Abstract
Background: Psychiatric patients with adverse childhood experiences (ACE) tend to be dysfunctional in the interoceptive part of their emotional experience. The integration of interoceptive emotional activity in the insular and cingulate cortices is linked to the regulation of sympathovagal balance. This makes heart rate variability (HRV) an ideal measure for providing feedback on emotion regulation in real time. Methods: A sample of one hundred (n=100) outpatients was evaluated. Participants underwent eight 30-minutes ACE exposure sessions during which patients were guided to experience bodily sensations related to ACE while their HRV was monitored using a commercial biofeedback device. Results: Comparing the results of first to last therapeutic session, a significant decrease in heart rate and an increase in HRV at the onset of the session were observed. Conclusions: This study suggests physiological impact of therapeutic interventions on the autonomic balance and underlines the interest of HRV biofeedback as a clinical practice.
Highlights
Heart rate variability Heart Rate Variability reflects an individual’s ability to adaptively cope with stress
The interaction between the two factors was significant (D=13.32; DF=1,55; p=0.001). This is due to the fact that of the decrease in heart rate variability (HRV) between Measurement 1 and Measurement 2 was relatively large during the second session (0.476 points; DF=1,55; p
The present study demonstrates an effect of biofeedback therapeutic interventions both in terms of heart rhythm and heart rhythm variability measurements
Summary
Heart rate variability Heart Rate Variability reflects an individual’s ability to adaptively cope with stress. When a person faces a threat, this may elicit a hyperarousal and “flight or fight” response[5], which leads to an inhibition of the parasympathetic system and an activation of the sympathetic system This corresponds to a decrease of HRV and often an increase in Heart Rhythm (HR)[6]. Emotional events may have an influence on the general stress level[7], which in turn is visible in the sympathetic/ parasympathetic balance These effects are transient because the higher nervous structures (essentially amygdala and prefrontal cortex) inhibit each other and, as soon as the stressor disappears, the system returns to parasympathetic tonus with low HR and high HRV. The integration of interoceptive emotional activity in the insular and cingulate cortices is linked to the regulation of sympathovagal balance This makes heart rate variability (HRV) an ideal measure for providing feedback on emotion regulation in real time. Conclusions: This study suggests physiological impact of therapeutic interventions on the autonomic balance and underlines the interest of HRV biofeedback as a clinical practice
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