Autonomic Arousal, Ethical Guilt, and Externalizing Behavior in Childhood: A Clinical Extension and Replication

Lower autonomic arousal is associated with higher externalizing behavior in childhood but the mechanisms explaining this link are still debated. One possibility is that lower autonomic arousal makes it difficult for children to anticipate or express social emotions, such as ethical guilt rooted in concern for others, thereby increasing their likelihood of externalizing behavior. However, evidence for this social-emotional hypothesis has been limited to community samples. The present study included ethnically diverse samples of 150 typically developing children (M_age = 8.01 years; 50% girls) and 62 children referred for clinically elevated externalizing behavior (M_age = 9.16 years; 16% girls; N = 212). Caregivers reported children's externalizing behavior. Children's respiratory sinus arrhythmia (RSA) was measured as an indicator of parasympathetic activity in response to hypothetical vignettes depicting externalizing behavior. Children's ethical guilt was coded from semi-structured interviews following each vignette. Greater RSA increases (indicating a low-arousal, rest-and-digest response) were associated with lower ethical guilt. Lower ethical guilt was associated with higher externalizing behavior. A significant indirect effect showed that RSA increases were associated with higher externalizing behavior through relative lapses in ethical guilt. Results were consistent across and within the community and clinical samples. Theoretical and practical implications for clinically elevated externalizing behavior are discussed.