Gender Matters: Nonlinear Relationships Between Heart Rate Variability and Depression and Positive Affect

Spangler, Derek P.; Dunn, Emily J.; Aldao, Amelia; Feeling, Nicole R.; Free, Matthew L.; Gillie, Brandon L.; Vasey, Michael W.; Williams, D.; Koenig, Julian; Thayer, Julian F.

doi:10.3389/fnins.2021.612566

Cited by 11 publications

(18 citation statements)

References 80 publications

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“…It is imperative that where possible, researchers work to understand how women and men may differ in the association between HRV and psychophysiological outcomes of interest. Results may yield interactions similar to those presented in the current study, or such gender differences may fundamentally change hypotheses and results (e.g., Williams et al, 2018;Spangler et al, 2021). For example, we showed gender to moderate the association between resting HRV and difficulties in emotion regulation, such that women showed a stronger association compared to men (Williams et al, 2018).…”

Section: Implications For Heart Rate Variability Researchsupporting

confidence: 68%

Gender Differences in Cardiac Chronotropic Control: Implications for Heart Rate Variability Research

Williams

Joseph

Gerardo

et al. 2021

Appl Psychophysiol Biofeedback

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There is a continuing debate concerning “adjustments” to heart period variability [i.e., heart rate variability (HRV)] for the heart period [i.e., increases inter-beat-intervals (IBI)]. To date, such arguments have not seriously considered the impact a demographic variable, such as gender, can have on the association between HRV and the heart period. A prior meta-analysis showed women to have greater HRV compared to men despite having shorter IBI and higher heart rate (HR). Thus, it is plausible that men and women differ in the association between HRV and HR/IBI. Thus, the present study investigates the potential moderating effect of gender on the association between HRV and indices of cardiac chronotropy, including both HR and IBI. Data from 633 participants (339 women) were available for analysis. Cardiac measures were assessed during a 5-min baseline-resting period. HRV measures included the standard deviation of inter-beat-intervals, root mean square of successive differences, and autoregressive high frequency power. Moderation analyses showed gender significantly moderated the association between all HRV variables and both HR and IBI (each p < 0.05). However, results were not consistent when using recently recommended HRV variables “adjusted” for IBI. Overall, the current investigation provides data illustrating a differential association between HRV and the heart period based on gender. Substantial neurophysiological evidence support the current findings; women show greater sensitivity to acetylcholine compared to men. If women show greater sensitivity to acetylcholine, and acetylcholine increases HRV and the heart period, then the association between HRV and the heart period indeed should be stronger in women compared to men. Taken together, these data suggest that routine “adjustments” to HRV for the heart period are unjustified and problematic at best. As it relates to the application of future HRV research, it is imperative that researchers continue to consider the potential impact of gender.

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Section: Implications For Heart Rate Variability Researchsupporting

confidence: 68%

Gender Differences in Cardiac Chronotropic Control: Implications for Heart Rate Variability Research

Williams

Joseph

Gerardo

et al. 2021

Appl Psychophysiol Biofeedback

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“…A further reason for nonsignificant associations at baseline might be the heterogenous psychopharmacological treatment of the patients examined in our study. Additionally, the association between HRV and depressive symptoms might not be linear, as recently found in a larger sample of women but not in men (e.g., Spangler et al, 2021).…”

mentioning

confidence: 85%

Higher Resting Cardiovagal Activity Predicts Larger Decrease of Depressive Symptoms in Inpatients Treated for Stress-Related Depression

