24-hour HRV measured from HF-HRV was obtained from 24-hours of ambulatory electocardiograph (ECG) recordings. Inclusion criteria for HRV requires that at least 80% of the recording show normal sinus rhythm. HF-HRV is a frequency domain measure of HRV which captures all heart rate variations occurring over the frequency band linked to respiration. Higher HF-HRV reflects stronger parasympathetic cardiac control. Low levels of HF-HRV are predictive of increased coronary heart disease risk. Means for HF-HRV are listed below, and evaluation of change in scores can be found in statistical analysis 1.

24-hour HRV measured from RMSSD was obtained from 24-hours of ambulatory electocardiograph (ECG) recordings. Inclusion criteria for HRV requires that at least 80% of the recording show normal sinus rhythm. RMSSD is a time domain measure of HRV which captures heart rate variations occurring over the frequency band linked to respiration. Higher RMSSD reflects stronger parasympathetic cardiac control. Means for RMSSD are listed below, and evaluation of change in scores can be found in statistical analysis 1.

24-hour urinary excretion of norepinephrine was obtained from 24-hours of urine collection. Inclusion criteria for 24-hour urine collection requires that at least 300 milliliters of urine be collected. Norepinephrine levels have been found to be elevated in PTSD and following trauma exposure. Norepinephrine is implicated in the association between cardiovascular disease and stress. Means for norepinephrine are listed below, and evaluation of change in scores can be found in statistical analysis 1.

24-hour urinary excretion of epinephrine was obtained from 24-hours of urine collection. Inclusion criteria for 24-hour urine collection requires that at least 300 milliliters of urine be collected. Epinephrine levels have been found to be elevated in PTSD and following trauma exposure. Epinephrine is implicated in the association between cardiovascular disease and stress. Means for epinephrine are listed below, and evaluation of change in scores can be found in statistical analysis 1.

Peripheral inflammation was measured from fasting levels of CRP. Inclusion criteria for measurement of hsCRP requires that the participant be free from active infections or acute inflammatory conditions; therefore, participants were required to be free of fever, infections, and acute inflammatory conditions for a minimum of 7 days prior to the blood draw. Oral temperatures were obtained from all participants to check for sickness at the time of blood draw. CRP will be measured because it has a strong correlation with cardiovascular morbidity and mortality. Means for hs-CRP are listed below, and evaluation of change in scores can be found in statistical analysis 1.

Vascular endothelial function was measured under fasting conditions from the percent change in dilation of the brachial artery following controlled occlusion of the artery. FMD is a measure of health of blood vessels. Lower flow mediated dilation is associated with poor cardiovascular health. FMD was measured because it has been correlated with cardiovascular morbidity and mortality and is reduced following trauma exposure. Means for FMD are listed below, and evaluation of change in scores can be found in statistical analysis 1.

WP-CON group will receive minimal attention in the form of weekly telephone calls to assess current emotional state and to provide supportive, nondirective, brief counseling if participants report experiencing a crisis. Any participant assigned to the WP-CON group will be given the opportunity to receive CPT-C after the post-waiting period assessment.

Total of all reporting groups

24-hour HRV measured from LF-HRV was obtained from 24-hours of ambulatory electrocardiograph (ECG) recordings. Inclusion criteria for HRV requires that at least 80% of the recording show normal sinus rhythm. LF-HRV is a frequency domain measure of HRV which captures all heart rate variations occurring over the frequency band linked to sympathetic vasomotor oscillations. Higher LF-HRV reflects stronger baroreflex cardiovascular control which is offset by increases in cardiac efferent sympathetic activity during periods of acute stress and physical activity. Low levels of LF-HRV are predictive of incident diabetes and increased coronary heart disease risk. Means for LF-HRV are listed below, and evaluation of change in scores can be found in statistical analysis 1.

At baseline in the CPT group, 3 participants had unusable HRV based on HRV inclusion criteria and 1 participant had an allergic reaction requiring early removal of the recorder. Imputation was used to impute outcomes for the post-intervention missing data (11 drop-outs (9 in the CPT group and 2 in the WP-CON group) and 2 additional participants in the CPT refused to wear the recorder post-intervention (one of which experienced the allergic reaction at baseline).

24-hour HRV measured from HF-HRV was obtained from 24-hours of ambulatory electocardiograph (ECG) recordings. Inclusion criteria for HRV requires that at least 80% of the recording show normal sinus rhythm. HF-HRV is a frequency domain measure of HRV which captures all heart rate variations occurring over the frequency band linked to respiration. Higher HF-HRV reflects stronger parasympathetic cardiac control. Low levels of HF-HRV are predictive of increased coronary heart disease risk. Means for HF-HRV are listed below, and evaluation of change in scores can be found in statistical analysis 1.

At baseline in the CPT group, 3 participants had unusable HRV based on HRV inclusion criteria and 1 participant had an allergic reaction requiring early removal of the recorder. Imputation was used to impute outcomes for the post-intervention missing data (11 drop-outs (9 in the CPT group and 2 in the WP-CON group) and 2 additional participants in the CPT refused to wear the recorder post-intervention (one of which experienced the allergic reaction at baseline).

