Heart rate reactivity during trauma recall as a predictor of treatment outcome in cognitive processing therapy for PTSD

Emotional engagement when recollecting a trauma memory is considered a key element of effective trauma-focused therapy. Research has shown that reduced physiological reactivity during trauma recall is associated with worse treatment outcomes for posttraumatic stress disorder (PTSD), but this has yet...

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Bibliographic Details
Published in:Behaviour research and therapy 2024-05, Vol.176, p.104519-104519, Article 104519
Main Authors: Carpenter, Joseph K., Pineles, Suzanne L., Griffin, Michael G., Pandey, Shivani, Werner, Kimberly, Kecala, Natalia M., Resick, Patricia A., Galovski, Tara E.
Format: Article
Language:English
Subjects:
Cognitive Behavioral Therapy - methods
Cognitive processing therapy
Female
Heart rate
Heart Rate - physiology
Humans
Physiological arousal
Posttraumatic stress disorder
Psychotherapy - methods
Stress Disorders, Post-Traumatic - psychology
Treatment dropouts
Treatment Outcome
Treatment outcomes
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Summary:Emotional engagement when recollecting a trauma memory is considered a key element of effective trauma-focused therapy. Research has shown that reduced physiological reactivity during trauma recall is associated with worse treatment outcomes for posttraumatic stress disorder (PTSD), but this has yet to be examined in a cognitively oriented treatment. This study examined whether pretreatment heart rate (HR) reactivity during trauma recall predicts PTSD symptom improvement and treatment dropout during Cognitive Processing Therapy (CPT) for PTSD. Participants were 142 women with PTSD secondary to interpersonal violence enrolled in one of two clinicals trials. HR reactivity reflected the mean increase in HR after listening to two 30-s scripts of the trauma memory prior to treatment. Linear mixed-effects models showed the effect of HR reactivity on change in total PTSD symptoms was not significant, but lower HR reactivity predicted less improvement in reexperiencing and avoidance and was associated with increased dropout. Findings suggest pretreatment physiological reactivity to the trauma memory may be a prognostic indicator of some elements of treatment response in CPT. Results tentatively support the importance of emotional activation during trauma recall in cognitive treatment of PTSD, though more research is needed to clarify how low HR reactivity impacts treatment. •Women with PTSD (n = 142) received 12 sessions of cognitive processing therapy (CPT).•Prior to treatment, heart rate reactivity (HRR) during trauma recall was measured.•Lower HRR predicted less improvement in reexperiencing and avoidance during CPT.•Lower HRR also predicted greater study and treatment dropout.•No association between pretreatment HRR and total PTSD symptom change was found.
ISSN:0005-7967
1873-622X
DOI:10.1016/j.brat.2024.104519