Abstract
Accumulating evidence indicates that psychotherapy participants show increased physiological responsiveness to stress. The purpose of the present study was to examine differences between individuals participating in outpatient psychotherapy and matched controls using an experimental design. Forty-two psychotherapy participants and 48 matched controls were assessed on cardiovascular and cortisol functioning at baseline, during the Trier Social Stress Test (TSST), and during a 20-min recovery period. Psychotherapy participants and matched controls did not differ at baseline or during the TSST on the physiological measures but psychotherapy participants had higher cortisol and heart rate (HR) during the recovery period. In regards to reactivity, cortisol increased during the recovery period for the psychotherapy participants but decreased for those in the matched control group. Psychotherapy participants experiencing clinically significant levels of distress displayed elevated systolic and diastolic blood pressure and HR during the TSST when compared to psychotherapy participants not experiencing clinically significant levels of distress. Overall, physiological reactivity to stress appears to be an important issue for those in psychotherapy and directly addressing this issue may help improve psychotherapy outcomes.
Highlights
High levels of psychological distress contribute to elevated physiological activity and negative health outcomes (Steptoe et al, 2005; Chida and Steptoe, 2010; Carroll et al, 2012)
The psychotherapy group scored significantly higher on the Outcome Questionnaire, a measure psychological distress that is related to psychotherapy outcome [Psychotherapy mean = 73.6 (25.7) and control group mean = 43.1 (16.5), t = 4.280, p < 0.001]
Gender and body mass index (BMI) were related to blood pressure and heart rate (HR) such that men had higher systolic blood pressure (SBP) (t = 6.073, p < 0.001) and lower HR (t = −3.230, p < 0.01) and those with higher BMI had higher SBP
Summary
High levels of psychological distress contribute to elevated physiological activity and negative health outcomes (Steptoe et al, 2005; Chida and Steptoe, 2010; Carroll et al, 2012). High levels of psychological distress are related to elevated physiological activity and addressing difficult topics in therapy such as previous trauma leads to increased physiological responses (Lindauer et al, 2006; Ham and Tronick, 2009; Ehrenthal et al, 2010). This is true in more severe pathology and inpatient studies. The purpose of the present study was to answer this question using a controlled laboratory stress paradigm comparing psychotherapy participants to a psychotherapy naïve control group
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