Respiratory sinus arrhythmia during worry forecasts stress-related increases in psychological distress

Predicting response to stepped-care cognitive behavioral therapy for insomnia using pre-treatment heart rate variability in cancer patients

OBJECTIVE

This study examined whether high frequency heart-rate variability (HF-HRV) and HF-HRV reactivity to worry moderate response to cognitive behavioural therapy for insomnia (CBT-I) within both a standard and stepped-care framework among cancer patients with comorbid insomnia. Biomarkers such as HF-HRV may predict response to CBT-I, a finding which could potentially inform patient allocation to different treatment intensities within a stepped-care framework.

METHODS

177 participants (86.3 % female; Mage = 55.3, SD = 10.4) were randomized to receive either stepped-care or standard CBT-I. 145 participants had their HRV assessed at pre-treatment during a rest and worry period. Insomnia symptoms were assessed using the Insomnia Severity Index (ISI) and daily sleep diary across five timepoints from pre-treatment to a 12-month post-treatment follow-up.

RESULTS

Resting HF-HRV was significantly associated with pre-treatment sleep efficiency and sleep onset latency but not ISI score. However, resting HF-HRV did not predict overall changes in insomnia across treatment and follow-up. Similarly, resting HF-HRV did not differentially predict changes in sleep diary parameters across standard or stepped-care groups. HRV reactivity was not related to any of the assessed outcome measures in both cross-sectional and longitudinal analyses.

CONCLUSION

Although resting HF-HRV was related to initial daily sleep parameters, HF-HRV measures did not significantly predict longitudinal responses to CBT-I. These findings suggest that HF-HRV does not predict treatment responsiveness to CBT-I interventions of different intensity in cancer patients.

Brain mechanisms underlying the modulation of heart rate variability when accepting and reappraising emotions

Heart rate variability (HRV) has been linked to resilience and emotion regulation (ER). How HRV and brain processing interact during ER, however, has remained elusive. Sixty-two subjects completed the acquisition of resting HRV and task HRV while performing an ER functional Magnetic Resonance Imaging (fMRI) paradigm, which included the differential strategies of ER reappraisal and acceptance in the context of viewing aversive pictures. We found high correlations of resting and task HRV across all emotion regulation strategies. Furthermore, individuals with high levels of resting, but not task, HRV showed numerically lower distress during ER with acceptance. Whole-brain fMRI parametrical modulation analyses revealed that higher task HRV covaried with dorso-medial prefrontal activation for reappraisal, and dorso-medial prefrontal, anterior cingulate and temporo-parietal junction activation for acceptance. Subjects with high resting HRV, compared to subjects with low resting HRV, showed higher activation in the pre-supplementary motor area during ER using a region of interest approach. This study demonstrates that while resting and task HRV exhibit a positive correlation, resting HRV seems to be a better predictor of ER capacity. Resting and task HRV were associated with ER brain activation in mid-line frontal cortex (i.e. DMPFC).

Perceived control, loneliness, early-life stress, and parents' perceptions of stress

The COVID-19 pandemic has highlighted the importance of understanding what contributes to individual variability in experiences of stress. Increases in stress related to the pandemic have been especially pronounced in parents, indicating a need for research examining what factors contribute to parents' perceptions of stress. Here, we assessed the relationship between parents' perceptions of stress, control, loneliness, and experiences of childhood trauma in two populations of caregivers. In Study 1, we examined the relationship between perceptions of stress, control, loneliness, and history of early stress, along with indices of socioeconomic risk and resting parasympathetic nervous systema activity, which has been linked to variability in perceptions of stress, in caregivers of young children. Perceived control, loneliness, childhood stress, and resting parasympathetic nervous system activity predicted caregivers' stress. In Study 2, we replicated these initial findings in a second sample of caregivers. Additionally, we examined how these processes change over time. Caregivers demonstrated significant changes in perceptions of control, loneliness, and stress, and changes in control and childhood trauma history were associated with changes in perceptions of stress. Together these results indicate the importance of assessing how caregivers perceive their environment when examining what contributes to increased risk for stress. Additionally, they suggest that caregivers' stress-related processes are malleable and provide insight into potential targets for interventions aimed at reducing parents' stress.

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.

