Effects of Mindfulness on Heart Rate and Anxiety

Mindfulness is an attention to and awareness of events and experiences as they occur. A growing body of literature supports a mindfulness-based approach for treating, reducing, or aiding in the prevention of emotional distress, such as depression and anxiety (Jenson et al., 2016). Mindfulness has been practiced universally and, more recently, has become a popular practice used by clinicians. It has been especially prevalent and effective in the field of psychopathology. Mindfulness is the quality of being in the present moment and being consciously aware of something, shifting one's focus to the present moment, accepting one's thoughts, feelings, and paying attention to their breath.

According to Baum (2010), "there is a moment of choice before we act upon stress, and in that space lies the power within us to regulate these emotions." Although nearly everyone has the capacity to be mindful, a mindful state is not the typical state of mind for most people. In fact, reaching a state of mindfulness is an effortful approach because one must override the automatic response to judge one's current internal and external situation and to react with the aim of correcting the situation accordingly (Baum, 2010).

Mindfulness is said to be an attribute of consciousness that promotes well-being (Brown,2003). Consciousness is a state that involves both awareness and attention. Awareness is the background detector of consciousness, which is continually monitoring our inner and outer environments. One may be aware of stimuli without the stimuli being at the center of attention. Attention is a process of focusing conscious awareness, providing sensitivity to a limited range of experiences (Brown, 2003). Granted, attention and awareness are fairly constant features of normal functioning, mindfulness can be considered to enhance the attention and awareness of a current experience or present reality (Brown, 2003).

Mindful interventions can take the form of meditation, deep breathing exercises, visualization, attentiveness to the senses, mindfulness-based cognitive therapy, mindfulness-based stress reduction, and other techniques. One of the most commonly used forms of a mindfulness approach is Mindfulness Based Stress Reduction (MBSR). This technique has been said to improve emotion regulation and also aid in the improvement of cognitive performance on tasks (Bellinger, Decaro & Rolsten, 2015). MBSR has been utilized in a variety of settings, such as classrooms, rehabilitation centers, studios, clinical settings, as well as being practiced individually. It has also become a popular technique used on college campuses by campus health services. Not only has MBSR been linked to psychological and physiological well-being, but it's a form of therapy that is cost-effective because, for many college students, there are not sufficient enough funds at their disposal to intervene effectively in treatment (Mahmoud, Staten, Hall & Lennie 2012).

College can be a time of acute stress and pressure for students. Academic performance paired with several other variables, including lack of time for study, timed testing environments, lack of rest, maintaining personal lives and, in most cases, working full time, can be major contributions to objective and subjective levels of anxiety and stress (Shearer, Hunt, Chowdbury & Nicole, 2016). Any of these factors can contribute to a student's perception of not having the energy or time to successfully cope with the unending responsibilities of the college experience. As students come to terms with increased academic pressures, personal, social, and typical pressures of life, these stressors can lead to increased anxiety, loneliness, hopelessness, difficulties with sleep, frequent illness, and, in extreme cases, suicidal ideation (Baghast & Kelly, 2014).
While some college students can adjust to the overwhelming challenges that arise from this new life experience, others struggle with the ever-increasing stressors. The impact of stressors experienced by college students is facilitated by the individual's ability to effectively cope with stressful situations. An increase in anxiety symptoms during phases of enormous stress can lead to serious long-term physiological problems like hypertension, diminished immune system defenses and higher levels of muscle tension. Along with the physiological problems, anxiety is linked to an array of psychological health problems that can range from anxiety and depression to interpersonal problems, maladaptive coping skills and poor ability to regulate emotion (Baghurst & Kelly, 2014).

Anxiety is a state of intrinsic emotional turmoil that is related to emotion regulation and adaptive coping behaviors. Emotion regulation is one potential framework for understanding mechanisms of mindfulness, conceptualized as the processes by which individuals modulate the experience, expression, and response to emotions (Mankus, Aldao, Kerns, Mayville & Mennin, 2013). Mindfulness may facilitate effective emotion regulation through improved ability to flexibly process emotional experiences by "being" present when attention is assigned to the experience and one's attributions of the experience, rather than simply "doing" (Mankus, Aldo, Kerns, Maryville Minnen, 2013).

Adaptive coping behaviors include evaluating the stressful situation, actively seeking support, reflecting on possible solutions, and taking actions to resolve the situation (Mahmoud, Staten, Hall, & Lennie, 2012). These behaviors aid in resolving the situation and result in positive psychological and emotional adjustment. On the contrary, maladaptive coping behaviors include efforts to withdraw from the taxing situation or avoid seeking solutions. Maladaptive behaviors incorporate self-blame, denial and avoidance, which may result in a failure to resolve the stressful situation and can be associated with increased anxiety (Mahmoud, Staten, Hall & Lennie, 2012). Mindful strategies have been shown to be useful adaptive coping strategies by researchers.

