Respiratory Sinus Arrhythmia Moderates the Association Between Adverse Childhood Experiences and Depressive Symptoms Through Stress Appraisals and Perseverative Thinking.

OBJECTIVE: Adverse childhood experiences (ACEs) confer risk for depressive symptoms in adulthood, potentially through maladaptive cognitive-affective responses to stress. The neurovisceral integration model suggests that resting respiratory sinus arrhythmia (RSA), an index of parasympathetic regulation, shapes capacity to regulate cognitive-affective stress responses. The present study tested whether stress-related appraisals and perseverative thinking mediated the association between ACEs and depressive symptoms, whether RSA moderated these pathways, and whether effects varied under chronic caregiving stress.

METHODS: Participants were 222 middle-aged mothers (mean age = 46.83, SD = 6.03) experiencing higher (n = 125) and lower (n = 97) caregiving stress. ACEs and depressive symptoms were assessed with the Childhood Trauma Questionnaire and CES-D. Perceived threat, perceived control, and perseverative thinking were measured through daily diaries. Resting RSA, CES-D, and daily measures were collected at 3 time points across 30 months.

RESULTS: Lower RSA strengthened the association between ACEs and depressive symptoms ( b = 0.269, SE = 0.060, p < .001). Lower perceived control [ b = 0.022, 95% CI (0.001, 0.049)] and greater perseverative thinking [ b = 0.072, 95% CI (0.020, 0.128)] mediated the association between ACEs and depressive symptoms; lower RSA strengthened associations between ACEs and these mediators. Higher ACEs were associated with greater perceived threat among mothers with higher caregiving stress and lower RSA ( b = 0.014, SE = 0.004, p < .001).

CONCLUSIONS: Early adversity is associated with depressive symptoms through stress-related cognitive-affective pathways. Lower RSA may reflect diminished regulatory capacity that strengthens associations between ACEs and maladaptive cognitive-affective stress responses.