Cited by 38Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesHeart Rate Variability and Autonomic ControlStress Responses and Cortisol

Psychophysiological assessment of stress reactivity and recovery in anxiety disorders

Tolin, David F., Lee, Eric, Levy, Hannah C., Das, Akanksha, Mammo, Liya, Katz, Benjamin W., Diefenbach, Gretchen J.·2021·Journal of Anxiety Disorders

Abstract

The present study aimed to examine changes in psychophysiological arousal from baseline to a stressor phase (reactivity) and from the stressor phase to a second resting phase (recovery) in patients with anxiety disorders. Fifty adult patients with DSM-5 anxiety disorders (panic disorder, generalized anxiety disorder, or social anxiety disorder) and 28 healthy control (HC) participants underwent psychophysiological monitoring including electrocardiogram, respiration rate, electrodermal activity, gastrocnemius electromyograph, and end-tidal CO 2 for a 3-min resting phase, a 6-min mild stressor phase, and a 3-min recovery phase. Anxious patients then went on to receive naturalistic cognitive-behavioral therapy (CBT) in a specialty outpatient clinic. Results for the reactivity phase indicated that compared to HCs, patients with social anxiety disorder exhibited heightened psychophysiological reactivity while patients with panic disorder and generalized anxiety disorder exhibited attenuated reactivity. Results for physiological recovery (return to baseline after the stressor was withdrawn) were mixed, but provided some support for slower autonomic recovery in patients with generalized anxiety disorder and panic disorder compared to HCs. Participants with all anxiety disorders exhibited diminished change in high frequency heart rate variability compared to HCs. Generally, psychophysiological reactivity and recovery were not associated with CBT outcome, though exploratory analyses indicated that greater respiration rate reactivity and stronger respiration rate recovery were associated with better CBT outcomes in patients with panic disorder.

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Crossref · 10.1016/j.janxdis.2021.102426

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Authors
Tolin, D. F., Lee, E., Levy, H. C., Das, A., Mammo, L., Katz, B. W., & Diefenbach, G. J.
Affiliations
Hartford Hospital (US)
Corresponding author
Tolin, David F.
Venue
Journal of Anxiety Disorders
Publisher
Elsevier BV
Published
2021-08
Volume
82
Pages
102426
ISSN
0887-6185 (ISSN-L)
OpenAlex
W3160373779
Cited by
38
References
52
Citations by year
2026: 6 · 2025: 15 · 2024: 7 · 2023: 5 · 2022: 4 · 2021: 1
FWCI
4.11
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Anxiety Disorders (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords
anxiety disorders, psychophysiological reactivity, autonomic recovery, stress reactivity, panic disorder, generalized anxiety disorder, social anxiety disorder, heart rate variability, respiration rate, electrodermal activity, end-tidal carbon dioxide
MeSH terms
Adult, Anxiety, Anxiety Disorders, Arousal, Humans, Psychophysiology, Panic Disorder

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