{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:46:10Z","timestamp":1792179970523,"version":"4.4.0"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2013,7,30]],"date-time":"2013-07-30T00:00:00Z","timestamp":1375142400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"DOI":"10.1371\/journal.pone.0070468","type":"journal-article","created":{"date-parts":[[2013,7,30]],"date-time":"2013-07-30T20:56:37Z","timestamp":1375217797000},"page":"e70468","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":136,"title":["Reduced Heart Rate Variability in Social Anxiety Disorder: Associations with Gender and Symptom Severity"],"prefix":"10.1371","volume":"8","author":[{"given":"Gail A.","family":"Alvares","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S.","family":"Quintana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew H.","family":"Kemp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Van Zwieten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard W.","family":"Balleine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian B.","family":"Hickie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Guastella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2013,7,30]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"2225","DOI":"10.1161\/01.CIR.90.5.2225","article-title":"Symptoms of anxiety and risk of coronary heart disease. The Normative Aging Study","volume":"90","author":"I Kawachi","year":"1994","journal-title":"Circulation"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.biopsycho.2005.08.009","article-title":"An autonomic flexibility\u2013neurovisceral integration model of anxiety and cardiac vagal tone","volume":"74","author":"B Friedman","year":"2007","journal-title":"Biological Psychology"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jad.2010.02.112","article-title":"Cardiovascular disease in persons with depressive and anxiety disorders","volume":"125","author":"N Vogelzangs","year":"2010","journal-title":"Journal of Affective Disorders"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1001\/archpsyc.62.6.593","article-title":"Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication","volume":"62","author":"RC Kessler","year":"2005","journal-title":"Archives of General Psychiatry"},{"key":"ref5","unstructured":"Clark DM, Wells A (1995) A cognitive model of social phobia. In: Heimberg R, Liebowitz M, Hope DA, Schneier FR, editors. Social phobia: Diagnosis, assessment and treatment. New York: Guilford Press. 69\u201393."},{"key":"ref6","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/j.1469-8986.1995.tb01213.x","article-title":"Orienting in a defensive world: Mammalian modifications of our evolutionary heritage. A polyvagal theory","volume":"32","author":"SW Porges","year":"1995","journal-title":"Psychophysiology"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/j.1749-6632.1997.tb51913.x","article-title":"Emotion: an evolutionary by-product of the neural regulation of the autonomic nervous system","volume":"807","author":"SW Porges","year":"2006","journal-title":"Annals of the New York Academy of Sciences"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1111\/j.1469-8986.1997.tb02140.x","article-title":"Heart rate variability: origins, methods, and interpretive caveats","volume":"34","author":"G Berntson","year":"1997","journal-title":"Psychophysiology"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.ijcard.2009.09.543","article-title":"The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors","volume":"141","author":"JF Thayer","year":"2010","journal-title":"International Journal of Cardiology"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1097\/PSY.0b013e3181a292a6","article-title":"Association between anxiety disorders and heart rate variability in The Netherlands Study of Depression and Anxiety (NESDA)","volume":"71","author":"CMM Licht","year":"2009","journal-title":"Psychosomatic Medicine"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1097\/00006842-200109000-00010","article-title":"Gender differences in psychophysiological responses to speech stress among older social phobics: congruence and incongruence between self-evaluative and cardiovascular reactions","volume":"63","author":"P Grossman","year":"2001","journal-title":"Psychosomatic Medicine"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.ijpsycho.2012.10.012","article-title":"Heart rate and heart rate variability in panic, social anxiety, obsessive\u2013compulsive, and generalized anxiety disorders at baseline and in response to relaxation and hyperventilation","volume":"87","author":"A Pittig","year":"2013","journal-title":"International Journal of Psychophysiology"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.ijpsycho.2013.03.016","article-title":"Does respiratory sinus arrhythmia (RSA) predict anxiety reduction during cognitive behavioral therapy (CBT) for social anxiety disorder (SAD)","volume":"88","author":"KJ Mathewson","year":"2013","journal-title":"International Journal of Psychophysiology"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1016\/S0008-6363(01)00508-9","article-title":"Gender, sex hormones and autonomic nervous control of the cardiovascular system","volume":"53","author":"AM Dart","year":"2002","journal-title":"Cardiovascular Research"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.autneu.2008.10.011","article-title":"Short-term heart rate variability in healthy young adults: the Cardiovascular Risk in Young Finns Study","volume":"145","author":"T Koskinen","year":"2009","journal-title":"Autonomic Neuroscience"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1056\/NEJM199906103402306","article-title":"The protective effects of estrogen on the cardiovascular system","volume":"340","author":"FH Epstein","year":"1999","journal-title":"New England Journal of Medicine"},{"key":"ref17","unstructured":"Brown T, Di Nardo PA, Barlow DH (1994) Anxiety Disorders Interview Schedule Adult Version (ADIS-IV). San Antonio, TX: Psychological Corporation\/Graywind Publications Incorporated."