Characterizing the relationship between flexibility, PTSD symptom severity, and implementation of an in-the-moment mobile-based intervention in women with substance use disorders
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Uhouse, Sarah Grace.
Characterizing the relationship between flexibility, PTSD symptom severity, and implementation of an in-the-moment mobile-based intervention in women with substance use disorders. Retrieved from
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TitleCharacterizing the relationship between flexibility, PTSD symptom severity, and implementation of an in-the-moment mobile-based intervention in women with substance use disorders
Date Created2022
Other Date2022-10 (degree)
Extent1 online resource (137 pages) : illustrations
DescriptionSubstance use disorders (SUDs) and posttraumatic stress disorder (PTSD) symptoms often co-occur. This comorbidity is associated with more severe symptom presentation, worse treatment outcomes, and reduced functioning. Women are more likely to receive a dual diagnosis compared to men, yet they are less likely to present to, and comply with, treatment. Understanding person-centered factors that may increase the acceptability and feasibility of interventions may reduce the prevalence and burden of SUD/PTSD symptoms in women by increasing treatment engagement. This study examined the construct of flexibility as an individual-level mechanism underlying the utilization of an in-the-moment heart rate variability biofeedback (HRVB) mobile-based application. Defined broadly, flexibility refers to the ability to adapt to changing internal and external environmental demands. In the current study, flexibility was assessed across three domains: physiological, measured by high frequency heart rate variability (HRV) and resonance frequency HRV; cognitive, measured by Trails-B task performance; and neural, explored through resting state functional connectivity within the salience network, and between the anterior cingulate cortex and bilateral dorsolateral prefrontal cortices. The study’s aims were to characterize the construct of flexibility across these domains, and understand the relationship between flexibility and PTSD symptom severity in women with SUDs. Additionally, the study sought to investigate the relationships between flexibility, PTSD symptom severity, and HRVB app use. Results suggested that physiological flexibility indicators relate to aspects of neural, but not cognitive, flexibility. Additionally, resonance frequency HRV may be the most sensitive flexibility predictor of PTSD symptom severity, as measured in this study. Although findings suggested a negative association between PTSD symptoms and HRVB app use, it is unclear to what extent flexibility contributed to this relationship. Other clinical indicators including age, substance use diagnostic group, and session attendance significantly contributed to the relationships between PTSD symptom severity, flexibility, and HRVB application implementation in women. These findings contribute foundational knowledge to the study of flexibility as a novel, theoretically-driven construct aimed at understanding co-occurring SUD and PTSD symptoms in women. This study further establishes innovative approaches for investigating flexibility, particularly physiological flexibility, as a person-centered factor contributing to the implementation of a novel HRVB mobile application in this population.
NotePh.D.
NoteIncludes bibliographical references
Genretheses
LanguageEnglish
CollectionSchool of Graduate Studies Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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