Associations of Emotion Regulation Difficulties with Cardiac Autonomic Balance and Regulation

Emotion regulation is a critical psychological process linked with cardiovascular health via the parasympathetic and sympathetic branches of the autonomic nervous system. While higher levels of cardiac autonomic balance (CAB), defined as the relative balance between the two branches, and cardiac autonomic regulation (CAR), defined as the total activity of both branches, have been used to conceptualize better self-regulation and physiological functioning, research has yet to explore their potential links with emotion regulation difficulties. Thus, we recruited 151 participants to collect resting CAB and CAR and administered the Difficulties in Emotion Regulation Scale, which contains six subscales assessing multiple facets of emotion regulation difficulties. Zero-order correlations showed higher overall difficulties in emotion regulation were linked with lower CAB and CAR. Adjusting for covariates, this pattern only held for CAR. When examining specific subscales, greater difficulties with accepting emotional responses, engaging in goal-oriented behavior, accessing emotion regulation strategies, and impulse control predicted lower CAR. Greater difficulties with emotional clarity predicted lower CAB. After adjusting for multiple comparisons, greater difficulties with impulse control and emotional clarity remained associated with CAR and CAB, respectively. These novel findings suggest that overall emotion regulation difficulties are linked with lower total autonomic activity but not autonomic balance. Additionally, we provide nuanced and clinically relevant evidence that various facets of emotion regulation difficulties are linked with specific autonomic dynamics.