Impact of Cognitive Behavioral Therapy on Resting Cardiac Parameters and Cortisol in Patients with Post-Traumatic Stress Disorder: A Pilot Randomized Clinical Trial

Raquel Menezes Gonçalves, Carlos Eduardo Norte, Gabriela Guerra Leal Souza, Eliane Volchan, Evandro Silva Freire Coutinho, Ivan Figueira, Paula Ventura


Post-Traumatic Stress Disorder (PTSD) has been associated with changes in psychophysiological and neuroendocrinal parameters. Cognitive Behavioral Therapy (CBT) is considered the treatment of choice for PTSD and is able to regularize altered neurobiological parameters; however, little is known about its effects on these parameters when measured during the therapeutic process. This pilot study aimed to evaluate the impact of CBT on cortisol and cardiac parameters measured at rest during the treatment of PTSD with comorbid major depression. 14 patients were randomized to four months of CBT or a waiting list. As expected, the experimental group had a greater reduction in PTSD symptoms and a large effect size. There was a reduction in the low frequency component of heart rate variability, which achieved borderline statistical significance and a large effect size. Salivary cortisol tended to track the progress of therapy, rising in the period of exposure and decreasing by the end of treatment. Despite the small sample size, this study opens the way for further research into the impact of CBT on the different biological markers of PTSD during the therapeutic process. This can hopefully help to optimize and personalize therapeutic studies while providing clues about modifications in bio behavioral pathological manifestations.

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