Alcohol dependence (AD) is resistant to treatment and many patients relapse within the first year following care. There is a need to better understand specific factors that predict and moderate treatment response to help in the formulation of improved treatments for AD. One promising individual difference factor that is thought to influence AD treatment efficacy is the ability to regulate affect, that is, an individual’s ability to understand or accept his or her emotional experience, engage in strategies to manage uncomfortable emotions in an adaptive manner, and respond appropriately to negative mood. To date, the psychophysiological components of affect regulation that occur outside of conscious awareness have not been well studied, although evidence suggests that individual differences in the ability to modulate arousal contribute to the development and maintenance of AD. The present study is an initial investigation of the relationship of psychophysiological indices of arousal modulation to levels of pre-treatment symptoms of anxiety and depression, as well as to changes in these symptoms over the course of treatment, in a sample of 50 women entering a 12-week clinical trial of CBT for alcohol dependence. Indices of heart rate variability (HRV), electrocardiogram (ECG) derived measures of neurocardiac signaling, were used to operationalize modulation of psychophysiological arousal. Potential differences in the relationship of HRV to anxiety and depression in participants with symptoms of cluster-B personality disorders (PDs) was also explored. At pre-treatment baseline, depression and PD symptomology, but not anxiety, were inversely associated with measures of HRV. Measures of pre-treatment HRV failed to directly predict change in anxiety and depression through the course of treatment. However, HRV did moderate the relationship between baseline and post-treatment levels of anxiety. Specifically, greater reduction in anxiety through the course of AD treatment was predicted by higher basal anxiety, only when this high basal anxiety co-occurred with high HRV. The present results are discussed within the framework of Polyvagal Theory (Porges, 2003). It is hypothesized that HRV may be an indicator of a biological mechanism that contributes to affect dysregulation in individuals with co-occurring AD and PD symptomology. Clinical implications of this perspective are discussed, and future directions for research are suggested.
Subject (authority = RUETD)
Topic
Psychology
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Rutgers University. Graduate School - New Brunswick
AssociatedObject
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.