Top

Research on Child and Adolescent Psychopathology

Gepubliceerd in:

11-06-2022

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

Auteurs: Chad E. Shenk, Brian Allen, Nancy A. Dreschel, Ming Wang, John M. Felt, Michelle P. Brown, Ashley M. Bucher, Michelle J. Chen, Anneke E. Olson

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 11/2022

Abstract

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a well-established treatment for pediatric posttraumatic stress disorder (PTSD). Animal-assisted therapy (AAT) has been proposed as an adjunct to TF-CBT that may improve treatment effects through enhanced targeting of affect regulation, as indexed by specific changes in the respiratory sinus arrhythmia (RSA). The current study reports results from a randomized controlled feasibility trial (N = 33; M_age = 11.79 [SD = 3.08]; 64% White; 67% female) that measured RSA during Sessions 1, 4, 8, and 12 of a twelve-session TF-CBT protocol and tested whether: 1) TF-CBT + AAT achieved higher average RSA amplitudes relative to TF-CBT alone, and 2) RSA regulation, defined as less variability around person-specific RSA slopes during treatment, explained variation in post-treatment PTSD symptoms. Multilevel modeling failed to support an effect for TF-CBT + AAT on RSA amplitudes (δ₀₀₁ = 0.08, p = 0.844). However, regardless of treatment condition, greater RSA withdrawal was observed within Sessions 4 (γ₁₁ = -.01, p < .001) and 12 (γ₁₃ = -.01, p = .015) relative to the Session 1 baseline. The average level of RSA amplitude in Session 8 was also significantly lower compared to Session 1 (γ₀₂ = -0.70, p = .046). Intraindividual regression models demonstrated that greater RSA regulation predicted improved PTSD symptoms at post-treatment after adjusting for pre-treatment levels (b₃ = 20.00, p = .012). These preliminary results offer support for future confirmatory trials testing whether affect regulation, as indexed by changes in RSA, is a mechanism of action for TF-CBT in the treatment of pediatric PTSD.

vorige artikel Depression and anxiety symptoms amongst kenyan adolescents: Psychometric Properties, Prevalence Rates and Associations with Psychosocial Wellbeing and Sociodemographic factors

volgende artikel The Latent Structure of Child and Adolescent Psychopathology and its Association with Different Forms of Trauma and Suicidality and Self-Harm

Allen, B., Shenk, C. E., Dreschel, N. E., Wang, M., Bucher, A. M., Desir, M. P., Chen, M. J., & Grabowski, S. R. (2021). Integrating Animal-Assisted Therapy Into TF-CBT for Abused Youth With PTSD: A Randomized Controlled Feasibility Trial. Child Maltreatment. https://doi.org/10.1177/1077559520988790CrossRefPubMedPubMedCentral

Beauchaine, T. P., Bell, Z., Knapton, E., McDonough-Caplan, H., Shader, T., & Zisner, A. (2019). Respiratory sinus arrhythmia reactivity across empirically based structural dimensions of psychopathology: A meta-analysis. Psychophysiology, 56(5), e13329. https://doi.org/10.1111/psyp.13329CrossRefPubMedPubMedCentral

Beauchaine, T. P., & Thayer, J. F. (2015). Heart rate variability as a transdiagnostic biomarker of psychopathology. International Journal of Psychophysiology, 98(2 Pt 2), 338–350. https://doi.org/10.1016/j.ijpsycho.2015.08.004CrossRefPubMed

Berntson, G. G., Bigger, J. T., Jr., Eckberg, D. L., Grossman, P., Kaufmann, P. G., Malik, M., Nagaraja, H. N., Porges, S. W., Saul, J. P., Stone, P. H., & van der Molen, M. W. (1997). Heart rate variability: Origins, methods, and interpretive caveats. Psychophysiology, 34(6), 623–648. https://doi.org/10.1111/j.1469-8986.1997.tb02140.xCrossRefPubMed

Blechert, J., Michael, T., Grossman, P., Lajtman, M., & Wilhelm, F. H. (2007). Autonomic and respiratory characteristics of posttraumatic stress disorder and panic disorder. Psychosomatic Medicine, 69(9), 935–943. https://doi.org/10.1097/PSY.0b013e31815a8f6bCrossRefPubMed

Brain-Body Center for Psychophysiology and Bioengineering, University of North Carolina, Chapel Hill. (2016). CardioBatch Plus Software.

