Features of the Relationship between Cardiorhythm Regulation and Components of Internal Picture of Disease in Students

The work is aimed at identifying the features of the mechanisms of regulation of cardiac rhythm, which determine adaptive behavior in situations of health disorders. Materials from two empirical studies conducted on a sample of 1^st to 4^th year students at Yelets University are presented. The study 1 (N=160) involved respondents aged 17 to 23 years of both sexes, of whom 37.5% had various health problems. In study 2 (N=60), students (average age 21±2.3 years), of which 50% belong to the category of chronically ill, 50% had periodic health problems. Study 2 included five stages, in which four levels of the internal picture of the disease (IPD) were diagnosed and cardiac rhythm measurements were performed at rest and against the background of existing disease memories. The following methods were used: SF-36 Health Status Survey, Health, Activity, and Mood questionnaire, SCL-90-R, “Coping behavior in stressful situations”, “Level of subjective control”, TATD method. The fixation of the heart rate variability was carried out using the hardware and software complex OMEGA-M. The results obtained allow us to say that there is a correlation between the individual components of IPD and the parameters of regulation of heart rate variability. The optimal state of the body's homeostatic systems, which ensure successful adaptation, is characterized by the activity of the parasympathetic department of autonomic nervous system in the process of cardioregulation.

1. Akimenko M.A., Vasserman L.I., Dubinina E.A. et al. Nauchnaya sistema V.M. Bekhtereva: ot psikhonevrologii k biopsikhosotsial'noi i gumanisticheskoi paradigmam v meditsine i psikhologii [Scientific system of V.M. Bekhterev: from psychoneurology to biopsychosocial and humanistic paradigms in medicine and psychology]. Obozrenie psikhiatrii i meditsinskoi psikhologii imeni V.M. Bekhtereva = V.M. Bekhterev Review of Psychiatry and Medical Psychology, 2018. No. 1, Pp. 13–16. (In Russ., abstr. in Engl.)
2. Baevskii R.M. Otsenka i klassifikatsiya urovnei zdorov'ya s tochki zreniya teorii adaptatsii [Assessment and classification of health levels based on adaptation theory]. Vestnik AMN SSSR = Herald AMS OF THE USSR, 1989. No. 8, pp. 73–78. (In Russ.)
3. Baevskii R.M., Ivanov G.G., Chireikin L.V. et al. Analiz variabel'nosti serdechnogo ritma pri ispol'zovanii razlichnykh elektrokardiograficheskikh system [Analysis of heart rate variability using various electrocardiographic systems]. Vestnik aritmologii = Journal of Arrhythmology, 2001. No. 24, pp. 65–87. (In Russ., abstr. in Engl.)
4. Bakhtoyarov S.E., Lattserds N.V. Vnutrennyaya kartina bolezni v terapevticheskoi praktike [The internal picture of the disease in therapeutic practice]. Materialy mezhdunarodnoi nauchnoi konferentsii “Meditsina: vyzovy segodnyashnego dnya” = Proceedings of the international scientific conference “Medicine: challenges of today”. Chelyabinsk: Dva komsomol'tsa, 2012. Pp. 1–3. (In Russ.)
5. Bakhchina A.V., Strizhova I.V. Dinamika variabel'nosti serdechnogo ritma u uchashchikhsya vo vremya zanyatiya v virtual'noi real'nosti [Students’ Dynamics of Heart Rate Variability during Virtual Reality Class]. Eksperimental'naya psikhologiya = Experimental Psychology (Russia), 2022. Vol. 15, no. 2, pp. 59–69. DOI: 10.17759/exppsy.2022150205 (In Russ., abstr. in Engl.)
6. Berezin F.B. Psikhicheskaya i psikhofiziologicheskaya adaptatsiya cheloveka [Mental and psychophysiological adaptation of a person]. Leningrad: Nauka, 1988. 267 p. (In Russ.)
7. Bogushevskaya Yu.V., Vasil'eva A.V., Ivchenko A.I. Vnutrennyaya kartina bolezni i modeli otnosheniya k lecheniyu u zhenshchin s somatizirovannymi rasstroistvami [Internal Picture of the Disease and Patterns of Attitude to Treatment in Women with Somatic Disorders]. Konsul'tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2023. Vol. 31, no. 4, pp. 105–124. DOI: 10.17759/cpp.2023310406 (In Russ., abstr. in Engl.)
8. Vasserman L.I., Ababkov V.A., Trifonova E.A. Sovladanie so stressom: teoriya i praktika [Coping with stress: theory and practice]. St. Petersburg: Rech', 2010. 191 p. (In Russ.)
