DON’T WORRY, BE MINDFUL: MINDFULNESS, PERSEVERATION, AND HEART RATE VARIABILITY Rolf A. Ritchie A Thesis Submitted to the Graduate College of Bowling Green State University in partial fulfillment of the requirements for the degree of MASTER OF ARTS August 2016 Committee: William O'Brien, Advisor Eric Dubow Verner Bingman © 2016 Rolf Ritchie All Rights Reserved iii ABSTRACT William H. O’Brien, Ph.D., Advisor Perseverative cognitions have been found to be a significant predictor of cardiovascular reactivity to stress which, in turn, is a predictor of cardiovascular disease. The link between perseveration and cardiovascular reactivity is supported in both laboratory and ambulatory research. Researchers have suggested that mindfulness may mediate the relationship between perseverative cognition and cardiovascular reactivity to stress. In the present study, participants were exposed to a social stressor task and their level of cardiovascular reactivity was analyzed in both an anticipatory and recovery condition. Results indicated that increased levels of mindfulness are associated with more complete recovery following a stressor and that increased levels of perseveration are associated with less complete recovery. iv ACKNOWLEDGEMENTS First and foremost, I would like to acknowledge my advisor Dr. William O’Brien for his continued guidance and assistance with this project. I would also like to thank my committee members Dr. Verner Bingman and Dr. Eric Dubow for their constructive feedback during the development of this master’s thesis. Furthermore, I would like to thank my research assistants, Kaitlyn Taddie, Carlie Forster, and Mckenna Freeman. Their assistance, both in the lab and outside of it, were essential to the completion of this project. I would also like to extend a heartfelt thanks to my fiancé Gina Mattei, who assisted with editorial feedback as well as emotional support after long hours in the lab. v TABLE OF CONTENTS Page INTRODUCTION………………………………………………………………………...... 1 METHOD…………………………………………………………………………….…….. 4 Participants……………………………….…………………………………………. 4 Measures.…………………………………………………………………………… 5 Demographics Questionnaire.………………………………………………………. 5 Acceptance and Action Questionnaire II…………………………………………… 5 Five Factor Mindfulness Questionnaire…………………………………………….. 5 Penn State Worry Questionnaire…….……………………………………………… 6 Ruminative Thought Style Questionnaire…..…………………………………...….. 7 Perseverative Thinking Questionnaire…..……………………….……………...….. 7 Heart rate variability………………………..…………………………………...….. 8 Trier Social Stress Test…..……………………………………………………...….. 9 Procedures…………………………………..…………………………………...….. 10 Major Analysis………………………….…..…………………………………...….. 11 Hypothesis One: Perseveration is associated with cardiovascular reactivity duration…...…………………………………...……………………………. 11 Hypothesis Two: Perseveration is inversely associated with mindfulness…. 11 Hypothesis Three: Mindfulness is inversely associated with cardiovascular reactivity duration…...……….…………………..…………………………. 12 Hypothesis Four: Mindfulness mediates the relationship between perseverative cognition and cardiovascular reactivity duration …...…………………… ... 12 vi RESULTS…………………………………………………………..…………..………… .. 13 Data Reduction……...……………………………………………………………… 13 Preliminary Analysis……...……………………………………………………… ... 13 Demographic variables and HRV………………………………………… .. 13 Correlations Among self-report measures.……………..………………… .. 14 Manipulation Check……………………..……………..…………………… 14 Main Analysis…………….……………………..……………..……...……………. 14 Perseveration and levels of HRV reactivity……………….……...………… 15 Perseveration and duration of HRV reactivity…...……..………...………… 15 Residualized HRV scores and perseveration…….……..………...………… 16 Mindfulness and levels of HRV reactivity……………..………...……… .... 16 Mindfulness and duration of HRV reactivity…………..………...……. ....... 17 Residualized HRV scores and mindfulness……………..………......…… ... 18 Mediation analysis……………………………………....………...……… .. 18 Female Participant Analyses…………....………...……………..………...……… .. 18 Correlations Among self-report measures.……………..………………… .. 19 Manipulation Check……………………..……………..…………………… 19 Perseveration and levels of HRV reactivity……………..………...……… .. 19 Perseveration and duration of HRV reactivity…………..………...……… .. 20 Residualized HRV scores and perseveration…….……..………...………… 21 Mindfulness and levels of HRV reactivity……………..………...……… .... 21 Mindfulness and duration of HRV reactivity…………..………...………… 22 Residualized HRV scores and mindfulness……………..………......…… ... 22 vii Mediation analysis……………………………………....………...……… .. 22 DISCUSSION.………………..……………………………………..…………..……… ..... 24 Limitations and Future Directions……….…..…...……………..………...……… .. 27 Conclusions………………..…………....………...……………..………...……… .. 28 REFERENCES.……...………..……………………………………..…………..