Carlos Eduardo Norte
Institute of Psychology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
Gabriela Guerra Leal Souza
Institute of Biological and Exact Sciences, Federal University of Ouro Preto (UFOP), Ouro Preto, MG, Brazil.
Ana Lucia Pedrozo
Institute of Psychology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
Ana Carolina Ferraz Mendonça-de-Souza
Institute of Biophysics Carlos Chagas Filho, UFRJ, Rio de Janeiro, RJ, Brazil.
Ivan Figueira
Institute of Psychiatry, UFRJ, Rio de Janeiro, RJ, Brazil.
Eliane Volchan
Institute of Biophysics Carlos Chagas Filho, UFRJ, Rio de Janeiro, RJ, Brazil.
Paula Rui Ventura
Institute of Psychology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
Abstract:
Resilience, as an outcome variable, has been largely neglected in the field of therapeutics. Our aim was to investigate the effects of cognitive behavioral therapy (CBT) on neurobiological markers of resilience in posttraumatic stress disorder (PTSD) patients. In this single-case experimental research, we assessed physiological (heart rate, respiratory rate, cardiac vagal tone, sympathetic balance and skin conductance) and neuroendocrine (cortisol and dehydroepiandrosterone − DHEA) variables; and psychometric self-report measures (negative affect, resilience, PTSD symptoms, depression, anxiety and social support). Physiological, neuroendocrine and psychometric responses at rest were measured before and after four months of CBT. The patient was a 45-year-old man who had suffered two armed robberies and failed to respond adequately to pharmacological treatment with paroxetine. CBT led to a reduction in heart rate, respiratory rate, sympathetic balance, skin conductance and cortisol. It also led to an increase in cardiac vagal tone and DHEA. Furthermore, CBT promoted reduction of PTSD symptoms, depression, anxiety and negative affect scores and enhancement of resilience and social support scores. CBT in this single case enhanced resilience-related factors such as DHEA, vagal tone, self-reported resilience and social support suggesting that this therapeutic strategy not only contributed to ‘anti’ pathology effects but to ‘pro’ well-being. Additionally, our results show the relevance of investigating the effects of psychological treatments in multiple neurobiological systems in the same PTSD patients to unveil the neurobiological underpinnings of resilience factors.
Keywords:Post-traumatic stress disorder, cognitive behavior therapy, resilience, neuroendocrine, psychophysiology.