Heart Rate Variability (HRV) and Posttraumatic Stress Disorder (PTSD): A Pilot Study

Abstract

Exposure to combat experiences is associated with increased risk of developing Post Traumatic Stress Disorder. Prolonged exposure therapy and cognitive processing therapy have garnered a significant amount of empirical support for PTSD treatment; however, they are not universally effective with some patients continuing to struggle with residual PTSD symptoms. Heart rate variability (HRV) is a measure of the autonomic nervous system functioning and reflects an individual's ability to adaptively cope with stress. A pilot study was undertaken to determine if veterans with PTSD (as measured by the Clinician-Administered PTSD Scale and the PTSD Checklist) would show significantly different HRV prior to an intervention at baseline compared to controls; specifically, to determine whether the HRV among veterans with PTSD is more depressed than that among veterans without PTSD. The study also aimed at assessing the feasibility, acceptability, and potential efficacy of providing HRV biofeedback as a treatment for PTSD. The findings suggest that implementing an HRV biofeedback as a treatment for PTSD is effective, feasible, and acceptable for veterans. Veterans with combat-related PTSD displayed significantly depressed HRV as compared to subjects without PTSD. When the veterans with PTSD were randomly assigned to receive either HRV biofeedback plus treatment as usual (TAU) or just TAU, the results indicated that HRV biofeedback significantly increased the HRV while reducing symptoms of PTSD. However, the TAU had no significant effect on either HRV or symptom reduction. A larger randomized control trial to validate these findings appears warranted.

Altered Resting-State Functional Connectivity of Basolateral and Centromedial Amygdala Complexes in Posttraumatic Stress Disorder

“…Significant correlations have been reported between the cardiac rate and resting BOLD signal time courses, particularly negative correlations in gray matter (Chang et al, 2009). Thus, possible differences in heart rate variability associated with PTSD (Tan et al, 2011) might confound the present results. Our approach conceptualized amygdala complexes as seeds and cortical regions as targets.…”

The STRIVE-ONR Project: Stress Resistance in Virtual Environments

“…They found that the SDNN was lower in this group compared with available norms, though only for all three conditions in combination. Tan, Dao, Farmer, Sutherland, and Gevirtz (2011) found that SDANN was significantly lower for the group of veterans with PTSD compared to control subjects, with a large effect size. The researchers further examined an HRV biofeedback paradigm, providing half of the PTSD group with eight HRV biofeedback sessions in addition to their ongoing treatment.…”

“…Studies have also shown that HRV biofeedback treatment can provide significant relief for individuals with combat related PTSD (Tan, Dao, Farmer, Sutherland, & Gevirtz, 2011;Zucker et al, 2009). Individuals with PTSD are able to alleviate symptoms (e.g., hyperarousal) through HRV biofeedback training, by controlling and maintaining their respiration at resonant frequency.…”

Combat Related Posttraumatic Stress Disorder – History, Prevalence, Etiology, Treatment, and Comorbidity

“…Clients undergoing heart rate variability training are asked to first meet with the therapist to determine what breathing rate will produce their greatest heart rate variability (Lehrer et. al., 2000;Tan et. al., 2011).…”