nach oben

Erschienen in:

16.06.2016 | Psychiatry and Preclinical Psychiatric Studies - Original Article

Heart rate variability in patients with post-traumatic stress disorder or borderline personality disorder: relationship to early life maltreatment

verfasst von: Peter-Wolfgang Meyer, Laura E. Müller, Arne Zastrow, Ilinca Schmidinger, Martin Bohus, Sabine C. Herpertz, Katja Bertsch

Erschienen in: Journal of Neural Transmission | Ausgabe 9/2016

Einloggen, um Zugang zu erhalten

Abstract

Traumatic experiences have severe impact on the autonomous nervous system. Heart rate variability (HRV) is a reliable psychophysiological marker for the autonomous nervous system functioning. Reduced vagally mediated HRV has been found in patients with post-traumatic stress disorder (PTSD) and, in some studies, in patients with borderline personality disorder (BPD). In this study, we compared HRV parameters of patients with PTSD, current BPD, and BPD in remission with healthy volunteers in a 5 min resting-state electrocardiogram recording. 91 unmedicated female participants took part in the study (18 with PTSD, 27 with the current BPD, 23 with BPD in remission, and 23 healthy volunteers). We found significant group differences in both time-domain and frequency-domain (total power, low-frequency and high-frequency power) HRV parameters. Root mean square of the successive differences (RMSSD) was lowest in patients with PTSD (M = 48.6 ms, SD = 23.5 ms) followed by patients with BPD in remission (M = 57.7 ms, SD = 31.5 ms) and patients with the current BPD (M = 71.1 ms, SD = 44.5 ms), while the highest RMSSD was found in healthy volunteers (M = 84.1 ms, SD = 41.7 ms). Variance of HRV was higher in patients with BPD than in patients with PTSD. In addition, RMSSD was significantly negatively correlated with self-reported early life maltreatment assessed with the Childhood Trauma Questionnaire. Our findings point out a complex interaction between traumatic experiences, the functioning of the autonomic nervous system, and psychopathology. Alterations in HRV might be related to early life maltreatment or associated psychological factors rather than diagnostic entities.

Austin MA, Riniolo TC, Porges SW (2007) Borderline personality disorder and emotion regulation: insights from the polyvagal theory. Brain Cogn 65:69–76. doi:10.1016/j.bandc.2006.05.007 CrossRefPubMedPubMedCentral

Beauchaine TP, Thayer JF (2015) Heart rate variability as a transdiagnostic biomarker of psychopathology. Int J Psychophysiol Off J Int Organ Psychophysiol 98:338–350. doi:10.1016/j.ijpsycho.2015.08.004

Beck AT, Steer RA, Brown GK (1996) Manual for the beck depression inventory-II. San Antonio, Psychological Corp

Bernstein DP, Fink L (1998) Childhood Trauma questionnaire: a retrospective self-report manual. The Psychological Corporation, San Antonio

Berntson GG et al (1997) Heart rate variability: origins, methods, and interpretive caveats. Psychophysiology 34:623–648CrossRefPubMed

Bertsch K, Hagemann D, Naumann E, Schachinger H, Schulz A (2012) Stability of heart rate variability indices reflecting parasympathetic activity. Psychophysiology 49:672–682. doi:10.1111/j.1469-8986.2011.01341.x CrossRefPubMed

Bruce SE, Buchholz KR, Brown WJ, Yan L, Durbin A, Sheline YI (2013) Altered emotional interference processing in the amygdala and insula in women with post-traumatic stress disorder. NeuroImage Clin 2:43–49. doi:10.1016/j.nicl.2012.11.003 CrossRef

Brudey C, Park J, Wiaderkiewicz J, Kobayashi I, Mellman T, Marvar P (2015) Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease. Am J Physiol Regul Integr Comp Physiol 309:R315–R321. doi:10.1152/ajpregu.00343.2014 CrossRefPubMedPubMedCentral

Bulheller S, Häcker HO (1998) Advanced Progressive Matrices (SPM) (Deutsche Bearbeitung und Normierung nach J. C. Raven). Pearson Assessment, Frankfurt

Cohen H, Kotler M, Matar MA, Kaplan Z, Loewenthal U, Miodownik H, Cassuto Y (1998) Analysis of heart rate variability in posttraumatic stress disorder patients in response to a trauma-related reminder. Biol Psychiatry 44:1054–1059CrossRefPubMed

DeGiorgio CM et al (2010) RMSSD, a measure of vagus-mediated heart rate variability, is associated with risk factors for SUDEP: the SUDEP-7 inventory. Epilepsy Behav E&B 19:78–81. doi:10.1016/j.yebeh.2010.06.011 CrossRef

