Heart Rate Variability as a Moderator of Trauma Writing Outcomes

Abstract

HEART RATE VARIABILITY AS A MODERATOR OF TRAUMA WRITING OUTCOMES By: Alison Eonta, M.S. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University, 2013. Major Director: Scott R. Vrana, Ph.D. Professor of Psychology Department of Psychology Writing about personal traumatic experiences is associated with beneficial effects on physical and psychological symptoms compared with writing about emotionally neutral events. However, not everyone benefits from trauma writing to the same extent. The present study hypothesized that the effectiveness of trauma writing may be moderated by emotion regulation, as indexed by respiratory sinus arrhythmia (RSA). Research also shows that greater physiological reactivity is predictive of better trauma writing outcomes. Given the importance of physiological output in emotional processing, response training was developed and found to increase appropriate physiological reactivity. Because higher RSA is thought to indicate a more flexible response style including processing both emotional and physiological cues, it was hypothesized that trauma writers with higher resting RSA who received response training (as opposed to stimulus or no training) would have the best outcomes. It was also predicted that higher resting RSA would be related to lower baseline levels of depression, posttraumatic stress disorder (PTSD), physical illness symptoms, heart rate, and skin conductance. In the current study, participants wrote for 20 minutes on three occasions about a personal traumatic event (n = 113) or a neutral topic (n = 133) and received response training (n = 79), stimulus training (n = 84) or no training (n = 83). Heart rate and skin conductance were recorded in sessions one and three during a 10-minute baseline, 20-minute writing, and 10minute recovery period. Self-reported trauma symptoms were assessed in each session. At baseline and one month after completing the sessions, participants filled out assessments of depression, PTSD, and physical illness symptoms. As predicted, participants with higher resting RSA who wrote about a trauma had greater reductions in symptoms of PTSD at post-writing session three. Higher resting RSA was also related to lower levels of resting heart rate and skin conductance. No relation was found between RSA and baseline symptoms of depression, PTSD, and physical illness. This study also found no effect of resting RSA as a moderator of response training outcomes.