Restricted autonomic flexibility in children with social phobia

Schmitz J, Kraemer M, Tuschen-Caffier B, Heinrichs N, Blechert J (2011)
Journal of Child Psychology and Psychiatry 52(11): 1203-1211.

Zeitschriftenaufsatz | Veröffentlicht | Englisch
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Schmitz, Julian; Kraemer, Martina; Tuschen-Caffier, Brunna; Heinrichs, NinaUniBi ; Blechert, Jens
Abstract / Bemerkung
Background: Psychophysiological hyperresponsiveness to social-evaluative stress plays a key role in current theories of social phobia (SP). Owing to the early onset of this disorder, the study of children with SP can help to improve etiological models. However, research to date has failed to clarify whether children with SP are physiologically hyperresponsive to stress or not. In addition, the existence of elevated pre-stressor baseline group differences complicates the interpretation of acute stress responses and therefore poses a challenge for this line of research. Drawing on current models of autonomic control to explain the relationship between baseline and stress responding in SP children and healthy controls (HC), we acquired a broad set of autonomic measures in our study. Method: To index baseline and stress reactivity and to assess autonomic flexibility, we assessed a comprehensive array of sympathetic and parasympathetic measures in SP children (aged 8 to 12 years; n = 30) and healthy control children (HC, n = 26), while exposing them to the Trier Social Stress Test for Children (TSST-C). Results: At baseline, the SP children showed higher levels of sympathetic (heart rate, electrodermal activity) and lower levels of parasympathetic (respiratory sinus arrhythmia, RSA) activation when compared to the HC children. During the TSST-C, the SP children showed similar HR responses but a limited RSA reactivity and a slower HR recovery relative to the HC children. Conclusion: Our study extends previous research by showing elevated baseline arousal and comparable stress responding in SP children relative to HC children. In addition, based on the autonomic flexibility model, we provide a potential explanation for the null findings of previous studies during stress. The pattern of elevated baseline heart rates and reduced RSA point to restricted autonomic flexibility in children with SP.
psychopathology; autonomic flexibility; Social phobia; children
Journal of Child Psychology and Psychiatry
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Schmitz J, Kraemer M, Tuschen-Caffier B, Heinrichs N, Blechert J. Restricted autonomic flexibility in children with social phobia. Journal of Child Psychology and Psychiatry. 2011;52(11):1203-1211.
Schmitz, J., Kraemer, M., Tuschen-Caffier, B., Heinrichs, N., & Blechert, J. (2011). Restricted autonomic flexibility in children with social phobia. Journal of Child Psychology and Psychiatry, 52(11), 1203-1211.
Schmitz, Julian, Kraemer, Martina, Tuschen-Caffier, Brunna, Heinrichs, Nina, and Blechert, Jens. 2011. “Restricted autonomic flexibility in children with social phobia”. Journal of Child Psychology and Psychiatry 52 (11): 1203-1211.
Schmitz, J., Kraemer, M., Tuschen-Caffier, B., Heinrichs, N., and Blechert, J. (2011). Restricted autonomic flexibility in children with social phobia. Journal of Child Psychology and Psychiatry 52, 1203-1211.
Schmitz, J., et al., 2011. Restricted autonomic flexibility in children with social phobia. Journal of Child Psychology and Psychiatry, 52(11), p 1203-1211.
J. Schmitz, et al., “Restricted autonomic flexibility in children with social phobia”, Journal of Child Psychology and Psychiatry, vol. 52, 2011, pp. 1203-1211.
Schmitz, J., Kraemer, M., Tuschen-Caffier, B., Heinrichs, N., Blechert, J.: Restricted autonomic flexibility in children with social phobia. Journal of Child Psychology and Psychiatry. 52, 1203-1211 (2011).
Schmitz, Julian, Kraemer, Martina, Tuschen-Caffier, Brunna, Heinrichs, Nina, and Blechert, Jens. “Restricted autonomic flexibility in children with social phobia”. Journal of Child Psychology and Psychiatry 52.11 (2011): 1203-1211.

40 Zitationen in Europe PMC

Daten bereitgestellt von Europe PubMed Central.

