Abstract
Veterans with posttraumatic stress symptoms exhibit reduced heart rate variability characteristic of autonomic nervous system dysregulation. Studies show heart rate variability biofeedback (HRVB) is effective in reducing posttraumatic stress symptoms by improving autonomic functioning. Participants in this pilot study were veterans of different war eras with military-related posttraumatic stress symptoms. The study aims were to examine the impact of a single session HRVB intervention on posttraumatic stress symptoms and heart rate variability, test persistence of effects, and determine if veterans would find the intervention acceptable. One group (n = 6) received training in diaphragmatic breathing and heart rate variability biofeedback, augmented by twice-daily practice using a smart phone and breath pacing app. A second group (n = 6) received only a single session of diaphragmatic breathing training. After 4 weeks, participants in the second group (n = 5) received the full intervention. HRVB significantly reduced global posttraumatic stress symptoms, whereas diaphragmatic breathing alone did not. Further, veterans found the approach acceptable, as demonstrated by a high degree of adherence with prescribed practice, low study attrition, and continued use over time. Results of this pilot study warrant further refinement of a protocol utilizing mHealth to treat posttraumatic stress symptoms in military populations.
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Acknowledgements
This research was supported by the Pat Tillman Foundation, the Foundation for Education and Research in Biofeedback (FERB), and a university graduate dissertation enhancement grant as part of a Three Paper Dissertation. We extend a special thanks to Dr. Wesley Center, Jeff Hensley, LPC, and Elizabeth Reep, LCSW, for their contributions to this research project. The lead author wishes to thank her dissertation committee for guidance during all phases of the research, and Bryan Butler, LPC and Kristen Elliott, LPC for assistance with preliminary data collection. Both authors wish to acknowledge Dr. Paul Lehrer for feedback and guidance. We wish to thank Ian Boggero, PhD, Cincinnati Children’s Hospital, Cincinnati, OH, for editing assistance and statistical consultation and Kristen McQuerry, PhD, Center for Clinical and Translational Science, Applied Statistics Laboratory, University of Kentucky, for statistical consultation.
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This human subjects study was approved by the university Institutional Review Board and was performed in accordance with the ethical standards set forth in the 1964 Declaration of Helsinki and subsequent amendments.
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Schuman, D.L., Killian, M.O. Pilot Study of a Single Session Heart Rate Variability Biofeedback Intervention on Veterans’ Posttraumatic Stress Symptoms. Appl Psychophysiol Biofeedback 44, 9–20 (2019). https://doi.org/10.1007/s10484-018-9415-3
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DOI: https://doi.org/10.1007/s10484-018-9415-3