Reduced heart rate variability and expressive suppression interact to prospectively predict COVID-19 pandemic-related post-traumatic stress symptoms

The COVID-19 pandemic is a unique period of stress that, in some cases, led to post-traumatic stress symptoms (PTSSs). Emotion regulation strategies are known to modulate the emotional response to stressful events. Expressive suppression (ES) is a maladaptive strategy related to the exacerbation of the physiological stress response. Heart rate variability (HRV), an index of cardiac autonomic balance strictly related to ES, was also shown to predict PTSSs. This was the first study to investigate whether the pre-pandemic ES use and resting-state HRV predicted pandemic-related PTSSs. Before the pandemic, 83 (58 females) university students completed the Emotion Regulation Questionnaire (ERQ), self-report measures of anxiety and depressive symptoms, and a three-minute resting-state electrocardiogram recording. After 12 months, 61 (45 females) participants completed a self-report measure of pandemic-related PTSSs and repeated the self-report psychological measures. Pre-pandemic anxiety symptoms prospectively predicted greater PTSSs. Moreover, a significant interaction between HRV and ES in predicting PTSSs emerged, whereby those who had higher levels of ES and reduced HRV showed higher PTSSs. These findings suggest that an integrated assessment of HRV and ES might be useful for identifying individuals who are more vulnerable to the development of PTSSs during crises.

Early childhood stress responses to psychosocial stressors: The state of the science

The aim of this systematic review was to better understand whether and to what extent psychosocial stressors are associated with hypothalamic-pituitary-adrenal axis or autonomic nervous system stress responses in young children (1-6 years of age). Studies were classified by psychosocial stressors from the ecobiodevelopmental model: social and economic resources, maternal mental health, parent-child relationships, and the physical environment. Of the 2388 identified studies, 32 met full inclusion criteria, including over 9107 children. Child physiologic stress responses were measured as hair and urinary cortisol and cortisone, salivary diurnal and reactive cortisol, salivary reactive alpha-amylase, and respiratory sinus arrhythmia. There were 107 identified relations between psychosocial stressors and physiologic stress responses. Nearly two thirds of these relations suggested that children have dysregulated stress responses as either significantly blunted (n = 27) or increased (n = 37); 43 relations were not significant. Children most consistently had significantly dysregulated stress responses if they experienced postnatal maternal depression or anxiety. Some reasons for the mixed findings may be related to characteristics of the child (i.e., moderators) or stressor, how the stress response or psychosocial stressor was measured, unmeasured variables (e.g., caregiving buffering), researcher degrees of freedom, or publication bias.

Heart Rate Variability, Sleep Quality, and Depression in the Context of Chronic Stress

BACKGROUND

Disrupted sleep quality is one of the proposed mechanisms through which chronic stress may lead to depression. However, there exist significant individual differences in sleep reactivity, which is the extent to which one experiences sleep disturbances in response to stress.

PURPOSE

The aim of the current study was to investigate whether low high-frequency heart rate variability (HRV), as a psychophysiological marker of poor emotional and physiological arousal regulation, predicts stress-related sleep disturbances associated with greater risk of depression symptoms.

METHODS

Using a chronic caregiving stress model, 125 mothers of adolescents with developmental disorders and 97 mothers of typically developing adolescents had their resting HRV and HRV reactivity recorded and completed a measure of depressive symptoms, as well as a 7 day sleep diary to assess their sleep quality. A moderated mediation model tested whether sleep quality mediated the association between chronic stress exposure and depressive symptoms and whether HRV moderated this mediation.

RESULTS

After controlling for participant age, body mass index, ethnicity, socioeconomic status, and employment status, poor sleep quality mediated the association between chronic stress and depressive symptoms. Resting HRV moderated this indirect effect such that individuals with lower HRV were more likely to report poorer sleep quality in the context of chronic stressor exposure, which, in turn, was related to greater depressive symptoms.

CONCLUSIONS

Lower HRV, a potential biomarker of increased sleep reactivity to stress, is associated with greater vulnerability to stress-related sleep disturbances, which, in turn, increases the risk for elevated depressive symptoms in response to chronic stress.