Brain-Body Center, University of Illinois at Chicago. (2007). CardioEdit Software.

Campbell, A. A., & Wisco, B. E. (2021). Respiratory sinus arrhythmia reactivity in anxiety and posttraumatic stress disorder: A review of literature. Clinical Psychology Review, 87, 102034. https://doi.org/10.1016/j.cpr.2021.102034CrossRefPubMed

Campbell, A. A., Wisco, B. E., Silvia, P. J., & Gay, N. G. (2019). Resting respiratory sinus arrhythmia and posttraumatic stress disorder: A meta-analysis. Biological Psychology, 144, 125–135. https://doi.org/10.1016/j.biopsycho.2019.02.005CrossRefPubMed

Chandler, C. K. (2005). Animal-Assisted Therapy in Counseling. Routledge.CrossRef

Cisler, J. M., Sigel, B. A., Kramer, T. L., Smitherman, S., Vanderzee, K., Pemberton, J., & Kilts, C. D. (2015). Amygdala response predicts trajectory of symptom reduction during Trauma-Focused Cognitive-Behavioral Therapy among adolescent girls with PTSD. Journal of Psychiatric Research, 71, 33–40. https://doi.org/10.1016/j.jpsychires.2015.09.011CrossRefPubMedPubMedCentral

Cohen, J. A., Bukstein, O., Walter, H., Benson, S. R., Chrisman, A., Farchione, T. R., Hamilton, J., Keable, H., Kinlan, J., Schoettle, U., Siegel, M., Stock, S., & Medicus, J. (2010). Practice parameter for the assessment and treatment of children and adolescents with posttraumatic stress disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 49(4), 414–430.

Cohen, J. A., Deblinger, E., Mannarino, A. P., & Steer, R. A. (2004). A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms. Journal of the American Academy of Child & Adolescent Psychiatry, 43(4), 393–402. https://doi.org/10.1097/00004583-200404000-00005CrossRef

Cohen, J. A., & Mannarino, A. P. (2015). Trauma-focused Cognitive Behavior Therapy for Traumatized Children and Families. Child and Adolescent Psychiatric Clinics of North America, 24(3), 557–570. https://doi.org/10.1016/j.chc.2015.02.005CrossRefPubMedPubMedCentral

Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2017). Treating Trauma and Traumatic Grief in Children and Adolescents (2nd ed.). Guilford Press.

Cohen, J. A., Mannarino, A. P., & Iyengar, S. (2011a). Community treatment of posttraumatic stress disorder for children exposed to intimate partner violence: A randomized controlled trial. Archives of Pediatrics and Adolescent Medicine, 165(1), 16–21. https://doi.org/10.1001/archpediatrics.2010.247CrossRefPubMed

Cohen, J. A., Mannarino, A. P., & Murray, L. K. (2011b). Trauma-focused CBT for youth who experience ongoing traumas. Child Abuse & Neglect, 35(8), 637–646. https://doi.org/10.1016/j.chiabu.2011.05.002CrossRef

Collins, L. M., Chakraborty, B., Murphy, S. A., & Strecher, V. (2009). Comparison of a phased experimental approach and a single randomized clinical trial for developing multicomponent behavioral interventions. Clinical Trials, 6(1), 5–15. https://doi.org/10.1177/1740774508100973CrossRefPubMed

Dale, L. P., Shaikh, S. K., Fasciano, L. C., Watorek, V. D., Heilman, K. J., & Porges, S. W. (2018). College females with maltreatment histories have atypical autonomic regulation and poor psychological wellbeing. Psychological Trauma, 10(4), 427–434. https://doi.org/10.1037/tra0000342CrossRefPubMed

