Assessing game experience: Heart rate variability, in-game behavior and self-report measures

A common practice among endurance athletes is to purposefully train in hot environments during a “heat stress camp.” However, combined exercise-heat stress poses threats to athlete well-being, and therefore, heat stress training has the potential to induce maladaptation. This case study describes the monitoring strategies used in a successful 3-week heat stress camp undertaken by 2 elite Ironman triathletes, namely resting heart rate variability, self-report well-being, and careful prescription of training based on previously collected physiological data. Despite the added heat stress, training volume very likely increased in both athletes, and training load very likely increased in one of the athletes, while resting heart rate variability and self-report well-being were maintained. There was also some evidence of favorable metabolic changes during routine laboratory testing following the camp. The authors therefore recommend that practitioners working with endurance athletes embarking on a heat stress training camp consider using the simple strategies employed in the present case study to reduce the risk of maladaptation and nonfunctional overreaching.

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Reduction of depressive symptoms during inpatient treatment is not associated with changes in heart rate variability

PLoS ONE ◽

10.1371/journal.pone.0248686 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0248686

Author(s):

Sabrina Neyer ◽

Michael Witthöft ◽

Mark Cropley ◽

Markus Pawelzik ◽

Ricardo Gregorio Lugo ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Depressive Symptoms ◽

Rating Scale ◽

Psychiatric Treatment ◽

Self Report ◽

Future Research ◽

Symptom Improvement ◽

Vagal Activity ◽

Before And After

Vagally mediated heart rate variability (HRV) is a psychophysiological indicator of mental and physical health. Limited research suggests there is reduced vagal activity and resulting lower HRV in patients with Major Depressive Disorder (MDD); however little is actually known about the association between HRV and symptoms of depression and whether the association mirrors symptom improvement following psychotherapy. The aim of this study was to investigate the association between antidepressant therapy, symptom change and HRV in 50 inpatients (68% females; 17–68 years) with a diagnosis of MDD. Severity of depressive symptoms was assessed by self-report (Beck Depression Inventory II) and the Hamilton Rating Scale of Depression. Measures of vagally mediated HRV (root mean square of successive differences and high-frequency) were assessed at multiple measurement points before and after inpatient psychotherapeutic and psychiatric treatment. Results showed an expected negative correlation between HRV and depressive symptoms at intake. Depressive symptoms improved (d = 0.84) without corresponding change in HRV, demonstrating a de-coupling between this psychophysiological indicator and symptom severity. To our knowledge, this study is the first to examine an association between HRV and depressive symptoms before and after psychotherapy. The observed de-coupling of depression and HRV, and its methodological implications for future research are discussed.

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Cognitive Failures: Relationship with Perceived Emotions, Stress, and Resting Vagally-Mediated Heart Rate Variability

Sustainability ◽

10.3390/su132413616 ◽

2021 ◽

Vol 13 (24) ◽

pp. 13616

Author(s):

Min You ◽

Sylvain Laborde ◽

Uirassu Borges ◽

Robert Samuel Vaughan ◽

Fabrice Dosseville

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Emotional Valence ◽

Self Report ◽

Hierarchical Regression ◽

Psychological Variables ◽

Cognitive Failures ◽

Everyday Task ◽

Cognitive Failures Questionnaire ◽

Negative Predictor

Cognitive failures represent everyday task failures that individuals are normally capable of completing. While cognitive failures measured with the Cognitive Failures Questionnaire can be considered a trait, the psychophysiological states associated with cognitive failures are yet to be fully understood. The aim of this paper was to investigate the extent to which the perception of experiencing cognitive failures in daily life is associated with both psychological (i.e., perceived emotional valence, emotional intensity, and stress), as well as physiological (i.e., vagally-mediated heart rate variability, vmHRV) variables. A total of 69 participants were involved in this study (47 male, 22 female; Mage = 22.4 years). Participants underwent a 5-min heart rate variability measurement and filled out the self-report psychological variables, before completing the Cognitive Failures Questionnaire, providing scores for Distractibility, Forgetfulness, and False Triggering. When combining the predictors together into a hierarchical regression analysis, only the model related to the Distractibility subscale was found to be significant (unique significant negative predictor: resting vmHRV). Further research should investigate whether influencing resting vmHRV, with interventions such as slow-paced breathing, may decrease the perception of cognitive failures related to distractibility.

