ArticlePsychosomatic medicine2014
Posttraumatic stress, heart rate variability, and the mediating role of behavioral health risks.
Article in Psychosomatic medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
49 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Autonomic dysfunction in posttraumatic stress disorder indexed by heart rate variability: a meta-analysis.Psychological medicine · 2020Pooled it
- Posttraumatic stress disorder and tobacco use: A systematic review and meta-analysis.Addictive behaviors · 2018Pooled it
- Find your rhythm and regulate: Breath-synced vibration feedback during breath-focused mindfulness reduces respiration variability in trauma-exposed adults.Journal of anxiety disorders · 2025Trial
- Effect of cognitive processing therapy on markers of cardiovascular risk in posttraumatic stress disorder patients: A randomized clinical trial.Journal of psychosomatic research · 2023Trial
- Horsepower: equine-assisted interventions are associated with reduced PTSD symptoms, improved sleep quality, and quality of life in military veterans with treatment-resistant PTSD.Frontiers in psychology · 2026Article
- Post-Traumatic Stress Disorder (PTSD) and Cardiovascular Diseases: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Functioning Level as a Buffer: Longitudinal Associations Between Heart Rate Variability and Post-Traumatic Stress Disorder Risk Over 2 Years.Psychiatry investigation · 2025Article
- Posttraumatic Stress, Posttraumatic Growth, and Heart Rate Variability Among Breast Cancer Survivors.Noro psikiyatri arsivi · 2025Article
- Laboratory and Real-World Experimental Approaches to Understanding Alcohol Relapse.Current topics in behavioral neurosciences · 2025Review
- Accrued reductions in heart rate following transcutaneous vagal nerve stimulation in adults with posttraumatic stress disorder.Frontiers in neuroscience · 2025Article
- Stress and substance use disorders: risk, relapse, and treatment outcomes.The Journal of clinical investigation · 2024Review
- Altered parasympathetic activity during sleep and emotionally arousing wakefulness in frequent nightmare recallers.European archives of psychiatry and clinical neuroscience · 2024Article
- Impacts of heart rate variability on post-traumatic stress disorder risks after physical injuries: amplification with childhood abuse histories.Frontiers in psychiatry · 2024Article
- Effects of Daily Posttraumatic Stress Disorder Symptoms on Heart Rate Variability.Psychosomatic medicine · 2024Article
- A rationale for considering heart/brain axis control in neuropsychiatric disease.Mammalian genome : official journal of the International Mammalian Genome Society · 2023Review
- The Intersectionality of Sex and Race in the Relationship Between Posttraumatic Stress Disorder and Cardiovascular Disease: A Scoping Review.Public health reviews · 2023Article
- Posttraumatic stress disorder (PTSD), sleep, and cardiovascular disease risk: A mechanism-focused narrative review.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2022Review
- A Web-Based Cognitive Behavioral Therapy, Mindfulness Meditation, and Yoga Intervention for Posttraumatic Stress Disorder: Single-Arm Experimental Clinical Trial.JMIR mental health · 2022Article
- Contrasting Associations Between Heart Rate Variability and Brainstem-Limbic Connectivity in Posttraumatic Stress Disorder and Its Dissociative Subtype: A Pilot Study.Frontiers in behavioral neuroscience · 2022Article
- Relationship between Anxiety Disorders and Anthropometric Indices, Risk Factors, and Symptoms of Cardiovascular Disorder in Children and Adolescents.Iranian journal of psychiatry · 2021Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectivePosttraumatic stress disorder (PTSD) has been linked to reduced heart rate variability (HRV), which is in turn a risk factor for cardiovascular disease and death. Although hyperarousal and anxiety are thought to underlie this association, behavioral health risks, including smoking, alcohol dependence, obesity, and sleep disturbance, represent potential mechanisms linking PTSD and HRV.
methodsTo test this hypothesis, short-term laboratory-based and 24-hour ambulatory measures of HRV were collected from 227 young adults (18-39 years), 107 of whom were diagnosed as having PTSD. Latent variable modeling was used to assess the relationship of PTSD symptoms with HRV along with potential behavioral health mediators.
resultsPTSD symptoms were associated with reduced HRV (β = -0.21, p = .002). However, this association was reduced in models that adjusted for cigarette consumption and history of alcohol dependence and was rendered nonsignificant in a model adjusting for sleep disturbance. Independent mediation effects were deemed significant via bootstrapping analysis. Together, the three behavioral health factors (cigarette consumption, history of alcohol dependence, and sleep disturbance) accounted for 94% of the shared variance between PTSD symptoms and HRV. Abdominal obesity was not a significant mediator.
conclusionsThese results indicate that behavioral factors-specifically smoking, alcohol overuse, and sleep disturbance-mediate the association between PTSD and HRV-based indices of autonomic nervous system dysregulation. Benefits from psychiatric and psychological interventions in PTSD may therefore be enhanced by including modification of health behaviors.
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Registered trials
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