Respiratory Sinus Arrhythmia Reactivity Research Articles

Effects of pre- and postnatal maternal stress on infant temperament and autonomic nervous system reactivity and regulation in a diverse, low-income population.

We examined the prospective associations of objective and subjective measures of stress during pregnancy with infant stress reactivity and regulation, an early-life predictor of psychopathology. In a racially and ethnically diverse low-income sample of 151 mother-infant dyads, maternal reports of stressful life events (SLE) and perceived stress (PS) were collected serially over gestation and the early postpartum period. Infant reactivity and regulation at 6 months of age was assessed via maternal report of temperament (negativity, surgency, and regulation) and infant parasympathetic nervous system physiology (respiratory sinus arrhythmia [RSA]) during the Still Face Paradigm. Regression models predicting infant temperament showed higher maternal prenatal PS predicted lower surgency and self-regulation but not negativity. Regression models predicting infant physiology showed higher numbers of SLE during gestation predicted greater RSA reactivity and weaker recovery. Tests of interactions revealed SLE predicted RSA reactivity only at moderate to high levels of PS. Thus, findings suggest objective and subjective measures of maternal prenatal stress uniquely predict infant behavior and physiology, adjusting for key pre- and postnatal covariates, and advance the limited evidence for such prenatal programming within high-risk populations. Assessing multiple levels of maternal stress and offspring stress reactivity and regulation provides a richer picture of intergenerational transmission of adversity.

Parent emotion socialization and pre-adolescent’s social and emotional adjustment: Moderating effects of autonomic nervous system reactivity

This study examined whether measures of children’s autonomic nervous system (ANS) reactivity to social stress moderated the effect of parent emotion socialization on children’s social and emotional adjustment. Sixty-one children (9–13 years) completed a peer rejection task while their respiratory sinus arrhythmia reactivity (RSA-R) and skin conductance level reactivity (SCL-R) were assessed. Parents’ report of supportive and non-supportive reactions to their child’s negative emotions served as measures of emotion socialization. Measures of children’s social and emotional adjustment included: teacher-rated peer rejection, aggression, and prosocial behavior and parent-rated aggressive/dysregulated behavior and emotion regulation skills. Measures of children’s ANS reactivity moderated the effect of parent emotion socialization on children’s adjustment. Supportive responses were more protective for children evidencing RSA augmentation whereas non-supportive responses were more detrimental for children evidencing low SCL-R. Thus children’s ANS reactivity during social stress may represent a biological vulnerability that influences sensitivity to parent emotion socialization.

Extraversion and cardiovascular responses to recurrent social stress: Effect of stress intensity

The present study sought to establish whether the effects of extraversion on cardiovascular responses to recurrent social stress are contingent on stress intensity. A 2×5×1 mixed-factorial experiment was conducted, with social stress intensity as a between-subject variable, study phase as a within-subject variable, extraversion as a continuous independent variable, and cardiovascular parameter (HR, SBP, DBP, or RSA) as a dependent variable. Extraversion (NEO-FFI), subjective stress, and physiological stress were measured in 166 undergraduate students randomly assigned to undergo moderate (n=82) or high-intensity (n=84) social stress (a public speaking task with different levels of social evaluation). All participants underwent continuous physiological monitoring while facing two consecutive stress exposures distributed across five laboratory phases: baseline, stress exposure 1, post-stress 1, stress exposure 2, post-stress 2. Results indicated that under moderate-intensity social stress, participants higher on extraversion exhibited lesser HR reactivity to stress than participants lower on extraversion, while under high-intensity social stress, they exhibited greater HR, SBP, DBP and RSA reactivity. Under both moderate- and high-intensity social stress, participants higher on extraversion exhibited pronounced SBP and DBP response adaptation to repeated stress, and showed either better degree of HR recovery or greater amount of SBP and DBP recovery after stress. These findings suggest that individuals higher on extraversion exhibit physiological flexibility to cope with social challenges and benefit from adaptive cardiovascular responses.

Respiratory Sinus Arrhythmia Activity Predicts Internalizing and Externalizing Behaviors in Non-referred Boys.

