Files and links (1)
Whole Thesis2.14 MB
Embargoed Access, Embargo ends: 31/01/2027
Doctoral Thesis
Return to Homeostasis: Targeting Autonomic Flexibility Through Heart Rate Variability Biofeedback for Co- Occurring PTSD and Chronic Pain
Doctor of Philosophy (PhD), Murdoch University
2025
DOI:
https://doi.org/10.60867/00000049
Abstract
Posttraumatic stress disorder (PTSD) and chronic pain (CP) are highly co-occurring conditions, characterised by poor treatment outcomes and shared mechanisms that exacerbate symptom severity and functional impairment. This randomised, waitlist-controlled trial evaluated the efficacy of a six-week heart rate variability biofeedback (HRVBF) intervention in improving concurrent symptoms of PTSD and CP. In addition, autonomic nervous system function and deficits in emotion regulation (ER) were investigated as potential mediators of symptom improvement. Eighty-two participants meeting clinical criteria for both conditions were randomised to either immediate intervention or waitlist control. Symptom changes and emotion dysregulation were assessed using validated psychometric measures, while autonomic function was assessed through HRV and respiration rate. The intervention group demonstrated significant reductions in PTSD symptoms, with a 24.3% decrease in PTSD Checklist total scores and improvement across all symptom clusters compared to no significant change in the waitlist group. Similarly, pain interference (Brief Pain Inventory) improved significantly (24.9% reduction), whereas reductions in pain intensity and pain disability did not differ significantly between the intervention and waitlist groups. In addition, deficits in ER decreased significantly over the course of the intervention, compared to the control group. On a physiological level, respiration rate and Low-Frequency HRV – which is considered to index baroreflex sensitivity – increased significantly in the intervention group compared to the waitlist, while RMSSD and High-Frequency HRV did not change significantly in either group. Moreover, increases in emotion regulation mediated subsequent decreases in PTSD symptom severity and pain interference, while changes in Low-Frequency HRV did not, highlighting a key pathway through which intervention effects unfolded. Together, these findings provide preliminary evidence that HRVBF is an effective transdiagnostic intervention for PTSD and CP and that enhancing emotion regulation capacities is a central mechanism of symptom improvement. This study represents the first to begin elucidating the mechanisms of action underlying HRVBF within a clinical sample with co-occurring PTSD and CP.
Details
- Title
- Return to Homeostasis: Targeting Autonomic Flexibility Through Heart Rate Variability Biofeedback for Co- Occurring PTSD and Chronic Pain
- Authors/Creators
- THEA Chadwick
- Contributors
- Danielle C. Mathersul (Supervisor) - Murdoch University, Personalised Medicine CentrePeter Drummond (Supervisor) - Murdoch University, Centre for Healthy Ageing
- Awarding Institution
- Murdoch University; Doctor of Philosophy (PhD)
- Identifiers
- 991005851088907891
- Murdoch Affiliation
- School of Psychology
- Resource Type
- Doctoral Thesis
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
Metrics
14 Record Views