The tell-tale heart: physiological reactivity during resolution of ambiguity in youth anxiety.
Rozenman M, Vreeland A, Iglesias M, Mendez M, Piacentini J., Cogn Emot 32(2), 2018
PMID: 28278737
Bumping heart and sweaty palms: physiological hyperarousal as a risk factor for child social anxiety.
Nikolić M, Aktar E, Bögels S, Colonnesi C, de Vente W., J Child Psychol Psychiatry 59(2), 2018
PMID: 28921527
Do clinically anxious children cluster according to their expression of factors that maintain child anxiety?
Pearcey S, Alkozei A, Chakrabarti B, Dodd H, Murayama K, Stuijfzand S, Creswell C., J Affect Disord 229(), 2018
PMID: 29334641
Learning by heart-the relationship between resting vagal tone and metacognitive judgments: a pilot study.
Meessen J, Sütterlin S, Gauggel S, Forkmann T., Cogn Process 19(4), 2018
PMID: 29796847
Trajectory of heart period to socioaffective threat in shy children.
Poole KL, Schmidt LA., Dev Psychobiol 60(8), 2018
PMID: 30125935
Stress system dysregulation in pediatric generalized anxiety disorder associated with comorbid depression.
Funke R, Eichler A, Distler J, Golub Y, Kratz O, Moll GH., Stress Health 33(5), 2017
PMID: 27982510
Aroused at Home: Basic Autonomic Regulation during Orthostatic and Physical Activation is Altered in Children with Social Anxiety Disorder.
Asbrand J, Blechert J, Nitschke K, Tuschen-Caffier B, Schmitz J., J Abnorm Child Psychol 45(1), 2017
PMID: 27037916
The role of stress reactivity in the long-term persistence of adolescent social anxiety symptoms.
Nelemans SA, Hale WW, Branje SJT, van Lier PAC, Koot HM, Meeus WHJ., Biol Psychol 125(), 2017
PMID: 28274660
Autonomic arousal in anxious and typically developing youth during a stressor involving error feedback.
Rozenman M, Sturm A, McCracken JT, Piacentini J., Eur Child Adolesc Psychiatry 26(12), 2017
PMID: 28527019
Impaired cardiac profile in adolescents with an increasing trajectory of anxiety when confronting an acute stressor.
de la Torre-Luque A, Fiol-Veny A, Bornas X, Balle M, Llabres J., Eur Child Adolesc Psychiatry 26(12), 2017
PMID: 28551841
Autonomic arousal in children of parents with and without social anxiety disorder: a high-risk study.
Nikolić M, de Vente W, Colonnesi C, Bögels SM., J Child Psychol Psychiatry 57(9), 2016
PMID: 27133173
Dual Cognitive and Biological Correlates of Anxiety in Autism Spectrum Disorders.
Hollocks MJ, Pickles A, Howlin P, Simonoff E., J Autism Dev Disord 46(10), 2016
PMID: 27465243
Alterations in HPA-axis and autonomic nervous system functioning in childhood anxiety disorders point to a chronic stress hypothesis.
Dieleman GC, Huizink AC, Tulen JH, Utens EM, Creemers HE, van der Ende J, Verhulst FC., Psychoneuroendocrinology 51(), 2015
PMID: 25305548
Cardiac autonomic regulation in autism and Fragile X syndrome: a review.
Klusek J, Roberts JE, Losh M., Psychol Bull 141(1), 2015
PMID: 25420222
Autonomic arousal in childhood anxiety disorders: associations with state anxiety and social anxiety disorder.
Alkozei A, Creswell C, Cooper PJ, Allen JJ., J Affect Disord 175(), 2015
PMID: 25590763
Vagal flexibility: A physiological predictor of social sensitivity.
Muhtadie L, Koslov K, Akinola M, Mendes WB., J Pers Soc Psychol 109(1), 2015
PMID: 25545841
Biological and psychological markers of stress in humans: focus on the Trier Social Stress Test.
Allen AP, Kennedy PJ, Cryan JF, Dinan TG, Clarke G., Neurosci Biobehav Rev 38(), 2014
PMID: 24239854
Effects of acute social stress on emotion processing in children.
Chen FS, Schmitz J, Domes G, Tuschen-Caffier B, Heinrichs M., Psychoneuroendocrinology 40(), 2014
PMID: 24485480
Somatic symptoms in children with anxiety disorders: an exploratory cross-sectional study of the relationship between subjective and objective measures.
Kristensen H, Oerbeck B, Torgersen HS, Hansen BH, Wyller VB., Eur Child Adolesc Psychiatry 23(9), 2014
PMID: 24390719
Heart rate variability during social interactions in children with and without psychopathology: a meta-analysis.
Shahrestani S, Stewart EM, Quintana DS, Hickie IB, Guastella AJ., J Child Psychol Psychiatry 55(9), 2014
PMID: 24635780
Differences in HPA-axis and heart rate responsiveness to psychosocial stress in children with autism spectrum disorders with and without co-morbid anxiety.
Hollocks MJ, Howlin P, Papadopoulos AS, Khondoker M, Simonoff E., Psychoneuroendocrinology 46(), 2014
PMID: 24882156
Neural response to the observable self in social anxiety disorder.
Pujol J, Giménez M, Ortiz H, Soriano-Mas C, López-Solà M, Farré M, Deus J, Merlo-Pich E, Harrison BJ, Cardoner N, Navinés R, Martín-Santos R., Psychol Med 43(4), 2013
PMID: 22895096
Respiratory sinus arrhythmia and auditory processing in autism: modifiable deficits of an integrated social engagement system?
Porges SW, Macellaio M, Stanfill SD, McCue K, Lewis GF, Harden ER, Handelman M, Denver J, Bazhenova OV, Heilman KJ., Int J Psychophysiol 88(3), 2013
PMID: 23201146
Taking a closer look: autonomic dysregulation in socially anxious children.
Schmitz J, Tuschen-Caffier B, Wilhelm FH, Blechert J., Eur Child Adolesc Psychiatry 22(10), 2013
PMID: 23549960
Cardiac vagal control and children's adaptive functioning: a meta-analysis.
Graziano P, Derefinko K., Biol Psychol 94(1), 2013
PMID: 23648264
Biased perception and interpretation of bodily anxiety symptoms in childhood social anxiety.
Schmitz J, Blechert J, Krämer M, Asbrand J, Tuschen-Caffier B., J Clin Child Adolesc Psychol 41(1), 2012
PMID: 22233249

