When two hearts beat as one: Heart-rate synchrony in social anxiety disorder

Maya Asher, Abigail L. Barthel, Stefan G. Hofmann, Hadas Okon-Singer, Idan M. Aderka

Research output: Contribution to journalArticlepeer-review


Individuals with social anxiety disorder (SAD) experience significant interpersonal impairment. However, little is known about the physiological processes that are associated with interpersonal dysfunction in the disorder. In the present study we examined heart-rate (HR) synchrony in SAD during “getting-acquainted” interactions between opposite-sex partners. Participants included 118 individuals who formed 59 dyads: 30 dyads that included one individual with SAD and one non-socially anxious (NSA) individual (SAD dyads) and 29 dyads that included two NSA individuals (control dyads). Dyads were randomly assigned to either a closeness-generating conversation or a small talk conversation. For closeness-generating conversations, we found that social anxiety was positively associated with HR synchrony in control dyads but negatively associated with HR synchrony in SAD dyads. These results remained when controlling for depressive symptoms and participants’ movement. Our findings suggest that in more intimate social contexts, SAD may impair the ability to create HR synchrony between interlocuters and this can have negative relational consequences. Our findings are further discussed in the context of cognitive behavioral and interpersonal models of SAD, and clinical and research implications are delineated.

Original languageEnglish
Article number103859
JournalBehaviour Research and Therapy
StatePublished - Jun 2021

Bibliographical note

Funding Information:
Dr. Hofmann receives financial support from the Alexander von Humboldt Foundation (as part of the Humboldt Prize), NIH/NCCIH (R01AT007257), NIH/NIMH (R01MH099021, U01MH108168), and the James S. McDonnell Foundation 21st Century Science Initiative in Understanding Human Cognition – Special Initiative. He receives compensation for his work as editor from SpringerNature and the Association for Psychological Science, and as an advisor from the Palo Alto Health Sciences Otsuka Pharmaceuticals, and for his work as a Subject Matter Expert from John Wiley & Sons, Inc. and SilverCloud Health, Inc. He also receives royalties and payments for his editorial work from various publishers.

Publisher Copyright:
© 2021 Elsevier Ltd


  • Heart-rate
  • Interpersonal processes
  • Social anxiety disorder
  • Synchrony

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Clinical Psychology
  • Psychiatry and Mental health


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