Systematic review and meta-analysis: altered autonomic functioning in youths with emotional dysregulation
Systematic review and meta-analysis: altered autonomic functioning in youths with emotional dysregulation
Objective: To systematically investigate if there is a significant association between markers of autonomic functioning and emotional dysregulation (ED) in children and adolescents. Method: Based on a preregistered protocol (PROSPERO: CRD42021239635), PubMed, Web of Knowledge/Science, Ovid MEDLINE, Embase, and APA PsycInfo databases were searched until April 21, 2021, to identify empirical studies reporting indices of autonomic nervous system (ANS) functioning in youths meeting DSM (version III, IV, IV-TR, 5 or 5-TR) or International Classification of Diseases (ICD) (version 9 or 10) criteria for any psychopathological/neurodevelopmental condition and assessed for ED with a validated scale. Eligible outcomes included correlation coefficients between ED and ANS measures or differences in ANS measures between youths with and without ED. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS) and the Newcastle-Ottawa Scale (NOS) for cohort studies. Random-effects meta-analyses were used for data synthesis. Results: There were 12 studies (1,016 participants) included in the descriptive review and 9 studies (567 participants) included in the meta-analyses. No evidence of a significant association between ED and altered cardiac or electrodermal functioning was found. However, exploratory meta-regressions suggested a possible association between reduced resting-state cardiac vagal control and increased ED. Conclusion: This study did not find evidence of an association between ED and autonomic dysfunction. However, preliminary evidence that reduced vagal control at rest might be a transdiagnostic marker of ED in young people was found. Additional studies comparing autonomic measures in youths with and without ED are needed and should also assess the effects of interventions for ED on ANS functioning. Study preregistration information: Systematic Review and Meta-Analysis: Is Autonomic Nervous System Functioning Atypical in Children and Adolescents With Emotional Dysregulation? https://www.crd.york.ac.uk/prospero/; CRD42021239635.
EDA, HRV, RSA, autonomic nervous system, emotional dysregulation
216-230
Bellato, Alessio
0ee4c34f-3850-4883-8b82-5717b74990f7
Sesso, Gianluca
d889cfde-20fe-4745-a4dd-f950100b1e3a
Milone, Annarita
aa0c9736-fad3-4db8-ae1f-ec2c1ba4ac8a
Masi, Gabriele
001c0cfb-da65-4209-b40d-531461bf68ed
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
23 February 2023
Bellato, Alessio
0ee4c34f-3850-4883-8b82-5717b74990f7
Sesso, Gianluca
d889cfde-20fe-4745-a4dd-f950100b1e3a
Milone, Annarita
aa0c9736-fad3-4db8-ae1f-ec2c1ba4ac8a
Masi, Gabriele
001c0cfb-da65-4209-b40d-531461bf68ed
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Bellato, Alessio, Sesso, Gianluca, Milone, Annarita, Masi, Gabriele and Cortese, Samuele
(2023)
Systematic review and meta-analysis: altered autonomic functioning in youths with emotional dysregulation.
Journal of the American Academy of Child and Adolescent Psychiatry, 63 (2), .
(doi:10.1016/j.jaac.2023.01.017).
Abstract
Objective: To systematically investigate if there is a significant association between markers of autonomic functioning and emotional dysregulation (ED) in children and adolescents. Method: Based on a preregistered protocol (PROSPERO: CRD42021239635), PubMed, Web of Knowledge/Science, Ovid MEDLINE, Embase, and APA PsycInfo databases were searched until April 21, 2021, to identify empirical studies reporting indices of autonomic nervous system (ANS) functioning in youths meeting DSM (version III, IV, IV-TR, 5 or 5-TR) or International Classification of Diseases (ICD) (version 9 or 10) criteria for any psychopathological/neurodevelopmental condition and assessed for ED with a validated scale. Eligible outcomes included correlation coefficients between ED and ANS measures or differences in ANS measures between youths with and without ED. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS) and the Newcastle-Ottawa Scale (NOS) for cohort studies. Random-effects meta-analyses were used for data synthesis. Results: There were 12 studies (1,016 participants) included in the descriptive review and 9 studies (567 participants) included in the meta-analyses. No evidence of a significant association between ED and altered cardiac or electrodermal functioning was found. However, exploratory meta-regressions suggested a possible association between reduced resting-state cardiac vagal control and increased ED. Conclusion: This study did not find evidence of an association between ED and autonomic dysfunction. However, preliminary evidence that reduced vagal control at rest might be a transdiagnostic marker of ED in young people was found. Additional studies comparing autonomic measures in youths with and without ED are needed and should also assess the effects of interventions for ED on ANS functioning. Study preregistration information: Systematic Review and Meta-Analysis: Is Autonomic Nervous System Functioning Atypical in Children and Adolescents With Emotional Dysregulation? https://www.crd.york.ac.uk/prospero/; CRD42021239635.
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Accepted/In Press date: 16 February 2023
e-pub ahead of print date: 23 February 2023
Published date: 23 February 2023
Additional Information:
Funding Information:
The study was partially supported by the Italian Ministry of Health: Ricerca Corrente (Project 2.10: Bipolar spectrum in youth, from cyclothymia to bipolar disorder: clinical and pharmacological implications; GM), and the “5 per 1000” voluntary contributions. Disclosure: Dr. Masi has received research grants from Lundbeck and Humana, has served on an advisory board for Angelini, and has been a speaker for Angelini, FB Health, Janssen, Lundbeck, and Otsuka. Prof. Cortese has declared honoraria and reimbursement for travel and accommodation expenses for lectures from the following nonprofit associations: Association for Child and Adolescent Mental Health (ACAMH), Canadian ADHD Alliance Resource (CADDRA), British Association for Psychopharmacology (BAP), and Healthcare Convention for educational activity on ADHD. He has served on the advisory board of ACAMH and the BAP. Drs. Bellato, Sesso, and Milone have reported no biomedical financial interests or potential conflicts of interest.
Keywords:
EDA, HRV, RSA, autonomic nervous system, emotional dysregulation
Identifiers
Local EPrints ID: 477134
URI: http://eprints.soton.ac.uk/id/eprint/477134
ISSN: 1527-5418
PURE UUID: 8eaa3252-53ca-4b2a-9b2e-5f839b874465
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Date deposited: 30 May 2023 16:34
Last modified: 17 Mar 2024 04:22
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Contributors
Author:
Alessio Bellato
Author:
Gianluca Sesso
Author:
Annarita Milone
Author:
Gabriele Masi
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