The Polyvagal Theory: phylogenetic contributions to social behavior

Publication guidelines for human heart rate and heart rate variability studies in psychophysiology-Part 1: Physiological underpinnings and foundations of measurement

This Committee Report provides methodological, interpretive, and reporting guidance for researchers who use measures of heart rate (HR) and heart rate variability (HRV) in psychophysiological research. We provide brief summaries of best practices in measuring HR and HRV via electrocardiographic and photoplethysmographic signals in laboratory, field (ambulatory), and brain-imaging contexts to address research questions incorporating measures of HR and HRV. The Report emphasizes evidence for the strengths and weaknesses of different recording and derivation methods for measures of HR and HRV. Along with this guidance, the Report reviews what is known about the origin of the heartbeat and its neural control, including factors that produce and influence HRV metrics. The Report concludes with checklists to guide authors in study design and analysis considerations, as well as guidance on the reporting of key methodological details and characteristics of the samples under study. It is expected that rigorous and transparent recording and reporting of HR and HRV measures will strengthen inferences across the many applications of these metrics in psychophysiology. The prior Committee Reports on HR and HRV are several decades old. Since their appearance, technologies for human cardiac and vascular monitoring in laboratory and daily life (i.e., ambulatory) contexts have greatly expanded. This Committee Report was prepared for the Society for Psychophysiological Research to provide updated methodological and interpretive guidance, as well as to summarize best practices for reporting HR and HRV studies in humans.

Impact of Loneliness on Training Gains with Heart Rate Variability Biofeedback in the Elderly: A Pilot Study

The negative impact of loneliness on the health of the elderly is particularly noticeable because of the effects of central control on the autonomic nervous system. Such an impact can be assessed through heart rate variability (HRV) analysis and can be modified using HRV biofeedback training. This study aimed to investigate the impact of different levels of social interaction reported by the elderly on HRV before and after training with HRV biofeedback and after a follow-up period. The participants of this pilot study comprised 16 elderly people of both sexes with a mean age of 71.20 ± 4.92 years. The participants were divided into two groups, the loneliness group (N = 8) and the no-loneliness group (N = 8), based on a combination of both criteria: the institutionalization condition (institutionalized or not) and the score on the loneliness scale (high or low). All participants had their HRV components recorded at baseline, after 14 training sessions with HRV biofeedback (three times a week, 15 min each for 4.5 weeks), and after 4.5 weeks of follow-up without training. After HRV biofeedback training, HRV components increased in both groups. However, the gains lasted at follow-up only in the no-loneliness group. In conclusion, loneliness can influence the maintenance of HRV after interruption of training with HRV biofeedback in the elderly. HRV biofeedback training can be an innovative and effective tool for complementary treatment of elderly individuals, but its effects on lonely elderly individuals need to be further investigated.

When the body fosters empathy: The interconnectivity between bodily reactivity, meditation, and embodied abstract concepts

Empathy is a fundamental social ability that allows humans to infer others' emotions and intentions. Empathy is thought to be rooted in bodily sensations coming from the autonomic nervous system. In parallel, the functionality and perceptions coming from the autonomic nervous system could be improved by practicing activities that involve mind-body interactions, such as meditation. Furthermore, perceptions from the autonomic nervous system are thought to be important in the embodiment of abstract concepts. Consequently, in the current study, we collected data online from 581 participants and explored the associations between levels of empathy and (1) the practice of meditation, music, and sports; (2) the impact of self-report measures on bodily awareness and reactivity; and (3) the embodiment of abstract concepts in interoception. In line with previous studies, Meditators were found to have higher empathy scores than Non-Meditators. In addition, lower levels of autonomic reactivity in organs above the diaphragm were associated with higher empathy. Finally, we also observed that empathy was positively associated with interoceptive components of abstract concepts in those participants with high autonomic reactivity. Taken together, the results suggest that meditation practice and having low autonomic reactivity are associated with empathy, arguably through the downregulation of autonomic responses. Implications for mind-body interaction in meditation and its role in promoting empathy are discussed.

Resting Heart Rate Variability and Emotion Dysregulation in Adolescents with Autism Spectrum Disorder

Emotion dysregulation is common among individuals with autism spectrum disorder (ASD). This study examined the relationship between emotion dysregulation and resting heart rate variability (HRV), a marker of the autonomic nervous system, in ASD adolescents. Resting HRV data were collected from ASD (n = 23) and typically developing (TD) adolescents (n = 32) via short-term electrocardiogram. Parents/caregivers reported participants' level of emotion dysregulation with the Emotion Dysregulation Inventory (EDI). Controlling for the effects of age and gender, regression analyses revealed moderating effects of group, suggesting that lower resting HRV was more strongly associated with greater emotion dysregulation in ASD than TD adolescents. The results support the view that disruptions in autonomic functioning may contribute to emotion dysregulation in ASD.

Integrated use of biofeedback and neurofeedback techniques in treating pathological conditions and improving performance: a narrative review

In recent years, the scientific community has begun tо explore the efficacy оf an integrated neurofeedback + biofeedback approach іn various conditions, both pathological and non-pathological. Although several studies have contributed valuable insights into its potential benefits, this review aims tо further investigate its effectiveness by synthesizing current findings and identifying areas for future research. Our goal іs tо provide a comprehensive overview that may highlight gaps іn the existing literature and propose directions for subsequent studies. The search for articles was conducted on the digital databases PubMed, Scopus, and Web of Science. Studies to have used the integrated neurofeedback + biofeedback approach published between 2014 and 2023 and reviews to have analyzed the efficacy of neurofeedback and biofeedback, separately, related to the same time interval and topics were selected. The search identified five studies compatible with the objectives of the review, related to several conditions: nicotine addiction, sports performance, Autism Spectrum Disorder (ASD), and Attention Deficit Hyperactivity Disorder (ADHD). The integrated neurofeedback + biofeedback approach has been shown to be effective in improving several aspects of these conditions, such as a reduction in the presence of psychiatric symptoms, anxiety, depression, and withdrawal symptoms and an increase in self-esteem in smokers; improvements in communication, imitation, social/cognitive awareness, and social behavior in ASD subjects; improvements in attention, alertness, and reaction time in sports champions; and improvements in attention and inhibitory control in ADHD subjects. Further research, characterized by greater methodological rigor, is therefore needed to determine the effectiveness of this method and the superiority, if any, of this type of training over the single administration of either. This review іs intended tо serve as a catalyst for future research, signaling promising directions for the advancement оf biofeedback and neurofeedback methodologies.

Variation in coupling across neural and cardiac systems of regulation is linked to markers of anxiety risk in preschool

Both cortical and parasympathetic systems are believed to regulate emotional arousal in the service of healthy development. Systemic coordination, or coupling, between putative regulatory functions begins in early childhood. Yet the degree of coupling between cortical and parasympathetic systems in young children remains unclear, particularly in relation to the development of typical or atypical emotion function. We tested whether cortical (ERN) and parasympathetic (respiratory sinus arrhythmia [RSA]) markers of regulation were coupled during cognitive challenge in preschoolers (N = 121). We found no main effect of RSA predicting ERN. We then tested children's typical and atypical emotion behavior (context-appropriate/context-inappropriate fear, anxiety symptoms, neuroendocrine reactivity) as moderators of early coupling in an effort to link patterns of coupling to adaptive emotional development. Negative coupling (i.e., smaller ERN, more RSA suppression or larger ERN, less RSA suppression) at age 3 was associated with greater atypical and less typical emotion behaviors, indicative of greater risk. Negative age 3 coupling was also visible for children who had greater Generalized Anxiety Disorder symptoms and blunted cortisol reactivity at age 5. Results suggest that negative coupling may reflect a maladaptive pattern across regulatory systems that is identifiable during the preschool years.