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Measurement of Cancer-Related Fatigue Based on Heart Rate Variability: Observational Study (Preprint)

10.2196/preprints.25791 ◽

2020 ◽

Author(s):

Chi-Huang Shih ◽

Pai-Chien Chou ◽

Ting-Ling Chou ◽

Tsai-Wei Huang

Keyword(s):

Lung Cancer ◽

Heart Rate ◽

Heart Rate Variability ◽

Targeted Therapy ◽

Subjective Experience ◽

Assessment Method ◽

Mapping Method ◽

Self Report ◽

Sleep Phase ◽

Cancer Related Fatigue

BACKGROUND Cancer-related fatigue is a serious side effect of cancer, and its treatment can disrupt the quality of life of patients. Clinically, the standard method for assessing cancer-related fatigue relies on subjective experience retrieved from patient self-reports, such as the Brief Fatigue Inventory (BFI). However, most patients do not self-report their fatigue levels. OBJECTIVE In this study, we aim to develop an objective cancer-related fatigue assessment method to track and monitor fatigue in patients with cancer. METHODS In total, 12 patients with lung cancer who were undergoing chemotherapy or targeted therapy were enrolled. We developed frequency-domain parameters of heart rate variability (HRV) and BFI based on a wearable-based HRV measurement system. All patients completed the BFI-Taiwan version questionnaire and wore the device for 7 consecutive days to record HRV parameters such as low frequency (LF), high frequency (HF), and LF-HF ratio (LF-HF). Statistical analysis was used to map the correlation between subjective fatigue and objective data. RESULTS A moderate positive correlation was observed between the average LF-HF ratio and BFI in the sleep phase (ρ=0.86). The mapped BFI score derived by the BFI mapping method could approximate the BFI from the patient self-report. The mean absolute error rate between the subjective and objective BFI scores was 3%. CONCLUSIONS LF-HF is highly correlated with the cancer-related fatigue experienced by patients with lung cancer undergoing chemotherapy or targeted therapy. Beyond revealing fatigue levels objectively, continuous HRV recordings through the photoplethysmography watch device and the defined parameters (LF-HF) can define the active phase and sleep phase in patients with lung cancer who undergo chemotherapy or targeted chemotherapy, allowing a deduction of their sleep patterns. CLINICALTRIAL

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Morality of the Heart: Heart Rate Variability and Moral Rule Adherence in Men

Frontiers in Neuroscience ◽

10.3389/fnins.2021.612712 ◽

2021 ◽

Vol 15 ◽

Author(s):

