When are Worry and Rumination Negatively Associated with Resting Respiratory Sinus Arrhythmia? It Depends: The Moderating Role of Cognitive Reappraisal

Abstract

Recent research has highlighted the importance of testing interactions between adaptive and maladaptive emotion regulation strategies when examining their associations with mental health. However, there has been little work on the interaction between adaptive strategies such as cognitive reappraisal and two forms of repetitive negative thinking (RNT)—worry and rumination. Furthermore, prior research has exclusively relied on self-report measures to assess mental health as the primary outcome and more research is needed to understand the psychophysiological correlates of emotion regulation. To address these limitations, we tested the interaction between cognitive reappraisal and RNT when predicting resting respiratory sinus arrhythmia, which measures heart rate variability across the respiratory cycle and is conceptualized as a transdiagnostic biomarker for psychopathology and emotion regulation capacities. We also predicted depression symptoms as a secondary outcome in an attempt to replicate prior research. In a sample of 233 undergraduates, we found that RNT had a negative association with resting respiratory sinus arrhythmia, but only among participants who reported low levels of cognitive reappraisal use. The effect of RNT on depressive symptoms was not moderated by cognitive reappraisal use. Overall, these results suggest that worry and rumination might have the most detrimental links with physiological functioning when people do not frequently use cognitive reappraisal to regulate affect. This study also underscores the necessity of utilizing psychophysiological measures when modeling interactions between regulatory strategies.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2

Notes

  1. 1.

    Percentages exceed 100% because participants were allowed to identify with more than one ethnicity, if applicable.

  2. 2.

    A similar pattern of results was observed when worry and rumination were entered as individual predictors of resting RSA in separate regression models. Therefore, similar interactive effects were observed when worry and rumination were tested separately or as a composite measure of RNT.

References

  1. Aldao, A., Jazaieri, H., Goldin, P. R., & Gross, J. J. (2014). Adaptive and maladaptive emotion regulation strategies: Interactive effects during CBT for social anxiety disorder. Journal of Anxiety Disorders,28(4), 382–389. https://doi.org/10.1016/j.janxdis.2014.03.005.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Aldao, A., & Nolen-Hoeksema, S. (2012). When are adaptive strategies most predictive of psychopathology? Journal of Abnormal Psychology,121(1), 276–281. https://doi.org/10.1037/a0023598.

    Article  PubMed  Google Scholar 

  3. Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review,30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004.

    Article  PubMed  Google Scholar 

  4. Arditte, K. A., Shaw, A. M., & Timpano, K. R. (2016). Repetitive negative thinking: A transdiagnostic correlate of affective disorders. Journal of Social and Clinical Psychology,35(3), 181–201. https://doi.org/10.1521/jscp.2016.35.3.181.

    Article  Google Scholar 

  5. Beauchaine, T. (2001). Vagal tone, development, and Gray’s motivational theory: Toward an integrated model of autonomic nervous system functioning in psychopathology. Development and Psychopathology,13(2), 183–214. https://doi.org/10.1017/S0954579401002012.

    CAS  Article  PubMed  Google Scholar 

  6. Beauchaine, T. P. (2015). Respiratory sinus arrhythmia: A transdiagnostic biomarker of emotion dysregulation and psychopathology. Current Opinion in Psychology,3, 43–47. https://doi.org/10.1016/j.copsyc.2015.01.017.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Beauchaine, T. P., & Thayer, J. F. (2015). Heart rate variability as a transdiagnostic biomarker of psychopathology. International Journal of Psychophysiology,98(2), 338–350. https://doi.org/10.1016/j.ijpsycho.2015.08.004.

    Article  PubMed  Google Scholar 

  8. Berking, M., & Wupperman, P. (2012). Emotion regulation and mental health: Recent findings, current challenges, and future directions. Current Opinion in Psychiatry,25(2), 128–134. https://doi.org/10.1097/YCO.0b013e3283503669.

