Abstract

Background: The association between decreased heart rate variability (HRV) and increased internalizing symptoms is well documented. Adolescence is a critical period for the development of mental health problems, in particular internalizing symptoms. Previous research has illustrated sex differences in adolescent HRV, such that females have reduced short-term resting state HRV compared to males. Studies on long-term ecological recordings of HRV in adolescents are scarce. The aims of the present study were, (a) to test if adolescent females show decreased long-term HRV and cardiac complexity (CC) compared to males, and (b) to explore whether sex and HRV and CC measures, as well as their interaction, would predict internalizing symptoms.Materials and Methods: HRV was recorded in n = 166 adolescents (86 girls), on a normal school day. HRV and CC measures were calculated on the interbeat interval time series.Results: Females showed lower HRV and CC in most of the assessed indices. Internalizing symptoms were mainly predicted by HRV whereas sex only predicted symptoms of social anxiety. The interaction between sex and HRV did not predict internalizing symptoms.Conclusions: Results suggest that reduced HRV should be considered as a potential contributor to exacerbating internalizing symptoms in adolescence. Girls with reduced HRV and CC might be prone to the development of internalizing disorders. HRV is a promising tool for the early identification of vulnerability.

Highlights

  • Studies have shown that prevalence rates for internalizing disorders (IDs; i.e., depression and anxiety) are higher among females than males (McLean et al, 2011; Beesdo-Baum and Knappe, 2012; Goldman, 2012)

  • As we examined heart rate variability (HRV) and cardiac complexity (CC) in a sample of healthy adolescents, students with any ID diagnoses were excluded (n = 3)

  • Females showed higher mean heart rate (HR) and decreased variability in both time-domain and frequency-domain measures when compared to males (p < 0.025, according to the Bonferroni correction)

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Summary

Introduction

Studies have shown that prevalence rates for internalizing disorders (IDs; i.e., depression and anxiety) are higher among females than males (McLean et al, 2011; Beesdo-Baum and Knappe, 2012; Goldman, 2012). The present study addresses the Negative Valence Systems Domain of the Research Domain Criteria (RDoC) framework (Insel et al, 2010; Insel, 2014) at the physiological autonomic level of analysis, and focuses on sex differences in heart regulation variability and complexity. By measuring the length of successive intervals, HRV is calculated, and it can be quantified using time domain measures (e.g., the standard deviation of successive intervals or SDNN) These measures do not give information about the sources of variability; instead, frequency domain measures of the HRV are used. The aims of the present study were, (a) to test if adolescent females show decreased long-term HRV and cardiac complexity (CC) compared to males, and (b) to explore whether sex and HRV and CC measures, as well as their interaction, would predict internalizing symptoms

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