Predictive Value of Heart Rate Measures on Posttraumatic Stress Disorder: A Critical Review of Select Recent Studies

Posttraumatic stress disorder (PTSD) is characterized by maladaptive psychophysiological changes, such as a reduced vagal tone and hyperarousal, indicating autonomic nervous system dysfunction. In particular, physiological measures of heart rate, and heart rate variability (HRV) have been linked with PTSD expression, indicating that these measures may have diagnostic value. It remains unclear, however, whether altered heart rate and HRV contribute to the risk of PTSD development. This paper provides an overview of the present understanding of psychophysiological factors that may causally contribute to the manifestation of PTSD. The predictive value of heart rate and HRV measures are evaluated. The following sources of evidence are critically reviewed: relationships between momentary HRV components and PTSD symptom severity, predictions of PTSD development from post-trauma heart rate, and predictions of PTSD development from pre-trauma HRV. Available data challenge preliminary findings that abnormalities in heart rate and HRV currently offer reliable insight into PTSD development, but suggest that with additional research, there is a promising role for physiological biomarkers of autonomic dysregulation in risk prediction of future psychopathology.