (46) = 0.377, p = 0.7079; see Table 1], Resting High-Frequency power normalized units -HF-HRV n.u [t (46) = 0.276, p = 0.7837; see Table 1], Resting peak High-Frequency values -pHF-HRV [t (46) = 1.144, p = 0.2585; see Table 1] and Symphatovagal balance Index -SVI [t (46) = 0.223, p = 0.8227; see Table 1]. ...
... Participants and behavioral scales. Male and female participants were matched both for age [t (46) = 0.218, p = 0.8283; see Table 1] and, for the Body Mass Index [t (46) = 1.893, p = 0.0646; see Table 1]. A series of further Student's t-test also revealed no differences between male and female participants in Resting Root Mean square of Successive Differences -RMMSD [t (46) = 0.261, p = 0.7949; see Table 1], Resting natural Log transformed High-Frequency power -Log-HF-HRV [t (46) = 0.377, p = 0.7079; see Table 1], Resting High-Frequency power normalized units -HF-HRV n.u [t (46) = 0.276, p = 0.7837; see Table 1], Resting peak High-Frequency values -pHF-HRV [t (46) = 1.144, p = 0.2585; see Table 1] and Symphatovagal balance Index -SVI [t (46) = 0.223, p = 0.8227; see Table 1]. ...
In this study, we explored vagally-mediated heart rate variability (vmHRV) responses, a psychophysiological index of cognitive self-regulatory control, to map the dynamics associated with empathic responses for pain towards an out-group member. Accordingly, Caucasian participants were asked to judge the experience of African and Caucasian actors touched with either a neutral or a harmful stimulus. Results showed that (1) explicit judgment of pain intensity in African actors yielded higher rating score and (2) took longer time compared to Caucasian actors, (3) these behavioural outcomes were associated with a significant increment of RMSSD, Log-HF-HRV and HF-HRV n.u., (4) resting HF-HRV n.u. predicted the participants’ lag-time to judge painful stimulations delivered to African actors. Interestingly, these dynamics were associated with a measure of implicit racial attitudes and were, in part, abolished when participants performed a concurrent task during videos presentation. Taken together our results support the idea that a cognitive effort is needed to self-regulate our implicit attitude as predicted by the ‘Contrasting Forces Model’.
... Emotion processing has also been studied alongside physiological measures (e.g., Gaebler et al., 2013;Spapé et al., 2017;Yang et al., 2007), and many studies have been focused on the relationships between emotion processing and cardiac autonomic activity (e.g., Bradley et al., 2008;Buss et al., 2005;Herbert et al., 2010). Recent studies suggest that emotions are the result of multiple processes, including cognition, experience, behaviors, and physiology (for a review, see Lench et al., 2011). ...
... Related studies examined HR responses in infants to emotional faces and found greater HR deceleration to faces depicting negative emotions compared to positive or neutral faces (e.g., Leppänen et al., 2010;Peltola et al., 2011). Studies have also examined different markers of cardiac activity (i.e., heart rate variability) in relation to emotional face processing, and more adaptive cardiac responding has been found to be associated with better emotion recognition (e.g., Bulut et al., 2018;Gaebler et al., 2013;Quintana et al., 2012). ...
Rapid and accurate emotion recognition is a crucial skill for social interactions, and visual attention to informative social cues in the environment can facilitate emotion recognition. Studies have found that emotion recognition is also associated with underlying cardiac autonomic responses. The current study examined (1) visual attention and cardiac response (change in heart rate) to emotionally-expressive faces and houses (as a nonsocial control image), and (2) associations between these responses and emotion recognition on the Reading the Mind in the Eyes Test (RMET) in college students. Results showed increased overall attention, but shorter first fixation durations, to faces as compared to houses. Across faces, attention was greater to eyes than mouth, but the magnitude of this difference was dependent on emotion. Analysis of cardiac responses revealed greater heart rate deceleration to happy and fearful faces as compared to neutral faces and houses. Better emotion recognition accuracy on the RMET was related to greater attention to faces, and eyes specifically, as well as greater heart rate deceleration to faces relative to houses. No relations between visual attention and cardiac response were found. The current work points to variations in visual attention and cardiac responses while viewing emotional faces that can be markers of emotion processing ability.
... Having a wide variation of symptoms and behaviour, severity, onset and course, depression is a very heterogeneous disorder (Lux and Kendler, 2010;Goldberg, 2011;Lieblich et al., 2015;Drysdale et al., 2017;Feczko et al., 2019). While behavioural correlates of depression are reported in DSM-5 2013, clinically-reliable physiological and biochemical markers for an objective diagnosis are unknown despite encouraging research findings (Rottenberg, 2007;Corrigan et al., 2010;Gaebler et al., 2013;Valenza and Scilingo, 2014;Garcia et al., 2016;Drysdale et al., 2017;Gentili et al., 2017;Brown et al., 2018;Caldwell and Steffen, 2018;Hartmann et al., 2019;Catrambone et al., 2021). ...
... Evidence on dysfunctional CAN and related BHI dynamics has been reported for depression and emotion dysregulation (Taggart et al., 2011;Terhaar et al., 2012;Gaebler et al., 2013;Gaebler et al., 2016;Catrambone et al., 2019). ...
If depressive symptoms are not caused by the physiological effects of a substance or other medical or neurological conditions, they are generally classified as mental disorders that target the central nervous system. However, recent evidence suggests that peripheral neural dynamics on cardiovascular control play a causal role in regulating and processing emotions. In this perspective, we explore the dynamics of the Central-Autonomic Network (CAN) and related brain-heart interplay (BHI), highlighting their psychophysiological correlates and clinical symptoms of depression. Thus, we suggest that depression may arise from dysregulated cardiac vagal and sympathovagal dynamics that lead to CAN and BHI dysfunctions. Therefore, treatments for depression should target the nervous system as a whole, with particular emphasis on regulating vagal and BHI dynamics.
... A complex and constantly changing heart rate (HR) is an indicator of healthy regulatory systems that can effectively adapt to sudden environmental and psychological challenges [1][2][3][4][5]. Thus, reduced heart rate variability (HRV) has not only been associated with poor cardiovascular health outcomes [6][7][8] and a range of vascular diseases [4,9,10], but also with different mental disorders and cognitive impairments [8,[11][12][13][14][15][16][17]. ...
... The model has gained ample support over the past decades as mounting evidence emerges, showing a significant relationship between HRV and prefrontal cortex activity [105][106][107][108]. This is in line with studies investigating the relationship between HRV and executive functioning, showing that participants with higher resting HRV (particularly short-term changes) performed better at different executive tasks, such as sustained attention [109,110], working memory [111,112] inhibition [106,[113][114][115], and cognitive flexibility [16,116,117]. Additionally, Hansen et al. [111] also highlighted the executive-specific advantage of higher vagally-mediated resting HRV which was not observed in non-executive tasks based on simple reaction time. ...
The use of heart rate variability (HRV) in research has been greatly popularized over the past decades due to the ease and affordability of HRV collection, coupled with its clinical relevance and significant relationships with psychophysiological constructs and psychopathological disorders. Despite the wide use of electrocardiogram (ECG) in research and advancement in sensors technology, the analytical approach and steps applied to obtain HRV measures can be seen as complex. Thus, posing a challenge to users who may not have the adequate background knowledge to obtain the HRV indices reliably. To maximize the impact of HRV-related research and its reproducibility, parallel advances in users’ understanding of the indices and the standardization of analysis pipelines in its utility will be crucial. This paper addresses this gap and aims to provide an overview of the most up-to-date and commonly used HRV indices, as well as common research areas that these indices have shown to be very useful, particularly in psychology. In addition, we also provide a step-by-step guide on how to perform HRV analysis using an integrative neurophysiological toolkit, NeuroKit2.
... A complex and constantly changing heart rate (HR) is an indicator of healthy regulatory systems that can effectively adapt to sudden environmental and psychological challenges [1][2][3][4][5]. Thus, reduced heart rate variability (HRV) has not only been associated with poor cardiovascular health outcomes [6][7][8] and a range of vascular diseases [4,9,10], but also with different mental disorders and cognitive impairments [8,[11][12][13][14][15][16][17]. ...
... The model has gained ample support over the past decades as mounting evidence emerges, showing a significant relationship between HRV and prefrontal cortex activity [105][106][107][108]. This is in line with studies investigating the relationship between HRV and executive functioning, showing that participants with higher resting HRV (particularly short-term changes) performed better at different executive tasks, such as sustained attention [109,110], working memory [111,112] inhibition [106,[113][114][115], and cognitive flexibility [16,116,117]. Additionally, Hansen et al. [111] also highlighted the executive-specific advantage of higher vagally-mediated resting HRV which was not observed in non-executive tasks based on simple reaction time. ...
The use of heart rate variability (HRV) in research has been greatly popularized over the past decades due to the ease and affordability of HRV collection, coupled with its clinical relevance and significant relationships with psychophysiological constructs and psychopathological disorders. Despite the wide use of electrocardiograms (ECG) in research and advancements in sensor technology, the analytical approach and steps applied to obtain HRV measures can be seen as complex. Thus, this poses a challenge to users who may not have the adequate background knowledge to obtain the HRV indices reliably. To maximize the impact of HRV-related research and its reproducibility, parallel advances in users' understanding of the indices and the standardization of analysis pipelines in its utility will be crucial. This paper addresses this gap and aims to provide an overview of the most up-to-date and commonly used HRV indices, as well as common research areas in which these indices have proven to be very useful, particularly in psychology. In addition, we also provide a step-by-step guide on how to perform HRV analysis using an integrative neurophysiological toolkit, NeuroKit2.
... From the initial pool of potentially eligible studies, we retained 32 studies for quantitative syntheses (Aimie-Salleh et al., 2019; Ardizzi et al., 2016;Buisman et al., 2019;Cȃrnuţȃ et al., 2015;Dale et al., 2018;Dileo et al., 2017;Duprey et al., 2019;Gaebler et al., 2013;Giuliano et al., 2018;Gordis et al., 2010;Goulter et al., 2019;Hagan et al., 2017;Herzog et al., 2018;Jin et al., 2018;Lovallo et al., 2012;Lunkenheimer et al., 2018;Lynch et al., 2015;McLaughlin et al., 2014;Meyer et al., 2016;Miskovic et al., 2009;Murray-Close and Rellini, 2012;Oshri et al., 2018;Patriquin et al., 2012;Reijman et al., 2014;Shenk et al., 2010Shenk et al., , 2012Stone et al., 2018;Tell et al., 2018;Thome et al., 2017;Waldron et al., 2015). ...
... Of the studies included in group comparison meta-analysis, 14 had explicitly recruited an ELM-exposed and a non-exposed but otherwise similar control group and resting-state HRV data for both groups were provided in respective published papers (Ardizzi et al., 2016;Dale et al., 2018;Dileo et al., 2017;Gordis et al., 2010;Goulter et al., 2019;Miskovic et al., 2009;Patriquin et al., 2012;Shenk et al., 2012;Stone et al., 2018), or upon request (Giuliano et al., 2018;Lynch et al., 2015;Murray-Close and Rellini, 2012;Shenk et al., 2010). The authors of the 11 remaining studies included in comparative meta-analysis responded to our request to re-allocate their samples into an ELM-exposed and a non-exposed control group and to provide respective summary resting-state HRV data for each group (Jin et al., 2018;Lovallo et al., 2012;Lunkenheimer et al., 2018;McLaughlin et al., 2014;Oshri et al., 2018;Reijman et al., 2014;Thome et al., 2017) or provided raw data (Aimie-Salleh et al., 2019; Gaebler et al., 2013;Meyer et al., 2016). ...