Because emotions are complex processes, emotional regulation can be assessed in a variety of ways (Mankus et al, 2013). Common variables under investigation when examining anxiety symptoms in previous physiological research include self-report measures, heart rate variability (HRV), blood pressure, cortisol levels, fMRI, and EEG information. Self-report is among the most commonly applied measure of anxiety in research because it assesses how an individual perceives their own anxious symptoms. However, as with all self-report measures, they are subject to demand characteristics and the major self-report measures also have disadvantages and may be more or less applicable to certain populations of people. Physiological measures of emotion regulation may be better indicators of enduring psychological change that results from mindfulness training. One autonomic indicator of flexible emotion regulation is heart rate variability, which underscores the degree to which the parasympathetic and sympathetic systems affect heart rate (Mankus et al, 2013).
Heart rate variability (HRV) is a physiological marker of a person's ability to regulate the stress response. HRV reflects the body's ability to respond to environmental challenges, as well as to self-regulate. Although somewhat counterintuitive, a higher HRV can be more adaptive because it reflects the body's capability to self-regulate in response to stressful situations (Shearer, Hunt, Chowdbury & Nicole, 2016). That is, the heart rate might increase in an immediate response to perceived stressors, but a person with good stress management skills should be able to bring their heart rate back down quickly, resulting in greater HRV.

Researchers (Shearer, Chowbury & Nicole, 2016) studied the effects of brief mindfulness meditation across a four-week span. Participants underwent heart rate and heart rate variability examinations after completing a series of cognitive tests. The goal of the researchers' work was to explore the relationship between mindfulness traits and stress response, working memory, and mood regulation. The researchers explored different techniques: mindful meditation, eyes-closed, and silence. They determined that mindfulness significantly affected anxiety levels. Mindfulness breathing reported higher levels of HRV, suggesting that those who participated in mindfulness were more attuned to the present moment and may have been better able to cope with academic stressors.

Over the course of eight weeks, researchers (Chal?, Pereira, Batista & Sancho, 2016) aimed to test the efficacy of a brief intervention program on anxiety and stress in college students, compared to a control group that received no intervention. Participants in the intervention group used the biofeedback program to learn to change their arousal and promote relaxation. Researchers used a Biofeedback modular program, the biofeedback 2000 is a device that monitors physiological data through skin-attached sensors. This device measured electrodermal activity, heart rate, body temperature, and increased movement (Chal?, Pereira, Batista & Sancho, 2016). The group that received the biofeedback training reported a significant reduction in their anxiety symptoms compared to the group where no intervention was made. These results are consistent with other studies that have larger sample sizes.

Similarly, researchers (Cho, Ryu, Noh & Lee, 2016) proposed that mindful breathing practices would increase positive thinking, mood, and lower anxiety levels. Contrasting with the mindfulness breathing, these researchers also utilized a cognitive reappraisal treatment as compared to no treatment at all. The treatments lasted six days. Participants completed several questionnaires both before and after to assess the following: testing anxiety, positive thoughts, and positive affect (Cho, Ryu, Noh & Lee). Consistent with their hypothesis, mindful breathing practice and cognitive reappraisal practice yielded large effect sizes in reducing test anxiety. Additionally, the mindful breathing condition scored significantly higher on positive thoughts than the cognitive reappraisal and control conditions (Cho, Ryu, Noh & Lee,2016).
Likewise, Bellinger, Decaro & Rolsten (2015) set out to examine whether mindfulness improves the emotional response to anxiety-producing testing situations, frees working memory resources, and improves performance. The researchers studied the effects of mindfulness in a (1) high-stakes testing environment in a laboratory; they also further extended their study by applying it in a (2) regular college classroom setting. Each study also used a 15-minute mindful breathing exercise. The results of their findings suggested that dispositional mindfulness benefited high-stakes test scores by reducing anxiety levels, both in the demanding mathematical laboratory settings and during a replication comparing quiz and test scores in calculus.

Mindfulness research has provided effective information and evidence that the technique can be a powerful tool to utilize as a therapeutic technique for a variety of stressors. However, the research regarding the effectiveness of MBSR on emotion regulation in brief sessions is limited, and further research must also determine how long mindfulness programs must be in order to balance effectiveness with efficiency (Shearer, Hunt, Chowdbury & Nicole, 2016).

The current gap in literature that influenced our research study is that a considerable amount of literature regarding mindfulness has studied the effects of mindfulness over longer periods of time and in regular intervals. The purpose of our study was to address our research question of whether mindfulness has an acute effect on heart rate along with perceived levels of anxiety. We hypothesized that the mindfulness exercise will show decreased levels of perceived anxiety as measured by self-report, as well as lower heart rate levels in the group who receive the mindfulness intervention.

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