Deblinger, E., Mannarino, A. P., Cohen, J. A., Runyon, M. K., & Steer, R. A. (2011). Trauma-focused cognitive behavioral therapy for children: Impact of the trauma narrative and treatment length. Depression & Anxiety, 28(1), 67–75. https://doi.org/10.1002/da.20744CrossRef

Dorsey, S., Lucid, L., Martin, P., King, K. M., O’Donnell, K., Murray, L. K., Wasonga, A. I., Itemba, D. K., Cohen, J. A., Manongi, R., & Whetten, K. (2020). Effectiveness of Task-Shifted Trauma-Focused Cognitive Behavioral Therapy for Children Who Experienced Parental Death and Posttraumatic Stress in Kenya and Tanzania: A Randomized Clinical Trial. JAMA Psychiatry. https://doi.org/10.1001/jamapsychiatry.2019.4475CrossRefPubMedPubMedCentral

Dorsey, S., McLaughlin, K. A., Kerns, S. E. U., Harrison, J. P., Lambert, H. K., Briggs, E. C., Revillion Cox, J., & Amaya-Jackson, L. (2017). Evidence Base Update for Psychosocial Treatments for Children and Adolescents Exposed to Traumatic Events. Journal of Clinical Child and Adolescent Psychology, 46(3), 303–330. https://doi.org/10.1080/15374416.2016.1220309CrossRefPubMed

Ebert, L., Amaya-Jackson, L., Markiewicz, J. M., Kisiel, C., & Fairbank, J. A. (2012). Use of the breakthrough series collaborative to support broad and sustained use of evidence-based trauma treatment for children in community practice settings. Administration and Policy in Mental Health, 39(3), 187–199. https://doi.org/10.1007/s10488-011-0347-yCrossRefPubMed

Goldbeck, L., Muche, R., Sachser, C., Tutus, D., & Rosner, R. (2016). Effectiveness of Trauma-Focused Cognitive Behavioral Therapy for Children and Adolescents: A Randomized Controlled Trial in Eight German Mental Health Clinics. Psychotherapy and Psychosomatics, 85(3), 159–170. https://doi.org/10.1159/000442824CrossRefPubMed

Gray, S. A. O., Lipschutz, R. S., & Scheeringa, M. S. (2018). Young Children’s Physiological Reactivity during Memory Recall: Associations with Posttraumatic Stress and Parent Physiological Synchrony. Journal of Abnormal Child Psychology, 46(4), 871–880. https://doi.org/10.1007/s10802-017-0326-1CrossRefPubMedPubMedCentral

Jenness, J. L., Miller, A. B., Rosen, M. L., & McLaughlin, K. A. (2019). Extinction Learning as a Potential Mechanism Linking High Vagal Tone with Lower PTSD Symptoms among Abused Youth. Journal of Abnormal Child Psychology, 47(4), 659–670. https://doi.org/10.1007/s10802-018-0464-0CrossRefPubMedPubMedCentral

John-Baptiste Bastien, R., Jongsma, H. E., Kabadayi, M., & Billings, J. (2020). The effectiveness of psychological interventions for post-traumatic stress disorder in children, adolescents and young adults: A systematic review and meta-analysis. Psychological Medicine, 50(10), 1598–1612. https://doi.org/10.1017/s0033291720002007CrossRefPubMed

Kaplow, J. B., Rolon-Arroyo, B., Layne, C. M., Rooney, E., Oosterhoff, B., Hill, R., Steinberg, A. M., Lotterman, J., Gallagher, K. A. S., & Pynoos, R. S. (2020). Validation of the UCLA PTSD Reaction Index for DSM-5: A Developmentally Informed Assessment Tool for Youth. Journal of the American Academy of Child and Adolescent Psychiatry, 59(1), 186–194. https://doi.org/10.1016/j.jaac.2018.10.019CrossRefPubMed

Krause-Parello, C. A., & Gulick, E. E. (2015). Forensic interviews for child sexual abuse allegations: An investigation into the effects of animal-assisted intervention on stress biomarkers. Journal of Child Sexual Abuse: Research, Treatment, & Program Innovations for Victims, Survivors, & Offenders, 24(8), 873–886. https://doi.org/10.1080/10538712.2015.1088916