Relationships Among Heart Rate Variability, Perceived Social Support, and Hopelessness in Adults With Ischemic Heart Disease

BACKGROUND

Lower perceived social support is associated with hopelessness in patients with ischemic heart disease (IHD). Higher perceived social support is associated with higher heart rate variability (HRV) in adults following a stressful event, but the relationship between HRV and hopelessness has not been examined in patients with IHD. The purpose of this research was to evaluate the relationships among HRV, perceived social support, and hopelessness in patients with IHD.

METHODS AND RESULTS

Ninety-four participants were enrolled while hospitalized for an IHD event at a large hospital in the United States. Data collection occurred 2 weeks after hospital discharge and included the State-Trait Hopelessness Scale, ENRICHD Social Support Inventory, Patient Health Questionnaire-9, a demographic form, and a short-term HRV measurement taken at rest. Linear models were used to assess associations between variables in unadjusted and adjusted models. Most participants were men (67%), married (75%), and non-Hispanic White (96%) and underwent coronary artery bypass surgery (57%). There were inverse correlations between high frequency HRV and state hopelessness (r=-0.21, P=0.008) and root mean square of successive differences between normal heartbeats HRV and state hopelessness (r=-0.20, P=0.012) after adjusting for important covariates. High frequency and root mean square of successive differences between normal heartbeats did not show evidence of mediating the relationship between perceived social support and hopelessness.

CONCLUSIONS

There were significant inverse correlations between parasympathetic measures of HRV and hopelessness. Assessing high frequency and root mean square of successive differences between normal heartbeats during early recovery following an IHD event could provide promising evidence for understanding a possible precursor to hopelessness and targets for future interventions. Registration Information: clinicaltrials.gov. Identifiers: NCT03907891, NCT05003791.

Role of autonomic, nociceptive, and limbic brainstem nuclei in core autism features

Although multiple theories have speculated about the brainstem reticular formation's involvement in autistic behaviors, the in vivo imaging of brainstem nuclei needed to test these theories has proven technologically challenging. Using methods to improve brainstem imaging in children, this study set out to elucidate the role of the autonomic, nociceptive, and limbic brainstem nuclei in the autism features of 145 children (74 autistic children, 6.0-10.9 years). Participants completed an assessment of core autism features and diffusion- and T1-weighted imaging optimized to improve brainstem images. After data reduction via principal component analysis, correlational analyses examined associations among autism features and the microstructural properties of brainstem clusters. Independent replication was performed in 43 adolescents (24 autistic, 13.0-17.9 years). We found specific nuclei, most robustly the parvicellular reticular formation-alpha (PCRtA) and to a lesser degree the lateral parabrachial nucleus (LPB) and ventral tegmental parabrachial pigmented complex (VTA-PBP), to be associated with autism features. The PCRtA and some of the LPB associations were independently found in the replication sample, but the VTA-PBP associations were not. Consistent with theoretical perspectives, the findings suggest that individual differences in pontine reticular formation nuclei contribute to the prominence of autistic features. Specifically, the PCRtA, a nucleus involved in mastication, digestion, and cardio-respiration in animal models, was associated with social communication in children, while the LPB, a pain-network nucleus, was associated with repetitive behaviors. These findings highlight the contributions of key autonomic brainstem nuclei to the expression of core autism features.

An investigation of cardiac vagal tone over time and its relation to vigilance performance: a growth curve modeling approach

Introduction

Research over the last couple of decades has demonstrated a relationship between psychophysiological measures, specifically cardiac functions, and cognitive performance. Regulation of the cardiac system under parasympathetic control is commonly referred to as cardiac vagal tone and is associated with the regulation of cognitive and socioemotional states. The goal of the current study was to capture the dynamic relationship between cardiac vagal tone and performance in a vigilance task.

Method/Results

We implemented a longitudinal growth curve modeling approach which unveiled a relationship between cardiac vagal tone and vigilance that was non-monotonic and dependent upon each person.

Discussion

The findings suggest that cardiac vagal tone may be a process-based physiological measure that further explains how the vigilance decrement manifests over time and differs across individuals. This contributes to our understanding of vigilance by modeling individual differences in cardiac vagal tone changes that occur over the course of the vigilance task.

Student arousal, engagement, and emotion relative to Physical Education periods in school

BACKGROUND

Exercise has transient effects on cognition and mood, however the impact of Physical Education (PE) on cognitive and affective processes across the school day has not been examined.

METHOD

This study used wearables and questionnaires to track student arousal, engagement, and emotion across school days/periods following PE. Skin conductance, heart rate, heart rate variability, and self-reported engagement, arousal, and valence were analyzed for 23 students (age 15-17 years) on days with and without PE.

RESULTS

Sympathetic arousal was significantly higher for two hours following PE and there were stronger decreases in arousal across other classes relative to days without PE. On days with PE, engagement decreased, whereas valence increased from morning to afternoon.

CONCLUSION

These findings highlight the importance of considering acute effects of PE on learning across the entire school day, and demonstrates the feasibility of wearables to clarify how the timing of PE could positively or negatively affect self-regulation and learning.

The physiological basis of leader-follower roles in the dyadic alternating tapping task

Introduction

Cooperative and collaborative behaviors are important concepts for co-creative communication. One of the key elements for these behaviors is the leader-follower roles in human communication. Leaders are those who maintain their own pace and rhythm, on the contrary, followers are those who follow the pace and rhythm of the other. Well-coordinated leader-follower roles would produce better cooperative and collaborative behaviors, which could promote co-creative communication.

Methods

Here, to explore the physiological basis for the leader-follower roles, we conducted the dyadic alternating tapping task with electrocardiographic and electroencephalographic recordings. The task would be stable for modeling human communication in the laboratory because it includes timing control in tens of milliseconds and turn-taking. Given that human communications are complex and constantly fluctuating, this study estimated the degree of leader-follower with the state-space model. This model allowed us to calculate two parameters independently for estimating the degree of leader-follower of each participant: αSelf (degree of one's tap(n) was explained by one's tap(n-1)) and αPair (degree of one's tap(n) was explained by one's tap (n-1) and pair's tap (n-1)).

Results

The result showed heart rate synchronization in the group in which both participants had high αPair. Also, the high-frequency component of heart rate variability was positively correlated with αPair. EEG analyses suggested the deactivation of the mirror neuron system (increasing φ1) in the participants with higher αSelf than lower ones. The activation of the mirror neuron system (increasing φ2) was shown in the participants with lower αPair than higher ones.

Discussion

These data of physiological basis for leader-follower roles could be useful for the constructivist approach to co-creative communication.

The "well-sibling" syndrome: hypnosis for the siblings of special needs children

Often overlooked by caregivers because of their ability to adapt to a challenging home life by making few demands themselves, the siblings of special needs children have unacknowledged needs of their own. They often are reluctant to participate in therapy because of their self-concept of having to be the "normal" or "perfect" child. Therapy with these children requires non-pathologizing and attuned rapport building focused on creative self-exploration without requests for change. Two composite case vignettes illustrate the power and versatility of clinical hypnosis to facilitate new learning about becoming visible in the therapeutic relationship and beyond.

