Positive affect and heart rate variability: Resources of resilience in the context of pain and stress

Adaptive self-regulation is crucial for reducing negative outcomes for chronic pain patients, particularly in the context of stress. Tonic heart rate variability (HRV), a measure of autonomic regulation of arousal, has been characterized as a stable index of resilience, while elevations in positive affect have been characterized as a dynamic process of resilience. The current study examined between-person differences in baseline HRV and within-person fluctuations in positive affect (PA) in relation to negative interpersonal events, perceived interpersonal stress, and pain in a community sample of fibromyalgia and osteoarthritis patients. Diaries were used to gather psychological data daily for 30 days. Up to 10 minutes of resting electrocardiography data were collected in a laboratory session and transformed into low-frequency (LF) and high-frequency (HF) measures of HRV. Hypotheses predicted that higher baseline HRV and elevations in daily PA would be linked to lower levels of perceived stress and pain, and that for individuals higher in HRV and for days of elevated PA, the event-stress and the stress-pain relations would be weaker. Multilevel modeling analyses provided support for some study hypotheses. Higher LF and HF were associated with lower levels of pain, and elevations in PA were related to lower levels of both stress and pain. Additionally, LF, HF, and changes in PA moderated the relation between perceived stress and daily pain, though the directions of these effects were not as expected. Furthermore, while LF and PA were positively associated, interactions were not detected between HRV and PA in the prediction of events or of pain. Future directions for exploring the relations between HRV and affect in the context of stress and pain are discussed Finally, implications for interventions targeting HRV and PA in fibromyalgia patients are described.