9. Vasserman L.I., Berebin M.A., Kosenkov N.I. O sistemnom podkhode v otsenke psikhicheskoi adaptatsii [On a systematic approach to the assessment of mental adaptation]. Obozrenie psikhiatrii i meditsinskoi psikhologii imeni V.M. Bekhtereva = V.M. Bekhterev Review of Psychiatry and Medical Psychology, 1994. No. 3, pp. 16–25. (In Russ.)
10. Vasserman L.I., Chugunov D.N., Shchelkova O.Yu. Sootnoshenie sub"ektivnykh i ob"ektivnykh faktorov v protsesse formirovaniya vnutrennei kartiny bolezni i sovladayushchego povedeniya [Relationships of Subjective and Objective Factors in the Process of Forming the Internal Picture of the Disease and Coping Behavior]. Konsul'tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2019. Vol. 27, no. 2, pp. 82–94. DOI: 10.17759/cpp.2019270206 (In Russ., abstr. in Engl.)
11. Glazyrina T.M., Solodkov A.S., Kulygin S.V. et al. Osobennosti vklada vnutrennei kartiny bolezni i klassa zabolevaniya na uroven' nervno-psikhicheskoi adaptatsii patsientov [Particulars of the contribution of internal picture of illness and disease on level of neuro-psichological adaptation pf patients]. Uchenye zapiski universiteta im. P.F. Lesgafta, 2016. No. 6 (136), pp. 218–221. DOI: 10.5930/issn.1994-4683.2016.06.136.p218-221 (In Russ., abstr. in Engl.)
12. Danilova N.N., Astaf'ev S.V. Vnimanie cheloveka kak spetsificheskaya svyaz' ritmov EEG s volnovymi modulyatorami serdechnogo ritma [Human attention as a specific linkage of EEG rhythms with the wave modulators of the cardiac rhythm]. Zhurnal vysshei nervnoi deyatel'nosti im. I.P. Pavlova = I.P. Pavlov Journal of Higher Nervous Activity, 2000. Vol. 50, no. 5, pp. 791–803. (In Russ., abstr. in Engl.)
13. Dobrin A.V., Shchuchka T.A., Polyakov R.Yu. Osobennosti svyazi sotsial'nogo intellekta s parametrami variabel'nosti kardioritma studentov pervogo kursa v protsesse vypolneniya kognitivnoi nagruzki [Peculiarities of the relationship between social intelligence and cardiorhythm variability parameters of first year students during cognitive load]. Perspektivy nauki i obrazovaniya = Perspectives of Science and Education, 2022. № 3 (57), pp. 486–506. DOI: 10.32744/pse.2022.3.28 (In Russ., abstr. in Engl.)
14. Doskin V.A., Lavrent'eva N.A., Miroshnikov M.P., Sharai V.B. Test differentsirovannoi samootsenki funktsional'nogo sostoyaniya [The test of differentiated self-assessment of functional status]. Voprosy psikhologii, 1973. No. 6, pp. 141–145. (In Russ.)
15. El'nikova O.E. Urovni vnutrennei kartiny bolezni u predstavitelei raznykh grupp zdorov'ya [Levels of internal disease patterns in representatives of different health groups]. Vestnik Rossiiskogo universiteta druzhby narodov. Seriya: Psikhologiya i pedagogika = RUDN Journal of Psychology and Pedagogics, 2015. No. 1, pp. 43–48. (In Russ., abstr. in Engl.)
16. El'nikova O.E. Diagnostika emotsional'nogo urovnya vnutrennei kartiny bolezni u predstavitelei raznykh grupp zdorov'ya [Diagnostics of emotional level of internal disease patterns among representatives of different groups of health]. Psikhologiya obrazovaniya v polikul'turnom prostranstve = Journal “Psychology of Education in Multicultural Space”, 2014. No. 3 (27), pp. 27–33. (In Russ., abstr. in Engl.)
17. Emel'yanova A.S., Simonyan L.A., Stepura E.E. Analiz elektrokardiogrammy studentov s raznym urovnem dvigatel'noi aktivnosti [Heart rate variability analysis of students with different motor activity levels]. Vestnik Rossiiskogo universiteta druzhby narodov. Seriya: Meditsina = RUDN Journal of Medicine, 2021. Vol. 25, no. 2, pp. 127–135. DOI: 10.22363/2313-0245-2021-25-2-127-135 (In Russ., abstr. in Engl.)
