Campbell Allison A, Wisco Blair E
Department of Psychology, University of North Carolina at Greensboro, United States of America.
Department of Psychology, University of North Carolina at Greensboro, United States of America.
Clin Psychol Rev. 2021 Jul;87:102034. doi: 10.1016/j.cpr.2021.102034. Epub 2021 Apr 17.
Respiratory sinus arrhythmia (RSA) reactivity is thought to indicate how adaptively one responds to stress. RSA reactivity has been examined across anxiety disorders and posttraumatic stress disorder (PTSD), to better understand the psychophysiological stress response of these disorders. The current state of the literature is mixed, and the association between RSA reactivity and PTSD/anxiety is unclear. This review examines RSA reactivity in response to laboratory stressor tasks across samples with anxiety and PTSD. Results indicated a complex literature that may suggest an association between anxiety/PTSD and RSA reactivity. There is evidence to suggest a pattern of heightened RSA withdrawal in PTSD and trait anxious samples. There was little evidence to suggest a heightened RSA withdrawal pattern in other anxiety disorders. This review also highlights methodological considerations which may allow for clearer interpretations of RSA reactivity. The current literature includes heterogeneity across stressor tasks, RSA measures, and comorbidities that complicates interpretation of results. Studies using samples with comorbid depression produce more consistent evidence of heightened RSA withdrawal in anxiety/PTSD. Future directions for understanding the contribution of these variables (i.e., stressor tasks, RSA measures, comorbid depression) and mechanisms contributing to the possible association between RSA reactivity and anxiety/PTSD are considered.
呼吸性窦性心律不齐（RSA）反应性被认为可表明个体对应激的适应能力。人们已对焦虑症和创伤后应激障碍（PTSD）患者的RSA反应性进行了研究，以更好地了解这些疾病的心理生理应激反应。目前的文献情况不一，RSA反应性与PTSD/焦虑之间的关联尚不清楚。本综述考察了焦虑症和PTSD患者样本在实验室应激任务中的RSA反应性。结果表明，相关文献情况复杂，可能提示焦虑症/PTSD与RSA反应性之间存在关联。有证据表明，PTSD患者和特质焦虑样本中存在RSA反应增强的模式。几乎没有证据表明其他焦虑症存在RSA反应增强的模式。本综述还强调了方法学上的考虑因素，这些因素可能有助于更清晰地解读RSA反应性。当前的文献在应激任务、RSA测量方法和共病情况方面存在异质性，这使得结果的解读变得复杂。使用伴有共病抑郁症样本的研究，在焦虑症/PTSD患者中得出了更一致的RSA反应增强的证据。文中还考虑了未来研究方向，即了解这些变量（即应激任务、RSA测量方法、共病抑郁症）的作用以及导致RSA反应性与焦虑症/PTSD之间可能存在关联的机制。
