Recent studies suggest that ruminative thoughts may be mediators of the prolonged physiological effects of stress. We hypothesized that autonomic dysregulation plays a role in the relation between rumination and health. Rumination was induced by an anger–recall task in 45 healthy subjects. Heart rate variability (HRV), baroreflex sensitivity (BRS), and baroreflex effectiveness index (BEI) change scores were evaluated to obtain the autonomic phenotype of rumination. Personality traits and endothelial activation were examined for their relation to autonomic responses during rumination. Degree of endothelial activation was assessed by circulating soluble intercellular adhesion molecule-1 (sICAM-1). Vagal withdrawal during rumination was greater for women than men. Larger decreases in the high frequency component of HRV were associated with higher levels of anger-in, depression, and sICAM-1 levels. BRS reactivity was negatively related to trait anxiety. BEI reactivity was positively related to anger-in, hostility, anxiety, and depression. Lower BEI and BRS recovery were associated with lower social desirability and higher anger-out, anxiety, and depression. Findings suggest that the autonomic dysregulation that characterizes rumination plays a role in the relationships between personality and cardiovascular health.
Recent research has highlighted the importance of the emotional nature of laboratory tasks in the study of cardiovascular reactivity (Linden and Rutledge, 1998). Glynn et al. (2002) found that the emotional vs. nonemotional nature of a task affected the cardiovascular response during and after the task. Only stressors with an emotional component, as assessed by poststress self-reports, have been associated with blood pressure (BP) elevations and delayed recovery, and the effects are independent of the original reactivity evoked by the task.
Personally-relevant recall tasks were found to be associated with more pronounced cardiovascular activation than other emotional tasks (Merritt et al., 2006), such as the viewing of film clips of higher emotional valence (Waldstein et al., 2000). Moreover, tasks evoking negative affect have been associated with the highest cardiovascular effects (Brosschot and Thayer, 2003). In fact, although immediate physiological responses to positive and negative emotional events may be of the same magnitude, physiological responses that follow negative events have a longer duration (Brosschot and Thayer, 1998, Linden et al., 1997 and Neumann et al., 2001). Laboratory results are consistent with ambulatory research supporting the notion that the greater the intensity of the negative emotional state the greater the cardiovascular effects (Shapiro et al., 2001).
The Anger Recall Interview is an effective tool for evaluating the accompanying physiological effects of a negative emotional event long after its occurrence (Ironson et al., 1992). Tasks requiring vocalization, however, pose methodological issues in the evaluation of autonomic responses (Suarez et al., 2004); for example, Girdler et al. (1990) found significant hemodynamic increases elicited by vocalization alone in the absence of emotional content. To avoid this confounding factor, the present study used a non-verbal version of the anger recall task (Ottaviani et al., 2006). The task required participants to “ruminate” on causes and consequences of a recalled episode in which they felt intense anger or rage. The potency of simply thinking about an anger-provoking event in determining cardiovascular activation has been previously demonstrated (Waldstein et al., 2000). Embodied cognition theories provide evidence that active thought simulates the affective properties of concepts in the emotional system; for example, the embodiment of anger might involve tension in muscles used to strike, innervation of certain facial muscles to form a scowl, and increases in blood pressure and peripheral resistance (Niedenthal, 2007).
“Rumination” is the theoretical construct commonly used to characterize the cognitions and negative affect evoked by stressful or anger-provoking events (Rusting and Nolen-Hoeksema, 1998). Gerin et al. (2006) suggested that prolonged anger may promote ruminative thoughts, and increased autonomic arousal may prolong anger, with these two processes operating as a feed-forward process. This hypothesis is consistent with the findings of slower recovery following an emotional stressor (e.g., Glynn et al., 2002). Moreover, the availability of a distracter after anger provocation has been shown to reduce the negative effects of rumination on recovery (Rusting and Nolen-Hoeksema, 1998 and Schwartz et al., 2000).