},{"key":"ref18","unstructured":"APA (2000) Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition, Text Revision. Washington DC: American Psychiatric Association."},{"key":"ref19","unstructured":"First MB, Spitzer RL, Gibbon M, Williams JB (2007) Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition. (SCID-I\/NP). New York: Biometrics Research, New York State Psychiatric Institute."},{"key":"ref20","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/0005-7967(94)00075-U","article-title":"The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories","volume":"33","author":"PF Lovibond","year":"1995","journal-title":"Behavior Research and Therapy"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1037\/1040-3590.19.1.133","article-title":"Development of an abbreviated Social Phobia and Anxiety Inventory (SPAI) using item response theory: The SPAI-23","volume":"19","author":"R Roberson-Nay","year":"2007","journal-title":"Psychological Assessment"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1111\/j.1360-0443.1993.tb02093.x","article-title":"Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-II","volume":"88","author":"JB Saunders","year":"1993","journal-title":"Addiction"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1249\/01.MSS.0000078924.61453.FB","article-title":"International Physical Activity Questionnaire (IPAQ): 12-country reliability and validity","volume":"35","author":"C Craig","year":"2003","journal-title":"Medicine & Science in Sports & Exercise"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1037\/1040-3590.10.2.176","article-title":"Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample","volume":"10","author":"MM Antony","year":"1998","journal-title":"Psychological Assessment"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1037\/a0027398","article-title":"Measuring social anxiety in college students: a comprehensive evaluation of the psychometric properties of the SPAI-23","volume":"24","author":"AR Schry","year":"2012","journal-title":"Psychological Assessment"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S0005-7894(05)80308-9","article-title":"Assessment of anxiety in social interaction and being observed by others: The Social Interaction Anxiety Scale and the Social Phobia Scale*","volume":"23","author":"RG Heimberg","year":"1993","journal-title":"Behavior Therapy"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1017\/S0033291701004056","article-title":"The Liebowitz Social Anxiety Scale: a comparison of the psychometric properties of self-report and clinician-administered formats","volume":"31","author":"DM Fresco","year":"2001","journal-title":"Psychological Medicine"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1017\/S0033291702006074","article-title":"Short screening scales to monitor population prevalences and trends in non-specific psychological distress","volume":"32","author":"RC Kessler","year":"2002","journal-title":"Psychological Medicine"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/1471-2288-6-57","article-title":"Dealing with missing data in a multi-question depression scale: a comparison of imputation methods","volume":"6","author":"FM Shrive","year":"2006","journal-title":"BMC Medical Research Methodology"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1007\/s00421-011-2079-9","article-title":"Possibilities and limitations of the polar RS800 in measuring heart rate variability at rest","volume":"112","author":"MB Wall\u00e9n","year":"2012","journal-title":"European Journal of Applied Physiology"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"4179","DOI":"10.1007\/s00421-012-2453-2","article-title":"On the validity of using the Polar RS800 heart rate monitor for heart rate variability research","volume":"112","author":"DS Quintana","year":"2012","journal-title":"European Journal of Applied Physiology"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1007\/s00421-010-1415-9","article-title":"Comparison of three mobile devices for measuring R\u2013R intervals and heart rate variability: Polar S810i, Suunto t6 and an ambulatory ECG system","volume":"109","author":"M Weippert","year":"2010","journal-title":"European Journal of Applied Physiology"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.biopsycho.2005.09.005","article-title":"Methodological issues in the quantification of respiratory sinus arrhythmia","volume":"74","author":"JW Denver","year":"2007","journal-title":"Biological Psychology"},{"key":"ref34","unstructured":"Cohen J (1988) Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Earlbaum Associates."