Lamb, D. G., Porges, E. C., Lewis, G. F., & Williamson, J. B. (2017). Non-invasive Vagal Nerve Stimulation Effects on Hyperarousal and Autonomic State in Patients with Posttraumatic Stress Disorder and History of Mild Traumatic Brain Injury: Preliminary Evidence. Front Med (lausanne), 4, 124. https://doi.org/10.3389/fmed.2017.00124CrossRef

Lewis, G. F., Furman, S. A., McCool, M. F., & Porges, S. W. (2012). Statistical strategies to quantify respiratory sinus arrhythmia: Are commonly used metrics equivalent? Biological Psychology, 89(2), 349–364. https://doi.org/10.1016/j.biopsycho.2011.11.009CrossRefPubMed

Lewis, G. F., Hourani, L., Tueller, S., Kizakevich, P., Bryant, S., Weimer, B., & Strange, L. (2015). Relaxation training assisted by heart rate variability biofeedback: Implication for a military predeployment stress inoculation protocol. Psychophysiology, 52(9), 1167–1174. https://doi.org/10.1111/psyp.12455CrossRefPubMed

Lipschutz, R. S., Gray, S. A. O., Weems, C. F., & Scheeringa, M. S. (2017). Respiratory Sinus Arrhythmia in Cognitive Behavioral Therapy for Posttraumatic Stress Symptoms in Children: Preliminary Treatment and Gender Effects. Applied Psychophysiology and Biofeedback, 42(4), 309–321. https://doi.org/10.1007/s10484-017-9377-xCrossRefPubMedPubMedCentral

Miskovic, V., Schmidt, L. A., Georgiades, K., Boyle, M., & MacMillan, H. L. (2009). Stability of resting frontal electroencephalogram (EEG) asymmetry and cardiac vagal tone in adolescent females exposed to child maltreatment. Developmental Psychobiology, 51(6), 474–487. https://doi.org/10.1002/dev.20387CrossRefPubMed

Murray, L. K., Skavenski, S., Kane, J. C., Mayeya, J., Dorsey, S., Cohen, J. A., Michalopoulos, L. T., Imasiku, M., & Bolton, P. A. (2015). Effectiveness of Trauma-Focused Cognitive Behavioral Therapy Among Trauma-Affected Children in Lusaka, Zambia: A Randomized Clinical Trial. JAMA Pediatrics, 169(8), 761–769. https://doi.org/10.1001/jamapediatrics.2015.0580CrossRefPubMedPubMedCentral

Nemeroff, C. B. (2016). Paradise Lost: The Neurobiological and Clinical Consequences of Child Abuse and Neglect. Neuron, 89(5), 892–909. https://doi.org/10.1016/j.neuron.2016.01.019CrossRefPubMed

Noble, L. J., Gonzalez, I. J., Meruva, V. B., Callahan, K. A., Belfort, B. D., Ramanathan, K. R., Meyers, E., Kilgard, M. P., Rennaker, R. L., & McIntyre, C. K. (2017). Effects of vagus nerve stimulation on extinction of conditioned fear and post-traumatic stress disorder symptoms in rats. Translational Psychiatry, 7(8), e1217. https://doi.org/10.1038/tp.2017.191CrossRefPubMedPubMedCentral

Parish-Plass, N. (2008). Animal-assisted therapy with children suffering from insecure attachment due to abuse and neglect: A method to lower the risk of intergenerational transmission of abuse? Clin Child Psychol Psychiatry, 13(1), 7–30. https://doi.org/10.1177/1359104507086338

Perry, N. B., Nelson, J. A., Swingler, M. M., Leerkes, E. M., Calkins, S. D., Marcovitch, S., & O’Brien, M. (2013). The relation between maternal emotional support and child physiological regulation across the preschool years. Developmental Psychobiology, 55(4), 382–394. https://doi.org/10.1002/dev.21042CrossRefPubMed

Porges, S. W. (1985). Method and Apparatus for Evaluating Rhythmic Oscillations in Aperiodic Physiological Response Systems 4,510,944. W. D. C. U. S. P. Office.

