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Cited by 269Heart Rate Variability and Autonomic ControlPosttraumatic Stress Disorder ResearchVagus Nerve Stimulation Research

Autonomic dysfunction in posttraumatic stress disorder indexed by heart rate variability: a meta-analysis

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Schneider, Martha, Schwerdtfeger, Andreas·2020·Psychological Medicine
DOI 10.1017/s003329172000207xPMC PMC7525781
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Abstract

Background: Changes in autonomic nervous system (ANS) function have been observed in a variety of psychological disorders, including posttraumatic stress disorder (PTSD). Analysis of heart rate variability (HRV) provides insight into the functioning of the ANS. Previous research on PTSD found lower HRV in PTSD patients compared to controls, indicating altered sympathetic and parasympathetic activity, but findings are inconsistent. The purpose of this meta-analysis was to examine differences in HRV indices between individuals with PTSD and healthy controls at baseline and during stress. Methods: The included primary studies present an aggregate of studies analyzing different HRV indices. Examined HRV indices were standard deviation of the normalized NN-intervals (SDNN), root mean square of successive differences (RMSSD), low-frequency (LF) and high-frequency (HF) spectral components, LF/HF ratio, and heart rate (HR). Moderating effects of study design, HRV and PTSD assessment, and sample characteristics were examined via subgroup-analyses and meta-regressions. Results: Random-effects meta-analyses for HRV parameters at rest revealed significant group differences for RMSSD and HF-HRV, suggesting lower parasympathetic activity in PTSD. The aggregated effect size for SDNN was medium, suggesting diminished total variability in PTSD. A small effect was found for LF-HRV. A higher LF/HF ratio was found in the PTSD sample as compared to controls. Individuals with PTSD showed significantly higher HR. During stress, individuals with PTSD showed higher HR and lower HF-HRV, both indicated by small effect sizes. Conclusions: Findings suggest that PTSD is associated with ANS dysfunction.

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  • If PTSD is examined without consideration of dissociative symptoms, there is consistent support for increased autonomic activity while resting and across experimental paradigms, as measured by HR, HRV parameters, and SC.

    “Additionally, if PTSD is examined without consideration of dissociative symptoms, there is consistent support for increased autonomic activity while resting and across experimental paradigms, as measured by HR, HRV parameters, and SC (Ge et al., 2020; Nagpal et al., 2013; Schneider & Schwerdtfeger, 2020).”

    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 Schneider & Schwerdtfeger, 2020

    The Abstract Results and Discussion report higher heart rate and lower HRV in PTSD at rest, and higher heart rate during stress. The Results section says the lower HF-HRV finding during stress did not reach significance; the paper does not assess skin conductance (SC) or establish a pattern across experimental paradigms. Methods also says dissociation was considered as a moderator, rather than simply disregarded. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Newer publications reveal publication bias in studies on heart rate variability and PTSD.

    “newer publications reveal publication bias in studies on heart rate variability and PTSD (Ge et al., 2020; Schneider & Schwerdtfeger, 2020).”

    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 Schneider & Schwerdtfeger, 2020

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Research works printed but not linked: 70