Recent focus on the consequences of early life adversity (ELA) in neurobiological research led to a variety of findings suggesting alterations in several physiological systems, such as the cardiovascular system. In this systematic review and meta-analysis, we focused on the relationship between early life maltreatment (ELM), one form of ELA, and resting vagal activity indexed by resting-state heart rate variability (HRV). A systematic search of the literature yielded 1′264 hits, of which 32 studies reporting data for group comparisons or correlations were included. By quantitative synthesis of existing studies using random-effect models, we found no evidence for a relationship between ELM exposure and resting vagal activity in principal. Conducting meta-regression analyses, however, we found the relationship between ELM and resting vagal activity to significantly vary as a function of both age and the presence of psychopathology. In light of the current multitude of vastly unclear pathways linking ELM to the onset of disease, we emphasize the need for further research and outline several aspects to consider in future studies.
... So far, only three studies have investigated the link between vmHRV and cognitive flexibility (Zahn, Adams, et al., 2016). However, the three identified studies used a stochastic reversal learning task (Ohira et al., 2013), emotion regulation after mood induction (Volokhov & Demaree, 2010), and problem solving (as assessed by the Trail-making test, Gaebler, Daniels, Lamke, Fydrich, & Walter, 2013) to assess cognitive flexibility. Using a stochastic reversal learning task, no behavioral relationship with vmHRV (as indexed by HF) was found (Ohira et al., 2013). ...
... Zahn, Adams, et al. (2016) classified reappraisal after mood induction as cognitive flexibility, because reappraisal indicates a shift from the induced negative mood towards a more positive way of thinking. Lastly, patients suffering from social anxiety disorder showed a negative correlation between performance on the Trail-Making Test (part B) and vmHRV, indicating better flexibility for individuals displaying higher HF scores (Gaebler et al., 2013). Because these studies did not use reliable, process-pure measures of cognitive flexibility and employed different measures of vmHRV, further investigation is warranted. ...
The neurovisceral integration model proposes that heart rate variability (HRV) is linked to prefrontal cortex activity via the vagus nerve, which connects the heart and the brain. HRV, an index of cardiac vagal tone, has been found to predict performance on several cognitive control tasks that rely on the prefrontal cortex. However, the link between HRV and the core cognitive control function “shifting” between tasks and mental sets is under-investigated. Therefore, the present study tested the neurovisceral integration model by examining, in 90 participants, the relationship between vagally mediated resting-state HRV and performance in a task-switching paradigm that provides a relatively process-pure measure of cognitive flexibility. As predicted, participants with higher resting-state HRV (indexed both by time domain and frequency domain measures) showed smaller switch costs (i.e., greater flexibility) than individuals with lower resting-state HRV. Our findings support the neurovisceral integration model and indicate that higher levels of vagally mediated resting-state HRV promote cognitive flexibility.
... In our research, we need to identify appropriate physiological measures that can be used to assess anxiety levels in real-time. Past research in the field of anxiety has utilized physiological assessments of autonomic nervous system activity, primarily heart rate variability (HRV) [2,20,21,41,48], and electrodermal activity (EDA) [22,59,63,69,82,86,95,98] to evaluate anxiety and emotional responses. EDA refers to the autonomic changes in the electrical properties of the skin. ...
The need to generate a spider to provoke a desired anxiety response arises in the context of personalized virtual reality exposure therapy (VRET), a treatment approach for arachnophobia. This treatment involves patients observing virtual spiders in order to become desensitized and decrease their phobia, which requires that the spiders elicit specific anxiety responses. However, VRET approaches tend to require therapists to hand-select the appropriate spider for each patient, which is a time-consuming process and takes significant technical knowledge and patient insight. While automated methods exist, they tend to employ rules-based approaches with minimal ability to adapt to specific users. To address these challenges, we present a framework for VRET utilizing procedural content generation (PCG) and reinforcement learning (RL), which automatically adapts a spider to elicit a desired anxiety response. We demonstrate the superior performance of this system compared to a more common rules-based VRET method.
... Hz [5], is often associated with Respiratory Sinus Arrhythmia (RSA) and can be well-thought-out a measure of pneumogastric activity due to its relation to vague nerve activity. The other primary HR oscillation described in HRV is the Low-Frequency (LF) oscillation, ranging between 0.04 and 0. 15 Hz, which encompasses the 10-second rhythm or Mayer wave [6]. ...
... This finding confirms the bodily hyper-focus of socially anxious individuals and is consistent with their increased IAc in social situations. However, when a task involving negative social feedback (faces expressing anger or fear) was performed during an fMRI scan, subjects with SAD showed lower IAc and anomalous cardio-regulatory functioning (Gaebler et al., 2013) -possibly due to excessive activation in this particular experimental condition. In accordance with their physiological hyper-activation in social situations, these participants reported an increased tendency to self-focus and suppress emotions, consistent with deficient IAw. ...
Attachment is the evolutionarily-established process through which humans create bonds with others to receive care from them. The phenomenon is as essential to our physical survival as it is to our psychological development. An increasing number of studies demonstrates that in sensitive periods during the early years of life, our brain circuitry is programmed in the interactions with our caregivers, with the imprinting of information over multiple attachment dimensions. Adopting a basic brain-computer analogy, we can think of this knowledge as the psycho-social firmware of our mind. According to a recently proposed extension of the classical three-dimensional view, one attachment dimension – somaticity – concerns the caregiver’s task of reflecting and confirming the child’s (internal) states – such as sensations, emotions, and representations – to support the child’s ability to identify and define those entities autonomously. Relying on multidisciplinary evidence – from neuroscientific, developmental, evolutionary, and clinical sources – we suggest that somaticity (H1) has the adaptive function to modulate our tendency to comply and affiliate with a reference group but also (H2) increases the vulnerability to developing Social Anxiety (SA) and Eating Disorders (EDs). We evaluate H1-H2, (1) indicating the evolutionary role of somaticity in modulating our affiliation tendency to optimize the ancestral threat-opportunity balance coming from infectious diseases and (2) showing the deep connection between SA-EDs and the features most closely related to somaticity – interoception and parenting style. Finally, we discuss three relevant implications of H1-H2: (A) Bringing into research focus the adaptive role of our firmware knowledge system versus the hardware (neural substrate) and software (higher cognition) ones. (B) Complementing the well-grounded Objectification and Allocentric Lock Theories, allowing us to integrate multiple levels of explanation on the etiology of psychopathology. (C) Suggesting the design of new psychological treatments. While not aiming to prove H1-H2, our analysis supports them and encourages their direct testing.
... In practice, noninvasive autonomic function tests along with heart rate variability are usually used to address the sympathovagal imbalance in various categories of patients. While the mentioned tests have proved to be effective, the expensive nature of the tests and the required expertise have emphasized the need for an established screening instrument to quantify symptoms of autonomic dysregulation [14]. ...
... Por lo tanto, ha sido posible relacionar los bajos niveles de la VRC con estados psicopatológicos tales como: estrés (Dishman et al., 2000), la impulsividad (Allen et al., 2000), la ansiedad (Chalmers et al., 2014;Friedman, 2007;Garakani et al., 2009;Licht et al., 2009;Saß et al., 2015), el mal funcionamiento social (Porges, 2011), trastornos de personalidad (Koenig, Kemp, Feeling et al., 2016) y la depresión (Beauchaine, 2001;Kemp et al., 2010;Kemp et al., 2012;Kemp et al., 2013;Porges, 2007;Rottenberg, 2007;Sgoifo et al., 2015;Taylor, 2010;Thayer et al., 2012;Saß et al., 2015;;Jarczok, 2018;Verkuil et al., 2015). Ahora, si bien es cierto que la mayoría de los estudios son consistentes al momento de comparar los cambios durante el procesamiento de las emociones entre pacientes con depresión y controles (Gaebler et al., 2013;Park et al., 2014), aún resulta necesario estudiar dicha relación en el caso de los individuos sanos o con sintomatología subumbral, la que ha mostrado asociarse a un deterioro en el funcionamiento (Burstein et al., 2014) y predecir futuros problemas de salud mental (Forsell, 2006). ...
The ability to regulate emotions is relevant to well-being, whereas the inability to adjust physiological systems in response to environmental demands is associated with the development and maintenance of psychopathology. Numerous studies demonstrate that Heart Rate Variability (HRV) is a psychophysiological marker of vagal regulation, which is reflected in psychological functioning indices. We recruited 201 volunteers: male and female undergraduate students (aged 18-29 years). Emotional regulation difficulties were measured with the Difficulties in Emotional Regulation Scale (DERS-E); psychological functioning, with the Outcome Questionnaire (OQ-30.2), and depressive symptomatology, with the Beck Depression Inventory (BDI-I). In addition, HRV was measured during a 5-min rest period with a built-in ambulatory electrocardiogram system as a valid psychophysiological measure of somatic processes underlying emotional processing. The aim was to demonstrate that: a) emotional regulation partially mediates the relationship between HRV and psychological functioning, and between HRV and depressive symptomatology; b) HRV is negatively associated with emotional regulation difficulties, impairments in psychological functioning, and depressive symptomatology; and c) emotional regulation difficulties are positively associated with impairments in psychological functioning, and depressive symptomatology. Results showed that the lower the HRV the higher the persons’ impairment in psychological functioning, when controlling for emotional regulation difficulties. However, HRV was not significantly related to participants' perception of emotional regulation difficulties nor with depressive symptomatology. Results are discussed and suggestions for future research are outlined.
... Heart rate (HR) is an indicator of the normal regulation of the human body that effectively adapts to environmental and psychological changes [1][2][3][4][5]. Reduced heart rate variability (HRV) is associated not only with poor cardiovascular health outcomes [6-8] and vascular disease [9][10][11][12][13], but also with various mental disorders and cognitive impairments [14][15][16][17][18][19][20][21]. HRV is an example of the close, yet complex coupling of the brain and the body. ...
Background
Heart Rate Variability is a simple tool to monitor cardiovascular stress. The proper function of the cardiovascular system is a problem among firefighters. Physical activity has health benefits being correlated with psychological stress. Physically active people should be more resilient to psychological stress but this has not always been demonstrated. The aim of this study was to determine whether cranial techniques would have an effect on HRV parameters. Osteopathy in the cranial reduces stress and improves cardiovascular function.
Methods
Fifty-seven firefighter cadets aged 18–24 years (21.63 ± 1.41) participated in the study. All subjects had their heart rate variability measured and were randomly assigned either to the cranial techniques (CS) group with therapy performed once a week for 5 weeks) or to the control group (CO). After 5 weeks heart rate variability was measured again in both groups.
Results
In the Friedman test, in the CS group there was a statistically significant effect of cranial techniques on HR and LF, but not on HF; in the CO group, a statistically significant difference was observed for HR, HF and LF. In the Nemenyi test, in the CS group there was a statistically significant difference for HR and LF and in the CO group for HR, HF and LF. After applying hierarchical clustering with Euclidean measure and the complete method, dendrograms were drawn up showing similarities for HR, HF and LF values.
Conclusion
The cranial techniques and touch might exert a beneficial effect on HRV.
... 6,7 All of the above concepts about HRV have been used in previous AD studies. [12][13][14][15][16][17][18][19][20][21] The HRV presentations in AD patients were somewhat different between studies. Some studies revealed that AD patients had significantly lower resting-state HRV than healthy individuals, whereas some others revealed non-significant inter-group differences. ...
Aims:
Patients with anxiety disorders (AD) have been found to have lower heart rate variability (HRV) than healthy individuals in some studies, but this was inconsistent. Furthermore, the influence of distinct diagnoses, study design, and demographic factors on the results was not comprehensively examined.
Methods:
We gathered studies comparing HRV in patients with AD and in healthy controls. The parasympathetic activity in the hierarchical order principle was adopted in the main analysis. We adopted the random effects model to calculate the standardized mean difference.
Results:
Of the 7805 screened studies, 99 were included in the quantitative analysis, with a total of 4897 AD patients and 5559 controls finally entered the meta-analysis. AD patients had a significantly lower resting-state HRV for parasympathetic activity compared to control (Hedges' g=-0.3897). For the diagnostic subgroup analysis relative to the controls, resting-state HRV was significantly lower in post-traumatic stress disorder, panic disorder, generalized anxiety disorder, and social anxiety disorder patients. HRV reactivity (all reactivity data, data on physiological challenge, and psychological challenge) did not show significant inter-group differences between AD patients and healthy subjects.
