Trauma and Autonomic Dysregulation: Episodic - Versus Systemic - Negative Affect Underlying Cardiovascular Risk in Posttraumatic Stress Disorder.

Published online

Journal Article

OBJECTIVE: Posttraumatic stress disorder (PTSD) has been linked to elevated heart rate (HR) and reduced heart-rate variability (HRV) in cross-sectional research. Recent evidence suggests that this link may be driven by individual differences in autonomic arousal associated with momentary negative affect (NA). Using ecological momentary assessment (EMA) of NA and minute-to-minute HR/HRV monitoring, we examined whether NA-related HR/HRV mediated the association of PTSD symptom severity with 24-hour HRV and endothelial functioning. METHODS: One hundred ninety-seven young adults (18-39 years old), 93 with PTSD, underwent one day of Holter monitoring while concurrently reporting NA levels via EMA. Two non-invasive measures of endothelial functioning-flow-mediated dilation (FMD) and hyperemic flow-were also collected. Multilevel modeling was used to assess the associations of momentary NA with HR and low- (LF) and high-frequency (HF) HRV during the 5-minute intervals following each EMA reading. Latent variable modeling was then used to determine whether individual differences in these associations mediated the association of PTSD symptom severity with 24-hour HRV, FMD, and hyperemic flow RESULTS: PTSD symptom severity was positively associated with NA-related autonomic arousal (β = .21, p < .001), which significantly mediated the association of PTSD symptom severity with 24-hour HRV and hyperemic flow, accounting for 62% and 34% of their associations, respectively, while overshadowing the influence of smoking, lifetime alcohol dependence, sleep duration, mean NA, and episodes of acute NA. CONCLUSIONS: Results suggest that NA-related autonomic arousal is both a primary factor driving cardiovascular risk in PTSD and a potential point of intervention.

Full Text

Duke Authors

Cited Authors

  • Dennis, PA; Kimbrel, NA; Sherwood, A; Calhoun, PS; Watkins, LL; Dennis, MF; Beckham, JC

Published Date

  • December 9, 2016

Published In

PubMed ID

  • 27941578

Pubmed Central ID

  • 27941578

Electronic International Standard Serial Number (EISSN)

  • 1534-7796

Digital Object Identifier (DOI)

  • 10.1097/PSY.0000000000000438


  • eng

Conference Location

  • United States