Physiological Stress Reactivity at the Beginning and End of Psychotherapy: Stress Response and Outcome

Physiological stress reactivity is related to psychotherapy outcomes. Research has shown that PTSD patients who respond positively to cognitive behavior therapy show decreased heart rate reactivity in response to trauma cues (Blanchard et al., 2002). Psychiatric patients who showed less physiologica...

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Bibliographic Details
Published in:Applied psychophysiology and biofeedback 2014-12, Vol.39 (3-4), p.315
Main Authors: Fidalgo, Louise G, Breton, Brigham, Schmuck, Dominic, Steffen, Patrick
Format: Article
Language:English
Subjects:
Behavioral health care
Biofeedback training
Care and treatment
Cognitive therapy
Heart beat
Medical research
Medicine, Experimental
Patient outcomes
Physiological aspects
Post-traumatic stress disorder
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Summary:Physiological stress reactivity is related to psychotherapy outcomes. Research has shown that PTSD patients who respond positively to cognitive behavior therapy show decreased heart rate reactivity in response to trauma cues (Blanchard et al., 2002). Psychiatric patients who showed less physiological stress reactivity before therapy had significantly better treatment outcomes at the end of therapy (Ehrenthal et al., 2010), suggesting that psychotherapy outcomes are negatively impacted by high stress reactivity. It is not known, however, how physiological stress reactivity is related to outcome in general psychotherapy patients. The purpose of the present study was to examine if physiological stress reactivity at the beginning of therapy can predict psychotherapy outcome at the end of therapy. We hypothesized that patients reporting higher levels of distress would have higher levels of physiological stress reactivity compared to less distressed psychotherapy patients, which would contribute to their lack of success in therapy. To test this hypothesis, we measured the physiological stress reactivity (respiration, heart rate variability, blood pressure and cortisol levels) of patients beginning psychotherapy using the Trier Social Stress Test (TSST). Our results show that on the Outcome Questionnaire (OQ-45), red responders (patients whose distress scores significantly go up after baseline) showed slower systolic blood pressure (SBP) recovery on the TSST (F = 3.101, p = .018). Our results also show that patients scoring high on the OQ-45 (above 63) have higher levels of heart rate and SBP (F = 3.804, p = .006) and take more time to reduce their stress levels during the recovery period compared to less distressed psychotherapy patients. In conclusion, we propose that stress-reducing techniques such as biofeedback will provide a useful adjunct to psychotherapy and will help improve the psychotherapeutic experience and the outcome of these patients. Keywords * Psychotherapy * Physiological stress reactivity * Trier social stress test
ISSN:1090-0586