title: Reduced heart rate responding to trauma reliving in trauma survivors with PTSD: correlates and consequences.
abstract: The authors investigated whether heart rate (HR) responses to voluntary recall of trauma memories (a) are related to posttraumatic stress disorder (PTSD), and (b) predict recovery 6 months later. Sixty-two assault survivors completed a recall task modeled on imaginal reliving in the initial weeks postassault. Possible cognitive modulators of HR responsivity were assessed; dissociation, rumination, trauma memory disorganization. Individuals with PTSD showed a reduced HR response to reliving compared to those without PTSD, but reported greater distress. Notably, higher HR response but not self-reported distress during reliving predicted greater symptom reduction at follow-up in participants with PTSD. Engagement in rumination was the only cognitive factor that predicted lower HR response. The data are in contrast to studies using trauma reminders to trigger memories, which have found greater physiological reactivity in PTSD. The authors' observations are consistent with models of PTSD that highlight differences between cued or stimulus-driven retrieval and intentional trauma recall, and with E. B. Foa and M. J. Kozak's (1986) hypothesis that full activation of trauma memories facilitates emotional processing.
authors.affiliation: School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom. s.l.halligan@reading.ac.uk
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Halligan
authors.forename: Tanja
authors.initials: T
authors.lastname: Michael
authors.forename: Frank H
authors.initials: FH
authors.lastname: Wilhelm
authors.forename: David M
authors.initials: DM
authors.lastname: Clark
authors.forename: Anke
authors.initials: A
authors.lastname: Ehlers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D001143:Arousal; D001288:Attention; D003463:Cues; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D004213:Dissociative Disorders / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006339:Heart Rate; D006801:Humans; D007092:Imagination; D008016:Life Change Events; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D012742:Sex Offenses / Q000523:psychology; D013223:Statistics as Topic; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology*; D014754:Violence / Q000523:psychology