Association between HRV and Social Anxiety in a College Population

Social anxiety is a condition marked by avoidance of social situations and marked stress when engaging in social interactions. In college populations, the prevalence rate has been observed as high as 33% and considering the newly independent circumstances freshman students face it would be advantageous to understand possible correlates in the form of HRV (Strahan, 2003). Heart rate variability (HRV) is a means of measuring the variance in heart rate that is attributed to the parasympathetic processes of the body. It has been found that in those with impaired functioning in regards to emotional regulation, a lowered HRV is present (Alvarez, 2013; Thayer, 2000). The study examined the association between HRV and symptoms of social anxiety measured by the Social Interaction Anxiety Scale (SIAS) among 68 students (mean age = 18.84, male = 52.9%), including possible confounding variables in the form of age, gender, and BMI. The SIAS scale used in the study is a twenty item questionnaire which provides a cutoff score for social phobia and at a higher value, social anxiety. HRV was measured using the Lead-II ECG technique with electrodes attached to the insides of both ankles and the right wrist. Baseline HRV was recorded for 10 minutes while participants watched a neutral stimulus video. Though we found no association between HRV and social anxiety (p = 0.608), our sample was impaired by data collection issues that resulted in a sample of 68 students from an original sample of 88. Additionally, our measure of social anxiety may not have captured the sub-clinical levels of social anxiety that impair college students more frequently than levels of social anxiety at the level of Social Anxiety Disorder. With less than one-third of the participants scoring above the threshold for social anxiety, the possibility of an analysis detecting a correlation between social anxiety and HRV would be affected

Alterations in amygdala-prefrontal functional connectivity account for excessive worry and autonomic dysregulation in generalized anxiety disorder

Background: Generalized anxiety disorder (GAD) is characterized by the core symptom of uncontrollable worry. Functional magnetic resonance imaging studies link this symptom to aberrant functional connectivity between the amygdala and prefrontal cortex. Patients with GAD also display a characteristic pattern of autonomic dysregulation. Although frontolimbic circuitry is implicated in the regulation of autonomic arousal, no previous study to our knowledge combined functional magnetic resonance imaging with peripheral physiologic monitoring in these patients to test the hypothesis that core symptoms of worry and autonomic dysregulation in GAD arise from a shared underlying neural mechanism. Methods: We used resting-state functional magnetic resonance imaging and the measurement of parasympathetic autonomic function (heart rate variability) in 19 patients with GAD and 21 control subjects to define neural correlates of autonomic and cognitive responses before and after induction of perseverative cognition. Seed-based analyses were conducted to quantify brain changes in functional connectivity with the right and left amygdala. Results: Before induction, patients showed relatively lower connectivity between the right amygdala and right superior frontal gyrus, right paracingulate/anterior cingulate cortex, and right supramarginal gyrus than control subjects. After induction, such connectivity patterns increased in patients with GAD and decreased in control subjects, and these changes tracked increases in state perseverative cognition. Moreover, decreases in functional connectivity between the left amygdala and subgenual cingulate cortex and between the right amygdala and caudate nucleus predicted the magnitude of reduction in heart rate variability after induction. Conclusions: Our results link functional brain mechanisms underlying worry and rumination to autonomic dyscontrol, highlighting overlapping neural substrates associated with cognitive and autonomic responses to the induction of perseverative cognitions in patients with GAD

Autonomic and brain morphological predictors of stress resilience

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

Heart rate variability is associated with amygdala functional connectivity with MPFC across younger and older adults

The ability to regulate emotion is crucial to promote well-being. Evidence suggests that the medial prefrontal cortex (mPFC) and adjacent anterior cingulate (ACC) modulate amygdala activity during emotion regulation. Yet less is known about whether the amygdala-mPFC circuit is linked with regulation of the autonomic nervous system and whether the relationship differs across the adult lifespan. The current study tested the hypothesis that heart rate variability (HRV) reflects the strength of mPFC-amygdala interaction across younger and older adults. We recorded participants’ heart rates at baseline and examined whether baseline HRV was associated with amygdala-mPFC functional connectivity during rest. We found that higher HRV was associated with stronger functional connectivity between the amygdala and the mPFC during rest across younger and older adults. In addition to this age-invariant pattern, there was an age-related change, such that greater HRV was linked with stronger functional connectivity between amygdala and ventrolateral PFC (vlPFC) in younger than in older adults. These results are in line with past evidence that vlPFC is involved in emotion regulation especially in younger adults. Taken together, our results support the neurovisceral integration model and suggest that higher heart rate variability is associated with neural mechanisms that support successful emotional regulation across the adult lifespan

Rapid heartbeat, but dry palms: reactions of heart rate and skin conductance levels to social rejection

