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Clinical Trial
. 2019 Aug;56(8):e13377.
doi: 10.1111/psyp.13377. Epub 2019 Apr 10.

Baseline resting heart rate variability predicts post-traumatic stress disorder treatment outcomes in adults with co-occurring substance use disorders and post-traumatic stress

Heather E Soder  1 , Margaret C Wardle  2 , Joy M Schmitz  1 , Scott D Lane  1 , Charles Green  1 , Anka A Vujanovic  3
Affiliations
Clinical Trial

Baseline resting heart rate variability predicts post-traumatic stress disorder treatment outcomes in adults with co-occurring substance use disorders and post-traumatic stress

Heather E Soder et al. Psychophysiology. 2019 Aug.

Abstract

Post-traumatic stress disorder (PTSD) symptoms are highly prevalent among individuals with substance use disorders (SUD), presenting a difficult-to-treat, complex comorbidity. Prognostic factors for treatment outcomes may characterize heterogeneity of the treated population and/or implicate mechanisms of action that are salient for improving treatments. High frequency heart rate variability (HF-HRV) is a suggested biomarker for emotion regulation-the ability to generate appropriate emotional responses via the influence of the parasympathetic nervous system on the heart. This initial study investigated the utility of baseline resting HF-HRV for predicting PTSD symptoms and substance use outcomes following treatment of 37 SUD participants with comorbid PTSD symptoms. Participants completed either standard cognitive- behavioral therapy (CBT) for SUD or a novel treatment of integrated post-traumatic stress and substance use that combined CBT for SUD with cognitive processing therapy for PTSD. Analyses demonstrated that higher HF-HRV predicted greater reduction in PTSD symptoms following both types of treatment. This suggests prognostic value of HF-HRV as a predictor of PTSD treatment outcomes; those with poorer autonomic emotional regulation may not respond as well to psychotherapy in general. This hypothesis-generating analysis identifies a putative biomarker that might have utility in treatment prediction.

Keywords: PTSD; heart rate variability; substance use; trauma; treatment.

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Figures

Figure 1.
Figure 1.
Improvement in PTSD Symptoms by baseline resting HF-HRV and treatment condition. Values are presented as change scores (baseline minus final, such that higher scores represent greater change) for interpretability and comparability. CAPS-5 = Clinician Administered PTSD Scale, HF-HRV = high-frequency heart rate variability, CBT = Standard Cognitive Behavioral Therapy for substance use disorders, TIPSS = Treatment of Integrated Posttraumatic Stress and Substance Use
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