title: Physiological concomitants of perseverative cognition: A systematic review and meta-analysis.
abstract: Rumination about the past and worries about the future (perseverative cognition) are extremely common, although pervasive and distressing, dysfunctional cognitive processes. Perseverative cognition is not only implicated in psychological health, contributing to mood worsening and psychopathology but, due to its ability to elicit prolonged physiological activity, is also considered to play a role in somatic health. Although there is emerging evidence that such negative and persistent thoughts have consequences on the body, this association has not yet been quantified. The aim of this study was to meta-analyze available studies on the physiological concomitants of perseverative cognition in healthy subjects. Separate meta-analyses were performed on each examined physiological parameter. Sixty studies were eligible for the analyses. Associations emerged between perseverative cognition and higher systolic blood pressure (SBP) (g = .45) and diastolic blood pressure (DBP) (g = .51) in experimental studies, and higher heart rate (HR) (g = .28 and g = .20) and cortisol (g = .36 and g = .32), and lower heart rate variability (HRV) (g = .15 and g = .27) in experimental and correlational studies, respectively. Significant moderators were sex, ethnicity, type of induction used to elicit perseverative cognition, assessment of state versus trait perseverative cognition, focus on worry or rumination, duration of physiological assessment, and quality of the studies. With the exception of blood pressure, results were not influenced by publication bias. Results show that perseverative cognition affects cardiovascular, autonomic, and endocrine nervous system activity, suggesting a pathogenic pathway to long-term disease outcomes and clarifying the still unexplained relationship between chronic stress and health vulnerability.
authors.affiliation: IRCSS Santa Lucia Foundation.
authors.forename: Cristina
authors.identifier: 0000-0002-5240-4387
authors.initials: C
authors.lastname: Ottaviani
authors.affiliation: Department of Psychology, The Ohio State University.
authors.forename: Julian F
authors.initials: JF
authors.lastname: Thayer
authors.affiliation: Institute of Psychology, Leiden University.
authors.forename: Bart
authors.identifier: 0000-0002-9991-0690
authors.initials: B
authors.lastname: Verkuil
authors.affiliation: IRCSS Santa Lucia Foundation.
authors.forename: Antonia
authors.initials: A
authors.lastname: Lonigro
authors.affiliation: Department of Psychology, Sapienza University of Rome.
authors.forename: Barbara
authors.initials: B
authors.lastname: Medea
authors.affiliation: Department of Psychology, Sapienza University of Rome.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Couyoumdjian
authors.affiliation: Institute of Psychology, Leiden University.
authors.forename: Jos F
authors.initials: JF
authors.lastname: Brosschot
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D003071:Cognition / Q000502:physiology*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D013315:Stress, Psychological / Q000378:metabolism / Q000503:physiopathology*; D013850:Thinking / Q000502:physiology*
chemical_list: D006854:Hydrocortisone