Conclusions:
The results supported that patients with AD had significantly lower resting-state HRV than the healthy population, but no alterations were found for HRV reactivity. This article is protected by copyright. All rights reserved.
... Based on a previous study (Gaebler et al., 2013) on the difference of SAD vs control group for HRV with an effect size of d=0.77, 44 patients (22 per arm) would be required to have an 80% chance of detecting this difference between patients with TMR vs. those in the control group. Besides, based on a study (Sterpenich et al., 2014) on the effect of associated vs non-associated sound during REM sleep on associative memory with a large effect size (g=1.01), ...
Background
Social anxiety disorder (SAD) is an anxiety disorder characterized by a significant amount of fear when confronted to social situations and can cause considerable distress in daily life. Exposure therapy, which is based on fear extinction, is a popular and effective treatment for SAD, although it does not often lead to full remission. Here, we aimed at improving exposure therapy outcome. Specifically, based on previous research showing that rapid eye movement (REM) sleep promotes the consolidation of extinction memory, we used targeted memory reactivation (TMR) during REM sleep to enhance extinction learning.
Methods
48 subjects (32 women and 16 men, mean age of 24.41 ± 4.91) with moderate or severe SAD according to DSM-5 participated in our study, and were randomly assigned to one of two matched groups: control or TMR group. All patients had two successive exposure therapy sessions in a virtual reality (VR) environment, where they were asked to give a public talk in front of a virtual jury. At the end of each session, and only in the TMR group (N=24), a sound was paired to the positive feedback phase of exposure therapy (i.e. approval of their performance), and which represents the extinction memory to be strengthened during REM sleep. All participants slept at home with a wearable headband device which automatically identified sleep stages online and administered the sound several times during REM sleep. Anxiety level was assessed using measures of sympathetic (electrodermal activity component : non-specific skin conductance responses, ns-SCRs) and parasympathetic (heart rate variability component : root mean square of successive differences between normal heartbeats, RMSSD) activity, and subjective measures (Subjective Units of Distress Scale, SUDS), during the preparation phase of their virtual talks before (T1) and after (T2) one full-night’s sleep with auditory stimulation and after one week of auditory stimulation at home (T3). Participants also filled in a dream diary one week prior and one week after the day of exposure therapy.
Results
Subjective anxiety was reduced during the second and third anticipatory preparation phase of exposure, compared to the first one, for both groups (p < 0.001). RMSSD levels were lower in the TMR group compared to the control group (p=.037) during the preparation phase after 8 nights of stimulation at home (T3). No significant result between groups was observed for SUDS and the ns-SCRs at T3. Importantly, the longer REM sleep and the more stimulations the TMR group (but not the control group) had at home, the less anxious (increased RMSSD) these participants were. Finally, fear in dreams correlated positively with measures of stress (ns-SCRs and SUDS) in this group.
Conclusions
TMR during REM sleep did not modulate the beneficial effect of exposure therapy on anxiety-related distress (SUDS). Yet, our results support that REM sleep can contribute to extinction processes and substantiate strong links between emotional experiences in dreams and waking stress levels in these patients.
... Chronic stress can cause a flattening of the diurnal pattern, lowering the early morning peak and elevating the low night-time levels [9]. The sympathetic nervous system (SNS) arm of the stress response causes an increase in circulating catecholamines, increased heart rate, decreased heart rate variability (especially decreased high-frequency heart rate variability), and raised salivary alpha-amylase [9,[17][18][19][20]. Symptoms of the stress response should also be assessed using validated questionnaires such as the Subclinical Stress Symptom Questionnaire-25 (SSQ-25) [21] or the Perceived Stress Scale-10 (PSS-10) [22]. ...
The stress response is a well-defined physiological function activated frequently by life events. However, sometimes the stress response can be inappropriate, excessive, or prolonged; in which case, it can hinder rather than help in coping with the stressor, impair normal functioning, and increase the risk of somatic and mental health disorders. There is a need for a more effective and safe pharmacological treatment that can dampen maladaptive stress responses. The endocannabinoid system is one of the main regulators of the stress response. A basal endocannabinoid tone inhibits the stress response, modulation of this tone permits/curtails an active stress response, and chronic deficiency in the endocannabinoid tone is associated with the pathological complications of chronic stress. Cannabidiol is a safe exogenous cannabinoid enhancer of the endocannabinoid system that could be a useful treatment for stress. There have been seven double-blind placebo controlled clinical trials of CBD for stress on a combined total of 232 participants and one partially controlled study on 120 participants. All showed that CBD was effective in significantly reducing the stress response and was non-inferior to pharmaceutical comparators, when included. The clinical trial results are supported by the established mechanisms of action of CBD (including increased N-arachidonylethanolamine levels) and extensive real-world and preclinical evidence of the effectiveness of CBD for treating stress.
... Low levels of the HRV high frequency (HF)primarily influenced by RSAhave specifically been shown to be an indicator for the state of depression in clinical populations (Hartmann et al., 2019;Koch et al., 2019). Additionally, reduced HF in patients with social anxiety disorder both at rest and upon emotional processing suggests a relationship between psychopathology and decreased parasympathetic flexibility (Gaebler et al., 2013). ...
Background: Parasympathetic function and emotional self-regulation (ESR) share neuroanatomic structures. Based on Porges’ Polyvagal Theory and the Neurovisceral Integration Model (NIM), we compared vagally mediated heart-rate variability (vmHRV) with psychometrically assessed ESR. We hypothesized that vmHRV and ESR would be associated during rest, a vagal function test, and recovery from that test. A significant association would justify the psychometric measuring of parasympathetic health, which is less burdensome than its psychophysiological assessment. Methods: 213 healthy males (aged 18 to 26, M = 20.29) took part in the present study. They completed the Emotion Regulation Questionnaire (ERQ) and underwent the Cold-Face Test (CFT) for four minutes wearing ambulatory electrocardiograms. High frequency (HF) band was used as a measure of vmHRV before, during, and after the CFT. Associations between the HF band and ESR were analyzed with partial rank correlations. Results: There was no significant association between ERQ scores and the response to the CFT itself. But there was an almost significant association between the ERQ scale Cognitive Appraisal and baseline vmHRV, and a significant association between Cognitive Appraisal and cardiac recovery from the CFT, i.e., participants with higher scores on that ESR scale revealed a tendency to exhibit greater vmHRV during baseline and they clearly exhibited greater vagal withdrawal during recovery from the CFT. Discussion: Cognitive appraisal as a psychometrically assessed emotion regulatory process was reflected in a more flexible parasympathetic activity (i.e., better cardiac vagal health) during recovery from an exclusively physiological stressor. This lends convergent validity to self-reported emotion regulation, and justification for its use as a measure of ESR as a trait, offering further support for the Polyvagal Theory and NIM.
... Nearly half of highly behaviorally inhibited children go on to develop SAD [5], probably caused by a propense genetic background [6] and triggered/intensified by environment factors [7]. The molecular and neuroanatomical knowledge of SAD evolved from the classic amygdala circuitry for conditioned fear [8] to recent evidences pointing to the involvement of other brain structures [9][10][11][12][13]. Although the relevance of genetic J o u r n a l P r e -p r o o f factors has been demonstrated, a lack of consistency is observed across the studies, in particular, the amount of variance explained by genetic factors from twin studies [14]. ...
Social Anxiety Disorder (SAD) is characterized by emotional and attentional biases as well as distorted negative self-beliefs. According this, we proposed to identify the brain structures and hub genes involved in SAD. An analysis in Pubmed and TRANSFAC was conducted and 72 genes were identified. Using Microarray data from Allen Human Brain Atlas it was possible to identify three modules of co-expressed genes from our gene set (R package WGCNA). Higher mean gene expression was found in cortico-medial group, basomedial nucleus, ATZ in amygdala and in head and tail of the caudate nucleus, nucleus accumbens and putamen in striatum. Our enrichment analysis identified the followed hub genes: DRD2, HTR1A, JUN, SP1 and HDAC4. We suggest that SAD is explained by delayed extinction of circuitry for conditioned fear caused by reduced activation of the dopaminergic and serotonergic systems due diminished expectation of reward during social interactions.
... This heightened awareness in turn might have let them sense bodily sensations more intensely and thus overrate these feelings. This is in line with studies showing that patients with SAD (Gaebler, Daniels, Lamke, Fydrich, & Walter, 2013) and high socially anxious individuals (Mauss et al., 2004) are less accurate than healthy controls to estimate their bodily reactions to stress, e.g. heartbeat and respiratory rate. ...
... At worst, results may indicate the effect of perceived frequency and valence of contact on neurological intergroup phenomena -a useful question in its own right. This question of whether personal beliefs and recollection of interactions with outgroup members is germane to face processing remains relevant, especially given that such cognitive phenomena -though potentially reconstructed -are likely to themselves be caused by more strictly objective phenomena such as local demographics and actual contact experience [54][55][56] . Future research could more directly test the hypothesis that (objective) intergroup contact modulates other-race face processing, by experimentally inducing intergroup contact of either positive or negative valence and investigating its immediate effects on the neural basis of race face processing. ...
In this study, we investigated the effect of intergroup contact on processing of own- and other-race faces using functional Magnetic Resonance Imaging (fMRI). Previous studies have shown a neural own-race effect with greater BOLD response to own race compared to other race faces. In our study, white participants completed a social-categorization task and an individuation task while viewing the faces of both black and white strangers after having answered questions about their previous experiences with black people. We found that positive contact modulated BOLD activity in the right fusiform gyrus (rFG) and left inferior occipital gyrus (lIOC), regions associated with face processing. Within these regions, higher positive contact was associated with higher activity when processing black, compared to white faces during the social categorisation task. We also found that in both regions a greater amount of individuating experience with black people was associated with greater activation for black vs. white faces in the individuation task. Quantity of contact, implicit racial bias and negatively valenced contact showed no effects. Our findings suggest that positive contact and individuating experience directly modulate processing of out-group faces in the visual cortex, and illustrate that contact quality rather than mere familiarity is an important factor in reducing the own race face effect.
... 3 Chalmers et al., 2014;Gaebler, Daniels, Lamke, Fydrich, & Walter, 2013;Pittig, Arch, Lam, & Craske, 2013). ...
Background:
Heart rate variability (HRV) is discussed to signal social safety. Conversely, shyness might be accompanied by attenuated feelings of social safety. This study aimed to examine if shy individuals show compromised HRV in everyday life and if social interactions with close others (both face to face and computer-mediated) might moderate this association.
Methods:
Social interactions and HRV (root mean squared successive differences) were recorded across three consecutive days in 51 participants.
Findings:
HRV was lower in shy as compared to non-shy individuals. When interacting with close others, HRV in shy individuals increased considerably, while there was no effect for non-shy individuals. Exploratory analyses confirmed that effects were more reliable for face-to-face as compared to computer-mediated interactions.
Discussion:
Shyness may be associated with compromised social engagement as indicated by lower HRV. However, shy individuals may benefit from face-to-face interactions with close others, thus suggesting a buffering effect on cardiac function.
... In clinical contexts, patients with anxiety disorders compared to healthy controls show decreased PNS activity at rest (Alvares et al., 2013;Thayer, Friedman, & Borkovec, 1996), smaller changes in HRV from baseline during cognitive stress and during recovery (Movius & Allen, 2005), and decreased HRV during implicit emotional face processing (Gaebler, Daniels, Lamke, Fydrich, & Walter, 2013) or worrying (Thayer et al., 1996). Beyond anxiety, patients with depression also show reduced PNS activity compared to healthy controls (Kemp et al., 2010) and individuals with high depressive symptoms exhibit stronger reduction in PNS activity during stress and relative to baseline compared to individuals with low depressive symptoms (Hughes & Stoney, 2000). ...
