A prospective examination of sex differences in posttraumatic autonomic functioning

• Authors: Antonia V. Seligowski, Harvard University; Elizabeth R. Steuber, Johns Hopkins Hospital; Rebecca Hinrichs, Emory University; Mariam H. Reda, Wayne State University; Charis N. Wiltshire, Wayne State University; Jennifer Stevens, Emory University; Gari Clifford, Emory University; Lauren Hudak, Emory University; Kerry Ressler, Emory University; Tanja Jovanovic, Emory University
• Journal Title: Neurobiology of Stress
• Volume: Volume 15
• Publisher: Elsevier | 2021-11-01
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1016/j.ynstr.2021.100384
• Subjects: Psychology, Cognitive; Psychology, Behavioral
• Keywords: Trauma; PTSD; Autonomic; Sex; Cardiovascular

Abstract

Background Cross-sectional studies have found that individuals with posttraumatic stress disorder (PTSD) exhibit deficits in autonomic functioning. While PTSD rates are twice as high in women compared to men, sex differences in autonomic functioning are relatively unknown among trauma-exposed populations. The current study used a prospective design to examine sex differences in posttraumatic autonomic functioning. Methods 192 participants were recruited from emergency departments following trauma exposure (Mean age = 35.88, 68.2% female). Skin conductance was measured in the emergency department; fear conditioning was completed two weeks later and included measures of blood pressure (BP), heart rate (HR), and high frequency heart rate variability (HF-HRV). PTSD symptoms were assessed 8 weeks after trauma. Results 2-week systolic BP was significantly higher in men, while 2-week HR was significantly higher in women, and a sex by PTSD interaction suggested that women who developed PTSD demonstrated the highest HR levels. Two-week HF-HRV was significantly lower in women, and a sex by PTSD interaction suggested that women with PTSD demonstrated the lowest HF-HRV levels. Skin conductance response in the emergency department was associated with 2-week HR and HF-HRV only among women who developed PTSD. Conclusions Our results indicate that there are notable sex differences in autonomic functioning among trauma-exposed individuals. Differences in sympathetic biomarkers (BP and HR) may have implications for cardiovascular disease risk given that sympathetic arousal is a mechanism implicated in this risk among PTSD populations. Future research examining differential pathways between PTSD and cardiovascular risk among men versus women is warranted.