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Heart Rate Variability Characteristics in a Large Group of Active-Duty Marines and Relationship to Posttraumatic Stress

Minassian, Arpi PhD; Geyer, Mark A. PhD; Baker, Dewleen G. MD; Nievergelt, Caroline M. PhD; O’Connor, Daniel T. MD; Risbrough, Victoria B. PhDfor the Marine Resiliency Study Team

doi: 10.1097/PSY.0000000000000056
Original Articles

Objective Heart rate variability (HRV), thought to reflect autonomic nervous system function, is lowered under conditions such as posttraumatic stress disorder (PTSD). The potential confounding effects of traumatic brain injury (TBI) and depression in the relationship between HRV and PTSD have not been elucidated in a large cohort of military service members. Here we describe HRV associations with stress disorder symptoms in a large study of Marines while accounting for well-known covariates of HRV and PTSD including TBI and depression.

Methods Four battalions of male active-duty Marines (n = 2430) were assessed 1 to 2 months before a combat deployment. HRV was measured during a 5-minute rest. Depression and PTSD were assessed using the Beck Depression Inventory and Clinician-Administered PTSD Scale, respectively.

Results When adjusting for covariates, including TBI, regression analyses showed that lower levels of high-frequency HRV were associated with a diagnosis of PTSD (β = −0.20, p = .035). Depression and PTSD severity were correlated (r = 0.49, p < .001); however, participants with PTSD but relatively low depression scores exhibited reduced high frequency compared with controls (p = .012). Marines with deployment experience (n = 1254) had lower HRV than did those with no experience (p = .033).

Conclusions This cross-sectional analysis of a large cohort supports associations between PTSD and reduced HRV when accounting for TBI and depression symptoms. Future postdeployment assessments will be used to determine whether predeployment HRV can predict vulnerability and resilience to the serious psychological and physiological consequences of combat exposure.

Supplemental digital content is available in the text.

From the Center of Excellence for Stress and Mental Health (A.M., M.A.G., D.G.B., C.M.N., V.B.R.), Veteran’s Administration, San Diego, California; Departments of Psychiatry (A.M., M.A.G., D.G.B., C.M.N., V.B.R.) and Medicine (D.T.O.), University of California San Diego, La Jolla, California; and VA San Diego Healthcare System (M.A.G., D.G.B., C.M.N., V.B.R.), San Diego, California.

Address correspondence and reprint requests to Arpi Minassian, PhD, Center of Excellence for Stress and Mental Health, Veteran’s Administration, San Diego, CA. E-mail:

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Received for publication July 8, 2013; revision received March 23, 2014.

Copyright © 2014 by American Psychosomatic Society
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