... Studies that combine resting and task-based measures of HRV with neuroimaging have focused on neural activity across a number of different contexts such as social stress (Ahs, Sollers, Furmark, Fredrikson, & Thayer, 2009), effortful cognitive and motor control (Critchley et al., 2003), emotion introspection (Weissman, Guyer, Ferrer, Robins, & Hastings, 2018), film and recall based emotion induction , and resting functional connectivity (Chang et al., 2013;Sakaki et al., 2016). Overall, however, surprisingly few studies have examined the relation between resting HRV and neural response to others' emotional expressions (Gaebler, Daniels, Lamke, Fydrich, & Walter, 2013). Furthermore, whether resting HRV is linked to putative neural mechanisms of sensorimotor resonance has not been studied. ...
Whether neurovisceral integration, reflected by resting high-frequency heart rate variability (HRV), constrains or facilitates neural reactivity to other people’s emotions is unclear. We assessed the relation between resting HRV and neural activation when observing and imitating emotional faces. We focused on brain regions implicated in sensorimotor resonance, salience detection and arousal. We used electrocardiogram data to compute resting HRV. Resting HRV measures were negatively correlated with activation in a portion of the inferior frontal gyrus showing mirror neuron properties, the insula and the amygdala in response to observation, but not imitation, of emotional faces. Thus, resting HRV appears to be linked to sensitivity to others’ emotional cues, both in terms of the tendency to map others’ emotional facial expressions onto one’s own motor system and to rapidly detect and mark others’ emotions as salient events. Resting HRV may reflect, in part, a threshold for increased processing of others’ emotional cues.
... The Hariri et al. (2000) task has been used by several research groups because of its robust amygdala activation. Most of the published articles using the task (e.g., Gaebler et al., 2013;Mattson et al., 2016;van Wingen et al., 2011) reported similar results to Hariri et al. (2000), but others have reported differential activation patterns specifically for the amygdala and hippocampus (Contreras-Rodríguez et al., 2014;Fagundo et al., 2014;Wang et al., 2004). Table 2 shows a selection of articles with their findings for limbic activation in addition to the preprocessing steps that were applied to the data, activations reported, motion correction information if described, the FWHM smoothing kernel used, spatial resolution if information was published, and scanner field strength. ...
Given the amygdala's role in survival mechanisms, and its pivotal contributions to psychological processes, it is no surprise that it is one of the most well-studied brain regions. One of the common methods for understanding the functional role of the amygdala is the use of functional magnetic resonance imaging (fMRI). However, fMRI tends to be acquired using resolutions that are not optimal for smaller brain structures. Furthermore, standard processing includes spatial smoothing and motion correction which further degrade the resolution of the data. Inferentially, this may be detrimental when determining if the amygdalae are active during a task. Indeed, studies using the same task may show differential amygdala(e) activation. Here, we examine the effects of well-accepted preprocessing steps on whole-brain submillimeter fMRI data to determine the impact on activation patterns associated with a robust task known to activate the amygdala(e). We analyzed 7T fMRI data from 30 healthy individuals collected at sub-millimeter in-plane resolution and used a field standard preprocessing pipeline with different combinations of smoothing kernels and motion correction options. Resultant amygdalae activation patterns were altered depending on which combination of smoothing and motion correction were performed, indicating that whole-brain preprocessing steps have a significant impact on the inferences that can be drawn about smaller, subcortical structures like the amygdala.
... HrV was also investigated in relation of state and trait anxiety (Gaebler et al., 2013;Pittig et al., 2013). Similarly to allergy mentioned earlier, anxiety disorders are considered a risk factor in developing cardiovascular disorders (chalmers et al., 2014;Vogelzangs et al., 2010). ...
Introduction. Heart rate variability (HRV) represents one of the most used biomarkers of cardiovascular health that offers insight on autonomic nervous system (ANS) activation. This study deals with the issue of abnormal functioning of the ANS in allergic individuals who were monitored during three consecutive years. Methods. Our aim was to analyze the influence of various stress protocols on HRV parameters, which could be used as markers of ANS activity and on subjective perception of stress described by STAI-X1 (State-Trait Anxiety Inventory). Four different stress protocols are compared here: 1. Psychosocial stress (PSST), 2. Cognitive stress, 3. Measurements in natural conditions and 4. PSST group test (GPSST). This study compares outcome of the four protocols also with referential HRV measurement. Results and Discussion. The findings show that the stress tasks which featured a social component (PSST a GPSST) triggered a more intensive physiological response in comparison to cognitive stress or with natural conditions measurements. We recorded an interesting and significant finding related to allergy: allergic subjects showed a tendency towards decreased heart rate frequency (HR) and increased overall HRV in all tests. However, in case of subjectively perceived stress, no differences between groups were recorded. Besides, the functioning of the ANS showed also gender differences represented by an increased HR and a decreased HRV in women. Conclusion. Our results show increased HR and decreased HRV in stress conditions in all stress protocols. Our data support the prior findings of sympathetic withdrawal and/or parasympathetic hyperactivation in individuals suffering from allergy, which could be one form of the dysregulation of the ANS. © 2018, Academy of Sciences of the Czech Republic. All rights reserved.
... A C C E P T E D M A N U S C R I P T Physiological foundation of empathy 6 Walter, 2013;Quintana, Guastella, Outhred, Hickie, & Kemp, 2012), we also hypothesized to find indices of HRV positively related to empathy measures. ...
The capacity to represent the emotional and mental states of others is referred to by the concept of empathy. Empathy further differentiates into an emotional and a cognitive subcomponent, which in turn is known to require a tacit perspective-taking process. However, whether the empathizer by himself needs to enter an affective state as a necessary precondition for emotional empathy remains a matter of debate. If empathy would require a vicarious emotional reaction, specific physiological markers of affective responding should be detectable in the empathizing person. In the present study, we investigated the relationship between self-reported empathy and psychophysiological responses in young, healthy participants. We assessed emotional and cognitive empathy with the Multifaceted Empathy Test on the one hand and the corresponding heart rate and skin conductance responses (SCR), affective startle modulation and heart rate variability on the other. We found a negative relationship between SCR and self-reported emotional empathy: higher SCR to emotional stimuli predicted lower empathy ratings. We conclude that physiological arousal is not necessary and might even diminish empathy for others.
... Pulse-to-pulse intervals are a sufficient proxy for cardiac inter-beat-intervals (IBIs) and suitable for analysis of HR and HRV (Selvaraj et al., 2008;Lu et al., 2009;Gil et al., 2010). Readout of pulse oximetry data was automated in MATLAB to determine IBIs based on the built-in Siemens peak detection algorithm, as described in Gaebler et al. (2013). IBIs were written in a text file and later analyzed using Kubios HRV analysis package 2.2 (Tarvainen et al., 2014), allowing for the calculation of time-and frequency-domain indices of RVA. ...
Major depressive disorder (MDD) has been associated with abnormalities in cortical thickness and autonomic function. Adolescence is a time notable for brain development and MDD onset. In healthy adolescents, greater resting state vagal activity (RVA) is associated with lower cortical thickness. The relationship between brain structural thickness and RVA in adolescents with MDD has not previously been studied. This secondary analysis drew on a sample of 37 non-depressed controls and 53 adolescents with MDD. Resting state heart rate and two indices of RVA (HF-HRV and RMSSD) were recorded during a neuroimaging session. Cortical thickness within fronto-limbic regions of interest was measured using Freesurfer analysis of T1-weighted high-resolution structural images. Self-reports of depression severity showed a significant interaction with cortical thickness of the right insula in predicting RMSSD (t = 2.22, p=.030, β = 5.44; model fit of the interaction term as indicated by the Bayes Factor (BF): 7.58) and HF-HRV (t = 2.09, p=.041, β = 4.72; BF: 7.94). Clinician ratings of depression severity showed further interactions. Findings underscore the important relationships between RVA and cortical development, suggesting two possible explanations: (1) in adolescent MDD, greater fronto-limbic thickness is compensatory for deficits in autonomic regulation; or (2) increased autonomic arousal results in delayed fronto-limbic maturation. Longitudinal research is necessary to further clarify the nature of the relationship between autonomic functioning and cortical development.
... More specifically, the meta-analysis also revealed decreased HRV in patients with SAD during resting state, albeit to a lesser extent than in most other anxiety disorders (Chalmers et al., 2014). Decreased HRV in patients with SAD during resting state was also found by other studies using RMSSD (Alvares et al., 2013;Garcia-Rubio et al., 2017) or high frequency power (Gaebler et al., 2013;Pittig et al., 2013). However, most studies have found no association between SAD and HRV during resting state using RMSSD (Klumbies et al., 2014) or high frequency power (Alkozei et al., 2015;Alvares et al., 2013;Faucher et al., 2016;Grossman et al., 2001;Schmitz et al., 2013). ...
Background:
Social anxiety disorder (SAD) is the extreme fear and avoidance of one or more social situations. The goal of the current study was to investigate whether heart rate variability (HRV) during resting state and a social performance task (SPT) is a candidate endophenotype of SAD.
Methods:
In this two-generation family study, patients with SAD with their partner and children, and their siblings with partner and children took part in a SPT (total n = 121, 9 families, 3-30 persons per family, age range: 8-61 years, 17 patients with SAD). In this task, participants had to watch and evaluate the speech of a female peer, and had to give a similar speech. HRV was measured during two resting state phases, and during anticipation, speech and recovery phases of the SPT. We tested two criteria for endophenotypes: co-segregation with SAD within families and heritability.
Results:
HRV did not co-segregate with SAD within families. Root mean square of successive differences during the first resting phase and recovery, and high frequency power during all phases of the task were heritable.
Limitations:
It should be noted that few participants were diagnosed with SAD. Results during the speech should be interpreted with caution, because the duration was short and there was a lot of movement.
Conclusions:
HRV during resting state and the SPT is a possible endophenotype, but not of SAD. As other studies have shown that HRV is related to different internalizing disorders, HRV might reflect a transdiagnostic genetic vulnerability for internalizing disorders. Future research should investigate which factors influence the development of psychopathology in persons with decreased HRV.
... ANS regulation is related to both attentional control and emotional regulation, and can be observed through the analysis of HRV (Porges, 2007;). HRV and especially HF-HRV is positively linked to good emotional regulation skills and therefore negatively associated with emotional or attentional dysfunctions such as social anxiety disorders (Gaebler, Daniels, Lamke, Fydrich, & Walter, 2013) or attention deficit hyperactivity disorders (Tonhajzerova et al., 2009). Low HRV has also been associated with chronic stress (Lucini, Riva, Pizzinelli, & Pagani, 2007;Pereira, Cerqueira, Palha, & Sousa, 2013) and burnout (Díaz-Rodríguez et al., 2011), It is also a good marker of cardiovascular risk (Assoumou et al., 2010;Schuster, Fischer, Thayer, Mauss, & Jarczok, 2016;Thayer, Yamamoto, & Brosschot, 2010). ...
La théorie polyvagale (Porges, 2007) propose la flexibilité physiologique comme corrélat des compétences socio-émotionnelles. Cette flexibilité physiologique est en partie déterminée par les interactions coeur-cerveau mesurables par la variabilité cardiaque de haute fréquence (HF-HRV). Selon cette théorie, une plus haute HF-HRV devrait être associée à une meilleure perception des émotions et à des comportements davantage prosociaux. Si plusieurs données tendent à corroborer cette proposition, aucune étude ne permet de tester précisément ces hypothèses. Nous avons donc mené une série d’études ayant pour but de les tester. Dans une première étude, nous avons testé le lien entre HF-HRV et comportement prosocial mesuré par le niveau de coopération. Le niveau de HF-HRV prédisait le niveau de coopération mais dans un contexte spécifique. Notre deuxième étude avait pour but de tester le lien entre HF-HRV et perception des émotions. Ici, le niveau de HF-HRV ne prédisait pas de meilleures performances en reconnaissance d’émotions. Nous avons ensuite voulu tester un éventuel lien causal existant entre HF-HRV et prosocialité. Pour cela nous avons réalisé une expérience (étude 3) visant à manipuler la HF-HRV par biofeedback. Le biofeedback augmentait la HF-HRV mais uniquement chez les individus avec une faible ligne de base. L’étude 4 testait si manipuler la HF-HRV par biofeedback modulait le comportement de coopération. Nous n’avons pas répliqué nosrésultats quant à l’efficacité du biofeedback et n’avons donc pas observé d’effet sur la coopération. La cinquième et dernière étude permettait de tester si manipuler la prosocialité modulait le niveau de HF-HRV. Nous n’avons pas observé d’effet de notre manipulation expérimentale sur la HF-HRV. En conclusion, la prédiction de la théorie polyvagale est corroborée par les données empiriques quant au lien entre HF-HRV et comportements prosociaux mais aucune confirmation n’a pu étayer le rapport entre perception des émotions et HF-HRV. Dans le cas des manipulations expérimentales à court terme, aucune relation causale entre HF-HRV et comportements prosociaux n’a été observée.
