Cortisol and post-traumatic stress disorder in adults

Meewisse, Marie-Louise; Reitsma, Johannes B.; Vries, Giel-Jan de; Gersons, Berthold P. R.; Olff, Miranda

doi:10.1192/bjp.bp.106.024877

Cited by 584 publications

(464 citation statements)

References 47 publications

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“…In addition, a DEX challenge revealed that a single bout of massive footshock did not produce an alteration to the HPA axis's ability to provide reliable negative feedback. This falls in agreement with human literature that individuals with PTSD do not exhibit chronically elevated levels of cortisol (e.g., Meewisse et al 2007;Yehuda and Seckl 2011). Because we did not sample blood at shorter time points (30, 60, 90 min) following footshock it is unclear when exactly CORT is normalized within this study.…”

Section: Discussionsupporting

confidence: 92%

Persistent effects of acute stress on fear and drug-seeking in a novel model of the comorbidity between post-traumatic stress disorder and addiction

2017

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Even following long periods of abstinence, individuals with anxiety disorders have high rates of relapse to drugs of abuse. Although many current models of relapse demonstrate effects of acute stress on drug-seeking, most of these studies examine stressful experiences that occur in close temporal and physical proximity to the reinstatement test. Here, we assess the effects of a stressful experience in one context on fear and drug-seeking in a different context. We adapt the stress-enhanced fear learning procedure to examine impacts on drug-seeking long after the stressful experience occurred. We find massive footshock in a distinct environment produced an acute increase in corticosterone, long-term hyper-responsivity to a single shock in different contexts with extensive histories of drug-seeking behaviors, enhancements in cocaineinduced conditioned place preference in mice, and persistent enhancements in cue-induced reinstatement of methamphetamine-seeking behavior in rats. Together, these experiments demonstrate that an acute trauma causes persistent changes in responsivity to mild stressors and drug-seeking behavior in other contexts, which mirrors aspects of the comorbidity between post-traumatic stress disorder and substance use disorders. These behavioral approaches provide novel procedures for investigating basic mechanisms underlying this comorbidity and they provide powerful tools for testing preclinical pharmacological and behavioral interventions. [Supplemental material is available for this article.]Compared with the general population, individuals diagnosed with post-traumatic stress disorder (PTSD) have higher rates of substance use disorders (SUDs) (Stewart 1996;McFarlane 1998;Ouimette et al. 1998;Back et al. 2000;Sonne et al. 2003;McCauley et al. 2012;Tipps et al. 2014;Roberts et al. 2015) and are twice as likely to use methamphetamine (METH) than are individuals with trauma exposure that does not lead to PTSD (Smith et al. 2010). Individuals with PTSD are also more likely to relapse to drugs of abuse when cues associated with drug-seeking are encountered, even long after periods of acute stress have ended (Bradizza et al. 2006), suggesting stressors that are temporally and contextually dissociated from drug-seeking may induce longterm changes that contribute to an increased risk for relapse.It has long been observed that stress is a potent inducer of reinstatement (an animal model of relapse) in rodents (e.g., Shaham et al. 2000;Erb et al. 2001;Sanchez and Sorg 2001;Boutrel et al. 2005;Redila and Chavkin 2008;Schindler et al. 2010). Although the ability of stress to induce reinstatement has been well established in the literature, most studies have focused on effects when the organism is tested in a state of acute stress within the drug-seeking context; few studies have evaluated the persistent effects of an acute stressor long after the stress has ended. Individuals with PTSD have traumatic experiences long before relapse and are unlikely to use drugs in the trauma-associated context; avoiding ...