58 References

Daten bereitgestellt von Europe PubMed Central.

APA, 1994
Increased whole-body auditory startle reflex and autonomic reactivity in children with anxiety disorders
Bakker, Journal of Psychiatry Neuroscience 34(), 2009
Somatic complaints in anxious children.
Beidel DC, Christ MG, Long PJ., J Abnorm Child Psychol 19(6), 1991
PMID: 1791272
Psychopathology of childhood social phobia.
Beidel DC, Turner SM, Morris TL., J Am Acad Child Adolesc Psychiatry 38(6), 1999
PMID: 10361781
Autonomic space and psychophysiological response.
Berntson GG, Cacioppo JT, Quigley KS, Fabro VT., Psychophysiology 31(1), 1994
PMID: 8146254
An approach to artifact identification: application to heart period data.
Berntson GG, Quigley KS, Jang JF, Boysen ST., Psychophysiology 27(5), 1990
PMID: 2274622
Autonomic and respiratory characteristics of posttraumatic stress disorder and panic disorder.
Blechert J, Michael T, Grossman P, Lajtman M, Wilhelm FH., Psychosom Med 69(9), 2007
PMID: 17991823

Attenuated free cortisol response to psychosocial stress in children with atopic dermatitis.
Buske-Kirschbaum A, Jobst S, Wustmans A, Kirschbaum C, Rauh W, Hellhammer D., Psychosom Med 59(4), 1997
PMID: 9251162
Child anxiety in primary care: prevalent but untreated.
Chavira DA, Stein MB, Bailey K, Stein MT., Depress Anxiety 20(4), 2004
PMID: 15643639