Dixon-Gordon KL, Chapman AL, Lovasz N, Walters K (2011) Too upset to think: the interplay of borderline personality features, negative emotions, and social problem solving in the laboratory. Personal Disorders. 2:243–260. doi:10.1037/a0021799 CrossRef

Donegan NH et al (2003) Amygdala hyperreactivity in borderline personality disorder: implications for emotional dysregulation. Biol Psychiatry 54:1284–1293CrossRefPubMed

DSM-IV-TR (2000) DSM library. Am Psychiatr Assoc. doi:10.1176/appi.books.9780890420249.dsm-iv-tr

Faravelli C, Catena M, Scarpato A, Ricca V (2007) Epidemiology of life events: life events and psychiatric disorders in the Sesto Fiorentino study. Psychother Psychosom 76:361–368. doi:10.1159/000107564 CrossRefPubMed

Fewtrell WD (2000) Fewtrell Depersonalisation Scale (FDS). APT Press, Leicester

First MB, Spitzer RL, Spitzer RL, Gibbon M, Williams JBW (2002) Structured clinical interview for DSM-IV-TR axis I disorders, research version, non-patient edition. (SCID-I/NP). Biometrics Research, New York State Psychiatric Institute, New York

Ford JD, Courtois CA (2014) Complex PTSD, affect dysregulation, and borderline personality disorder. Borderline Personal Disorder Emot Dysregul 1:9. doi:10.1186/2051-6673-1-9 CrossRef

Gill JM, Saligan L, Woods S, Page G (2009) PTSD is associated with an excess of inflammatory immune activities. Perspect Psychiatr Care 45:262–277. doi:10.1111/j.1744-6163.2009.00229.x CrossRefPubMed

Gola H et al (2013) Posttraumatic stress disorder is associated with an enhanced spontaneous production of pro-inflammatory cytokines by peripheral blood mononuclear cells. BMC Psychiatry 13:40. doi:10.1186/1471-244x-13-40 CrossRefPubMedPubMedCentral

Gratz KL, Tull MT, Matusiewicz AM, Breetz AA, Lejuez CW (2013) Multimodal examination of emotion regulation difficulties as a function of co-occurring avoidant personality disorder among women with borderline personality disorder. Personal Disorders 4:304–314. doi:10.1037/per0000020 CrossRef

Grippo AJ, Johnson AK (2009) Stress, depression, and cardiovascular dysregulation: a review of neurobiological mechanisms and the integration of research from preclinical disease models. Stress (Amsterdam, Netherlands) 12:1–21. doi:10.1080/10253890802046281 CrossRef

Hallman DM, Olsson EM, von Scheele B, Melin L, Lyskov E (2011) Effects of heart rate variability biofeedback in subjects with stress-related chronic neck pain: a pilot study. Appl Psychophysiol Biofeedback 36:71–80. doi:10.1007/s10484-011-9147-0 CrossRefPubMed

Izurieta Hidalgo NA, Oelkers-Ax R, Nagy K, Mancke F, Bohus M, Herpertz SC, Bertsch K (2015) Time course of facial emotion processing in women with borderline personality disorder: an ERP study. J Psychiatry Neurosci 41:16–26. doi:10.1503/jpn.140215 CrossRef

Kemp AH, Quintana DS, Felmingham KL, Matthews S, Jelinek HF (2012) Depression, comorbid anxiety disorders, and heart rate variability in physically healthy, unmedicated patients: implications for cardiovascular risk. PLoS One 7:e30777. doi:10.1371/journal.pone.0030777 CrossRefPubMedPubMedCentral

Kessler RC, Davis CG, Kendler KS (1997) Childhood adversity and adult psychiatric disorder in the US National Comorbidity Survey. Psychol Med 27:1101–1119CrossRefPubMed

Kim S, Wollburg E, Roth WT (2012) Opposing breathing therapies for panic disorder: a randomized controlled trial of lowering vs raising end-tidal P(CO₂). J Clin Psychiatry 73:931–939. doi:10.4088/JCP.11m07068 CrossRefPubMed

Koenig J, Jarczok MN, Ellis RJ, Warth M, Hillecke TK, Thayer JF (2015) Lowered parasympathetic activity in apparently healthy subjects with self-reported symptoms of pain: preliminary results from a pilot study. Pain Pract Off J World Inst Pain 15:314–318. doi:10.1111/papr.12177 CrossRef

