Measuring psychosocial stress with heart rate variability-based methods in different health and age groups
Open accessAbstract
Objective. Autonomic nervous system function and thereby bodily stress and recovery reactions may be assessed by wearable devices measuring heart rate (HR) and its variability (HRV). So far, the validity of HRV-based stress assessments has been mainly studied in healthy populations. In this study, we determined how psychosocial stress affects physiological and psychological stress responses in both young (18–30 years) and middle-aged (45–64 years) healthy individuals as well as in patients with arterial hypertension and/or either prior evidence of prediabetes or type 2 diabetes. We also studied how an HRV-based stress index (Relax-Stress Intensity, RSI) relates to perceived stress (PS) and cortisol (CRT) responses during psychosocial stress. Approach. A total of 197 participants were divided into three groups: (1) healthy young (HY, N = 63), (2) healthy middle-aged (HM, N = 61) and (3) patients with cardiometabolic risk factors (Pts, N = 73, 32–65 years). The participants underwent a group version of Trier Social Stress Test (TSST-G). HR, HRV (quantified as root mean square of successive differences of R–R intervals, RMSSD), RSI, PS, and salivary CRT were measured regularly during TSST-G and a subsequent recovery period. Main results. All groups showed significant stress reactions during TSST-G as indicated by significant responses of HR, RMSSD, RSI, PS, and salivary CRT. Between-group differences were also observed in all measures. Correlation and regression analyses implied RSI being the strongest predictor of CRT response, while HR was more closely associated with PS. Significance. The HRV-based stress index mirrors responses of CRT, which is an independent marker for physiological stress, around TSST-G. Thus, the HRV-based stress index may be used to quantify physiological responses to psychosocial stress across various health and age groups.
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Physiological sensor data cleaning with autoencoders
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Asch, A., Govindan, R. B., Bartolini, E., Chirumamilla, V. C., Pleau, C., O’Donnell, M., & Schlatterer, S. D. (2026) · Scientific Reports · doi:10.1038/s41598-026-43506-8 · Cited by 2 · see citing works
Lykov, Y. A., Александровна, К. А., Marchenkova, L., Korolev, Y. N., Rozhkova, E. A., & Zubareva, N. N. (2026) · Bulletin of Rehabilitation Medicine · doi:10.38025/2078-1962-2026-25-2-63-76 · Cited by 2 · see citing works
Wevers, A., Román-Mata, S. S., Ledesma, S. N., & Pruimboom, L. (2024) · Biomedicines · doi:10.3390/biomedicines12112539 · Cited by 2 · see citing works
“A recent observational study on 197 participants indicated that RSI—an HRV-based stress index—reacts to physiological changes related to psychosocial stress and recovery [16,196].”
A Novel Approach for Acute Mental Stress Mitigation Through Adapted Binaural Beats: A Pilot Study
Raggi, M., Chiri, S., Roatta, S., Rabbito, R., & Mesin, L. (2025) · Applied Sciences · doi:10.3390/app15105742 · Cited by 2 · see citing works
“The results do not indicate a significant increase in this temporal metric, which is associated with lower acute mental stress [50].”
Krogstie, J., & Sharma, K. (2025) · Software & Systems Modeling · doi:10.1007/s10270-025-01329-7 · Cited by 6 · see citing works
“In several recent contributions (independent studies, meta-analysis, and systematic literature reviews), HRV-based measurements are appropriate [5, 17, 101, 115].”
Investigating Functional Data Analysis for Wearable Physiological Sensor Data in Stress Evaluation
Carmisciano, L., Boschi, T., Chiaromonte, F., Delmastro, F., & Vandin, A. (2024) · IEEE Symposium on Computers and Communications (ISCC) · doi:10.1109/iscc61673.2024.10733576 · Cited by 1 · see citing works
“On the positive side, it eases computation and interpretation by summarizing the entire signal(s) of each individual through a few simple metrics, on which classical linear regression [23] and clustering [2] can be straightforwardly employed.”
BackgroundSutarto, A. P., Izzah, N., & Kusumawardani, R. I. (2024) · Journal of Health Sciences and Medical Development · doi:10.56741/hesmed.v3i03.686 · Cited by 1 · see citing works
“Conversely, low HRV indicates potential physical health issues, such as cardiovascular disease [13] and mental health problems [14].”
Anandan, M., & Palanisamy, R. (2025) · IEEE Sensors Letters · doi:10.1109/lsens.2025.3605112 · Cited by 1 · see citing works
“Time-domain HRV features, such as root-mean-square successive difference (RMSSD) and standard deviation of NN intervals (SDNN), are utilized to differentiate stress and nonstress conditions [4].”