Meaning in life and vagally-mediated heart rate variability: Evidence of a quadratic relationship at baseline and vagal reactivity differences

Higher meaning in life (MIL) consistently predicts better health, but the physiological processes underlying this relationship are not well understood. This study examined the relationship between MIL and vagally-mediated heart rate variability (VmHRV) under resting (N = 77), stressor (n = 73), and mindfulness intervention (n = 72) conditions. Regression was used for MIL-VmHRV analyses at baseline, and longitudinal mixed models were used to examine phasic changes in VmHRV as a function of MIL. Regression revealed a quadratic MIL-VmHRV relationship, and mixed models linked higher MIL to greater stress-reactivity but not enhanced stress-attenuation. MIL and mindfulness did not interact to influence VmHRV recovery after experimental stress. Findings suggest that cardiac vagal tone and cardiac vagal reactivity are linked to MIL, shedding light on the physiology underlying MIL and its health associations.

Heart rate variability moderates the between- and within-person associations between daily stress and negative affect

Stress exposure increases risk for depressive symptoms. However, there are substantial individual differences in affective responses to stress. High-frequency heart rate variability (HF-HRV), a marker of vagally-mediated parasympathetic activity, has been conceptualized as a psychophysiological index of emotion regulation that may moderate individuals' responses to stress. Using a daily diary design, we tested whether individual differences in resting HF-HRV moderated the association between daily child-related stress and negative affect among a sample of 84 heterosexual couples with preschool-aged children. After controlling for participants' age, gender, socioeconomic status, employment status, and ethnicity, hierarchical linear modeling revealed that resting HF-HRV moderated both the between-person and within-person associations between self-reported child-related stress and daily negative affect. Between-person analyses indicated that the strength of the positive association between mean daily child stress and negative affect across the daily diary period increased with decreasing resting HF-HRV. Similarly, within-person analyses indicated that on days when participants reported more child-related stress than usual, the magnitude of the increase in negative affect on that day was inversely related to resting HF-HRV. Taken together, these findings suggest that lower resting HF-HRV may index vulnerability to stress-related disturbances in negative affect. This increased negative affective response to daily stress may be one pathway through which individuals with lower resting HF-HRV are at increased risk for depressive symptoms over time.

Emotion regulation and psychological distress in cancer survivors: A systematic review and meta-analysis

Emotion regulation may affect the levels of psychological distress of cancer survivors, but inconsistencies exist among studies regarding the direction of this effect. The systematic review and meta-analysis sought to estimate the associations between emotion regulation patterns (repression, suppression, experiential avoidance and cognitive reappraisal) and psychological distress among cancer survivors. Fifteen studies met inclusion criteria for systematic review, and seven studies focussing on suppression were included in the meta-analysis. The systematic review pointed to a marked variability in associations among the emotion regulation patterns and psychological distress. The three meta-regressions of the relationships between suppression and psychological distress found significant fixed- and random-effect sizes (except marginal significance of a random-effect model for partial correlation). Subgroup analysis showed no moderation effect of time since diagnosis or study quality, but a significant difference (fixed-effect model only, p = 0.005) was found between correlative studies and those controlling for confounders. The current study suggests that suppression is related to elevated levels of psychological distress among cancer survivors, although large inconsistencies exist among studies and publication bias could not be ruled out. Further studies with large samples and a consistent approach are thus required to evaluate the associations of emotion regulation patterns and psychological distress.

Respiratory sinus arrhythmia as a dyadic protective factor in the transition to parenthood

Considerable heterogeneity has been observed in couples' adjustment to the transition to parenthood (TTP). One potential yet understudied predictor of emotional adjustment to the TTP is the new parents' capacity for regulation. A widely accepted biological marker of this capacity is respiratory sinus arrhythmia (RSA), which is closely tied to parasympathetic activation. In the present work, we sought to examine the role of tonic RSA and RSA reactivity as possible protective dyadic factors in the TTP. As part of a larger study, we recruited a sample (N = 100) of TTP couples. At 15 weeks postpartum, the couples took part in a lab session during which their RSA was assessed both at rest (tonic RSA) and during four affiliative dyadic interactions (RSA reactivity). Following this session, couples completed daily diaries over a period of 3 weeks, reporting their daily levels of negative affect and stress. A Multivariate Actor Partner Interdependence Model was used to examine the extent to which each partner's RSA predicted their own and their partner's negative affect (NA) level, as well as NA stress-reactivity (i.e., the strength of the within-person stress-affect association). New mothers' tonic RSA predicted their own lower NA level and NA stress-reactivity; both their tonic RSA and RSA reactivity predicted their (male) partners' lower NA level; and finally, new fathers' tonic RSA and RSA reactivity predicted their (female) partners' lower NA stress-reactivity. These results suggest that RSA may serve as a personal and dyadic protective factor.

