The Effect of Diaphragmatic Breathing on Stress Caused By a Socially Stressful Paradigm on Young Adult Males with Autism Spectrum Disorder

Background:  

One of the hallmarks of Autism Spectrum Disorder (ASD) is difficulty with social interactions and forming appropriate social relationships. ASD is often comorbid with social anxiety and those with ASD report higher levels of stress in social situations. Therefore, one predominate theory is that the social deficit seen in individuals with ASD is due to an increased anxiety associated with social interactions. Anxiety in those diagnosed with ASD is of considerable concern because frequent elevated levels of cortisol associated with stress and anxiety can negatively affect brain development and general health.

Diaphragmatic breathing (DB) techniques have consistently been shown to improve self-reported anxiety and associated autonomic cardiac responses. Furthermore, research has shown that these techniques have successfully lowered the stress response in other populations diagnosed with mental health disorders

Objectives:  

The goal of this study was to investigate whether DB techniques would be useful in decreasing stress in young adult males with ASD following a socially stressful paradigm. 

Methods:

Participants for this study were 26 males (M_age = 21.1) including participants with an ASD diagnosis (n_ASD = 16) and participants without an ASD diagnosis (n_non-ASD = 10). Heart rate variability (HRV) for all participants was measured during baseline, a socially stressful activity, and recovery periods as a biomarker of autonomic nervous system response linked with emotional stress. The baseline period consisted of participants sitting quietly. The activity period consisted of participants taking part in The Talking, Feeling, and Doing Game^® with two confederates. In order to induce a socially stressful paradigm, confederates were instructed prior to the session not to provide the participant any social feedback while playing the game. During the recovery period, participants were randomly selected into one of two conditions (DB or control conditions). Participants in the DB condition were coached through a DB exercise paced at 6-10 breaths per minute. Participants in the control condition were instructed to sit quietly. The associated stress response was evaluated through statistical analyses of the HRV parameters measured at the three data points.

Results:  

Period (baseline, activity, recovery) x condition (DB, control) repeated measures ANOVAs were conducted analyzing high frequency: low frequency (HF:LF) HRV for the ASD and non-ASD groups separately. There was a significant main effect of condition (F(1,14) = 6.84, p<.02) on HRV for the ASD group.

Independent samples t-tests for the ASD participants indicated that HF:LF HRV did not differ between the DB and control conditions during baseline or activity periods (all p>.43). However, the DB group had a significantly lower HF:LF HRV (M_DB = -0.04, SD_DB = 0.02) than the control group (M_control = 0.92, SD_control = 0.39; t(16) = -0.74, p<.001) during the recovery period.    

Conclusions:  

Results reveal that DB successfully decreased stress as measured by HRV in a socially stressful paradigm in young adult males with ASD compared to controls (non-DB). These results indicate that DB may be a beneficial technique to decrease stress related to social anxiety for those with ASD.