Background: Social rejection elicits negative mood, emotional distress and neural activity in networks that are associated with physical pain. However, studies assessing physiological reactions to social rejection are rare and results of these studies were found to be ambiguous. Therefore, the present study aimed to examine and specify physiological effects of social rejection.Methods: Participants (N = 50) were assigned to either a social exclusion or inclusion condition of a virtual ball-tossing game (Cyberball). Immediate and delayed physiological (skin conductance level and heart rate) reactions were recorded. In addition, subjects reported levels of affect, emotional states and fundamental needs.Results: Subjects who were socially rejected showed increased heart rates. However, social rejection had no effect on subjects’ skin conductance levels. Both conditions showed heightened arousal on this measurement. Furthermore, psychological consequences of social rejection indicated the validity of the paradigm.Conclusions: Our results reveal that social rejection evokes an immediate physiological reaction. Accelerated heart rates indicate that behavior activation rather than inhibition is associated with socially threatening events. In addition, results revealed gender-specific response patterns suggesting that sample characteristics such as differences in gender may account for ambiguous findings of physiological reactions to social rejection

Stress Reactivity in Chronic Tinnitus

Tinnitus is primarily an auditory symptom. Yet not only patients and clinicians, but also current pathophysiological models relate the onset and maintenance of tinnitus to stress. Here physiological and psychological stress reactivity was investigated in 19 patients with subjective chronic tinnitus and 19 comparable healthy controls. All participants underwent five consecutive measurements in one session including three resting conditions and two stress tasks in between (mental arithmetic and concentration on tinnitus/ear noise). Stress reactivity was assessed by heart rate (HR), heart rate variability (HRV) and subjective ratings for each of the five measurements. In patients with tinnitus, mean HR was overall decreased and blunted in response to acute stress induced by mental arithmetic compared to controls. HRV measures did not differ between both groups. Tinnitus sufferers indicated more subjective stress and increased awareness of tinnitus after the mental arithmetic task (during both resting and concentration on tinnitus measurements), but perceived similar levels of stress during mental arithmetic stress. In contrast to controls, HR and HRV were not correlated and also strain reports and physiological data were not associated in tinnitus. Our data show hints for a desynchronization of physiological and psychological stress reactivity in chronic tinnitus

Do prefrontal midline electrodes provide unique neurophysiologic information in Major Depressive Disorder?

Brain oscillatory activity from the midline prefrontal region has been shown to reflect brain dysfunction in subjects with Major Depressive Disorder (MDD). It is not known, however, whether electrodes from this area provide unique information about brain function in MDD. We examined a set of midline sites and two other prefrontal locations for detecting cerebral activity differences between subjects with MDD and healthy controls. Resting awake quantitative EEG (qEEG) data were recorded from 168 subjects: 47 never-depressed adults and 121 with a current major depressive episode. Individual midline electrodes (Fpz, Fz, Cz, Pz, and Oz) and prefrontal electrodes outside the hairline (Fp1, Fp2) were examined with absolute and relative power and cordance in the theta band. We found that MDD subjects exhibited higher values of cordance (p = 0.0066) at Fpz than controls; no significant differences were found at other locations, and power measures showed trend-level differences. Depressed adults showed higher midline cordance than did never-depressed subjects at the most-anterior midline channel. Salient abnormalities in MDD may be detectable by focusing on the prefrontal midline region, and EEG metrics from focused electrode arrays may offer clinical practicality for clinical monitoring

Social trauma : consequences of emotional maltreatment on physiological reactions to social rejection in subjects with social anxiety disorder