... Another important question is if the different parameters of HRV mirror the state of the ANS. It has been shown, that representations of ANS in the brain and brain centers involved in HRV are mainly the same (122)(123)(124)(125). However, does HF correlate with the parasympathetic tone? ...
Heart-rate variability (HRV) is frequently introduced as mirroring imbalances within the autonomous nerve system. Many investigations are based on the paradigm that increased sympathetic tone is associated with decreased parasympathetic tone and vice versa. But HRV is probably more than an indicator for probable disturbances in the autonomous system. Some perturbations trigger not reciprocal, but parallel changes of vagal and sympathetic nerve activity. HRV has also been considered as a surrogate parameter of the complex interaction between brain and cardiovascular system. Systems biology is an inter-disciplinary field of study focusing on complex interactions within biological systems like the cardiovascular system, with the help of computational models and time series analysis, beyond others. Time series are considered surrogates of the particular system, reflecting robustness or fragility. Increased variability is usually seen as associated with a good health condition, whereas lowered variability might signify pathological changes. This might explain why lower HRV parameters were related to decreased life expectancy in several studies. Newer integrating theories have been proposed. According to them, HRV reflects as much the state of the heart as the state of the brain. The polyvagal theory suggests that the physiological state dictates the range of behavior and psychological experience. Stressful events perpetuate the rhythms of autonomic states, and subsequently, behaviors. Reduced variability will according to this theory not only be a surrogate but represent a fundamental homeostasis mechanism in a pathological state. The neurovisceral integration model proposes that cardiac vagal tone, described in HRV beyond others as HF-index, can mirror the functional balance of the neural networks implicated in emotion–cognition interactions. Both recent models represent a more holistic approach to understanding the significance of HRV.
... In fact, previous studies have reported that social phobia and OCD can be simultaneously present in some subjects (Camuri et al., 2014) (Baldwin, Brandish, & Meron, 2008). In addition, there are considerable evidences showing that patients with social phobia course with higher social sensitivity (Boll et al., 2016;Gaebler, Daniels, Lamke, Fydrich, & Walter, 2013;Veit et al., 2002). Future studies should explore and control to what extent in that social effects are related to the presence of social phobia symptoms. ...
Background:
Error monitoring, cognitive control and motor inhibition control are proposed as cognitive alterations disrupted in obsessive-compulsive disorder (OCD). OCD has also been associated with an increased sensitivity to social evaluations. The effect of a social simulation over electrophysiological indices of cognitive alterations in OCD was examined.
Methods:
A case-control cross-sectional study measuring event-related potentials (ERP) for error monitoring (Error-Related Negativity), cognitive control (N2) and motor control (LRP) was conducted. We analyzed twenty OCD patients and twenty control participants. ERP were recorded during a social game consisting of a visual discrimination task, which was performed in the presence of a simulated superior or an inferior player.
Results:
Significant social effects (different ERP amplitudes in Superior vs. Inferior player conditions) were found for OCD patients, but not for controls, in all ERP components. Performing the task against a simulated inferior player reduced abnormal ERP responses in OCD to levels observed in controls. The hierarchy-induced ERP effects were accompanied effects over reaction times in OCD patients.
Conclusions:
Social context modulates signatures of abnormal cognitive functioning in OCD, therefore experiencing a social superiority position impacts over cognitive processes in OCD such as error monitoring mechanisms. These results open the door for the research of new therapeutic choices.
In this chapter depth of emotion is explored suggesting that emotional depth can partly explain the bad reputation of emotions.
Wearable technology holds promise for monitoring and managing Social Anxiety Disorder (SAD), yet the absence of clear biomarkers specific to SAD hampers its effectiveness. This paper explores this issue by presenting a study investigating variances in heart rate, heart rate variability, and skin conductance between socially anxious and non-anxious individuals. One hundred eleven non-clinical student participants participated in groups of three in three anxiety-provoking activities (i.e., speech, group discussion, and interview) in a controlled lab-based study. During the study, electrocardiogram (ECG) and electrodermal activity (EDA) signals were captured via on-body electrodes. During data analysis, participants were divided into four groups based on their self-reported anxiety level (“None”, “mild”, “moderate”, and “severe”). Between-group analysis shows that discriminating ECG features (i.e., HR and MeanNN) could identify anxious individuals during anxiety-provoking activities, while EDA could not. Moreover, the discriminating ECG features improved the classification accuracy of anxious and non-anxious individuals in different machine-learning techniques. The findings need to be further scrutinized in real-world settings for the generalizability of the results.
Humans' ability to interact with strangers is fundamental, and an individual's mentalizing ability is closely linked to inferences and interactions with strangers. The main aim of this study is to identify the quantitative mentalizing capability with social distance preferences and interaction attitudes with individual variation. In the first two experiments, we examined association between mentalizing ability, social anxiety and conducted behavioral experiments with Virtual Social Distance (VSD, experiment 2a, N = 223) and Real Social Distance (RSD, experiment 2b, N = 45) preference tasks. In experiment 3, we induced the "social exclusion" paradigm (N = 94) and linked it to the measured dynamic characteristic of mentalization. The findings reveal that: (i) individuals with lower capability of self-perception show a greater degree of social anxiety and a diminished capacity for meta-cognition; (ii) higher degree of "social anxiety" associates more with VSD preference naturally; and (iii) participants from the "socially excluded group" show decreasing tendency in their mentalizing capability. The results provide new insights into social distance preferences and how social environment variations affect sub-clinical social anxious individuals, highlighting individual differences in social interaction preference. It may also have the potential for intervention and treatment for people with anxiety in social interactions.
Stress has a major impact on both an individual and a societal level. Early recognition of the negative impact of stress or reduced resilience can be used in personalized interventions that enable the user to break the identified pattern through timely feedback, and thus limit the emergence of stress-related problems. The emergence of wearable sensor technology makes it possible to continuously monitor relevant behavioral and physical parameters such as sleep and heart rate variability (HRV). Sleep and HRV have been linked to stress and resilience in population studies, but knowledge on whether these relationships also apply within individuals, which is necessary for the aforementioned personalization, is lacking. This thesis introduces a cyclical conceptual model for resilience and four observational studies that test relationships between sleep, HRV and subjective resilience-related outcomes within participants using different types of data analysis at different timeframes. The relationships from the conceptual model and the related hypotheses are broadly confirmed in these studies. Participants tended to have more favorable subjective stress- and resilience-related outcomes on days with a relatively high resting HRV or long total sleep duration. Also, having a resting HRV that fluctuates relatively little from day to day was related to less stress and somatization. However, the strength of the relationships found was modest. The current findings can therefore not yet be directly implemented to initiate meaningful feedback, but they do provide starting points for future research and take a relevant step towards the possible future development of automated resilience interventions.
The effects of stress may be alleviated when its impact or a decreased stress-resilience are detected early. This study explores whether wearable-measured sleep and resting HRV in police officers can be predicted by stress-related Ecological Momentary Assessment (EMA) measures in preceding days and predict stress-related EMA outcomes in subsequent days. Eight police officers used an Oura ring to collect daily Total Sleep Time (TST) and resting Heart Rate Variability (HRV) and an EMA app for measuring demands, stress, mental exhaustion, and vigor during 15–55 weeks. Vector Autoregression (VAR) models were created and complemented by Granger causation tests and Impulse Response Function visualizations. Demands negatively predicted TST and HRV in one participant. TST negatively predicted demands, stress, and mental exhaustion in two, three, and five participants, respectively, and positively predicted vigor in five participants. HRV negatively predicted demands in two participants, and stress and mental exhaustion in one participant. Changes in HRV lasted longer than those in TST. Bidirectional associations of TST and resting HRV with stress-related outcomes were observed at a weak-to-moderate strength, but not consistently across participants. TST and resting HRV are more consistent predictors of stress-resilience in upcoming days than indicators of stress-related measures in prior days.
Eating disorders (EDs) and social anxiety disorder (SAD) are characterized by high levels of fear and effectively treated with exposure therapy. Physiological markers of fear can elucidate how exposure influences psychophysiological processes underlying psychopathology. In the current study ( N = 109), we measured heart rate variability, heart rate, and electrodermal activity (EDA) with wearable sensors during ED fear, SAD fear, and neutral scripts. Bayesian ridge-regression models tested physiological features during these scripts as predictors of momentary and trait ED and SAD symptoms and determined which physiological features most strongly predicted symptoms. Across models, prediction error was low, which indicates high predictive accuracy. The most salient predictors were EDA features during the neutral script. These findings suggest physiological markers can accurately predict ED and SAD symptoms. This research highlights the utility of wearable sensor technology as a complement to exposure therapy and informs research, assessment, and treatment for anxiety-based disorders.
Negative emotions play a dominant role in daily human life, and mentalizing and empathy are also basic sociability in social life. However, little is known regards the neurophysiological pattern of negative experiences in immersive environments and how people with different sociabilities respond to the negative emotional stimuli at behavioral and neural levels. The present study investigated the neurophysiological representation of negative affective experiences and whether such variations are associated with one's sociability. To address this question, we examined four types of negative emotions that frequently occurred in real life: angry, anxious, fearful, and helpless. We combined naturalistic neuroimaging under virtual reality, multimodal neurophysiological recording, and behavioral measures. Inter-subject representational similarity analysis was conducted to capture the individual differences in the neurophysiological representations of negative emotional experiences. The behavioral and neurophysiological indices revealed that although the emotion ratings were uniquely different, a similar electroencephalography response pattern across these negative emotions was found over the parieto-occipital electrodes. Furthermore, the neurophysiological representations indeed reflected interpersonal variations regarding mentalizing and empathic abilities. Our findings yielded a common pattern of neurophysiological responses toward different negative affective experiences in VR. Moreover, the current results indicate the potential of taking a sociability perspective for understanding the interpersonal variations in the neurophysiological representation of emotion.
Anxiety is often conceptualised as the prototypical disorder of interoception (one’s perception of bodily states). Whilst theoretical models predict an association between interoceptive accuracy and anxiety, empirical work has produced mixed results. This manuscript presents a pre-registered systematic review (https://osf.io/2h5xz) and meta-analysis of 55 studies, obtained via a Pubmed search on 9th November 2020, examining the relationship between state and trait anxiety and objectively measured cardiac interoceptive accuracy as assessed by heartbeat counting and discrimination tasks. Potential moderators of this relationship - the age, gender and clinical diagnoses of participants, the anxiety measures used and the study design - were also explored. Overall, we found no evidence for an association between cardiac interoceptive accuracy and anxiety, with none of the factors examined moderating this finding. We discuss the implications these findings have for future research, with a particular focus on the need for further investigation of the relationship between anxiety and other facets of interoception.
Background
Social anxiety disorder (SAD) is characterized by a significant amount of fear when confronted to social situations. Exposure therapy, which is based on fear extinction, does not often lead to full remission. Here, based on evidence showing that rapid eye movement (REM) sleep promotes the consolidation of extinction memory, we used targeted memory reactivation (TMR) during REM sleep to enhance extinction learning in SAD.
