Heart rate and skin conductance associations with physical aggression, psychopathy, antisocial personality disorder and conduct disorder: An updated meta-analysis

•Resting heart rate remains the best replicated biological correlate of antisocial spectrum behavior.•Physiological measures might be used to differentiate between (and within) types of antisocial spectrum behaviour.•Physiological measures might be used to aid in diagnosing subtypes of mental health disorders.•Effect sizes are largest for the most violent offenders and for psychopathy, but smaller for aggression and antisocial personality disorder. The associations between physiological measures (i.e., heart rate and skin conductance) of autonomic nervous system (ANS) activity and severe antisocial spectrum behavior (AB) were meta-analyzed. We used an exhaustive partitioning of variables relevant to the ANS–AB association and investigated four highly relevant questions (on declining effect sizes, psychopathy subscales, moderators, and ANS measures) that are thought to be transformative for future research on AB. We investigated a broad spectrum of physiological measures (e.g., heart rate (variability), pre-ejection period) in relation to AB. The search date for the current meta-analysis was on January 1st, 2020, includes 101 studies and 769 effect sizes. Results indicate that effect sizes are heterogeneous and bidirectional. The careful partitioning of variables sheds light on the complex associations that were obscured in previous meta-analyses. Effects are largest for the most violent offenders and for psychopathy and are dependent on the experimental tasks used, parameters calculated, and analyses run. Understanding the specificity of physiological reactions may be expedient for differentiating between (and within) types of AB.