Emotion dysregulation and heart rate variability improve in US veterans undergoing treatment for posttraumatic stress disorder: Secondary exploratory analyses from a randomised controlled trial
Abstract Background Emotion regulation (ER) is a key process underlying posttraumatic stress disorder (PTSD), yet, little is known about how ER changes with PTSD treatment. Understanding these effects may shed light on treatment processes. Methods We recently completed a non-inferiority design rando...
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-022-03886-3 |
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| author | Danielle C. Mathersul Kamini Dixit R. Jay Schulz-Heik Timothy J. Avery Jamie M. Zeitzer Peter J. Bayley |
| author_facet | Danielle C. Mathersul Kamini Dixit R. Jay Schulz-Heik Timothy J. Avery Jamie M. Zeitzer Peter J. Bayley |
| author_sort | Danielle C. Mathersul |
| collection | DOAJ |
| description | Abstract Background Emotion regulation (ER) is a key process underlying posttraumatic stress disorder (PTSD), yet, little is known about how ER changes with PTSD treatment. Understanding these effects may shed light on treatment processes. Methods We recently completed a non-inferiority design randomised controlled trial demonstrating that a breathing-based yoga practice (Sudarshan kriya yoga; SKY) was not clinically inferior to cognitive processing therapy (CPT) across symptoms of PTSD, depression, or negative affect. Here, in secondary exploratory analyses (intent-to-treat N = 85; per protocol N = 59), we examined whether self-reported ER (Difficulties in Emotion Regulation Scale; DERS) and physiological ER (heart rate variability; HRV) improved with treatment for clinically significant PTSD symptoms among US Veterans. Results DERS-Total and all six subscales improved with small-to-moderate effect sizes (d = .24–.66) following CPT or SKY, with no differences between treatment groups. Following SKY (but not CPT), HR max–min (average difference between maximum and minimum beats per minute), LF/HF (low-to-high frequency) ratio, and normalised HF-HRV (high frequency power) improved (moved towards a healthier profile; d = .42–.55). Conclusions To our knowledge, this is the first study to demonstrate that a breathing-based yoga (SKY) improved both voluntary/intentional and automatic/physiological ER. In contrast, trauma-focused therapy (CPT) only reliably improved self-reported ER. Findings have implications for PTSD treatment and interventions for emotional disorders more broadly. Trial registration Secondary analyses of ClinicalTrials.gov NCT02366403 . |
| first_indexed | 2024-04-14T08:25:05Z |
| format | Article |
| id | doaj.art-41bb218f72e44135a0aaa71673ffd887 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-04-14T08:25:05Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-41bb218f72e44135a0aaa71673ffd8872022-12-22T02:04:06ZengBMCBMC Psychiatry1471-244X2022-04-0122111210.1186/s12888-022-03886-3Emotion dysregulation and heart rate variability improve in US veterans undergoing treatment for posttraumatic stress disorder: Secondary exploratory analyses from a randomised controlled trialDanielle C. Mathersul0Kamini Dixit1R. Jay Schulz-Heik2Timothy J. Avery3Jamie M. Zeitzer4Peter J. Bayley5War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care SystemWar Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care SystemWar Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care SystemWar Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care SystemDepartment of Psychiatry and Behavioral Sciences, Stanford University School of MedicineWar Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care SystemAbstract Background Emotion regulation (ER) is a key process underlying posttraumatic stress disorder (PTSD), yet, little is known about how ER changes with PTSD treatment. Understanding these effects may shed light on treatment processes. Methods We recently completed a non-inferiority design randomised controlled trial demonstrating that a breathing-based yoga practice (Sudarshan kriya yoga; SKY) was not clinically inferior to cognitive processing therapy (CPT) across symptoms of PTSD, depression, or negative affect. Here, in secondary exploratory analyses (intent-to-treat N = 85; per protocol N = 59), we examined whether self-reported ER (Difficulties in Emotion Regulation Scale; DERS) and physiological ER (heart rate variability; HRV) improved with treatment for clinically significant PTSD symptoms among US Veterans. Results DERS-Total and all six subscales improved with small-to-moderate effect sizes (d = .24–.66) following CPT or SKY, with no differences between treatment groups. Following SKY (but not CPT), HR max–min (average difference between maximum and minimum beats per minute), LF/HF (low-to-high frequency) ratio, and normalised HF-HRV (high frequency power) improved (moved towards a healthier profile; d = .42–.55). Conclusions To our knowledge, this is the first study to demonstrate that a breathing-based yoga (SKY) improved both voluntary/intentional and automatic/physiological ER. In contrast, trauma-focused therapy (CPT) only reliably improved self-reported ER. Findings have implications for PTSD treatment and interventions for emotional disorders more broadly. Trial registration Secondary analyses of ClinicalTrials.gov NCT02366403 .https://doi.org/10.1186/s12888-022-03886-3Posttraumatic stress disorderPTSDEmotion regulationHeart rate variabilityHRVYoga |
| spellingShingle | Danielle C. Mathersul Kamini Dixit R. Jay Schulz-Heik Timothy J. Avery Jamie M. Zeitzer Peter J. Bayley Emotion dysregulation and heart rate variability improve in US veterans undergoing treatment for posttraumatic stress disorder: Secondary exploratory analyses from a randomised controlled trial BMC Psychiatry Posttraumatic stress disorder PTSD Emotion regulation Heart rate variability HRV Yoga |
| title | Emotion dysregulation and heart rate variability improve in US veterans undergoing treatment for posttraumatic stress disorder: Secondary exploratory analyses from a randomised controlled trial |
| title_full | Emotion dysregulation and heart rate variability improve in US veterans undergoing treatment for posttraumatic stress disorder: Secondary exploratory analyses from a randomised controlled trial |
| title_fullStr | Emotion dysregulation and heart rate variability improve in US veterans undergoing treatment for posttraumatic stress disorder: Secondary exploratory analyses from a randomised controlled trial |
| title_full_unstemmed | Emotion dysregulation and heart rate variability improve in US veterans undergoing treatment for posttraumatic stress disorder: Secondary exploratory analyses from a randomised controlled trial |
| title_short | Emotion dysregulation and heart rate variability improve in US veterans undergoing treatment for posttraumatic stress disorder: Secondary exploratory analyses from a randomised controlled trial |
| title_sort | emotion dysregulation and heart rate variability improve in us veterans undergoing treatment for posttraumatic stress disorder secondary exploratory analyses from a randomised controlled trial |
| topic | Posttraumatic stress disorder PTSD Emotion regulation Heart rate variability HRV Yoga |
| url | https://doi.org/10.1186/s12888-022-03886-3 |
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