The psychological costs of behavioral immunity following COVID-19 diagnosis.

Prior COVID-19 infection may elevate activity of the behavioral immune system-the psychological mechanisms that foster avoidance of infection cues-to protect the individual from contracting the infection in the future. Such "adaptive behavioral immunity" may come with psychological costs, such as exacerbating the global pandemic's disruption of social and emotional processes (i.e., pandemic disruption). To investigate that idea, we tested a mediational pathway linking prior COVID infection and pandemic disruption through behavioral immunity markers, assessed with subjective emotional ratings. This was tested in a sample of 734 Mechanical Turk workers who completed study procedures online during the global pandemic (September 2021-January 2022). Behavioral immunity markers were estimated with an affective image rating paradigm. Here, participants reported experienced disgust/fear and appraisals of sickness/harm risk to images varying in emotional content. Participants self-reported on their previous COVID-19 diagnosis history and level of pandemic disruption. The findings support the proposed mediational pathway and suggest that a prior COVID-19 infection is associated with broadly elevated threat emotionality, even to neutral stimuli that do not typically elicit threat emotions. This elevated threat emotionality was in turn related to disrupted socioemotional functioning within the pandemic context. These findings inform the psychological mechanisms that might predispose COVID survivors to mental health difficulties.

Anticipatory cardiac deceleration estimates cognitive performance in virtual reality beyond tonic heart period and heart period variability.

Anticipatory cardiac deceleration is the lengthening of heart period before an expected event. It appears to reflect preparation that supports rapid action. The current study sought to bolster anticipatory deceleration as a practical and unique estimator of performance efficiency. To this end, we examined relationships between deceleration and virtual reality performance under low and high time pressure. Importantly, we investigated whether deceleration separately estimates performance beyond basal heart period and basal high-frequency heart rate variability (other vagally influenced metrics related to cognition). Thirty participants completed an immersive virtual reality (VR) cognitive performance task across six longitudinal sessions. Anticipatory deceleration and basal heart period/heart period variability were quantified from electrocardiography collected during pre-task anticipatory countdowns and baseline periods, respectively. At the between-person level, we found that greater anticipatory declaration was related to superior accuracy and faster response times (RT). The relation between deceleration and accuracy was stronger under high relative to low time pressure, when good performance requires greater efficiency. Findings for heart period and heart period variability largely converge with the prior literature, but importantly, were statistically separate from deceleration effects on performance. Lastly, deceleration effects were detected using anticipatory periods that are more practical (shorter and more intermittent) than those typically employed. Taken together, findings suggest that anticipatory deceleration is a unique and practical correlate of cognitive-motor efficiency apart from heart period and heart period variability in virtual reality.

Neural and behavioral adaptations to frontal theta neurofeedback training: A proof of concept study.

Previous neurofeedback research has shown training-related frontal theta increases and performance improvements on some executive tasks in real feedback versus sham control groups. However, typical sham control groups receive false or non-contingent feedback, making it difficult to know whether observed differences between groups are associated with accurate contingent feedback or other cognitive mechanisms (motivation, control strategies, attentional engagement, fatigue, etc.). To address this question, we investigated differences between two frontal theta training groups, each receiving accurate contingent feedback, but with different top-down goals: (1) increase and (2) alternate increase/decrease. We hypothesized that the increase group would exhibit greater increases in frontal theta compared to the alternate group, which would exhibit lower frontal theta during down- versus up-modulation blocks over sessions. We also hypothesized that the alternate group would exhibit greater performance improvements on a Go-NoGo shooting task requiring alterations in behavioral activation and inhibition, as the alternate group would be trained with greater task specificity, suggesting that receiving accurate contingent feedback may be the more salient learning mechanism underlying frontal theta neurofeedback training gains. Thirty young healthy volunteers were randomly assigned to increase or alternate groups. Training consisted of an orientation session, five neurofeedback training sessions (six blocks of six 30-s trials of FCz theta modulation (4-7 Hz) separated by 10-s rest intervals), and six Go-NoGo testing sessions (four blocks of 90 trials in both Low and High time-stress conditions). Multilevel modeling revealed greater frontal theta increases in the alternate group over training sessions. Further, Go-NoGo task performance increased at a greater rate in the increase group (accuracy and reaction time, but not commission errors). Overall, these results reject our hypotheses and suggest that changes in frontal theta and performance outcomes were not explained by reinforcement learning afforded by accurate contingent feedback. We discuss our findings in terms of alternative conceptual and methodological considerations, as well as limitations of this research.

