Physiological and Psychological Predictors of Mood and Behavioral Functioning in Patients with Anxiety-Related Disorders

Abstract

Background: Anxiety disorders involve psychological symptoms, physiological arousal, and functional disruption, yet these domains are often examined separately. This study evaluated physiological and psychological predictors of mood disturbance and behavioral functioning in adults with anxiety-related disorders.

Methods: A simulation-based analytical cross-sectional dataset comprising 220 adult patient records was analysed. Physiological indicators included resting heart rate (HR), heart-rate variability indexed by RMSSD (HRV-RMSSD), blood pressure, sleep duration, and daily steps. Psychological variables included anxiety severity (GAD-7), intolerance of uncertainty (IUS-12), and emotion-regulation difficulties (DERS-16). Mood disturbance was indexed by the PHQ-9 and behavioral functioning by the WSAS. Pearson correlations, hierarchical multiple regression, and one-way analysis of variance were used.

Results: GAD-7 was strongly associated with PHQ-9 (r = .692, p < .001) and WSAS (r = .727, p < .001). Lower HRV and shorter sleep duration were also associated with higher anxiety, mood disturbance, and functional impairment. In the fully adjusted mood model, shorter sleep (β = -.144, p = .013), GAD-7 (β = .369, p < .001), and DERS-16 (β = .239, p < .001) remained significant; the model explained 55.4% of PHQ-9 variance. For WSAS, GAD-7 was the only significant independent predictor (β = .540, p < .001), and the final model explained 55.8% of variance. Resting HR was highest in panic disorder, while IUS-12 scores were highest in generalized anxiety disorder.