Associations among maternal lifetime trauma, psychological symptoms in pregnancy, and infant stress reactivity and regulation

Maternal trauma has intergenerational implications, including worse birth outcomes, altered brain morphology, and poorer mental health. Research investigating intergenerational effects of maternal trauma on infant stress reactivity and regulation is limited. Maternal mental health during pregnancy may be a contributor: psychopathology is a sequela of trauma exposure and predictor of altered self-regulatory capacity in offspring of affected mothers. We assessed associations among maternal lifetime trauma and infant stress responsivity, mediated by psychological symptoms in pregnancy. Mothers reported lifetime trauma history and anxiety, depressive, and posttraumatic stress symptoms during pregnancy. At infant age 6 months, stress reactivity and regulation were assessed via maternal behavior ratings (Infant Behavior Questionnaire-Revised, IBQ-R) and behavioral (negative mood) and physiological (respiratory sinus arrhythmia, RSA) markers during a laboratory stressor (Still-Face Paradigm). Maternal trauma was directly associated with lower infant physiological regulation and indirectly associated with lower levels of both infant behavioral and physiological regulation via higher maternal anxiety during pregnancy. Maternal trauma was also indirectly associated with higher infant reactivity via higher maternal anxiety during pregnancy. Post hoc analyses indicated differential contributions of maternal prenatal versus postnatal anxiety to infant outcomes. Findings highlight potential contributory mechanisms toward maladaptive child stress response, which has been associated with poor behavioral, cognitive, and academic outcomes.

Data mining techniques in psychotherapy: applications for studying therapeutic alliance

Therapeutic Alliance (TA) has been consistently reported as a robust predictor of therapy outcomes and is one of the most investigated therapy relational factors. Research on therapists' and clients' contributions to the alliance development and the alliance-outcome relationship had shown mixed results. The relation of the therapist's and client's biological markers with the alliance is an important and under-investigated topic. Taking advantage of data mining techniques, this exploratory study aimed to investigate the role of different therapist and client factors, including heart rate (HR) and electrodermal activity (EDA), in relation to TA. Twenty-two dyads with 6 therapists and 22 clients participated in the study. The Working Alliance Inventory (WAI) was used to evaluate the client's and therapist's perception of the alliance at the end of each session and through the therapy processes. The Cross-Industry Standard Process for Data Mining (CRISP-DM) was used to explore patterns that may contribute to TA. Machine Learning (ML) models have been employed to provide insights into the predictors and correlates of TA. Our results showed that Linear Regression (LR) was the best technique for predicting the therapist's TA, with client "Diagnostic" and therapy "Termination" being identified as significant predictors of the therapist's TA. In addition, for clients' TA, the Random Forest (RF) was shown to have the best performance. The therapist's TA and therapy "Outcome" were observed as the most influential predictors for the client's TA. In addition, while the Heart Rate (therapist) was negatively associated with the therapist's TA, EDA in the client was a physiological indicator related to the client's TA. Overall, these findings can assist in identifying key factors that therapists should focus on to enhance the quality of therapeutic alliance. Results are discussed in terms of their consistency with empirical literature, innovative and interdisciplinary research on the therapeutic alliance field, and, in particular, the use of the Data Mining approach in a psychotherapy context.

Sound stimulation using the individual's heart rate to improve the stability and homeostasis of the autonomic nervous system

OBJECTIVES

In this study, we explain the role of enhancing the stability and homeostasis of the autonomic nervous system (ANS) by proposing the average heart rate sound resonance (aHRSR), a sound stimulation to prevent imbalance of ANS due to dynamic movement. The effect of aHRSR on ANS was analyzed through the time and frequency domain of heart rate variability (HRV) using the photoplethysmogram data (PPG) of 22 participants (DUIRB-202109-12).

METHOD

When the subjects performed dynamic movements that could cause changes in the ANS, HRV indicators using PPG data for 5 min before and after the movements were analyzed according to the presence or absence of aHRSR. The standard deviation of the NN intervals (SDNN), the square root of the mean squared differences of the NN intervals (RMSSD), low-frequency band (LF), and high-frequency band (HF), which represent sympathetic and parasympathetic nerve activity, were used as indicators, where SNDD and LF represent total ANS and sympathetic activity, while RMSSD and HF represent parasympathetic activity.

RESULTS

As the effects of aHRSR on dynamic movement, the recovery time of RR interval was advanced by about 15 s, SDNN increased from ([44.16 ± 13.11] to [47.85 ± 15.16]) ms, and RMSSD increased from ([23.73 ± 9.95] to [31.89 ± 12.48]) ms (p < 0.05), increasing the stability of the ANS and reducing instability. The effect of homeostasis of the ANS according to aHRSR is also shown in reducing the change rate of LF from (-13.83 to -8.83) %, and the rate of change of HF from (10.59 to 3.27) %.

CONCLUSIONS

These results suggest that aHRSR can affect the cardiovascular system by assisting physiological movements that occur during dynamic movement.

Silence and its effects on the autonomic nervous system: A systematic review

This systematic review explores the influence of silence on the autonomic nervous system. The Polyvagal Theory has been used as a reference model to describe the autonomic nervous system by explaining its role in emotional regulation, social engagement, and adaptive physiological responses. PubMed, Scopus, PsycInfo, EMBASE, and Google Scholar were systematically searched up until July 2023 for relevant studies. The literature search yielded 511 results, and 37 studies were eventually included in this review. Silence affects the autonomic nervous system differently based on whether it is inner or outer silence. Inner silence enhances activity of the ventral vagus, favoring social engagement, and reducing sympathetic nervous system activity and physiological stress. Outer silence, conversely, can induce a heightened state of alertness, potentially triggering vagal brake removal and sympathetic nervous system activation, though with training, it can foster inner silence, preventing such activation. The autonomic nervous system response to silence can also be influenced by other factors such as context, familiarity with silence, presence and quality of outer noise, and empathy.

Development and Parasympathetic Regulation in Male and Female Adolescents with Autism Spectrum Disorder: A Two-Timepoint Longitudinal Study

Prolonged dysregulation of the autonomic nervous system (ANS) may increase propensity for physical or psychiatric illness. The current study examined differences in respiratory sinus arrhythmia (RSA) regulation in 215 adolescents with or without autism spectrum disorder (ASD) at Time 1 (T1; 10-13 years old) and 1 year later (Time 2; T2). Linear mixed effects models demonstrated lower RSA regulation in ASD, and a small interaction effect, showing blunted change in RSA from T1 to T2. Developmental differences in RSA regulation were particularly notable in females with ASD and those taking psychotropic medications. Results expand previous findings of reduced parasympathetic regulation in ASD by revealing a blunted developmental slope, indicating diagnostic differences may persist or worsen over time, particularly in females.

Vagal flexibility to negative emotions moderates the relations between environmental risk and adjustment problems in childhood

Neurobiological and social-contextual influences shape children's adjustment, yet limited biopsychosocial studies have integrated temporal features when modeling physiological regulation of emotion. This study explored whether a common underlying pattern of non-linear change in respiratory sinus arrhythmia (RSA) across emotional scenarios characterized 4-6 year-old children's parasympathetic reactivity (N = 180). Additionally, we tested whether dynamic RSA reactivity was an index of neurobiological susceptibility or a diathesis in the association between socioeconomic status, authoritarian parenting, and the development of externalizing problems (EP) and internalizing problems over two years. There was a shared RSA pattern across all emotions, characterized by more initial RSA suppression and a subsequent return toward baseline, which we call vagal flexibility (VF). VF interacted with parenting to predict EP. More authoritarian parenting predicted increased EP two years later only when VF was low; conversely, when VF was very high, authoritarian mothers reported that their children had fewer EP. Altogether, children's patterns of dynamic RSA change to negative emotions can be characterized by a higher order factor, and the nature by which VF contributes to EP depends on maternal socialization practices, with low VF augmenting and high VF buffering children against the effects of authoritarian parenting.

