Heart rate variability biofeedback intero-nociceptive emotion exposure therapy for adverse childhood experiences

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.

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Heart Rate Variability and Inflammatory Stress Response in Young African American Men: Implications for Cardiovascular Risk

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.745864 ◽

2021 ◽

Vol 8 ◽

Author(s):

Dina Tell ◽

Robert L. Burr ◽

Herbert L. Mathews ◽

Linda Witek Janusek

Keyword(s):

Cardiovascular Disease ◽

Heart Rate ◽

Heart Rate Variability ◽

African American ◽

Adverse Childhood Experiences ◽

African American Men ◽

Childhood Adversity ◽

Childhood Experiences ◽

Adverse Childhood ◽

Response To Stress

Background: African American men have a disproportionately higher incidence of and suffer greater severity and earlier death from cardiovascular disease (CVD). A common feature of many diseases, which disproportionately afflict disadvantaged African Americans, is inflammation. In particular, inflammation plays a decisive role in the pathogenesis of CVD in that persistent inflammation contributes to plaque evolution and destabilization. Adverse childhood experiences increase the risk for adult inflammatory based disease, particularly cardiovascular disease. This inflammatory burden becomes evident during stressful events and may be related to alterations in autonomic nervous system (ANS) activity. We previously reported that African American men who experienced childhood adversity exhibited a greater inflammatory (IL-6) response to acute stress challenge (Trier Social Stress Test – TSST). The purpose of this study was to determine whether altered ANS activity, as measured by heart rate variability (HRV), contributes to a greater proinflammatory response to stress in those exposed to childhood adversity.Methods: Thirty-four African American adult males underwent the TSST while instrumented with Holter monitors to record continuous heart rate for HRV determination. HRV was calculated as the low frequency (LF) to high frequency (HF) heart rate ratio (LF/HF), with higher LF/HF ratios corresponding to higher sympathetic vs. parasympathetic activity. Salivary samples were collected pre- and post-TSST to measure the proinflammatory cytokine IL-6. Childhood adversity was assessed by the Childhood Trauma Questionnaire.Results: Hierarchical linear modeling demonstrated that higher levels of physical abuse were related to a steeper rise in LF/HF ratio during the TSST. Further, a higher LF/HF ratio, in combination with greater exposure to emotional and physical abuse was associated with a greater IL-6 response to the TSST.Conclusions: These findings suggest that adverse childhood experiences associate with an adult phenotype characterized by an altered ANS response to stress as well as a greater proinflammatory (IL-6) response to an acute stressor. Elevations in salivary inflammatory markers have been associated with increased CVD risk. In conclusion, these findings suggest a role for the ANS in the underlying neuro-biological processes whereby childhood adversity predisposes to a more intense inflammatory response to stressful challenge during adulthood.

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Correlation of adverse childhood experiences with psychiatric disorders and aggressiveness in adulthood

Vojnosanitetski pregled ◽

10.2298/vsp1008653s ◽

2010 ◽

Vol 67 (8) ◽

pp. 653-658 ◽

Cited By ~ 2

Author(s):

Ljiljana Samardzic ◽

Gordana Nikolic ◽

Grozdanko Grbesa ◽

Maja Simonovic ◽

Tatjana Milenkovic

Keyword(s):

Psychiatric Disorders ◽

Adverse Childhood Experiences ◽

Psychotic Disorders ◽

Psychiatric Patients ◽

Statistical Significance ◽

Healthy Individuals ◽

Childhood Experiences ◽

Positive Correlation ◽

Adverse Childhood ◽

Significant Difference

Background/Aim. Consequences of individual adverse childhood experiences for adult mental health have been precisely studied during past decades. The focus of past research was mainly on childhood maltreatment and neglect. The aim of this paper was to determine association between multiple adverse childhood experiences and psychiatric disorders, as well as their correlation to the degree and type of aggressiveness in adult psychiatric patients. Methods. One hundred and thirteen psychiatric outpatients were divided into three diagnostic groups: psychotics, non-psychotics and alcoholics and compared with fourty healthy individuals. Adverse childhood experiences data were gathered retrospectively, using the Adverse childhood experiences questionnaire and explanatory interview. Aggressiveness was assessed using Buss-Perry Aggression Questionnaire. The Student's t test, ANOVA and correlational analysis were used for evaluation of statistical significance of differences among the groups. A value p < 0.05 was considered statistically significant. Results. Our results showed that the mean number of adverse childhood experiences in each group of psychiatric patients, as well as in the whole group of patients, was statistically significantly higher than in the group of healthy individuals (p < 0.001); there was a statistically significant difference in score of physical aggressiveness between the patients exposed to adverse childhood experiences and those who were not exposed to them (p < 0.05); scores of physical aggressiveness were in positive correlation with the number of adverse childhood experiences (p < 0.05). The highest mean score of adverse childhood experiences was evidenced in the group of patients with psychotic disorders. Conclusion. Multiple adverse childhood experiences are significantly associated with psychotic disorders, nonpsychotic disorders and alcohol dependence in adulthood and their presence is important morbidity risk factor for psychiatric disorders. They are in positive correlation with physical aggressiveness of the patients from these diagnostic groups.