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Section: Discussionsupporting

confidence: 92%

Persistent effects of acute stress on fear and drug-seeking in a novel model of the comorbidity between post-traumatic stress disorder and addiction

2017

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“…45,46 Psychological comorbidities have been shown to affect cortisol secretion patterns. 47,48 We cannot address this issue in our study because we did not collect data on psychological comorbidities. Another possible limitation of this study is that salivary cortisol measures were taken on a single workday.…”

Section: Study Limitationsmentioning

confidence: 99%

Hypothalamic-Pituitary-Adrenal Axis Function: Relative Contributions of Perceived Stress and Obesity in Women

Farag

Moore²,

Lovallo³

et al. 2008

Journal of Women's Health

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Objective: A range of behavioral and psychosocial factors may contribute to a chronically stimulated hypothalamic-pituitary-adrenal (HPA) axis and subsequently altered diurnal patterns. The goal of this cross-sectional study was to examine associations among diurnal cortisol levels, perceived stress, and obesity patterns. Methods: Seventy-eight women (aged 24-72 years) employed in a rural public school system completed the perceived stress scale, collected diurnal saliva samples, and underwent anthropometric assessments. Reduced peak-to-nadir cortisol values across the day were considered a sign of impairment in HPA function. A series of linear regression models determined the best predictors of diurnal cortisol variation. Results: There was a marginal linear trend in stress levels across body mass index (BMI) categories, with obese women reporting the highest levels of stress (p ϭ 0.07). Perceived stress was the only significant predictor of the degree of flattening of the diurnal cortisol curve in the sample as a whole (␤ ϭ Ϫ0.042, R 2 ϭ 0.11, F ϭ 8.6, p ϭ 0.005), indicating reduction in the normal diurnal pattern. Among overweight women (BMI ϭ 25-29.9 kg/m 2 ), stress and waist circumference combined predicted 35% of the variability in diurnal cortisol. In contrast, among obese women (BMI Ն 30 kg/m 2 ), BMI predicted 31% of the variability in diurnal cortisol (F ϭ 13.8, p ϭ 0.001), but stress was no longer significantly related to diurnal cortisol. Conclusions: Psychological stress predicts a significant portion of HPA axis functioning. In overweight women, perceived stress and waist circumference were of approximately equal importance in predicting adrenal cortisol secretion. However, among obese women, a major portion of the diurnal cortisol variation was predicted by BMI alone, not stress or waist circumference. This may help elucidate the mechanisms linking obesity to increased risk of cardiovascular disease (CVD).

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“…A number of explanations for this heterogeneity of results are conceivable: given the high complexity of PTSD, potential explanations include betweenstudy differences in patient characteristics such as gender, disease comorbidity, medication or drug intake as well as severity, type and frequency of traumatic events (e.g. Rasmusson et al, 2003;Meewisse et al, 2007). In addition to these, it is however also likely that methodological factors associated with the assessment of cortisol might have contributed to the inconsistency of results (Meewisse et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

“…Rasmusson et al, 2003;Meewisse et al, 2007). In addition to these, it is however also likely that methodological factors associated with the assessment of cortisol might have contributed to the inconsistency of results (Meewisse et al, 2007). The HPA axis constitutes a highly dynamic system which is influenced by a range of situational factors (e.g.…”

Section: Introductionmentioning

confidence: 99%

Increased cortisol concentrations in hair of severely traumatized Ugandan individuals with PTSD

Steudte

Kolassa

Stalder

et al. 2011

Psychoneuroendocrinology

159

102

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Abstract:The influence of post-traumatic stress disorder (PTSD) on cortisol levels is not yet clear. We examined long-term cortisol levels in severely traumatized survivors of the Northern Uganda civil war -10 individuals with and 17 without PTSD -by assessing hair cortisol. PTSD patients exhibited higher long-term cortisol concentrations than non-PTSD participants, and the cortisol level was positively correlated with the number of traumatic event types experienced. Our results indicate a chronic stress reaction in PTSD patients, especially under conditions of recurring trauma.

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Cortisol and post-traumatic stress disorder in adults

Abstract: Low cortisol levels in PTSD are only found under certain conditions. Future research should elucidate whether low cortisol is related to gender or abuse and depends on the measurement methods used.

Cited by 584 publications

References 47 publications

Persistent effects of acute stress on fear and drug-seeking in a novel model of the comorbidity between post-traumatic stress disorder and addiction

Persistent effects of acute stress on fear and drug-seeking in a novel model of the comorbidity between post-traumatic stress disorder and addiction

Hypothalamic-Pituitary-Adrenal Axis Function: Relative Contributions of Perceived Stress and Obesity in Women

Increased cortisol concentrations in hair of severely traumatized Ugandan individuals with PTSD

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