Cardiac timing and threatening stimuli influence response inhibition and ex-Gaussian parameters of reaction time in a Go/No-go task.

Sensorimotor responses vary as a function of the cardiac cycle phase. These effects, known as cardiac cycle time effects, have been explained by the inhibition of cardiac afferent signals on information processing. However, the validity of cardiac cycle time effects is challenged by mixed findings. Factors such as current information processing and affective context may modulate cardiac cycle time effects and account for inconsistencies in the literature. The current study examines the influence of cardiac cycle time and threatening stimuli on two aspects of sensorimotor processing, response speed and inhibition. Thirty-four participants (Mage  = 19.35 years; 29 female) completed an auditory Go/No-go task in no face, neutral face, and fearful face conditions. Faces were presented at either cardiac diastole or systole. Participants' reaction times (RTs) during Go trials and failures in response inhibition during No-go trials were recorded. The ex-Gaussian model was fit to RT data in each condition deriving the parameters, mu (µ) and tau (τ), that indicate response speed and attentional lapses, respectively. Repeated measures ANOVA were used to analyze behavioral data. Results showed that cardiac systole prolonged µ but decreased τ, and that cardiac diastole reduced inhibition errors in the fearful face condition but not in other conditions. These findings indicate that cardiac timing differentially modulates sensory-perceptual and top-down attentional processes and cardiac timing interacts with threatening contexts to influence response inhibition. These results highlight the specificity of cardiac cycle time effects on sensorimotor processing.

Unraveling the cognitive correlates of heart rate variability with the drift diffusion model.

The Neurovisceral Integration Model posits a link between resting vagally mediated heart rate variability (vmHRV) and cognitive control. Empirical support for this link is mixed, potentially due to coarse performance metrics such as mean response time (RT). To clarify this issue, we tested the relationships between resting vmHRV and refined estimates of cognitive control- as revealed by the ex-Gaussian model of RT and, to a greater extent, the drift diffusion model (DDM, a computational model of two-choice performance). Participants (N = 174) completed a five-minute resting baseline while ECG was collected followed by a Simon spatial conflict task. The root mean square of successive differences in interbeat intervals was calculated to index resting vmHRV. Resting vmHRV was unrelated to Simon mean RT and accuracy rates, but was inversely related to the ex-Gaussian parameter reflecting slow RTs (tau); however, this finding was attenuated after adjustment for covariates. High resting vmHRV was related to faster drift rates and slower non-decision times, DDM parameters reflecting goal-directed cognition and sensorimotor processes, respectively. The DDM effects survived covariate adjustment and were specific to incongruent trials (i.e., when cognitive control demands were high). Findings suggest a link between vmHRV and cognitive control vis-a-vis drift rate, and potentially, a link between vmHRV and motoric inhibition vis-a-vis non-decision time. These cognitive correlates would have been missed with reliance on traditional performance. Findings are discussed with respect to the inhibitory processes that promote effective performance in high vmHRV individuals.

A physiological and dynamical systems model of stress.

Stress responses vary drastically for a given set of stimuli, individuals, or points in time. A potential source of this variance that is not well characterized arises from the theory of stress as a dynamical system, which implies a complex, nonlinear relationship between environmental/situational inputs and the development/experience of stress. In this framework, stress vs. non-stress states exist as attractor basins in a physiologic phase space. Here, we develop a model of stress as a dynamical system by coupling closed loop physiologic control to a dynamic oscillator in an attractor landscape. By characterizing the evolution of this model through phase space, we demonstrate strong sensitivity to the parameters controlling the dynamics and demonstrate multiple features of stress responses found in current research, implying that these parameters may contribute to a significant source of variability observed in empiric stress research.

Gender Matters: Nonlinear Relationships Between Heart Rate Variability and Depression and Positive Affect.

Vagally mediated heart rate variability (vmHRV), a measure of the parasympathetic nervous system's control over the heart, is often negatively related to maladaptive emotional outcomes. Recent work suggests that quadratic relationships involving these factors may be present; however, research has not investigated gender differences in these nonlinear functions. To address this gap, the current study tested for quadratic relationships between resting vmHRV and depression and positive affect while investigating gender differences in these relationships. Significant quadratic effects were found between resting vmHRV and reports of both depression symptoms and positive affect in women but not men. Specifically, the lowest levels of depression and the highest levels of positive affect were found at moderate vmHRV in women. These results suggest that examinations of vmHRV's nonlinear associations require the consideration of gender. Our findings are interpreted based on proposed differential neuropsychological mechanisms of vmHRV in men versus women.