24-hour HRV measured from RMSSD was obtained from 24-hours of ambulatory electocardiograph (ECG) recordings. Inclusion criteria for HRV requires that at least 80% of the recording show normal sinus rhythm. RMSSD is a time domain measure of HRV which captures heart rate variations occurring over the frequency band linked to respiration. Higher RMSSD reflects stronger parasympathetic cardiac control. Means for RMSSD are listed below, and evaluation of change in scores can be found in statistical analysis 1.

At baseline in the CPT group, 3 participants had unusable HRV based on HRV inclusion criteria and 1 participant had an allergic reaction requiring early removal of the recorder. Imputation was used to impute outcomes for the post-intervention missing data (11 drop-outs (9 in the CPT group and 2 in the WP-CON group) and 2 additional participants in the CPT refused to wear the recorder post-intervention (one of which experienced the allergic reaction at baseline).

24-hour urinary excretion of norepinephrine was obtained from 24-hours of urine collection. Inclusion criteria for 24-hour urine collection requires that at least 300 milliliters of urine be collected. Norepinephrine levels have been found to be elevated in PTSD and following trauma exposure. Norepinephrine is implicated in the association between cardiovascular disease and stress. Means for norepinephrine are listed below, and evaluation of change in scores can be found in statistical analysis 1.

At baseline in the WP-CON group, 1 participant had unusable urinary norepinephrine based on the 24-hour urine inclusion criteria. Imputation was used to impute the missing data from the the 14 participants who did not have post-intervention data either due to dropping out of the study (8 in the CPT group and 2 in the WP-CON group), due to technical problems with sample analysis (n=2), failure to meet inclusion criteria for urine collection (n=1) or refusal to collect urine (n=1)

24-hour urinary excretion of epinephrine was obtained from 24-hours of urine collection. Inclusion criteria for 24-hour urine collection requires that at least 300 milliliters of urine be collected. Epinephrine levels have been found to be elevated in PTSD and following trauma exposure. Epinephrine is implicated in the association between cardiovascular disease and stress. Means for epinephrine are listed below, and evaluation of change in scores can be found in statistical analysis 1.

At baseline in the WP-CON group, 1 participant had unusable urinary norepinephrine based on the 24-hour urine inclusion criteria. Imputation was used to impute the missing data from the 14 participants who did not have post-intervention data due to either dropping out of the study (8 in the CPT group and 2 in the WP-CON group), due to technical problems with sample analysis (n=2), failure to meet inclusion criteria for urine collection (n=1) or refusal to collect urine (n=1)

Peripheral inflammation was measured from fasting levels of CRP. Inclusion criteria for measurement of hsCRP requires that the participant be free from active infections or acute inflammatory conditions; therefore, participants were required to be free of fever, infections, and acute inflammatory conditions for a minimum of 7 days prior to the blood draw. Oral temperatures were obtained from all participants to check for sickness at the time of blood draw. CRP will be measured because it has a strong correlation with cardiovascular morbidity and mortality. Means for hs-CRP are listed below, and evaluation of change in scores can be found in statistical analysis 1.

At baseline in the CPT group, 3 participants reported infections which violated protocol criteria and 1 sample was not analyzed due to technical problems. At baseline in the WP-CON group, 1 participant refused blood draw. Imputation was used to impute the missing data from the 17 participants who either dropped out (9 in the CPT group and 2 in the WL-CON group), had infection (1 in the CPT group), experienced technical problems (4 in the CPT group), or refused (1 in the WP-CON group)

Vascular endothelial function was measured under fasting conditions from the percent change in dilation of the brachial artery following controlled occlusion of the artery. FMD is a measure of health of blood vessels. Lower flow mediated dilation is associated with poor cardiovascular health. FMD was measured because it has been correlated with cardiovascular morbidity and mortality and is reduced following trauma exposure. Means for FMD are listed below, and evaluation of change in scores can be found in statistical analysis 1.

Imputation was used to impute data from the 11 participants who were missing post-intervention data due to dropping out of the study (9 in the CPT group and 2 in the WL-CON group).

Fasting plasma insulin is a measure of insulin resistance and is a independent predictor of cardiovascular mortality and of autonomic neuropathy. PTSD has been associated with increased incidence of diabetes and metabolic dysfunction. Means for fasting insulin are listed below, and evaluation of change in scores can be found in statistical analysis 1.

Subgroup of participants with no history of diabetes.

Fasting plasma glucose is a measure of diabetes risk and is a independent predictor of cardiovascular mortality and of autonomic neuropathy. PTSD has been associated with increased incidence of diabetes and metabolic dysfunction. Means for fasting glucose are listed below, and evaluation of change in scores can be found in statistical analysis 1.

Subgroup of participants with no history of diabetes.

WP-CON group will receive minimal attention in the form of weekly telephone calls to assess current emotional state and to provide supportive, nondirective, brief counseling if participants report experiencing a crisis. Any participant assigned to the WP-CON group will be given the opportunity to receive CPT-C after the post-waiting period assessment.

Any participant assigned to the WP-CON group will be given the opportunity to receive CPT-C after the post-waiting period assessment. Participants are not required to participate in this therapy or the study assessments; it is completely voluntary. Any data collected from this group of participants will not be included in primary or secondary outcome analysis.

Related to wearing electrodes