Person-centered profiles of parasympathetic physiology, anxiety symptoms, and depressive symptoms in mothers and fathers of young children

Respiratory sinus arrhythmia (RSA) is a biomarker of mental health, but RSA-symptom relations in parents of young children are understudied. We examined how anxiety symptoms, depressive symptoms, resting RSA, and RSA reactivity during challenging parent-child interactions clustered in a community sample of mothers (N = 126) and fathers (N = 87) of 3-year-olds and whether profiles predicted child emotional and behavioral dysregulation at age 4. Mothers fit four profiles (Typical, Mild Risk, Moderate Risk/Withdrawal, and Moderate Risk/Augmentation), suggesting that RSA reactivity was distinct by predominant symptom type at higher levels of risk: specifically, heightened RSA withdrawal was associated with a higher probability of anxiety symptoms and RSA augmentation was associated with a higher probability of depressive symptoms. Fathers fit three profiles (Typical, Mild Risk, and Moderate Risk) where Moderate Risk was characterized by RSA augmentation and a higher probability of both anxiety and depressive symptoms. Mild risk profiles showed heightened resting RSA for mothers and fathers but no differences in RSA reactivity. Both mild and moderate risk profiles predicted higher child dysregulation 1 year later compared to typical profiles. Findings offer preliminary evidence that parasympathetic physiology covaries with symptoms differently for mothers and fathers and that parental profiles of physiology and symptoms inform children's developmental psychopathology.

Autonomy-restrictive socialization of anger: Associations with school-aged children's physiology, trait anxiety, state distress, and relationship closeness

Parental socialization that infringes on children's autonomy may have consequences for physiological regulation, trait anxiety, and state distress. One such practice is the use of positive conditional regard (CR)-the provision of extra attention/affection when children meet parents' expectations. Self-determination theory proposes that CR thwarts satisfaction of children's basic needs for relatedness and autonomy by placing these needs in conflict. We evaluate associations among children's (N = 106, 51% male, M_age  = 10.27 years, SD = 1.09) reports of their mothers' use of positive CR to suppress anger expression (PCR-anger), their physiological regulation (resting respiratory sinus arrhythmia, RSA), and their trait anxiety and state distress, in light of perceived relationship closeness. After controlling demographics, mothers' reports of positive and negative CR-anger, children's reports of mothers' negative CR-anger and depressive symptoms, greater child-reported positive CR-anger was significantly associated with greater child anxiety and with lower resting RSA. Resting RSA mediated associations of child-reported positive CR-anger with greater child anxiety and post-failure distress. These indirect effects were significant for children low or moderate in closeness to mother. We conclude that autonomy-restrictive socialization is a concurrent correlate of children's physiological regulation, anxiety, and state distress, with these associations dependent on relational distance.

Relationships between respiratory sinus arrhythmia and stress in college students

The purpose of this study was to examine the relationships between university students' respiratory sinus arrhythmia (RSA) profiles and both retrospective and momentary ratings of stress. Participants were undergraduate students enrolled in an introductory health science course (N = 64). Participants provided RSA data at rest (tonic) and following an orthostatic challenge (phasic), completed the 10-item Perceived Stress Scale (PSS), and completed 6 daily ecological momentary assessments (EMA) of stress for 1 week. Higher tonic RSA was associated with lower perceived stress assessed via PSS and average EMA responses. Those with higher tonic RSA did not differ in their experience of stress across the week, whereas those with lower tonic RSA experienced increased stress across the week, and these trajectories varied as a function of phasic responses. These findings suggest a need for greater emphasis on behavioral strategies for maintaining and enhancing autonomic nervous system health among college students.

Is emotion regulation associated with cancer-related psychological symptoms?

OBJECTIVES

This study examined the cross-sectional and prospective relationships between subjective (cognitive reappraisal, expressive suppression and experiential avoidance) and objective (high-frequency heart rate variability [HF-HRV]) measures of emotion regulation (ER) and a set of psychological symptoms (anxiety, depression, fear of cancer recurrence [FCR], insomnia, fatigue, pain, and cognitive impairments) among women receiving radiation therapy for non-metastatic breast cancer.

DESIGN

Eighty-one participants completed a battery of self-report scales within 10 days before the start of radiotherapy (T1) and within 10 days after its end (T2; approximately 6 weeks after T1). HF-HRV at rest was measured at T1.