Preschoolers' emotion reactivity and regulation: Links with maternal psychological distress and child behavior problems

Maladaptive offspring emotion regulation has been identified as one pathway linking maternal and child psychological well-being in school-aged children. Whether such a pathway is present earlier in life still remains unclear. The present study investigated the role of preschoolers' emotion reactivity and regulation in the association between maternal psychological distress and child internalizing and externalizing problems. Children's emotion reactivity and regulation were assessed through both observed behavior and physiology. At 42 months of age, children (n = 251; 128 girls) completed a fear induction task during which their heart-rate variability was assessed and their behavior was monitored, and maternal self-reports on depressive mood and anxiety were collected. At 48 months mothers and fathers reported on their children's internalizing and externalizing problems. Higher maternal depressive mood was associated with lower child fear-related reactivity and regulation, as indexed by heart-rate variability. The latter mediated the association between higher maternal depressive mood and higher preschoolers' externalizing problems. Overall, our findings support the role of preschoolers' emotion reactivity and regulation in the relationship between maternal psychological distress and children's socio-emotional difficulties. This role may also depend on the discrete emotion to which children react or seek to regulate as, here, we only assessed fear-related reactivity and regulation.

Athletes' self-compassion and emotional resilience to failure: the mediating role of vagal reactivity

Whether athletes' self-compassion predicts their emotional resilience to failure has yet to be empirically tested. Moreover, as an important physiological process of stress regulation, vagal reactivity is a plausible physiological mechanism for this relationship. Through a laboratory-based observational study of 90 college athletes, this research explores the influence of athletes' trait self-compassion on their emotional resilience when recalling failure, and examines whether vagal reactivity plays a mediating role. The results show that self-compassion did not significantly predict athletes' positive emotions but did significantly predict better recovery from negative emotions after recalling failure events. Furthermore, vagal reactivity was a significant mediator between self-compassion and recovery from negative emotions.

[Manual spinal therapy techniques to stimulate the autonomic nervous system: a scoping review]

BACKGROUND

Physical interventions or manual therapeutic techniques (MTTe) such as mobilisation, manipulation or soft tissue techniques not only have an influence on the target tissue with improvement of metabolism or reduction of hypertonic muscles. They are also used for balance regulation in central nervous changes of the autonomic nervous system (ANS). To date, there is a lack of empirical evidence on impact mechanisms and target locations of MTTe on the ANS. This scoping review aims to provide an overview of the evidence on the application of MTTe at diverse levels of the spine with a view to the ANS.

METHOD

A systematic literature search was conducted on CENTRAL, Google Scholar, Osteopathic Research Web, PEDro and PubMed. The scope and content of the literature were documented. The results of the included and referenced studies were summarised in a narrative approach with the focus being on the most significant clinical aspects.

RESULTS

MTTe was described as manipulations, mobilisations, myofascial techniques and cervical traction. In 27 out of 35 studies, therapeutic treatments were carried out on healthy volunteers. Ten studies analysed immediate effects in patients, while two studies were designed as longitudinal studies in patients with hypertension. Over a period of four to eight weeks, the frequency of intervention was between one and three MTTe sessions a week.

CONCLUSION

The study results proved to be heterogeneous. For this reason, it is not possible to draw definitive, explicit and generally valid statements regarding the type and intensity as well as the segmental level at which MTTe should be applied in order to trigger specific positive ANS response mechanisms. Consequently, longitudinal studies with follow-up are recommended for future studies. In addition, comprehensive effects of MTTe should be evaluated in groups of patients with different characteristics.

A pragmatic feasibility trial of the Primary Care Intervention for PTSD: A health service delivery model to reduce health disparities for low-income and BIPOC youth

OBJECTIVE

This study is a non-randomized pragmatic trial to assess the feasibility and acceptability of the Primary Care Intervention for Posttraumatic stress disorder (PCIP) (Srivastava et al., 2021), an Integrated Behavioral Health Care treatment for PTSD in adolescents.

METHOD

Following routine clinic procedures, youth who were suspected of having trauma-related mental health symptoms were referred by their primary care providers to integrated care social workers for evaluation. The integrated care social workers referred the first 23 youth whom they suspected of having PTSD to the research study. Twenty youth consented to the study and 19 completed the pre-assessment (17 female; mean age = 19.32, SD = 2.11; range 14-22 years). More than 40% identified as Black and a third as Hispanic/Latinx. PCIP mechanisms and clinical outcomes were assessed pre- and post-treatment, and at one-month follow-up. Participants and therapists completed post-treatment qualitative interviews to assess feasibility and acceptability, and treatment sessions were audio recorded to assess fidelity.

RESULTS

Findings suggest high acceptability, satisfaction, and feasibility of the PCIP delivered in "real-life" safety net pediatric primary care. Integrated care social workers had high treatment fidelity. Despite the small sample size, there was significant improvement in symptom scores of anxiety (g = 0.68, p = 0.02) and substance use (g = 0.36, p = 0.04) from pre to post, and depression symptoms (g = 0.38, p = 0.04) from pre to follow-up. Qualitative data from patients who completed exit interviews and integrated social workers indicated high satisfaction with the treatment, with some participants reporting that the integrated intervention was more acceptable and less stigmatizing than seeking mental health care outside of primary care.

CONCLUSIONS

The PCIP may improve treatment engagement and access for vulnerable youth. Promising findings of high acceptability, feasibility, and initial clinical effectiveness suggest that PCIP warrants larger-scale study as part of routine care in pediatric integrated care.

Facilitating dyadic synchrony in psychotherapy sessions: Systematic review and meta-analysis

Objective: This paper highlights the facilitation of dyadic synchrony as a core psychotherapist skill that occurs at the non-verbal level and underlies many other therapeutic methods. We define dyadic synchrony, differentiate it from similar constructs, and provide an excerpt illustrating dyadic synchrony in a psychotherapy session. Method: We then present a systematic review of 17 studies that have examined the associations between dyadic synchrony and psychotherapy outcomes. We also conduct a meta-analysis of 8 studies that examined whether there is more synchrony between clients and therapists than would be expected by chance. Results: Weighted box score analysis revealed that the overall association of synchrony and proximal as well as distal outcomes was neutral to mildly positive. The results of the meta-analysis indicated that real client-therapist dyad pairs exhibited synchronized behavioral patterns to a much greater extent than a sample of randomly paired people who did not actually speak. Conclusion: Our discussion revolves around how synchrony can be facilitated in a beneficial way, as well as situations in which it may not be beneficial. We conclude with training implications and therapeutic practices.

Initial Outcomes of the Safe and Sound Protocol on Patients with Adult Autism Spectrum Disorder: Exploratory Pilot Study

Sensory impairments are common features of autism spectrum disorder (ASD) and are associated with its social impairments. However, there is no established treatment for these impairments in adults with ASD. The Safe & Sound Protocol (SSP) is a listening program designed to improve social communication skills by reducing auditory hypersensitivity. We investigated the effectiveness of the SSP for adults with ASD. We administered the SSP to six participants with ASD aged 21-44 years old, and the effects were assessed using the Social Responsiveness Scale, Second Edition (SRS-2). Secondary outcomes were assessed using the Center for Epidemiological Studies Depression Scale (CES-D), State-Trait Anxiety Inventory (STAI), WHO Quality of Life 26 (WHOQOL-BREF), and Adolescent/Adult Sensory Profile (A/ASP). In this study, only the Social Awareness scale of the SRS-2 Family-Report showed a significant improvement after the intervention. In addition, it was significantly correlated with physical health of WHOQOL-BREF (r = -0.577, p = 0.012), state and trait anxiety of STAI (r = 0.576, p = 0.012; r = 0.708, p = 0.00009, respectively), and CES-D (r = 0.465, p = 0.05). In conclusion, the SSP has a partial effect on social impairments in adults with ASD, specifically on the Social Awareness subscale of the SRS-2.