Methods
Forty-eight subjects with SAD were randomly assigned to two groups: control or TMR group. All patients had two successive exposure therapy sessions in a virtual reality (VR) environment, where they were asked to give a public talk in front of a virtual jury. At the end of each session, and only in the TMR group (N = 24), a sound was paired to the positive feedback phase of therapy (i.e., approval of their performance), which represented the memory to be strengthened during REM sleep. All participants slept at home with a wearable headband device which automatically identified sleep stages and administered the sound during REM sleep. Participants' anxiety level was assessed using measures of parasympathetic (root mean square of successive differences between normal heartbeats, RMSSD) and sympathetic (non-specific skin conductance responses, ns-SCRs) activity, and subjective measures (Subjective Units of Distress Scale, SUDS), during the preparation phase of their talks before (T1) and after (T2) one full-night's sleep and after 1 week at home (T3). Participants also filled in a dream diary.
Results
We observed an effect of time on subjective measures of anxiety (SUDS). We did not find any difference in the anxiety levels of the two groups after 1 week of TMR at home. Importantly, the longer the total duration of REM sleep and the more stimulations the TMR group had at home, the less anxious (increased RMSSD) these participants were. Finally, fear in dreams correlated positively with ns-SCRs and SUDS at T3 in the TMR group.
Conclusion
TMR during REM sleep did not significantly modulate the beneficial effect of therapy on subjective anxiety. Yet, our results support that REM sleep can contribute to extinction processes and substantiate strong links between emotions in dreams and waking stress levels in these patients.
Respiratory sinus arrhythmia (RSA) reactivity is thought to indicate how adaptively one responds to stress. RSA reactivity has been examined across anxiety disorders and posttraumatic stress disorder (PTSD), to better understand the psychophysiological stress response of these disorders. The current state of the literature is mixed, and the association between RSA reactivity and PTSD/anxiety is unclear. This review examines RSA reactivity in response to laboratory stressor tasks across samples with anxiety and PTSD. Results indicated a complex literature that may suggest an association between anxiety/PTSD and RSA reactivity. There is evidence to suggest a pattern of heightened RSA withdrawal in PTSD and trait anxious samples. There was little evidence to suggest a heightened RSA withdrawal pattern in other anxiety disorders. This review also highlights methodological considerations which may allow for clearer interpretations of RSA reactivity. The current literature includes heterogeneity across stressor tasks, RSA measures, and comorbidities that complicates interpretation of results. Studies using samples with comorbid depression produce more consistent evidence of heightened RSA withdrawal in anxiety/PTSD. Future directions for understanding the contribution of these variables (i.e., stressor tasks, RSA measures, comorbid depression) and mechanisms contributing to the possible association between RSA reactivity and anxiety/PTSD are considered.
Heart rate variability (HRV), a measure of the variability in intervals between subsequent heart beats, is now widely considered an index of emotion regulatory capacity and the ability to adapt flexibly to changing environmental demands. Abnormalities in HRV are implicated in a host of psychopathologies, making it a potentially powerful transdiagnostic biobehavioral change mechanism in treatment interventions. While most mental illnesses are associated with low HRV, eating disorders have been linked to elevated HRV. We examined 62 research articles on HRV in psychopathology to test the hypothesis that there is an “ideal range” of HRV that predicts optimal functioning. Relationships between symptom severity and parameters that quantify HRV were examined graphically. More extreme time-domain HRV measures, both high and low, were associated with psychopathology, whereas healthy controls displayed mid-range values. Findings preliminarily support the hypothesis that there is an “ideal range” of HRV that could be targeted in biofeedback interventions.
Anxiety symptoms co-occur with cardiovascular health problems, with increasing evidence suggesting the role of autonomic dysfunction. Yet, there is limited behavior genetic research on underlying mechanisms. In this twin study, we investigated the phenotypic, genetic and environmental associations between a latent anxiety factor and three cardiovascular autonomic function factors: interbeat interval (IBI, time between heart beats), heart rate variability (HRV, overall fluctuation of heart-beat intervals) and baroreflex sensitivity (BRS, efficiency in regulating blood pressure [BP]). Multivariate twin models were fit using data of female twins ( N = 250) of the Twin Interdisciplinary Neuroticism Study (TWINS). A significant negative association was identified between latent anxiety and BRS factors ( r = −.24, 95% CI [−.40, −.07]). Findings suggest that this relationship was mostly explained by correlated shared environmental influences, and there was no evidence for pleiotropic genetic or unique environmental effects. We also identified negative relationships between anxiety symptoms and HRV ( r = −.17, 95% CI [−.34, .00]) and IBI factors ( r = −.13, 95% CI [−.29, .04]), though these associations did not reach statistical significance. Findings implicate that higher anxiety scores are associated with decreased efficiency in short-term BP regulation, providing support for autonomic dysfunction with anxiety symptomatology. The baroreflex system may be a key mechanism underlying the anxiety–cardiovascular health relationship.
This study explored self‐regulatory efforts during the viewing of couple interactions and their association with relationship satisfaction. High‐frequency heart rate variability (HF‐HRV) was measured for each participant during a video recall of a recent couple interaction to quantify the self‐regulatory processes governed by parasympathetic activity. Among 30 couples, HF‐HRV was measured continuously during three specific periods to explore its change over time using a video‐recall procedure: (1) resting state; (2) viewing of couple interactions (expressing daily life situations and conflictual interactions); and (3) recovery. Results of multilevel models revealed a u‐shaped pattern of HF‐HRV responses for men and women across the three periods with a nadir at the midway through the process. This pattern of physiological change (vagal suppression) reflects a flexible response to a stressful situation. Nevertheless, the pattern of physiological responses varied according to the level of relationship satisfaction. Men who were more satisfied in their couple relationship presented greater vagal suppression than dissatisfied men. In contrast, no significant HF‐HRV changes were found in women over the different periods of the video‐recall procedure and no moderating effect of relationship satisfaction. We discuss the different patterns of physiological responses observed both for men and women in terms of interindividual variability according to the level of their relationship satisfaction. The present study highlights the important role of relationship satisfaction in regulatory processes.
Objective:
The aim of this study is to examine social functioning in patients with schizophrenia and bipolar disorder and explore the psychological and neurophysiological predictors of social functioning.
Methods:
Twenty-seven patients with schizophrenia and thirty patients with bipolar disorder, as well as twenty-five healthy controls, completed measures of social functioning (questionnaire of social functioning), neurocognition (Verbal fluency, Korean-Auditory Verbal Learning Test), and social cognition (basic empathy scale and Social Attribution Task-Multiple Choice), and the childhood trauma questionnaire (CTQ). For neurophysiological measurements, mismatch negativity and heart rate variability (HRV) were recorded from all participants. Multiple hierarchical regression was performed to explore the impact of factors on social functioning.
Results:
The results showed that CTQ-emotional neglect significantly predicted social functioning in schizophrenia group, while HRV-high frequency significantly predicted social functioning in bipolar disorder patients. Furthermore, emotional neglect and HRV-HF still predicted social functioning in all of the subjects after controlling for the diagnostic criteria.
Conclusion:
Our results implicated that even though each group has different predictors of social functioning, early traumatic events and HRV could be important indicators of functional outcome irrespective of what group they are.
In this investigation we explored how two dimensions underlying current models of psychopathology, threat sensitivity and executive cognitive processing, may come together to influence downstream responses to social threat. Specifically, we investigated how set-shifting ability influences responses to simulated peer-rejection in high threat sensitive individuals (n = 66) selected from a larger sample. Our findings suggest the possibility of risk-reducing benefits imparted from higher set-shifting and executive resources. In particular, we saw evidence of greater approach-related behavior, including higher intensity positive emotional expressions and a relative increase in the proportion of parasympathetic activity, with higher set-shifting. Our findings join a small but growing body of research examining how risks elevated by threat sensitivity may be mitigated by executive cognitive processing.
Objective: Evidence suggests increased cardiovascular risk and autonomic impairment among individuals with chronic anxiety. Little attention, however, has been paid to the anxiety disorder of social phobia despite its high prevalence. Additionally, gender- and age-related cardiovascular profiles have not been examined in relation to social phobia. This study investigated cardiovascular responses to a socially threatening situation among older men and women with social phobia and control subjects. Methods: Thirty subjects with social phobia and 30 control subjects (mean age = 65 years) were assessed during baseline, paced breathing, speech preparation, and speech presentation. Electrocardiographic variables, blood pressure, respiration, and emotional state (self-reported) were monitored. Hemodynamic variables included heart rate, blood pressure, cardiac output, and systemic vascular resistance; autonomic measures were respiratory sinus arrhythmia and baroreflex sensitivity, both markers of cardiac vagal control, and 0.10-Hz systolic blood pressure variability, an index of sympathetic vasomotor tone. Results: Subjects with social phobia, in contrast to nonanxious control subjects, manifested more anxiety, embarrassment, and somatic complaints in response to stress; however, physiological measures generally did not distinguish groups. Interaction effects indicated that socially phobic women were hyperresponsive to the stressor with respect to self-reported, hemodynamic, and autonomic parameters. Socially phobic men manifested no physiological differences in comparison with control subjects, but they reported more psychological and somatic complaints. Conclusions: Gender differences in subjective and physiological responses to a socially threatening situation indicate congruence between perceived social anxiety and physiological responses in older women but not men. We found no evidence of impaired cardiovascular autonomic regulation among socially phobic men despite other reports that phobically anxious men are at greater cardiovascular risk.
Given the relevance of child maltreatment for the development and treatment of many mental disorders, the objective of our study was the psychometric evaluation of the German version of the Childhood Trauma Questionnaire (CTQ). In a sample of psychiatric patients (N=1 524) the established factor structure (i. e. sexual, physical and emotional abuse as well as physical and emotional neglect) was replicated by means of confirmatory factor analysis. The internal consistency of all scales (apart from physical neglect) was high (Cronbachs alpha >/= 0.89). Correlations between the CTQ and self-report measures for posttraumatic stress, dissociation and general psychopathology were low to moderate. The psychometric properties of the German version of the CTQ were similar to the American original; it proved to be a reliable and valid screen for the retrospective assessment of child maltreatment. Language: en
Background
Social anxiety disorder (SAD) is widely thought to be characterized by heightened behavioral and limbic reactivity to socio-emotional stimuli. However, although behavioral findings are clear, neural findings are surprisingly mixed.
Methods
Using functional magnetic resonance imaging (fMRI), we examined behavioral and brain responses in a priori emotion generative regions of interest (amygdala and insula) in 67 patients with generalized SAD and in 28 healthy controls (HC) during three distinct socio-emotional tasks. We administered these socio-emotional tasks during one fMRI scanning session: 1) looming harsh faces (Faces); 2) videotaped actors delivering social criticism (Criticism); and 3) written negative self-beliefs (Beliefs).
Results
In each task, SAD patients reported heightened negative emotion, compared to HC. There were, however, no SAD versus HC differential brain responses in the amygdala and insula. Between-group whole-brain analyses confirmed no group differences in the responses of the amygdala and insula, and indicated different brain networks activated during each of the tasks. In SAD participants, social anxiety symptom severity was associated with increased BOLD signal in the left insula during the Faces task.
Conclusions
The similar responses in amygdala and insula in SAD and HC participants suggest that heightened negative emotion responses reported by patients with SAD may be related to dysfunction in higher cognitive processes (e.g., distorted appraisal, attention biases, or ineffective cognitive reappraisal). In addition, the findings of this study emphasize the differential effects of socio-emotional experimental tasks.