………… 24 APPENDIX A. INITIAL STEPS AND RECRUITMENT FOR NEW PARTICIPANTS… 70 APPENDIX B. INITIAL PROTOCOL………………………………….……..…………… 71 APPENDIX C. DEMOGRAPHIC INVENTORY………..………….………..…………… 72 APPENDIX D. ACCEPTANCE AND ACTION QUESTIONNAIRE-II…...…….……… . 75 APPENDIX E. FIVE FACET MINDFULNESS QUESTIONNAIRE………..…………… 76 APPENDIX F. PENN STATE WORRY QUESTIONNAIRE…….….…………………… 77 APPENDIX G. RUMINATIVE THOUGHT STYLE QUESTIONNAIRE……………..… 78 APPENDIX H. PERSEVERATIVE THINKING QUESTIONNAIRE…….……………… 79 APPENDIX I. PROTOCOLS FOR BIOPAC EQUIPMENT…....….………………...…… 80 APPENDIX J. ELECTRODE PLACEMENT GUIDE………..…………..…..…………… 82 APPENDIX K. RECORDED TRIER SOCIAL STRESS TEST SCRIPT………..….….… 83 APPENDIX L. CONFEDERATE RECRUITMENT AND TRAINING PROTOCOLS… .. 84 APPENDIX M. TRIER SOCIAL STRESS TEST PROTOCOL…………………...……… 85 APPENDIX N. PERSEVERATION AND MINDFULNESS INFORMED CONSENT FORM ...…....………….………..….….……..……………………………………………. 87 APPENDIX O. POST TEST SELF RATING SCALE……..….….……….……………… 89 APPENDIX P. DEBRIEFING SCRIPT ………….………..….….……..……………… .... 90 APPENDIX Q. …………………………………………………………............................. 91 viii LIST OF TABLES Table Page 1 Demographic Characteristics of the Sample .............................................................. 40 2 Main Effect Analysis with Gender as a Covariate ..................................................... 41 3 Correlations Between Self-Report Measures of Mindfulness and Perseveration ...... 42 4 Within Group Analyses for Main Effect by Condition .............................................. 43 5 Between and Within Subject Effects by Self-Report Measure Grouping .................. 44 6 Correlations Between Self-Report Measures of Perseveration and Recovery Duration…………………………………………………………………………….. 45 7 Correlations Between Self-Report Measures of Perseveration and Residual Recovery Scores…………………………………………………………………..................... 46 8 Within Group Analyses for High Mindfulness Participants by Condition ................ 47 9 Within Group Analyses for Low Mindfulness Participants by Condition ................. 48 10 Correlations Between Self-Report Measures of Mindfulness and Recovery Duration…………………………………………………………………………….. 49 11 Correlations Between Self-report Measures of Mindfulness and Residual Recovery Scores……….. ........................................................................................................... 50 12 Mediation Analysis with RTS, FFMQ, and Residual Recovery 1 ............................. 51 13 Indirect Effects of Mediation Paths ........................................................................... 52 14 Correlations Between Self-Report Measures of Mindfulness and Perseveration Among Female Participants .................................................................................................... 53 15 Within Group Analyses of Condition Main Effect for Female Participants .............. 54 ix 16 Between and Within Subject Effects by Self-Report Measure Grouping for Female 54 Participants……………… ........................................................................................... 55 17 Within Group Analyses for Low RTS by Condition Among Female Participants .... 56 18 Paired Sample t-tests for High RTS by Condition Among Female Participants ....... 57 19 Correlations Between Self-Report Measures of Perseveration and Recovery Duration Among Female Participants ........................................................................ 58 20 Correlations Between Self-Report Measures of Perseveration and Residual Recovery Periods Among Female Participants ……………… .................................................... 59 21 Within Group Analyses for High Mindfulness Female Participants by Condition ... 60 22 Within Group Analyses for Low Mindfulness Female Participants by Condition .... 61 23 Correlations Between Self-Report Measures of Mindfulness and Recovery Duration Among Female Participants……… ............................................................. 62 24 Correlations Between Self-Report Measures of Mindfulness and Residual Recovery Scores Among Female Participants ……………… ..................................................... 63 25 Mediation Analysis for RTS, FFMQ, and Residual Recovery 1 Among Female Participants ……………… .......................................................................................... 64 x LIST OF FIGURES Figure Page 1 HRV Condition and Gender ....................................................................................... 65 2 HRV and Condition ................................................................................................... 66 3 Mindfulness Levels, HRV, and Condition ................................................................. 67 4 Mediation Analysis for RTS, FFMQ, and Residual