Worry is associated with robust reductions in heart rate variability: a transdiagnostic study of anxiety psychopathology.

John A Chalmers,Daniel S Quintana,Andrew H Kemp,James A J Heathers,Maree J Abbott

doi:10.1186/s40359-016-0138-z

Abstract

BackgroundIndividuals with anxiety disorders display reduced resting-state heart rate variability (HRV), although findings have been contradictory and the role of specific symptoms has been less clear. It is possible that HRV reductions may transcend diagnostic categories, consistent with dimensional-trait models of psychopathology. Here we investigated whether anxiety disorders or symptoms of anxiety, stress, worry and depression are more strongly associated with resting-state HRV.MethodsResting-state HRV was calculated in participants with clinical anxiety (n = 25) and healthy controls (n = 58). Symptom severity measures of worry, anxiety, stress, and depression were also collected from participants, regardless of diagnosis.ResultsParticipants who fulfilled DSM-IV criteria for an anxiety disorder displayed diminished HRV, a difference at trend level significance (p = .1, Hedges’ g = -.37, BF10 = .84). High worriers (Total n = 41; n = 22 diagnosed with an anxiety disorder and n = 19 not meeting criteria for any psychopathology) displayed a robust reduction in resting state HRV relative to low worriers (p = .001, Hedges’ g = -.75, BF10 = 28.16).ConclusionsThe specific symptom of worry – not the diagnosis of an anxiety disorder – was associated with the most robust reductions in HRV, indicating that HRV may provide a transdiagnostic biomarker of worry. These results enhance understanding of the relationship between the cardiac autonomic nervous system and anxiety psychopathology, providing support for dimensional-trait models consistent with the Research Domain Criteria framework.Electronic supplementary materialThe online version of this article (doi:10.1186/s40359-016-0138-z) contains supplementary material, which is available to authorized users.

Highlights

Individuals with anxiety disorders display reduced resting-state heart rate variability (HRV), findings have been contradictory and the role of specific symptoms has been less clear
Body mass index (BMI) was not significantly correlated with HRV (r = 0.02; 95 % CI: -.2 to .24; p = .84), with the Bayes factor (BF) providing substantial evidence that these variables are not related (BF10 = .14). These findings suggest that group differences in BMI are unlikely to contribute to differences in HRV in the present
This study examined whether HRV in participants who fulfilled DSM-IV criteria for an anxiety disorder differed from control participants at resting state, and whether HRV reductions were more reliably associated with measures of depression, anxiety, stress, and worry, consistent with dimensional-trait models of psychopathology

Summary

Introduction

Individuals with anxiety disorders display reduced resting-state heart rate variability (HRV), findings have been contradictory and the role of specific symptoms has been less clear. We investigated whether anxiety disorders or symptoms of anxiety, stress, worry and depression are more strongly associated with resting-state HRV. Reductions in resting-state heart rate variability (HRV) reflect cardiac autonomic dysfunction, which plays a key role in the development of cardiovascular diseases. Low HRV is associated with a wide variety of psychological states, behaviours and conditions including reduced capacity for self-regulation, enhanced withdrawal behaviours, psychiatric illness and cardiovascular disease [14,15,16,17,18,19] leading us to suggest previously that HRV may help to elucidate the pathways linking mental and physical health [13].

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