Koenig J, Kemp AH, Feeling NR, Thayer JF, Kaess M (2016a) Resting state vagal tone in borderline personality disorder: a meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 64:18–26. doi:10.1016/j.pnpbp.2015.07.002 CrossRefPubMed

Koenig J, Williams DP, Kemp AH, Thayer JF (2016b) Vagally mediated heart rate variability in headache patients-a systematic review and meta-analysis. Cephalalgia Int J Headache 36:265–278. doi:10.1177/0333102415583989 CrossRef

Koval P, Ogrinz B, Kuppens P, Van den Bergh O, Tuerlinckx F, Sutterlin S (2013) Affective instability in daily life is predicted by resting heart rate variability. PLoS One 8:e81536. doi:10.1371/journal.pone.0081536 CrossRefPubMedPubMedCentral

Lande RG, Williams LB, Francis JL, Gragnani C, Morin ML (2010) Efficacy of biofeedback for post-traumatic stress disorder. Complement Ther Med 18:256–259. doi:10.1016/j.ctim.2010.08.004 CrossRefPubMed

Lehrer PM, Gevirtz R (2014) Heart rate variability biofeedback: how and why does it work? Front Psychol 5:756. doi:10.3389/fpsyg.2014.00756 CrossRefPubMedPubMedCentral

Lehrer PM et al (2003) Heart rate variability biofeedback increases baroreflex gain and peak expiratory flow. Psychosom Med 65:796–805CrossRefPubMed

Lieb K, Rexhausen JE, Kahl KG, Schweiger U, Philipsen A, Hellhammer DH, Bohus M (2004) Increased diurnal salivary cortisol in women with borderline personality disorder. J Psychiatr Res 38:559–565. doi:10.1016/j.jpsychires.2004.04.002 CrossRefPubMed

Loranger AW et al (1994) The International Personality Disorder Examination: The World Health Organization/Alcohol, Drug Abuse, and Mental Health Administration international pilot study of personality disorders. Arch General Psychiatry 51:215–224CrossRef

Ludäscher P, Valerius G, Stiglmayr C, Mauchnik J, Lanius RA, Bohus M, Schmahl C (2010) Pain sensitivity and neural processing during dissociative states in patients with borderline personality disorder with and without comorbid posttraumatic stress disorder: a pilot study. J Psychiatry Neurosci JPN 35:177–184. doi:10.1503/jpn.090022 CrossRefPubMed

McFarlane AC (2010) The long-term costs of traumatic stress: intertwined physical and psychological consequences. World Psychiatry Off J World Psychiatric Association (WPA) 9:3–10

Minassian A, Geyer MA, Baker DG, Nievergelt CM, O’Connor DT, Risbrough VB (2014) Heart rate variability characteristics in a large group of active-duty marines and relationship to posttraumatic stress. Psychosom Med 76:292–301. doi:10.1097/psy.0000000000000056 CrossRefPubMedPubMedCentral

Minassian A, Maihofer AX, Baker DG, Nievergelt CM, Geyer MA, Risbrough VB (2015) Association of predeployment heart rate variability with risk of postdeployment posttraumatic stress disorder in active-duty marines. JAMA Psychiatry 72:979–986. doi:10.1001/jamapsychiatry.2015.0922 CrossRefPubMed

Müller LE, Schulz A, Andermann M, Gäbel A, Gescher DM, Spohn A, Herpertz SC, Bertsch K (2015) Cortical representation of afferent bodily signals in borderline personality disorder: neural correlates and relationship to emotional dysregulation. JAMA Psychiatry 72:1077–1086CrossRefPubMed

Park G, Thayer JF (2014) From the heart to the mind: cardiac vagal tone modulates top-down and bottom-up visual perception and attention to emotional stimuli. Front Psychol 5:278. doi:10.3389/fpsyg.2014.00278 CrossRefPubMedPubMedCentral

Patron E, Benvenuti SM, Favretto G, Valfre C, Bonfa C, Gasparotto R, Palomba D (2013) Biofeedback assisted control of respiratory sinus arrhythmia as a biobehavioral intervention for depressive symptoms in patients after cardiac surgery: a preliminary study. Appl Psychophysiol Biofeedback 38:1–9. doi:10.1007/s10484-012-9202-5 CrossRefPubMed

Pietrek C, Elbert T, Weierstall R, Müller O, Rockstroh B (2013) Childhood adversity in relation to psychiatric disorders. Psychiatry Res 206:103–110CrossRefPubMed

Rausch J, Gabel A, Nagy K, Kleindienst N, Herpertz SC, Bertsch K (2015) Increased testosterone levels and cortisol awakening responses in patients with borderline personality disorder: gender and trait aggressiveness matter. Psychoneuroendocrinology 55:116–127. doi:10.1016/j.psyneuen.2015.02.002 CrossRefPubMed