    Article  PubMed  Google Scholar 

  9. Berntson, G. G., Thomas Bigger, J., Eckberg, D. L., Grossman, P., Kaufmann, P. G., Malik, M., et al. (1997). Heart rate variability: Origins, methods, and interpretive caveats. Psychophysiology,34(6), 623–648. https://doi.org/10.1111/j.1469-8986.1997.tb02140.x.

    CAS  Article  PubMed  Google Scholar 

  10. Bonanno, G. A., & Burton, C. L. (2013). Regulatory flexibility: An individual differences perspective on coping and emotion regulation. Perspectives on Psychological Science,8(6), 591–612. https://doi.org/10.1177/1745691613504116.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Borkovec, T. (1994). The nature, functions, and origins of worry. In G. C. L. Davey & F. Tallis (Eds.), Worrying: Perspectives on theory, assessment and treatment (pp. 5–33). New York: Wiley.

    Google Scholar 

  12. Borkovec, T. D., Alcaine, O., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 77–108). New York: Guilford Press.

    Google Scholar 

  13. Buhle, J. T., Silvers, J. A., Wager, T. D., Lopez, R., Onyemekwu, C., Kober, H., et al. (2014). Cognitive reappraisal of emotion: A meta-analysis of human neuroimaging studies. Cerebral Cortex,24(11), 2981–2990. https://doi.org/10.1093/cercor/bht154.

    Article  Google Scholar 

  14. Caspi, A., Sugden, K., Moffitt, T. E., Taylor, A., Craig, I. W., Harrington, H., et al. (2003). Influence of life stress on depression: Moderation by a polymorphism in the 5-HTT gene. Science,301(5631), 386–389. https://doi.org/10.1126/science.1083968.

    CAS  Article  PubMed  Google Scholar 

  15. Chalmers, J. A., Quintana, D. S., Abbott, M. J.-A., & Kemp, A. H. (2014). Anxiety disorders are associated with reduced heart rate variability: A meta-analysis. Frontiers in Psychiatry,5, 80. https://doi.org/10.3389/fpsyt.2014.00080.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Davis, M., Montgomery, I., & Wilson, G. (2002). Worry and heart rate variables: Autonomic rigidity under challenge. Journal of Anxiety Disorders,16(6), 639–659. https://doi.org/10.1016/S0887-6185(02)00132-9.

    Article  PubMed  Google Scholar 

  17. Ehring, T., & Watkins, E. R. (2008). Repetitive negative thinking as a transdiagnostic process. International Journal of Cognitive Therapy,1(3), 192–205. https://doi.org/10.1521/ijct.2008.1.3.192.

    Article  Google Scholar 

  18. Ford, B. Q., Mauss, I. B., Troy, A. S., Smolen, A., & Hankin, B. (2014). Emotion regulation moderates the risk associated with the 5-HTT gene and stress in children. Emotion (Washington, DC),14(5), 930–939. https://doi.org/10.1037/a0036835.

    Article  Google Scholar 

  19. Fresco, D. M., Frankel, A. N., Mennin, D. S., Turk, C. L., & Heimberg, R. G. (2002). Distinct and overlapping features of rumination and worry: The relationship of cognitive production to negative affective states. Cognitive Therapy and Research,26(2), 179–188. https://doi.org/10.1023/A:1014517718949.

    Article  Google Scholar 

  20. Gerteis, A. K. S., & Schwerdtfeger, A. R. (2016). When rumination counts: Perceived social support and heart rate variability in daily life. Psychophysiology,53(7), 1034–1043. https://doi.org/10.1111/psyp.12652.

    Article  PubMed  Google Scholar 

  21. Goldin, P. R., McRae, K., Ramel, W., & Gross, J. J. (2008). The neural bases of emotion regulation: Reappraisal and suppression of negative emotion. Biological Psychiatry,63(6), 577–586. https://doi.org/10.1016/j.biopsych.2007.05.031.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Gross, J. J. (1998a). Antecedent- and response-focused emotion regulation: Divergent consequences for experience, expression, and physiology. Journal of Personality and Social Psychology,74(1), 224–237. https://doi.org/10.1037/0022-3514.74.1.224.

