Blunted salivary cortisol response to psychosocial stress in women with posttraumatic stress disorder

Metz, Sophie; Duesenberg, Moritz; Hellmann-Regen, Julian; Wolf, Oliver T.; Röepke, Stefan; Otte, Christian; Wingenfeld, Katja

doi:10.1016/j.jpsychires.2020.07.014

Cited by 38 publications

(20 citation statements)

References 47 publications

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“…The lack of effect of the pandemic on the Veteran group's risk factors may be due to a few reasons, the first being a blunted stress response. Veterans demonstrate blunted cortisol concentrations to a social stress test compared to civilians [ 57 ] and this finding is similar in individuals with post-traumatic stress disorder [ 58 , 59 ]. These attenuated stress responses may be due to an altered hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system.…”

Section: Discussionmentioning

confidence: 97%

The impact of COVID-19 on cardiovascular health behaviors in student veterans

Canjar

Richard

Kappus

2022

Nutrition, Metabolism and Cardiovascular Diseases

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Background and aims Pandemics have previously resulted in increased cardiovascular morbidity and mortality. It is unclear if the effects of the COVID-19 pandemic will be amplified in individuals at high risk for cardiovascular disease, such as military populations, resulting in augmented cardiovascular events in Veterans. The purpose of this study was to determine if traditional behavioral risk factors for cardiovascular disease are amplified due to the COVID-19 pandemic and if risk factors are more prevalent in Veterans compared to non-Veterans. Methods and results Thirty-two student Veterans and 46 non-Veteran students between the ages of 18 and 35 completed a Qualtrics self-report questionnaire assessing health behaviors, physical activity, and mental health both before and during COVID-19. Veterans displayed worse pre-COVID cardiovascular health behaviors such as poor sleep habits, greater use of tobacco, alcohol, and energy drinks, and lower values of social engagement compared to non-Veterans. Many health behaviors remained unchanged in student Veterans during the pandemic. The non-Veteran group exhibited augmentation of cardiovascular health behaviors during COVID-19, shown through the worsening sleep habits, increased anxiety, and reduced physical activity. Conclusion Student Veterans demonstrate heightened risk for cardiovascular disease based on the pre-COVID elevation of behavioral risk factors. These behavioral factors continued to remain elevated during the COVID-19 pandemic. Non-Veteran students displayed amplification of behavioral risk factors for cardiovascular disease due to the COVID-19 pandemic. These results highlight the need for resources and interventions for our student veterans and suggest long-term cardiovascular consequences for all students who suffered through the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 97%

The impact of COVID-19 on cardiovascular health behaviors in student veterans

Canjar

Richard

Kappus

2022

Nutrition, Metabolism and Cardiovascular Diseases

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“…Clarifying whether women who feel more stressed show higher levels of stress hormones would be interesting. Furthermore, it is known that in chronic stress, the acute stress response may actually be blunted ( 81 ). Might this result in counter-intuitive impacts on women's ovulatory cycles?…”

Section: Future Directions and Perspectivesmentioning

confidence: 99%

Chronic Stress and Ovulatory Dysfunction: Implications in Times of COVID-19

Vigil

Meléndez²,

Soto

et al. 2022

Front. Glob. Womens Health

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Stress is known to be associated with adverse health outcomes. The COVID-19 pandemic and its associated lockdowns are examples of chronic stressors. Lockdown measures inadvertently caused significant psychological distress and became a powerful source of anxiety/stress, sleep disturbances, nutritional changes and weight gain. Stress is known to impact women's health specifically, through hypothalamic-pituitary-gonadal (HPG) axis dysfunction and resultant ovulatory dysfunction. Such dysfunction may manifest in menstrual irregularities and/or infertility due to hypothalamic hypogonadism. Here, we review the key physiological mediators of stress and associated ovulatory dysfunction. The kisspeptinergic system is comprised of sets of neurons located in the hypothalamus, the rostral periventricular region of the third ventricle (RP3V) and the arcuate nucleus (ARC). This system links nutrition, reproductive signals and stress. It plays a key role in the function of the HPG axis. During chronic stress, the kisspeptinergic system affects the HPG axis, GnRH pulsatility, and, therefore, ovulation. Leptin, insulin and corticotrophin-releasing hormone (CRH) are thought to be additional key modulators in the behavioral responses to chronic stress and may contribute to stress-related ovulatory dysfunction. This mini-review also summarizes and appraises the available evidence on the negative impact of chronic stress as a result of the COVID-19 pandemic lockdowns. It proposes physiological mechanisms to explain the observed effects on women's reproductive health and well-being. The review suggests areas for future research.

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“…The findings of this study may point to one possible explanation of mixed results by indicating that some individuals with PTSD have chronically low levels, while others do not-and these basal levels may inform whether someone responds to elevation stimuli. Additionally, regarding stress responses, there is some evidence of a blunted cortisol response to acute stressors in previous work (Metz et al, 2020). There is also a body of literature that suggests individuals who respond to psychotherapy demonstrate increases in low levels of basal cortisol over time (Olff et al, 2007), suggesting that finding treatments that work for individuals may result in regulation of the HPA axis, though more research is needed in this area.…”

Section: Distinctions Between Case Typesmentioning

confidence: 99%

Biopsychosocial correlates and individual differences for eliciting moral elevation in veterans with PTSD: An experimental case series

McGuire¹,

Nguyen²,

Burns³

et al. 2022

Preprint

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Background and Objectives: A promising approach to incorporate positive psychology principles into trauma-focused treatment is moral elevation—feeling inspired by witnessing a virtuous act. This study aimed to explore potential links between inducing moral elevation and relevant outcomes in a series of case examples.Methods: Veterans with probable PTSD completed experimental tasks including a written trauma narrative exercise and watching videos designed to elicit elevation. Participants also completed baseline assessments, repeated measures of trauma-related cognitions, emotions, state elevation, and saliva sample collection. Four individual cases were identified and reviewed: two positive responders (high elevation scores after videos) and two nonresponders (restricted elevation response).Results: Positive responder cases shared a trajectory of decreased cognitions, emotions, and moral injury distress from after the trauma narrative exercise to after elevation exercises, whereas nonresponders reported minimal to no changes. Positive responders also demonstrated decreases in cortisol that continued to decline in a delay period, whereas nonresponders demonstrated increases in cortisol. Additional differences were identified regarding history of experiences and dispositional traits.Limitations: This case series analysis is limited to four participants and does not include a control condition, which limits causal claims. These findings also represent experiences in a controlled laboratory setting; thus, it is unclear if they generalize to daily life for veterans with PTSD.Conclusions: Future work is needed to expand our understanding of whether higher levels of state elevation contribute to changes in biopsychosocial outcomes, and to determine individual factors that indicate who might benefit from elevation-based interventions.

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Blunted salivary cortisol response to psychosocial stress in women with posttraumatic stress disorder

Cited by 38 publications

References 47 publications

The impact of COVID-19 on cardiovascular health behaviors in student veterans

The impact of COVID-19 on cardiovascular health behaviors in student veterans

Chronic Stress and Ovulatory Dysfunction: Implications in Times of COVID-19

Biopsychosocial correlates and individual differences for eliciting moral elevation in veterans with PTSD: An experimental case series

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