Examining the Crux of Autonomic Dysfunction in Posttraumatic Stress Disorder

OBJECTIVE: Posttraumatic stress disorder (PTSD) has been linked to elevated heart rate (HR) and reduced heart rate variability (HRV) in cross-sectional research. Using ecological momentary assessment and minute-to-minute HRV/HR monitoring, we examined whether cross-sectional associations between PTSD symptom severity and HRV/HR were due to overall elevations in distress levels or to attenuated autonomic regulation during episodes of acute distress. METHODS: Two hundred nineteen young adults (18-39 years old), 99 with PTSD, underwent 1 day of Holter monitoring and concurrently reported distress levels via ecological momentary assessment. Using multilevel modeling, we examined the associations between momentary distress and the 5-minute means for low-frequency (LF) and high-frequency (HF) HRV and HR immediately following distress ratings, and whether PTSD symptom severity moderated these associations. RESULTS: Compared with the controls, participants with PTSD recorded higher ambulatory distress (mean [standard deviation] = 1.7 [0.5] versus 1.2 [0.3], p .27). However, baseline PTSD symptom severity was associated with elevated HR (t(1257) = 2.76, p = .006) and attenuated LF (t(1257) = -3.86, p < .001) and HF (t(1257) = -2.62, p = .009) in response to acute momentary distress. CONCLUSIONS: Results suggest that PTSD is associated with heightened arousal after situational distress and could explain prior findings associating PTSD with HR/HRV. Implications for treatment and cardiovascular risk are discussed

Ambulatory · Autonomic nervous system · Blood pressure · Cardiology · Distress · Heart rate · Heart rate variability · Posttraumatic stress · Psychiatry · Clinical Psychology · Heart Rate Variability and Autonomic Control · Internal Medicine · Medicine · Posttraumatic Stress Disorder Research · Psychology · Stress Responses and Cortisol

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