title: Emotional stress and heart rate variability measures associated with cardiovascular risk in relocated Katrina survivors.
abstract: OBJECTIVE
  To explore the effects of hurricane exposure and forced relocation on the mind and body, we compared psychiatric diagnoses and symptoms with heart rate variability (HRV) for 34 relocated Katrina survivors and 34 demographically matched controls.
  
  
  METHODS
  All participants were healthy and free of psychiatric and cardiovascular medications. We measured symptoms of posttraumatic stress disorder (PTSD) (Clinician-Administered PTSD Scale 1) and depression (Beck Depression Inventory), Axis I psychiatric diagnoses (Structured Clinical Interview for DSM-IV), psychosocial disability (Sheehan Disability Scale), and power spectral analysis HRV reactivity to trauma reminders.
  
  
  RESULTS
  Katrina-related PTSD occurred in 38% of survivors and 12% of controls. Survivors reported higher levels of PTSD and depression symptoms, within diagnostic ranges, and greater psychosocial disability than controls. Survivors had higher resting heart rate (80.82 [standard deviation = 13.60] versus 74.85 [10.67], p = .05), lower parasympathetic (high-frequency [HF] normalized unit) baseline HRV activity (40.14 [23.81] versus 50.67 [19.93], p = .04) and less reactivity with trauma cues (-2.63 [20.70] versus -11.96 [15.84], p = .04), and higher baseline sympathovagal activity (low frequency/HF ratio) (2.84 [3.08] versus 1.35 [1.08], p = .04) than controls. Survivors with depression (n = 12) and with depression and PTSD combined (n = 7), but not those with PTSD (n = 13), had flattened parasympathetic responsiveness to trauma cues. HRV indices correlated with depressive (low frequency/HF, p = .01; HF normalized unit, p = .046) but not PTSD symptoms (p values > .05).
  
  
  CONCLUSIONS
  Results showed this multilayer trauma's impact on emotional health and HRV-based measures of autonomic nervous system dysregulation. Specifically, dysregulation of depressed survivors' HRV in response to trauma reminders supports more autonomic involvement in traumatic loss/depression than in PTSD. Diagnostic criteria for PTSD include physiologic reactivity, and the present findings suggest that, in this setting, altered physiologic reactivity observed when PTSD coexists with depression.
authors.affiliation: Department of Psychiatry, University of Oklahoma Health Sciences Center, WP 3440, PO Box 26901, Oklahoma City, OK 73190, USA. Phebe-Tucker@ouhsc.edu
authors.forename: Phebe
authors.initials: P
authors.lastname: Tucker
authors.forename: Betty
authors.initials: B
authors.lastname: Pfefferbaum
authors.forename: Haekyung
authors.initials: H
authors.lastname: Jeon-Slaughter
authors.forename: Qaiser
authors.initials: Q
authors.lastname: Khan
authors.forename: Theresa
authors.initials: T
authors.lastname: Garton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002908:Chronic Disease; D055867:Cyclonic Storms; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000503:physiopathology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004190:Disasters; D004812:Epidemiologic Methods; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D008922:Mississippi / Q000453:epidemiology; D055820:New Orleans / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult