Heart Rate Biofeedback and Cold Pressor Pain

ABSTRACT This study addressed the relative contributions of self‐regulated heart rate change and belief that heart rate is changing in an instructed direction to the perception of cold pressor pain. Forty male volunteers were each assigned to one of four combinations of increase or decrease heart rate instructions and increase or decrease feedback conditions. Subjects were given an initial 45‐sec cold pressor test, 25 feedback trials, and a final cold pressor in which they were told to change their heart rate in the instructed direction, but without the aid of feedback. Subjects were instructed specifically that increased heart rate was associated with increased pain and decreased heart rate with decreased pain. The veridical groups (consistent instructions and feedback) showed appropriate heart rate changes during biofeedback training and parallel changes in heart rate and pain perception during the final cold pressor. The non‐veridical (reverse) feedback groups showed no heart rate change during biofeedback training and no relationship between heart rate and pain perception changes during the final cold pressor test. EMG, respiration, and skin conductance data are presented, and several mechanisms are proposed to explain the physiological and subjective changes.