Resting High Frequency Heart Rate Variability and PTSD Symptomatology in Veterans: Effects of Respiration, Role in Elevated Heart Rate, and Extension to Spouses.

•Posttraumatic stress disorder (PTSD) is associated with low resting heart rate variability (HRV).•However, the role of respiration in this association has not been determined in prior research.•In 65 U.S. Veterans, clinically diagnosed PTSD was associated with lower high-frequency HRV.•This association held while controlling respiration, but was not seen in Veterans’ spouses.•In mediational analyses, low HRV accounted for elevated resting heart rate in PTSD.