Respiratory sinus arrhythmia reactivity to a sad film predicts depression symptom improvement and symptomatic trajectory

Abstract

Respiratory sinus arrhythmia (RSA) reactivity, an index of cardiac vagal tone, has been linked to self-regulation and the severity and course of depression (Rottenberg, 2007). Although initial data supports the proposition that RSA withdrawal during a sad film is a specific predictor of depression course (Fraguas, 2007; Rottenberg, 2005), the robustness and specificity of this finding are unclear. To provide a stronger test, RSA reactivity to three emotion films (happy, sad, fear) and to a more robust stressor, a speech task, were examined in currently depressed individuals (n = 37), who were assessed for their degree of symptomatic improvement over 30 weeks. Robust RSA reactivity to the sad film uniquely predicted overall symptom improvement over 30 weeks. RSA reactivity to both sad and stressful stimuli predicted the speed and maintenance of symptomatic improvement. The current analyses provide the most robust support to date that RSA withdrawal to sad stimuli (but not stressful) has specificity in predicting the overall symptomatic improvement. In contrast, RSA reactivity to negative stimuli (both sad and stressful) predicted the trajectory of depression course. Patients’ engagement with sad stimuli may be an important sign to attend to in therapeutic settings.

Perseverate or decenter? Differential effects of metacognition on the relationship between parasympathetic inflexibility and symptoms of depression in a multi-wave study

“…Although evaluating depression on a dimensional level may improve potential power to detect nuanced effects and is consistent with evidence supporting the dimensional structure of depression (e.g., Liu, 2016), the clinical significance of the present results is not immediately clear (although results with RSA reactivity in clinical samples have paralleled those in the present study; e.g., Fraguas et al, 2007; Panaite et al, 2016; Rottenberg, Kasch, Gross, & Gotlib, 2002; Rottenberg, Salomon, Gross, & Gotlib, 2005). Future studies also should consider evaluating depression severity and perseverative cognition using interviewer-based methods that may be less susceptible to reporter bias than self-report scales.…”

“…However, recent work has suggested that RSA reactivity (vagal withdrawal) in response to sadness might be an index of regulatory flexibility that is particularly relevant to understanding depression and depression risk (for recent reviews, see Hamilton & Alloy, 2016; Stange et al, in press). Indeed, MDD appears to be characterized by a lack of RSA reactivity in response to sadness (Bylsma et al, 2014; Rottenberg, Clift, Bolden, & Salomon, 2007a), and individuals who have lower RSA reactivity (or vagal withdrawal) may be at risk for the onset of symptoms of depression and a poorer course of MDD (Panaite et al, 2016; Rottenberg et al, 2005; Stange et al, 2017). However, few such prospective studies have been conducted to evaluate the extent to which low RSA reactivity confers risk for future depression.…”

Atypical reactivity of heart rate variability to stress and depression across development: Systematic review of the literature and directions for future research

“…The most commonly used situation was one in which participants defended themselves from an offense, such as being wrongly accused of theft or defending themselves against a traffic ticket (Ahrens et al, 2008; Bylsma et al, 2014; Cyranowski, Hofkens, Swartz, Salomon, & Gianaros, 2011; Hughes & Stoney, 2000; Panaite et al, 2016; Rottenberg et al, 2007). Another study included role-playing tasks, such as providing negative feedback to an employee and an unscripted debate on abortion (Gordon et al, 2012).…”

“…Most film clips were a sadness-induction (Rottenberg, Wilhelm, Gross, & Gotlib, 2003), usually a clip from “The Champ” in which a boy is grieving over the death of his father (Panaite et al, 2016; Pang & Beauchaine, 2013; Rottenberg, Salomon, Gross, & Gotlib, 2005; Yaroslavsky, Bylsma, Rottenberg, & Kovacs, 2013a; Yaroslavsky, Rottenberg, & Kovacs, 2013b, Yaroslavsky, Rottenberg, & Kovacs, 2014). For children, sadness-inducing film clips included the scene from “The Lion King” when the young lion is in the stampede (Gentzler, Santucci, Kovacs, & Fox, 2009; Yaroslavsky et al, 2014).…”

“…These studies predominantly examined RSA or HF-HRV reactivity in individuals diagnosed with MDD versus a control group of healthy individuals (Bylsma et al, 2014; Cyranowski et al, 2011; Ehrenthal et al, 2010; Rottenberg et al, 2003; 2007; Yaroslavsky et al, 2014), and two studies examined RSA reactivity in the course of depression among those with MDD (Panaite et al, 2016; Rottenberg et al, 2005). Three studies also included the other indices of HRV, including LF-HRV and LF/HF ratio, in MDD versus control groups (Liang et al, 2015; Nugent et al, 2011; Shinba et al, 2014).…”