{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:12:13Z","timestamp":1787497933449,"version":"build-2736575974"},"reference-count":94,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T00:00:00Z","timestamp":1661385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007653","name":"Universit\u00e4tsklinikum Jena","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007653","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Recent studies suggest that lower resting heart rate variability (HRV) is associated with elevated vulnerability to depressive rumination. In this study, we tested whether increases in HRV after HRV-biofeedback training are accompanied by reductions in rumination levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Sixteen patients suffering from depression completed a 6-week HRV-biofeedback training and fourteen patients completed a control condition in which there was no intervention (waitlist). The training included five sessions per week at home using a smartphone application and an ECG belt. Depressive symptoms and autonomic function at rest and during induced rumination were assessed before and after each of the two conditions. We used a well-established rumination induction task to provoke a state of pervasive rumination while recording various physiological signals simultaneously. Changes in HRV, respiration rate, skin conductance, and pupil diameter were compared between conditions and time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A significant correlation was found between resting HRV and rumination levels, both assessed at the first laboratory session (\n                      <jats:italic>r<\/jats:italic>\n                      = -0.43,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05). Induction of rumination led to an acceleration of heart rate and skin conductance increases. After biofeedback training, resting vagal HRV was increased (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.01) and self-ratings of state anxiety (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05), rumination (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05), perceived stress (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05), and depressive symptoms (QIDS, BDI; both\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05) were decreased. In the control condition, there were no changes in autonomic indices or depressive symptomatology. A significant interaction effect group x time on HRV was observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results indicate that a smartphone-based HRV-biofeedback intervention can be applied to improve cardiovagal function and to reduce depressive symptoms including self-rated rumination tendencies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2022.961294","type":"journal-article","created":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T01:31:51Z","timestamp":1661391111000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Depressive rumination and heart rate variability: A pilot study on the effect of biofeedback on rumination and its physiological concomitants"],"prefix":"10.3389","volume":"13","author":[{"given":"Andy","family":"Schumann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadin","family":"Helbing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Rieger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Suttkus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl-J\u00fcrgen","family":"B\u00e4r","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/S2215-0366(21)00395-3","article-title":"Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019.","volume":"9","author":"Ferrari","year":"2022","journal-title":"Lancet Psychiatry."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.1016\/S0140-6736(21)02143-7","article-title":"Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic.","volume":"398","author":"Santomauro","year":"2021","journal-title":"Lancet."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019.","volume":"396","author":"Vos","year":"2020","journal-title":"Lancet."},{"key":"B4","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1111\/j.1600-0447.1994.tb05794.x","article-title":"Epidemiology of depression: prevalence, risk factors and treatment situation.","volume":"89","author":"Lehtinen","year":"1994","journal-title":"Acta Psychiatr Scand."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2763","DOI":"10.1093\/eurheartj\/ehl338","article-title":"Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146 538 participants in 54 observational studies.","volume":"27","author":"Nicholson","year":"2006","journal-title":"Eur Heart J."},{"key":"B6","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/j.neubiorev.2016.07.003","article-title":"Depression and cardiovascular disease: epidemiological evidence on their linking mechanisms.","volume":"74","author":"Penninx","year":"2015","journal-title":"Neurosci Biobehav Rev."},{"key":"B7","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/S0165-1781(02)00225-1","article-title":"Relationship between major depression and heart rate variability. 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