The protective role of heart rate variability against ruminative thoughts in university students accessing Psychological Support Services

Background: University students have a high likelihood of developing depressive symptoms. To counteract the increasing demand for psychological support, university clinical services are developing assessment protocols aimed at improving the early identification of mental disorders. In this context, psychological features (e.g., rumination) and altered autonomic balance (e.g., low heart rate variability, HRV) are well-established predictors of the onset and exacerbation of depressive symptoms. Objective: The present study aimed to explore the reciprocal interaction between rumination and HRV in predicting the severity of depressive symptoms among university students accessing Psychological Support Services (PSS) for emotional distress (support-seeking group) has been compared to a group drawn from the general population of college students outside of PSS (control group). Method: Thirty-six (26 F) support-seeking students and 39 (28 F) controls completed the Beck Depression Inventory, the Beck Anxiety Inventory, and the Rumination Response Scale. HRV was measured through a smartphone app during a guided online meeting with a trained researcher. Results: The main results indicated a statistically significant interaction between levels of rumination and HRV in predicting depressive symptoms among support-seeking students, suggesting that increased HRV may buffer the impact of rumination on depressive symptoms. Conclusion: These results highlight the important role of multidimensional assessment protocols that include psychological and physiological measures, for the selective identification of risk of developing anxiety and depression among university students. Interventions could include self-regulation training aimed at improving cardiac vagal control to counteract the negative effect of rumination on the exacerbation of depressive symptoms.