Reynard A, Gevirtz R, Berlow R, Brown M, Boutelle K (2011) Heart rate variability as a marker of self-regulation. Appl Psychophysiol Biofeedback 36:209–215. doi:10.1007/s10484-011-9162-1 CrossRefPubMed

Rich-Edwards JW et al (2012) Physical and sexual abuse in childhood as predictors of early-onset cardiovascular events in women. Circulation 126:920–927. doi:10.1161/circulationaha.111.076877 CrossRefPubMedPubMedCentral

Rosenbaum S, Stubbs B, Ward PB, Steel Z, Lederman O, Vancampfort D (2015) The prevalence and risk of metabolic syndrome and its components among people with posttraumatic stress disorder: a systematic review and meta-analysis. Metab Clin Exp 64:926–933. doi:10.1016/j.metabol.2015.04.009 CrossRefPubMed

Sahar T, Shalev AY, Porges SW (2001) Vagal modulation of responses to mental challenge in posttraumatic stress disorder. Biol Psychiatry 49:637–643CrossRefPubMed

Sammito S, Thielmann B, Zimmermann P, Bockelmann I (2015) Influence of post-traumatic stress disorder on heart rate variability as marker of the autonomic nervous system—a systematic review. Fortschr Neurol Psychiatr 83:30–37. doi:10.1055/s-0034-1398779 CrossRefPubMed

Sanislow CA et al (2010) Developing constructs for psychopathology research: research domain criteria. J Abnorm Psychol 119:631–639. doi:10.1037/a0020909 CrossRefPubMed

Schipke JD, Arnold G, Pelzer M (1999) Effect of respiration rate on short-term heart rate variability. J Clin Basic Cardiol 2(1):92–95

Schmahl C, Berne K, Krause A, Kleindienst N, Valerius G, Vermetten E, Bohus M (2009) Hippocampus and amygdala volumes in patients with borderline personality disorder with or without posttraumatic stress disorder. J Psychiatry Neurosci JPN 34:289–295PubMed

Schmahl C et al (2014) Mechanisms of disturbed emotion processing and social interaction in borderline personality disorder: state of knowledge and research agenda of the German Clinical Research Unit. Borderline Personal Disord Emot Dysregul 1:12. doi:10.1186/2051-6673-1-12 CrossRefPubMedPubMedCentral

Shonkoff JP, Garner AS (2012) The lifelong effects of early childhood adversity and toxic stress. Pediatrics 129:e232–e246. doi:10.1542/peds.2011-2663 CrossRefPubMed

Silvia PJ, Jackson BA, Sopko RS (2014) Does baseline heart rate variability reflect stable positive emotionality? Personal Individ Differ 70:183–187. doi:10.1016/j.paid.2014.07.003 CrossRef

Song HS, Lehrer PM (2003) The effects of specific respiratory rates on heart rate and heart rate variability. Appl Psychophysiol Biofeedback 28:13–23CrossRefPubMed

Steptoe A, Kivimaki M (2012) Stress and cardiovascular disease. Nature Rev Cardiol 9:360–370. doi:10.1038/nrcardio.2012.45 CrossRef

Tan G, Dao TK, Farmer L, Sutherland RJ, Gevirtz R (2011) Heart rate variability (HRV) and posttraumatic stress disorder (PTSD): a pilot study. Appl Psychophysiol Biofeedback 36:27–35. doi:10.1007/s10484-010-9141-y CrossRefPubMed

Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation 93:1043–1065CrossRef

Tharion E, Samuel P, Rajalakshmi R, Gnanasenthil G, Subramanian RK (2012) Influence of deep breathing exercise on spontaneous respiratory rate and heart rate variability: a randomised controlled trial in healthy subjects. Indian J Physiol Pharmacol 56:80–87PubMed

Thayer J, Hansen A, Saus-Rose E, Johnsen B (2009) Heart rate variability, prefrontal neural function, and cognitive performance: the neurovisceral integration perspective on self-regulation, adaptation, and health. Ann Behav Med 37:141–153. doi:10.1007/s12160-009-9101-z CrossRefPubMed

Tucker P, Pfefferbaum B, Jeon-Slaughter H, Khan Q, Garton T (2012) Emotional stress and heart rate variability measures associated with cardiovascular risk in relocated Katrina survivors. Psychosom Med 74:160–168. doi:10.1097/PSY.0b013e318240a801 CrossRefPubMed

