A prospective examination of sex differences in posttraumatic autonomic functioning

Antonia V. Seligowski, Elizabeth R. Steuber, Rebecca Mary Hinrichs, Mariam H. Reda, Charis N. Wiltshire, Cassandra P. Wanna, Sterling J. Winters, Karlye A. Phillips, Stacey L. House, Francesca L. Beaudoin, Xinming An, Jennifer S. Stevens, Donglin Zeng, Thomas C. Neylan, Gari D. Clifford, Sarah D. Linnstaedt, Laura T. Germine, Kenneth A. Bollen, Guia Guffanti, Scott L. RauchJohn P. Haran, Alan B. Storrow, Brittany E. Punches, Michael C. Kurz, Vishnu P. Murty, Meghan E. McGrath, Lauren A. Hudak, Jose L. Pascual, Mark J. Seamon, Elizabeth M. Datner, Anna Marie Chang, Claire Pearson, David A. Peak, Roland C. Merchant, Robert M. Domeier, Niels K. Rathlev, Brian J. O'Neil, Leon D. Sanchez, Steven Bruce, Mark L. Miller, Robert H. Pietrzak, Jutta Joormann, Deanna M. Barch, Diego A. Pizzagalli, John F. Sheridan, Beatriz Luna, Steven E. Harte, James M. Elliott, Karestan C. Koenen, Ronald C. Kessler, Samuel A. McLean, Kerry J. Ressler, Tanja Jovanovic

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Cross-sectional studies have found that individuals with  posttraumatic stress disorder  (PTSD) exhibit deficits in autonomic functioning. While PTSD rates are twice as high in women compared to men, sex differences in autonomic functioning are relatively unknown among trauma-exposed populations. The current study used a prospective design to examine sex differences in posttraumatic autonomic functioning.
Methods
192 participants were recruited from emergency departments following trauma exposure ( Mean  age = 35.88, 68.2% female). Skin conductance was measured in the emergency department; fear conditioning was completed two weeks later and included measures of blood pressure (BP), heart rate (HR), and high frequency heart rate variability (HF-HRV). PTSD symptoms were assessed 8 weeks after trauma.
Results
2-week systolic BP was significantly higher in men, while 2-week HR was significantly higher in women, and a sex by PTSD interaction suggested that women who developed PTSD demonstrated the highest HR levels. Two-week HF-HRV was significantly lower in women, and a sex by PTSD interaction suggested that women with PTSD demonstrated the lowest HF-HRV levels.  Skin conductance response  in the emergency department was associated with 2-week HR and HF-HRV only among women who developed PTSD.
Conclusions
Our results indicate that there are notable sex differences in autonomic functioning among trauma-exposed individuals. Differences in sympathetic biomarkers (BP and HR) may have implications for cardiovascular disease risk given that sympathetic arousal is a mechanism implicated in this risk among PTSD populations. Future research examining differential pathways between PTSD and cardiovascular risk among men versus women is warranted.

Original languageAmerican English
JournalNeurobiology of Stress
Volume15
DOIs
StatePublished - Nov 2021

Keywords

  • Autonomic
  • Cardiovascular
  • PTSD
  • Sex
  • Trauma

Disciplines

  • Psychiatry and Psychology

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