Abstract
Post-traumatic stress disorder (PTSD) is characterized by deficits in cognitive functioning, particularly cognitive control. Moreover, these deficits are thought to play a critical role in the etiology and maintenance of core PTSD symptoms such as intrusive thoughts and memories. However, the psychophysiological concomitants of cognitive control remain largely unexamined. In this article, we suggest that individual differences in heart rate variability (HRV), a physiological index of self-regulatory capacity, may underlie the association between cognitive control ability and intrusive cognitions in PTSD. We review evidence showing that individual differences in HRV at rest are related to prefrontal cortical activity and performance on a broad range of cognitive control tasks. We highlight the importance of inhibition as a mechanism by which HRV promotes successful cognitive control. In addition, we summarize recent research linking individual differences in HRV to performance on laboratory tasks that assess the ability to control unwanted memories and intrusive thoughts. We conclude by suggesting that future studies should examine the role of low HRV as a risk factor for developing PTSD.
Highlights
Traumatic experiences can greatly alter an individual’s cognitive, emotional, and physiological functioning as demonstrated by those with post-traumatic stress disorder (PTSD), who experience avoidance, hyperarousal, and re-experiencing symptoms (American Psychiatric Association, 2013)
DIRECTIONS A large body of evidence suggests that PTSD is characterized by cognitive control deficits, which in turn have been linked to the re-experiencing of symptoms such as intrusive thoughts and memories
Building from the common neural basis for cognitive regulation and physiological regulation of the autonomic nervous system, the neurovisceral integration model suggests that individual differences in heart rate variability (HRV) may be a peripheral marker of cognitive control ability
Summary
Traumatic experiences can greatly alter an individual’s cognitive, emotional, and physiological functioning as demonstrated by those with post-traumatic stress disorder (PTSD), who experience avoidance, hyperarousal, and re-experiencing symptoms (American Psychiatric Association, 2013). The neural structures of the CAN include the anterior cingulate, the insula, the ventromedial prefrontal cortices, the central nucleus of the amygdala, the paraventricular and related nuclei of the hypothalamus, the periaquaductual gray matter, the nucleus of the solitary tract (NTS), the nucleus ambiguous, and the medullary tegmental field, among others (Thayer and Lane, 2009; Thayer et al, 2012) These components are reciprocally interconnected, allowing the prefrontal cortex to exert inhibitory control over subcortical structures in order to generate cognitive, behavioral, and physiological responses that support goal-directed behavior and adaptability. The output of this inhibitory cortico-subcortical circuit extends to autonomic inputs to the heart, including the vagus nerve In this model, higher levels of HRV (i.e., greater vagal tone) at rest are a product of a system in which the prefrontal cortex exerts inhibitory control over subcortical circuits allowing the organism to respond to environmental challenges in a controlled and adaptive manner when needed. For this reason, examining the parasympathetic influence on the heart via HRV can provide an index of an individual’s capacity to effectively function in a complex and challenging environment
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