Atypical respiratory sinus arrhythmia (RSA), a biomarker of emotion dysregulation, is associated with both externalizing and internalizing behaviors. In addition, social adversity and gender may moderate this association. In this study, we investigated if RSA (both resting RSA and RSA reactivity in an emotion regulation task) predicts externalizing and/or internalizing behaviors and the extent to which social adversity moderates this relationship. Two hundred and fifty-three children (at Time 1, mean age = 9.05, SD = 0.60, 48% boys) and their caregivers from the community participated in this study. Resting RSA and RSA reactivity were assessed, and caregivers reported children’s externalizing and internalizing behaviors at both Time 1 and Time 2 (1 year later). We found that lower resting RSA (but not RSA reactivity) at Time 1 was associated with increased externalizing and internalizing behaviors at Time 2 in boys, even after controlling for the effects of Time 1 behavioral problems and Time 2 age. Moreover, there was a significant interaction effect between Time 1 resting RSA and social adversity such that lower resting RSA predicted higher externalizing and internalizing behaviors in boys only under conditions of high social adversity. Follow-up analyses revealed that these predictive effects were stronger for externalizing behavior than for internalizing behavior. No significant effects were found for girls. Our findings provide further evidence that low resting RSA may be a transdiagnostic biomarker of emotion dysregulation and a predisposing risk factor for both types of behavior problems, in particular for boys who grow up in adverse environments. We conclude that biosocial interaction effects and gender differences should be considered when examining the etiological mechanisms of child psychopathology.

Respiratory Sinus Arrhythmia in Cognitive Behavioral Therapy for Posttraumatic Stress Symptoms in Children: Preliminary Treatment and Gender Effects.

Cognitive behavioral therapy (CBT) is an efficacious treatment for posttraumatic stress disorder (PTSD) symptoms, but the effect of CBT on physiological indicators is largely unknown. Respiratory sinus arrhythmia (RSA) is an established parasympathetic marker of self-regulatory capacity and stress responsivity. The present study tested if and how resting RSA and RSA reactivity changed following treatment among a sample of children (n = 48) who experienced at least one traumatic event and presented with PTSD symptoms. RSA reactivity was measured in response to personalized trauma-related scripts. Results indicated that changes in RSA after treatment were dependent on pretreatment resting levels of RSA, with individuals with high and low pretreatment resting RSA levels appearing to converge over time in both resting RSA and RSA reactivity by the 3-month follow up. Specific to RSA reactivity, a sex difference was evident, as following treatment, females showed less RSA withdrawal whereas males showed more RSA withdrawal. PTSD symptoms were significantly reduced after CBT but symptom change was not associated with pretreatment resting RSA levels. Overall, these results suggest that there may be multiple physiological patterns within children with PTSD and the direction of the physiological changes after CBT may depend on initial differences in resting RSA levels.

Prospective relations between intrusive parenting and child behavior problems: Differential moderation by parasympathetic nervous system regulation and child sex

This study examined children's parasympathetic nervous system (PNS) regulation, which was indexed by respiratory sinus arrhythmia (RSA) during rest, reactivity, and recovery episodes, and sex as moderators of predicted relations between observed intrusive parenting and later observer-rated child behavior problems. Child-caregiver dyads (N=250; 50% girls; 46% Latino/a) completed a series of laboratory assessments yielding independent measures of intrusive parenting at age 4, PNS regulation at age 6, and child behavior problems at age 8. Results indicated that intrusive parenting was related to more internalizing problems among boys who showed low RSA reactivity (i.e., PNS withdrawal from pre-startle to startle challenge), but RSA reactivity did not moderate this relation among girls. Interestingly, RSA recovery (i.e., PNS activation from startle challenge to post-startle) moderated these relations differently for boys and girls. For girls with relatively low RSA post-startle (i.e., less recovery), intrusive parenting was positively related to both internalizing and externalizing problems. However, the reverse was true for boys, such that there was a significant positive relation between intrusive parenting and later externalizing problems among boys who evidenced relatively high RSA post-startle (i.e., more recovery). Findings provide evidence for the moderation of intrusive caregiving effects by children's PNS regulation while highlighting the differential patterning of these relations across distinct phases of the regulatory response and as a function of child sex.

Physiological Markers of Interpersonal Stress Generation in Depression.

