Emotion dysregulation and dissociation contribute to decreased heart rate variability to an acute psychosocial stressor in trauma-exposed Black women
Open accessAbstract
Reduced heart rate variability (HRV) in response to stress is a biomarker of emotion dysregulation (ED) and is related to posttraumatic stress disorder (PTSD), yet less is known about its role with dissociation in trauma-exposed adults. The goals of the current study were to examine unique patterns of associations between ED, dissociation, and PTSD with HRV at 15, 30, and 45 min (T1, T2, T3) following an acute psychosocial stressor task in a sample of 49 trauma-exposed, urban-dwelling Black women. Associations with baseline psychophysiology measures were also examined. ED and dissociation were assessed using self-report; PTSD was determined using a semi-structured interview. Heart rate (HR) and HRV, indexed with low frequency/high frequency (LF/HF) ratio and respiratory sinus arrhythmia (RSA), were measured with electrocardiogram recordings. ED and dissociation were positively correlated with LF/HF ratio at T3 (p < .05). There were no significant differences between individuals with PTSD versus those without PTSD in HR or HRV following acute stressor; PTSD diagnosis was related to higher HR at baseline. Latent growth modeling revealed that ED was associated with higher LF/HF ratio directly following acute stressor, while dissociation was associated with increase in LF/HF ratio over time. These findings demonstrate that ED is related to higher sympathetic reactivity for a prolonged period of time following stress exposure, while dissociation shows a delayed association with LF/HF ratio, suggesting a distinct impaired parasympathetic activation pattern exists for dissociation.
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None of the other studies found correlations between heart rate variability and trait dissociation after exposure to trauma-related material or general stress stimuli.
“None of the other studies found correlations between HRV and trait dissociation after exposure to trauma related material (Hauschildt et al., 2011) or general stress stimuli (Powers et al., 2021; Schäflein et al., 2018).”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Powers et al., 2021
The Results (page not supplied) report a significant positive association between dissociation and the LF/HF measure of heart rate variability 45 minutes after a general psychosocial stressor. The Methods describe dissociation as past-month symptoms measured by questionnaire, rather than a momentary response. Thus, this study found the kind of post-stressor association the citing sentence says it did not find. (LLM, conf=0.90)
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Experimental — accuracy not yet measuredTwo studies using the TSST found a decrease in heart rate during stress induction that was associated with trait dissociation.
“Two studies using TSST (Powers et al., 2021; Simeon et al., 2008) found a decrease in heart rate during stress induction which was associated with trait dissociation”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Powers et al., 2021
The Methods (page unavailable) confirm that this study used the TSST. The Results (page unavailable) associate dissociation with a higher LF/HF heart-rate-variability ratio 45 minutes after the stressor, not with a decrease in heart rate during stress induction. This paper therefore supports the TSST and dissociation elements, but not the claimed heart-rate finding. (LLM, conf=0.86)
Experimental — accuracy not yet measuredTrait dissociation is negatively correlated with heart rate during experimentally-induced social stress.
“studies which have proven that trait dissociation is negatively correlated with heart rate during experimentally-induced social stress (Powers et al., 2021; Simeon et al., 2008).”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Powers et al., 2021
The Results (page not available) report a positive association between dissociation and the LF/HF heart-rate-variability ratio 45 minutes after the stressor, not a negative correlation with heart rate. I searched the paper’s discussion of dissociation, heart rate, and post-stressor correlations; the available passages do not establish the claimed heart-rate relationship. (LLM, conf=0.72)
Experimental — accuracy not yet measuredPowers et al. (2021) confirmed a negative correlation (r = −.65, p = .009) between trait dissociation and heart rate during the Trier Social Stress Test, and observed this relationship even at baseline (r = −.52, p = .047).
“This negative correlation (r = −.65, p = .009) between trait dissociation and HR during the TSST was confirmed by Powers et al. (2021), who observed this relationship even at baseline (r = −.52, p = .047).”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Powers et al. (2021)
The Results (page unavailable) report a positive association between dissociation and LF/HF ratio at a post-TSST time point, but do not report the claimed negative correlations with heart rate during the TSST or at baseline. Searches for the stated correlation coefficients and p-values, and for a negative dissociation–heart-rate relationship, found no matching passage in our copy. (LLM, conf=0.76)
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Sorted by citations
Beutler, S., Mertens, Y. L., Ladner, L., Schellong, J., Croy, I., & Daniels, J. K. (2022) · European Journal of Psychotraumatology · doi:10.1080/20008066.2022.2132599 · Cited by 64 · see citing works
“…Walther, Lis, Schmahl, & Bohus (2018) X Ladwig et al. (2002) X Lanius et al. (2002) X Malta et al. (2021) X Metz et al. (2020) X Pole et al. (2006) X Powers et al. (2021) X Rhudy, Davis, Williams, McCabe, & Byrd (2008 X Sack, Cillien, & Hopper (2012) X Schäflein, Sattel, Schmidt, & Sack (2018) X X…”
BackgroundResultInfluential
- Authors
- Powers, A., Mekawi, Y., Fickenwirth, M., Nugent, N. R., Dixon, H. D., Minton, S., Kim, Y. J., Gluck, R., Carter, S., Fani, N., Schwartz, A. C., Bradley, B., Umpierrez, G. E., Pace, T. W. W., Jovanovic, T., Michopoulos, V., & Gillespie, C. F.
- Affiliations
- Emory University (US)
- Brown University (US)
- Georgia State University (US)
- University of Arizona (US)
- Corresponding author
- Powers, Abigail
- ORCID
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2021-10
- Volume
- 142
- Pages
- 125-131
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC8429185
- OpenAlex
- W3187698005
- Cited by
- 25
- References
- 13
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 5 · 2023: 5 · 2022: 6
- FWCI
- 2.64
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Advancing Translational Sciences
- National Center for Complementary and Integrative Health (K23AT009713)
- National Institute of Mental Health (MH099211, MH102890)
- National Institute of Child Health and Human Development (HD071982)
- National Heart, Lung, and Blood Institute (T32HL130025)
- National Center for Research Resources (M01 RR00039)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- emotional dysregulation, dissociation, heart rate variability, post-traumatic stress disorder, trauma exposure, Black women, acute psychosocial stress, LF/HF ratio, respiratory sinus arrhythmia, sympathetic response, parasympathetic activation, baseline heart rate
- MeSH terms
- Adult, Dissociative Disorders, Emotions, Female, Heart Rate, Humans, Stress Disorders, Post-Traumatic, Respiratory Sinus Arrhythmia
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