Project Summary Heightened cardiovascular reactivity to acute stressors is a common symptom of posttraumatic stress (PTS). Integrative mind-body health practices have shown promise for the treatment of PTS and stress-related disorders. Many of these integrative practices include pranayam, the practice of controlled breathing. Mind-body practices often use a type of pranayam that emphasizes slowed, deep breathing, as a strategy to calm physiological stress reactions. Pranayam has yet to be studied as an isolated, acute coping response when confronted with trauma reminders. Little is known about how well this strategy actually works to calm one’s hyperarousal symptoms, particularly elevated cardiovascular reactivity. Pranayam has been explored generally as a method of calming the stress response, though not in the context of trauma and not isolated as a coping strategy for managing acute distress. Identifying effective methods to calm cardiovascular responses to trauma reminders is important given the association of exaggerated cardiovascular reactivity with later risk for cardiovascular disease. For this project, we examine 1) how effective pranayam is at reducing hyperarousal in response to trauma reminders, both in spontaneous daily use and in a directed lab task, 2) whether higher levels of interoceptive awareness increase the effect that pranayam has on lowering hyperarousal reactions, 3) if emotion regulation skills mediate the relationship between pranayam use and cardiovascular reactivity. We are conducting this study within a sample of 130 female sexual trauma survivors. We will compare pranayam to a cognitive-based coping strategy, cognitive reappraisal, to determine if pranayam is an effective means of calming trauma cue-induced hyperarousal. Hyperarousal will be determined by cardiovascular measures of arousal, including heart rate, heart rate variability, and blood pressure. By isolating and explicitly testing deep breathing pranayam, we can determine if pranayam is the mechanism through which mind-body health interventions may exert their effects. This simple, parsimonious strategy can be emphasized as a primary coping strategy for survivors who may have limited time or few available resources. This project serves as a training vehicle through which the applicant can work towards her long-term research goals of examining how integrative mind-body health interventions may impact the stress response in trauma-exposed populations. This project is the next phase of the applicant’s broader career research goal of identifying and understanding the mechanisms through which mind-body interventions can reduce cardiovascular risk, particularly for trauma survivors who are at increased risk for cardiovascular disease.