Key result
High levels of worry were associated with a robust reduction in resting-state heart rate variability compared to low levels of worry (Hedges' g -0.75), whereas clinical anxiety diagnosis showed only a trend-level reduction.
Why the study?
Is the specific symptom of worry or the diagnosis of an anxiety disorder more strongly associated with reduced resting-state heart rate variability?
Cross-Sectional (n=83)
No
Is the specific symptom of worry or the diagnosis of an anxiety disorder more strongly associated with reduced resting-state heart rate variability?
Standardized Mean Difference: -0.75 (95% CI -1.2–-0.3)
Absolute Event Rate: 6.24% vs 6.94%
p-value: p=0.001
The specific symptom of worry, rather than a categorical anxiety disorder diagnosis, is robustly associated with reduced resting-state heart rate variability, supporting its use as a transdiagnostic biomarker.
High worry links to lower HRV more than anxiety diagnosis; leaves open targeted worry interventions for autonomic health.
BACKGROUND: Individuals with anxiety disorders display reduced resting-state heart rate variability (HRV), although findings have been contradictory and the role of specific symptoms has been less clear. It is possible that HRV reductions may transcend diagnostic categories, consistent with dimensional-trait models of psychopathology. Here we investigated whether anxiety disorders or symptoms of anxiety, stress, worry and depression are more strongly associated with resting-state HRV. METHODS: Resting-state HRV was calculated in participants with clinical anxiety (n = 25) and healthy controls (n = 58). Symptom severity measures of worry, anxiety, stress, and depression were also collected from participants, regardless of diagnosis. RESULTS: Participants who fulfilled DSM-IV criteria for an anxiety disorder displayed diminished HRV, a difference at trend level significance (p = .1, Hedges' g = -.37, BF10 = .84). High worriers (Total n = 41; n = 22 diagnosed with an anxiety disorder and n = 19 not meeting criteria for any psychopathology) displayed a robust reduction in resting state HRV relative to low worriers (p = .001, Hedges' g = -.75, BF10 = 28.16). CONCLUSIONS: The specific symptom of worry - not the diagnosis of an anxiety disorder - was associated with the most robust reductions in HRV, indicating that HRV may provide a transdiagnostic biomarker of worry. These results enhance understanding of the relationship between the cardiac autonomic nervous system and anxiety psychopathology, providing support for dimensional-trait models consistent with the Research Domain Criteria framework.
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Chalmers et al. (2016) conducted a cross-sectional in Anxiety and Worry (n=83). High worry vs. Low worry was evaluated on Resting-state high-frequency heart rate variability (HF-HRV) (Hedges' g -0.75, 95% CI -1.2 to -0.3, p=0.001). High levels of worry were associated with a robust reduction in resting-state heart rate variability compared to low levels of worry (Hedges' g -0.75), whereas clinical anxiety diagnosis showed only a trend-level reduction.
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