The Evaluation of Emotional Intelligence by the Analysis of Heart Rate Variability

Emotional intelligence (EI) is a critical social intelligence skill that refers to an individual's ability to assess their own emotions and those of others. While EI has been shown to predict an individual's productivity, personal success, and ability to maintain positive relationships, its assessment has primarily relied on subjective reports, which are vulnerable to response distortion and limit the validity of the assessment. To address this limitation, we propose a novel method for assessing EI based on physiological responses-specifically heart rate variability (HRV) and dynamics. We conducted four experiments to develop this method. First, we designed, analyzed, and selected photos to evaluate the ability to recognize emotions. Second, we produced and selected facial expression stimuli (i.e., avatars) that were standardized based on a two-dimensional model. Third, we obtained physiological response data (HRV and dynamics) from participants as they viewed the photos and avatars. Finally, we analyzed HRV measures to produce an evaluation criterion for assessing EI. Results showed that participants' low and high EI could be discriminated based on the number of HRV indices that were statistically different between the two groups. Specifically, 14 HRV indices, including HF (high-frequency power), lnHF (the natural logarithm of HF), and RSA (respiratory sinus arrhythmia), were significant markers for discerning between low and high EI groups. Our method has implications for improving the validity of EI assessment by providing objective and quantifiable measures that are less vulnerable to response distortion.

Respiratory sinus arrhythmia moderates the interpersonal consequences of brooding rumination

Brooding rumination is an intrapersonal emotion regulation strategy associated with negative interpersonal consequences. Resting respiratory sinus arrhythmia (RSA), a psychophysiological marker of self-regulatory capacity, may buffer the association between maladaptive emotion regulation and negative interpersonal behaviors. The current work examines the moderating effect of RSA on the association between brooding rumination and different negative interpersonal consequences. Across three convenience samples, individuals with lower RSA showed a stronger association between brooding rumination and more negative interpersonal behaviors as well as less perception of received instrumental social support (Study 1; n = 154), higher levels of interviewer-rated interpersonal stress (Study 2; n = 42) and a stronger indirect association between brooding rumination and depressive symptoms via daily interpersonal stress (Study 3; n = 222). These findings highlight the negative interpersonal consequences of brooding rumination, particularly among individuals with lower RSA.

The role of strategy-use and parasympathetic functioning in maternal emotion regulation

Research has recognized that parental emotion regulation influences whether parents respond sensitively to their children in challenging parenting situations. However, parental emotion regulation is usually assessed using questionnaires that are not about parenting, rather than through examining parents' reaction to specific parenting situations that might evoke negative emotions. This study investigates individual differences in mothers' emotion regulation during parenting, specifically examining the relation between their subjective negative emotions and observed parenting behaviors and whether this relation is moderated by cognitive (strategies to manage negative emotions) and physiological (resting baseline and reactivity of respiratory sinus arrhythmia; RSA) processes. Data of 157 mothers' self-reported negative emotions and strategy-use, their RSA, observed maternal responsiveness, and their preschool-age children's (30-60 months, 49.7% female) challenging behaviors were collected during a Wait Task, in which mothers told children to wait before opening an appealing gift. Regression analysis indicated that, after controlling for how challenging children were, mothers' level of negative emotion was not associated with observed level of maternal responsiveness. In line with hypotheses, the association was moderated by mothers' resting RSA and the extent to which they suppressed negative emotions. However, contrary to hypotheses, the association was not moderated by use of reappraisal, distraction, or rumination, or RSA reactivity. The significant findings suggest that, although mothers' subjective experiences of negative emotions are not necessarily related to less responsive parenting behaviors, the link between maternal emotions and parenting behavior may indicate differences in how mothers engage cognitive strategies as well as their physiological regulation capacity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Exploring Subtypes of Repetitive Behavior in Children with Autism Through Functional Analysis and Wearable Technology: a Pilot Biobehavioral Assessment

Objectives

Prior research has established assessment methodologies, such as functional analysis to identify specific contexts in which restricted and repetitive behavior (RRB) occurs, and measures of heart rate variability (HRV) to index the level of autonomic arousal in individuals with autism spectrum disorder (ASD). Yet, a gap remains in integrating multiple assessment methodologies to examine the complex underlying mechanisms of RRB. This study piloted a multi-disciplinary approach to assess both the functional behavioral and neurophysiological factors that may underlie occurrences of RRB. The study (a) evaluated the effect of a modified functional analysis protocol on delineating functional subtypes of RRB and (b) explored the effect of using a wearable technology within a functional analysis on identifying the relationship between RRB and HRV.

Method

A single-case alternating treatment design was used to randomly alternate noncontingent low-stimulation and high-stimulation conditions in a modified functional analysis protocol. Simultaneous measurement of RRB and HRV was obtained through direct behavioral observations and a wristband that collects blood volume pulse, respectively. Visual analysis of time series data was used to determine the functional subtypes of RRB, and nonparametric correlational analyses were conducted to determine the association between HRV and RRB.

Results

Findings from a sample of six participants suggest preliminary effectiveness of the assessment protocol in identifying subtypes of RRB and a significant correlation between HRV and RRB.

Conclusions

This study demonstrates the potential effect and usability of a wearable technology-aided biobehavioral approach to assess RRB and HRV in individuals with ASD.

Distinct components of cardiovascular health are linked with age-related differences in cognitive abilities

Cardiovascular ageing contributes to cognitive impairment. However, the unique and synergistic contributions of multiple cardiovascular factors to cognitive function remain unclear because they are often condensed into a single composite score or examined in isolation. We hypothesized that vascular risk factors, electrocardiographic features and blood pressure indices reveal multiple latent vascular factors, with independent contributions to cognition. In a population-based deep-phenotyping study (n = 708, age 18-88), path analysis revealed three latent vascular factors dissociating the autonomic nervous system response from two components of blood pressure. These three factors made unique and additive contributions to the variability in crystallized and fluid intelligence. The discrepancy in fluid relative to crystallized intelligence, indicative of cognitive decline, was associated with a latent vascular factor predominantly expressing pulse pressure. This suggests that higher pulse pressure is associated with cognitive decline from expected performance. The effect was stronger in older adults. Controlling pulse pressure may help to preserve cognition, particularly in older adults. Our findings highlight the need to better understand the multifactorial nature of vascular aging.

Epilepsy and Autism Spectrum Disorder (ASD): The Underlying Mechanisms and Therapy Targets Related to Adenosine

Epilepsy and autism spectrum disorder (ASD) are highly mutually comorbid, suggesting potential overlaps in genetic etiology, pathophysiology, and neurodevelopmental abnormalities. Adenosine, an endogenous anticonvulsant and neuroprotective neuromodulator of the brain, has been proved to affect the process of epilepsy and ASD. On the one hand, adenosine plays a crucial role in preventing the progression and development of epilepsy through adenosine receptordependent and -independent ways. On the other hand, adenosine signaling can not only regulate core symptoms but also improve comorbid disorders in ASD. Given the important role of adenosine in epilepsy and ASD, therapeutic strategies related to adenosine, including the ketogenic diet, neuromodulation therapy, and adenosine augmentation therapy, have been suggested for the arrangement of epilepsy and ASD. There are several proposals in this review. Firstly, it is necessary to further discuss the relationship between both diseases based on the comorbid symptoms and mechanisms of epilepsy and ASD. Secondly, it is important to explore the role of adenosine involved in epilepsy and ASD. Lastly, potential therapeutic value and clinical approaches of adenosine-related therapies in treating epilepsy and ASD need to be emphasized.