Abnormalities in parasympathetic nervous system activity have been linked to depression, but less is known about processes underlying this relationship. The present study evaluated resting and stress-reactive respiratory sinus arrhythmia (RSA) to a laboratory stressor as predictors of daily interpersonal stress generation and depressive symptoms, whether stress generation mediated the relationship between RSA and depressive symptoms, and potential sex differences. A sample of formerly depressed 102 emerging adults (18-22 years; 78% female) completed a laboratory stressor and daily assessments of stressors and depressive symptoms over two weeks. Multilevel modeling revealed that: 1) lower resting RSA predicted daily depressive symptoms; 2) less RSA reactivity predicted interpersonal stress generation, 3) interpersonal dependent stressors mediated the relationship between RSA reactivity and daily depressive symptoms, and 4) sex differences occurred in the resting RSA-depression relationship. These findings highlight the importance of resting RSA and RSA reactivity in the examination of depression and interpersonal processes.

Children's Autonomic Nervous System Reactivity Moderates the Relations between Family Adversity and Sleep Problems in Latino 5-Year Olds in the CHAMACOS Study.

Sleep problems are common for young children especially if they live in adverse home environments. Some studies investigate if young children may also be at a higher risk of sleep problems if they have a specific biological sensitivity to adversity. This paper addresses the research question, does the relations between children’s exposure to family adversities and their sleep problems differ depending on their autonomic nervous system’s sensitivity to challenges? As part of a larger cohort study of Latino, low-income families, we assessed the cross-sectional relations among family demographics (education, marital status), adversities [routines, major life events (MLE)], and biological sensitivity as measured by autonomic nervous system (ANS) reactivity associated with parent-rated sleep problems when the children were 5 years old. Mothers were interviewed in English or Spanish and completed demographic, family, and child measures. The children completed a 15-min standardized protocol while continuous cardiac measures of the ANS [respiratory sinus arrhythmia (RSA), preejection period (PEP)] were collected during resting and four challenge conditions. Reactivity was defined as the mean of the responses to the four challenge conditions minus the first resting condition. Four ANS profiles, co-activation, co-inhibition, reciprocal low RSA and PEP reactivity, and reciprocal high RSA and PEP reactivity, were created by dichotomizing the reactivity scores as high or low reactivity. Logistic regression models showed there were significant main effects for children living in families with fewer daily routines having more sleep problems than for children living in families with daily routines. There were significant interactions for children with low PEP reactivity and for children with the reciprocal, low reactivity profiles who experienced major family life events in predicting children’s sleep problems. Children who had a reciprocal, low reactivity ANS profile had more sleep problems if they also experienced MLE than children who experienced fewer MLE. These findings suggest that children who experience family adversities have different risks for developing sleep problems depending on their biological sensitivity. Interventions are needed for young Latino children that support family routines and reduce the impact of family adversities to help them develop healthy sleep practices.

Respiratory Sinus Arrhythmia Predicts Restricted Repetitive Behavior Severity.

In addition to social communication deficits, restricted repetitive behaviors (RRBs) are a key diagnostic feature of autism spectrum disorder (ASD). Dysfunction of the autonomic nervous system (ANS) in ASD has been posited as a mechanism of RRBs; however, most studies investigating ANS activity in ASD have focused on its relation to social functioning. This study used respiratory sinus arrhythmia (RSA) patterns to measure ANS functioning and analyze its relation to RRBs in children with and without an ASD diagnosis. Baseline RSA and RSA reactivity predicted RRB severity and exploratory analyses revealed these measures may be associated with RRB subgroups. These results are discussed in regards to the behavioral literature on RRBs and the benefits of finding biomarkers for these behaviors.

Maternal emotion regulation during child distress, child anxiety accommodation, and links between maternal and child anxiety

Environmental contributions are thought to play a primary role in the familial aggregation of anxiety, but parenting influences remain poorly understood. We examined dynamic relations between maternal anxiety, maternal emotion regulation (ER) during child distress, maternal accommodation of child distress, and child anxiety. Mothers (N=45) of youth ages 3–8 years (M=4.8) participated in an experimental task during which they listened to a standardized audio recording of a child in anxious distress pleading for parental intervention. Measures of maternal and child anxiety, mothers’ affective states, mothers’ ER strategies during the child distress, and maternal accommodation of child anxiety were collected. Mothers’ resting respiratory sinus arrhythmia (RSA) reactivity during the recording was also acquired. Higher maternal negative affect and greater maternal ER switching (i.e., using multiple ER strategies in a short time without positive regulatory results) during child distress were associated with child anxiety. Sequential mediation modeling showed that maternal anxiety predicted ineffective maternal ER during child distress exposure, which in turn predicted greater maternal accommodation, which in turn predicted higher child anxiety. Findings support the mediating roles of maternal ER and accommodation in linking maternal and child anxiety, and suggest that ineffective maternal ER and subsequent attempts to accommodate child distress may act as mechanisms underlying the familial aggregation of anxiety.

