{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T19:23:52Z","timestamp":1780082632267,"version":"3.54.0"},"reference-count":55,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,6,30]],"date-time":"2017-06-30T00:00:00Z","timestamp":1498780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychophysiology"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The autonomic regulation in blood\u2010injection\u2010injury (BII) phobia has received particular attention due to the unique link between fear and fainting in this anxiety disorder. However, systematic exploration of sympathetic and parasympathetic cardiac activity during exposure to phobia\u2010relevant emotional stimuli has remained rare and inconclusive, including with regard to disgust, a frequent response to BII stimuli. Existing studies using respiratory sinus arrhythmia (RSA) as a noninvasive index of parasympathetic cardiac activity also have not accounted sufficiently for effects of respiration. We compared 60 participants with BII phobia (27 with and 33 without history of loss of consciousness) and 20 healthy controls during emotion induction with films, including a disgust and a BII\u2010relevant surgery film. Cardiorespiratory activity was measured continuously, with RSA (controlled for respiration) and T\u2010wave amplitude (TWA; as a noninvasive index of sympathetic cardiac activity) extracted. Significant increases in RSA during the surgery film were observed for participants with a history of loss of consciousness compared to others, but controlling for respiration eliminated these differences. Sympathetic effects with heart rate accelerations, which were most pronounced for the disgust film, did not differentiate groups. However, substantial increases in RSA and TWA, suggesting parasympathetic excitation and sympathetic withdrawal, were observed in five participants that became presyncopal during the surgery film. Thus, parasympathetic excitation and sympathetic withdrawal appear to be cardinal autonomic features in BII phobia, but larger studies of participants reaching presyncopal states in BII\u2010relevant stimulus exposure are needed to consolidate these findings.<\/jats:p>","DOI":"10.1111\/psyp.12900","type":"journal-article","created":{"date-parts":[[2017,7,1]],"date-time":"2017-07-01T04:56:43Z","timestamp":1498885003000},"page":"1512-1527","source":"Crossref","is-referenced-by-count":16,"title":["Sympathetic and parasympathetic cardiac responses to phobia\u2010relevant and disgust\u2010specific emotion provocation in blood\u2010injection\u2010injury phobia with and without fainting history"],"prefix":"10.1111","volume":"54","author":[{"given":"Erica","family":"Simon","sequence":"first","affiliation":[{"name":"Palo Alto Veterans Institute for Research Palo Alto California USA"},{"name":"National Center for PTSD\u2014Dissemination and Training Division Menlo Park California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia E.","family":"Meuret","sequence":"additional","affiliation":[{"name":"Department of Psychology Southern Methodist University Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Ritz","sequence":"additional","affiliation":[{"name":"Department of Psychology Southern Methodist University Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,6,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890423349"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2466\/pms.1997.84.2.505"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2009.04.008"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsycho.2010.02.004"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-295X.98.4.459"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1993.75.5.2310"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awm037"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2002.037192"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-89-3-403"},{"key":"e_1_2_6_11_1","volume-title":"Structured Clinical Interview of DSM\u2010IV: Patient edition (SCID\u2010I\/P, Version 2.0)","author":"First M. 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