Alexander Lischke ◽

Matthias Weippert ◽

Anett Mau-Moeller ◽

Rike Pahnke

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Positive Association ◽

Self Report ◽

Moral Rule ◽

Physiological Processes ◽

Neural Processes ◽

Efficient Integration ◽

Moral Rules ◽

Report Measure

Moral rules are a cornerstone of many societies. Most moral rules are concerned with the welfare of other individuals, reflecting individuals’ innate aversion against harming other individuals. Harming others is associated with aversive experiences, implying that individuals who are sensitive to the aversiveness of these experiences are more likely to follow moral rules than individuals who are insensitive to the aversiveness of these experiences. Individuals’ sensitivity for aversive experiences depends on individuals’ ability to integrate the underlying neural and physiological processes: Individuals who are more efficient in integrating these processes are more sensitive to the aversiveness that is associated with moral rule violations than individuals who are less efficient in integrating these processes. Individuals who differ in their ability to integrate these processes may, thus, also differ in their inclination to follow moral rules. We tested this assumption in a sample of healthy individuals (67 males) who completed measures of moral rule adherence and integration abilities. Moral rule adherence was assessed with self-report measure and integration abilities were assessed with a resting state measure of heart rate variability (HRV), which reflects prefrontal–(para-)limbic engagement during the integration of physical and neural processes. We found a positive association between individuals’ HRV and individuals’ moral rule adherence, implying that individuals with efficient integration abilities were more inclined to follow moral rules than individuals with inefficient integration abilities. Our findings support the assumption that individuals with different integration abilities also differ in moral rule adherence, presumably because of differences in aversiveness sensitivity.

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Measurement of Cancer-Related Fatigue Based on Heart Rate Variability: Observational Study

Journal of Medical Internet Research ◽

10.2196/25791 ◽

2021 ◽

Vol 23 (7) ◽

pp. e25791

Author(s):

Chi-Huang Shih ◽

Pai-Chien Chou ◽

Ting-Ling Chou ◽

Tsai-Wei Huang

Keyword(s):

Lung Cancer ◽

Heart Rate ◽

Heart Rate Variability ◽

Targeted Therapy ◽

Subjective Experience ◽

Assessment Method ◽

Mapping Method ◽

Self Report ◽

Sleep Phase ◽

Cancer Related Fatigue

Background Cancer-related fatigue is a serious side effect of cancer, and its treatment can disrupt the quality of life of patients. Clinically, the standard method for assessing cancer-related fatigue relies on subjective experience retrieved from patient self-reports, such as the Brief Fatigue Inventory (BFI). However, most patients do not self-report their fatigue levels. Objective In this study, we aim to develop an objective cancer-related fatigue assessment method to track and monitor fatigue in patients with cancer. Methods In total, 12 patients with lung cancer who were undergoing chemotherapy or targeted therapy were enrolled. We developed frequency-domain parameters of heart rate variability (HRV) and BFI based on a wearable-based HRV measurement system. All patients completed the BFI-Taiwan version questionnaire and wore the device for 7 consecutive days to record HRV parameters such as low frequency (LF), high frequency (HF), and LF-HF ratio (LF-HF). Statistical analysis was used to map the correlation between subjective fatigue and objective data. Results A moderate positive correlation was observed between the average LF-HF ratio and BFI in the sleep phase (ρ=0.86). The mapped BFI score derived by the BFI mapping method could approximate the BFI from the patient self-report. The mean absolute error rate between the subjective and objective BFI scores was 3%. Conclusions LF-HF is highly correlated with the cancer-related fatigue experienced by patients with lung cancer undergoing chemotherapy or targeted therapy. Beyond revealing fatigue levels objectively, continuous HRV recordings through the photoplethysmography watch device and the defined parameters (LF-HF) can define the active phase and sleep phase in patients with lung cancer who undergo chemotherapy or targeted chemotherapy, allowing a deduction of their sleep patterns.

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Burden and Heart Rate Variability in Bipolar Disorder Family Caregivers

Western Journal of Nursing Research ◽

10.1177/01939459211063660 ◽

2021 ◽

pp. 019394592110636

Author(s):

Elizabeth Williams ◽

Jaclene A. Zauszniewski

Keyword(s):

Bipolar Disorder ◽

Heart Rate ◽

Heart Rate Variability ◽

African American ◽

Family Caregivers ◽

Psychological Stress ◽

Self Report ◽

Future Research ◽

Race And Gender ◽

And Gender

Family caregivers of persons with bipolar disorder experience considerable stress. Yet, studies have not examined whether their stress differs by race and gender. This preliminary analysis of baseline data from 228 African American and White family caregivers of adults with bipolar disorder who were enrolled in a randomized controlled trial examined race and gender differences on two validated self-report measures of psychological stress (caregiver burden and caregiver reactions) and an electrocardiography device used to capture heart rate variability (HRV). No statistically significant differences were found by race or gender on either measure of psychological stress. African American caregivers had significantly lower scores on two indices of HRV compared to White caregivers. Women had significantly lower scores on one index of HRV compared to men. Low HRV indicates greater stress and mortality risk. Future research should include HRV to measure caregiver stress and implement relevant interventions.

