Heart Rate Assessment for Posttraumatic Stress Disorder Symptoms among Military Veterans: A Narrative Literature Review

2018 ◽  
Vol 62 (1) ◽  
pp. 1727-1728
Author(s):  
Kunal Khanade ◽  
Farzan Sasangohar
Keyword(s):  
Heart Rate ◽  
Continuous Monitoring ◽  
Stress Disorder ◽  
Military Veterans ◽  
Fluctuation Analysis ◽  
Resting Heart Rate ◽  
Ptsd Symptoms ◽  
Time Frequency ◽  
Non Linear ◽  
Research Gap

Post-Traumatic Stress Disorder (PTSD) is a psychiatric condition affecting as much as 20% of the returning veterans from the current wars in Afghanistan and Iraq (Ramchand et al., 2010). Due to its prevalence, assessment and intervention methods for PTSD symptoms among veterans are timely to ensure veterans’ faster recovery and their reintegration into society. A narrative review of literature was conducted to examine the literature on techniques and methods for detection and measurement of PTSD symptoms. Relevant reviews and seminal papers associated with psychophysiological measurements with emphasis on heart rate, the prevalence of PTSD in military veterans, and detection of PTSD were included. Psychophysiology involves the non-invasive recording of biological processes simultaneously (Pole, 2007). The measures that were found to be reliably related to PTSD are: (1) higher resting heart rate; (2) larger heart rate responses to standardized trauma cues; and (3) for idiographic cues facial muscle electromyography (EMG) and heart rate responses (Pole, 2007). Studies based on heart rate found that there were five beats per minute (bpm) increase in resting heart rates for combat veterans who suffer from PTSD compared to those who were not diagnosed (Beckham et al., 2000, Woodward et al., 2009). Buckley et al. (2004) found that for a mixed population (veterans and civilians) PTSD patients had a resting heart rate increase of 6.6 bpm compared to non-PTSD patients while adjusting for covariates. The exact mechanisms of how stress affects heart rate are not well-known; however, it is possible to observe stressful events and relate these to physiological changes in heart rate that can be measured using modern sensors (Andreoli et al., 2010). In the literature, heart rate is analyzed using statistical, geometric, frequency domain, time-frequency and non-linear feature analysis (Acharya et al., 2006). Non-linear features have been developed to quantify the dynamics of heart rate fluctuations. These include approximate entropy, Detrended Fluctuation Analysis (DFA), Lyapunov exponent, Recurrence Plots (RPs) and Correlation Dimension (CD) (Pincus, 1991; Huikuri et al., 2000; Acharya et al., 2004; Acharya et al., 2006). Our synthesis resulted in identification of three research gaps. Heart rate analysis has shown promise to link PTSD symptoms to differences in PTSD and non-PTSD subjects (Pole, 2007) but a characterization of PTSD symptoms from heart rate data seems to remain a research gap. While continuous monitoring of physiological parameters is gaining momentum, this particular method has not been studied to infer key characteristics associated with PTSD among military veterans. Continuous monitoring might be able to highlight muted response to startle or treatment. There is also a research gap in the assessment of heart rate accelerations and decelerations in response to specific PTSD symptoms (Khanade et al., 2017). The investigation into accelerations/decelerations associated with PTSD hyper-arousal triggers might have a potential to detect hyper-arousal instantaneously and would shed light on trigger-specific interventions to reduce harmful effects of PTSD triggers in a timely manner. In addition, most studies were conducted to observe differences among PTSD and non-PTSD populations. More work is warranted to focus on PTSD patients in isolation to explain variety of triggers and their specific physiological reactions.

COMPREHENSIVE ANALYSIS OF NORMAL AND DIABETIC HEART RATE SIGNALS: A REVIEW

2012 ◽  
Vol 12 (05) ◽  
pp. 1240033 ◽  
Author(s):  
OLIVER FAUST ◽  
V. RAMANAN PRASAD ◽  
G. SWAPNA ◽  
SUBHAGATA CHATTOPADHYAY ◽  
TEIK-CHENG LIM
Keyword(s):  
Heart Rate ◽  
Organ Damage ◽  
Extraction Methods ◽  
Time Frequency ◽  
Ecg Signals ◽  
Cardiac Health ◽  
Non Linear ◽  
Non Stationary Signal ◽  
Early Diagnosis Of Diabetes ◽  
Typical Range

