Study finds those with less body response to stress had more PTSD signs after COVID-19

People who did not have a large heart rate response to a stress task showed more symptoms of post-traumatic stress disorder (PTSD) related to the novel coronavirus (COVID-19) than others, according to new research by Baylor University published in the journal Psychosomatic Medicine.

For the study, which included 120 participants, researchers measured resting heart rate and blood pressure before and during a standard acute psychological stress test. They asked participants to do mental math, rather than writing down figures or using a calculator, and give the scorers verbal responses. In a four-minute test, participants were asked to add consecutive single-digit numbers while remembering the most recent and adding it to the next number presented. They did this while being videotaped with a scorer present and looking at themselves in a mirror. The biological reactions were measured by blood pressure and heart rate, the researchers said.

The study's first phase, which ended in February 2020, was done in Central Texas. After the pandemic's onset, researchers launched a second phase between March 26 and April 5, sending participants a follow-up questionnaire about COVID-19. When asked, none had tested positive for COVID-19 and 87.5 percent were living in a city or state with a shelter-in-place order.

The questionnaire included standard items used to measure PTSD symptoms of intrusion (dreaming about the event and having trouble staying asleep), hyperarousal (irritability and having trouble concentrating) and avoidance (trying not to think or talk about the event) in the seven days before they responded to the questionnaire.

The findings are in line with a previous study of soldiers, which showed that a lower response of cortisol to an acute psychological stress task before deployment predicted greater PTSD symptoms post deployment. The study supports growing evidence that lower biological arousal in response to psychological stress may be bad for health outcomes, particularly mental health outcomes.

The researchers said that future research should aim for more comprehensive measures of biological reactivity and include a lifetime history of traumatic event exposure. However, the current study did account for childhood trauma and diagnosis of a mental health condition before the pandemic's onset, according to Annie Ginty, PhD, principal investigator and assistant professor of psychology and neuroscience at Baylor University.

"Since findings suggest that individuals with diminished arousal to active stress may be at greater risk for negative mental health outcomes,” said Ginty in a statement, “it could be helpful to offer preventive treatment or resources to them at the early stages of stress or trauma exposure.”

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