ISSN 2586-0151 (Print) | ISSN 2586-0046 (Online)
대한불안의학회지 (20권2호 35-40)
Heart Rate Variability Reactivity and Avoidance in Social Anxiety Disorder
사회불안장애의 회피 증상과 심박변이도 반응성
Si Woo Kim1 , Dasom Lee1 , Jae Hyun Kim1 , Su Jin Kwak1 , Deung Hyun Kang2 , Soo-Hee Choi1,3, and So-Yeon Kim4
1 Department of Psychiatry, Seoul National University Hospital, Seoul, 2 Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, 3 Department of Psychiatry, Seoul National University College of Medicine, Seoul, 4 Department of Psychology, Duksung Women’s University, Seoul, Korea
Objectives : 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).
Conclusions : 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. (Anxiety and Mood 2024;20(2):35-40)
Social anxiety disorder; Heart Rate Variability; HRV reactivity; Performance avoidance.
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