Educational level modifies the relationship between standard deviation of NN intervals (SDNN) and post-traumatic stress disorder development over two-years
Ji Min Yoo 1, 1, 1, Ju-Wan Kim 1, 1, 1, Hee-Ju Kang 1, 1, 1, Hyunseok Jang 2, 2, 2, Jung-Chul Kim 2, 2, 2, Ju-Yeon Lee 1, 1, 1, Sung-Wan Kim 1, 1, 1, Il-Seon Shin 1, 1, 1, Jae-Min Kim 1, 1, 1*
1Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea, 2Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
Received: June 7, 2024; Revised: July 13, 2024; Accepted: July 13, 2024; Published online: July 13, 2024.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objectives: This study investigated how educational levels modify the relationship between the Standard Deviation of NN Intervals (SDNN) of heart rate variability and the development of post-traumatic stress disorder (PTSD).
Methods: Participants with physical injuries were enrolled from a trauma center and monitored over two years. Initial assessments included SDNN and educational attainment, along with socio-demographic and clinical variables. PTSD diagnoses were made at 3, 6, 12, and 24 months post-injury using the Clinician-Administered PTSD Scale for DSM-5. Logistic regression analyses were conducted.
Results: Of the 538 participants, 58 (10.8%) developed PTSD during the follow-up period. A significant interaction effect was observed: lower SDNN was significantly linked to PTSD in individuals with higher education, but not in those with lower education.
Conclusion: The study identified education-dependent associations between SDNN and PTSD development, emphasizing the importance of tailored PTSD prevention strategies that consider both SDNN and educational levels.
Keywords: posttraumatic stress disorder, education, heart rate variability, SDNN, longitudinal study

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