Parasympathetic Regulation and Inhibitory Control Predict the Development of Externalizing Problems in Early Childhood.

The current report examined the longitudinal relations between cognitive self-regulation, physiological self-regulation, and externalizing problems. At age 4 (n=98; 49 girls) and 6 (n=87; 42 girls), children completed the Day-Night task, which taps the inhibitory control dimension of executive function. During the task, cardiac activity was measured and respiratory sinus arrhythmia (RSA) was derived as an index of parasympathetic activity. Mothers reported on externalizing problems. A cross-lagged path model was used to estimate longitudinal predictions while controlling for stability in all constructs over time. Earlier inhibitory control negatively predicted later externalizing problems, but not vice versa. However, RSA reactivity moderated this link; better inhibitory control predicted fewer externalizing problems only when reactivity to the Day-Night task ranged from mild RSA suppression to RSA augmentation. Externalizing problems at 6years were highest among preschoolers who augmented RSA but showed poor inhibitory control performance, suggesting that risk for psychopathology may be better delineated by viewing self-regulation from an integrated, multi-system perspective.

Parasympathetic reactivity and disruptive behavior problems in young children during interactions with their mothers and other adults: A preliminary investigation.

Parasympathetic nervous system influences on cardiac functions-commonly indexed via respiratory sinus arrhythmia (RSA)-are central to self-regulation. RSA suppression during challenging emotional and cognitive tasks is often associated with better emotional and behavioral functioning in preschoolers. However, the links between RSA suppression and child behavior across various challenging interpersonal contexts remains unclear. The present study experimentally evaluated the relationship between child RSA reactivity to adult (mother vs. study staff) direction and disruptive behavior problems in children ages 3-8 with varying levels of disruptive behavior problems (N = 43). Reduced RSA suppression in the context of mothers' play-based direction was associated with more severe child behavior problems. In contrast, RSA suppression in the context of staff play-based direction was not associated with behavior problems. Findings suggest that the association between RSA suppression and child behavior problems may vary by social context (i.e., mother vs. other adult direction-givers). Findings are discussed in regard to RSA as an indicator of autonomic self-regulation that has relevance to child disruptive behavior problems.

Post-Traumatic Stress, Mother’s Emotion Regulation, and Parenting in Survivors of Intimate Partner Violence

Post-traumatic stress symptoms (PTSS) are high among female survivors of intimate partner violence (IPV), and children of parents experiencing PTSS are at heightened risk for a wide range of emotional and behavioral problems. Parenting has significant influence on child adjustment, and although links have been found between parental psychopathology and maladaptive parenting, little is known about the factors that may explain this relation. The current study examines mother's emotion regulation (ER) as a factor influencing the relation between mother PTSS and parenting around children's emotions in a study sample of sixty-four female survivors of IPV and their 6- to 12-year-old children. Mothers reported on their own PTSS and their parenting. Respiratory sinus arrhythmia (RSA) was used as a psychophysiological index of mother's ER. Experiential components of mother's ER was also measured by observer coding of the Meta-Emotion Interview, a structured assessment that asks parents about their attitudes toward and experiences with emotions, including their regulation of emotions. Mother's RSA reactivity moderated the relation between PTSS and negative parenting. There was also a significant indirect relation between mothers' PTSS symptom severity and supportive parenting reactions through mothers' self-report of ER. Results suggest that mother's ER abilities represent factors that significantly affect associations between maternal PTSS and parent's emotion socialization practices. Implications for assessment and intervention with families exposed to the stress of IPV are discussed.

Parasympathetic Nervous System Reactivity Moderates Associations Between Children's Executive Functioning and Social and Academic Competence.