18. Zaitseva O.I., Kolodyazhnaya T.A. Sostoyanie i svyaz' vegetativnoi nervnoi sistemy s psikhoemotsional'nym statusom u shkol'nikov [State and communication vegetative nervous system with psycho-emotional status in schoolchildren]. Sovremennye problemy nauki i obrazovaniya = Modern problems of science and education, 2016. No. 2. URL: https://science-education.ru/ru/article/view?id=24193 (Accessed: 17.01.2024) (In Russ., abstr. in Engl.)
19. Zakhar'yan E.A., Chernyi E.V. Otnoshenie patsienta k bolezni kak prediktor ee techeniya i iskhoda [Patient attitude towards disease as a predictor of its course and outcome]. Klinicheskaya meditsina = Clinical Medicine (Russian Journal), 2023. No. 101 (11), pp. 538–548. DOI: 10.30629/0023-2149-2023-101-11-538-548 (In Russ., abstr. in Engl.)
20. Zyabkina I.V. Vnutrennyaya kartina zdorov'ya i vnutrennyaya kartina bolezni [Mental image of health and mental image of illness]. Uchenye zapiski Krymskogo federal'nogo universiteta imeni V.I. Vernadskogo. Sotsiologiya. Pedagogika. Psikhologiya = Scientific Notes of V.I. Vernadsky Crimean Federal University. Sociology. Pedagogy. Psychology, 2021. Vol. 7 (73), no. 1, pp. 126–137. (In Russ., abstr. in Engl.)
21. Kaznacheev V.P., Baevskii R.M., Berseva A.P. Donozologicheskaya diagnostika v praktike massovykh obsledovanii naseleniya [Prenosological diagnostics in the practice of mass population surveys]. Leningrad: Meditsina, 1980. 260 p. (In Russ.)
22. Klyucharev V.A., Zubarev I.P., Shestakova A.N. Neirobiologicheskie mekhanizmy sotsial'nogo vliyaniya [Neurobiological mechanisms of social influence]. Eksperimental'naya psikhologiya = Experimental Psychology (Russia), 2014. Vol. 7, no. 4, pp. 20–36. (In Russ., abstr. in Engl.)
23. Kryukova T.L. Metody izucheniya sovladayushchego povedeniya: tri koping-shkaly. Izd. 2-e, ispr., dop.). [Methods of studying coping behavior: three coping scales. 2nd ed., corrected, supplemented).] Kostroma: KGU im. N.A. Nekrasova, Avantitul, 2010. 64 p. (In Russ)
24. Limonova A.S., Germanova K.N., Gantman M.V. et al. Neirovistseral'nye vzaimodeistviya v ramkakh osi mozg–serdtse kak osnova neirokardiologii [Neurovisceral interactions within the brain-heart axis as the basis of neurocardiology]. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention, 2022. No. 21 (10), pp. 3435. DOI: 10.15829/1728-8800-2022-3435(In Russ., abstr. in Engl.)
25. Lichko A.E., Ivanov N.L. Mediko-psikhologicheskoe obsledovanie somaticheskikh bol'nykh [Medical and psychological examination of somatic patients]. Zhurnal nevropatologii i psikhiatrii im. S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry, 1980. No. 8, pp. 1195–1198. (In Russ., abstr. in Engl.)
26. Maslennikova O.M., Ardashev V.N., Novikov E.M. et al. Otsenka predtestovoi veroyatnosti ishemicheskoi bolezni serdtsa po dannym dispersionnogo kartirovaniya elektrokardiogrammy i analiza variabel'nosti serdechnogo ritma [Assessment of the pre-test probability of ischemic heart disease according to the data of dispersion mapping of an electrocardiogram and analysis of heart rate variability]. Klinicheskaya meditsina = Clinical medicine (Russian Journal), 2022. No. 100 (4-5), pp. 178–184. DOI: 10.30629/0023-2149-2022-100-4-5-178-184 (In Russ., abstr. in Engl.)
27. Mashin V.A. Variabel'nosti cerdechnogo ritma. Trekhfaktornaya model' VSR v issledovaniyakh funktsional'nykh sostoyanii cheloveka [Heart rate variability: A three-factor model of HRV in studies of human functional states]. LAMBERT Academic Publishing GmbH & Co., 2012. 580 p. (In Russ.)
28. Milyukov V.E., Zharikova T.S. Kriterii formirovaniya vozrastnykh grupp patsientov v meditsinskikh issledovaniyakh [Criteria for the formation of age groups of patients in clinical studies]. Klinicheskaya meditsina = Clinical Medicine (Russia), 2015. Vol. 93, no. 11, pp. 5–11. (In Russ., abstr. in Engl.)
