PTSD psychotherapy improves blood pressure but leaves HPA axis feedback sensitivity stable and unaffected: First evidence from a pre-post treatment study

Clinically meaningful posttraumatic stress disorder (PTSD) improvement and incident hypertension, hyperlipidemia, and weight loss.

“…Our results are consistent with previous studies indicating PTSD treatment is associated with reduced risk for hypertension (Burg et al, 2017; Schubert et al, 2019). We are not aware of existing research designed to determine whether PTSD improvement is associated with incident hyperlipidemia.…”

“…It is not known if clinically significant improvements in PTSD are associated with reduced risk for these poor health outcomes. A few exceptions include evidence that adequate PTSD treatment is associated with reduced blood pressure (Burg et al, 2017; Schubert et al, 2019). In addition, a large retrospective cohort study revealed that veterans with PTSD who did versus did not have clinically meaningful reduction in PTSD Checklist scores were 50% less likely to develop T2D (Scherrer et al, 2019).…”

Posttraumatic Stress Disorder Treatment Effects on Cardiovascular Physiology: A Systematic Review and Agenda for Future Research

“…The effects of CBT on CVR with regard to general stressors were more mixed—two studies found some evidence for reduced CVR (Hinton et al., 2009; Schubert et al. 2019), whereas two others did not (Rabe et al., 2006; Blanchard et al., 2002). Five of the six studies that examined the effect of EMDR on CVR found that EMDR reduced CVR to trauma‐related stressors (Aubert‐Khalfa et al., 2008; Montgomery & Ayllon, 1994; Rogers et al., 1999; Sack et al., 2008; Wahbeh et al., 2016), and one study found that EMDR attenuated CVR to a general stressor (Renfrey & Spates, 1994).…”

“…Eleven of the 12 studies that tested some implementation of CBT found reduced CVR to traumarelated stressors (Blanchard et al, 2002;Dunne et al, 2012;Fecteau & Nicki, 1999;Griffin et al, 2012;Rabe et al, 2006;Lindhauer et al, 2006), including all six studies that utilized a primary exposure component (Bourassa, Stevens, et al, 2020;Loucks et al, 2019;Maples-Keller et al, 2019;Tuerk et al, 2018;Wangelin & Tuerk, 2015;Wells et al, 2015). The effects of CBT on CVR with regard to general stressors were more mixed-two studies found some evidence for reduced CVR (Hinton et al, 2009;Schubert et al 2019), whereas two others did not (Rabe et al, 2006;Blanchard et al, 2002). Five of the six studies that examined the effect of EMDR on CVR found that EMDR reduced CVR to trauma-related stressors (Aubert-Khalfa et al, 2008;Montgomery & Ayllon, 1994;Rogers et al, 1999;Sack et al, 2008;Wahbeh et al, 2016), and one study found that EMDR attenuated CVR to a general stressor (Renfrey & Spates, 1994).…”

Targeting the stress response in pediatric pain: current evidence for psychosocial intervention and avenues for future investigation

“…In the context of PTSD, a recent review indicated that certain trauma-focused interventions, including TF-CBT, prolonged exposure (PE), and eye-movement desensitization reprocessing, performed on adults with PTSD, are effective in mitigating dysregulation in basal cortisol levels and the cortisol awakening response in certain subsamples; however, more broad results from these studies remain mixed. 86 , 99 , 100 In youth particularly, evidence suggests that certain aspects of HPA axis functioning (eg, basal cortisol levels) may be indicative of who may be more or less responsive to TF-CBT 113 and MBSR 63 and, moreover, may be a more reliable measure of treatment response than subjective measures such as psychological questionnaires. 63 This latter finding supports the rationality of efforts to objectively measure treatment response through biological measures such as saliva assay rather than rely on traditional pain measures such as (self-reported) disability and pain intensity.…”