Reduced autonomic flexibility as a predictor for future anxiety in girls from the general population: The TRAILS study (original) (raw)
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Anxiety and depression in adolescent females : Autonomic regulation and differentiation
2010
The prevalence of anxiety and depression is on the increase in adolescent girls, as estimated by self-assessed symptom reports. There is a need for implementation of validated instruments to identify those in need of treatment. The concept of autonomic self-regulation may help us to elucidate possible pathophysiological pathways of anxiety disorders and depression. Heart rate variability (HRV) provides a tool to assess the descending vagal inhibitory tone, i.e. the capacity of autonomic self-regulation. This perspective gives a framework for evaluating practices of allostatic competence as possible methods for preventing and treating of anxiety disorders and depression in adolescent girls. The present work is intended to create a platform for future studies aimed in this direction.
Clinical and autonomic functions: A study of childhood anxiety disorders
Annals of Saudi Medicine, 2011
T he aggregate anxiety disorders constitute the set of most prevalent psychiatric disorders in children and adolescents, with estimates of point prevalence ranging from 3% to 13%. 1 Generalized anxiety disorder has been noted to be common in children and adolescents, with a prevalence of 3.6% to 7.3% in a community sample. 1 Studies conducted in the USA and Europe, including Scandinavia, largely support the view that social phobia ranks among the most prevalent of the anxiety disorders in the general population. 2 Estimates range from fairly low lifetime rates of 1% to 4% in studies conducted in the early 1980s to considerably higher estimates of 7% to 16% in later studies utilizing DSM-III-R criteria. Anxious children often present with physical complaints rather than overt worries
Restricted autonomic flexibility in children with social phobia
Journal of Child Psychology and Psychiatry, 2011
Background: Psychophysiological hyperresponsiveness to social-evaluative stress plays a key role in current theories of social phobia (SP). Owing to the early onset of this disorder, the study of children with SP can help to improve etiological models. However, research to date has failed to clarify whether children with SP are physiologically hyperresponsive to stress or not. In addition, the existence of elevated pre-stressor baseline group differences complicates the interpretation of acute stress responses and therefore poses a challenge for this line of research. Drawing on current models of autonomic control to explain the relationship between baseline and stress responding in SP children and healthy controls (HC), we acquired a broad set of autonomic measures in our study. Method: To index baseline and stress reactivity and to assess autonomic flexibility, we assessed a comprehensive array of sympathetic and parasympathetic measures in SP children (aged 8 to 12 years; n = 30) and healthy control children (HC, n = 26), while exposing them to the Trier Social Stress Test for Children (TSST-C). Results: At baseline, the SP children showed higher levels of sympathetic (heart rate, electrodermal activity) and lower levels of parasympathetic (respiratory sinus arrhythmia, RSA) activation when compared to the HC children. During the TSST-C, the SP children showed similar HR responses but a limited RSA reactivity and a slower HR recovery relative to the HC children. Conclusion: Our study extends previous research by showing elevated baseline arousal and comparable stress responding in SP children relative to HC children. In addition, based on the autonomic flexibility model, we provide a potential explanation for the null findings of previous studies during stress. The pattern of elevated baseline heart rates and reduced RSA point to restricted autonomic flexibility in children with SP.
Journal of affective disorders, 2015
Psychophysiological theories suggest that individuals with anxiety disorders may evidence inflexibility in their autonomic activity at rest and when responding to stressors. In addition, theories of social anxiety disorder, in particular, highlight the importance of physical symptoms. Research on autonomic activity in childhood (social) anxiety disorders, however, is scarce and has produced inconsistent findings, possibly because of methodological limitations. The present study aimed to account for limitations of previous studies and measured respiratory sinus arrhythmia (RSA) and heart rate (HR) using Actiheart heart rate monitors and software (Version 4) during rest and in response to a social and a non-social stressor in 60 anxious (30 socially anxious and 30 'other' anxious), and 30 nonanxious sex-and age-matched 7-12 year olds. In addition, the effect of state anxiety during the tasks was explored. No group differences at rest or in response to stress were found. Import...
Biological Psychology, 2009
We investigated the temperamental traits high-intensity pleasure (temperamental activation) and shyness (temperamental inhibition) in relation to autonomic function as measured by heart rate (HR), respiratory sinus arrhythmia (RSA), and baroreflex sensitivity (BRS) in 938 10-13-year-old preadolescents from a population cohort. Temperament was evaluated by parent reports on the Revised Early Adolescent Temperament Questionnaire. Autonomic measurements were obtained in supine and standing position. High-intensity pleasure was negatively associated with supine HR and positively with supine RSA and BRS in both genders. Shyness was positively related to supine BRS in girls only. Orthostatic-based autonomic reactivity (difference) scores adjusted for supine values were unrelated to temperamental measures. It appeared that higher scores on temperamental activation and inhibition are associated with higher cardiac vagal activity (RSA) and/or flexible regulation of autonomic balance (BRS), implicating healthy physiological functioning. Moreover, results suggest a physiological basis promoting the tendency towards engagement in high-intensity activities.