    CAS  Article  PubMed  Google Scholar 

  23. Gross, J. J. (1998b). The emerging field of emotion regulation: An integrative review. Review of General Psychology,2(3), 271–299. https://doi.org/10.1037/1089-2680.2.3.271.

    Article  Google Scholar 

  24. Gross, J. J. (2002). Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology,39(3), 281–291. https://doi.org/10.1017/S0048577201393198.

    Article  PubMed  Google Scholar 

  25. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology,85(2), 348–362. https://doi.org/10.1037/0022-3514.85.2.348.

    Article  PubMed  Google Scholar 

  26. Gross, J. J., & Muñoz, R. F. (1995). Emotion regulation and mental health. Clinical Psychology: Science and Practice,2(2), 151–164. https://doi.org/10.1111/j.1468-2850.1995.tb00036.x.

    Article  Google Scholar 

  27. Grossman, P., & Taylor, E. W. (2007). Toward understanding respiratory sinus arrhythmia: Relations to cardiac vagal tone, evolution and biobehavioral functions. Biological Psychology,74(2), 263–285. https://doi.org/10.1016/j.biopsycho.2005.11.014.

    Article  PubMed  Google Scholar 

  28. Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford Publications Inc.

    Google Scholar 

  29. Hofmann, S. G., Heering, S., Sawyer, A. T., & Asnaani, A. (2009). How to handle anxiety: The effects of reappraisal, acceptance, and suppression strategies on anxious arousal. Behaviour Research and Therapy,47(5), 389–394. https://doi.org/10.1016/j.brat.2009.02.010.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Hofmann, S. G., Moscovitch, D. A., Litz, B. T., Kim, H.-J., Davis, L. L., & Pizzagalli, D. A. (2005). The worried mind: Autonomic and prefrontal activation during worrying. Emotion,5(4), 464. https://doi.org/10.1037/1528-3542.5.4.464.

    Article  PubMed  Google Scholar 

  31. Hong, R. Y. (2007). Worry and rumination: Differential associations with anxious and depressive symptoms and coping behavior. Behaviour Research and Therapy,45(2), 277–290. https://doi.org/10.1016/j.brat.2006.03.006.

    Article  PubMed  Google Scholar 

  32. Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., et al. (2010). Research Domain Criteria (RDoC): Toward a new classification framework for research on mental disorders. American Journal of Psychiatry,167(7), 748–751. https://doi.org/10.1176/appi.ajp.2010.09091379.

    Article  PubMed  Google Scholar 

  33. Karg, K., Burmeister, M., Shedden, K., & Sen, S. (2011). The serotonin transporter promoter variant (5-HTTLPR), stress, and depression meta-analysis revisited: Evidence of genetic moderation. Archives of General Psychiatry,68(5), 444–454. https://doi.org/10.1001/archgenpsychiatry.2010.189.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Koenig, J., Kemp, A. H., Beauchaine, T. P., Thayer, J. F., & Kaess, M. (2016). Depression and resting state heart rate variability in children and adolescents: A systematic review and meta-analysis. Clinical Psychology Review,46, 136–150. https://doi.org/10.1016/j.cpr.2016.04.013.

    Article  PubMed  Google Scholar 

  35. Kohl, A., Rief, W., & Glombiewski, J. A. (2012). How effective are acceptance strategies? A meta-analytic review of experimental results. Journal of Behavior Therapy and Experimental Psychiatry,43(4), 988–1001. https://doi.org/10.1016/j.jbtep.2012.03.004.

    Article  PubMed  Google Scholar 

  36. Lieberman, M. D., Inagaki, T. K., Tabibnia, G., & Crockett, M. J. (2011). Subjective responses to emotional stimuli during labeling, reappraisal, and distraction. Emotion,11(3), 468–480. https://doi.org/10.1037/a0023503.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Mauss, I. B., Cook, C. L., Cheng, J. Y. J., & Gross, J. J. (2007). Individual differences in cognitive reappraisal: Experiential and physiological responses to an anger provocation. International Journal of Psychophysiology,66(2), 116–124. https://doi.org/10.1016/j.ijpsycho.2007.03.017.

