title: They know their trauma by heart: an assessment of psychophysiological failure to recover in PTSD.
abstract: BACKGROUND
  Posttraumatic stress disorder (PTSD) develops following exposure to atraumatic event and is characterized by persistent intense reactivity to trauma related cues. Equally important, but less studied, is the failure to restore physiological homeostasis after these excessive reactions. This study investigates psychophysiological markers of sustained cardiac activity after exposure to reminders of traumatic event in PTSD patients.
  
  
  METHODS
  Participants passively listened to neutral and personal traumatic event while electrocardiogram was continuously recorded. Heart rate (HR) and heart rate variability (HRV) were analyzed in 19 PTSD patients and 16 trauma-exposed controls.
  
  
  RESULTS
  Both PTSD patients and trauma exposed controls exhibited a significant increase in HR to the exposure of their personal trauma. PTSD patients sustained the increase of HR while controls recovered to basal levels. In PTSD patients, sustained HR was positively associated with re-experiencing symptoms. The PTSD group also showed a reduced HRV (a measure of parasympathetic influence on the heart) during personal trauma exposure and lack of recovery.
  
  
  CONCLUSIONS
  The sample size was small and PTSD patients were under medication.
  
  
  CONCLUSIONS
  Our findings provide an experimental account of the failure of PTSD patients to exhibit physiological recovery after exposure to trauma-related stimuli. PTSD patients exhibited a sustained tachycardia with attenuation of HRV that persisted even after cessation of the stressor. Re-experiencing symptoms facilitated engagement in the trauma cues, suggesting that, in their daily-life, patients most likely present repeated episodes of sustained over-reactivity, which may underpin the emotional dysregulation characteristic of PTSD.
authors.affiliation: Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: Norte
authors.forename: Gabriela Guerra L
authors.initials: GG
authors.lastname: Souza
authors.forename: Liliane
authors.initials: L
authors.lastname: Vilete
authors.forename: Carla
authors.initials: C
authors.lastname: Marques-Portella
authors.forename: Evandro Silva F
authors.initials: ES
authors.lastname: Coutinho
authors.forename: Ivan
authors.initials: I
authors.lastname: Figueira
authors.forename: Eliane
authors.initials: E
authors.lastname: Volchan
mesh_terms: D000328:Adult; D003463:Cues; D004562:Electrocardiography; D004644:Emotions; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011603:Psychophysiology; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology* / Q000523:psychology*; D055815:Young Adult