A preliminary systematic review and meta-analysis on the effects of heart rate variability biofeedback on heart rate variability and respiration of athletes

To date, there is no quantitative review examining the influence of heart rate variability biofeedback (HRV BFB) on the athlete population. Such an undertaking may provide valuable information on the autonomic and respiration responses of athletes when performing HRV BFB. Thus, purpose of this preliminary systematic review and meta-analysis on the effects of HRV BFB on HRV and respiration of athletes. Searches of Springerlink, SportDiscus, Web of Science, PROQUEST Academic Research Library, Google Scholar, and ScienceDirect were conducted for studies that met the following criteria: (1) experimental studies involving athletes that underwent randomized control trial; (2) availability of HRV BFB as a treatment compared with a control (CON)/placebo (PLA); (3) any pre and post HRV variable and/or breathing frequency as dependent variable/s; and, (4) peer-reviewed articles written in English. Four out of 660 studies involving 115 athletes (25 females and 90 males) ages 16-30 years old were assessed in this review. Preliminary findings suggest the promising ability of HRV BFB to improve respiratory mechanics in athlete population. More work is needed to determine the autonomic modulatory effect of HRV BFB in athletes.

Long-term benefits of heart rate variability biofeedback training in older adults with different levels of social interaction: a pilot study

To test whether heart rate variability (HRV) biofeedback training benefits older adults with different social interaction levels.

METHODS

32 older adults (16 were institutionalized and 16 were not). Both groups received 14 sessions, 15 min, 3 times a week, with half of the individuals receiving HRV biofeedback training and the other half receiving control training. The following parameters were assessed immediately before and after training, and 4.5 weeks after the last session (follow-up period): aerobic conditioning, anthropometric data, emotional scores, and HRV components.

RESULTS

Before the training, the institutionalized individuals had higher scores of loneliness (p < 0.01) and depression (p < 0.0001) and lower social touches (p < 0.0001), body mass (p = 0.04), and body fat percentage (p = 0.002) than the non-institutionalized individuals. HRV biofeedback improved symptoms of depression in both groups. HRV improved only in the non-institutionalized group, and loneliness only in the institutionalized group. Lastly, all changes persisted after the follow-up period.

CONCLUSIONS

HRV biofeedback training was effective in improving symptoms of depression in older adults. Improvement of HRV and loneliness was dependent on the level of social interaction.

Perceived Social Support and Heart Rate Variability: An Integrative Review

The purpose of this integrative review is to explore and synthesize literature about the relationship between perceived social support and cardiac vagal modulation, measured by heart rate variability (HRV), during phases of an acute stress response to assess this potential relationship underlying the stress-buffering effects of perceived social support. A systematic search of seven databases was conducted, including MEDLINE, CINAHL, PsychINFO, Embase, ProQuest, medRxiv, and clinicaltrials.gov. Eight studies met the inclusion criteria and were systematically synthesized. A quality appraisal was completed for each included study. Majority of studies focused on time and frequency domain measures of HRV thought to reflect parasympathetic modulation of heart rate and identified them as positively associated with perceived social support during rest, stress induction, and recovery from an acute stressor. Results highlight the importance for nurses and other health care professionals to assess patients' perceived social support, as increased perceived social support may contribute to an adaptive stress response.

Autonomic tone in children and adults: Pupillary, electrodermal and cardiac activity at rest

Considering the suspected involvement of the autonomic nervous system (ANS) in several neurodevelopmental disorders, a description of its tonus in typical populations and of its maturation between childhood and adulthood is necessary. We aimed to arrive at a better understanding of the maturation of the sympathetic (SNS) and parasympathetic (PNS) tonus by comparing children and adults at rest, via recordings of multiple ANS indices. We recorded simultaneously pupil diameter, electrodermal activity (EDA) and cardiac activity (RR interval and HRV: heart rate variability) in 29 children (6-12 years old) and 30 adults (20-42 years old) during a 5-min rest period. Children exhibited lower RR intervals, higher LF peak frequencies, and lower LF/HF (low frequency/high frequency) ratios compared to adults. Children also produced more spontaneous EDA peaks, reflected in a larger EDA AUC (area under the curve), in comparison with adults. Finally, children displayed a larger median pupil diameter and a higher pupillary hippus frequency than adults. Our results converged towards higher SNS and PNS tones in children compared to adults. Childhood would thus be characterized by a high autonomic tone, possibly reflecting a physiological state compatible with developmental acquisitions.

Temperamental and physiological regulatory capacity in infancy: Links with toddler behavior problems

Although correlates of temperamental regulatory processes in childhood have been well established, there is considerably less work examining correlates and moderators of rudimentary forms of temperamental regulation in infancy. We examined whether infants' physiological regulation indexed via changes in respiratory sinus arrhythmia (RSA) across phases of the Still-Face Paradigm moderated the association between maternal-reported infant regulatory capacity at 8 months (N = 50, M_age = 8.51 months, SD_age = 0.28 months, 25 girls) and behavior problems at 14 months. We found that cardiac vagal regulation from baseline to still-face moderated the relation between infant regulatory capacity at 8 months and behavior problems at 14 months. Among infants who displayed relatively high cardiac vagal regulation from baseline to still-face, regulatory capacity was negatively associated with behavior problems. There was no relation between regulatory capacity and behavior problems among infants who displayed average or relatively low cardiac vagal regulation. We speculate that high levels of regulatory capacity and cardiac vagal regulation may allow infants to focus their attention outward and cope with emotionally evocative environmental demands as they arise even in the absence of external regulation provided by their caregivers.

Gazing the dusty mirror: Joint effect of narcissism and sadism on workplace incivility via indirect effect of paranoia, antagonism, and emotional intelligence

Workplace productivity is badly affected by many negative factors such as narcissism, and sadism. In addition, paranoia and antagonism play an important role in increasing workplace incivility. Through emotional intelligence, such negative behaviors could be addressed by managers and their junior colleagues. The current study aims to investigate the parallel mediating role of paranoia, antagonism, and emotional intelligence on the relationship between narcissism, sadism, and workplace incivility. A survey approach was used. Primary data was collected in PLS-SEM. The population of the study was all faculty members in higher education institutions in the Khyber Pakhtunkhwa (Pakistan) region. A measurement model and structural model were developed. The measurement model demonstrated that convergent and discriminant validities were established. The structural model's findings revealed that narcissism, antagonism, and emotional intelligence were not mediated between narcissism and workplace incivility. Similarly, emotional intelligence did not play any mediating role between sadism and workplace incivility. This implied that emotional intelligence has no role in decreasing or reducing workplace uncivil behavior.

