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Respiratory sinus arrhythmia: a transdiagnostic biomarker of emotion dysregulation and psychopathology
Open accessAbstract
In the past two decades, respiratory sinus arrhythmia (RSA)-an index of parasympathetic nervous system (PNS)-mediated cardiac control-has emerged as a reliable peripheral biomarker of emotion regulation (ER). Reduced RSA and excessive RSA reactivity (i.e., withdrawal) to emotional challenge are observed consistently among individuals with poor ER capabilities, including those with various forms of internalizing and externalizing psychopathology, and those with specific psychopathological syndromes, including anxiety, phobias, attention problems, autism, callousness, conduct disorder, depression, non-suicidal self-injury, panic disorder, and trait hostility. Emerging evidence suggests that low RSA and excessive RSA reactivity index poor ER because they are downstream peripheral markers of prefrontal cortex (PFC) dysfunction. Poorly modulated inhibitory efferent pathways from the medial PFC to the PNS result in reduced RSA and excessive RSA reactivity. According to this perspective, RSA is a non-invasive proxy for poor executive control over behavior, which characterizes most forms of psychopathology.
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“possibly helping to explain the ANS dysfunction consistently reported across psychopathologies [51, 52].”
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“Since most forms of psychopathology are characterized by PFC dysfunction [44,45 ], they are also characterized by low resting RSA and excessive RSA reactivity, peripheral biomarkers of poor executive control [41].”
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“been previously proposed in theoretical work (Beauchaine, 2015; Beauchaine and Cicchetti, 2019; Beauchaine and Thayer, 2015), which emphasize transdiagnostic mechanisms underlying psychopathology.”
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“Reduced HRV, frequently observed in individuals with emotional lability or anxiety, may be consistent with slower or less precise updating of autonomic predictions, though this interpretation remains inferential (Beauchaine, 2015).”
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“…mental health conditions to participate, given that factors like anxiety, depression, and alexithymia can impact emotional and physiological functioning (Beauchaine, 2015; Thayer & Brosschot, 2005), future studies should include measures of these variables when conducting research in this area.”
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“This variability aligns with broader evidence that neural biomarkers of emotion regulation may show developmental shifts (Beauchaine, 2015; Grillon et al., 2019; Gunnar & Quevedo, 2007; Meyer, 2017), high-lighting the need to clarify how theta-related neural mechanisms contribute to emotional…”
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“Subgroup estimates were similar across risk levels: 24.8% for high risk (95% CI [21.2, 28.6], k = 17), 23.9% for low risk (95% CI [22.5, 25.3], k = 151), and 23.5% for moderate risk (95% CI [22.0, 24.9], k = 120).”
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“Measures such as heart rate variability (HRV) are interpreted as reflecting the functional integrity of neural networks involved in self-regulation, cognitive flexibility, and adaptive responses to environmental demands (Thayer et al., 2012; Beauchaine, 2015).”
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“As parasympathetic activation relates to multifaceted aspects of socio-emotional functioning (Beauchaine, 2015; Thayer and Lane, 2000), the synchronization between multiple participants’ parasympathetic activity may indicate shared emotional processes (Palumbo et al., 2017; Denk et al., 2026b).”
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“These findings stand in contrast to studies with other communities that suggest PNS measures are robustly associated with psychopathology (Beauchaine, 2015; Beauchaine & Thayer, 2015).”
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“Parasympathetic regulation is commonly indexed by baseline respiratory sinus arrhythmia (RSA), a well-established marker of vagal-mediated parasympathetic activity (Beauchaine, 2015; Madden-Rusnak et al., 2023; S. W. Porges, 1995).”
Longitudinal Resting State Heart Rate Variability in Young Children With Autism
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“…has accumulated to support baseline RSA as an index of emotion regulation capacity and executive functioning, with higher baseline RSA associated with better behavioral regulation in social and cognitively demanding contexts (Appelhans and Luecken 2006; Beauchaine 2015; Thayer and Lane 2009).”
InfluentialChang, L., Zhou, J., Luo, Y., Xu, J., & Zhang, H. (2026) · The Journal of Genetic Psychology · doi:10.1080/00221325.2026.2717632
Yang, Y., Poole, K. L., & Schmidt, L. A. (2026) · Developmental Psychobiology · doi:10.1002/dev.70192
“However, existing work in child samples has focused largely on the independent relations between overall frontal brain activity 1 (Dawson 1994 ; Xu et al. 2023 ) and RSA (Beauchaine 2015 ; Hastings and Kahle 2019 ) with indices of emotion regulation and internalizing behaviors.”
Goemaere, H., Braet, J., Verbeken, S., Claes, L., & Braet, C. (2026) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-026-01501-7
“RSA serves as an index of changes in inhibitory parasympathetic-vagal control on the cardiac sinoatrial node (Beauchaine, 2001, 2015; Berntson et al., 1993; Porges, 1995).”
Childhood trauma and adolescent sleep problems: The roles of perceived stress and vagal regulation
Zeng, Y., & Lü, W. (2026) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2026.113478
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“Respiratory sinus arrhythmia [RSA (14)] and the root mean square of successive differences [RMSSD (15)], by contrast, are heart rate variability measures commonly used as indices of parasympathetic cardiac activity.”
Chronic Invalidation: An Underexplored Source of Autistic Distress
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Associations Between Parity and Parasympathetic Regulation in Response to Infant Crying
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“Together with age and other relevant background characteristics, particular attention was given to anxiety, due to its established association with RSA reactivity (T. P. Beauchaine 2015 ) and its relevance to maternal responses to infant cues (Guo et al. 2018 ).”
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Metadata
- Authors
- Beauchaine, T. P.
- Affiliations
- The Ohio State University (US)
- Corresponding author
- Beauchaine, Theodore P
- Venue
- Current Opinion in Psychology
- Publisher
- Elsevier BV
- Published
- 2015-06
- Volume
- 3
- Pages
- 43-47
- ISSN
- 2352-250X (ISSN-L)
- PMC
- PMC4389219
- OpenAlex
- W2008969489
- Cited by
- 529
- References
- 50
- Citations by year
- 2026: 52 · 2025: 51 · 2024: 47 · 2023: 53 · 2022: 47 · 2021: 79 · 2020: 63 · 2019: 47 · 2018: 36 · 2017: 28 · 2016: 17 · 2015: 8
- FWCI
- 5.12
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Opinion in Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH063699)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- respiratory sinus arrhythmia, emotion regulation, parasympathetic nervous system, emotional dysregulation, psychopathology, internalizing disorders, externalizing disorders, anxiety, autism spectrum disorder, depression, non-suicidal self-injury, panic disorder, trait hostility, prefrontal cortex dysfunction, executive function, peripheral biomarkers
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