ER is a broad construct that encompasses awareness, comprehension (across cognitive, physiological, and behavioural manifestations), and adaptive and contextually appropriate responding to emotional experiences, which may be either voluntary/intentional or automatic. Įmotion regulation (ER) is a key process underlying many mental health disorders, including PTSD. Yet, despite demonstrating significantly larger effect sizes than wait-list controls, psychopharmacological medications, or supportive therapy (average effect size = 0.43, n.s ), up to two-thirds of individuals retain a PTSD diagnosis following trauma-focused therapy. ![]() Trauma-focused therapies – including cognitive processing therapy (CPT), prolonged exposure therapy (PE), imaginal exposure (IE), eye-movement desensitisation and reprocessing (EMDR), and trauma-focused cognitive behavioural therapy (TF-CBT) – are the recommended first-line, “gold standard”, evidence-based treatments for PTSD. Posttraumatic stress disorder (PTSD) is a debilitating mental health disorder that develops in some – but not all – individuals after exposure to a traumatic event. Findings have implications for PTSD treatment and interventions for emotional disorders more broadly. In contrast, trauma-focused therapy (CPT) only reliably improved self-reported ER. To our knowledge, this is the first study to demonstrate that a breathing-based yoga (SKY) improved both voluntary/intentional and automatic/physiological ER. Following SKY (but not CPT), HR max–min (average difference between maximum and minimum beats per minute), LF/HF (low-to-high frequency) ratio, and normalised HF-HRV (high frequency power) improved (moved towards a healthier profile d = .42–.55). ResultsĭERS-Total and all six subscales improved with small-to-moderate effect sizes ( d = .24–.66) following CPT or SKY, with no differences between treatment groups. Here, in secondary exploratory analyses (intent-to-treat N = 85 per protocol N = 59), we examined whether self-reported ER (Difficulties in Emotion Regulation Scale DERS) and physiological ER (heart rate variability HRV) improved with treatment for clinically significant PTSD symptoms among US Veterans. ![]() We recently completed a non-inferiority design randomised controlled trial demonstrating that a breathing-based yoga practice (Sudarshan kriya yoga SKY) was not clinically inferior to cognitive processing therapy (CPT) across symptoms of PTSD, depression, or negative affect. Understanding these effects may shed light on treatment processes. Emotion regulation (ER) is a key process underlying posttraumatic stress disorder (PTSD), yet, little is known about how ER changes with PTSD treatment.
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