Examining the Prospective Relationship between Pre-Disaster Respiratory Sinus Arrhythmia and Post-Disaster Posttraumatic Stress Disorder Symptoms in Children

Abstract

Previous studies have examined the concurrent relationship between posttraumatic stress disorder (PTSD) and a range of psychophysiological variables, including respiratory sinus arrhythmia (RSA). However, there is a lack of research examining the prospective development of trauma symptomatology, and the directionality of the association between RSA level and PTSD has yet to be determined. The current study is the first prospective study to examine whether RSA level and RSA reactivity are risk factors for PTSD symptoms in children. Assessments were conducted both prior to (Time 1) and following (Time 2) a natural disaster (i.e., Hurricane Katrina). Participants were 36 children who were 3-6 years-old during the Time 1 assessment. Structured diagnostic interviews were used to assess PTSD symptoms at both Time 1 and Time 2. RSA level during a neutral stimulus, RSA reactivity to emotional video stimuli (distress, joy, and trauma videos) and RSA reactivity to memory stimuli (remote happy memory, trauma memory, mother's recall of the trauma memory) were also collected at both time points. Time 1 RSA level during a neutral stimulus was a significant predictor of Time 2 PTSD symptoms (controlling for age, Time 1 PTSD symptoms, Time 2 neutral RSA level), such that lower RSA during a neutral condition was related to higher PTSD symptoms. Also, Time 1 RSA reactivity in response to memory (but not video) stimuli, in the form of relatively less vagal withdrawal, was a significant predictor of more Time 2 PTSD symptoms (controlling for age, Time 1 PTSD symptoms, Time 2 RSA reactivity). This unique prospective study provides evidence for level of RSA and RSA reactivity as pre-existing clinical markers of stress sensitivity that predict psychopathology following a trauma.

Early posttraumatic autonomic and endocrine markers to predict posttraumatic stress symptoms after a preventive intervention with oxytocin

“…Predictions are controlled for age, time between traumatic event and T2 as well as pre-treatment PTSD symptoms. Mikolajewski & Scheeringa, 2018;Minassian et al, 2015;Morris et al, 2016;Pyne et al, 2016;Shaikh Al Arab et al, 2012) We assessed HR(V) parameters during rest within the first 12 days posttrauma and did not observe any prognostic effects. The comparison with previous findings suggests that resting HR(V) measured before or acutely after trauma has prognostic value, whereas this value diminishes over time, supporting the recommendation to apply a stage-dependent approach to investigate biological mechanisms associated with PTSD (McFarlane, Lawrence-Wood, van Hooff, Malhi, & Yehuda, 2017).…”

“…To date, three prospective studies investigated pretrauma HRV. These reported that pretrauma lower resting HRV was associated with higher posttrauma PTSD symptoms in male military personnel (Minassian et al, 2015 ) and a mixed-sex sample of children (Mikolajewski & Scheeringa, 2018 ). The third study, again in a predominantly male, military personnel sample, found this association was specific to the context of high pretrauma symptoms (Pyne et al, 2016 ).…”

A Latent Profile Analysis of Co-occurring Youth Posttraumatic Stress and Conduct Problems Following Community Trauma

“…Following a disaster, perhaps youth with a specific genotype or neural dysfunction may be more likely to manifest trauma response through the development of co-occurring PTS and CPs. For example, research has shown that genetic variations interact with maltreatment to influence youth aggression (Bryushkova et al, 2016), and youth Respiratory Sinus Arrhythmia before a natural disaster predicts post-disaster PTSD symptoms (Mikolajewski & Scheeringa, 2018). Similar physiological and neural pathways are implicated in youth PTS and CPs (e.g., Blair, Veroude, & Buitelaar, 2018; Morey, Haswell, Hooper, & De Bellis, 2016), perhaps accounting in part for the overrepresentation of CP among youth with the most severe PTS.…”

Reexamination of diathesis stress and neurotoxic stress theories: A qualitative review of pre‐trauma neurobiology in relation to posttraumatic stress symptoms

“…Of the eight studies that measured indices of the autonomic nervous system (ANS), all eight supported the DST in relation to one or more variables Guthrie & Bryant, 2005, 2006Mikolajewski & Scheeringa, 2016;Minassian et al, 2015;Orr et al, 2012;Pole et al, 2009;Pyne et al, 2016). Two of the studies also repeated the measurement of an ANS variable after the index trauma and were capable of testing the NST, and both were negative for the NST (Guthrie & Bryant, 2005;Mikolajewski & Scheeringa, 2016).…”

“…Many of the subjects in these studies experienced traumas prior to their index traumas in the studies. However, two studies included samples with no prior trauma exposure and both found support for the DST Mikolajewski & Scheeringa, 2016). The majority of participants in the studies were self-selected individuals who entered military and first-responder careers.…”