A large section of the world's population is affected by diabetes mellitus (DM), commonly referred to as "diabetes." Every year, the number of cases of DM is increasing. Diabetes has a strong genetic basis, hence it is very difficult to cure, but can be controlled with medications to prevent subsequent organ damage. Therefore, early diagnosis of diabetes is very important. In this paper, we examine how diabetes affects cardiac health, which is reflected through heart rate variability (HRV), as observed in electrocardiography (ECG) signals. Such signals provide clues for both the presence and severity of diabetes as well as diabetes-induced cardiac impairments. Heart rate (HR) is a non-linear and non-stationary signal. Thus, extracting useful information from HRV signals is a difficult task. We review several sophisticated signal processing and information extraction methods in order to establish measurable relationships between the presence and the extent of diabetes as well as the changes in the HRV signals. Furthermore, we discuss a typical range of values for several statistical, geometric, time domain, frequency domain, time–frequency, and non-linear features for HR signals from 15 normal and 15 diabetic subjects. We found that non-linear analysis is the most suitable approach to capture and analyze the subtle changes in HRV signals caused by diabetes.

scholarly journals Outdoor recreational activity experiences improve psychological wellbeing of military veterans with post-traumatic stress disorder: Positive findings from a pilot study and a randomised controlled trial

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241763
Author(s):  
Mark Wheeler ◽  
Nicholas R. Cooper ◽  
Leanne Andrews ◽  
Jamie Hacker Hughes ◽  
Marie Juanchich ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Military Veterans ◽  
Ptsd Symptoms ◽  
Outdoor Activity ◽  
Post Traumatic Stress ◽  
Link Type ◽  
Post Traumatic

Exposure to the natural environment is increasingly considered to benefit psychological health. Recent reports in the literature also suggest that outdoor exposure that includes recreational pursuits such as surfing or fishing coupled with opportunities for social interaction with peers may be beneficial to Armed Forces Veterans experiencing Post-Traumatic Stress Disorder (PTSD). Two studies were conducted to evaluate this possibility. In particular, these studies aimed to test the hypothesis that a brief group outdoor activity would decrease participants’ symptoms as assessed by established measures of PTSD, depression, anxiety and perceived stress, and increase participants’ sense of general social functioning and psychological growth. Experiment one employed a repeated measures design in which UK men and women military veterans with PTSD (N = 30) participated in a group outdoor activity (angling, equine care, or archery and falconry combined). Psychological measures were taken at 2 weeks prior, 2 weeks post, and at 4 month follow up. We obtained a significant within participant main effect indicating significant reduction in PTSD symptoms. Experiment two was a waitlist controlled randomised experiment employing an angling experience (N = 18) and 2 week follow up. In experiment 2 the predicted interaction of Group (Experimental vs. Waitlist Control) X Time (2 weeks pre vs. 2 weeks post) was obtained indicating that the experience resulted in significant reduction in PTSD symptoms relative to waitlist controls. The effect size was large. Additional analyses confirmed that the observed effects might also be considered clinically significant and reliable. In sum, peer outdoor experiences are beneficial and offer potential to complement existing provision for military veterans with Post Traumatic Stress Disorder. Trial registration The authors confirm that all ongoing and related trials for this intervention are registered. The studies reported in this manuscript are registered as clinical trials at ISRCTN: Pilot ID– ISRCTN15325073 RCT ID– ISRCTN59395217

Early prediction of serious infections in febrile infants incorporating heart rate variability in an emergency department: a pilot study

2021 ◽  
pp. emermed-2020-210675
Author(s):  
Shu-Ling Chong ◽  
Gene Yong-Kwang Ong ◽  
John Carson Allen ◽  
Jan Hau Lee ◽  
Rupini Piragasam ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Vital Signs ◽  
Model Performance ◽  
Diagnostic Challenge ◽  
Poincaré Plot ◽  
Time Frequency ◽  
Young Infants ◽  
Serious Infections ◽  
Non Linear