},{"key":"ref35","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/BF02322053","article-title":"Standardized tests of heart rate variability: normal ranges obtained from 309 healthy humans, and effects of age, gender, and heart rate","volume":"11","author":"M Agelink","year":"2001","journal-title":"Clinical Autonomic Research"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.amjcard.2003.09.065","article-title":"Influence of age, gender, body mass index, and functional capacity on heart rate variability in a cohort of subjects without heart disease","volume":"93","author":"I Antelmi","year":"2004","journal-title":"The American Journal of Cardiology"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1152\/jappl.1996.81.2.743","article-title":"Role of aerobic capacity and body mass index in the age-associated decline in heart rate variability","volume":"81","author":"EA Byrne","year":"1996","journal-title":"Journal of Applied Physiology"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.jmpt.2007.04.001","article-title":"Effect of age and sex on heart rate variability in healthy subjects","volume":"30","author":"J Zhang","year":"2007","journal-title":"Journal of Manipulative and Physiological Therapeutics"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/j.neuroimage.2009.05.091","article-title":"High-frequency heart rate variability and cortico-striatal activity in men and women with social phobia","volume":"47","author":"F \u00c5hs","year":"2009","journal-title":"NeuroImage"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"e30777","DOI":"10.1371\/journal.pone.0030777","article-title":"Depression, comorbid anxiety disorders, and heart rate variability in physically healthy,unmedicated patients: implications for cardiovascular risk","volume":"7","author":"AH Kemp","year":"2012","journal-title":"PLoS ONE"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"E23","DOI":"10.1111\/j.1530-0277.2012.01913.x","article-title":"A meta-analysis on the impact of alcohol dependence on short-term resting-state heart rate variability: implications for cardiovascular risk","volume":"37","author":"DS Quintana","year":"2013","journal-title":"Alcoholism: Clinical and Experimental Research"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.cpr.2005.05.004","article-title":"The relationship between social anxiety disorder and alcohol use disorders: A critical review","volume":"25","author":"EP Morris","year":"2005","journal-title":"Clinical Psychology Review"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1002\/da.20533","article-title":"Effect of medication and psychotherapy on heart rate variability in panic disorder","volume":"26","author":"A Garakani","year":"2009","journal-title":"Depression and Anxiety"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1111\/j.1600-0447.1995.tb09749.x","article-title":"Clinical recovery from panic disorder is associated with evidence of changes in cardiovascular regulation","volume":"91","author":"H Middleton","year":"1995","journal-title":"Acta Psychiatrica Scandinavica"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1159\/000079113","article-title":"Individual trait anxiety levels characterizing the properties of Zen meditation","volume":"50","author":"T Murata","year":"2004","journal-title":"Neuropsychobiology"},{"key":"ref46","doi-asserted-by":"crossref","first-page":"e46597","DOI":"10.1371\/journal.pone.0046597","article-title":"Matter over mind: a randomised-controlled trial of single-session biofeedback training on performance anxiety and heart rate variability in musicians","volume":"7","author":"R Wells","year":"2012","journal-title":"PLoS ONE"},{"key":"ref47","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1161\/01.CIR.95.4.818","article-title":"Is worrying bad for your heart? A prospective study of worry and coronary heart disease in the normative aging study","volume":"95","author":"LD Kubzansky","year":"1997","journal-title":"Circulation"},{"key":"ref48","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1111\/j.1751-7893.2012.00364.x","article-title":"Clinical staging model applied to young people presenting with social anxiety","volume":"6","author":"PJF Clarke","year":"2012","journal-title":"Early Intervention in Psychiatry"},{"key":"ref49","doi-asserted-by":"crossref","first-page":"e3","DOI":"10.1016\/j.biopsych.2010.07.030","article-title":"Is heart rate variability reduced in depression without cardiovascular disease","volume":"69","author":"AH Kemp","year":"2011","journal-title":"Biological Psychiatry"}],"container-title":["PLoS ONE"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/dx.plos.org\/10.1371\/journal.pone.0070468","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,7,20]],"date-time":"2019-07-20T01:20:31Z","timestamp":1563585631000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0070468"}},"subtitle":[],"editor":[{"given":"Leonardo","family":"Fontenelle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2013,7,30]]},"references-count":49,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2013,7,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0070468","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,7,30]]}}}