Heart Rate Variability as a Moderator of Trauma Writing Outcomes

Writing about personal traumatic experiences is associated with beneficial effects on physical and psychological symptoms compared with writing about emotionally neutral events. However, not everyone benefits from trauma writing to the same extent. The present study hypothesized that the effectiveness of trauma writing may be moderated by emotion regulation, as indexed by respiratory sinus arrhythmia (RSA). Research also shows that greater physiological reactivity is predictive of better trauma writing outcomes. Given the importance of physiological output in emotional processing, response training was developed and found to increase appropriate physiological reactivity. Because higher RSA is thought to indicate a more flexible response style including processing both emotional and physiological cues, it was hypothesized that trauma writers with higher resting RSA who received response training (as opposed to stimulus or no training) would have the best outcomes. It was also predicted that higher resting RSA would be related to lower baseline levels of depression, posttraumatic stress disorder (PTSD), physical illness symptoms, heart rate, and skin conductance. In the current study, participants wrote for 20 minutes on three occasions about a personal traumatic event (n = 113) or a neutral topic (n = 133) and received response training (n = 79), stimulus training (n = 84) or no training (n = 83). Heart rate and skin conductance were recorded in sessions one and three during a 10-minute baseline, 20-minute writing, and 10-minute recovery period. Self-reported trauma symptoms were assessed in each session. At baseline and one month after completing the sessions, participants filled out assessments of depression, PTSD, and physical illness symptoms. As predicted, participants with higher resting RSA who wrote about a trauma had greater reductions in symptoms of PTSD at post-writing session three. Higher resting RSA was also related to lower levels of resting heart rate and skin conductance. No relation was found between RSA and baseline symptoms of depression, PTSD, and physical illness. This study also found no effect of resting RSA as a moderator of response training outcomes

The influence of ethnicity and gender on the relationship between Posttraumatic Stress Disorder status and cardiovascular responding

Past research has found inconsistent effects of posttraumatic stress disorder (PTSD) status on cardiovascular responding. Inconsistencies may be explained by demographic differences in study samples. In this study, the influence of gender and ethnicity on the relationship between PTSD status and cardiovascular responding was explored. Participants’ (N = 245) heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) readings were taken throughout baseline and anger recall periods. For all gender by ethnicity groups, baseline HR was higher in participants with PTSD than without PTSD, except for Black men. Whites with PTSD had lower baseline SBP than Whites without PTSD; the opposite was true for Blacks. Men and Blacks with PTSD had larger HR increases during anger imagery than men and Blacks without PTSD, whereas women and Whites showed the opposite pattern. Results suggest demographic variables may account for inconsistent effects of PTSD on cardiovascular responding

Enhancing the Benefits of Written Emotional Disclosure Through Response Training

Writing about a personal stressful event has been found to have psychological and physical health benefits, especially when physiological response increases during writing. Response training was developed to amplify appropriate physiological reactivity in imagery exposure. The present study examined whether response training enhances the benefits of written emotional disclosure. Participants were assigned to either a written emotional disclosure condition (n = 113) or a neutral writing condition (n = 133). Participants in each condition wrote for 20 minutes on three occasions and received response training (n = 79), stimulus training (n = 84) or no training (n = 83). Heart rate and skin conductance were recorded throughout a 10-minute baseline, 20-minute writing, and a 10-minute recovery period. Self-reported emotion was assessed in each session. One month after completing the sessions, participants completed follow-up assessments of psychological and physical health outcomes. Emotional disclosure elicited greater physiological reactivity and self-reported emotion than neutral writing. Response training amplified physiological reactivity to emotional disclosure. Greater heart rate during emotional disclosure was associated with the greatest reductions in event-related distress, depression, and physical illness symptoms at follow-up, especially among response trained participants. Results support an exposure explanation of emotional disclosure effects and are the first to demonstrate that response training facilitates emotional processing and may be a beneficial adjunct to written emotional disclosure