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A smartphone-based mindful breathing task with assessment of heart-rate variability for clinically relevant chronic pain, depression, and anxiety: Protocol for a randomized-controlled trial (Preprint)

10.2196/preprints.14119 ◽

2019 ◽

Author(s):

Abid Azam ◽

Vered Latman ◽

Joel Katz

Keyword(s):

Heart Rate ◽

Chronic Pain ◽

Randomized Controlled Trial ◽

Heart Rate Variability ◽

Mindfulness Meditation ◽

Controlled Trial ◽

Self Report ◽

Depression And Anxiety ◽

Stress Induction ◽

Randomized Controlled

BACKGROUND Mindfulness meditation is a commonly used psychological intervention for pain, mood, and anxiety conditions, but can be challenging to practice when dealing with severe symptoms without proper training experience. The Mindfulness Meditation App (MMA) is a supportive training tool specifically developed for the present study, to aid in the practice of mindful breathing using a smartphone. OBJECTIVE The aim of the present study is to evaluate the psychophysiological effects of the MMA. Specifically, the study aims to assess parasympathetic functioning using heart-rate variability (HRV; primary outcome), pain and mood symptoms, mind-wandering and present awareness, and breath focus in groups of participants who self-report clinically significant symptoms of chronic pain (CP), depression and/or anxiety (DA), as well as control participants (C) who do not meet criteria for either. METHODS The present study is a two-arm randomized-controlled trial (registration #NCT03296007), taking place at York University in Toronto, Canada. Sixty participants in each group of CP, DA, or C (N=180 total) will be pre-screened and randomly assigned by a 1:1 ratio to a mindfulness meditation app (MMA+) condition or a mindfulness meditation condition without the app (MMA-) after a brief stress-induction procedure. In MMA+, participants will practice mindful breathing with a smartphone and press “breath” or “other” buttons at the sound of audio tones if their awareness was on breathing or another experience, respectively. HRV and respiration data will be obtained during rest (5 minutes), stress-induction (5 minutes), and meditation condition (12 minutes). Participants will complete psychological self-report inventories before and after the stress-induction, and after the meditation condition. RESULTS Recruitment for the study began in November 2017 and is expected to be completed in July of 2019. CONCLUSIONS This RCT will inform the design of mindfulness meditation training tools delivered by apps and web platforms for the treatment of chronic pain, depression, and anxiety conditions. CLINICALTRIAL ClinicalTrials.gov: NCT03296007

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Heart Rate Variability Indices as Possible Biomarkers for the Severity of Post-traumatic Stress Disorder Following Pregnancy Loss

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.700920 ◽

2022 ◽

Vol 12 ◽

Author(s):

Cláudia de Faria Cardoso ◽

Natalia Tiemi Ohe ◽

Yazan Bader ◽

Nariman Afify ◽

Zahrah Al-Homedi ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Pregnancy Loss ◽

