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Heart Rate Variability Reactivity and Avoidance in Social Anxiety Disorder

사회불안장애의 회피 증상과 심박변이도 반응성

  • Si Woo Kim (Department of Psychiatry, Seoul National University Hospital) ;
  • Dasom Lee (Department of Psychiatry, Seoul National University Hospital) ;
  • Jae Hyun Kim (Department of Psychiatry, Seoul National University Hospital) ;
  • Su Jin Kwak (Department of Psychiatry, Seoul National University Hospital) ;
  • Deung Hyun Kang (Department of Psychiatry, SMG-SNU Boramae Medical Center) ;
  • Soo-Hee, Choi (Department of Psychiatry, Seoul National University Hospital) ;
  • So-Yeon Kim (Department of Psychology, Duksung Women's University)
  • 김시우 (서울대학교병원 정신건강의학과) ;
  • 이다솜 (서울대학교병원 정신건강의학과) ;
  • 김재현 (서울대학교병원 정신건강의학과) ;
  • 곽수진 (서울대학교병원 정신건강의학과) ;
  • 강등현 (서울특별시 보라매병원 정신건강의학과) ;
  • 최수희 (서울대학교병원 정신건강의학과) ;
  • 김소연 (덕성여자대학교 심리학과)
  • Received : 2024.10.11
  • Accepted : 2024.10.23
  • Published : 2024.10.30

Abstract

Objective : Reduced resting heart rate variability (HRV) is well-documented in anxiety and mood disorders; however, limited research exists on HRV reactivity during emotional processing. This study examined HRV reactivity to angry faces in social anxiety disorder (SAD) patients and its association with symptom severity. Methods : Twenty-six SAD patients and 35 controls participated. HRV was measured using the root mean square of successive differences (RMSSD). RMSSD reactivity was calculated by subtracting RMSSD during angry and neutral face processing from baseline RMSSD. Group differences in RMSSD reactivity and its relationship with social anxiety symptoms were analyzed. Results : SAD patients exhibited lower RMSSD reactivity compared to controls during both angry (t54.829=3.03, p=0.004) and neutral face processing (t52.877=2.18, p=0.034). In the SAD group, RMSSD reactivity during angry face processing significantly explained variance in performance avoidance subscale scores of the Liebowitz Social Anxiety Scale (R2=0.208, β=-0.456, F1,23=6.054, p=0.022). Conclusion : Reduced HRV reactivity in SAD may reflect impaired autonomic flexibility and difficulty responding to emotionally relevant stressors. Lower HRV reactivity is associated with greater symptom severity, specifically performance-related avoidance, highlighting HRV's potential as a physiological marker for identifying specific symptoms in SAD.

Keywords

Acknowledgement

본 연구는 한국연구재단(2019R1A2C1086581) 및 한국과학기술연구원(2E32060-22-P015)의 지원을 받아 수행된 연구사업임.

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