    Article  PubMed  Google Scholar 

  38. McEvoy, P. M., Watson, H., Watkins, E. R., & Nathan, P. (2013). The relationship between worry, rumination, and comorbidity: Evidence for repetitive negative thinking as a transdiagnostic construct. Journal of Affective Disorders,151(1), 313–320. https://doi.org/10.1016/j.jad.2013.06.014.

    Article  PubMed  Google Scholar 

  39. McMahon, T. P., & Naragon-Gainey, K. (2018). The moderating effect of maladaptive emotion regulation strategies on reappraisal: A daily diary study. Cognitive Therapy and Research. https://doi.org/10.1007/s10608-018-9913-x.

    Article  Google Scholar 

  40. McRae, K., Ciesielski, B., & Gross, J. J. (2012). Unpacking cognitive reappraisal: Goals, tactics, and outcomes. Emotion,12(2), 250–255. https://doi.org/10.1037/a0026351.

    Article  PubMed  Google Scholar 

  41. Mennin, D. S., & Fresco, D. M. (2013). What, me worry and ruminate about DSM-5 and RDoC? The importance of targeting negative self-referential processing. Clinical Psychology: Science and Practice,20(3), 258–267. https://doi.org/10.1111/cpsp.12038.

    Article  Google Scholar 

  42. Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2002). Applying an emotion regulation framework to integrative approaches to generalized anxiety disorder. Clinical Psychology: Science and Practice,9(1), 85–90. https://doi.org/10.1093/clipsy.9.1.85.

    Article  Google Scholar 

  43. Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2005). Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder. Behaviour Research and Therapy,43(10), 1281–1310. https://doi.org/10.1016/j.brat.2004.08.008.

    Article  PubMed  Google Scholar 

  44. Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn state worry questionnaire. Behaviour Research and Therapy,28(6), 487–495. https://doi.org/10.1016/0005-7967(90)90135-6.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  45. Naragon-Gainey, K., McMahon, T. P., & Chacko, T. P. (2017). The structure of common emotion regulation strategies: A meta-analytic examination. Psychological Bulletin,143(4), 384–427. https://doi.org/10.1037/bul0000093.

    Article  PubMed  Google Scholar 

  46. Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology,100(4), 569–582. https://doi.org/10.1037/0021-843X.100.4.569.

    CAS  Article  PubMed  Google Scholar 

  47. Nolen-Hoeksema, S., Wisco, B. E., & Lyubomirsky, S. (2008). Rethinking rumination. Perspectives on Psychological Science,3(5), 400–424. https://doi.org/10.1111/j.1745-6924.2008.00088.x.

    Article  PubMed  Google Scholar 

  48. Ochsner, K. N., Bunge, S. A., Gross, J. J., & Gabrieli, J. D. E. (2002). Rethinking feelings: An fMRI study of the cognitive regulation of emotion. Journal of Cognitive Neuroscience,14(8), 1215–1229. https://doi.org/10.1162/089892902760807212.

    Article  PubMed  Google Scholar 

  49. Pakenham, K. I. (2005). Benefit finding in multiple sclerosis and associations with positive and negative outcomes. Health Psychology,24(2), 123–132. https://doi.org/10.1037/0278-6133.24.2.123.

    Article  PubMed  Google Scholar 

  50. Plate, A. J., Aldao, A., Quintero, J. M., & Mennin, D. S. (2016). Interactions between reappraisal and emotional nonacceptance in psychopathology: Examining disability and depression symptoms in generalized anxiety disorder. Cognitive Therapy and Research,40(6), 733–746. https://doi.org/10.1007/s10608-016-9793-x.

    Article  Google Scholar 

  51. Porges, S. W. (2007). The polyvagal perspective. Biological Psychology,74(2), 116–143. https://doi.org/10.1016/j.biopsycho.2006.06.009.

    Article  PubMed  Google Scholar 

  52. Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement,1(3), 385–401. https://doi.org/10.1177/014662167700100306.

    Article  Google Scholar 

  53. Rottenberg, J. (2007). Cardiac vagal control in depression: A critical analysis. Biological Psychology,74(2), 200–211. https://doi.org/10.1016/j.biopsycho.2005.08.010.

