The effects of rumination, hostility, and distraction on cardiovascular reactivity and recovery from anger recall in healthy women

Cardiovascular reactivity and recovery following an emotional stressor may play a crucial role in mediating the relation between psychosocial factors (e.g. hostility and anger) and cardiovascular disease. Hostility has been associated with trait rumination. Trait rumination, a tendency to focus attention on negative thoughts and emotions and be prone to feelings of revenge, is not adequately captured in current measures of hostility. The current study examined whether trait rumination, indexed by the Dissipation-Rumination Scale, has an independent effect of increasing cardiovascular reactivity and prolonging cardiovascular recovery from angry events above and beyond hostility as measured by the Cook-Medley Hostility Scale. The effect of distraction on cardiovascular recovery from anger recall was also examined. Diastolic and systolic blood pressure (DBP; SBP), heart rate (HR), high and low frequency heart rate variability (HF; LF), preejection period (PEP), stroke index (SI), cardiac index (CI) and total peripheral resistance index (TPR) were collected from 80 healthy women (ages 18--30) during a 15-min baseline, a 3-min anger recall, and a 10-min recovery. Half of the participants were randomly assigned to a distraction condition (i.e. reading a neutral article) during recovery. Hierarchical regressions, controlling for hostility scores, revealed that trait rumination was predictive of increased SI (p<.03) during the anger-recall task. Trait rumination also predicted slower post-task recovery for HR ( p<.007) and SI (p<.001). An interaction between trait rumination and distraction was found to predict SI (p<.O1) and CI (p<.04), such that those with high trait rumination experienced a greater benefit from distraction than individuals low in trait rumination and high in trait rumination in the no distraction condition. Thus, trait rumination appears to increase cardiac reactivity and prolong recovery from anger, independent of hostility, which may partly explain interrelations among anger, stress responses, and cardiovascular disease risk. These findings also suggest that distraction may be a useful intervention to reduce the physiological impact of trait rumination.