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Moderating Laboratory Adaptation with the Use of a Heart-rate Variability Biofeedback Device (StressEraser®)

Applied Psychophysiology and Biofeedback ◽

10.1007/s10484-009-9086-1 ◽

2009 ◽

Vol 34 (4) ◽

pp. 245-249 ◽

Cited By ~ 27

Author(s):

Matthew R. Ebben ◽

Vadim Kurbatov ◽

Charles P. Pollak

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Heart Rate Variability Biofeedback ◽

Laboratory Adaptation ◽

Biofeedback Device

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Changes in heart rate variability to emotional information in short- and long-term alcohol abstinent patients

European Psychiatry ◽

10.1016/j.eurpsy.2015.09.204 ◽

2015 ◽

Vol 30 (S2) ◽

pp. S108-S108

Author(s):

C. Claisse ◽

O. Cottencin ◽

L. Ott ◽

G. Berna ◽

T. Danel ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Emotional Experience ◽

Therapeutic Interventions ◽

Emotional Stimuli ◽

Emotional Information ◽

Emotional Information Processing ◽

Reliable Marker ◽

Risk Of Relapse

IntroductionSevere alcohol use disorders (AUD, DSM5 criteria, 2013) are associated with changes in the dynamics of emotional processes and emotional experience [1]. The aim of the study was to compare emotional information processing in patients with AUD in short-term abstinence (STA, less than 1 month) and in long-term abstinence (LTA, at least 6 months) with control participants (C). We studied the parasympathetic branch of the autonomic nervous system with the heart rate variability (HRV) and more particularly high frequencies (HF). This indicator is recognized as a reliable marker of physiological activation in reaction to emotional stimuli and as a good marker of vulnerability to AUD [2].MethodThe recording was performed for all participants during presentation of high emotional inducing stimuli presenting human interactions [3]. For each participant HRV was recorded before, during and after induction. Participants were asked to evaluate the intensity and the valence of emotional stimuli. In addition, a clinical and cognitive assessment was performed. We proposed in this study for abstinence in short- and in long-term to combine both behavioral and cognitive measures to this physiological indicator.ResultsWe observed:– significant differences in HF-HRV between LTA and STA groups, controls and STA groups but not between LTA and C groups;– significant correlations between craving scores [4] and HF-HRV results in LTA and STA groups.ProspectThe results support the relationship between the ability to process emotional information and the risk of relapse. HF-HRV results indicate specific deficits in regulation in STA group and also recoveries in LTA group. It suggests specific different therapeutic interventions in preventing the risk of relapse or maintenance of addiction.

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Yohimbine-Induced Reactivity of Heart Rate Variability in Unmedicated Depressed Patients With and Without Adverse Childhood Experience

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.734904 ◽

2021 ◽

Vol 12 ◽

Author(s):

Christian Eric Deuter ◽

Christian Otte ◽

Katja Wingenfeld ◽

Linn Kristina Kuehl

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Repeated Measures ◽

Stressful Life Events ◽

Developmental Stress ◽

Double Blind ◽

Childhood Experiences ◽

Repeated Measures Design ◽

Adverse Childhood ◽

Before And After

Stressful life events play a role in the pathogenesis of major depressive disorder (MDD) and many patients with MDD were exposed to developmental stress due to adverse childhood experiences (ACE). Furthermore, dysregulation of the autonomic nervous system and higher incidence of cardiovascular disease are found in MDD. In MDD, and independently in individuals with ACE, abnormalities in heart rate variability (HRV) have been reported. While these are often confounded, we systematically investigated them with a study which included MDD patients with/without ACE as well as healthy individuals with/without ACE. With this study, we investigated the influence of noradrenergic stimulation on HRV reactivity in unmedicated participants in a randomized, double-blind, repeated measures design. Our sample consisted of men and women with MDD and ACE (n = 25), MDD without ACE (n = 24), healthy participants with ACE (n = 27), and without ACE (n = 48). Participants received a 10 mg single dose of the alpha-2 antagonist yohimbine that increases noradrenergic activity or placebo on 2 separate days, with ECG recordings before and after drug administration at defined intervals. We found lower basal HRV in MDD and ACE: patients with MDD had reduced RMSSD whereas participants with ACE had lower LF-HRV. Contrary to our hypothesis, there was no effect of yohimbine. With this study, we were able to replicate previous findings on HRV differences in MDD and ACE. From the null effect of yohimbine, we conclude that the yohimbine-induced sympathetic activation is not a significant driver of HRV in MDD and ACE.

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