Porges, S. W. (2003). The Polyvagal Theory: Phylogenetic contributions to social behavior. Physiology & Behavior, 79(3), 503–513.CrossRef

Porges, S. W. (2021). Cardiac vagal tone: A neurophysiological mechanism that evolved in mammals to dampen threat reactions and promote sociality. World Psychiatry, 20(2), 296–298. https://doi.org/10.1002/wps.20871CrossRefPubMedPubMedCentral

Porges, S. W., & Bohrer, R. E. (1990). The analysis of periodic processes in psychophysiological research. In J. T. Cacioppo & L. G. Tassinary (Eds.), Principles of psychophysiology: Physical, Social, and Inferential Elements (pp. 708–753, Chapter xiii, 914 Pages). Cambridge University Press, New York, NY.

Porges, S. W., Doussard-Roosevelt, J. A., Portales, A. L., & Greenspan, S. I. (1996). Infant regulation of the vagal “brake” predicts child behavior problems: A psychobiological model of social behavior. Developmental Psychobiology, 29(8), 697–712. https://doi.org/10.1002/(sici)1098-2302(199612)29:8%3c697::Aid-dev5%3e3.0.Co;2-oCrossRefPubMed

Pynoos, R. S., & Steinberg, A. M. (2015). The UCLA PTSD Reaction Index for Children and Adolescents - DSM-5. Behavioral Health Innovations, LLC.

R Core Team. (2020). R: A language and environment for statistical computing. R Foundation for Statistical Computing. https://www.R-project.org

Reichert, E., Bermel, L., & Sori, C. F. (2016). Animal-assisted therapy for sexually abused children. In C. F. Sori, L. L. Kecker, & M. E. Bachenberg (Eds.), The Therapist’s Notebook for Children and Adolescents: Homework, Handouts, and Activities for Use in Psychotherapy (2nd ed., pp. 125–130). Routledge.

Ross, S. L., Sharma-Patel, K., Brown, E. J., Huntt, J. S., & Chaplin, W. F. (2021). Complex trauma and Trauma-Focused Cognitive-Behavioral Therapy: How do trauma chronicity and PTSD presentation affect treatment outcome? Child Abuse and Neglect, 111, 104734. https://doi.org/10.1016/j.chiabu.2020.104734CrossRefPubMed

Sachser, C., Keller, F., & Goldbeck, L. (2017). Complex PTSD as proposed for ICD-11: Validation of a new disorder in children and adolescents and their response to Trauma-Focused Cognitive Behavioral Therapy. Journal of Child Psychology and Psychiatry, 58(2), 160–168. https://doi.org/10.1111/jcpp.12640CrossRefPubMed

Sack, M., Hopper, J. W., & Lamprecht, F. (2004). Low respiratory sinus arrhythmia and prolonged psychophysiological arousal in posttraumatic stress disorder: Heart rate dynamics and individual differences in arousal regulation. Biological Psychiatry, 55(3), 284–290.CrossRefPubMed

Sack, M., Lempa, W., Steinmetz, A., Lamprecht, F., & Hofmann, A. (2008). Alterations in autonomic tone during trauma exposure using eye movement desensitization and reprocessing (EMDR)–results of a preliminary investigation. Journal of Anxiety Disorders, 22(7), 1264–1271. https://doi.org/10.1016/j.janxdis.2008.01.007CrossRefPubMed

Schneider, M., & Schwerdtfeger, A. (2020). Autonomic dysfunction in posttraumatic stress disorder indexed by heart rate variability: A meta-analysis. Psychological Medicine, 50(12), 1937–1948. https://doi.org/10.1017/s003329172000207xCrossRefPubMedPubMedCentral

Sheeran, P., Klein, W. M. P., & Rothman, A. J. (2017). Health behavior change: Moving from observation to intervention. Annual Review of Psychology, 68, 573–600. https://doi.org/10.1146/annurev-psych-010416-044007

