A prospective examination of sex differences in posttraumatic autonomic functioning.

Authors

• Antonia V Seligowski, Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
• Elizabeth R Steuber, Department of Psychiatry, Johns Hopkins Hospital, Baltimore, MD, 21287, USA
• Rebecca Hinrichs, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA
• Mariam H Reda, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA
• Charis N Wiltshire, Wayne State University, Detroit, MA, 48202, USA
• Cassandra P Wanna, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA
• Sterling J Winters, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA
• Karlye A Phillips, McLean Hospital, Belmont, MA, 02478, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
• Stacey L House, Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
• Francesca L Beaudoin, Department of Emergency Medicine & Department of Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Rhode Island Hospital and the Miriam Hospital, Providence, RI, 02930, USA
• Xinming An, Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
• Jennifer S Stevens, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA
• Donglin Zeng, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27559, USA
• Thomas C Neylan, Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, 94143, USA
• Gari D Clifford, Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, 30332, USA; Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA
• Sarah D Linnstaedt, Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
• Laura T Germine, Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA; The Many Brains Project, Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
• Kenneth A Bollen, Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
• Guia Guffanti, Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
• Scott L Rauch, Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA; Department of Psychiatry, McLean Hospital, Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
• John P Haran, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA
• Alan B Storrow, Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
• Christopher Lewandowski, Department of Emergency Medicine, Henry Ford Health System, Detroit, MI, 48202, USA
• Paul I Musey, Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
• Phyllis L Hendry, Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA
• Sophia Sheikh, Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA
• Christopher W Jones, Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, 08103, USA
• Brittany E Punches, Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA; College of Nursing, University of Cincinnati, Cincinnati, OH, 45221, USA
• Michael C Kurz, Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, 35294, USA; Department of Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham, AL, 35294, USA; Center for Injury Science, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
• Vishnu P Murty, Department of Psychology, Temple University, Philadelphia, PA, 19121, USA
• Meghan E McGrath, Department of Emergency Medicine, Boston Medical Center, Boston, MA, 02118, USA
• Lauren A Hudak, Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, 30329, USA
• Jose L Pascual, Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA; Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, 19104, USA
• Mark J Seamon, Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA; Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, 19104, USA
• Elizabeth M Datner, Department of Emergency Medicine, Einstein Healthcare Network, Pennsylvania, PA, 19141, USA; Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Pennsylvania, PA, 19107, USAFollow
• Anna Marie Chang, Department of Emergency Medicine, Jefferson University Hospitals, Pennsylvania, PA, 19107, USAFollow
• Claire Pearson, Department of Emergency Medicine, Wayne State University, Detroit, MA, 48202, USA
• David A Peak, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
• Roland C Merchant, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
• Robert M Domeier, Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, 48197, USA
• Niels K Rathlev, Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, 01107, USA
• Brian J O'Neil, Department of Emergency Medicine, Wayne State University, Detroit, MA, 48202, USA
• Leon D Sanchez, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA; Department of Emergency Medicine, Harvard Medical School, Boston, MA, 02115, USA
• Steven E Bruce, Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, 63121, USA
• Mark W Miller, National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, 02130, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02118, USA
• Robert H Pietrzak, National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
• Jutta Joormann, Department of Psychology, Yale School of Medicine, New Haven, CT, 06510, USA
• Deanna M Barch, Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63130, USA
• Diego A Pizzagalli, Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA ; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
• John F Sheridan, Department of Biosciences, OSU Wexner Medical Center, Columbus, OH, 43210, USA; Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, OH, 43211, USA
• Beatriz Luna, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA
• Steven E Harte, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA; Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
• James M Elliott, Kolling Institute of Medical Research, University of Sydney, St Leonards, New South Wales, 2065, Australia; Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, 2006, Australia; Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60208, USA
• Karestan C Koenen, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA
• Ronald C Kessler, Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA
• Samuel A McLean, Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA; Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
• Kerry J Ressler, Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA ; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
• Tanja Jovanovic, Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA

Document Type

Article

Publication Date

11-1-2021

Comments

This article is the author's final published version in Neurobiology of Stress, Volume 15, November 2021, Article number 100384.

The published version is available at https://doi.org10.1016/j.ynstr.2021.100384

Copyright © 2021 The Authors

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 (

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.

Recommended Citation

Seligowski, Antonia V; Steuber, Elizabeth R; Hinrichs, Rebecca; Reda, Mariam H; Wiltshire, Charis N; Wanna, Cassandra P; Winters, Sterling J; Phillips, Karlye A; House, Stacey L; Beaudoin, Francesca L; An, Xinming; Stevens, Jennifer S; Zeng, Donglin; Neylan, Thomas C; Clifford, Gari D; Linnstaedt, Sarah D; Germine, Laura T; Bollen, Kenneth A; Guffanti, Guia; Rauch, Scott L; Haran, John P; Storrow, Alan B; Lewandowski, Christopher; Musey, Paul I; Hendry, Phyllis L; Sheikh, Sophia; Jones, Christopher W; Punches, Brittany E; Kurz, Michael C; Murty, Vishnu P; McGrath, Meghan E; Hudak, Lauren A; Pascual, Jose L; Seamon, Mark J; Datner, Elizabeth M; Chang, Anna Marie; Pearson, Claire; Peak, David A; Merchant, Roland C; Domeier, Robert M; Rathlev, Niels K; O'Neil, Brian J; Sanchez, Leon D; Bruce, Steven E; Miller, Mark W; Pietrzak, Robert H; Joormann, Jutta; Barch, Deanna M; Pizzagalli, Diego A; Sheridan, John F; Luna, Beatriz; Harte, Steven E; Elliott, James M; Koenen, Karestan C; Kessler, Ronald C; McLean, Samuel A; Ressler, Kerry J; and Jovanovic, Tanja, "A prospective examination of sex differences in posttraumatic autonomic functioning." (2021). Department of Emergency Medicine Faculty Papers. Paper 170.
https://jdc.jefferson.edu/emfp/170

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

34485632

Language

English