Comparing Trauma-Informed Heart Rate Variability Biofeedback and Present Centered Therapy for Veterans with PTSD and Substance Use Disorders

What this Trial Is About

Researchers are studying veterans who have both posttraumatic stress disorder PTSD and substance use disorders SUDs, as these combined conditions increase the risk of hypertension and cardiovascular diseases, often leading to premature death. The trial aims to compare the effects of Trauma Informed Heart Rate Variability Biofeedback T-HRVB with Present Centered Therapy PCT to see how each impacts symptoms and physiological outcomes in this high-risk group. This study addresses a gap by comparing these two active interventions among veterans engaged in residential PTSD programs at the Coatesville VA Medical Center. Participants will be randomly assigned to one of two groups the T-HRVB group, which receives six sessions of biofeedback combined with trauma-informed psychotherapy to improve autonomic nervous system regulation and coping skills or the PCT group, which receives six supportive psychotherapy sessions focused on stress reduction and psychoeducation. Both treatments involve active sessions designed to reduce PTSD and SUD symptoms, with T-HRVB emphasizing breathing techniques to increase heart rate variability while PCT serves as an active control. Veterans will attend visits before and after the treatment period for diagnostic interviews, questionnaires related to PTSD and SUD symptoms, and physiological assessments including heart rate, respiratory sinus arrhythmia, skin conductance, and PTSD symptom scales. The primary outcomes include changes in the Clinician Administered PTSD Scale for DSM-5 Revised and baseline physiological measures. The study monitors participants through the first and last week of treatment, with safety and symptom screening conducted throughout the process.

The Many Roads to Trauma Recovery: A Clinical Trial Comparing Empirically Supported Treatments for Veterans With Co-Morbid Posttraumatic Stress and Substance Use Disorder Symptoms