Shenk, C. E., Ammerman, R. T., Teeters, A. R., Bensman, H. E., Allen, E. K., Putnam, F. W., & Van Ginkel, J. B. (2017). History of Maltreatment in Childhood and Subsequent Parenting Stress in At-Risk, First-Time Mothers: Identifying Points of Intervention During Home Visiting. Prevention Science, 18(3), 361–370. https://doi.org/10.1007/s11121-017-0758-4CrossRefPubMed

Sigrist, C., Mürner-Lavanchy, I., Peschel, S. K. V., Schmidt, S. J., Kaess, M., & Koenig, J. (2021). Early Life Maltreatment and Resting-State Heart Rate Variability: A Systematic Review and Meta-Analysis. Neuroscience and Biobehavioral Reviews. https://doi.org/10.1016/j.neubiorev.2020.10.026CrossRefPubMed

Souza, R. R., Robertson, N. M., Pruitt, D. T., Gonzales, P. A., Hays, S. A., Rennaker, R. L., Kilgard, M. P., & McIntyre, C. K. (2019). Vagus nerve stimulation reverses the extinction impairments in a model of PTSD with prolonged and repeated trauma. Stress, 22(4), 509–520. https://doi.org/10.1080/10253890.2019.1602604CrossRefPubMed

Steinberg, A. M., Brymer, M. J., Kim, S., Briggs, E. C., Ippen, C. G., Ostrowski, S. A., Gully, K. J., & Pynoos, R. S. (2013). Psychometric properties of the UCLA PTSD Reaction Index: Part I. Journal of Traumatic Stress, 26(1), 1–9. https://doi.org/10.1002/jts.21780CrossRefPubMed

Tedeschi, P., Sisa, M. L., Olmert, M. D., Parish-Plass, N., & Yount, R. (2015). Treating human trauma with the help of animals: Trauma informed intervention for child maltreatment and adult post-traumatic stress. In A. H. Fine (Ed.), 4th ed. (4th ed. ed., pp. 305–319, Chapter xxvii, 427 Pages). Elsevier Academic Press, San Diego, CA. https://doi.org/10.1016/B978-0-12-801292-5.00022-5

Webb, C., Hayes, A., Grasso, D., Laurenceau, J. P., & Deblinger, E. (2014). Trauma-Focused Cognitive Behavioral Therapy for Youth: Effectiveness in a Community Setting. Psychological Trauma, 6(5), 555–562. https://doi.org/10.1037/a0037364CrossRefPubMedPubMedCentral

Titel: Respiratory Sinus Arrhythmia Change during Trauma-Focused Cognitive-Behavioral Therapy: Results from a Randomized Controlled Feasibility Trial
Auteurs: Chad E. Shenk
Brian Allen
Nancy A. Dreschel
Ming Wang
John M. Felt
Michelle P. Brown
Ashley M. Bucher
Michelle J. Chen
Anneke E. Olson
Publicatiedatum: 11-06-2022
Uitgeverij: Springer US
Gepubliceerd in: Research on Child and Adolescent Psychopathology / Uitgave 11/2022
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI: https://doi.org/10.1007/s10802-022-00946-w

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Log in om toegang te krijgen

Andere artikelen Uitgave 11/2022

Socio-ecological Resilience Relates to Lower Internalizing Symptoms among Adolescents during the Strictest Period of COVID-19 Lockdown in Perú

The Latent Structure of Child and Adolescent Psychopathology and its Association with Different Forms of Trauma and Suicidality and Self-Harm

Associations among ADHD symptoms, ODD symptoms, and borderline personality features: A network analysis

Depression and anxiety symptoms amongst kenyan adolescents: Psychometric Properties, Prevalence Rates and Associations with Psychosocial Wellbeing and Sociodemographic factors

Correction To: Childhood Behavioral Inhibition and Overcontrol: Relationships with Cognitive Functioning, Error Monitoring, Anxiety and Obsessive–compulsive Symptoms

Joint Consideration of Inhibitory Control and Irritability in Young Children: Contributions to Emergent Psychopathology