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Respiratory Sinus Arrhythmia Change during Trauma-Focused Cognitive-Behavioral Therapy: Results from a Randomized

Chad E Shenk1,2,3, Brian Allen4,5,6, Nancy A Dreschel7

  • 1Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA. ces140@psu.edu.

Research on Child and Adolescent Psychopathology
|June 11, 2022
PubMed

Insights

This study found that while animal-assisted therapy (AAT) did not enhance respiratory sinus arrhythmia (RSA) during Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), better RSA regulation predicted reduced PTSD symptoms in children. Further research is warranted.

Area of Science:

  • Psychology
  • Clinical Psychology
  • Psychophysiology

Background:

  • Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a standard treatment for pediatric PTSD.
  • Animal-assisted therapy (AAT) is proposed to enhance TF-CBT by improving affect regulation, measured by respiratory sinus arrhythmia (RSA).

Purpose of the Study:

  • To examine if TF-CBT combined with AAT (TF-CBT+AAT) improves RSA amplitudes compared to TF-CBT alone.
  • To determine if RSA regulation predicts post-treatment PTSD symptom severity in children undergoing TF-CBT.

Main Methods:

  • A randomized controlled feasibility trial with 33 children was conducted.
  • RSA was measured at multiple time points during a 12-session TF-CBT protocol.
  • Multilevel modeling and intraindividual regression analyses were used to analyze RSA and PTSD symptom data.

Main Results:

  • TF-CBT+AAT did not show a significant effect on RSA amplitudes compared to TF-CBT alone.
  • Greater RSA withdrawal was observed during later treatment sessions.
  • Improved RSA regulation was associated with reduced PTSD symptoms post-treatment, irrespective of AAT inclusion.

Conclusions:

  • While AAT did not directly impact RSA amplitudes in this feasibility trial, the findings suggest that RSA regulation may be a crucial mechanism of change in TF-CBT for pediatric PTSD.
  • These preliminary results support further investigation into affect regulation via RSA as a target for optimizing TF-CBT efficacy.

Keywords:
Mechanisms of actionPosttraumatic stress disorderRandomized controlled trialRespiratory sinus arrhythmiaTrauma-focused cognitive-behavioral therapy

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