Resting heart rate variability modulates the effects of concurrent working memory load on affective startle modification.

Vagally mediated heart rate variability (vmHRV) is thought to index top-down control processes in emotion regulation. According to the Generalized Unsafety Theory of Stress (GUTS), resting vmHRV indexes top-down resources that are needed to inhibit subcortical threat circuits, which is important for context-appropriate affective responding. Although this notion has been supported by studies of affective startle (SR) modification, direct evidence that top-down resources are the linking mechanism between vmHRV and context-appropriate affective responding has been lacking. To investigate this possible mechanism, college-aged participants (n = 92) were recruited to complete a picture viewing task and a concurrent working memory (WM) task. Concurrent WM load was manipulated, and the auditory SR stimulus was delivered while viewing affective pictures. Electrocardiography and electromyography were recorded to assess vmHRV and SR eyeblink, respectively. Results showed that WM load attenuated affective SR modification. As expected, the attenuating effects of load on affective SR modification were stronger among low vmHRV relative to high vmHRV individuals, indicating that vmHRV is linked to context-appropriate affective responding through the mechanism of top-down resources. These results support the GUTS and suggest that atypical affective responding among low vmHRV individuals is attributed to the lack of WM resources. Our findings highlight the relation between vmHRV and top-down resources that have been implicated in emotion regulation and contribute to a better understanding of emotion dysregulation in psychopathology.

Interplay between state anxiety, heart rate variability, and cognition: An ex-Gaussian analysis of response times.

The present study employed an ex-Gaussian model of response times (RTs) to elucidate the cognitive processes related to experimentally induced state anxiety (SA) and vagally mediated heart rate variability (vmHRV), an indicator of adaptive responses in both cognitive and affective domains. Participants (n = 110) completed a dual task composed of (i) a flanker attention and (2) working memory load task, while SA was induced by threat of noise. Electrocardiography was measured during the dual task and during four baseline periods in order to calculate vmHRV. RTs on the flanker task were fit to an ex-Gaussian distribution, which estimated three RT parameters: mu (Gaussian mean), sigma (Gaussian SD), and tau (combination of exponential mean and SD). First, findings indicate that threat of noise was associated with reductions in mu and tau, suggesting that SA might improve attention and motor responding. Second, higher resting vmHRV was associated with lower tau (averaged across conditions) and stronger threat-related decreases in tau. Third, intra-individual decreases in vmHRV were accompanied by concomitant decreases in tau. These findings support roles for trait and state vagal control in guiding adaptive anxiety-related (and anxiety-unrelated) attentional responses. Findings are consistent with extant theories that emphasize functional interrelations among emotion, cognition, and vagal function.

Vagal Flexibility Mediates the Association Between Resting Vagal Activity and Cognitive Performance Stability Across Varying Socioemotional Demands.

Vagal flexibility describes the ability to modulate cardiac vagal responses to fit a dynamic range of challenges. Extant theory on vagal function implies that vagal flexibility is a mediating mechanism through which resting vagal activity, a putative individual difference related to self-regulation, affects adaptive behavior and cognition. Nevertheless, little research has directly tested this hypothesis, thereby leaving fundamental mechanisms of vagal function and adaptability unclear. To this end, 47 healthy subjects completed a 5 min baseline followed by Stroop tasks combined with concurrent auditory distractors. There were four different Stroop task conditions that varied the social and emotional content of the auditory distractors. Electrocardiogram was continuously recorded to assess vagal responses to each condition as heart rate variability [root mean square of successive differences (RMSSDs)] reactivity. Vagal flexibility significantly mediated the association between resting vagal activity and stability of inhibition performance (Stroop interference) scores. In particular, higher resting RMSSD was related to higher standard deviation of RMSSD reactivity scores, reflecting greater differences in RMSSD reactivity between distractor conditions (i.e., greater vagal flexibility). Greater vagal flexibility was in turn related to more stability in Stroop interference across the same conditions. The mean of RMSSD reactivity scores across conditions was not significantly related to resting RMSSD or stability in Stroop performance, and mean RMSSD reactivity did not mediate relations between resting RMSSD and stability in Stroop performance. Overall, findings suggest that vagal flexibility may promote the effects of resting vagal activity on stabilizing cognitive inhibition in the face of environmental perturbations.