RESULTS

Canonical correlation analyses revealed that higher levels of experiential avoidance and expressive suppression were cross-sectionally associated with higher levels of all symptoms, except pain, at T1 and at T2 (both p's < 0.0001). Higher levels of suppression and reappraisal at T1 were marginally associated with reduced FCR and with increased depression and fatigue between T1 and T2 (p = 0.07). HF-HRV was not associated with symptoms cross-sectionally or prospectively.

CONCLUSIONS

Although preliminary, these results are consistent with the hypothesis that maladaptive ER strategies, assessed subjectively, may cross-sectionally act as a transdiagnostic mechanism underlying several cancer-related psychological symptoms.

Dyadic Coping, Respiratory Sinus Arrhythmia, and Depressive Symptoms Among Parents of Preschool Children

Respiratory sinus arrhythmia (RSA) is a biomarker of cardiac vagal tone that has been linked to social functioning. Recent studies suggest that RSA moderates the impact of interpersonal processes on psychosocial adjustment. The goal of this study was to assess whether RSA would moderate the association between dyadic coping (DC) and depressive symptoms. Eighty cohabiting couples raising preschool children completed the Dyadic Coping Inventory, the Center for Epidemiological Study-Depression scale and had their RSA assessed during a laboratory session. Couples completed follow-up assessments of depressive symptoms 6 and 12 months later. Data were analyzed using an Actor-Partner Interdependence Model. Results indicated that RSA moderated the actor effect of negative DC on depression in men, such that men with lower RSA had a stronger association between their own ratings of negative DC within the couple relationship and their own depressive symptoms, compared to their counterparts with higher RSA. RSA also moderated the partner effect of delegated DC on depressive symptoms. Among men with higher RSA, there was a significant negative association between their partner’s ratings of delegated DC within the couple relationship and the men’s depressive symptoms, whereas partner-rated delegated DC was unrelated to depressive symptoms among men with lower RSA. These results suggest that men with higher RSA may possess social skills and abilities that attenuate the association between stressful marital interactions and negative mood.

High-Frequency Heart Rate Variability Reactivity and Trait Worry Interact to Predict the Development of Sleep Disturbances in Response to a Naturalistic Stressor

BACKGROUND

High-frequency heart rate variability (HF-HRV) reactivity was proposed as a vulnerability factor for stress-induced sleep disturbances. Its effect may be amplified among individuals with high trait worry or sleep reactivity.

PURPOSE

This study evaluated whether HF-HRV reactivity to a worry induction, sleep reactivity, and trait worry predict increases in sleep disturbances in response to academic stress, a naturalistic stressor.

METHOD

A longitudinal study following 102 undergraduate students during an academic semester with well-defined periods of lower and higher academic stress was conducted. HF-HRV reactivity to a worry induction, trait worry using the Penn State Worry Questionnaire, and sleep reactivity using the Ford Insomnia Stress Reactivity Test were measured during the low stress period. Sleep disturbances using the Pittsburgh Sleep Quality Index were assessed twice during the lower stress period and three times during the higher stress period.

RESULTS

Greater reductions in HF-HRV in response to the worry induction predicted increases in sleep disturbances from the lower to the higher academic stress period. Trait worry moderated this association: individuals with both higher trait worry and greater HF-HRV reactivity to worry had larger increases in stress-related sleep disturbances over time, compared to participants with lower trait worry and HF-HRV reactivity. A similar, but marginally significant effect was found for sleep reactivity.

CONCLUSION

This study supports the role of HF-HRV reactivity as a vulnerability factor for stress-induced sleep disturbances. The combination of high trait worry and high HF-HRV reactivity to worry might identify a subgroup of individuals most vulnerable to stress-related sleep disturbances.

