WHY THE POLYVAGAL THEORY IS UNTENABLE An international expert evaluation of the polyvagal theory and commentary upon Porges, S.W. (2025). Polyvagal theory: current status, clinical applications, and future directions. Clin. Neuropsychiatry, 22(3), 169-184.

Grossman P, Ackland GL, Allen AM, Berntson GG, Booth LC, Burghardt GM, Buron J, Dinets V, Doody JS, Dutschmann M, Farmer DG, Fisher JP, Gourine AV, Joyner MJ, Karemaker JM, Khalsa SS, Lakatta EG, Leite CA, Macefield VG, Machado BH, McAllen RM, Menuet C, Mendelowitz D, Moraes DJ, Neuhuber W, Ottaviani MM, Paterson DJ, Paton JF, Pellegrino PR, Ramchandra R, Shanks J, Schwaber JS, Shivkumar K, Spyer KM, Taylor EW, Taylor JA, Wang T, Yao ST, Zucker IH (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Book Volume: 23

Pages Range: 169-184

Journal Issue: 1

DOI: 10.36131/cnfioritieditore20260110

Abstract

Thirty-nine highly acknowledged experts in the areas of the physiology and the evolution of the vagus nerve and of vertebrate social behavior (many whose works have been cited in the polyvagal theory [PVT] literature as supporting the theory) were invited by the first author to participate as co-authors of this article. They were asked to evaluate the PVT and comment upon an overview of the theory written by its author (Porges, 2025a). All those invited, save one, accepted and co-authored the paper. The dissenting scholar was “unfamiliar with the PVT.” This article specifically appraises--based upon the current state of knowledge of autonomic function and vertebrate evolution--several major elements of the PVT, as described in Porges (2025a) and elsewhere. These include: 1) the validity of PVT assumptions that respiratory sinus arrhythmia is a direct measure of the extent of central vagal drive to the heart; 2) PVT characterizations regarding the neuroanatomy and functions of two major brainstem vagal nuclei, the ventrally situated Nucleus Ambiguus and the Dorsal Motor Nucleus of the vagus nerve; 3) PVT assertions regarding the evolution of the vagus nerve; 4) PVT claims about the specificity of mammalian social behavior in relation to nonmammalian vertebrates, and 5) PVT interpretations of earlier seminal physiological literature. All co-authors agree that major tenets of the PVT are not supported by past or current knowledge and, in several instances, are inconsistent with the broader evidence base. Since the topics addressed constitute fundamental premises of the PVT, we conclude that the PVT is untenable, because it is not defensible based on existing neurophysiological and evolutionary evidence. The psychological elements composing the superstructure of the PVT are primarily derived from earlier psychological literature and are neither clarified nor strengthened by PVT constructs that lack evidence. This article does not intend to address alternative explanations about relations between vagal function and psychological processes, although such explanations do exist.

Authors with CRIS profile

Involved external institutions

University of São Paulo / Universidade de São Paulo (USP) Brazil (BR) Ospedale S. Maria della Misericordia / Azienda Ospedaliera di Perugia Italy (IT) University of Oxford United Kingdom (GB) University of California Los Angeles (UCLA) United States (USA) (US) University College London (UCL) United Kingdom (GB) Harvard University United States (USA) (US) Aarhus University Denmark (DK) Thomas Jefferson University Hospitals United States (USA) (US) Queen Mary University of London United Kingdom (GB) Ohio State University United States (USA) (US) The University of Melbourne Australia (AU) Université de Lausanne (UNIL) Switzerland (CH) University of Tennessee (UTK) United States (USA) (US) University of South Florida (USF) United States (USA) (US) Case Western Reserve University United States (USA) (US) Monash University Australia (AU) University of Nebraska Medical Center (UNMC) United States (USA) (US) Mayo Clinic United States (USA) (US) University of Amsterdam Netherlands (NL) The Jane and Terry Semel Institute for Neuroscience and Human Behavior United States (USA) (US) Universidade Federal de São Carlos (UFSCar) / Federal University of São Carlos Brazil (BR) Institut de Neurobiologie de la Méditerranée (Inmed) France (FR) George Washington University (GWU) United States (USA) (US) University of Birmingham United Kingdom (GB) Universitätsspital Basel Switzerland (CH)

How to cite

APA:

Grossman, P., Ackland, G.L., Allen, A.M., Berntson, G.G., Booth, L.C., Burghardt, G.M.,... Zucker, I.H. (2026). WHY THE POLYVAGAL THEORY IS UNTENABLE An international expert evaluation of the polyvagal theory and commentary upon Porges, S.W. (2025). Polyvagal theory: current status, clinical applications, and future directions. Clin. Neuropsychiatry, 22(3), 169-184. Clinical Neuropsychiatry, 23(1), 169-184. https://doi.org/10.36131/cnfioritieditore20260110

MLA:

Grossman, Paul, et al. "WHY THE POLYVAGAL THEORY IS UNTENABLE An international expert evaluation of the polyvagal theory and commentary upon Porges, S.W. (2025). Polyvagal theory: current status, clinical applications, and future directions. Clin. Neuropsychiatry, 22(3), 169-184." Clinical Neuropsychiatry 23.1 (2026): 169-184.

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