Childhood Maltreatment Influences Autonomic Regulation and Mental Health in College Students

Lourdes P Dale; Jacek Kolacz; Jennifer Mazmanyan; Kalie G Leon; Karli Johonnot; Nadia Bossemeyer Biernacki; Stephen W Porges

doi:10.3389/fpsyt.2022.841749

Childhood Maltreatment Influences Autonomic Regulation and Mental Health in College Students

Front Psychiatry. 2022 Jun 2:13:841749. doi: 10.3389/fpsyt.2022.841749. eCollection 2022.

Authors

Lourdes P Dale¹, Jacek Kolacz^{2

3}, Jennifer Mazmanyan⁴, Kalie G Leon⁵, Karli Johonnot⁴, Nadia Bossemeyer Biernacki⁵, Stephen W Porges^{2

6}

Affiliations

¹ Department of Psychiatry, College of Medicine-Jacksonville, University of Florida, Jacksonville, FL, United States.
² Traumatic Stress Research Consortium, Kinsey Institute, Indiana University, Bloomington, IN, United States.
³ Socioneural Physiology Laboratory, Kinsey Institute, Indiana University, Bloomington, IN, United States.
⁴ Department of Psychology, University of Hartford, West Hartford, CT, United States.
⁵ Department of Psychology, University of North Florida, Jacksonville, FL, United States.
⁶ Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.

Abstract

Childhood maltreatment history may influence autonomic reactivity and recovery to stressors. Hypothetically, the maltreatment history may contribute to a retuned autonomic nervous system that is reflected in a novel metric, vagal efficiency (VE), designed to assess the functional efficiency of vagal cardioinhibitory pathways on heart rate. We explored whether VE mediates the well-documented relationship between maltreatment history and psychiatric symptoms. We also investigated the relationship between measures of autonomic regulation in response to the physical and emotional challenges and psychiatric symptoms. Participants (n = 167) completed self-report measures of psychiatric symptoms and had continuous beat-to-beat heart rate monitored before, during, and after physical and emotional stressors. Participants with maltreatment histories exhibited lower VE, which mediated the association of maltreatment history and the psychiatric symptoms of anxiety and depression. Consistent with prior literature, there were significant associations between maltreatment history and autonomic reactivity (i.e., heart rate and respiratory sinus arrhythmia) during emotional and physical challenges; however, when VE was entered as a covariate these associations were no longer statistically significant. Blunted VE may reflect a neural pathway through which maltreatment retunes autonomic regulation and provides a neurophysiological platform that increases mental health risk.

Keywords: PTSD; Polyvagal Theory; heart rate variability; maltreatment; respiratory sinus arrhythmia; vagal efficiency.