Psychophysiological assessment of stress reactivity and recovery in 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 Results for physiological recovery (return to baseline after the stressor was withdrawn) were mixed, but provided some support for slower autonomic recovery in patients with generalized anxiety disorder and panic disorder compared to HCs.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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Individuals with versus without generalized anxiety disorder self-reported heightened emotional intensity and more difficulty bouncing back from strong increases in negative emotions.
“Further, individuals with (versus without) GAD self-reported heightened emotional intensity and more difficulty bouncing back from strong increases in negative emotions [22, 23].”
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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.
- ORCID
- 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
- Licence
- 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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