Diagnostic and Physical Effects in Parasympathetic Response to Social Evaluation in Youth With and Without Autism Spectrum Disorder

Individuals with autism spectrum disorder (ASD) may demonstrate atypical autonomic (ANS) responses; however, research remains inconsistent. This study examined parasympathetic response during social evaluation in 241 youth (10-13 years) with ASD (n = 138) or typical development (TD; n = 103). Diagnosis, age, pubertal development, and body mass index (BMI) were hypothesized to be associated with ANS function. Linear mixed effects models demonstrated lower RSA in ASD relative to TD in a base model with no covariates. However, when accounting for differences in BMI, there was no evidence of atypical parasympathetic regulation in youth with ASD. As lower parasympathetic regulation may increase susceptibility for a number of conditions, it will be important to elucidate the link between BMI and the ANS, especially in ASD.

Breastfeeding duration and vagal regulation of infants and mothers

BACKGROUND

Vagal regulation within the parasympathetic nervous system supports self-regulation and social engagement. Research has suggested that early feeding practices may influence mother-infant vagal functioning.

AIM

We aimed to examine the association between breastfeeding duration and mother-infant vagal regulation during an interaction. We hypothesized that breastfeeding duration would be positively associated with adaptive vagal regulation in infants and mothers.

METHOD

204 mother-infant dyads (infant mean age 6 months) completed the face-to-face still-face (FFSF) task. During the task, vagal regulation indexed by respiratory sinus arrhythmia (RSA, a component of heart rate variability) was calculated through continuously recorded electrocardiogram signals. Breastfeeding duration and demographic information were reported by mothers. Linear mixed models were adopted to estimate the associations between breastfeeding duration and repeated measures of RSA in infants and mothers throughout the FFSF.

RESULTS

Infants breastfed for a longer duration demonstrated lower RSA throughout the FFSF (B = -0.06, 95 % CI: -0.09 to -0.03), suggesting active physiological mobilization to engage in interaction and regulate distress. Mothers with longer breastfeeding duration displayed higher baseline RSA and higher overall RSA levels (higher vagal control) during the FFSF (B = 0.06, 95 % CI: 0.02 to 0.09), indicating a calmer and regulated state.

CONCLUSION

Longer breastfeeding duration was associated with more adaptive mother-infant vagal regulation during the interaction, indicating a positive dose-response association. This finding reveals breastfeeding practice as a factor contributing to infant effective vagal regulation and further supports WHO recommendation on exclusive breastfeeding for the first 6 months and continuing breastfeeding to 24 months and beyond.

Integrative Model of Human-Animal Interactions: A One Health-One Welfare Systemic Approach to Studying HAI

The Integrative Model of Human-Animal Interactions (IMHAI) described herewith provides a conceptual framework for the study of interspecies interactions and aims to model the primary emotional processes involved in human-animal interactions. This model was developed from theoretical inputs from three fundamental disciplines for understanding interspecies interactions: neuroscience, psychology and ethology, with the objective of providing a transdisciplinary approach on which field professionals and researchers can build and collaborate. Seminal works in affective neuroscience offer a common basis between humans and animals and, as such, can be applied to the study of interspecies interactions from a One Health-One Welfare perspective. On the one hand, Jaak Panksepp's research revealed that primary/basic emotions originate in the deep subcortical regions of the brain and are shared by all mammals, including humans. On the other hand, several works in the field of neuroscience show that the basic physiological state is largely determined by the perception of safety. Thus, emotional expression reflects the state of an individual's permanent adaptation to ever-changing environmental demands. Based on this evidence and over 5 years of action research using grounded theory, alternating between research and practice, the IMHAI proposes a systemic approach to the study of primary-process emotional affects during interspecies social interactions, through the processes of emotional transfer, embodied communication and interactive emotional regulation. IMHAI aims to generate new hypotheses and predictions on affective behavior and interspecies communication. Application of such a model should promote risk prevention and the establishment of positive links between humans and animals thereby contributing to their respective wellbeing.

Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Biobehavioural Synchrony in Musculoskeletal Care

Touch is recognised as crucial for survival, fostering cooperative communication, accelerating recovery, reducing hospital stays, and promoting overall wellness and the therapeutic alliance. In this hypothesis and theory paper, we present an entwined model that combines touch for alignment and active inference to explain how the brain develops "priors" necessary for the health care provider to engage with the patient effectively. We appeal to active inference to explain the empirically integrative neurophysiological and behavioural mechanisms that underwrite synchronous relationships through touch. Specifically, we offer a formal framework for understanding - and explaining - the role of therapeutic touch and hands-on care in developing a therapeutic alliance and synchrony between health care providers and their patients in musculoskeletal care. We first review the crucial importance of therapeutic touch and its clinical role in facilitating the formation of a solid therapeutic alliance and in regulating allostasis. We then consider how touch is used clinically - to promote cooperative communication, demonstrate empathy, overcome uncertainty, and infer the mental states of others - through the lens of active inference. We conclude that touch plays a crucial role in achieving successful clinical outcomes and adapting previous priors to create intertwined beliefs. The ensuing framework may help healthcare providers in the field of musculoskeletal care to use hands-on care to strengthen the therapeutic alliance, minimise prediction errors (a.k.a., free energy), and thereby promote recovery from physical and psychological impairments.

Respiratory Sinus Arrhythmia Change during Trauma-Focused Cognitive-Behavioral Therapy: Results from a Randomized Controlled Feasibility Trial

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a well-established treatment for pediatric posttraumatic stress disorder (PTSD). Animal-assisted therapy (AAT) has been proposed as an adjunct to TF-CBT that may improve treatment effects through enhanced targeting of affect regulation, as indexed by specific changes in the respiratory sinus arrhythmia (RSA). The current study reports results from a randomized controlled feasibility trial (N = 33; M_age = 11.79 [SD = 3.08]; 64% White; 67% female) that measured RSA during Sessions 1, 4, 8, and 12 of a twelve-session TF-CBT protocol and tested whether: 1) TF-CBT + AAT achieved higher average RSA amplitudes relative to TF-CBT alone, and 2) RSA regulation, defined as less variability around person-specific RSA slopes during treatment, explained variation in post-treatment PTSD symptoms. Multilevel modeling failed to support an effect for TF-CBT + AAT on RSA amplitudes (δ₀₀₁ = 0.08, p = 0.844). However, regardless of treatment condition, greater RSA withdrawal was observed within Sessions 4 (γ₁₁ = -.01, p < .001) and 12 (γ₁₃ = -.01, p = .015) relative to the Session 1 baseline. The average level of RSA amplitude in Session 8 was also significantly lower compared to Session 1 (γ₀₂ = -0.70, p = .046). Intraindividual regression models demonstrated that greater RSA regulation predicted improved PTSD symptoms at post-treatment after adjusting for pre-treatment levels (b₃ = 20.00, p = .012). These preliminary results offer support for future confirmatory trials testing whether affect regulation, as indexed by changes in RSA, is a mechanism of action for TF-CBT in the treatment of pediatric PTSD.

How emotions, relationships, and culture constitute each other: advances in social functionalist theory

Social Functionalist Theory (SFT) emerged 20 years ago to orient emotion science to the social nature of emotion. Here we expand upon SFT and make the case for how emotions, relationships, and culture constitute one another. First, we posit that emotions enable the individual to meet six "relational needs" within social interactions: security, commitment, status, trust, fairness, and belongingness. Building upon this new theorising, we detail four principles concerning emotional experience, cognition, expression, and the cultural archiving of emotion. We conclude by considering the bidirectional influences between culture, relationships, and emotion, outlining areas of future inquiry.

Impact of digital social media on the perception of loneliness and social isolation in older adults

OBJECTIVE

to synthesize knowledge about the use of social media and the perception of loneliness and/or social isolation in older adults.

