從自主神經彈性觀點探討類廣泛性焦慮疾患和高特質焦慮的自主神經反應、注意控制、與情緒調節

On Exploring Cardiac Autonomic Activation, Attention Control, and Emotion Regulation in Subclinical Generalized Anxiety Disorder and Trait Anxiety: From the Perspective of Autonomic Flexibility

10.30074/FJMH.202409_37(3).0001

林子筠(Tzu-Yun Lin)；鄧閔鴻(Min-Hung Teng)；盧偉信(Wei-Hsin Lu)

心跳變異率 ； 自主神經彈性 ； 注意控制 ； 情緒調節 ； 廣泛性焦慮症 ； attention control ； autonomic flexibility ； emotion regulation ； generalized anxiety disorder ； heart rate variability

中華心理衛生學刊

37卷3期（2024 / 09 / 01）

179 - 227

繁體中文;英文

研究目的：本研究旨在探討類廣泛性焦慮症（generalized anxiety disorder, GAD）者與高特質焦慮者，在注意力、情緒調節、和自主神經系統調節功能表現的型態是否相似。研究方法：本研究招募類GAD組、高特質焦慮組、與健康一般組各20人（平均年齡 = 22.03，女性佔75%）。所有參與者先填寫一系列自陳式量表，之後連結心電圖（electrocardiogram, ECG），並依序進行基準期、憂慮期、注意力網絡作業（attention network task, ANT）、以及情緒史楚普叫色作業（emotional Stroop task, EST）等二認知作業期，最後則是緩和期。研究結果：（1）類GAD組和高特質焦慮組自評情緒調節困難程度皆高於一般組，而自評注意力控制能力則皆低於一般組。（2）相對健康一般組，類GAD組與高特質焦慮組的整體心跳變異指標，包含心跳間期的標準差（standard deviation of all normal to normal intervals, SDNN）和總功率（total power, TP），以及高頻功率（high frequency power, HF）與低頻功率（low frequency power, LF）指標均明顯較低。（3）三組參與者在二認知作業表現均未能發現顯著差異。研究結論：本研究進一步證實具GAD症狀個體呈現注意力控制能力較弱、情緒調節困難及自主神經活性較低的現象，同時高特質焦慮者也有相似表徵。

Purpose: Patients with Generalized Anxiety Disorder (GAD) may show cognitive and emotional vulnerabilities, such as impaired attention control, heightened attentional bias toward threat-related stimuli, and emotional dysregulation. Reduced autonomic activity is considered a physiological vulnerability factor for individuals with high trait anxiety because it increases the likelihood of developing anxiety disorders. When the prefrontal cortex disinhibits its inhibitory control, it affects individual adaptability, leading to attentive, affective and autonomic dysfunction. Clinically, as Heart rate variability (HRV) reflects the functions of prefrontal cortex, it can serve as a biomarker for top-down self-regulation. We used HRV to investigate whether individuals with subclinical GAD and those with high trait anxiety have similar performance in attention, emotional regulation, and autonomic nervous system regulation. Methods: We recruited 20 people each for the subclinical GAD group, high trait anxiety group, and no-anxiety group. The overall sample had a mean age of 22.03 years (75% female). All participants filled out a series of self-report scales before they were connected to an electrocardiogram (ECG). After establishing a baseline ECG, the participants received a worry-inducing task, an attention network task, and the emotional Stroop task. Next, they were led into emotional relaxation. Results: We identified 3 main results: 1) The subclinical GAD group and the high trait anxiety group reported higher levels of emotional regulation difficulty and showed lower attentional control ability compared to the no-anxiety group. 2) The subclinical GAD group and the high trait anxiety group also had significantly lower values in the overall HRV indicators than did the no-anxiety group, including standard deviation of normal-to-normal intervals, total power, high frequency power, and low frequency power. 3) No significant differences were observed among the three groups regarding their performance in the attention network and emotional Stroop tasks. Conclusions: The analysis verified that individuals with GAD and those with high trait anxiety both exhibit weak attentional control, difficulty in emotional regulation, and lower autonomic nervous system activity. These findings support the basic assumptions of the neurovisceral integration model. Further research is needed with careful control of participants' characteristics, including matching the clinical population in age, gender ratios, depression levels, and health conditions. Additionally, since attentional control deficits in anxious individuals may only occur when processing emotional stimuli, it is necessary to further evaluate the attention network function of these groups in response to emotionally stimulating words.

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