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Related Concept Videos

Post-traumatic Stress Disorder01:27

Post-traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is a psychiatric condition that arises following exposure to traumatic events such as natural disasters, forced displacement, or severe accidents. It significantly impairs individuals' ability to cope with daily activities and disrupts their emotional and psychological equilibrium.
Symptoms and Behavioral Manifestations
A spectrum of distressing symptoms characterizes PTSD. Recurrent flashbacks, where individuals involuntarily relive traumatic events, are a...
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Introspection, long upheld as a reliable route to self-knowledge, involves examining one's thoughts, emotions, and mental processes. It underpins many psychological practices, from mindfulness meditation to psychotherapy and self-help strategies. However, empirical evidence challenges the accuracy of introspection as a means of understanding oneself.Limitations of Introspective InsightSeminal work by Nisbett and Wilson demonstrated that individuals are frequently unaware of the true causes...
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Other Factors Affecting Respiration Centers01:17

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Physiological Control of Respiration01:23

Physiological Control of Respiration

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Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

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Related Experiment Video

Updated: Jun 28, 2026

The use of Biofeedback in Clinical Virtual Reality: The INTREPID Project
06:52

The use of Biofeedback in Clinical Virtual Reality: The INTREPID Project

Published on: November 12, 2009

Beyond the Breath: Improving Interoceptive Awareness & Autonomic Regulation through Trauma-Informed Biofeedback for

Alexander A Puhalla1, F AnNa Hughes2, Timothy McCoy2,3

  • 1Coatesville Veterans Affairs Medical Center, 1400 Blackhorse Hl Rd, Coatesville, PA, 19320, USA. alexander.puhalla@va.gov.

Applied Psychophysiology and Biofeedback
|June 27, 2026
PubMed
Summary

Trauma-informed Heart Rate Variability Biofeedback (T-HRVB) improved autonomic nervous system (ANS) balance and interoceptive awareness in veterans with PTSD. This intervention shows promise for enhancing PTSD treatment outcomes.

Keywords:
BiofeedbackHeart rate variabilityInteroceptive awarenessPosttraumatic stress disorderSelf-regulationVeterans

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Area of Science:

  • Psychophysiology
  • Trauma Studies
  • Neuroscience

Background:

  • Posttraumatic stress disorder (PTSD) is associated with autonomic nervous system (ANS) imbalance, including sympathetic nervous system (SNS) hyperreactivity and reduced parasympathetic nervous system (PNS) activity.
  • Standard evidence-based psychotherapies (EBPs) for PTSD may not fully resolve ANS dysfunction or related health issues like hypertension.
  • Adjunctive interventions targeting ANS balance, such as Heart Rate Variability Biofeedback (HRVB), are being explored.

Purpose of the Study:

  • To investigate the effectiveness of Trauma Informed Heart Rate Variability Biofeedback (T-HRVB) as an adjunctive intervention for veterans with PTSD.
  • To examine the impact of T-HRVB on heart rate variability (HRV) and interoceptive awareness.
  • To assess changes in HRV metrics and self-reported interoceptive capacities in veterans undergoing T-HRVB.

Main Methods:

  • Thirty-seven veterans undergoing outpatient or residential PTSD treatment participated in T-HRVB.
  • Heart rate variability (HRV) and self-report measures of interoceptive awareness were collected pre- and post-intervention.
  • Data analysis focused on changes in HRV parameters and components of interoceptive awareness (listening, trusting, self-regulation).

Main Results:

  • Significant improvements were observed in multiple HRV variables, indicating enhanced autonomic regulation.
  • Participants demonstrated significant increases in interoceptive listening, trusting, and self-regulation.
  • These findings suggest T-HRVB positively impacts both physiological and psychological aspects of PTSD.

Conclusions:

  • Trauma Informed Heart Rate Variability Biofeedback (T-HRVB) is a promising adjunctive intervention for veterans with PTSD.
  • T-HRVB effectively enhances heart rate variability (HRV) and interoceptive awareness, contributing to improved self-regulation.
  • Further research is warranted to compare T-HRVB with other active PTSD treatment modalities.