Umetani K, Singer DH, McCraty R, Atkinson M (1998) Twenty-four hour time domain heart rate variability and heart rate: relations to age and gender over nine decades. J Am Coll Cardiol 31:593–601CrossRefPubMed

Wahbeh H, Oken BS (2013) Peak high-frequency HRV and peak alpha frequency higher in PTSD. Appl Psychophysiol Biofeedback 38:57–69. doi:10.1007/s10484-012-9208-z CrossRefPubMedPubMedCentral

Weinberg A, Klonsky ED, Hajcak G (2009) Autonomic impairment in borderline personality disorder: a laboratory investigation. Brain Cogn 71:279–286. doi:10.1016/j.bandc.2009.07.014 CrossRefPubMed

Wessa M, Rohleder N, Kirschbaum C, Flor H (2006) Altered cortisol awakening response in posttraumatic stress disorder. Psychoneuroendocrinology 31:209–215. doi:10.1016/j.psyneuen.2005.06.010 CrossRefPubMed

Williamson JB, Porges EC, Lamb DG, Porges SW (2014) Maladaptive autonomic regulation in PTSD accelerates physiological aging. Front Psychol 5:1571. doi:10.3389/fpsyg.2014.01571 PubMed

Zanarini MC, Vujanovic AA, Parachini EA, Boulanger JL, Frankenburg FR, Hennen J (2003) Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD): a continuous measure of DSM-IV borderline psychopathology. J Pers Disord 17:233–242CrossRefPubMed

Zucker TL, Samuelson KW, Muench F, Greenberg MA, Gevirtz RN (2009) The effects of respiratory sinus arrhythmia biofeedback on heart rate variability and posttraumatic stress disorder symptoms: a pilot study. Appl Psychophysiol Biofeedback 34:135–143. doi:10.1007/s10484-009-9085-2 CrossRefPubMed

Titel: Heart rate variability in patients with post-traumatic stress disorder or borderline personality disorder: relationship to early life maltreatment
verfasst von: Peter-Wolfgang Meyer
Laura E. Müller
Arne Zastrow
Ilinca Schmidinger
Martin Bohus
Sabine C. Herpertz
Katja Bertsch
Publikationsdatum: 16.06.2016
Verlag: Springer Vienna
Erschienen in: Journal of Neural Transmission / Ausgabe 9/2016
Print ISSN: 0300-9564
Elektronische ISSN: 1435-1463
DOI: https://doi.org/10.1007/s00702-016-1584-8

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Demenzkranke durch Antipsychotika vielfach gefährdet

Demenz Nachrichten

Der Einsatz von Antipsychotika gegen psychische und Verhaltenssymptome in Zusammenhang mit Demenzerkrankungen erfordert eine sorgfältige Nutzen-Risiken-Abwägung. Neuen Erkenntnissen zufolge sind auf der Risikoseite weitere schwerwiegende Ereignisse zu berücksichtigen.

Nicht Creutzfeldt Jakob, sondern Abführtee-Vergiftung

29.05.2024 Hyponatriämie Nachrichten

Eine ältere Frau trinkt regelmäßig Sennesblättertee gegen ihre Verstopfung. Der scheint plötzlich gut zu wirken. Auf Durchfall und Erbrechen folgt allerdings eine Hyponatriämie. Nach deren Korrektur kommt es plötzlich zu progredienten Kognitions- und Verhaltensstörungen.

Schutz der Synapsen bei Alzheimer

29.05.2024 Morbus Alzheimer Nachrichten

Mit einem Neurotrophin-Rezeptor-Modulator lässt sich möglicherweise eine bestehende Alzheimerdemenz etwas abschwächen: Erste Phase-2-Daten deuten auf einen verbesserten Synapsenschutz.

Sozialer Aufstieg verringert Demenzgefahr

24.05.2024 Demenz Nachrichten

Ein hohes soziales Niveau ist mit die beste Versicherung gegen eine Demenz. Noch geringer ist das Demenzrisiko für Menschen, die sozial aufsteigen: Sie gewinnen fast zwei demenzfreie Lebensjahre. Umgekehrt steigt die Demenzgefahr beim sozialen Abstieg.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 9/2016

The sexually dimorphic impact of maltreatment on cortical thickness, surface area and gyrification

Multidimensional assessment of neuroendocrine and psychopathological profiles in maltreated youth

The transgenerational transmission of childhood adversity: behavioral, cellular, and epigenetic correlates

Cross-generational influences on childhood anxiety disorders: pathways and mechanisms

Sex-specific differences in adrenocortical attunement in mothers with a history of childhood abuse and their 5-month-old boys and girls