METHOD

integrative literature review with primary studies published in full, in Portuguese, English or Spanish, between September 2014 and July 2020 in the databases: American Psychological Association Database, Cumulative Index to Nursing & Allied Health Literature, Latin American and Caribbean Health Sciences Literature databases, Web of Science and PubMed.

RESULTS

11 articles were included, categorized based on the types of technologies: "the use of the Internet", encompassing social networking sites, the internet and applications; "communication devices", with the use of smartphones, tablets and iPads and "types of communication" covering the use of interpersonal means of communication in the digital age, such as video calls and emails. There were positive results (63.6%) regarding the use of social media to minimize the perception of loneliness and/or social isolation in the older adults.

CONCLUSION

the scientific evidence shows that the use of digital social media can reduce the perception of loneliness and/or isolation in older adults. Furthermore, the internet can favor greater contact between the older adults and family members and can serve as a source of support, provide a greater sense of belonging in the community and reduce loneliness.

An event-based analysis of maternal physiological reactivity following aversive child behaviors

Research investigating the association between parents' physiological reactivity and their ability to self-regulate in parenting contexts typically examines the average physiological response across the duration of a dyadic task, conflating reactivity across a multitude of parent and child behaviors. The present study utilized a moving-window analytical technique to generate a continuous, second × second time series of mothers' high-frequency heart rate variability (HF-HRV) to conduct an event-based analysis of maternal reactivity in the 10 s following an aversive child event. Analyses examined whether maternal reactivity related to parenting behaviors similarly among maltreating (n = 48) and non-maltreating (n = 29) mother-preschooler dyads. Results indicate that maternal behavior was not associated with average HF-HRV reactivity, but mothers who demonstrated an increase in HF-HRV immediately following a negative child event were more likely to engage in behaviors to return the dyad to a positive state. Findings were specific to incidents of negative child behavior, and results were not moderated by maltreatment status. These results highlight the value of using an event-based design to isolate reactivity in response to targeted events to understand how physiological reactivity supports parenting.

Do Hypertensive Men Spy With an Angry Little Eye? Anger Recognition in Men With Essential Hypertension - Cross-sectional and Prospective Findings

BACKGROUND

Higher trait anger has inconsistently been associated with hypertension and hypertension development, but social context in terms of recognition of other persons' anger has been neglected in this context.

PURPOSE

Here, we investigated anger recognition of facial affect and trait anger in essential hypertensive and normotensive men in addition to prospective associations with blood pressure (BP) increases.

METHODS

Baseline assessment comprised a total of 145 participants including 57 essential hypertensive and 65 normotensive men who were otherwise healthy and medication-free. Seventy-two eligible participants additionally completed follow-up assessment 3.1 (±0.08 SEM) years later to analyze BP changes over time. We assessed emotion recognition of facial affect with a paradigm displaying mixed facial affect of two morphed basic emotions including anger, fear, sadness, and happiness. Trait anger was assessed with the Spielberger trait anger scale.

RESULTS

Cross-sectionally, we found that with increasing BP, hypertensive men overrated anger displayed in facial expressions of mixed emotions as compared to normotensive men (ps ≤ .019) while there were no differences in trait anger (p = .16). Prospectively, the interaction between mean anger recognition and trait anger independently predicted BP increases from baseline to follow-up (ps ≤ .043), in that overrating displayed anger predicted future BP increases only if trait anger was high.

CONCLUSIONS

Our findings indicate an anger recognition bias in men with essential hypertension and that overrating displayed anger in combination with higher trait anger seems to predict future BP increases. This might be of clinical relevance for the development and progression of hypertension and cardiovascular disease.

Improvement in parasympathetic regulation is associated with engagement in classroom activity in primary school children experiencing poor classroom climate

BACKGROUND

Self-regulation promotes engagement within the classroom. At a physiological level, a good indicator of the ability of the system to self-regulate is cardiac vagal tone (CVT).

AIMS

The present study aims to assess children's change over time (1 year) in their parasympathetic regulation (by way of CVT) in response to a social and cognitive stressor. Moreover, it addresses whether, if present, this change over time in regulation influences students' engagement in classroom activities while also accounting for classroom climate.

SAMPLE

Forty-nine second graders were assessed at two time points: November 2018 (T1) and 1 year later in 2019 (T2).

METHODS

Children's CVT was registered at rest and while performing a stressful task during which they were asked to cognitively perform while being socially evaluated. Children were also interviewed on how much they feel engaged in classroom activities and their perceptions of classroom climate.

RESULTS

A repeated measures analysis of variance including 2 Time Points ×2 Phases of CVT Registration (baseline and during the stressful task) revealed a significant decrease in cardiac vagal activity from baseline to the task at T1, indicating that initially most children were not able to self-regulate and gave way to a stress response when facing the stressful task. The pattern changed at T2 when an active regulation took place signalled by an increase in CVT from baseline to the stressful task. Data analysis also revealed that among children who perceived a poorer classroom climate, the display of greater parasympathetic regulation over time was linked with higher active engagement in classroom activities.

CONCLUSIONS

Growth in physiological regulation in response to a challenging task is associated with better engagement in classroom activities. Interventions and educational practice promoting the development of self-regulation strategies are recommended.

How and Why Could Smiling Influence Physical Health? A Conceptual Review

Smiling has been a topic of interest to psychologists for decades, with a myriad of studies tying this behavior to well-being. Despite this, we know surprisingly little about the nature of the connections between smiling and physical health. We review the literature connecting both naturally occurring smiles and experimentally manipulated smiles to physical health and health-relevant outcomes. This work is discussed in the context of existing affect and health-relevant theoretical models that help explain the connection between smiling and physical health including the facial feedback hypothesis, the undoing hypothesis, the generalized unsafety theory of stress, and polyvagal theory. We also describe a number of plausible pathways, some new and relatively untested, through which smiling may influence physical health such as trait or state positive affect, social relationships, stress buffering, and the oculocardiac reflex. Finally, we provide a discussion of possible future directions, including the importance of cultural variation and replication. Although this field is still in its infancy, the findings from both naturally occurring smile studies and experimentally manipulated smile studies consistently suggest that smiling may have a number of health-relevant benefits including beneficially impacting our physiology during acute stress, improved stress recovery, and reduced illness over time.

The Effects of Heart Rate Variability (HRV) Biofeedback on HRV Reactivity and Recovery During and After Anger Recall Task for Patients with Coronary Artery Disease

Patients with coronary artery disease (CAD) often experience anger events before cardiovascular events. Anger is a psychological risk factor and causes underlying psychophysiological mechanisms to lose balance of the autonomic nervous system (ANS). The heart rate variability (HRV) was the common index for ANS regulation. It has been confirmed that heart rate variability biofeedback (HRV-BF) restored ANS balance in patients with CAD during the resting state. However, the effects of HRV-BF during and after the anger event remain unknown. This study aimed to examine the effects of HRV-BF on ANS reactivity and recovery during the anger recall task in patients with CAD. This study was a randomized control trial with a wait-list control group design, with forty patients in the HRV-BF group (for six sessions) and 44 patients in the control group. All patients received five stages of an anger recall task, including baseline, neutral recall task, neutral recovery, anger recall task, and anger recovery. HRV reactivity in the HRV-BF group at the post-test was lower than that in the control group. HRV recovery at the post-test in the HRV-BF group was higher than that in the control group. The HRV-BF reduced ANS reactivity during anger events and increased ANS recovery after anger events for CAD patients. The possible mechanisms of HRV-BF may increase total HRV, ANS regulation, and baroreflex activation at anger events for patients with CAD, and may be a suitable program for cardiac rehabilitation.