Power spectral analysis of the beat-to-beat variations of heart rate or the heart period (R–R interval) has become widely used to quantify cardiac autonomic regulation (Appel et al., 1989; Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology, 1996; Berntson et al., 1997; Denver et al., 2007; Thayler et al., 2010; Billman, 2011). This technique partitions the total variance (the “power”) of a continuous series of beats into its frequency components, typically identifying two or three main peaks: Very Low Frequency (VLF) <0.04 Hz, Low Frequency (LF), 0.04–0.15 Hz, and High Frequency (HF) 0.15–0.4 Hz. It should be noted that the HF peak is shifted to a higher range (typically 0.24–1.04 Hz) in infants and during exercise (Berntson et al., 1997). The HF peak is widely believed to reflect cardiac parasympathetic nerve activity while the LF, although more complex, is often assumed to have a dominant sympathetic component (Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology, 1996; Berntson et al., 1997; Billman, 2011). Based upon these assumptions, Pagani and co-workers proposed that the ratio of LF to HF (LF/HF) could be used to quantify the changing relationship between sympathetic and parasympathetic nerve activities (i.e., the sympatho-vagal balance) (Pagani et al., 1984, 1986; Malliani et al., 1991) in both health and disease. However, this concept has been challenged (Kingwell et al., 1994; Koh et al., 1994; Hopf et al., 1995; Eckberg, 1997; Houle and Billman, 1999; Billman, 2011). Despite serious and largely under-appreciated limitations, the LF/HF ratio has gained wide acceptance as a tool to assess cardiovascular autonomic regulation where increases in LF/HF are assumed to reflect a shift to “sympathetic dominance” and decreases in this index correspond to a “parasympathetic dominance.” Therefore, it is vital to provide a critical assessment of the assumptions upon which this concept is based.
Feelings are mental experiences of body states. They signify physiological need (for example, hunger), tissue injury (for example, pain), optimal function (for example, well-being), threats to the organism (for example, fear or anger) or specific social interactions (for example, compassion, gratitude or love). Feelings constitute a crucial component of the mechanisms of life regulation, from simple to complex. Their neural substrates can be found at all levels of the nervous system, from individual neurons to subcortical nuclei and cortical regions.
Background:
Musical performance is a skilled activity performed under intense pressure, thus is often a profound source of anxiety. In other contexts, anxiety and its concomitant symptoms of sympathetic nervous system arousal have been successfully ameliorated with HRV biofeedback (HRV BF), a technique involving slow breathing which augments autonomic and emotional regulatory capacity.
Objective:
This randomised-controlled study explored the impact of a single 30-minute session of HRV BF on anxiety in response to a highly stressful music performance.
Methods:
A total of 46 trained musicians participated in this study and were randomly allocated to a slow breathing with or without biofeedback or no-treatment control group. A 3 Group×2 Time mixed experimental design was employed to compare the effect of group before and after intervention on performance anxiety (STAI-S) and frequency domain measures of HRV.
Results:
Slow breathing groups (n=30) showed significantly greater improvements in high frequency (HF) and LF/HF ratio measures of HRV relative to control (n=15) during 5 minute recordings of performance anticipation following the intervention (effect size: η(2) =0.122 and η(2) =0.116, respectively). The addition of biofeedback to a slow breathing protocol did not produce differential results. While intervention groups did not exhibit an overall reduction in self-reported anxiety, participants with high baseline anxiety who received the intervention (n=15) displayed greater reductions in self-reported state anxiety relative to those in the control condition (n=7) (r=0.379).
Conclusions:
These findings indicate that a single session of slow breathing, regardless of biofeedback, is sufficient for controlling physiological arousal in anticipation of psychosocial stress associated with music performance and that slow breathing is particularly helpful for musicians with high levels of anxiety. Future research is needed to further examine the effects of HRV BF as a low-cost, non-pharmacological treatment for music performance anxiety.
Context: Current behavioral measures poorly predict treatment outcome in social anxiety disorder (SAD). To our knowledge, this is the first study to examine neuroimaging-based treatment prediction in SAD.
Objective: To measure brain activation in patients with SAD as a biomarker to predict subsequent response to cognitive behavioral therapy (CBT).
Design: Functional magnetic resonance imaging (fMRI) data were collected prior to CBT intervention. Changes in clinical status were regressed on brain responses and tested for selectivity for social stimuli.
Setting: Patients were treated with protocol-based CBT at anxiety disorder programs at Boston University or Massachusetts General Hospital and underwent neuroimaging data collection at Massachusetts Institute of Technology.
Patients: Thirty-nine medication-free patients meeting DSM-IV criteria for the generalized subtype of SAD.
Interventions: Brain responses to angry vs neutral faces or emotional vs neutral scenes were examined with fMRI prior to initiation of CBT.
Main Outcome Measures: Whole-brain regression analyses with differential fMRI responses for angry vs neutral faces and changes in Liebowitz Social Anxiety Scale score as the treatment outcome measure.
Results: Pretreatment responses significantly predicted subsequent treatment outcome of patients selectively for social stimuli and particularly in regions of higher-order visual cortex. Combining the brain measures with information on clinical severity accounted for more than 40% of the variance in treatment response and substantially exceeded predictions based on clinical measures at baseline. Prediction success was unaffected by testing for potential confounding factors such as depression severity at baseline.
Conclusions: The results suggest that brain imaging can provide biomarkers that substantially improve predictions for the success of cognitive behavioral interventions and more generally suggest that such biomarkers may offer evidence-based, personalized medicine approaches for optimally selecting among treatment options for a patient.
This study examined the effects of mindfulness-based stress reduction (MBSR) on the brain–behavior mechanisms of self-referential processing in patients with social anxiety disorder (SAD). Sixteen patients underwent functional magnetic resonance imaging while encoding self-referential, valence, and orthographic features of social trait adjectives. Post-MBSR, 14 patients completed neuroimaging. Compared to baseline, MBSR completers showed (a) increased self-esteem and decreased anxiety, (b) increased positive and decreased nega-tive self-endorsement, (c) increased activity in a brain network related to attention regula-tion, and (d) reduced activity in brain systems implicated in conceptual-linguistic self-view. MBSR-related changes in maladaptive or distorted social self-view in adults diagnosed with SAD may be related to modulation of conceptual self-processing and attention regulation. Self-referential processing may serve as a functional biobehavioral target to measure the effects of mindfulness training. S ocial anxiety disorder (SAD) is a common and frequently debilitating condition character-ized by intense fear of evaluation in social or performance situations (Jefferys, 1997; Kessler et al., 1994). SAD has an early onset (Otto et al., 2001) and regularly precedes other anxiety, mood, and substance abuse/dependence disorders (Lampe, Salde, Issakidis, & Andrews, 2003; Matza, Revicki, Davidson, & Stewart, 2003). SAD is associated with significant distress and functional impairment in both work and social domains (Lochner et al., 2003; Rapee, 1995; Schneier et al., 1994) and typically persists unless treated (Clark & Wells, 1995). The early onset of SAD magnifies its impact, including increased school dropout (Van Ameringen, Mancini, & Farvolden, 2003), poor social integra-tion, and increased comorbid psychopathology (Lampe et al., 2003; Matza et al., 2003; Randall, Thomas, & Thevos, 2001).
The main assumption of the present study is that emotional experience is coupled to perception of bodily processes. From this it is deduced that individuals who show good perception of heart activity tend to exhibit higher levels of a momentarily experienced emotion (in this case anxiety) and to score higher on the personality trait “Emotional Lability.” The aspect of cardiac awareness considered here is perception of heart beats. Subjects were instructed to count heart beats (only by concentrating on their body but not by taking their pulse) during a signalled time interval and the reported number of beats was then compared to the actual number of beats as extracted from the EKG. Additionally, skin conductance and respiration were recorded. During the experimental task (i.e., counting heart beats) increases in heart rate, respiration rate and number of spontaneous fluctuations in skin conductance were recorded. Groups of good and poor perceivers were formed on the basis of accuracy on the perception task. The two groups did not differ in heart rate; however, in State Anxiety and Emotional Lability, the group of good perceivers had significantly higher scores. The importance of visceroception for emotional experience is pointed out and the relevance for clinical psychology is discussed.
The neurovisceral integration model (Thayer, J. F., & Lane, R. D., 2000, A model of neurovisceral integration in emotion regulation and dysregulation. Journal of Affective Disorders, 61, 201-216. doi:10.1016/S0165-0327(00)00338-4) proposes that individual differences in heart rate variability (HRV)-an index of cardiac vagal tone-are associated with attentional and emotional self-regulation. In this article, we demonstrate that individual differences in resting HRV predict the functioning of the inhibition of return (IOR), an inhibitory attentional mechanism highly adaptive to novelty search, in response to affectively significant face cues. As predicted, participants with lower HRV exhibited a smaller IOR effect to fearful versus neutral face cues than participants with higher HRV, which shows a failure to inhibit attention from affectively significant cues and instigate novelty search. In contrast, participants with higher HRV exhibited similar IOR effects to fearful and neutral face cues, which shows an ability to inhibit attention from cues and instigate novelty search. Their ability to inhibit attention was most pronounced to high spatial frequency fearful face cues, suggesting that this effect may be mediated by cortical mechanisms. The current research demonstrates that individual differences in HRV predict attentional inhibition and suggests that successful inhibition and novelty search may be mediated by cortical inhibitory mechanisms among people with high cardiac vagal tone. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
There is evidence that heart rate variability (HRV) is reduced in major depressive disorder (MDD), although there is debate about whether this effect is caused by medication or the disorder per se. MDD is associated with a two to fourfold increase in the risk of cardiac mortality, and HRV is a robust predictor of cardiac mortality; determining a direct link between HRV and not only MDD, but common comorbid anxiety disorders, will point to psychiatric indicators for cardiovascular risk reduction.
To determine in physically healthy, unmedicated patients whether (1) HRV is reduced in MDD relative to controls, and (2) HRV reductions are driven by MDD alone, comorbid generalized anxiety disorder (GAD, characterized by anxious anticipation), or comorbid panic and posttraumatic stress disorders (PD/PTSD, characterized by anxious arousal).
A case-control study in 2006 and 2007 on 73 MDD patients, including 24 without anxiety comorbidity, 24 with GAD, and 14 with PD/PTSD. Seventy-three MDD and 94 healthy age- and sex-matched control participants were recruited from the general community. Participants had no history of drug addiction, alcoholism, brain injury, loss of consciousness, stroke, neurological disorder, or serious medical conditions. There were no significant differences between the four groups in age, gender, BMI, or alcohol use.
HRV was calculated from electrocardiography under a standardized short-term resting state condition.
HRV was reduced in MDD relative to controls, an effect associated with a medium effect size. MDD participants with comorbid generalized anxiety disorder displayed the greatest reductions in HRV relative to controls, an effect associated with a large effect size.
Unmedicated, physically healthy MDD patients with and without comorbid anxiety had reduced HRV. Those with comorbid GAD showed the greatest reductions. Implications for cardiovascular risk reduction strategies in otherwise healthy patients with psychiatric illness are discussed.
Describes the Interpersonal Reactivity Index (IRI) and its relationships with measures of social functioning, self-esteem, emotionality, and sensitivity to others. 677 male and 667 female undergraduates served as Ss. Each of the 4 IRI subscales displayed a distinctive and predictable pattern of relationships with these measures, as well as with previous unidimensional empathy measures. Findings provide evidence for a multidimensional approach to empathy. (29 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).
Emotions are widely held to involve changes in experiential, behavioural, and physiological systems. It is not clear, however, just how tightly coupled these changes are during emotional responding. To examine this issue, we induced social anxiety in 47 high trait social anxiety (HTSA) and 50 low trait social anxiety (LTSA) participants using an impromptu speech paradigm. We assessed anxiety experience, behaviour, perceived physiological activation, and actual physiological activation. HTSA participants felt more anxious, perceived greater physiological activation, and exhibited more anxiety behaviour than LTSA participants. Unexpectedly, the two groups did not differ in objectively measured physiological responding. Internal analyses indicated that for both HTSA and LTSA participants, anxiety experience was associated with perceived physiological activation, but not with actual physiological responding. These results suggest that anxiety experience and perceived physiological activation may be less tightly coupled with actual physiological responses than is typically thought.