Physiological feelings.

The role of peripheral physiology in the experience of emotion has been debated since the 19th century following the seminal proposal by William James that somatic responses to stimuli determine subjective emotion. Subsequent views have integrated the forebrain's ability to initiate, represent and simulate such physiological events. Modern affective neuroscience envisions an interacting network of "bottom-up" and "top-down" signaling in which the peripheral (PNS) and central nervous systems both receive and generate the experience of emotion. "Feelings" serves as a term for the perception of these physical changes whether emanating from actual somatic events or from the brain's representation of such. "Interoception" has come to represent the brain's receipt and representation of these actual and "virtual" somatic changes that may or may not enter conscious awareness but, nonetheless, influence feelings. Such information can originate from diverse sources including endocrine, immune and gastrointestinal systems as well as the PNS. We here examine physiological feelings from diverse perspectives including current and historical theories, evolution, neuroanatomy and physiology, development, regulatory processes, pathology and linguistics.

Linking Emotional Reactivity Between Laboratory Tasks and Immersive Environments Using Behavior and Physiology.

An event or experience can induce different emotional responses between individuals, including strong variability based on task parameters or environmental context. Physiological correlates of emotional reactivity, as well as related constructs of stress and anxiety, have been found across many physiological metrics, including heart rate and brain activity. However, the interdependances and interactions across contexts and between physiological systems are not well understood. Here, we recruited military and law enforcement to complete two experimental sessions across two different days. In the laboratory session, participants viewed high-arousal negative images while brain activity electroencephalogram (EEG) was recorded from the scalp, and functional connectivity was computed during the task and used as a predictor of emotional response during the other experimental session. In an immersive simulation session, participants performed a shoot-don't-shoot scenario while heart rate electrocardiography (ECG) was recorded. Our analysis examined the relationship between the sessions, including behavioral responses (emotional intensity ratings, task performance, and self-report anxiety) and physiology from different modalities [brain connectivity and heart rate variability (HRV)]. Results replicated previous research and found that behavioral performance was modulated within-session based on varying levels of emotional intensity in the laboratory session (t (24) = 4.062, p < 0.0005) and stress level in the simulation session (Z = 2.45, corrected p-value = 0.0142). Both behavior and physiology demonstrated cross-session relationships. Behaviorally, higher intensity ratings in the laboratory was related to higher self-report anxiety in the immersive simulation during low-stress (r = 0.465, N = 25, p = 0.019) and high-stress (r = 0.400, N = 25, p = 0.047) conditions. Physiologically, brain connectivity in the theta band during the laboratory session significantly predicted low-frequency HRV in the simulation session (p < 0.05); furthermore, a frontoparietal connection accounted for emotional intensity ratings during the attend laboratory condition (r = 0.486, p = 0.011) and self-report anxiety after the high-stress simulation condition (r = 0.389, p = 0.035). Interestingly, the predictive power of the brain activity occurred only for the conditions where participants had higher levels of emotional reactivity, stress, or anxiety. Taken together, our findings describe an integrated behavioral and physiological characterization of emotional reactivity.

Sex moderates the relationship between resting heart rate variability and self-reported difficulties in emotion regulation.

Lower resting vagally mediated heart rate variability (HRV) is thought to reflect poorer function of the neurophysiological pathways underlying emotion regulation (ER) and thus, poorer ER abilities. Sex differences in resting HRV exists such that women typically exhibit higher resting HRV than men. It is proposed that greater HRV in women reflects compensation for greater negative affect such as anxiety and depression. However, research has not yet investigated how the association between resting HRV and every day perceived difficulties in ER may be moderated by sex. The current study sought to test this in a sample of 362 young participants (207 females, mean age of 19). Resting HRV was assessed during a 5-min baseline period using an electrocardiogram. Participants then completed the 36-item Difficulties in Emotion Regulation Scale (DERS) designed to evaluate participant's daily difficulties in ER. Controlling for several covariates, sex significantly moderated the relationship between resting HRV and ER difficulties, such that women showed a much stronger relationship compared with men. Specifically, women with lower HRV reported greater difficulties in ER compared with men with lower HRV, whereas women with higher HRV reported slightly lesser difficulties in ER compared with all men. Overall, this study supports a deeper understanding of how neurophysiological differences in ER between men and women-as indexed by resting HRV-may contribute to how effectively individuals regulate their emotions on a day-to-day basis, with implications for well-being. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Body mass index and parasympathetic nervous system reactivity and recovery following graded exercise.

