Gender moderates diurnal cortisol in relation to trauma and PTSD symptoms: A study in Sri Lankan adolescents

Nicolson, Nancy A.; Ponnamperuma, Thyagi

doi:10.1016/j.psyneuen.2019.02.012

Cited by 16 publications

(10 citation statements)

References 61 publications

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“…We did not detect any effects in cycling women, which might be attributable to their small sample size – the effects of GR feedback sensitivity could not even be tested in this group – or to the remaining heterogeneity within this group due to different cycle phases. It was a specific concern of our study to differentiate effects of sex and hormonal contraception use, in order to consider interactions with gonadal steroids that have previously been suggested (Engel et al, 2019 ; Kamkwalala et al, 2012 ; Kirschbaum et al, 1999 ; Nicolson & Ponnamperuma, 2019 ; Stock et al, 1994 ). However, future studies should specifically investigate cycling women and the impact of menstrual cycle phases.…”

Section: Discussionmentioning

confidence: 99%

“…One aspect that has largely been neglected is the impact of participants’ sex and, accordingly, gonadal steroid-related status on the prognostic value of biological markers for PTSD symptom development. There is accumulating evidence that cross-sectional associations between PTSD symptoms and HRV (Kamkwalala et al, 2012 ), as well as diurnal cortisol output (Nicolson & Ponnamperuma, 2019 ), are sex-dependent. Furthermore, HPA axis function and oxytocin concentrations differ between men and women, and, within women, are additionally influenced by hormonal contraception use and menstrual cycle phase (Engel, Klusmann, Ditzen, Knaevelsrud, & Schumacher, 2019 ; Kirschbaum, Kudielka, Gaab, Schommer, & Hellhammer, 1999 ; Stock, Karlsson, & von Schoultz, 1994 ).…”

Section: Introductionmentioning

confidence: 99%

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Early posttraumatic autonomic and endocrine markers to predict posttraumatic stress symptoms after a preventive intervention with oxytocin

Engel

Zuiden

Frijling

et al. 2020

European Journal of Psychotraumatology

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Background: Efficient prevention of posttraumatic stress disorder (PTSD) needs to target individuals with an increased risk for adverse outcome after trauma. Prognostic or prescriptive biological markers assessed early posttrauma may inform personalized treatment recommendations. Objective: To test prognostic and prescriptive effects of early (posttraumatic) autonomic and endocrine markers on PTSD symptom development. Method: Autonomic and endocrine markers were assessed within 12 days posttrauma and before treatment initiation within a randomized placebo-controlled trial investigating repeated oxytocin administration as preventive intervention for PTSD. Linear mixed effects models were used to test the effects of heart rate (variability), resting cortisol, morning cortisol and cortisol awakening response (CAR), cortisol suppression by dexamethasone and resting oxytocin on PTSD symptoms 1.5, 3 and 6 months posttrauma in men (n = 54), women using hormonal contraception (n = 27) and cycling women (n = 19). Results: We found significant prognostic effects of resting oxytocin and cortisol suppression. In women using hormonal contraception, higher oxytocin was associated with higher PTSD symptoms across follow-up. Stronger cortisol suppression by dexamethasone, reflecting increased glucocorticoid receptor feedback sensitivity, was associated with lower PTSD symptoms across follow-up in men, but with higher symptoms at 1.5 months in women using hormonal contraception. These effects were independent of treatment condition. No further significant prognostic or prescriptive effects were detected. Conclusion: Our exploratory study indicates that resting oxytocin and glucocorticoid receptor feedback sensitivity early posttrauma are associated with subsequent PTSD symptom severity. Notably, prognostic effects depended on sex and hormonal contraception use, emphasizing the necessity to consider these factors in biomedical PTSD research.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Early posttraumatic autonomic and endocrine markers to predict posttraumatic stress symptoms after a preventive intervention with oxytocin

Engel

Zuiden

Frijling

et al. 2020

European Journal of Psychotraumatology

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“…Several diseases like diabetes mellitus, hypertension, depression and heart diseases are found to be related to obesity and higher BMI. It is a common conception that people with obesity suffer with more psychological agony, which leads to development of anxiety [14]. According to a meta-analysis report, there is higher co-morbidity with anxiety, depression and obesity in adults and youth.…”

Section: Introductionmentioning

confidence: 99%

Relationship of Major Depression with Body Mass Index and Salivary Cortisol

Khan

Zaffar

Rehan

et al. 2020

Cureus

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“…Our results also showed the number of potentially traumatic events, related to the earthquake, as predictors of the MOODS-SR rhythmicity and vegetative functions impairment, positively moderated by re-experiencing symptoms. There is evidence that traumatic experiences, including disasters, lead to changes in diurnal cortisol patterns (90)(91)(92) and that a cumulative trauma exposure may progressively disrupt circadian rhythms and other vegetative functions, including sleep, eating behaviors, or somatic complaints (70,(93)(94)(95)(96)(97)(98)(99). Our results showed the relationship between the traumatic events burden and rhythmicity and vegetative functions impairment in subjects with medium-high levels of re-experiencing symptoms only.…”

Section: Discussionmentioning

confidence: 54%

Disrupted Rhythmicity and Vegetative Functions Relate to PTSD and Gender in Earthquake Survivors

et al. 2020

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Background: Increasing evidence indicates that survivors to traumatic events may show disruption of sleep pattern, eating and sexual behaviors, and somatic symptoms suggestive of alterations of biorhythmicity and vegetative functions. Therefore, the aim of this study was to investigate these possible alterations in a sample of survivors in the aftermath of earthquake exposure, with particular attention to gender differences and impact of post-traumatic stress disorder (PTSD). Methods: High school senior students, who had been exposed to the 2009 L'Aquila earthquake, were enrolled 21 months after the traumatic event and evaluated by the Trauma and Loss Spectrum Self-Report to investigate PTSD rates and by a domain of the Mood Spectrum Self-Report–Lifetime Version (MOODS-SR), to explore alterations in circadian/seasonal rhythms and vegetative functions. Results: The rates of endorsement of MOODS-SR rhythmicity and vegetative functions domain and subdomain scores were significantly higher in survivors with PTSD with respect to those without it. Among all earthquake survivors, women reported higher scores than men on the rhythmicity and vegetative functions domain and subdomain scores, except for the rhythmicity and sexual functions ones. Female survivors without PTSD showed significantly higher scores than men in the rhythmicity and vegetative functions total scores and the sleep and weight and appetite subdomains. Potentially traumatic events burden predicted rhythmicity and vegetative functions impairment, with a moderation effect of re-experiencing symptoms. Conclusions: We report impairments in rhythmicity, sleep, eating, and sexual and somatic health in survivors to a massive earthquake, particularly among subjects with PTSD and higher re-experiencing symptoms, with specific gender-related differences. Evaluating symptoms of impaired rhythmicity and vegetative functions seems essential for a more accurate assessment and clinical management of survivors to a mass trauma.

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Gender moderates diurnal cortisol in relation to trauma and PTSD symptoms: A study in Sri Lankan adolescents

Cited by 16 publications

References 61 publications

Early posttraumatic autonomic and endocrine markers to predict posttraumatic stress symptoms after a preventive intervention with oxytocin

Early posttraumatic autonomic and endocrine markers to predict posttraumatic stress symptoms after a preventive intervention with oxytocin

Relationship of Major Depression with Body Mass Index and Salivary Cortisol

Disrupted Rhythmicity and Vegetative Functions Relate to PTSD and Gender in Earthquake Survivors

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