  1. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.) Arlington VA: Author.
  2. Benjamini, Y., & Hochberg, Y. (1996). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society B, 57, 289– 300.
  3. * Bertram, F., Jamison, A. L., Slightam, C., Kim, S., Roth, H. L., & Roth, W. T. (2014). Autonomic arousal during actigraphically estimated waking and sleep in male veterans with PTSD. Journal of Traumatic Stress, 27(5), 610– 617. doi: 10.1002/jts.21947. 25322890 · DOI
  4. * Brady, R. E., Constans, J. I., Marx, B. P., Spira, J. L., Gevirtz, R., Kimbrell, T. A., … Pyne, J. M. (2015). Effect of symptom over-reporting on heart rate variability in veterans with posttraumatic stress disorder. Journal of Trauma & Dissociation, 16(5), 551– 562. doi: 10.1080/15299732.2015.1021505. 26011249 · DOI
  5. Camm, A. J., Malik, M., Bigger, J. T., Breithardt, G., Cerutti, S., Cohen, R. J., … Lombardi, F. (1996). Heart rate variability: Standards of measurement, physiological interpretation and clinical use (Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology). Circulation, 93, 1043– 1065. doi: 10.1161/01.CIR.93.5.1043. 8598068 · DOI · Paper page
  6. Campbell, A. A., Wisco, B. E., Silvia, P. J., & Gay, N. G. (2019). Resting respiratory sinus arrhythmia and posttraumatic stress disorder: A meta-analysis. Biological Psychology, 144, 125– 135. doi: 10.1016/j.biopsycho.2019.02.005. 30779926 · DOI
  7. * Chang, H. A., Chang, C. C., Tzeng, N. S., Kuo, T. B., Lu, R. B., & Huang, S. Y. (2013). Decreased cardiac vagal control in drug-naïve patients with posttraumatic stress disorder. Psychiatry Investigation, 10(2), 121. doi: 10.4306/pi.2013.10.2.121. 23798959 PMC3687045 · DOI · Paper page
  8. * Chang, H. Y., Shin, K. M., Kim, N. H., & Chung, Y. K. (2016). PS263. Association between heart rate variability (HRV) and posttraumatic stress symptoms in female victims of sexual violence. International Journal of Neuropsychopharmacology, 19(Suppl. 1), 95. doi: 10.1093/ijnp/pyw043.263. · DOI
  9. * Clausen, A. N., Aupperle, R. L., Sisante, J. F. V., Wilson, D. R., & Billinger, S. A. (2016). Pilot investigation of PTSD, autonomic reactivity, and cardiovascular health in physically healthy combat veterans. PLoS ONE, 11(9), e0162547. doi: 10.1371/journal.pone.0162547. 27607181 PMC5015867 · DOI
  10. Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155– 159. Retrieved from https://psycnet.apa.org/buy/1992-37683-001. 19565683
  11. de Godoy, M. F. (2016). Nonlinear analysis of heart rate variability: A comprehensive review. Journal of Cardiology and Therapy, 3(3), 528– 533. Retrieved from http://ghrnet.org/index.php/jct/article/view/1724.
  12. * Dennis, P. A., Dedert, E. A., Van Voorhees, E. E., Watkins, L. L., Hayano, J., Calhoun, P. S., … Beckham, J. C. (2016). Examining the crux of autonomic dysfunction in PTSD: Whether chronic or situational distress underlies elevated heart rate and attenuated heart-rate variability. Psychosomatic Medicine, 78(7), 805. doi: 10.1097/PSY0000000000000326. 27057817 PMC5003742 · DOI
  13. * Dennis, P. A., Watkins, L., Calhoun, P. S., Oddone, A., Sherwood, A., Dennis, M. F., … Beckham, J. C. (2014). Posttraumatic stress, heart-rate variability, and the mediating role of behavioral health risks. Psychosomatic Medicine, 76(8), 629. doi: 10.1097/PSY.0000000000000110. 25264973 PMC4197067 · DOI
  14. Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315(7109), 629– 634. doi: 10.1136/bmj.315.7109.629. 9310563 PMC2127453 · DOI · Paper page
  15. Elliott, K., & Lawrenson, G. (Eds.). (2009). Development of the autonomic nervous system. Chichester: John Wiley & Sons.
  16. Endicott, J., & Spitzer, R. L. (1978). A diagnostic interview: The schedule for affective disorders and schizophrenia. Archives of General Psychiatry, 35(7), 837– 844. 678037
