Grossman · Biological psychology 2023 · narrative review and theoretical critique · n=?

Fundamental challenges and likely refutations of the five basic premises of the polyvagal theory.

Cited 86 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and theoretical critique without new empirical human data

PubMed 37230290 · doi:10.1016/j.biopsycho.2023.108589 · record verified 2026-08-28

What was done

The author conducted a critical narrative review evaluating the five core premises of polyvagal theory as formulated by Porges, specifically examining assumptions regarding dorsal versus ventral vagal heart-rate regulation, socioemotional behavior links, vagal evolutionary history, and the use of respiratory sinus arrhythmia (RSA) as an index of vagal tone.

What was found

The abstract reports no numerical data. The author argues from existing literature that all five basic premises of polyvagal theory are either untenable or highly implausible, noting that assumptions such as the absence of RSA in reptiles are contradicted by evidence, and that treating RSA as synonymous with cardiac vagal tone is conceptually invalid.

Why it matters

Polyvagal theory is influential in clinical psychology and somatic therapies, but this review highlights major neurophysiological and evolutionary contradictions underlying its core claims.

Limits

This is a theoretical critique and narrative review containing no original empirical measurements, systematic search methodology, or quantitative data.

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