Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1440 Canal St., MS8448, New Orleans, LA, 70112, USA.
Department of Psychology, Tulane University, 2007 Percival Stern Hall, New Orleans, LA, 70118, USA.
Appl Psychophysiol Biofeedback. 2017 Dec;42(4):309-321. doi: 10.1007/s10484-017-9377-x.
Cognitive behavioral therapy (CBT) is an efficacious treatment for posttraumatic stress disorder (PTSD) symptoms, but the effect of CBT on physiological indicators is largely unknown. Respiratory sinus arrhythmia (RSA) is an established parasympathetic marker of self-regulatory capacity and stress responsivity. The present study tested if and how resting RSA and RSA reactivity changed following treatment among a sample of children (n = 48) who experienced at least one traumatic event and presented with PTSD symptoms. RSA reactivity was measured in response to personalized trauma-related scripts. Results indicated that changes in RSA after treatment were dependent on pretreatment resting levels of RSA, with individuals with high and low pretreatment resting RSA levels appearing to converge over time in both resting RSA and RSA reactivity by the 3-month follow up. Specific to RSA reactivity, a sex difference was evident, as following treatment, females showed less RSA withdrawal whereas males showed more RSA withdrawal. PTSD symptoms were significantly reduced after CBT but symptom change was not associated with pretreatment resting RSA levels. Overall, these results suggest that there may be multiple physiological patterns within children with PTSD and the direction of the physiological changes after CBT may depend on initial differences in resting RSA levels.
认知行为疗法（CBT）是一种有效的创伤后应激障碍（PTSD）症状治疗方法，但 CBT 对生理指标的影响在很大程度上尚不清楚。呼吸窦性心律失常（RSA）是自主调节能力和应激反应的既定副交感神经标志物。本研究测试了在经历至少一次创伤事件并出现 PTSD 症状的儿童样本（n=48）中，治疗后静息 RSA 和 RSA 反应性是否以及如何发生变化。RSA 反应性是针对个性化创伤相关脚本进行测量的。结果表明，治疗后 RSA 的变化取决于治疗前静息 RSA 水平，具有高和低治疗前静息 RSA 水平的个体在 3 个月随访时，在静息 RSA 和 RSA 反应性方面似乎随着时间的推移而趋同。具体到 RSA 反应性，存在性别差异，因为治疗后，女性的 RSA 抑制较少，而男性的 RSA 抑制较多。PTSD 症状在 CBT 后显著减轻，但症状变化与治疗前静息 RSA 水平无关。总体而言，这些结果表明，PTSD 儿童可能存在多种生理模式，CBT 后生理变化的方向可能取决于初始静息 RSA 水平的差异。