  17. Goldstein, D. S., Bentho, O., Park, M. Y., & Sharabi, Y. (2011). Low-frequency power of heart rate variability is not a measure of cardiac sympathetic tone but may be a measure of modulation of cardiac autonomic outflows by baroreflexes. Experimental Physiology, 96(12), 1255– 1261. doi: 10.1113/expphysiol.2010.056259. 21890520 PMC3224799 · DOI · Paper page
  18. * Hauschildt, M., Peters, M. J., Moritz, S., & Jelinek, L. (2011). Heart rate variability in response to affective scenes in posttraumatic stress disorder. Biological Psychology, 88(2-3), 215– 222. doi: 10.1016/j.biopsycho.2011.08.004. 21856373 · DOI · Paper page
  19. Higgins, J. P., & Green, S. (Eds.). (2011). Cochrane handbook for systematic reviews of interventions. Chichester: John Wiley & Sons.
  20. Higgins, J. P., & Thompson, S. G. (2002). Quantifying heterogeneity in a meta-analysis. Statistics in Medicine, 21(11), 1539– 1558. doi: 10.1002/sim.1186. 12111919 · DOI · Paper page
  21. Hillebrand, S., Gast, K. B., de Mutsert, R., Swenne, C. A., Jukema, J. W., Middeldorp, S., … Dekkers, O. M. (2013). Heart rate variability and first cardiovascular event in populations without known cardiovascular disease: Meta-analysis and dose–response meta-regression. Europace, 15(5), 742– 749. doi: 10.1093/europace/eus341. 23370966 · DOI
  22. Insulander, P., & Vallin, H. (2005). Gender differences in electrophysiologic effects of mental stress and autonomic tone inhibition: A study in healthy individuals. Journal of Cardiovascular Electrophysiology, 16(1), 59– 63. doi: 10.1046/j.1540-8167.2005.04177.x. 15673389 · DOI
  23. Jänig, W. (2008). Integrative action of the autonomic nervous system: Neurobiology of homeostasis. Cambridge: Cambridge University Press.
  24. Johnson, B. K. (2018). Physiology of the autonomic nervous system In E. Farag, M. Argalious, J.E. Tetzlaff & D. Sharma (Eds.), Basic sciences in anesthesia (pp. 355– 364). Cham: Springer. doi: 10.1007/978-3-319-62067-1_19. · DOI
  25. * Kamkwalala, A., Norrholm, S. D., Poole, J. M., Brown, A., Donley, S., Duncan, E., … Jovanovic, T. (2012). Dark-enhanced startle responses and heart rate variability in a traumatized civilian sample: Putative sex-specific correlates of posttraumatic stress disorder. Psychosomatic Medicine, 74(2), 153. doi: 10.1097/PSY.0b013e318240803a. 22286850 PMC3674026 · DOI
  26. Keane, T. M., Malloy, P. F., & Fairbank, J. A. (1984). Empirical development of an MMPI subscale for the assessment of combat-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 52(5), 888. doi: 10.1037/0022-006X.52.5.888. 6501674 · DOI
  27. Kearns, N. T., Carl, E., Stein, A. T., Vujanovic, A. A., Zvolensky, M. J., Smits, J. A., & Powers, M. B. (2018). Posttraumatic stress disorder and cigarette smoking: A systematic review. Depression and Anxiety, 35(11), 1056– 1072. doi: 10.1002/da.22828. 30192425 · DOI · Paper page
  28. * Keary, T. A., Hughes, J. W., & Palmieri, P. A. (2009). Women with posttraumatic stress disorder have larger decreases in heart rate variability during stress tasks. International Journal of Psychophysiology, 73(3), 257– 264. doi: 10.1016/j.ijpsycho.2009.04.003. 19374925 · DOI
  29. * Kobayashi, I., Lavela, J., & Mellman, T. A. (2014). Nocturnal autonomic balance and sleep in PTSD and resilience. Journal of Traumatic Stress, 27(6), 712– 716. doi: 10.1002/jts.21973. 25403523 · DOI
  30. Koenig, J., & Thayer, J. F. (2016). Sex differences in healthy human heart rate variability: A meta-analysis. Neuroscience & Biobehavioral Reviews, 64, 288– 310. doi: 10.1016/j.neubiorev.2016.03.007. 26964804 · DOI · Paper page
  31. * Lakusic, N., Fuckar, K., Mahovic, D., Cerovec, D., Majsec, M., & Stancin, N. (2007). Characteristics of heart rate variability in war veterans with post-traumatic stress disorder after myocardial infarction. Military Medicine, 172(11), 1190- 1193. doi: 10.7205/MILMED.172.11.1190. 18062395 · DOI
  32. * Lee, S. M., Han, H., Jang, K. I., Huh, S., Huh, H. J., Joo, J. Y., & Chae, J. H. (2018). Heart rate variability associated with posttraumatic stress disorder in victims’ families of Sewol ferry disaster. Psychiatry Research, 259, 277– 282. doi: 10.1016/j.psychres.2017.08.062. 29091829 · DOI
