Heart Rate Variability in Translational Social Work Research: An Index of Social-Behavioral Health

Background. Heart rate variability (HRV), the beat-to-beat modulation of heart rate by the parasympathetic nervous system, has been shown through a robust body of research to be an index of physical and psychological health and adaptation.  According to the neurovisceral integration model, a network of central (e.g., prefrontal cortex – PFC, and anterior cingulate cortex - ACC) and autonomic (e.g., vagus nerve) nervous system structures exerts regulatory influences over perturbations to visceral homeostasis, such as those evoked during exposure to stress, trauma, or addictive cues. Hypothetically, regulation of such perturbations is reflected in HRV, and thus, HRV may serve as an indicator of regulated (or dysregulated) responding. The purpose of this presentation is to discuss findings across a number of studies that demonstrate the utility of HRV in social work research.

Methods. HRV was analyzed among three distinct samples: a sample of alcohol dependent adults in long-term residential treatment (N = 58) participating in a RCT of Mindfulness-Oriented Recovery Enhancement (MORE), a sample of chronic pain patients receiving long-term opioid pharmacotherapy (N = 115) who also participated in a RCT of MORE, and a sample of MSW students (N = 57) who participated in an experiment examining effects of brief mindfulness training on emotion regulation. HRV was analyzed at rest as well as during tasks designed to tap capacity for self-regulating emotion and attention (i.e., dot probe test, reappraisal task). Data were analyzed using repeated measures ANOVA, zero-order correlations, logistic regression, and multivariate path analysis.

Results. Among the alcohol dependent sample, MORE led to significant HRV recovery following exposure to stress and alcohol cues, and participants with attenuated HRV reactivity to alcohol cues evidenced significantly reduced risk of relapse by 6 month follow-up. Among the chronic pain sample, MORE led to significant increases in HRV to positive emotional stimuli, which mediated the effect of MORE on reducing opioid craving. Among the MSW student sample, both self-reported positive reappraisal and self-awareness were significantly correlated with HRV during reappraisal of negative emotions.

Implications for Practice. Across three disparate samples, HRV was significantly associated with enhanced social-emotional functioning and predictive of crucial health-related behavioral outcomes (i.e., alcohol relapse). Because HRV measurement and analysis is noninvasive and relatively inexpensive, this measure is wholly accessible to social work researchers. When incorporated into research designs with high internal and external validity, HRV may reflect key social and behavioral processes implicated in increased longevity and human flourishing.