Psychophysiological Changes in Individuals With Repetitive Negative Thinking During Idleness And on Assigning A Cognitive Task: A Biofeedback-Based Comparative Study

Abstract

Background: Repetitive negative thinking (RNT) is a transdiagnostic cognitive process implicated in anxiety, depressive, and adjustment disorders, and is linked to autonomic dysregulation and reduced heart rate variability. Whether a brief, task-based biofeedback session can shift these physiological and subjective indices away from a ruminative, idle state has not been well studied in Indian outpatient populations.

Objectives: To assess and compare psychophysiological parameters and subjective distress/relaxation percentages during a period of idleness versus a period of task-based biofeedback in individuals with high RNT, and to examine consistency of these effects across age, gender, and diagnostic subgroups.

Methods: In this cross-sectional comparative study, 80 participants aged 18–58 years with adjustment disorder, anxiety disorder, depression, or obsessive thoughts, and a Penn State Worry Questionnaire score ≥20, underwent 10 minutes of baseline biofeedback monitoring during idleness followed by a structured cognitive task (auditory-discrimination and sustained-attention exercises) under continued biofeedback monitoring. Heart rate (HR), respiratory rate (RR), galvanic skin response (GSR), peripheral temperature, and biofeedback-derived relaxation and distress percentages were recorded before and after the task using the RMS Relax 701 Advanced Bio-Feedback System. The Wilcoxon signed-rank test compared paired values; p<0.05 was considered significant.

Results: Median HR fell from 86 (80.5–91.5) to 75 (72–82) bpm (p<0.001). Relaxation percentage rose from 77% (72–82) to 90% (86–93) (p<0.001), while distress fell from 22% (19.3–27.5) to 10% (7–14) (p<0.001). RR, GSR, and temperature did not change significantly. Effects were preserved across age strata (≤30 vs >30 years), gender, and diagnostic subgroups (generalized anxiety disorder [GAD] and depression).

Conclusions: A single, brief session combining a structured cognitive task with real-time biofeedback produced a rapid, reproducible reduction in heart rate and subjective distress and an increase in relaxation among individuals with high RNT, independent of age, gender, or diagnosis. This low-cost, scalable approach merits further evaluation as an adjunctive, transdiagnostic intervention in resource-constrained mental health settings.