29. Mukhin V.N. Yakovlev N.M., Klimenko V.M. Svyaz' variabel'nosti serdechnogo ritma s urovnem aktivatsii lobnoi kory [Association of heart rate variability and frontal cortex activation]. Rossiiskii fiziologicheskii zhurnal im. I.M. Sechenova = Russian Physiological Journal, 2011. Vol. 97, no. 11, pp. 1281–1288. (In Russ., abstr. in Engl.)
30. Myasishchev V.N. Psikhologiya otnoshenii [Psychology of relations]. Ed. by A.A. Bodalev. Moscow: Publ. house “Institute of Practical Psychology”; Voronezh: NPO “MODEK”, 1995. 356 p. (In Russ.)
31. Nikolaeva E.I., Vergunov E.G., El'nikova O.E. Model' ustoichivoi adaptatsii khronicheski bol'nykh lyudei s ispol'zovaniem variabel'nosti kardioritma [The model of sustainable adaptation of chronic patients using heart rate variability]. Sovremennye problemy nauki i obrazovaniya = Modern problems of science and education, 2015. No. 1-1, pp. 1578. URL: https://science-education.ru/ru/article/view?id=19223 (Accessed: 04.01.2024) (In Russ., abstr. in Engl.)
32. Novik A.A, Ionova T.I. Rukovodstvo po issledovaniyu kachestva zhizni v meditsine [Guidelines for the study of quality of life in medicine]. 2nd ed. Ed. by Yu.L. Shevchenko. Moscow: OLMA PRESS, 2007. 313 p. (In Russ.)
33. Popugaev K.A., Lubnin A.Yu., Zabelin M.V., Samoilov A.S. Avtonomnaya nervnaya sistema i ee disbalans v neiroreanimatsii [Autonomic nervous system and its imbalance in neuro intensive care unit]. Anesteziologiya i reanimatologiya = Russian Journal of Anesthesiology and Reanimatology, 2016. Vol. 61, no. 2, pp. 137–142. DOI: 10.18821/0201-7563-2016-61-2-137-142 (In Russ., abstr. in Engl.)
34. Psikhologicheskaya diagnostika otnosheniya k bolezni: posobie dlya vrachei [Psychological diagnosis of the attitude to the disease: a manual for doctors]. St. Petersburg: St. Petersburg Scientific Research Psychoneurological Institute named after V.M. Bekhterev, 2005. 33 p. (In Russ.)
35. Putilin L.V., Prokhorov D.Yu. Trend pokazatelei variabel'nosti serdechnogo ritma i rol' spetsial'nosti u ordinatorov za 2013–2022 gody [The trend of heart rate variability indicators and the role of specialty among residents for 2013-2022]. Rossiiskii kardiologicheskii zhurnal = Russian Journal of Cardiology, 2023. Vol. 28, no.6S, pp. 17–18. (In Russ., abstr. in Engl.)
36. Rean A.A. Prakticheskaya psikhodiagnostika lichnosti: Uchebnoe posobie. [Practical psychodiagnostics of personality: A textbook.] SPb: Izd-vo SPb un-ta, 2001. 224 p. (In Russ.)
37. Soldatova O.G., Shilov S.N., Potylitsina V.Yu. Vzaimosvyaz' osobennostei temperamenta s nespetsificheskoi rezistentnost'yu organizma i urovnem zdorov'ya [Intercorrelation between temperament peculiarities with non-specific body resistance and state of health]. Nevrologicheskii vestnik = Neurological Bulletin, 2008. Vol. 40, no. 1, pp. 10–13. (In Russ., abstr. in Engl.)
38. Solodukhin A.V., Seryi A.V., Yanitskii M.S., Trubnikova O.A. Vozmozhnosti metodov kognitivno- povedencheskoi psikhoterapii v izmenenii vnutrennei kartiny bolezni u patsientov s ishemicheskoi bolezn'yu serdtsa [Cognitive behavioral therapy: An option for changing internal picture of disease in patients with coronary artery disease]. Fundamental'naya i klinicheskaya meditsina = Fundamental and Clinical Medicine, 2017. Vol. 2, no. 1, pp. 84–90. (In Russ., abstr. in Engl.)
