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Body awareness disorders and reactivity are mentioned across a range of clinical problems. Constitutional differences in the control of the bodily state are thought to generate a vulnerability to psychological symptoms. Autonomic nervous system dysfunctions have been associated with anxiety, depression, and post-traumatic stress. Though interoception may be a transdiagnostic mechanism promoting the improvement of clinical symptomatology, few psychometrically sound, symptom-independent, self-report measures, informed by brain–body circuits, are available for research and clinical use. We validated the Italian version of the body perception questionnaire (BPQ)—short form and found that response categories could be collapsed from five to three and that the questionnaire retained a three-factor structure with items reduced from 46 to 22 (BPQ-22). The first factor was loaded by body awareness items; the second factor comprised some items from the body awareness scale and some from the subdiaphragmatic reactivity scale (but all related to bloating and digestive issues), and the third factor by supradiaphragmatic reactivity items. The BPQ-22 had sound psychometric properties, good convergent and discriminant validity and test–retest reliability and could be used in clinical and research settings in which the body perception assessment is of interest. Psychometric findings in light of the polyvagal theory are discussed.

Yoga therapy is a newly emerging, self-regulating complementary and integrative healthcare (CIH) practice. It is growing in its professionalization, recognition and utilization with a demonstrated commitment to setting practice standards, educational and accreditation standards, and promoting research to support its efficacy for various populations and conditions. However, heterogeneity of practice, poor reporting standards, and lack of a broadly accepted understanding of the neurophysiological mechanisms involved in yoga therapy limits the structuring of testable hypotheses and clinical applications. Current proposed frameworks of yoga-based practices focus on the integration of bottom-up neurophysiological and top-down neurocognitive mechanisms. In addition, it has been proposed that phenomenology and first person ethical inquiry can provide a lens through which yoga therapy is viewed as a process that contributes towards eudaimonic well-being in the experience of pain, illness or disability. In this article we build on these frameworks, and propose a model of yoga therapy that converges with Polyvagal Theory (PVT). PVT links the evolution of the autonomic nervous system to the emergence of prosocial behaviors and posits that the neural platforms supporting social behavior are involved in maintaining health, growth and restoration. This explanatory model which connects neurophysiological patterns of autonomic regulation and expression of emotional and social behavior, is increasingly utilized as a framework for understanding human behavior, stress and illness. Specifically, we describe how PVT can be conceptualized as a neurophysiological counterpart to the yogic concept of the , or qualities of nature. Similar to the neural platforms described in PVT, the provide the foundation from which behavioral, emotional and physical attributes emerge. We describe how these two different yet analogous frameworks-one based in neurophysiology and the other in an ancient wisdom tradition-highlight yoga therapy's promotion of physical, mental and social wellbeing for self-regulation and resilience. This parallel between the neural platforms of PVT and the of yoga is instrumental in creating a translational framework for yoga therapy to align with its philosophical foundations. Consequently, yoga therapy can operate as a distinct practice rather than fitting into an outside model for its utilization in research and clinical contexts.

Polyvagal theory (PVT) offers an integrative model of autonomic regulation that accounts for the evolution, neuroanatomy, and functional organization of the vagus nerve in relation to behavioral and emotional processes. This article revisits PVT by synthesizing its scientific foundations with recent advancements in transcriptomics, neurophysiology, and clinical application. Particular emphasis is placed on the theory's hierarchical model of the autonomic nervous system, the role of the ventral vagal complex in social behavior, and the construct of neuroception—the neural process by which safety and threat are detected without conscious awareness. The discussion incorporates both theoretical refinement and empirical validation while addressing common misconceptions and critiques of the model. In addition to the scientific narrative, the author offers a personal perspective on the intellectual and experiential origins of PVT, illustrating its translational value in clinical and therapeutic settings. By combining rigorous science with experiential insight, this article seeks to advance understanding of the autonomic foundations of social behavior and mental health.

Teaching is a genuinely social and highly demanding task. Drawing on Porges' phylogenetic polyvagal theory with three evolved systems and three associated behavioral responses (social engagement, mobilization, and immobilization), we investigated teachers' heart rate and heart rate variability in social interactions using ambulatory assessments. We continuously measured heart rate and heart rate variability of 42 apparently healthy teachers on a work and leisure day with ambulatory electrocardiogram. We videotaped four consecutive, same-day lectures of each teacher. We trained observers to code student aggression and frontal teaching behaviors in an event sampling procedure with the behavior observation system for analyzing aggressive behavior in school settings. Additionally, perceived teacher-student relationship, social support from other teachers / school management, occupational complaints, and vital exhaustion were assessed by teacher self-reports. Teachers showed an increased heart rate and a decreased heart rate variability on a workday compared to a leisure day, anticipatory stress before classes, as well as insufficient recovery during lunchtime. Observed student aggression and high proportion of frontal teaching were associated with lower heart rate variability, while better perceived teacher-student relationship was correlated with higher heart rate variability. Differently, teachers' psychological strain and heart rate variability were unrelated to each other. Corresponding to polyvagal theory, results suggest that successful social interactions are fundamental for teachers' favorable cardiological reactions.

