Heart rate variability characteristics in a large group of active-duty marines and relationship to posttraumatic stress.
Heart rate variability characteristics in a large group of active-duty marines and relationship to posttraumatic stress.
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DOI：
10.1097/psy.0000000000000056
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发表时间：
2014-05
影响因子：
3.3
通讯作者：
Marine Resiliency Study Team
中科院分区：
文献类型：
--
作者：
Minassian A;Geyer MA;Baker DG;Nievergelt CM;O'Connor DT;Risbrough VB;Marine Resiliency Study Team
心率变异性（HRV）被认为反映了自主神经系统的功能，在创伤后应激障碍（PTSD）等情况下会降低。创伤性脑损伤（TBI）和抑郁在HRV和创伤后应激障碍之间的关系中潜在的混杂效应尚未在一大批军人中得到阐明。在此，我们在一项针对海军陆战队员的大型研究中描述了HRV与应激障碍症状的关联，同时考虑了众所周知的HRV和创伤后应激障碍的协变量，包括创伤性脑损伤和抑郁症。4个营的男性现役海军陆战队（N=2430）在战斗部署前1-2个月进行了评估。在休息5分钟时测量HRV。抑郁和PTSD分别采用贝克抑郁量表和临床医生管理的PTSD量表进行评估。在考虑了包括TBI在内的协变量后，回归表明，较低水平的高频（HF） HRV与PTSD的诊断相关（β = - 0.20, p= 0.035）。抑郁症和PTSD的严重程度相关（r= 0.49, p <.001），然而，与对照组相比，PTSD但抑郁评分相对较低的参与者表现出较低的HF （p=.012）。有部署经验的陆战队员（n=1254）的HRV低于没有部署经验的陆战队员（p = 0.033）。当考虑到创伤性脑损伤和抑郁症状时，这项大型队列的横断面分析支持PTSD和HRV降低之间的关联。未来的部署后评估将用于确定部署前HRV是否可以预测战斗暴露的严重心理和生理后果的脆弱性和复原力。
Heart rate variability (HRV), thought to reflect autonomic nervous system function, is lowered in conditions such as posttraumatic stress disorder (PTSD). The potential confounding effects of traumatic brain injury (TBI) and depression in the relationship between HRV and PTSD have not been elucidated in a large cohort of military service members. Here we describe HRV associations with stress disorder symptoms in a large study of Marines, while accounting for well-known covariates of HRV and PTSD including TBI and depression. Four battalions of male active-duty Marines (N=2430) were assessed 1-2 months prior to a combat deployment. HRV was measured during 5 minutes of rest. Depression and PTSD were assessed using the Beck Depression Inventory and Clinician Administered PTSD scale respectively. After accounting for covariates including TBI, a regression indicated that lower levels of high frequency (HF) HRV were associated with a diagnosis of PTSD (beta = -.20, p=.035). Depression and PTSD severity were correlated (r= .49, p <.001), however participants with PTSD but relatively low depression scores exhibited reduced HF compared to controls (p=.012). Marines with deployment experience (n=1254) had lower HRV than those with no experience (p = .033). This cross-sectional analysis of a large cohort supports associations between PTSD and reduced HRV when accounting for TBI and depression symptoms. Future post-deployment assessments will be used to determine whether pre-deployment HRV can predict vulnerability and resilience to the serious psychological and physiological consequences of combat exposure.