This study examined whether children with poor executive functioning (EF) evidenced less social and academic impairments, compared to other children, if they demonstrated adaptive parasympathetic nervous system (PNS) regulation during experiences of failure. Participants with and without clinical elevations in ADHD symptoms (N = 61; 9-13years; 48% male; 85% Caucasian) were administered a battery of EF tests and completed manipulated social and cognitive failure tasks. While participants completed failure tasks, respiratory sinus arrhythmia reactivity (RSA-R) was measured as an indicator of PNS reactivity. Children's social and academic impairment in daily life was assessed based on parent and teacher report on multiple measures. RSA-R during social failure moderated the association between poor EF and adult-rated social impairment and RSA-R during cognitive failure moderated the association between poor EF and adult-rated academic impairment. Simple effects indicated that poor EF was significantly associated with impairment when children demonstrated RSA activation (increased PNS activity) but not when children demonstrated RSA withdrawal (decreases in PNS activity). Domain-crossed models (e.g., reactivity to social failure predicting academic impairment) were not significant, suggesting that the moderating effect of RSA-R was domain-specific. Results suggest that not all children with poor EF evidence social and academic impairment; RSA withdrawal during experiences of failure may be protective specifically for children with impaired EF skills.

Socioeconomic Adversity, Negativity in the Parent Child-Relationship, and Physiological Reactivity: An Examination of Pathways and Interactive Processes Affecting Young Children's Physical Health.

We tested the hypothesis that socioeconomic status (SES) would predict children's physical health problems at the end of kindergarten among children whose parent reported greater parent-child relationship (PCR) negativity and/or who exhibited greater parasympathetic (RSA) reactivity. We also tested whether RSA and PCR negativity mediated the SES-health association. Data were collected from 338 children (mean [SD] age, 5.32 [.32] years) and their primary caregivers (87% biological mothers) during the fall and subsequent spring of kindergarten. In the fall, parents reported income and education level (SES) and PCR negativity, and RSA reactivity was assessed via a standardized challenge protocol for young children. In the fall and then spring, parents reported children's chronic medical conditions and physical health impairments. Multivariate regression was conducted within a structural equation-modeling framework to test hypotheses. Significant interactions were found between SES and PCR negativity (b = -0.074, p = .035) and between SES and RSA reactivity (b = 0.169, p = .019) as predicts children's spring health impairment, adjusting for health in the preceding fall. Lower SES was associated with greater health impairment among children whose parents reported more PCR negativity (b = -0.110, p = .024) and children who showed greater RSA reactivity (b = -0.106, p = .011). Socioeconomic status was unrelated to physical health at low PCR negativity or RSA reactivity. Mediation models were not supported. Parent-child relationship quality and individual differences in stress reactivity may modulate the influence of SES on physical health in childhood.

Links between autonomic activity and implicit learning

The somatic marker hypothesis posits that autonomic activity occurring in response to specific stimuli aids in implicit learning, the learning of information without explicit awareness of what has been learned. This study investigated whether respiratory sinus arrhythmia (RSA), a measure of autonomic nervous system activity, predicted changes in implicit learning. The interaction of resting RSA and RSA reactivity (change in RSA during the implicit learning task) was associated with changes in implicit learning, with those who had higher resting RSA and greater RSA withdrawal during the task performing better. These findings contribute to a better understanding of the autonomic processes that may underlie implicit learning and are discussed in relation to potential links between autonomic activity, implicit learning, and decision making.

Physiological adaptation to recurrent social stress of extraversion.

The present studies examined the influence of extraversion on physiological reactivity, recovery, and physiological habituation-sensitization to repeated social stressors. In Study 1, subjective and physiological data were collected from 97 college students who were categorized as high (n = 51) and low (n = 46) on extraversion (NEO-FFI) across five laboratory stages: baseline, stress 1, poststress 1, stress 2, and poststress 2. Results indicated high extraversion (HE) participants exhibited relative lesser heart rate (HR) reactivity and respiratory sinus arrhythmia (RSA) withdrawals to, and more complete HR and RSA recovery after the first social stress, and also exhibited relative lesser HR reactivity to the second social stress. When repeatedly exposed to a social stressor, HE participants showed pronounced systolic blood pressure (SBP) adaptation, low extraversion (LE) participants displayed diastolic blood pressure (DBP) sensitization. In Study 2, data were collected from another 78 participants (HE: n = 40, LE: n = 38) across the same laboratory stages with speech performance videotaped. After controlling for the speech styles, Study 2 found the same HR response and SBP/DBP adaptation pattern across extraversion groups to social stress as Study 1 but not RSA reactivity. These findings suggest extraverts exhibit more adaptive physiological reactivity to recurrent social stressors, which thus might benefit their health.

Sleep duration and RSA suppression as predictors of internalizing and externalizing behaviors.