Stress Disorder ◽

Self Report ◽

Deep Breathing ◽

Post Traumatic Stress ◽

Time Data ◽

Normal Sinus ◽

Deep Breathing Test

Background: Psychological distress, such as posttraumatic stress disorder (PTSD), is commonly evaluated using subjective questionnaires, a method prone to self-report bias. The study's working hypothesis was that levels of autonomic dysfunction determined by heart rate variability (HRV) measures are associated with the severity of PTSD in women following pregnancy loss.Methods: This was an observational prospective cohort study with 53 patients enrolled. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) PTSD scale (PCL-5) was used to assess the severity of PTSD in women after pregnancy loss. The cardiac autonomic function was assessed using HRV measurements during a deep breathing test using an HRV scanner system with wireless ECG enabling real-time data analysis and visualization. HRV measures were: standard deviation (SD) of normal R-R wave intervals [SDNN, ms], square root of the mean of the sum of the squares of differences between adjacent normal R wave intervals [RMSSD, ms], and the number of all R-R intervals in which the change in consecutive normal sinus intervals exceeds 50 milliseconds divided by the total number of R-R intervals measured [pNN50 = (NN50/n-1)*100%] [pNN50%].Results: The PCL-5 scores had a statistically significant association with HRV indices (SDNN; RMSSD, and pNN50%). Patients with PTSD had similar mean heart rate values as compared to patients without PTSD (PCL-5), but significantly higher SDNN [median[IQR, interquartile range]: 90.1 (69.1–112.1) vs. 52.5 (36.8–65.6)], RMSSD [59.4 (37.5–74.9) vs. 31.9 (19.3 – 44.0)], and PNN50% values [25.7 (16.4–37.7) vs. 10.6 (1.5–21.9)]. The SDNN of the deep breathing test HRV was effective at distinguishing between patients with PTSD and those without, with an AUC = 0.83 +/− 0.06 (95 % CI 0.94, p = 0.0001) of the ROC model.Conclusions: In this study, HRV indices as biomarkers of cardiac dysautonomia were found to be significantly related to the severity of PTSD symptoms in women after pregnancy loss.

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Abstract WP183: Heart Rate Variability Is Associated With Stroke, Independent Of Traditional Cardiovascular Risk Factors

Stroke ◽

10.1161/str.44.suppl_1.awp183 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Adina Zeki Al Hazzouri ◽

Mary Haan

Keyword(s):

Risk Factors ◽

Heart Rate ◽

Heart Rate Variability ◽

Mexican Americans ◽

Community Dwelling ◽

Self Report ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Logistic Regression Models ◽

Icd 10

Introduction: U.S. Hispanics show higher burden of stroke compared to non-Hispanic whites. Stroke-related disparities may be driven by differences in cardiovascular disease (CVD) risk factors. Subclinical measures of CVD such as Heart Rate Variability (HRV) are highly sensitive and strong predictors of CVD events. Yet, the majority of work is limited to clinical settings. We assessed the hypothesis that reduced HRV is associated with higher prevalence of stroke in community-dwelling older Mexican Americans from the Sacramento Area Latino Study on Aging and that this association persists above and beyond traditional CVD risk factors. Methods: SALSA is a prospective cohort study with 7 annual visits. In a subsample of 869 participants, we assessed HRV at either visit 5 or 6 using the ANS2000 which is an ECG monitor and respiration pacer. Several R waves are detected in a deep breath cycle resulting in the estimation of Regular R bar, a measure of HRV. R bar was analyzed in quartiles (Q1 to Q4= low to high HRV). We ascertained stroke based on self-report of a physician diagnosis, hospitalization, and death based on ICD-10 codes I60 to I69. We used logistic regression models to estimate the associations between quartiles of HRV and the odds of having had a first-ever stroke at any time during the study. We reported prevalence odds ratios (OR) and 95%CI. Results: A total of 124 first-ever strokes occurred across the study period. The odds of a stroke was 109% higher in Quartile 1 HRV (OR=2.09; 95%CI=1.13; 3.90), 65% higher in Quartile 2 (OR=1.65; 95%CI=0.88; 3.10), and 1% higher in Quartile 3 (OR=1.01; 95%CI=0.52; 1.99), as compared to Quartile 4, adjusted for age, sex, income, smoking, alcohol consumption, diabetes, systolic blood pressure, beta blocker and dementia status. Conclusion: Our results suggest that reduced HRV is associated with ever having a stroke, above and beyond traditional CVD risk factors.

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