A prospective examination of sex differences in posttraumatic autonomic functioning

• DOI: 10.1016/j.ynstr.2021.100384
• Publication Date: 2021-08-21T23:14:50Z
• Authors: Antonia V. Seligo...; Elizabeth R. Steuber; Rebecca Hinrichs; Mariam H. Reda; Charis N. Wiltshire; Cassandra P. Wanna; Sterling J. Winters; Karlye A. Phillips; Stacey L. House; Francesca L. Beau...; Xinming An; Jennifer S. Stevens; Donglin Zeng; Thomas C. Neylan; Gari D. Clifford; Sarah D. Linnstaedt; Laura T. Germine; Kenneth A. Bollen; Guia Guffanti; Scott L. Rauch; John P. Haran; Alan B. Storrow; Christopher Lewan...; Paul I. Musey; Phyllis L. Hendry; Sophia Sheikh; Christopher W. Jones; Brittany E. Punches; Michael C. Kurz; Vishnu P. Murty; Meghan E. McGrath; Lauren A. Hudak; Jose L. Pascual; Mark J. Seamon; Elizabeth M. Datner; Anna M. Chang; Claire Pearson; David A. Peak; Roland C. Merchant; Robert M. Domeier; Niels K. Rathlev; Brian J. O'Neil; Leon D. Sanchez; Steven E. Bruce; Mark W. Miller; Robert H. Pietrzak; Jutta Joormann; Deanna M. Barch; Diego A. Pizzagalli; John F. Sheridan; Beatriz Luna; Steven E. Harte; James M. Elliott; Karestan C. Koenen; Ronald C. Kessler; Samuel A. McLean; Kerry J. Ressler; Tanja Jovanovic
• Keywords: systolic blood pressure; sex determination; 150; Psychiatry and Psychology; Cardiovascular; Jefferson University Hospitals; 0302 clinical medicine; arousal; cardiovascular disease; heart rate; Medicine and Health Sciences; Original Research Article; 10. No inequality; emergency ward; Neuroscience and Neurobiology; adult; QP351-495; heart rate variability; blood pressure; PTSD; 3. Good health; Department of Emergency Medicine; female; Autonomic; Thomas Jefferson University; posttraumatic stress disorder; Emergency Medicine; fear; Sex; RC321-571; cardiovascular risk; Neurophysiology and neuropsychology; sex difference; Gender and Sexuality; 610; Neurosciences. Biological psychiatry. Neuropsychiatry; electrocardiogram; Trauma; Article; 03 medical and health sciences; male; human; psychophysiology; RC346-429; electrodermal response; ICTS (Institute of Clinical and Translational Sciences); major clinical study; blood pressure monitoring; Sidney Kimmel Medical College; Neurology. Diseases of the nervous system

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.