Emotion dysregulation and heart rate variability improve in US veterans undergoing treatment for posttraumatic stress disorder: Secondary exploratory analyses from a randomised controlled trial

Mathersul, D.C., Dixit, K., Schulz-Heik, R.J., Avery, T.J., Zeitzer, J.M. and Bayley, P.J. (2022) 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, 22 (1). Art. 268.

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.

Item Type:	Journal Article
Murdoch Affiliation(s):	Psychology, Counselling, Exercise Science and Chiropractic Centre for Molecular Medicine and Innovative Therapeutics (CMMIT) Health Futures Institute
Publisher:	BioMed Central
Copyright:	© 2022 The Authors.
United Nations SDGs:	Goal 3: Good Health and Well-Being
URI:	http://researchrepository.murdoch.edu.au/id/eprint/64549

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