  33. * Lee, E. A. D., & Theus, S. A. (2012). Lower heart rate variability associated with military sexual trauma rape and posttraumatic stress disorder. Biological Research for Nursing, 14(4), 412– 418. doi: 10.1177/1099800412454453. 22899708 · DOI
  34. * Liu, C. X., Bing, B. I. N., Yong, M. A., Xie, Z. Y., & Sen, L. I. (2019). Effect of post-traumatic stress disorder on human blood pressure, heart rate, and heart rate variability. Medical Journal of Chinese People's Liberation Army, 44(2), 162– 165. doi: 10.11855/j.issn.0577-7402.2019.02.12. · DOI
  35. * Meyer, P. W., Mueller, L. E., Zastrow, A., Schmidinger, I., Bohus, M., Herpertz, S. C., & Bertsch, K. (2016). Heart rate variability in patients with post-traumatic stress disorder or borderline personality disorder: Relationship to early life maltreatment. Journal of Neural Transmission, 123(9), 1107– 1118. doi: 10.1007/s00702-016-1584-8. 27311838 · DOI
  36. * Minassian, A., Geyer, M. A., Baker, D. G., Nievergelt, C. M., O'Connor, D. T., & Risbrough, V. B., & MRS Team. (2014). Heart rate variability characteristics in a large group of active-duty marines and relationship to posttraumatic stress. Psychosomatic Medicine, 76(4), 292. doi: 10.1097/PSY.0000000000000056. 24804881 PMC4062545 · DOI
  37. Minassian, A., Maihofer, A. X., Baker, D. G., Nievergelt, C. M., Geyer, M. A., & Risbrough, V. B. (2015). Association of predeployment heart rate variability with risk of postdeployment posttraumatic stress disorder in active-duty marines. JAMA Psychiatry, 72(10), 979– 986. doi: 10.1001/jamapsychiatry.2015.0922. 26353072 · DOI
  38. * Mitani, S., Fujita, M., Sakamoto, S., & Shirakawa, T. (2006). Effect of autogenic training on cardiac autonomic nervous activity in high-risk fire service workers for posttraumatic stress disorder. Journal of Psychosomatic Research, 60(5), 439– 444. doi: 10.1016/j.jpsychores.2005.09.005. 16650583 · DOI
  39. * Moon, E., Lee, S. H., Kim, D. H., & Hwang, B. (2013). Comparative study of heart rate variability in patients with schizophrenia, bipolar disorder, post-traumatic stress disorder, or major depressive disorder. Clinical Psychopharmacology and Neuroscience, 11(3), 137. doi: 10.9758/cpn.2013.11.3.137. 24465250 PMC3897762 · DOI
  40. Murison, R. (2016). The neurobiology of stress In M. Al'Absi & M.A. Flaten (Eds.), Neuroscience of pain, stress, and emotion. (pp. 29– 49). London: Academic Press 10.1016/C2013-0-16065-5. · DOI
  41. Nagpal, M., Gleichauf, K., & Ginsberg, J. (2013). Meta-analysis of heart rate variability as a psychophysiological indicator of posttraumatic stress disorder. Journal of Trauma & Treatment, 3(2167–1222), 1000182. doi: 10.4172/2167-1222.1000182. · DOI
  42. * Norte, C. E., Souza, G. G. L., Vilete, L., Marques-Portella, C., Coutinho, E. S. F., Figueira, I., & Volchan, E. (2013). They know their trauma by heart: An assessment of psychophysiological failure to recover in PTSD. Journal of Affective Disorders, 150(1), 136– 141. doi: 10.1016/j.jad.2012.11.039. 23273551 · DOI · Paper page
  43. Orr, S. P., & Roth, W. T. (2000). Psychophysiological assessment: Clinical applications for PTSD. Journal of Affective Disorders, 61(3), 225– 240. doi: 10.1016/S0165-0327(00)00340-2. 11163424 · DOI · Paper page
  44. * Park, J. E., Lee, J. Y., Kang, S. H., Choi, J. H., Kim, T. Y., So, H. S., & Yoon, I. Y. (2017). Heart rate variability of chronic posttraumatic stress disorder in the Korean veterans. Psychiatry Research, 255, 72– 77. doi: 10.1016/j.psychres.2017.05.011. 28528244 · DOI
  45. Ralevski, E., Petrakis, I., & Altemus, M. (2018). Heart rate variability in alcohol use: A review. Pharmacology Biochemistry and Behavior, 176, 83– 92. doi: 10.1016/j.pbb.2018.12.003. 30529588 · DOI