Although the conceptual interplay among the biological and clinical features of sleep, arousal, and emotion regulation has been noted, little is understood about how indices of sleep duration and parasympathetic reactivity operate jointly to predict adjustment in early childhood. Using a sample of 123 toddlers, the present study examined sleep duration and RSA reactivity as predictors of internalizing and externalizing behaviors. Parents reported on children's sleep duration and adjustment. RSA reactivity was assessed via children's responses to fear-eliciting stimuli and an inhibitory control challenge. Findings demonstrated that greater RSA suppression to both types of tasks in combination with longer sleep duration was concurrently associated with less internalizing. In contrast, greater RSA augmentation to an inhibitory control task in the context of shorter sleep duration predicted more externalizing 1 year later. The significance of duration of toddlers' sleep as well as the context in which physiological regulatory difficulties occurs is discussed.

Interactive effects of attachment and FKBP5 genotype on school-aged children’s emotion regulation and depressive symptoms

Attachment insecurity is influenced by both environmental and genetic factors, but few studies have examined the effects of gene-environment interactions. In the context of environmental stress, a functional variant in the glucocorticoid receptor co-chaperone FKBP5 gene has been repeatedly shown to increase risk for psychiatric illness, including depression. We expand on prior work by exploring cross-sectional attachment by gene effects on both attachment insecurity and downstream physiological and behavioral measures in a diverse community sample of school-aged children (N=99, 49% girls, Mage=10.29years, 66.6% non-White) and their mothers. Specifically, we examined moderating effects of FKBP5 rs3800373 genotype on the links between parenting insensitivity (overcontrol) and child attachment. Further, we assessed whether FKBP5 moderates the links between maternal and child attachment and children’s emotion regulation self-report, respiratory sinus arrhythmia (RSA) in response to a standardized laboratory stressor, and depressive symptoms. Higher levels of overcontrol predicted lower child attachment security only in FKBP5 minor allele carriers. Among children with two minor alleles (CC), attachment security was negatively associated with emotion suppression, rumination, depressive symptoms, and RSA reactivity; similarly, for these children, maternal attachment anxiety was positively associated with depressive symptoms. The findings can be conceptualized in a differential susceptibility framework, where the FKBP5 minor allele confers either risk or resilience, depending on the parenting environment.

Respiratory sinus arrhythmia reactivity of internet addiction abusers in negative and positive emotional states using film clips stimulation.

Background and aimsPeople with internet addiction (IA) suffer from mental, physical, social, and occupational problems. IA includes psychological and physiological syndromes, and among the syndromes, emotion was suggested important mental and physiological expressions of IA. However, few physiologically emotional characters of IA were investigated. Autonomic nervous system (ANS) activity was a good link between IA and emotion, and respiratory sinus arrhythmia (RSA) gained from ANS was hypothesized related to IA.MethodsAn emotional induction experiment using negative and positive emotional films was conducted to validate the hypotheses. Thirty-four participants recruited from college were classified into high-risk IA group (HIA) and low-risk IA group (LIA). The respiratory signals, ECG signals, and self-assessed emotional intensity were acquired. The relationship and difference between IA and RSA was tested using descriptive statistics and inferential statistics.ResultsThe RSA values of HIA were lower than those of LIA both before and after the induction of positive and negative emotions. When participants experienced a negative emotion (anger or fear), their RSA values declined; the decline for HIA was greater than that for LIA. The RSA values of HIA participants before induction of fear, happiness, or surprise, statistically significantly differed from that after induction of those emotions, with p values of 0.007, 0.04 and 0.01 respectively. The difference between the changes in RSA values upon the induction of surprise of HIA and LIA was statistically significant difference (p = 0.03). The interaction between two IA groups among emotional induction states was statistically significant difference.ConclusionsRSA value here was the main variable that reflected ANS activity, and especially vagus nerve regulation. The results revealed that the changes in RSA values were biologically significantly different between HIA and LIA, especially when sadness, happiness, or surprise was induced. HIA people exhibited stronger RSA reactivity following negative emotion than LIA people, but the RSA reactivity following positive emotion was weaker. This study provides more physiological information about IA and assists further investigation on the regulation of the ANS for IA abusers. The results will benefit the further application, early detection, therapy, and even early prevention.Clinical trial registration details This study was approved by the Institution Review Board of the National Taiwan University Hospital, Hsinchu Branch (Hsinchu, Taiwan), under the research project: A study of interactions between cognition, emotion and physiology (contract no.100IRB-32)