Autonomic arousal in anxious and typically developing youth during a stressor involving error feedback

Anxiety has been proposed to influence psychophysiological reactivity in children and adolescents. However, the extant empirical literature has not always found physiological reactivity to be associated with anxiety in youth. Further, most investigations have not examined psychophysiological reactivity in real time over the course of acute stress. To test the impact of anxiety disorder status on autonomic arousal in youth, we compared youth with primary anxiety disorders (N = 24) to typically developing (TD) youth (N = 22) on heart rate (HR), heart rate variability (HRV), and respiratory sinus arrhythmia (RSA) during an acute stressor in which youth received error-related feedback. We also conducted exploratory analyses on youth performance during the task. Youth ages 9-17 participated in the arithmetic portion of the Trier Social Stress Test for Children (Buske-Kirschbaum et al., Psychosom 59:419-426, 1997), during which time they received consecutive, standardized feedback that they made calculation errors. Results indicated that, compared to their TD counterparts, the anxious group demonstrated elevated HR and suppressed HRV during initial provision of error feedback and during the recovery period. No group differences were found for RSA. Additionally, overall TD youth made a greater proportion of errors than anxious youth. Clinically, these findings may provide preliminary support for anxious youth exhibiting physiological reactivity in response to receipt of error-related feedback, and may have implications for understanding biological processes during stress. This work underscores the need for further study of when and how anxiety may influence autonomic reactivity over the course of stress.