Psychological Medicine

Original Articles

Decreased heart rate variability during emotion regulation in subjects at risk for psychopathology

M. Di Simplicioa1a2 c1, G. Costolonia2, D. Westerna3, B. Hansona3, P. Taggarta4 and C. J. Harmera1

a1 University Department of Psychiatry, Warneford Hospital, Oxford, UK

a2 Neuroscience Department, Psychiatry Section, University of Siena, Siena, Italy

a3 Department of Mechanical Engineering, University College London, London, UK

a4 Neurocardiology Research Unit, University College London, London, UK


Background Dysfunctions in the regulation of emotional responses are related to poor psychological well-being and increased impact of cardiovascular disease. It has been suggested that the relationship between negative affect and higher morbidity could be mediated by a dysregulation of the autonomic nervous system (ANS), for example, of heart rate variability (HRV). Neuroticism is a personality trait associated with a maladaptive emotion regulation and also with alterations in ANS function. However, it is unknown whether subjects with high neuroticism present with specific biases in emotion regulation associated with reduced HRV.

Method In total, 33 healthy subjects (n=13, highly neurotic) performed an emotion regulation task, during which they were instructed to either passively view negative pictures or attempt to down-regulate the affect elicited by the images. During the task an electrocardiogram was recorded and HRV was measured by calculation of the high frequency spectrum (HF-HRV).

Results A significant interaction between task condition and personality group was observed on HF-HRV measures (F 1,31=6.569, p=0.016). This was driven by subjects with low neuroticism presenting higher HF-HRV during down-regulation compared to passive exposure to negative stimuli, while subjects with high neuroticism reported an opposite tendency.

Conclusions Our results show reduced HF-HRV during cognitive reappraisal of negative stimuli in high neuroticism and indicate a specific link between loss of flexibility in the parasympathetic cardiovascular tone and emotion regulation, consistent with previous work. Such findings support the importance of exploring the combination of ANS adaptability and emotional dysregulation in neuroticism as different facets of a common psychosomatic vulnerability factor.

(Received January 24 2011)

(Revised October 03 2011)

(Accepted October 03 2011)

(Online publication November 09 2011)


c1 Address for correspondence: Dr M. Di Simplicio, Department of Psychiatry, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, UK. (Email: