Polyvagal Theory and developmental psychopathology: Emotion dysregulation and conduct problems from preschool to adolescence

Abstract

In science, theories lend coherence to vast amounts of descriptive information. However, current diagnostic approaches in psychopathology are primarily atheoretical, emphasizing description over etiological mechanisms. We describe the importance of Polyvagal Theory toward understanding the etiology of emotion dysregulation, a hallmark of psychopathology. When combined with theories of social reinforcement and motivation, Polyvagal Theory specifies etiological mechanisms through which distinct patterns of psychopathology emerge. In this paper, we summarize three studies evaluating autonomic nervous system functioning in children with conduct problems, ages 4-18. At all age ranges, these children exhibit attenuated sympathetic nervous system responses to reward, suggesting deficiencies in approach motivation. By middle school, this reward insensitivity is met with inadequate vagal modulation of cardiac output, suggesting additional deficiencies in emotion regulation. We propose a biosocial developmental model of conduct problems in which inherited impulsivity is amplified through social reinforcement of emotional lability. Implications for early intervention are discussed.

Affective Decision-Making and Externalizing Behaviors: The Role of Autonomic Activity

“…Our results did not support the hypothesis that parasympathetic arousal would be related to ADHD and ODD symptoms or mediate the relation between affective decision-making and externalizing symptoms. It is possible that the children in the present study had not yet evidenced the relation between attenuated parasympathetic activity and externalizing behaviors that appears to come "online" in middle childhood (Beauchaine et al 2007). …”

“…RSA typically is used as an estimate of vagal tone because it is a proxy for regulatory processes that cannot readily be measured non-invasively. In terms of the relation between RSA and vagal tone, RSA results from decreases in vagal efference during inhalation, which increase heart rate, and increases in vagal efference during exhalation, which decrease heart rate (Beauchaine 2001).Externalizing behaviors are related to decreased SNS and PNS activity (e.g., Beauchaine et al 2007;Calkins and Dedmon 2000;Pine et al 1998), though associations differ depending on the type of externalizing behaviors and age period considered. For instance, preschool children with ADHD and ODD exhibit attenuated SNS, but not PNS activity (Beauchaine et al 2007;Crowell et al 2006).…”

“…Externalizing behaviors are related to decreased SNS and PNS activity (e.g., Beauchaine et al 2007;Calkins and Dedmon 2000;Pine et al 1998), though associations differ depending on the type of externalizing behaviors and age period considered. For instance, preschool children with ADHD and ODD exhibit attenuated SNS, but not PNS activity (Beauchaine et al 2007;Crowell et al 2006).…”

“…For instance, preschool children with ADHD and ODD exhibit attenuated SNS, but not PNS activity (Beauchaine et al 2007;Crowell et al 2006). In middle childhood and adolescence, ODD and CD are associated with attenuated SNS and PNS activity (Beauchaine et al , 2007, which suggests that PNS activity may come "online" during middle childhood and SNS deficiencies may emerge before reductions in PNS activity.…”

“…For instance, preschool children with ADHD and ODD exhibit attenuated SNS, but not PNS activity (Beauchaine et al 2007;Crowell et al 2006). In middle childhood and adolescence, ODD and CD are associated with attenuated SNS and PNS activity (Beauchaine et al , 2007, which suggests that PNS activity may come "online" during middle childhood and SNS deficiencies may emerge before reductions in PNS activity. The relation between attenuated PNS activity and externalizing problems that has been reported among middle class children and adolescents (e.g., Beauchaine et al 2007) also has been demonstrated among urban boys at risk for delinquency; moreover, this relation remained significant even after controlling for age, ethnicity, and socioeconomic status (SES; Pine et al 1998).…”