A Pilot Study Evaluating the Physiological Parameters of Performance-Induced Stress in Undergraduate Music Students

Music performance anxiety (MPA) is a specific condition for musicians. Although it can have a negative influence on their music careers, little attention is paid to this phenomenon both in the professional environment and in stress research. In the current pilot study, insight was gained into the physiology of the autonomic stress response related to anxiety in musicians when performing on stage by using a wearable biosensor patch for registration of a range of physiological parameters. Also, the validity of two different psychometric questionnaires in objectifying the stress response on stage to predict the individual stress response was explored. The autonomic physiological parameters (heart rate, respiratory rate, skin temperature) of 11 violists and violinists were collected while performing on stage and in resting state using the VitalConnect HealthPatch®. In addition, scores on validated questionnaires in research on MPA (State Anxiety Inventory, Kenny Music Performance Anxiety Inventory, Short Form Health Survey) were collected in order to try to objectify the magnitude of the subjective level of both MPA and experienced stress. The registration of the autonomic parameters showed a significant increase in heart rate, respiratory rate, and stress level from resting state measurements during stage performance. Analysis of heart rate variability showed a shift from indices of parasympathetic nervous system activity during baseline measurements towards indices of sympathetic nervous system activity during stress measurements. Surprisingly, none of the questionnaires was correlated to the physiological stress parameters on stage. In conclusion, the wearable biosensor patch proved to be an adequate tool to assess physiological stress parameters on stage. The different questionnaires did not contribute to the prediction of its occurrence in a group of musicians.

Cardiac vagal control as a marker of emotion regulation in healthy adults: A review

In the last two decades, a growing body of theory and research has targeted the role of cardiac vagal control (CVC) in emotional responding. This research has either focused on resting CVC (also denoted as cardiac vagal tone) or phasic changes in CVC (also denoted as vagal reactivity) in response to affective stimuli. The present paper is aimed at reporting a review of the papers published between 1996 and 2016, and focused on the results of 135 papers examining cardiac vagal control as a physiological marker of emotion regulation in healthy adults. The review shows that studies have employed a wide array of methodologies and measures, often leading to conflicting results. High resting CVC has been associated with better down-regulation of negative affect, use of adaptive regulatory strategies, and more flexible emotional responding. Concerning phasic changes, research has consistently found decreased CVC in response to stress, while CVC increases have been shown to reflect either self-regulatory efforts or recovery from stress. Despite conflicting results, we conclude that existing literature supports the use of CVC as a noninvasive, objective marker of emotion regulation.

The moderating influence of heart rate variability on stressor-elicited change in pupillary and attentional indices of emotional processing: An eye-Tracking study

Low resting heart rate variability (HRV) is associated with a broad array of negative psychosocial outcomes. Recent theoretical explications of HRV suggest it is an autonomic marker of emotion regulation capacity, but limited research has examined its relationship with emotional information processing indices. The present study utilized eye-tracking methodology to test HRV's theorized role as a marker of emotion regulation capacity in a non-clinical sample. Attentional biases towards threatening, dysphoric, and positive emotional information as well as affective modulation of pupil size were assessed before and after a stress induction. Low resting HRV marginally predicted larger increases in attentional bias towards positive emotional stimuli from pre to post-stress induction and significantly predicted decreased pupil dilation to positive stimuli after the stress induction only; exploratory analyses suggested that this pattern might reflect an unsuccessful attempt at anxious mood repair. HRV was unrelated to negative emotional information processing. Findings are consistent with existing theories of HRV's psychological significance and suggest a specific association with altered positive emotional processing under acute stress.

Attention bias towards negative emotional information and its relationship with daily worry in the context of acute stress: An eye-tracking study

Cognitive theories of anxiety psychopathology cite biased attention towards threat as a central vulnerability and maintaining factor. However, many studies have found threat bias indices to have poor reliability and have failed to observe the theorized relationship between threat bias and anxiety symptoms; this may be due to the non-unitary nature of threat bias and the influence of state-level variables on its expression. Accumulating data suggests that state anxious mood is important for the robust expression of threat bias and for relations to emerge between threat bias and symptoms, though this possibility has not been experimentally tested. Eye-tracking was used to assess multiple forms of threat bias (i.e., early vigilance, sustained attention, facilitated engagement, delayed disengagement) thought to be related to anxiety. A non-clinical sample (N = 165) was recruited to test the hypothesis that biased attention towards threat, but not dysphoric or positive emotional stimuli, during an anxious mood induction, but not at a pre-stress baseline, would prospectively predict greater worry symptoms on days in which more naturalistic stressors occurred. Results revealed the hypothesized moderation effect for sustained attention towards threat after the mood induction but not at baseline, though sustained attention towards dysphoric stimuli also moderated the effect of stressors on worry. Worry-relevant sustained attention towards negative emotional stimuli may be a partially mood-context dependent phenomenon.