Prolonged autonomic activation, perseverative negative cognition, and daily stressors

Prolonged activation is believed to be a key factor mediating between stress and later disease outcomes. However, few studies have directly addressed the psychological factors that cause prolonged activation. We propose that perseverative negative cognition is such a factor; perseverative cognition (PC) was associated with enhanced autonomic activation and negative health outcomes in other studies. In this study, the hypotheses were tested that in daily life, daily stressors as well as perseverative cognition (operationalized as worry) cause enhanced autonomic activation, and that worry-at least partly mediates the effects of daily stressors. In an ambulatory study of 73 subjects from a general population, worry, daily stressors, heart rate (HR) and heart rate variability (mean squared successive differences, MSD) were assessed using diaries and ambulatory physiological equipment, occurrence of worry or a stressor was asked over 60-min periods in 1 day, including several questions concerning the affective and cognitive nature of stressors, and worry. Both daily stressors and worry were independently associated with increased HR and MSD during these periods, especially when they involved intimate relationships and financial problems. Associations were strongest for stressors, but worry occurred three times as often, having a larger overall impact. Moreover, effects of worry were stronger in combination with feelings of tension. Thus, perseverative cognition (worry) has an autonomic effect of its own, but the autonomic effects of daily stressors may be either mediated by different or more specific types of perseverative cognition or by other mechanisms. (C) 2002 Elsevier Science B.V. All rights reserved.