OBJECTIVES: The present study sought to expand upon prior investigations examining patterns of vagally mediated heart rate variability (vmHRV) and perceived exertion as a function of body mass index (BMI) in response to and recovery from exercise. METHODS: Participants underwent a resting (baseline) period, followed by a graded exercise protocol on an ergometer with ascending difficulty stages, and finally another resting (recovery) period. Individuals were stratified into three BMI groups: low, moderate, and high. RESULTS: Individuals in the high BMI group exhibited a significantly greater decrease in vmHRV from baseline to graded exercise in comparison to the moderate BMI group. Individuals in the high BMI group also showed significantly lower vmHRV at recovery compared with baseline than individuals with moderate BMI; indicating that the high BMI group's vmHRV did not recover to the degree of those in the moderate BMI group. No significant results regarding vmHRV were found in the low BMI group. Of note, BMI and perceived exertion during the recovery period were positively associated. Results also showed a significant negative association between vmHRV and perceived exertion at each grade of exercise. There was no significant association between vmHRV and perceived exertion during baseline or recovery. CONCLUSIONS: This report extends prior research studying BMI and patterns of vmHRV reactivity in the domain of physical exercise. Our data contribute to previous reports suggesting that high BMI can lead to maladaptive patterns of vmHRV reactivity to and recovery from physical exercise.

Intra-Individual Variability in Vagal Control Is Associated With Response Inhibition Under Stress.

Dynamic intra-individual variability (IIV) in cardiac vagal control across multiple situations is believed to contribute to adaptive cognition under stress; however, a dearth of research has empirically tested this notion. To this end, we examined 25 U.S. Army Soldiers (all male, mean age = 30.73, standard deviation (SD) = 7.71) whose high-frequency heart rate variability (HF-HRV) was measured during a resting baseline and during three conditions of a shooting task (training, low stress, high stress). Response inhibition was measured as the correct rejection (CR) of friendly targets during the low and high stress conditions. We tested the association between the SD of HF-HRV across all four task conditions (IIV in vagal control) and changes in response inhibition between low and high stress. Greater differences in vagal control between conditions (larger IIV) were associated with higher tonic vagal control during rest, and stronger stress-related decreases in response inhibition. These results suggest that flexibility in vagal control is supported by tonic vagal control, but this flexibility also uniquely relates to adaptive cognition under stress. Findings are consistent with neurobehavioral and dynamical systems theories of vagal function.

Improving Real-Life Estimates of Emotion Based on Heart Rate: A Perspective on Taking Metabolic Heart Rate Into Account.

Extracting information about emotion from heart rate in real life is challenged by the concurrent effect of physical activity on heart rate caused by metabolic need. "Non-metabolic heart rate," which refers to the heart rate that is caused by factors other than physical activity, may be a more sensitive and more universally applicable correlate of emotion than heart rate itself. The aim of the present article is to explore the evidence that non-metabolic heart rate, as it has been determined up until now, indeed reflects emotion. We focus on methods using accelerometry since these sensors are readily available in devices suitable for daily life usage. The evidence that non-metabolic heart rate as determined by existing methods reflect emotion is limited. Alternative possible routes are explored. We conclude that for real-life cases, estimating the type and intensity of activities based on accelerometry (and other information), and in turn use those to determine the non-metabolic heart rate for emotion is most promising.

Different profiles of decision making and physiology under varying levels of stress in trained military personnel.

Decision making is one of the most vital processes we use every day, ranging from mundane decisions about what to eat to life-threatening choices such as how to avoid a car collision. Thus, the context in which our decisions are made is critical, and our physiology enables adaptive responses that account for how environmental stress influences our performance. The relationship between stress and decision making can additionally be affected by one's expertise in making decisions in high-threat environments, where experts can develop an adaptive response that mitigates the negative impacts of stress. In the present study, 26 male military personnel made friend/foe discriminations in an environment where we manipulated the level of stress. In the high-stress condition, participants received a shock when they incorrectly shot a friend or missed shooting a foe; in the low-stress condition, participants received a vibration for an incorrect decision. We characterized performance using signal detection theory to investigate whether a participant changed their decision criterion to avoid making an error. Results showed that under high-stress, participants made more false alarms, mistaking friends as foes, and this co-occurred with increased high frequency heart rate variability. Finally, we examined the relationship between decision making and physiology, and found that participants exhibited adaptive behavioral and physiological profiles under different stress levels. We interpret this adaptive profile as a marker of an expert's ingrained training that does not require top down control, suggesting a way that expert training in high-stress environments helps to buffer negative impacts of stress on performance.

