Feeling Safe: A Comprehensive Systematic Literature Review of Psychiatric Disorders through the Lens of Polyvagal Theory

Safety on a psychological level is progressively renowned as fundamental to mental health issues andpsychological well-being. The concept of feeling safe based on polyvagal theory, proposed by Stephen Porges(2011), has emerged as a comprehensive structure for understanding the autonomic nervous system's role inregulating social behavior, emotional processing, and physiological reactions. This review aims to explore theapplication of polyvagal theory in the understanding of psychiatric disorders, with a focus on how autonomicnervous system dysregulation influences emotional and behavioral manifestations, thereby contributing to thedevelopment of effective therapeutic interventions aimed at enhancing feelings of safety and well-being in thepatients suffering from psychiatric disorders. The systematic literature review technique based on the PRISMAmodel was used for this purpose. Sources were obtained through PubMed, APA PsycArticles, PLOS, ResearchGate, Google Scholar, and PubMed Central (PMC) database, using different keywords as the primary descriptorand limiting the sources to English-language articles published in the last ten years from 2013 to 2023. Thereview synthesized findings from various studies investigating the association between the polyvagal theoryand psychiatric disorders, including anxiety disorders, depression, psychotic disorders, post-traumatic stressdisorder (PTSD), borderline personality disorder, and childhood disorders including conduct disorder, attentiondeficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD). The results exhibit that individualsuffering from these psychiatric disorders frequently displayed autonomic nervous system dysregulation, asproposed by the polyvagal theory, which seems to be a shared feature in many psychiatric disorders. Thesystematic review highlighted the significance of physiological aspects of mental health and indicates thatinterventions focusing on autonomic regulation may hold the potential to assuage the basic symptoms relevantto psychiatric disorders. Additional research work is defensible to clarify the primary mechanisms and improvethe implication of interventions which are based on polyvagal theory for better clinical outcomes.