  46. Rombold-Bruehl, F., Otte, C., Renneberg, B., Schmied, A., Zimmermann-Viehoff, F., Wingenfeld, K., & Roepke, S. (2019). Lower heart rate variability at baseline is associated with more consecutive intrusive memories in an experimental distressing film paradigm. The World Journal of Biological Psychiatry, 20(8), 662– 667. doi: 10.1080/15622975.2017.1372628. 29022753 · DOI
  47. Sahar, T., Shalev, A. Y., & Porges, S. W. (2001). Vagal modulation of responses to mental challenge in posttraumatic stress disorder. Biological Psychiatry, 49(7), 637– 643. doi: 10.111/psyp.12027. 11297721
  48. Schwarzer, G. (2007). meta: An R package for meta-analysis. R News, 7(3), 40– 45.
  49. Schwerdtfeger, A. R., Schwarz, G., Pfurtscheller, K., Thayer, J. F., Jarczok, M. N., & Pfurtscheller, G. (2020). Heart Rate Variability (HRV): From brain death to resonance breathing at 6 breaths/minute. Clinical Neurophysiology, 131 (3), 676– 693. doi: 10.1016/j.clinph.2019.11.03. 31978852 · DOI
  50. Seligowski, A. V., Lebois, L. A., Hill, S. B., Kahhale, I., Wolff, J. D., Jovanovic, T., … Ressler, K. J. (2019). Autonomic responses to fear conditioning among women with PTSD and dissociation. Depression and Anxiety, 36(7), 625– 634. doi: 10.1002/da.22903. 31012207 PMC6602841 · DOI · Paper page
  51. * Shaikh al arab, A., Guédon-Moreau, L., Ducrocq, F., Molenda, S., Duhem, S., Salleron, J., … Vaiva, G. (2012). Temporal analysis of heart rate variability as a predictor of post traumatic stress disorder in road traffic accidents survivors. Journal of Psychiatric Research, 46(6), 790– 796. doi: 10.1016/j.jpsychires.2012.02.006. 22425487 · DOI · Paper page
  52. * Slewa-Younan, S., Chippendale, K., Heriseanu, A., Lujic, S., Atto, J., & Raphael, B. (2012). Measures of psychophysiological arousal among resettled traumatized Iraqi refugees seeking psychological treatment. Journal of Traumatic Stress, 25(3), 348– 352. doi: 10.1002/jts.21694. 22685092 · DOI
  53. Smith, B. N., Tyzik, A. L., Neylan, T. C., & Cohen, B. E. (2015). PTSD And obesity in younger and older veterans: Results from the mind your heart study. Psychiatry Research, 229(3), 895– 900. doi: 10.1016/j.psychres.2015.07.044. 26210650 PMC4568132 · DOI
  54. * Song, B. A., Yoo, S. Y., Kang, H. Y., Byeon, S. H., Shin, S. H., Hwang, E. J., & Lee, S. H. (2011). Post-traumatic stress disorder, depression, and heart-rate variability among North Korean defectors. Psychiatry Investigation, 8(4), 297. doi: 10.4306/pi.2011.8.4.297. 22216038 PMC3246136 · DOI
  55. * Spiller, T. R., Liddell, B. J., Schick, M., Morina, N., Schnyder, U., Pfaltz, M., … Nickerson, A. (2019). Emotional reactivity, emotion regulation capacity, and posttraumatic stress disorder in traumatized refugees: An experimental investigation. Journal of Traumatic Stress, 32(1), 32– 41. doi: 10.1002/jts.22371. 30729584 · DOI
  56. * Tan, G., Dao, T. K., Farmer, L., Sutherland, R. J., & Gevirtz, R. (2011). Heart rate variability (HRV) and posttraumatic stress disorder (PTSD): A pilot study. Applied Psychophysiology and Biofeedback, 36(1), 27– 35. doi: 10.1007/s10484-010-9141. 20680439 · DOI
  57. * Tan, G., Fink, B., Dao, T. K., Hebert, R., Farmer, L. S., Sanders, A., … Gevirtz, R. (2009). Associations among pain, PTSD, mTBI, and heart rate variability in veterans of Operation Enduring and Iraqi Freedom: A pilot study. Pain Medicine, 10(7), 1237– 1245. doi: 10.1111/j.1526-4637.2009.00712.x. 19818034 · DOI
  58. * Thome, J., Densmore, M., Frewen, P. A., McKinnon, M. C., Théberge, J., Nicholson, A. A., … Lanius, R. A. (2017). Desynchronization of autonomic response and central autonomic network connectivity in posttraumatic stress disorder. Human Brain Mapping, 38(1), 27– 40. doi: 10.1002/hbm.23340. 27647521 PMC6866719 · DOI
  59. Triggiani, A. I., Valenzano, A., Ciliberti, M. A. P., Moscatelli, F., Villani, S., Monda, M., … Cibelli, G. (2017). Heart rate variability is reduced in underweight and overweight healthy adult women. Clinical Physiology and Functional Imaging, 37(2), 162– 167. doi: 10.1111/cpf.12281. 26211739 · DOI