Psychosomatic Medicine, 2009
To determine whether patients with different types of anxiety disorder (panic disorder, social phobia, generalized anxiety disorder) have higher heart rate and lower heart rate variability compared with healthy controls in a sample that was sufficiently powered to examine the confounding effects of lifestyle and antidepressants. Methods: The standard deviation of the normal-to-normal intervals (SDNN), heart rate (HR), and respiratory sinus arrhythmia (RSA) were measured in 2059 subjects (mean age ϭ 41.7 years, 66.8% female) participating in The Netherlands Study of Depression and Anxiety (NESDA). Based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) and Composite International Diagnostic Interview (CIDI), NESDA participants were classified as healthy controls (n ϭ 616), subjects with an anxiety diagnosis earlier in life (n ϭ 420), and subjects with current anxiety diagnosis (n ϭ 1059). Results: Current anxious subjects had a significantly lower SDNN and RSA compared with controls. RSA was also significantly lower in remitted anxious subjects compared with controls. These associations were similar across the three different types of anxiety disorders. Adjustment for lifestyle had little impact. However, additional adjustment for antidepressant use reduced all significant associations between anxiety and HRV to nonsignificant. Anxious subjects who used a tricyclic antidepressant, a selective serotonin reuptake inhibitor, or another antidepressant showed significantly lower mean SDNN and RSA compared with controls (effect sizes ϭ 0.20 -0.80 for SDNN and 0.42-0.79 for RSA). Nonmedicated anxious subjects did not differ from controls in mean SDNN and RSA. Conclusion: This study shows that anxiety disorders are associated with significantly lower HR variability, but the association seems to be driven by the effects of antidepressants. Key words: anxiety disorder, SDNN, RSA, cardiac vagal control, heart rate, antidepressants.
Heart rate variability study of childhood anxiety disorders
Journal of Cardiovascular Disease Research, 2011
Background: The current study aims at assessment of heart rate variability among children and adolescents with childhood anxiety disorder, using the case-control design. Materials and Methods: The study was carried out at a tertiary care multispecialty hospital. It included 34 children and adolescents with diagnosis of childhood anxiety disorder, in the age range of eight to eighteen years, and 30 age-and sex-matched healthy controls. Heart-rate variability was studied using the standard protocol. Results: Significantly reduced variability of the heart rate was observed in both the time as well as frequency domains in the disorder group as compared to the control group. These findings indicate decreases in the sympathetic and parasympathetic activity in the disorder group, thus representing diminished physiological variability at rest. Conclusions: The notion of autonomic inflexibility, as seen in the current study, has important implications for stability in biological systems. The loss of variability in the physiological systems in general, and in the cardiovascular system in particular, has an association with a number of diseases and dysfunctions.
Sex- and Age-Dependent Differences in Autonomic Nervous System Functioning in Adolescents
The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2017
We assessed sex- and age-dependent differences in a cross-sectional analysis of cardiac autonomic nervous system (ANS) regulation during sleep in adolescents. Nocturnal heart rate (HR) and heart rate variability (HRV) metrics, reflecting ANS functioning, were analyzed across the night and within undisturbed rapid eye movement (REM) and non-REM sleep in 149 healthy adolescents (12-22 years; 67 female) from the National Consortium on Alcohol and Neurodevelopment in Adolescence. Nocturnal HR was slower in older, more pubertally advanced boys than in younger boys. In girls, HR did not vary according to age or maturity, although overall HRV and vagal modulation declined with age. Although younger boys and girls had similar HR, the male-female HR difference increased by ~2.4 bpm every year (p < .01, higher in older girls). Boys and girls showed expected increases in total HRV across the night but this within-night "recovery" was blunted in girls compared with boys (p < .05...
Journal of Abnormal Child Psychology, 2014
The present study is informed by the theory of allostatic load to examine how multiple stress responsive biomarkers are related to mental health outcomes. Data are from the TRAILS study, a large prospective population study of 715 Dutch adolescents (50.9 % girls), assessed at 16.3 and 19.1 years. Reactivity measures of the hypothalamic pituitaryadrenal (HPA) axis and autonomic nervous system (ANS) biomarkers (heart rate, HR; respiratory sinus arrhythmia, RSA; and pre-ejection period, PEP) to a social stress task were used to predict concurrent and longitudinal changes in internalizing and externalizing symptoms. Hierarchical linear modeling revealed relatively few single effects for each biomarker with the exception that high HR reactivity predicted concurrent internalizing problems in boys. More interestingly, interactions were found between HPA-axis reactivity and sympathetic and parasympathetic reactivity. Boys with high