Respiratory sinus arrhythmia as a potential measure in substance use treatment–outcome studies

Abstract

Background and Aims Dysfunction of physiological regulation systems may underlie the disrupted emotional and self-regulatory processes among people with substance use disorder (SUD). This paper reviews evidence as to whether respiratory sinus arrhythmia (RSA), as a psychophysiological index of emotional regulation, could provide useful information in treatment-outcome research to provide insights into recovery processes. Methods We reviewed use of RSA in clinical research and studies on SUD treatment. Search terms for the review of RSA in clinical research included respiratory sinus arrhythmia, heart rate variability, vagal, cardiac vagal control, psychophysiology, intervention, treatment, mindfulness, mind-body, mental health, substance use, chemical dependence, regulation, emotion regulation. For the review of RSA in intervention studies, we included only those that provided adequate description of psychophysiological methods, and examined RSA in the context of an intervention study. Results RSA appears to be able to provide an index of self-regulatory capacity; however it has been little used in either intervention or treatment research. Of the four intervention studies included in this review, all were mindfulness-based interventions. Two studies were with substance using samples and both showed pre-post increases in RSA and related improved substance use outcomes. Two of the three studies were RCTs and both showed significant increases in RSA in the experimental compared to comparison condition. Conclusion Respiratory sinus arrhythmia may be a useful index of emotional regulation in people with substance use disorder, and a potential measure of underlying mechanisms for SUD treatment studies, particularly mindfulness-based interventions.

Cardiac autonomic function and hot flashes among perimenopausal and postmenopausal women

“…29 However, increased RSA levels are also known to be associated with greater interoceptive awareness, or increased sensitivity to bodily states. 30 A relationship between higher resting parasympathetic activation and more frequent self-reported hot flashes may therefore reflect greater sensitivity to detecting or perceiving hot flashes, resulting from greater interoception among these women. Future research may benefit from investigating how individual differences in interoception mediate the link between RSA levels and the subjective experience or reporting of hot flashes.…”

Upper gastrointestinal complications following ablation therapy for atrial fibrillation

“…Therefore, ECG with maneuvers of adequate vagal stimulation might increase sensitivity of this simple measurement to predict vagal dysfunction. Respiratory sinus arrhythmia has been used to appraise vagal function in diverse clinical situations, including as an index of emotional regulation in people with substance use disorder 32 or a marker of the vagal tonic inhibition of the release of proinflammatory cytokines in patients with ischemic heart disease 33 or as a monitor of emotional control in patients with psychiatric illness treated with biofeedback. 34 …”

Emotion dysregulation and autonomic responses to film, rumination, and body awareness: Extending psychophysiological research to a naturalistic clinical setting and a chemically dependent female sample

“…Emotion dysregulation is a transdiagnostic vulnerability that may contribute to the emergence and maintenance of substance dependence among those who initiate use (e.g., Berking & Wupperman, ; Price & Crowell, ). Indeed, emotion regulation deficits are common in clinical samples, such as those with internalizing, externalizing, or co‐occurring internalizing/externalizing forms of psychopathology (Gross & Munoz, ; Vasilev, Crowell, Beauchaine, Mead, & Gatzke‐Kopp, ).…”

“…However, no studies have looked at whether a brief guided interoceptive (i.e., bodily) awareness task can induce positive affect and physiological changes in the moment, even without prior training. This is interesting given that mindfulness and interoceptive awareness are theorized to be a primary means of enhancing positive and reducing negative affect among substance users, and psychophysiological changes are a potential mechanism underlying such outcomes (Bowen et al, ; Price & Crowell, ).…”

“…Thus, there are relatively fewer studies that have gone into clinical treatment settings to conduct transdiagnostic biological research with participants who are socioeconomically, emotionally, and/or physically disadvantaged, and who often have multiple comorbid conditions. Emotion dysregulation is a transdiagnostic vulnerability that may contribute to the emergence and maintenance of substance dependence among those who initiate use (e.g., Price & Crowell, 2016). Indeed, emotion regulation deficits are common in clinical samples, such as those with internalizing, externalizing, or co-occurring internalizing/externalizing forms of psychopathology (Gross & Munoz, 1995;Vasilev, Crowell, Beauchaine, Mead, & Gatzke-Kopp, 2009).…”