Cardiovascular Disease and Psychiatric Comorbidity: The Potential Role of Perseverative Cognition
Open accessAbstract
The high comorbidity between psychiatric disorders and cardiovascular disease has received increasing attention, yet little is known about the processes linking the two. One plausible contributing mechanism is the tendency of those with psychiatric disorders to ruminate on stressful events. This phenomenon, sometimes called perseverative cognition, can extend the psychological and physiological effects of stress, which could contribute to cardiovascular disease etiology. In this paper, we discuss the potential role of perseverative cognition in mediating the relationship between psychiatric illness and cardiovascular disease. Rumination can delay physiological recovery from acute stress, which in turn has been found to predict future cardiovascular health. This delayed recovery could act as a mechanism in the longitudinal link between worry and cardiovascular health. The cognitive inflexibility that characterizes mood and anxiety disorders may then contribute to disease not by producing greater reactivity, but instead through extending activation, increasing the risks for cardiovascular damage.
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Chronic cognitive perseveration is linked to ongoing emotional reactions and downstream stress physiology that ultimately progresses to stress-related chronic disease.
“This model articulates a pathway by which chronic cognitive perseveration is linked to ongoing emotional reactions and downstream stress physiology (e.g., cardiovascular, metabolic, neuroendocrine, and immune/inflammatory systems) that ultimately progresses to stress-related chronic disease [13, 14].”
From Mindfulness Meditation Targets Transdiagnostic Symptoms Implicated in Stress-Related Disorders: Understanding Relationships between Changes in Mindfulness, Sleep Quality, and Physical Symptoms (2018) · cites this paper as [14]
The Introduction and §4 describe perseverative cognition as extending emotional stress and physiological reactivity beyond the stressful event. The Introduction and §5 propose that prolonged reactivity could contribute to cardiovascular disease, but §5 says the causal role of rumination remains unclear. The paper does not establish inevitable progression to chronic disease or the claimed pathway through metabolic, neuroendocrine, and immune/inflammatory systems. (LLM, conf=0.87)
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To understand a journal through four features: An example of Journal of Integrative Cardiology
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- Authors
- Larsen, B. A., & Christenfeld, N. J. S.
- Affiliations
- University of California San Diego (US)
- Corresponding author
- Larsen, Britta A.
- ORCID
- Larsen, Britta A.
- Venue
- Cardiovascular Psychiatry and Neurology
- Publisher
- Hindawi Limited
- Published
- 2009-07-22
- Volume
- 2009
- Pages
- 1-8
- ISSN
- 2090-0163 (ISSN-L)
- 2090-0171
- PMC
- PMC2790803
- OpenAlex
- W2028674066
- Cited by
- 61
- References
- 52
- Citations by year
- 2025: 5 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 3 · 2020: 4 · 2019: 4 · 2018: 4 · 2017: 5 · 2016: 7 · 2015: 6 · 2014: 3 · 2013: 3 · 2012: 2
- FWCI
- 1.30
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Cardiovascular Psychiatry and Neurology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- perseverative cognition, rumination, cardiovascular disease, psychiatric comorbidity, stress recovery, cardiovascular health, cognitive inflexibility, mood disorders, anxiety disorders, worry
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