Cohen, 1988
Self-reported and actual physiological responses in social phobia.
Edelmann RJ, Baker SR., Br J Clin Psychol 41(Pt 1), 2002
PMID: 11931674
Public and private heart rate feedback in social phobia: a manipulation of anxiety visibility.
Gerlach AL, Mourlane D, Rist F., Cogn Behav Ther 33(1), 2004
PMID: 15224627
Blushing and physiological arousability in social phobia.
Gerlach AL, Wilhelm FH, Gruber K, Roth WT., J Abnorm Psychol 110(2), 2001
PMID: 11358019
Reduced autonomic flexibility as a predictor for future anxiety in girls from the general population: The TRAILS study.
Greaves-Lord K, Tulen J, Dietrich A, Sondeijker F, van Roon A, Oldehinkel A, Ormel J, Verhulst F, Huizink A., Psychiatry Res 179(2), 2010
PMID: 20483486
Effects of respiratory interval on vagal modulation of heart rate.
Hayano J, Mukai S, Sakakibara M, Okada A, Takata K, Fujinami T., Am. J. Physiol. 267(1 Pt 2), 1994
PMID: 7914066
Differentiating social phobia from shyness.
Heiser NA, Turner SM, Beidel DC, Roberson-Nay R., J Anxiety Disord 23(4), 2008
PMID: 19028075
Psychophysiological differences between subgroups of social phobia.
Hofmann SG, Newman MG, Ehlers A, Roth WT., J Abnorm Psychol 104(1), 1995
PMID: 7897046
Biological bases of childhood shyness.
Kagan J, Reznick JS, Snidman N., Science 240(4849), 1988
PMID: 3353713
Buffering children from marital conflict and dissolution.
Katz LF, Gottman JM., J Clin Child Psychol 26(2), 1997
PMID: 9169376
T-wave amplitude: relationships to phasic RSA and heart period changes.
Kline KP, Ginsburg GP, Johnston JR., Int J Psychophysiol 29(3), 1998
PMID: 9666382

Krämer, 2011
Social Anxiety Scale for Children Revised: Factor structure and concurrent validity
La, Journal of Clinical Child Psychology 22(), 1993
Clinical and biological markers for outcome in schizophrenia: A review of a longitudinal follow-up study in Uppsala schizophrenia research project
Lindstrom, Neuropsychopharmacology 14(3 Suppl.), 1996
Ein Fragebogen zur Erfassung sozialer Angst bei Kindern (SASC-R-D)
Melfsen, Kindheit und Entwicklung 6(), 1997
Anxiety, antisocial behavior, and heart rate regulation in adolescent males.
Mezzacappa E, Tremblay RE, Kindlon D, Saul JP, Arseneault L, Seguin J, Pihl RO, Earls F., J Child Psychol Psychiatry 38(4), 1997
PMID: 9232491
Misunderstanding analysis of covariance.
Miller GA, Chapman JP., J Abnorm Psychol 110(1), 2001
PMID: 11261398
Enhanced stress reactivity in paediatric anxiety disorders: implications for future cardiovascular health.
Monk C, Kovelenko P, Ellman LM, Sloan RP, Bagiella E, Gorman JM, Pine DS., Int. J. Neuropsychopharmacol. 4(2), 2001
PMID: 11468091
Respiratory pathophysiology of panic disorder: an ambulatory monitoring study.
Pfaltz MC, Michael T, Grossman P, Blechert J, Wilhelm FH., Psychosom Med 71(8), 2009
PMID: 19737858
The polyvagal perspective.
Porges SW., Biol Psychol 74(2), 2006
PMID: 17049418
Infant regulation of the vagal "brake" predicts child behavior problems: a psychobiological model of social behavior.
Porges SW, Doussard-Roosevelt JA, Portales AL, Greenspan SI., Dev Psychobiol 29(8), 1996
PMID: 8958482
Vagal tone and temperament as predictors of emotion regulation strategies in young children.
Santucci AK, Silk JS, Shaw DS, Gentzler A, Fox NA, Kovacs M., Dev Psychobiol 50(3), 2008
PMID: 18335488

Schneider, 2008
Cardiac vagal tone and sustained attention in school-age children.
Suess PE, Porges SW, Plude DJ., Psychophysiology 31(1), 1994
PMID: 8146250
Psychosomatics and psychopathology: looking up and down from the brain.
Thayer JF, Brosschot JF., Psychoneuroendocrinology 30(10), 2005
PMID: 16005156
A model of neurovisceral integration in emotion regulation and dysregulation.
Thayer JF, Lane RD., J Affect Disord 61(3), 2000
PMID: 11163422

WHO, 1992
Basimetric approach (law of initial values) to biological rhythms
Wilder, Annals of the New York Academy of Siences 98(), 1962
Detection of speaking with a new respiratory inductive plethysmography system.
Wilhelm FH, Handke EM, Roth WT., Biomed Sci Instrum 39(), 2003
PMID: 12724882

Wilhelm, 2005

Wilhelm, 2006
Heart rate and QT variability in children with anxiety disorders: a preliminary report.
Yeragani VK, Rao KA, Pohl R, Jampala VC, Balon R., Depress Anxiety 13(2), 2001
PMID: 11301923

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