Resting heart rate variability is associated with ex-Gaussian metrics of intra-individual reaction time variability.

The relationships between vagally mediated heart rate variability (vmHRV) and the cognitive mechanisms underlying performance can be elucidated with ex-Gaussian modeling-an approach that quantifies two different forms of intra-individual variability (IIV) in reaction time (RT). To this end, the current study examined relations of resting vmHRV to whole-distribution and ex-Gaussian IIV. Subjects (N = 83) completed a 5-minute baseline while vmHRV (root mean square of successive differences; RMSSD) was measured. Ex-Gaussian (sigma, tau) and whole-distribution (standard deviation) estimates of IIV were derived from reaction times on a Stroop task. Resting vmHRV was found to be inversely related to tau (exponential IIV) but not to sigma (Gaussian IIV) or the whole-distribution standard deviation of RTs. Findings suggest that individuals with high vmHRV can better prevent attentional lapses but not difficulties with motor control. These findings inform the differential relationships of cardiac vagal control to the cognitive processes underlying human performance.

Resting Heart Rate Variability, Facets of Rumination and Trait Anxiety: Implications for the Perseverative Cognition Hypothesis.

The perseverative cognition hypothesis (PCH) posits that perseveration, defined as the repetitive or sustained activation of cognitive representations of a real or imagined stressor, is a primary mechanism linking psychological (or stress) vulnerability with poor health and disease. Resting vagally mediated heart rate variability (vmHRV) is an important indicator of self-regulatory abilities, stress vulnerability and overall health. Those with lower resting vmHRV are more vulnerable to stress, and thus more likely to engage in perseverative cognition and experience subsequent negative mental health outcomes such as anxiety. Recent research suggests that rumination-one of the core mechanisms underlying perseveration-is a construct containing (at least) two maladaptive (depressive and brooding) and one adaptive (reflective) types of rumination. However, to date, research has not examined how the association between resting vmHRV may differ between these three facets of rumination, in addition to these facets' mechanistic role in linking lower resting vmHRV with greater trait anxiety. The current cross-sectional study explores these relationships in a sample of 203 participants (112 females, 76 ethnic minorities, mean age = 19.43, standard deviation = 1.87). Resting vmHRV was assessed during a 5-min-resting period using an Electrocardiogram (ECG). Both trait rumination (including the three facets) and anxiety were assessed via self-report scales. Significant negative associations were found between resting vmHRV and maladaptive, but not adaptive, forms of perseveration. Similarly, mediation analyses showed a significant indirect relationship between resting vmHRV and anxiety through maladaptive, but not adaptive, facets of rumination. Our findings support the PCH such that those with stress vulnerability, as indexed by lower resting vmHRV, are more likely to engage in maladaptive perseverative cognition and thus experience negative outcomes such as anxiety. Our data also lend a novel outlook on the PCH; resting vmHRV is not related to reflective rumination and thus, this facet of perseveration may be a neutral, but not beneficial, factor in the link between stress vulnerability and psychological well-being.

A Little Goes a Long Way: Low Working Memory Load Is Associated with Optimal Distractor Inhibition and Increased Vagal Control under Anxiety.

Anxiety impairs both inhibition of distraction and attentional focus. It is unclear whether these impairments are reduced or exacerbated when loading working memory with non-affective information. Cardiac vagal control has been related to top-down regulation of anxiety; therefore, vagal control may reflect load-related inhibition of distraction under anxiety. The present study examined whether: (1) the enhancing and impairing effects of load on inhibition exist together in a non-linear function, (2) there is a similar association between inhibition and concurrent vagal control under anxiety. During anxiogenic threat-of-noise, 116 subjects maintained a digit series of varying lengths (0, 2, 4, and 6 digits) while completing a visual flanker task. The task was broken into four blocks, with a baseline period preceding each. Electrocardiography was acquired throughout to quantify vagal control as high-frequency heart rate variability (HRV). There were significant quadratic relations of working memory load to flanker performance and to HRV, but no associations between HRV and performance. Results indicate that low load was associated with relatively better inhibition and increased HRV. These findings suggest that attentional performance under anxiety depends on the availability of working memory resources, which might be reflected by vagal control. These results have implications for treating anxiety disorders, in which regulation of anxiety can be optimized for attentional focus.