39. Tarabrina N.V., Agarkov V.A., Bykhovets Yu.V. et al. Prakticheskoe rukovodstvo po psikhologii posttravmaticheskogo stressa. Chast` 1. Teoriya i metody. [Practical guide to the psychology of post-traumatic stress. Part 1. Theory and methods. Moscow: Cogito-Center, 2007. 207 p. (In Russ.)
40. Fazleeva E.V., Shalavina A.S., Vasenkov N.V. i dr. Sostoyanie zdorov'ya studencheskoi molodezhi: tendentsii, problemy, resheniya [Health status of youth students: trends, problems, solutions]. Mir nauki. Pedagogika i psikhologiya = World of Science. Pedagogy and psychology, 2022. Vol. 10, no. 5. URL: https://mir-nauki.com/PDF/01PDMN522.pdf (Date of access: 30.06.2024) (In Russ., abstr. in Engl.)
41. Shilov S.N., Ignatova I.A., Ignatova I.A. et al. Teoriya adaptatsii-readaptatsii v sovremennykh predstavleniyakh “Zdorov'e” [Adaptation-readaptation theory in the current notion about definition of “Health”]. Fundamental'nye issledovaniya = Fundamental research, 2015. No. 1-6, pp. 1275–1280. URL: https://fundamental-research.ru/ru/article/view?id=37758 (Date of access: 08.01.2024) (In Russ., abstr. in Engl.)
42. Shlyk N.I. Serdechnyi ritm i tip regulyatsii u detei, podrostkov i sportsmenov [Heart rate and type of regulation in children, adolescents and athletes]. Izhevsk: Publ. house “Udmurtskii universitet”, 2009. 259 p. (In Russ.)
43. Shlyk N.I. Ekspress-otsenka funktsional'noi gotovnosti organizma sportsmenov k trenirovochnoi i sorevnovatel'noi deyatel'nosti (po dannym analiza variabel'nosti serdechnogo ritma) [Express-evaluation of the functional readiness of the organism athletes for training and competitive activity (according to the analysis of heart rate variability)]. Nauka i sport: sovremennye tendentsii = Science and Sport: modern tendencies, 2015. Vol. 9, no. 4, pp. 5–15. (In Russ., abstr. in Engl.)
44. Shlyk N.I. Normativy pokazatelei variabel'nosti serdechnogo ritma v pokoe i ortostaze pri raznykh diapazonakh znacheniya MxDMn i ikh izmenenie u biatlonistov v trenirovochnom protsesse [Heart rate variability standards at rest and orthostasis at different MxDMn values and their change in biathletes during the training process]. Chelovek. Sport. Meditsina = Human. Sport. Medicine, 2020. Vol. 20, no. 4, pp. 5–24. DOI: 10.14529/hsm200401(In Russ., abstr. in Engl.)
45. Alba G., Vila J., Rey B. et al. The relationship between heart rate variability and electroencephalography functional connectivity variability is associated with cognitive flexibility. Frontiers in Human Neuroscience, 2019. Vol. 13, art. 64. DOI: 10.3389/fnhum.2019.00064
46. Aslan H., Cetkin T., Demir R. Effects of chronic illness adaptation on the healthy lifestyle behaviours of patients in internal services. Cukurova Medical Journal, 2021. Vol. 46, no. 3, pp. 1140–1149. DOI: 10.17826/cumj.913997
47. Fanghella M., Gaigg S.B., Candidi M. et al. Somatosensory evoked potentials reveal reduced embodiment of emotions in autism. Journal of Neuroscience, 2022. Vol. 42, no. 11, pp. 2298–2312. DOI: 10.1523/JNEUROSCI.0706-21.2022
48. Franks P.W., Hanson R.L., Knowler W.C. et al. Childhood obesity, other cardiovascular risk factors, and premature death. The New England Journal of Medicine, 2010. Vol. 362 (6), pp. 485–493. DOI: 10.1056/NEJMoa0904130
49. Gayathri R., Manyeswari P., Mahanta P., Bapu K.G.V. Relationship between health promoting behaviors, self-compassion and health value among medical students. International Journal of Indian Psychology, 2023. Vol. 11 (3), pp. 628–637. DOI: 10.25215/1103.060
50. Izuma K., Adolphs R. Social manipulation of preference in the human brain. Neuron, 2013. Vol. 78, no. 3, pp. 563–573. DOI: 10.1016/j.neuron.2013.03.023
51. Izuma K., Matsumoto M., Murayama K. et al. Neural correlates of cognitive dissonance and choice-induced preference change. Proceedings of the National Academy of Sciences, 2010. Vol. 107, no. 51, pp. 22014–22019. DOI: 10.1073/pnas.1011879108