Marca

Pallich

Holtforth

et al. 2022

Journal of Psychophysiology

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Abstract. Depression is one of the most prevalent mental disorders, with treatment outcomes generally being unsatisfactory. The identification of outcome predictors could contribute to improving diagnosis, treatment, and outcome. Heart rate variability (HRV), an index of cardiovagal activity, has been proposed as a potential correlate of depression as well as a predictor of treatment effectiveness. The aim of the present study was to examine if HRV at baseline could predict the outcome of inpatient treatment for stress-related depressive disorder (SRDD). Depressive symptoms of n = 57 inpatients with an SRDD, who were treated in a specialized burnout ward, were assessed using the Beck Depression Inventory (BDI) at the beginning, the end of treatment, and at 3-month follow-up. HRV (i.e., RMSSD, the root mean square of successive RR interval differences) was determined from a five-minute measurement in the supine position. RMSSD was not significantly associated with the BDI score at the beginning, end, and follow-up. Higher RMSSD was revealed to be a significant predictor of a stronger decrease in depressive severity from the beginning to the end of the treatment. Thereby, the regression model explained 7.6% of the total variance in the BDI decrease. The results revealed initial HRV to predict a larger decrease in depressive severity. Therefore, resting HRV represents a physiological resource and index of successful neurovisceral interaction, which supports inpatients in benefitting from specialized treatment.

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“…safeness, contentment, warmth) and positive affective dispositions (e.g. agreeableness, gratitude, meaning in life) suggest a quadratic rather than linear association with HRV [25][26][27][28][29][30]. This may also be true for HRV's association with compassion, although few studies have examined this possibility (c.f.…”

Section: The Vagus Nerve and Self-regulationmentioning

confidence: 99%

A bioelectronic route to compassion: Rationale and study protocol for combining transcutaneous vagus nerve stimulation (tVNS) with compassionate mental imagery

Kamboj

Peniket²,

Simeonov³

2023

PLoS ONE

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Background The vagus nerve (VN) is a neural nexus between the brain and body, enabling bidirectional regulation of mental functioning and peripheral physiology. Some limited correlational findings suggest an association between VN activation and a particular form of self-regulation: compassionate responding. Interventions that are geared towards strengthening self-compassion in particular, can serve as an antidote to toxic shame and self-criticism and improve psychological health. Objective We describe a protocol for examining the role of VN activation on ‘state’ self-compassion, self-criticism, and related outcomes. By combining transcutaneous vagus nerve stimulation (tVNS) with a brief imagery-based self-compassion intervention, we aim to preliminarily test additivity versus synergy between these distinct bottom-up and top-down methods for putatively regulating vagal activity. We also test whether the effects of VN stimulation accumulate with daily stimulation and daily compassionate imagery practice. Methods Using a randomized 2 x 2 factorial (stimulation x imagery condition) design, healthy volunteers (n = 120) receive active (tragus) or sham (earlobe) tVNS plus standardized (audio-recorded) self-compassionate or sham mental imagery instructions. These interventions are delivered in a university-based psychological laboratory in two sessions, one week apart, as well as being self-administered between sessions by participants at home. Pre-stimulation, peri-stimulation and post-imagery measures of state self-compassion, self-criticism and related self-report outcomes are assessed in two lab sessions, separated by a week (Days 1 and 8). Heart rate variability is used as a physiological metric of vagal activity and an eye-tracking task assesses attentional bias to compassionate faces during the two lab sessions. On Days 2–7, participants continue their randomly assigned stimulation and imagery tasks at home, and complete state measures at the end of each remote session. Discussion Demonstrating modulation of compassionate responding using tVNS would support a causal link between VN activation and compassion. This would provide a basis for future studies of bioelectronic approaches to augmenting therapeutic contemplative techniques. Clinical trials registration ClinicalTrials.gov, Identifier: NCT05441774 (Date: July 1st 2022). OSF registration https://osf.io/4t9ha.

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Gender Matters: Nonlinear Relationships Between Heart Rate Variability and Depression and Positive Affect

Cited by 11 publications

References 80 publications

Gender Differences in Cardiac Chronotropic Control: Implications for Heart Rate Variability Research

Gender Differences in Cardiac Chronotropic Control: Implications for Heart Rate Variability Research

Higher Resting Cardiovagal Activity Predicts Larger Decrease of Depressive Symptoms in Inpatients Treated for Stress-Related Depression

A bioelectronic route to compassion: Rationale and study protocol for combining transcutaneous vagus nerve stimulation (tVNS) with compassionate mental imagery

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