Psychological adjustment and heart rate variability in ovarian cancer survivors

Francesco De Vincenzo, Chiara Cosentino, Rossella Mattea Quinto, Silvia Di Leo, Anna Contardi, Sara Guidotti, Luca Iani, Carlo Pruneti


Introduction: Body image, posttraumatic growth, quality of life, coping, and social support are relevant concepts to ovarian cancer survivors. This study aimed to examine the associations among these concepts as well as their relationships with heart rate variability (HRV), which is an index of vagal tone. 

Methods: an exploratory and correlational study was conducted on 25 ovarian cancer survivors. We used self-report measures to assess psychological variables. HRV parameters recorded for this study were analyzed in the time domain and in the frequency domain. Spearman correlations were performed.

Results: Positive attitude coping strategy was associated with psychological and physical distress related to problems of appearance (Rho = -.57, p < .01), emotional functioning (Rho = .53, p < .01), and global health (Rho = .47, p < .05). Problem solving coping strategy was correlated with a higher posttraumatic growth, namely greater personal strength (Rho = .44, p < .05) and better relationships with others (Rho = .40, p < .05). Seeking social support was associated with growth in relationships with others (Rho = .40, p < .05). Higher HRV parameters were associated with higher physical functioning (SDNN: Rho = .59, p < .01; RMSSD: Rho = .54; p < .01; pNN50: Rho = .56, p < .01; HF: Rho = .58, p < .01). The ratio of low-frequency to high-frequency power (LF/HF) was negatively associated with posttraumatic growth (i.e., personal strength: Rho = .51, p < .05; new possibilities: Rho = -.54, p < .01).

Discussion: Positive attitude and problem solving coping strategies may facilitate psychological adjustment to ovarian cancer. The strong association between markers of vagal tone and physical functioning offers insights on the possible role of vagus nerve in ovarian cancer survivors. These findings should be further investigated by future studies with larger samples and longitudinal designs.


Vagal tone; Posttraumatic growth; Body image; Coping; Social support; Clinical psychology.

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