A brief breathing challenge reveals a cardiac correlate of generalized anxiety beyond resting physiology and interoceptive measures

In 207 young adults, lower respiratory sinus arrhythmia during slow paced breathing—relative to resting predictions—tracks more severe generalized anxiety symptoms (β = -0.21, BF = 13).

• Why it matters: Resting autonomic markers like heart rate variability weakly predict mental health, possibly because spontaneous state factors obscure regulatory differences that a standardized breathing challenge can reveal.
• What they did: Participants completed ECG recordings at rest and during paced breathing at 6 and 20 breaths/min; RSA during slow breathing was compared with RSA predicted from resting RSA, and symptoms were analyzed alongside interoceptive measures.
• The result: The slow-breathing RSA association with generalized anxiety persisted after controlling depressive symptoms, concentrated in those with at least moderate anxiety, while interoceptive accuracy showed no link to symptoms or slow-breathing RSA.

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