52. Karatepe H., Atik D., Özcan Yüce U. Adaptation with the chronic disease and expectations from nurses. Erciyes Medical Journal, 2020. Vol. 42 (1), pp. 18–24. DOI: 10.14744/etd.2019.83446
53. Kenjaev B.I. Heart rate variability and its determination in students by the express method. American Journal of Pediatric Medicine and Health Sciences, 2024. Vol. 2 (4), pp. 43–45. URL: https://grnjournal.us/index.php/AJPMHS/article/view/4215
54. Kütmeç Yilmaz C., Kara F.Ş. The effect of spiritual well-being on adaptation to chronic illness among people with chronic illnesses. Perspective in Psychiatric Care, 2021. Vol. 57 (1), pp. 318–325. DOI: 10.1111/ppc.12566
55. McCraty R., Shaffer F. Heart rate variability: New perspectives on physiological mechanisms, assessment of self-regulatory capacity, and health risk. Global Advances in Health and Medicine, 2015. Vol. 4 (1), pp. 46–61. DOI: 10.7453/gahmj.2014.073
56. Mewes R. Recent developments on psychological factors in medically unexplained symptoms and somatoform disorders. Frontiers in Public Health, 2022. Vol. 10, e1033203. DOI: 10.3389/fpubh.2022.1033203
57. Motzkin J.C., Philippi C.L., Wolf R.C. et al. Ventromedial prefrontal cortex lesions alter neural and physiological correlates of anticipation. The Journal of Neuroscience, 2014. Vol. 34 (31), pp. 10430–10437. DOI: 10.1523/JNEUROSCI.1446-14.2014
58. Nikolaeva T., Golubeva E., Skorlupkin D., Yarchenkova L. Heart rate variability during mental and physical load in students. Siberian Journal of Life Sciences and Agriculture, 2022. Vol. 14 (1), pp. 336–350. DOI: 10.1523/JNEUROSCI.1446-14.2014
59. Riganello F., Candelieri A., Quintieri M. et al. Heart rate variability: An index of brain processing in vegetative state? An artificial intelligence, data mining study. Clinical Neurophysiology, 2010. Vol. 121 (12), pp. 2024–2034. DOI: 10.1016/j.clinph.2010.05.010
60. Sakaki M., Yoo H.J., Nga L. et al. Heart rate variability is associated with amygdala functional connectivity with MPFC across younger and older adults. Neuroimage, 2016. Vol. 139, pp. 44–52. DOI: 10.1016/j.neuroimage.2016.05.076
61. Shah A., Wittbrodt M., Bremner J. et al. Cardiovascular pathophysiology from the cardioneural perspective and its clinical applications. Trends in Cardiovascular Medicine, 2022. Vol. 32 (3), pp. 172–177. DOI: 10.1016/J.TCM.2021.03.001
62. Sirgy M.J. The psychology of quality of life. Wellbeing and Positive Mental Health. NY: Springer, 2012. 622 p.
63. Smith R., Thayer J.F., Khalsa S.S., Lane R.D. The hierarchical basis of neurovisceral integration. Neuroscience & Biobehavioral Reviews, 2017. Vol. 75, pp. 274–296. DOI: 10.1016/j.neubiorev.2017.02.003
64. Thayer J.F., Ahs F., Fredrikson M. et al. A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health. Neuroscience & Biobehavioral Reviews, 2012. Vol. 36 (2), pp. 747–756. DOI: 10.1016/j.neubiorev.2011.11.009
65. Thayer J.F., Hansen A.L., Saus Rose E., Johnsen B.H. Heart rate variability, prefrontal neural function, and cognitive performance: the neurovisceral integration perspective on self regulation, adaptation, and health. Annals of Behavioral Medicine, 2009. Vol. 37 (2), pp. 141–153. DOI: 10.1007/s12160-009-9101-z
66. Ware J.E., Snow K.K., Kosinski M., Gandek B. SF-36 Health Survey. Manual and interpretation guide //The Health Institute, New England Medical Center. Boston, Mass.,1993
67. von Känel R. Psychosocial stress and cardiovascular risk: current opinion. Swiss Medical Weekly, 2012. Vol. 142 (1). DOI: 10.4414/smw.2012.13502
68. Yoo H.J., Thayer J.F., Greening S. et al. Brain structural concomitants of resting state heart rate variability in the young and old: Evidence from two independent samples. Brain Structure and Function, 2018. Vol. 223 (2), pp. 727–737. DOI: 10.1007/s00429-017-1519-7