BackgroundEarly differentiation of febrile young infants with from those without serious infections (SIs) remains a diagnostic challenge. We sought to (1) compare vital signs and heart rate variability (HRV) parameters between febrile infants with versus without SIs, (2) assess the performance of HRV and vital signs with reference to current triage tools and (3) compare HRV and vital signs to HRV, vital signs and blood biomarkers, when predicting for the presence of SIs.MethodsUsing a prospective observational design, we recruited patients <3 months old presenting to a tertiary paediatric ED in Singapore from December 2018 through November 2019. We obtained patient demographic characteristics, triage assessment (including the Severity Index Score (SIS)), HRV parameters (time, frequency and non-linear domains) and laboratory results. We performed multivariable logistic regression analyses to predict the presence of an SI, using area under the curve (AUC) with the corresponding 95% CI to assess predictive capability.ResultsAmong 203 infants with a mean age of 38.4 days (SD 27.6), 67 infants (33.0%) had an SI. There were significant differences in the time, frequency and non-linear domains of HRV parameters between infants with versus without SIs. In predicting SIs, gender, temperature and the HRV non-linear parameter Poincaré plot SD2 (AUC 0.78, 95% CI 0.71 to 0.84) performed better than SIS alone (AUC 0.61, 95% CI 0.53 to 0.68). Model performance improved with the addition of absolute neutrophil count and C reactive protein (AUC 0.82, 95% CI 0.76 to 0.89).ConclusionAn exploratory prediction model incorporating HRV and biomarkers improved prediction of SIs. Further research is needed to assess if HRV can identify which young febrile infants have an SI at ED triage.Trial registration numberNCT04103151.

Delayed-Onset Posttraumatic Stress Disorder: A Prospective Evaluation

2002 ◽  
Vol 36 (2) ◽  
pp. 205-209 ◽  
Author(s):  
Richard A Bryant ◽  
Allison G Harvey
Keyword(s):  
Heart Rate ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Traumatic Event ◽  
Resting Heart Rate ◽  
Delayed Onset ◽  
Vehicle Accident

Objective: Delayed onset posttraumatic stress disorder (PTSD) refers to PTSD that develops at least 6 months after the traumatic event. This study aimed to index the features of patients who develop delayed-onset PTSD. Method: This study investigated delayed onset PTSD by prospectively assessing 103 motor vehicle accident survivors within 1 month of the motor vehicle accident for acute stress disorder, and subsequently assessing them for PTSD 6 months post-accident, and 2 years post-accident. Patients were initially assessed for symptoms of traumatic stress, anxiety, depression, and resting heart rate. Results: Five patients displayed PTSD 2 years post-trauma without meeting PTSD criteria 6 months posttrauma. Delayed onset cases were characterized by elevated psychopathology scores and resting heart rate levels within the initial month and elevated psychopathology 6 months posttrauma. Conclusions: These findings suggest that cases of delayed onset PTSD suffer subsyndromal levels of posttraumatic stress prior to the diagnosis of PTSD. These findings challenge the notion of PTSD developing after a period without symptoms.

The Impact of Exposure Therapy on Resting Heart Rate and Heart Rate Reactivity Among Active-Duty Soldiers With Posttraumatic Stress Disorder

2020 ◽  
Vol 82 (1) ◽  
pp. 108-114 ◽  
Author(s):  
Kyle J. Bourassa ◽  
Elizabeth S. Stevens ◽  
Andrea C. Katz ◽  
Barbara O. Rothbaum ◽  
Greg M. Reger ◽  
...  
Keyword(s):  
Heart Rate ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Exposure Therapy ◽  
Active Duty ◽  
Resting Heart Rate ◽  
Heart Rate Reactivity ◽  
The Impact

Non-linear analysis of heart rate variability for evaluating the acute effects of caffeinated beverages in young adults

2020 ◽  
Vol 30 (7) ◽  
pp. 1018-1023 ◽  
Author(s):  
Serife G. Caliskan ◽  
Mehmet D. Bilgin
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Young Adults ◽  
Approximate Entropy ◽  
Energy Drink ◽  
High Rate ◽  
Largest Lyapunov Exponent ◽  
Fluctuation Analysis ◽  
Electrocardiogram Signals ◽  
Non Linear

AbstractCaffeinated beverages are the most consumed substances in the world. High rate of uptake of these beverages leads to various cardiovascular disorders ranging from palpitations to coronary failure. The objective of the study is to ascertain how the complexity parameters of heart rate variability are affected by acute consumption of caffeinated beverages in young adults.Electrocardiogram measurements were performed before consuming drinks. After consuming the drinks, measurements were done again at 30 minutes and 60 minutes. Heart rate variability signals were acquired from electrocardiogram signals. Also, the signals were reconstructed in the phase space and largest Lyapunov exponent, correlation dimension, approximate entropy, and detrended fluctuation analysis values were calculated.Heart rate increased for energy drink and cola groups but not in coffee group. Non-linear parameter values of energy drink, coffee, and cola group are increased within 60 minutes after drink consumption. This change is statistically significant just for energy drink group.Energy drink consumption increases the complexity of the cardiovascular system in young adults significantly. Coffee and cola consumption have no significant effect on the non-linear parameters of heart rate variability.

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