Salivary cortisol, posttraumatic stress symptoms, and general health in the acute phase and during 9-month follow-up

Aardal-Eriksson, Elisabeth; Eriksson, Thomas; Thorell, Lars‐Håkan

doi:10.1016/s0006-3223(01)01253-7

Cited by 85 publications

(52 citation statements)

References 26 publications

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“…In line with previous studies (Aardal-Eriksson et al, 2001;Delahanty et al, 2000;Ehring et al, 2008;McFarlane et al, 2011), our findings confirm the hypothesis that the development of PTSD may partly be explained by dysfunctioning of the HPA-axis. Moreover, we extended previous results by showing that cortisol is not only a predictor for acute PTSD symptoms, but continues to predict chronic PTSD symptoms at 6 months, even when controlling for relevant trauma and injury characteristics.…”

Section: Discussionsupporting

confidence: 93%

“…This study is the first to show a predictive effect of plasma cortisol, whereas previous studies finding predictive effects for cortisol used saliva or urine samples (Aardal-Eriksson et al, 2001;Delahanty et al, 2000;Ehring et al, 2008;McFarlane et al, 2011). It is possible that our larger sample provided sufficient power for the analyses.…”

Section: Discussionmentioning

confidence: 73%

“…Some studies have found that low cortisol levels immediately or in the first days following trauma predict PTSD diagnosis (Delahanty et al, 2000;McFarlane et al, 1997) or symptoms (Aardal-Eriksson et al, 2001;Ehring et al, 2008;McFarlane et al, 2011). In some of these studies, however, the association disappeared when controlling for possible confounding variables, such as injury severity and history of PTSD (Delahanty et al, 2000), and time of the accident or blood sampling (McFarlane et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

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The role of acute cortisol and DHEAS in predicting acute and chronic PTSD symptoms

Mouthaan

Sijbrandij²,

Luitse

et al. 2014

Psychoneuroendocrinology

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SummaryBackground: Decreased activation of the hypothalamus-pituitary-adrenal (HPA) axis in response to stress is suspected to be a vulnerability factor for posttraumatic stress disorder (PTSD). Previous studies showed inconsistent findings regarding the role of cortisol in predicting PTSD. In addition, no prospective studies have examined the role of dehydroepiandrosterone (DHEA), or its sulfate form DHEAS, and the cortisol-to-DHEA(S) ratio in predicting PTSD. In this study, we tested whether acute plasma cortisol, DHEAS and the cortisol-to-DHEAS ratio predicted PTSD symptoms at 6 weeks and 6 months post-trauma. Methods: Blood samples of 397 adult level-1 trauma center patients, taken at the trauma resuscitation room within hours after the injury, were analyzed for cortisol and DHEAS levels. PTSD symptoms were assessed at 6 weeks and 6 months post-trauma with the Clinician Administered PTSD Scale. Results: Multivariate linear regression analyses showed that lower cortisol predicted PTSD symptoms at both 6 weeks and 6 months, controlling for age, gender, time of blood sampling, injury, trauma history, and admission to intensive care. Higher DHEAS and a smaller cortisol-to-DHEAS ratio predicted PTSD symptoms at 6 weeks, but not after controlling for the same variables, and not at 6 months. Conclusions: Our study provides important new evidence on the crucial role of the HPA-axis in response to trauma by showing that acute cortisol and DHEAS levels predict PTSD symptoms in survivors of recent trauma. #

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

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The role of acute cortisol and DHEAS in predicting acute and chronic PTSD symptoms

Mouthaan

Sijbrandij²,

Luitse

et al. 2014

Psychoneuroendocrinology

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“…The release of cortisol is one of many ways by which the organism prepares itself to deal with physical or psychological challenges (Sapolsky, Romero, & Munck, 2000). Interestingly, both high and low levels of circulating cortisol have been associated with nonoptimal adult outcomes (Hsu, Garside, Massey, McAllister, & Williams, 2003;Lupien, Gillin, & Hauger, 1999;Young, Sahakian, Robbins, & Cowen, 1999), thus creating a U-shaped function relating cortisol levels to behavioral risk (see Aardal-Eriksson, Eriksson, & Thorell, 2001;Kristenson, Eriksen, Sluiter, Starke, & Ursin, 2004;Mason et al, 2001;Yehuda, Boisoneau, Lowy, & Giller, 1995).…”

Section: The Hpa Systemmentioning

confidence: 99%

Psychophysiological correlates of parenting behavior in mothers of young children

Mills‐Koonce

Propper

Gariépy

et al. 2009

Developmental Psychobiology

106

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This study investigated HPA and vagal functioning as correlates of parenting in mothers of 175 six-month-old children. Salivary cortisol indexed HPA functioning and respiratory sinus arrhythmia (RSA) reduction indexed vagal regulation. Positive engagement and negative intrusiveness were observed during the Face-to-Face Still Face Paradigm (FFSFP) reunion and a semi-structured free play episode. Mixed modeling was used to examine differences in maternal behaviors across contexts as a function of psychophysiology. Main effects of cortisol levels, as well as interactions with RSA reduction and context, predicted negative intrusiveness. Mothers with high cortisol exhibited more negative intrusiveness if they also had lower RSA reduction. Mothers were also less negatively intrusive during the FFSFP than the free play if they had lower cortisol levels. There were no associations between psychophysiological measures and positive engagement. The findings suggest: (1) that parenting behaviors are associated with maternal stress physiology; (2) considerations of single physiological systems related to parenting behaviors may be incomplete; and (3) type and context of behaviors must be considered when examining biobehavioral associations with parenting.

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“…This is revealed in intrusions that in turn may cause a re-release of glucocorticoids and catecholamines which further enhance the consolidation of the traumatic memory. Evidence for this positive feedback loop comes from studies that found that the onset of PTSD is associated with increased heart rate variability [7][8][9][10], urinary (nor)epinephrine [11][12][13] and a dysregulated cortisol response [13][14][15][16][17]. Medication that acts on the hyperadrenergic state may prevent this positive feedback loop [6] and subsequent PTSD.…”

mentioning

confidence: 99%

The role of early pharmacotherapy in the development of posttraumatic stress disorder symptoms after traumatic injury: an observational cohort study in consecutive patients

Mouthaan

Sijbrandij

Reitsma

et al. 2015

General Hospital Psychiatry

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Salivary cortisol, posttraumatic stress symptoms, and general health in the acute phase and during 9-month follow-up

Cited by 85 publications

References 26 publications

The role of acute cortisol and DHEAS in predicting acute and chronic PTSD symptoms

The role of acute cortisol and DHEAS in predicting acute and chronic PTSD symptoms

Psychophysiological correlates of parenting behavior in mothers of young children

The role of early pharmacotherapy in the development of posttraumatic stress disorder symptoms after traumatic injury: an observational cohort study in consecutive patients

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