Respiratory Sinus Arrhythmia (RSA), heart rate, and accuracy and latency of emotion recognition were evaluated in children with autism spectrum disorders (ASD) and typically developing children while viewing videos of faces slowly transitioning from a neutral expression to one of six basic emotions (e.g., anger, disgust, fear, happiness, sadness, and surprise). Children with ASD were slower in emotion recognition and selectively made more errors in detecting anger. ASD children had lower amplitude RSA and faster heart rate. Within the ASD group, children with higher amplitude RSA recognized emotions faster. Less severe ASD symptoms and increased gaze to the eye region in children with ASD were related to more accurate emotion recognition.

The concept of neuroception of psychological safety, rooted in Polyvagal Theory, offers a framework for understanding how individuals perceive safety at a physiological and psychological level. Illness may disrupt this perception and affect bodily regulation, emotional resilience, social connection, and self-compassion. This study aims to explore how experiences of being unwell, across both acute and chronic contexts, affect individuals’ neuroception of psychological safety. Semi-structured interviews were conducted with eleven adult participants aged 20–79, including individuals with both acute and chronic illness experiences. Interview questions were informed by the Neuroception of Psychological Safety and Polyvagal Theory. Data were analysed using reflexive thematic analysis, following Braun and Clarke’s six-step process. Four key themes were identified: dysregulation and the narrowing window of tolerance (reduced emotional resilience and heightened bodily sensitivity); distrust and disappointment (a rupture in bodily and self-trust); responsibility and internalised guilt (moral and emotional burdens around illness and recovery); and illness demands attention and disrupts social connection (withdrawal, emotional depletion, and compromised compassion). Across these themes, participants described a diminished sense of psychological safety when unwell, shaped by both internal physiological changes and altered social dynamics. Illness can profoundly undermine psychological safety by disrupting neurobiological regulation, altering relational engagement, and eroding trust in one’s body and self. These findings highlight the importance of integrating psychological safety principles into models of care, particularly in how individuals experience and recover from illness.

This study investigated the benefits of using a biofeedback intervention programme to train children in controlling their heart rate variability (HRV) through slow-paced breathing in real time. HRV biofeedback interventions focused on showing subjects to breathe such that their HRV numbers rise, improving their self-regulation. The HRV biofeedback intervention, focused on breathing, was conducted with primary education students aged between 7 and 11 years. The programme consisted of five biofeedback sessions, where students were taught to breathe six long and slow pairs of breaths per minute, to increase their HRV. After participation in the programme, students, regardless of gender, increased their HRV in a statistically significant fashion with a large effect, but this effect was not the same for all ages. HRV biofeedback interventions are rarely applied in schools and given the effectiveness of the intervention to improve HRV in children, the applied implications of our results in educational settings are discussed, especially taking into account the children’s ages.

Several studies have suggested a correlation between heart rate variability (HRV), emotion regulation (ER), psychopathological conditions, and cognitive functions in the past two decades. Specifically, recent data seem to support the hypothesis that low-frequency heart rate variability (LF-HRV), an index of sympathetic cardiac control, correlates with worse executive performances, worse ER, and specific psychopathological dimensions. The present work aims to review the previous findings on these topics and integrate them from two main cornerstones of this perspective: Porges’ Polyvagal Theory and Thayer and Lane’s Neurovisceral Integration Model, which are necessary to understand these associations better. For this reason, based on these two approaches, we point out that low HRV is associated with emotional dysregulation, worse cognitive performance, and transversal psychopathological conditions. We report studies that underline the importance of considering the heart-brain relation in order to shed light on the necessity to implement psychophysiology into a broader perspective on emotions, mental health, and good cognitive functioning. This integration is beneficial not only as a theoretical ground from which to start for further research studies but as a starting point for new theoretical perspectives useful in clinical practice.

The aim of this study is to investigate how the schema modes defined in Schema Theory group together and accordingly question the conceptualization of schema modes considering the theories combining evolutionary, neuroscientific, and psychological point of views in psychology literature. It was hypothesized that there would be differences in the categorization and conceptualization of schema modes conceptualized by Schema Theory based on Polyvagal Theory. The sample of the study consists of 2032 participants aged between 18 and 71 years old ( M  = 36.00, SD  = 14.312) who applied to a psychotherapy center in Istanbul working with the approach of Schema Therapy. Short Schema Mode Inventory was applied to the participants. According to the results of the second-order factor analysis, compliant surrenderer, healthy adult, punitive parent, happy child, and detached protector modes were clustered in the first factor. Impulsive child, enraged child, condescending, and easily bored child modes were loaded under the second factor while demanding parent, detached self-soother, and status-seeking modes were loaded under the third factor. When the results were evaluated with respect to Polyvagal Theory, it was determined that the first factor represented the parasympathetic nervous system activation and consisted of schema modes that include surrender, freezing, and socialization responses while the second factor consisting of schema modes related to flight or fight responses represented the sympathetic nervous system activation. Moreover, the third factor consisted of the schema modes of the sympathetic nervous system, which included flight or fight responses with parasympathetic inhibition (vagal brake). The results were discussed in line with the literature.