Social anxiety symptoms, heart rate variability, and vocal emotion recognition in women: evidence for parasympathetically-mediated positivity bias

Madison, Annelise A.; Vasey, Michael W.; Emery, Charles F.

doi:10.1080/10615806.2020.1839733

Cited by 7 publications

(7 citation statements)

References 61 publications

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“…The higher the HRV reduction was the more severe were the symptoms of social interaction anxiety, fear, and avoidance [ 1 ]. Interestingly, in women with more social anxiety symptoms, lower RMSSD scores measured during an emotion recognition task were associated with higher recognition accuracy [ 36 ]. In males, cooperative social behavior was facilitated by increased vagal tone [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Virtual reality biofeedback interventions for treating anxiety

Kothgassner

Goreis

Bauda

et al. 2022

Wien Klin Wochenschr

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Summary Background Virtual reality (VR)-based biofeedback is a relatively new intervention and is increasingly being used for the treatment of anxiety disorders. This is the first research synthesis regarding effects and efficacy of this novel mode of treatment. Method We conducted a systematic review and meta-analysis of the VR biofeedback literature on treating anxiety symptoms. The MEDLINE/PubMed, Scopus and Web of Science databases were searched for eligible pre-post comparisons and randomized controlled trials (RCTs). We used self-reported anxiety, heart rate (HR), and heart rate variability (HRV) as primary outcome measures. Results A total of 7 studies with 191 participants reported VR biofeedback interventions. Of these studies 5 were RCTs, with 103 participants receiving VR biofeedback and 99 control participants (either 2D biofeedback or waiting list controls). We found that VR biofeedback significantly lowers self-reported anxiety (g = −0.28) and HR (g = −0.45), but not HRV. Furthermore, there were no significant differences in outcomes between VR biofeedback and 2D biofeedback but a significant reduction in HR in the VR biofeedback group compared with the waiting list (g = −0.52). Conclusion While the first findings are optimistic, more controlled studies with a wider variety of samples are needed to bring this field forward. Particularly, children and adolescents may profit from the combination of gamification elements, VR, and biofeedback.

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Section: Discussionmentioning

confidence: 99%

Virtual reality biofeedback interventions for treating anxiety

Kothgassner

Goreis

Bauda

et al. 2022

Wien Klin Wochenschr

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“…The RMSSD is used to estimate the vagally mediated changes in heart rate variability (HRV) ( 65 ) and presents the advantage of closely representing parasympathetic activity ( 66 ), and being relatively free of respiratory influences compared to other variables calculated from HRV ( 67 ). Lower levels of RMSSD have been associated with higher anxiety in several anxiety disorders, including SAD ( 66 , 68 ).…”

Section: Methodsmentioning

confidence: 99%

“…The anticipatory phase of social performance (e.g., preparation of public speaking) was chosen as the main phase to study social anxiety, as it has been shown to be particularly stressful ( 71 ). We have originally selected the RMSSD as the primary physiological measure, while ns-SCRs as the secondary outcome measure, as it has been shown that heart rate measures may be more sensitive in measuring social anxiety than electrodermal activity ( 66 , 68 , 72 ).…”

Section: Methodsmentioning

confidence: 99%

Targeted Memory Reactivation During REM Sleep in Patients With Social Anxiety Disorder

et al. 2022

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BackgroundSocial anxiety disorder (SAD) is characterized by a significant amount of fear when confronted to social situations. Exposure therapy, which is based on fear extinction, does not often lead to full remission. Here, based on evidence showing that rapid eye movement (REM) sleep promotes the consolidation of extinction memory, we used targeted memory reactivation (TMR) during REM sleep to enhance extinction learning in SAD.MethodsForty-eight subjects with SAD were randomly assigned to two groups: control or TMR group. All patients had two successive exposure therapy sessions in a virtual reality (VR) environment, where they were asked to give a public talk in front of a virtual jury. At the end of each session, and only in the TMR group (N = 24), a sound was paired to the positive feedback phase of therapy (i.e., approval of their performance), which represented the memory to be strengthened during REM sleep. All participants slept at home with a wearable headband device which automatically identified sleep stages and administered the sound during REM sleep. Participants' anxiety level was assessed using measures of parasympathetic (root mean square of successive differences between normal heartbeats, RMSSD) and sympathetic (non-specific skin conductance responses, ns-SCRs) activity, and subjective measures (Subjective Units of Distress Scale, SUDS), during the preparation phase of their talks before (T1) and after (T2) one full-night's sleep and after 1 week at home (T3). Participants also filled in a dream diary.ResultsWe observed an effect of time on subjective measures of anxiety (SUDS). We did not find any difference in the anxiety levels of the two groups after 1 week of TMR at home. Importantly, the longer the total duration of REM sleep and the more stimulations the TMR group had at home, the less anxious (increased RMSSD) these participants were. Finally, fear in dreams correlated positively with ns-SCRs and SUDS at T3 in the TMR group.ConclusionTMR during REM sleep did not significantly modulate the beneficial effect of therapy on subjective anxiety. Yet, our results support that REM sleep can contribute to extinction processes and substantiate strong links between emotions in dreams and waking stress levels in these patients.

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“…HRV during a resting state and while performing social cognitive tasks was not significant in participants with SAD (Harrewijn et al, 2018a). In comparison, SAD was negatively linked to HRV during an emotional recognition task, and participants exhibited a significant decrease in HRV (Madison, 2019). Reduction in HRV was found in females with SAD as opposed to HCs and in patients on psychotropic medication as opposed to patients without medication (Alvares et al, 2013).…”

Section: Biomarkers Of Social Anxiety Disordermentioning

confidence: 81%

Review of EEG, ERP, and Brain Connectivity Estimators as Predictive Biomarkers of Social Anxiety Disorder

et al. 2020

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Social anxiety disorder (SAD) is characterized by a fear of negative evaluation, negative self-belief and extreme avoidance of social situations. These recurrent symptoms are thought to maintain the severity and substantial impairment in social and cognitive thoughts. SAD is associated with a disruption in neuronal networks implicated in emotional regulation, perceptual stimulus functions, and emotion processing, suggesting a network system to delineate the electrocortical endophenotypes of SAD. This paper seeks to provide a comprehensive review of the most frequently studied electroencephalographic (EEG) spectral coupling, event-related potential (ERP), visualevent potential (VEP), and other connectivity estimators in social anxiety during rest, anticipation, stimulus processing, and recovery states. A search on Web of Science provided 97 studies that document electrocortical biomarkers and relevant constructs pertaining to individuals with SAD. This study aims to identify SAD neuronal biomarkers and provide insight into the differences in these biomarkers based on EEG, ERPs, VEP, and brain connectivity networks in SAD patients and healthy controls (HC). Furthermore, we proposed recommendations to improve methods of delineating the electrocortical endophenotypes of SAD, e.g., a fusion of EEG with other modalities such as functional magnetic resonance imaging (fMRI) and magnetoencephalograms (MEG), to realize better effectiveness than EEG alone, in order to ultimately evolve the treatment selection process, and to review the possibility of using electrocortical measures in the early diagnosis and endophenotype examination of SAD.

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Social anxiety symptoms, heart rate variability, and vocal emotion recognition in women: evidence for parasympathetically-mediated positivity bias

Cited by 7 publications

References 61 publications

Virtual reality biofeedback interventions for treating anxiety

Virtual reality biofeedback interventions for treating anxiety

Targeted Memory Reactivation During REM Sleep in Patients With Social Anxiety Disorder

Review of EEG, ERP, and Brain Connectivity Estimators as Predictive Biomarkers of Social Anxiety Disorder

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