  60. * Tucker, P., Pfefferbaum, B., Jeon-Slaughter, H., Khan, Q., & Garton, T. (2012). Emotional stress and heart rate variability measures associated with cardiovascular risk in relocated Katrina survivors. Psychosomatic Medicine, 74(2), 160– 168. doi: 10.1097/PSY.0b013e318240a801. 22286851 · DOI
  61. Umetani, K., Singer, D.H., McCraty, R., & Atkionson, M. (1998). Twenty-four hour time domain heart rate variability and heart rate: Relations to age and gender over nine decades. Journal of the American College of Cardiology, 31(3), 593– 601. 9502641
  62. van Aert, R. C. M., & van Assen, M. A. L. M. (2018). Correcting for publication bias in a meta-analysis with the p-uniform* method. Manuscript submitted for publication Retrieved from: https://osfio/preprints/bitss/zqjr92018. PMC12948804 41760983
  63. Viechtbauer, W. (2010). Conducting meta-analyses in R with the metafor package. Journal of Statistical Software, 36(3), 1– 48. Retrieved from https://limo.libis.be/primo-explore/fulldisplay?docid=LIRIAS1059637&context=L&vid=Lirias&search_scope=Lirias&tab=default_tab&lang=en_US&fromSitemap=1.
  64. Voss, A., Schulz, S., Schroeder, R., Baumert, M., & Caminal, P. (2008). Methods derived from nonlinear dynamics for analysing heart rate variability. Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences, 367(1887), 277– 296. doi: 10.1098/rsta.2008.0232. 18977726 · DOI
  65. * Wahbeh, H., & Oken, B. S. (2013a). A pilot study of clinical measures to assess mind-body intervention effects for those with and without PTSD. Alternative & Integrative Medicine, 2, 116. doi: 10.4172/2327-5162.1000116. 24949490 PMC4060973 · DOI
  66. * Wahbeh, H., & Oken, B. S. (2013b). Peak high-frequency HRV and peak alpha frequency higher in PTSD. Applied Psychophysiology and Biofeedback, 38(1), 57– 69. doi: 10.1007/s10484-012-9208-z. 23178990 PMC3578126 · DOI
  67. Weathers, F. W., Keane, T. M., & Davidson, J. R. (2001). Clinician-administered PTSD scale: A review of the first ten years of research. Depression and Anxiety, 13(3), 132– 156. 11387733
  68. * Woodward, S. H., Arsenault, N. J., Voelker, K., Nguyen, T., Lynch, J., Skultety, K., … Sheikh, J. I. (2009). Autonomic activation during sleep in posttraumatic stress disorder and panic: A mattress actigraphic study. Biological Psychiatry, 66(1), 41– 46. doi: 10.1016/j.biopsych.2009.01.005. 19232575 PMC2734329 · DOI · Paper page
  69. * Woodward, S. H., Kaloupek, D. G., Schaer, M., Martinez, C., & Eliez, S. (2008). Right anterior cingulate cortical volume covaries with respiratory sinus arrhythmia magnitude in combat veterans. Journal of Rehabilitation Research & Development, 45(3), 451– 463. 10.1682/JRRD.2007.06.0082. 18629753 · DOI
  70. Yehuda, R., Southwick, S., Giller, E., Ma, X., & Mason, J. (1992) Urinary catecholamine excretion and severity of PTSD symptoms in Vietnam combat veterans. Journal of Nervous & Mental Disease. 180, 321– 325. 1583475

Cited by

Sorted by citations

Authors
Schneider, M., & Schwerdtfeger, A.
Affiliations
University of Graz (AT)
Corresponding author
Schneider, Martha
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2020-08-28
Volume
50
Issue
12
Pages
1937-1948
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s003329172000207x
PMC
PMC7525781
OpenAlex
W3082061616
Cited by
269
References
18
Citations by year
2026: 57 · 2025: 55 · 2024: 51 · 2023: 49 · 2022: 47 · 2021: 9
FWCI
4.45
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychological Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
Keywords
post-traumatic stress disorder, heart rate variability, autonomic dysfunction, parasympathetic activity, sympathetic activity, stress response, heart rate, spectral analysis of HRV, LF/HF ratio
MeSH terms
Autonomic Nervous System, Heart Rate, Humans, Stress Disorders, Post-Traumatic

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