Iffland B. Social trauma : consequences of emotional maltreatment on physiological reactions to social rejection in subjects with social anxiety disorder. Bielefeld: Universität Bielefeld; 2013.A history of child maltreatment is associated with psychopathology, predominantly affective and anxiety disorders as well as substance abuse. In the past, research has primarily focused on the consequences of physical abuse, sexual abuse, physical neglect or combinations of these types of maltreatment. However, besides physical and sexual transgressions, child maltreatment does also involve emotional abuse and emotional neglect. Although it was suggested that the consequences of emotional maltreatment might be as severe as the outcomes of physical or sexual maltreatment, there is little knowledge about the unique effects of emotional maltreatment on psychopathology. However, there is a growing body of evidence for an association of emotional maltreatment by caretakers and psychopathology, particularly social anxiety. In addition to emotional maltreatment that involves abuse and neglect by parents and other caretakers, emotional abusive treatments (also referred to as emotional victimization) are highly prevalent among peers. Similar to emotional maltreatment by parents or caretakers, emotional peer victimization contributes to various forms of general psychopathology, e.g., depression, anger-hostility, dissociation, and drug use. However, peer victimization is particularly associated with characteristics of social anxiety disorder. Social anxiety disorder (SAD) is a common anxiety disorder, which is characterized by persistent fear of social or performance situations, fear of negative evaluation, social avoidance of general and new situations, as well as physiological symptoms in social situations. However, the mechanisms that associate emotional maltreatment by caretakers as well as peers and social anxiety are still unknown. Models of cognitive vulnerability suggest that negative learning experiences establish associative information structures in memory that activate various stereotype and pathological behavioral programs in similar situations. This conceptualization predicts that social events may provoke more intense reactions in emotional maltreated subjects as such situations trigger associative response elements of social traumatic experiences. A key element of emotional maltreatment is social rejection. Experiences of social rejection elicit negative mood, emotional distress, and activity of neural networks that are associated with the processing of physical pain. However, because physiological reactions to social rejection were found to be ambiguous, there remains a need for clarification of the impact and direction of social rejection on other physiological measures such as heart rate and skin conductance. In socially anxious subjects, social rejection elicited immediate and delayed effects on psychological outcomes. Therefore both, physiological reactions in healthy subjects as well as increased psychological reactions in socially anxious subjects were suggested in previous studies. However, a combination of these, i.e., an investigation of physiological reactions in socially anxious subjects, was not presented, yet. This might be of specific interest, as fear of social rejection is one of the core components of social anxiety. Accordingly, socially anxious subjects should present stronger and prolonged physiological reactions to social rejection. However, there is so far minimal evidence that experiences of aversive social situations evoke an associative network and an activation of associative memory processing. The aim of the present work was to address this point and to explore the impact of prior emotional maltreatment on physiological reactions to social rejection. In addition, it was assumed that associative memory representations are potential links between maltreatment and social anxiety disorder. Thus, the effect of a history of emotional maltreatment on the experience of potential traumatic social events was expected to be even stronger for subjects with SAD. In a first step, the association of emotional maltreatment with social anxiety was examined. Results indicate a relation of childhood maltreatment with psychopathology, and in particular, social anxiety symptoms. Moreover, it was demonstrated that the relative impact of emotional forms of abuse and neglect might even be higher than indicated by previous research on child maltreatment, which had mainly focused on physical and sexual types of abuse and neglect. Moreover, emotional maltreatment mediated the association of physical maltreatment and social anxiety. In addition to emotional maltreatment through parents and other caretakers, reports of emotional peer victimizations were independently related to social anxiety symptoms. Thus, it was concluded that symptoms of social anxiety are mainly predicted by emotional types of victimization, either in childhood through the caretakers, or during childhood and adolescence through peers. As a second step, physiological reactions to social rejection were examined in healthy subjects. The results suggest that social rejection evokes reactions of the autonomic nervous system (ANS) apparent in accelerated heart rates. Although the effects of social rejection did not imply changes of skin conductance levels, it was concluded that the autonomic nervous system is affected by experiences of social exclusion indicating that behavior activation rather than inhibition is associated with socially threatening events. After that the link between social rejection and physiological reactions had been established, it was examined whether these reactions are affected by histories of emotional maltreatment and symptoms of social anxiety. Data suggested that reactions to an episode of social exclusion were primarily influenced by the degree of relational peer victimization rather than by the diagnosis of SAD. While an increase in skin conductance immediately after the exclusion was observed for all groups of subjects, this physiological response was attenuated among the subjects with a history of peer victimization. In general, the results provided evidence for the existence and significance of associative networks and associative memory processing that is established by experiences of emotional maltreatment. In line with memory models of traumatic events and network models of emotional processing, a history of emotional maltreatment altered physiological reactions to a social challenge. After it has been demonstrated that experiences of emotional maltreatment place individuals at risk for symptoms of social anxiety disorder, findings indicate that associative information processing may account for an enhanced cognitive vulnerability for social anxiety. Although the mechanisms involved remain uncertain, it may be speculated that altered physiological reactivity in subjects with a history of emotional maltreatment contributes to the development of social anxiety. Importantly, the findings of the present research highlight the role of emotional forms of abuse and neglect in the development of a wide range of psychological disorders. Besides the impact of emotional maltreatment on social anxiety, the present research suggested influences of emotional maltreatment on various types of psychopathology. These findings establish a cross-diagnostical perspective on the consequences of emotional maltreatment. Assuming that experiences of emotional abuse and neglect account for various forms of symptomatology, it may be speculated that a plurality of patients would benefit from treatments that address these experiences. Therefore, the development of therapeutic interventions that combine disorder-specific treatments with an approach that focuses on adverse life experiences including social trauma should be a main goal of future clinical research

Positive Psychology and Men: The Tell-Tale Heart

Gender differences are often overlooked or minimized in research regarding well-being. Men and women respond differently to stress, such that men experience higher risk of cardiovascular events. Yet despite their greater potential to benefit, men seem to exhibit less interest and participation than women in activities shown by research to enhance well-being. Heart rate variability provides a sensitive and reliable index of well-being and adaptability both at rest and across various stressors. Research suggests that heart rate variability is influenced not only by physiological processes, but also cognitive and emotional processes, which differ between men and women. Neurological factors underlying these differences may suggest future directions for improving well-being in men