Chen, D.-R. (2025) · IEEE Symposium on Computers and Communications (ISCC) · doi:10.1109/iscc65549.2025.11326113 · Cited by 1 · see citing works
“This fluctuation in the time between successive heart beats is HRV [13] [14].”
Lehesvuori, S., Järvinen, M., Lämsä, J., Heilala, V., & Hämäläinen, R. (2026) · Instructional Science · doi:10.1007/s11251-026-09786-3 · Cited by 1 · see citing works
“Furthermore, experiences of stress can be measured in multiple ways, including experi - ence-based sampling methods (Zhou et al., 2021), biomarker testing (Jõgi et al., 2023), and physiological measurements (Seipäjärvi et al., 2022).”
СУЧАСНІ ДОСЛІДЖЕННЯ ВІКОВИХ ОСОБЛИВОСТЕЙ ВАРІАБЕЛЬНОСТІ СЕРЦЕВОГО РИТМУ: ТЕОРЕТИЧНІ АСПЕКТИ
Ляшенко, В. П., & Дуванов, Д. С. (2024) · Слобожанський науковий вісник. Серія Природничі науки. · doi:10.32782/naturalspu/2024.1.3 · Cited by 1 · see citing works
Zhang, L., Hu, H., & Wu, S. (2023) · International Conference on Intelligent Computing and Human-Computer Interaction (ICHCI) · doi:10.1109/ichci58871.2023.10278007
“In this context, the proposed design aims to evaluate stress through emotion recognition [4] and HRV [5] usin g interactive and data visualization design to solve the problems of traditional stress evaluation methods being time-consuming and labour-intensive and to provide users with a clearer…”
MethodMeilinda, I. M., Sugiarto, S., Saleh, S. M., & Achmad, A. (2025) · MethodsX · doi:10.1016/j.mex.2025.103240
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Shah, S., Ahmed, A., & Ahmed, A. (2025) · Balkan Journal of Dental Medicine · doi:10.5937/bjdm2503144g
Khalil, H., Turner, C. A., Murphy-Weinberg, V., Gates, L., Li, F. Y., Onica, A., Arakawa, K., Weinberg, L. S., Stack, C., Lopez, J. F., et al. (2026) · medRxiv · doi:10.64898/2026.01.27.26344962
Lu, S., Chui, C., & Li, L. (2026) · Innovation in Aging · doi:10.1093/geroni/igag044
“HR, measured as the number of heart beats per minute, often increases in response to the body’s fight-or-flight response (Seip € aj € arvi et al., 2022).”
Zhang, F., Gomo, I. F., & Sharma, K. (2026) · ACM International Conference on Interaction Design and Children (IDC) · doi:10.1145/3773077.3810979
Methodological trends in biological assessment of children’s daily stress: A scoping review
Kang, S.-J., & Kim, E. (2026) · PLoS ONE · doi:10.1371/journal.pone.0355460
“Moreover, they can be recorded noninvasively using sensors, enabling real-time assessment of physiological responses [63].”
- Authors
- Seipäjärvi, S. M., Tuomola, A., Juurakko, J., Rottensteiner, M., Rissanen, A.-P. E., Kurkela, J. L. O., Kujala, U. M., Laukkanen, J. A., & Wikgren, J.
- Affiliations
- University of Jyväskylä (FI)
- Central Finland Health Care District (FI)
- University of Helsinki (FI)
- Corresponding author
- Seipäjärvi, Santtu M
- ORCID
- Venue
- Physiological Measurement
- Publisher
- IOP Publishing
- Published
- 2022-05-25
- Volume
- 43
- Issue
- 5
- Pages
- 055002
- ISSN
- 0967-3334 (ISSN-L)
- 1361-6579
- OpenAlex
- W4225137380
- Cited by
- 47
- References
- 53
- Citations by year
- 2026: 7 · 2025: 16 · 2024: 14 · 2023: 10
- FWCI
- 7.02
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Physiological Measurement (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Jyväskylä University Digital Archive (University of Jyväskylä) (submittedVersion, cc-by)
- Työväentutkimus Vuosikirja (submittedVersion)
- Funders
- Firstbeat Technologies Oy
- Business Finland (2697/31/2018)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Emotion and Mood Recognition
- Keywords
- psychosocial stress, heart rate variability, perceived stress, salivary cortisol, Trier Social Stress Test, autonomic nervous system, age differences, hypertension, prediabetes, type 2 diabetes, cardiometabolic risk, wearable devices, stress recovery
- MeSH terms
- Diabetes Mellitus, Type 2, Heart Rate, Humans, Hydrocortisone, Middle Aged, Stress, Physiological, Stress, Psychological
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