Resting-state fMRI (RS-fMRI) has been drawing more and more attention in recent years. However, a publicly available, systematically integrated and easy-to-use tool for RS-fMRI data processing is still lacking. We developed a toolkit for the analysis of RS-fMRI data, namely the RESting-state fMRI data analysis Toolkit (REST). REST was developed in MATLAB with graphical user interface (GUI). After data preprocessing with SPM or AFNI, a few analytic methods can be performed in REST, including functional connectivity analysis based on linear correlation, regional homogeneity, amplitude of low frequency fluctuation (ALFF), and fractional ALFF. A few additional functions were implemented in REST, including a DICOM sorter, linear trend removal, bandpass filtering, time course extraction, regression of covariates, image calculator, statistical analysis, and slice viewer (for result visualization, multiple comparison correction, etc.). REST is an open-source package and is freely available at http://www.restfmri.net.
A great challenge to the field of visual neuroscience is to understand how faces are encoded and represented within the human brain. Here we show evidence from functional magnetic resonance imaging (fMRI) for spatially distributed processing of the whole face and its components in face-sensitive human visual cortex. We used multi-class linear pattern classifiers constructed with a leave-one-scan-out verification procedure to discriminate brain activation patterns elicited by whole faces, the internal features alone, and the external head outline alone. Furthermore, our results suggest that whole faces are represented disproportionately in the fusiform cortex (FFA) whereas the building blocks of faces are represented disproportionately in occipitotemporal cortex (OFA). Faces and face components may therefore be organized with functional clustering within both the FFA and OFA, but with specialization for face components in the OFA and the whole face in the FFA.
Functional magnetic resonance imaging (fMRI) studies have identified spatially distinct face-selective regions in human cortex. These regions have been linked together to form the components of a cortical network specialized for face perception but the cognitive operations performed in each region are not well understood. In this paper, we review the evidence concerning one of these face-selective regions, the occipital face area (OFA), to better understand what cognitive operations it performs in the face perception network. Neuropsychological evidence and transcranial magnetic stimulation (TMS) studies demonstrate the OFA is necessary for accurate face perception. fMRI and TMS studies investigating the functional role of the OFA suggest that it preferentially represents the parts of a face, including the eyes, nose, and mouth and that it does so at an early stage of visual perception. These studies are consistent with the hypothesis that the OFA is the first stage in a hierarchical face perception network in which the OFA represents facial components prior to subsequent processing of increasingly complex facial features in higher face-selective cortical regions.
What is most intriguing about heart rate (HR) variability is that there is so much of it. HR is constantly responding both rapidly and slowly to various physiological perturbations. We now understand that the frequency and amplitude of these HR fluctuations are indicative of the autonomic control systems underlying the response.
To facilitate a multidimensional approach to empathy the Interpersonal Reactivity Index (IRI) includes 4 subscales: Perspective-Taking (PT) Fantasy (FS) Empathic Concern (EC) and Personal Distress (PD). The aim of the present study was to establish the convergent and discriminant validity of these 4 subscales. Hypothesized relationships among the IRI subscales between the subscales and measures of other psychological constructs (social functioning self-esteem emotionality and sensitivity to others) and between the subscales and extant empathy measures were examined. Study subjects included 677 male and 667 female students enrolled in undergraduate psychology classes at the University of Texas. The IRI scales not only exhibited the predicted relationships among themselves but also were related in the expected manner to other measures. Higher PT scores were consistently associated with better social functioning and higher self-esteem; in contrast Fantasy scores were unrelated to these 2 characteristics. High EC scores were positively associated with shyness and anxiety but negatively linked to egotism. The most substantial relationships in the study involved the PD scale. PD scores were strongly linked with low self-esteem and poor interpersonal functioning as well as a constellation of vulnerability uncertainty and fearfulness. These findings support a multidimensional approach to empathy by providing evidence that the 4 qualities tapped by the IRI are indeed separate constructs each related in specific ways to other psychological measures.
Errors in Byline, Author Affiliations, and Acknowledgment. In the Original Article titled “Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication,” published in the June issue of the ARCHIVES (2005;62:617-627), an author’s name was inadvertently omitted from the byline on page 617. The byline should have appeared as follows: “Ronald C. Kessler, PhD; Wai Tat Chiu, AM; Olga Demler, MA, MS; Kathleen R. Merikangas, PhD; Ellen E. Walters, MS.” Also on that page, the affiliations paragraph should have appeared as follows: Department of Health Care Policy, Harvard Medical School, Boston, Mass (Drs Kessler, Chiu, Demler, and Walters); Section on Developmental Genetic Epidemiology, National Institute of Mental Health, Bethesda, Md (Dr Merikangas). On page 626, the acknowledgment paragraph should have appeared as follows: We thank Jerry Garcia, BA, Sara Belopavlovich, BA, Eric Bourke, BA, and Todd Strauss, MAT, for assistance with manuscript preparation and the staff of the WMH Data Collection and Data Analysis Coordination Centres for assistance with instrumentation, fieldwork, and consultation on the data analysis. We appreciate the helpful comments of William Eaton, PhD, Michael Von Korff, ScD, and Hans-Ulrich Wittchen, PhD, on earlier manuscripts. Online versions of this article on the Archives of General Psychiatry Web site were corrected on June 10, 2005.
We propose a general hypothesis that integrates affective and cognitive processing with neuroanatomy to explain anxiety pronenes. The premise is that individuals who are prone to anxiety show an altered interoceptive prediction signal, i.e., manifest augmented detection of the difference between the observed and expected body state. As a consequence, the increased prediction signal of a prospective aversive body state triggers an increase in anxious affect, worrisome thoughts and other avoidance behaviors. The anterior insula is proposed to play a key role in this process. Further testing of this model--which should include investigation of genetic and environmental influences--may lead to the development of novel treatments that attenuate this altered interoceptive prediction signal in patients with anxiety disorders.
Respiratory activity phasically alters membrane potentials of preganglionic vagal and sympathetic motoneurones and continuously modulates their responsiveness to stimulatory inputs. The most obvious manifestation of this ‘respiratory gating’ is respiratory sinus arrhythmia, the rhythmic fluctuations of electrocardiographic R–R intervals observed in healthy resting humans. Phasic autonomic motoneurone firing, reflecting the throughput of the system, depends importantly on the intensity of stimulatory inputs, such that when levels of stimulation are low (as with high arterial pressure and sympathetic activity, or low arterial pressure and vagal activity), respiratory fluctuations of sympathetic or vagal firing are also low. The respiratory gate has a finite capacity, and high levels of stimulation override the ability of respiration to gate autonomic responsiveness. Autonomic throughput also depends importantly on other factors, including especially, the frequency of breathing, the rate at which the gate opens and closes. Respiratory sinus arrhythmia is small at rapid, and large at slow breathing rates. The strong correlation between systolic pressure and R–R intervals at respiratory frequencies reflects the influence of respiration on these two measures, rather than arterial baroreflex physiology. A wide range of evidence suggests that respiratory activity gates the timing of autonomic motoneurone firing, but does not influence its tonic level. I propose that the most enduring significance of respiratory gating is its use as a precisely controlled experimental tool to tease out and better understand otherwise inaccessible human autonomic neurophysiological mechanisms.
In der vorliegenden Arbeit wurde die von den Autoren des Instrumentes postulierte dreifaktorielle Struktur der deutschen Version der 20-Item-Toronto-Alexithymie-Skala an einer Stichprobe von 419 psychogen erkrankten Patienten mittels konfirmatorischer Faktorenanalyse überprüft. Es ergab sich jedoch weder eine befriedigende interne Konsistenz aller Subskalen, noch resultierte eine akzeptable Anpassung der erhobenen Daten an das dreifaktorielle Modell. Mittels explorativer Hauptkomponentenanalyse war daraufhin der Versuch unternommen worden, ein konsistenteres Alternativmodell zu ermitteln. Die resultierende vierfaktorielle Struktur ist inhaltlich gut interpretierbar und konsistent sowohl im Hinblick auf Theorie als auch auf empirische Befunde zum Alexithymiekonstrukt. Zur weiteren Absicherung der Stabilität der resultierenden Struktur ist noch eine Kreuzvalidierung an einer zweiten Stichprobe notwendig.
Factorial Structure and Psychometric Properties of the German Version of the Toronto Alexithymia Scale (TAS-20) of Psychosomatic Patients
The present paper describes the attempt to cross-validate the three-factorial structure of the German Version of the 20-Item Toronto Alexithymia Scale in a population of 419 patients, suffering of psychogenic disorders. However, results neither revealed good internal consistencies nor was it possible to obtain an acceptable adaptation of the empirical data on the postulated model. Therefore an explorative factor analysis was performed in order to get a more consistent factor model. The hereby resulting four-factorial structure was congruent with reference to theoretical and empirical data of alexithmyia. However, additional crossvalidation in other populations has to be investigated.
Selbstauskunftsinstrumente haben sich in der Erforschung des klinisch noch zu wenig beachteten Depersonalisations-Derealisations-Syndroms als unverzichtbare Hilfsmittel erwiesen. In neueren Untersuchungen hat sich die Cambridge Depersonalisation Scale (CDS) dabei als sinnvolles Instrument hervorgetan. Mit der vorliegenden Arbeit wird die Validierung der autorisierten deutschen Version der Cambridge Depersonalisation Scale (CDS) an einer Stichprobe von 91 stationären Patienten, 43 mit pathologischer Depersonalisation und 48 ohne pathologische Depersonalisation, vorgestellt. Als Goldstandard dienen die entsprechenden Kapitel des Strukturierten Klinischen Interviews für DSM-IV Dissoziative Störungen (SKID-D). Als weiteres Kriterium der externen Validität wird der Fragebogen zu Dissoziativen Symptomen verwendet. Die deutsche Version der CDS zeigt eine gute interne Konsistenz (α = 0,95 und Guttman Split-half = 0,95) und konnte Patienten mit pathologischer Depersonalisation von Patienten ohne solche sehr gut differenzieren. Die deutsche Version der CDS kann deshalb als reliables und valides Instrument angesehen werden.
Zusammenfassung. Eines der ersten validierten Instrumente zur wissenschaftlichen Untersuchung von Emotionsregulationsprozessen, stellt der englischsprachige Emotion Regulation Questionnaire (ERQ) von Gross und John (2003) dar. Dieser erlaubt es, Praferenzen fur zwei haufig angewandte Strategien zur Emotionsregulation, namlich Unterdruckung (suppression) und Neubewertung (reappraisal) zu erfassen. Die deutsche Version wurde in drei Ubersetzungsschritten an jeweils einer Gruppe von Studenten (n = 113/167/174) erprobt. Dabei stand eine moglichst enge Orientierung am englischen Original sowie die Optimierung der Faktoren-Ladungen auf die zwei Komponenten im Vordergrund. Eine Faktorenanalyse mit iterativer Kommunalitatenschatzung und Varimax-Rotation wurde verwendet. Entsprechend unserem Ziel erreichten die Alpha-Werte (innere Konsistenz) als Reliabilitatsmas fur Unterdruckung und Neubewertung die Durchschnittswerte des amerikanischen Originalfragebogens. Wir entwickelten ein Instrument, das einfach und in kur...
Zusammenfassung. Erhohte private Selbstaufmerksamkeit (SAM) ist wiederholt als Risikofaktor fur die Entstehung und/oder Aufrechterhaltung von psychischen Storungen diskutiert worden. Der maladaptive Aspekt der SAM ist weniger durch Dauer und Intensitat, sondern durch die Inflexibilitat des Zustands der SAM gekennzeichnet. Mangels entsprechender Mesinstrumente wird eine eigene Skala “Dysfunktionale SAM” theoretisch begrundet, entwickelt und an mehreren gesunden und klinischen Stichproben im Hinblick auf Reliabilitat und verschiedene Validitatsaspekte untersucht. Die testtheoretische Eignung der Skala kann insgesamt als gut eingestuft werden. Um auch die fur die Selbstregulation adaptiven Formen der SAM zu operationalisieren, wird eine zweite Skala “Funktionale SAM” vorgeschlagen. Auch ihre testtheoretischen Kennwerte und Validitatsaspekte werden dargestellt und diskutiert. Insgesamt wird mit dem “Fragebogen zur Dysfunktionalen und Funktionalen Selbstaufmerksamkeit” (DFS) ein neues okonomisches (22-Item-) V...