    Article  PubMed  Google Scholar 

  54. Segerstrom, S. C., Tsao, J. C. I., Alden, L. E., & Craske, M. G. (2000). Worry and rumination: Repetitive thought as a concomitant and predictor of negative mood. Cognitive Therapy and Research,24(6), 671–688. https://doi.org/10.1023/A:1005587311498.

    Article  Google Scholar 

  55. Thayer, J. F., Åhs, F., Fredrikson, M., Sollers, J. J., III, & Wager, T. D. (2012). A meta-analysis of heart rate variability and neuroimaging studies: Implications for heart rate variability as a marker of stress and health. Neuroscience & Biobehavioral Reviews,36(2), 747–756. https://doi.org/10.1016/j.neubiorev.2011.11.009.

    Article  Google Scholar 

  56. Thayer, J. F., Hansen, A. L., Saus-Rose, E., & Johnsen, B. H. (2009). Heart rate variability, prefrontal neural function, and cognitive performance: The neurovisceral integration perspective on self-regulation, adaptation, and health. Annals of Behavioral Medicine,37(2), 141–153. https://doi.org/10.1007/s12160-009-9101-z.

    Article  PubMed  Google Scholar 

  57. Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: A psychometric analysis. Cognitive Therapy and Research,27(3), 247–259. https://doi.org/10.1023/A:1023910315561.

    Article  Google Scholar 

  58. Troy, A. S., Wilhelm, F. H., Shallcross, A. J., & Mauss, I. B. (2010). Seeing the silver lining: Cognitive reappraisal ability moderates the relationship between stress and depressive symptoms. Emotion,10(6), 783–795. https://doi.org/10.1037/a0020262.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Watkins, E., Moulds, M., & Mackintosh, B. (2005). Comparisons between rumination and worry in a non-clinical population. Behaviour Research and Therapy,43(12), 1577–1585. https://doi.org/10.1016/j.brat.2004.11.008.

    Article  PubMed  Google Scholar 

  60. Watkins, E. R. (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin,134(2), 163. https://doi.org/10.1037/0033-2909.134.2.163.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Webb, T. L., Miles, E., & Sheeran, P. (2012). Dealing with feeling: A meta-analysis of the effectiveness of strategies derived from the process model of emotion regulation. Psychological Bulletin,138(4), 775–808. https://doi.org/10.1037/a0027600.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Woody, M. L., McGeary, J. E., & Gibb, B. E. (2014). Brooding rumination and heart rate variability in women at high and low risk for depression: Group differences and moderation by COMT genotype. Journal of Abnormal Psychology,123(1), 61–67. https://doi.org/10.1037/a0035450.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Zahn, D., Adams, J., Krohn, J., Wenzel, M., Mann, C. G., Gomille, L. K., et al. (2016). Heart rate variability and self-control—A meta-analysis. Biological psychology,115, 9–26. https://doi.org/10.1016/j.biopsycho.2015.12.007.

    Article  PubMed  Google Scholar 

  64. Zhang, X., Ersner-Hershfield, H., & Fung, H. H. (2010). Age differences in poignancy: Cognitive reappraisal as a moderator. Psychology and Aging,25(2), 310. https://doi.org/10.1037/a0019078.

    Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Andre J. Plate.

Ethics declarations

Conflict of Interest

Andre J. Plate, Emily J. Dunn, Kara Christensen and Amelia Aldao declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Animal Rights

This article does not contain any studies with animals performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Plate, A.J., Dunn, E.J., Christensen, K. et al. When are Worry and Rumination Negatively Associated with Resting Respiratory Sinus Arrhythmia? It Depends: The Moderating Role of Cognitive Reappraisal. Cogn Ther Res 44, 874–884 (2020). https://doi.org/10.1007/s10608-020-10099-z

Download citation

Keywords

  • Resting respiratory sinus arrhythmia
  • Depression
  • Worry
  • Rumination
  • Repetitive negative thinking
  • Cognitive reappraisal