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A Longitudinal Examination of Heart-Rate and Heart Rate Variability as Risk Markers for Child Posttraumatic Stress Symptoms in an Acute Injury Sample


Haag, Katharina; Hiller, Rachel; Peyk, Peter; Michael, Tanja; Meiser-Stedman, Richard; Fearon, Pasco; Ehlers, Anke; Halligan, Sarah L (2019). A Longitudinal Examination of Heart-Rate and Heart Rate Variability as Risk Markers for Child Posttraumatic Stress Symptoms in an Acute Injury Sample. Journal of Abnormal Child Psychology, 47(11):1811-1820.

Abstract

Heart rate (HR) alterations in the immediate aftermath of trauma-exposure have been proposed to be potentially useful markers for child and adolescent posttraumatic stress disorder (PTSD). However, it is not yet clear if this holds true for measures taken more distal to the trauma, and no studies have investigated the predictive validity of more sensitive HR variability (HRV) indices. We recruited 76 parent-child pairs (child age 6 to 13 years) after the child experienced a traumatic event leading to presentation at a hospital emergency department. At 1-month post trauma (T1), HR recordings were obtained at rest, and while children verbally recounted their traumatic experience, both alone and together with a parent. Child post-traumatic stress symptoms (PTSS) were assessed concurrently (T1), and at 3 (T2) and 6-month (T3) follow-ups. We found that for T1, elevated mean HR during trauma narratives, but not at baseline, was positively associated with PTSS, with some evidence that HRV-indices were negatively cross-sectionally associated with PTSS. Furthermore, T1 HR indices predicted PTSS at T2 and partially at T3, although these effects did not hold when T1 PTSS were added to the model. Findings suggest that, consistent with the adult literature, HR indices in children may be a concurrent marker of higher PTSS and may be predictive of longer term distress. The findings encourage further investigations that track child HR and HRV in relation to PTSS over time after trauma, in order to examine how biological profiles evolve in those with persistent symptoms.

Abstract

Heart rate (HR) alterations in the immediate aftermath of trauma-exposure have been proposed to be potentially useful markers for child and adolescent posttraumatic stress disorder (PTSD). However, it is not yet clear if this holds true for measures taken more distal to the trauma, and no studies have investigated the predictive validity of more sensitive HR variability (HRV) indices. We recruited 76 parent-child pairs (child age 6 to 13 years) after the child experienced a traumatic event leading to presentation at a hospital emergency department. At 1-month post trauma (T1), HR recordings were obtained at rest, and while children verbally recounted their traumatic experience, both alone and together with a parent. Child post-traumatic stress symptoms (PTSS) were assessed concurrently (T1), and at 3 (T2) and 6-month (T3) follow-ups. We found that for T1, elevated mean HR during trauma narratives, but not at baseline, was positively associated with PTSS, with some evidence that HRV-indices were negatively cross-sectionally associated with PTSS. Furthermore, T1 HR indices predicted PTSS at T2 and partially at T3, although these effects did not hold when T1 PTSS were added to the model. Findings suggest that, consistent with the adult literature, HR indices in children may be a concurrent marker of higher PTSS and may be predictive of longer term distress. The findings encourage further investigations that track child HR and HRV in relation to PTSS over time after trauma, in order to examine how biological profiles evolve in those with persistent symptoms.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Klinik für Konsiliarpsychiatrie und Psychosomatik
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Social Sciences & Humanities > Developmental and Educational Psychology
Health Sciences > Psychiatry and Mental Health
Uncontrolled Keywords:Developmental and Educational Psychology, Psychiatry and Mental health
Language:English
Date:1 November 2019
Deposited On:12 Feb 2021 09:16
Last Modified:13 Feb 2021 21:00
Publisher:Springer
ISSN:0091-0627
OA Status:Hybrid
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1007/s10802-019-00553-2
PubMed ID:31073881

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