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Alcohol Use Disorder Moderates the Effect of Age on Heart Rate Variability in Veterans With Posttraumatic Stress Disorder

Ray, John M. PhD*†‡; Pyne, Jeffrey M. MD*†‡; Gevirtz, Richard N. PhD§

The Journal of Nervous and Mental Disease: October 2017 - Volume 205 - Issue 10 - p 793–800
doi: 10.1097/NMD.0000000000000718
Original Articles

Research on heart rate variability (HRV) in posttraumatic stress disorder (PTSD) and comorbid alcohol use disorder (AUD) is limited despite its use as a biomarker of both disorders. This study examined whether AUD comorbidity contributes an additive effect on HRV for veterans with PTSD. HRV was assessed in 70 male Operation Enduring Freedom/Operation Iraqi Freedom veterans with PTSD, including 32 with co-occurring AUD. Mean HRV values for both groups were below the mean for healthy adults, but additive effects of PTSD and AUD on HRV were not observed. Consistent with prior studies, hierarchical regressions showed that HRV decreased with age in the PTSD-only group. However, HRV increased slightly with age among veterans with both PTSD and AUD. This interaction remained significant after controlling for common HRV covariates. These findings support HRV as a biomarker of PTSD and extend research by demonstrating the complex relationship between PTSD and HRV in the context of co-occurring AUD.

*Center for Mental Health Outcomes Research, and †South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock; ‡Division of Health Sciences Research, Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and §Alliant International University, San Diego, California.

Send reprint requests to John M. Ray, PhD, Center for Mental Health Outcomes Research, Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, Building 58 (152/NLR), North Little Rock, AR 72114. E-mail:

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