Ten‐year follow‐up study of cortisol levels in aging holocaust survivors with and without PTSD

Yehuda, Rachel; Morris, Adam; Labinsky, Ellen; Zemelman, Shelly; Schmeidler, James

doi:10.1002/jts.20228

Cited by 53 publications

(28 citation statements)

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“…For instance, in 90 accident victims followed for 3 years, there was an increase from two cases of full PTSD at 1 year to four cases at 3 years and a decrease of one case with full PTSD to subthreshold PTSD during the same period [24]. In 28 Holocaust survivors followed for 10 years, diagnostic PTSD status changed in six subjects with 3 of 12 cases developing PTSD and with 3 of 16 cases remitting [25].…”

Section: Discussionmentioning

confidence: 99%

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Trajectory of Posttraumatic Stress Disorder Caused by Myocardial Infarction: A Two-Year Follow-up Study

Abbas

Schmid

Guler

et al. 2009

Int J Psychiatry Med

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Objective: A substantial proportion of patients develop posttraumatic stress disorder (PTSD) following myocardial infarction (MI). Previous research on the trajectory over time of PTSD in post-MI patients is scant and refers to self-rated posttraumatic symptoms. The aim of this study was to investigate the longitudinal course of an interviewer-rated diagnosis of PTSD and PTSD symptom severity following MI. Methods: Study participants were 40 patients (78% men, mean age 54 ± 8 years) who were diagnosed with PTSD using the Clinician-administered PTSD Scale (CAPS) after an average of 5 ± 4 months (range 2-16 months) following an index MI. After a mean follow-up of 26 ± 6 months (range 12-36 months), 24 patients underwent a second diagnostic interview. Results: Two-thirds of patients (n = 16) still qualified for a diagnosis of PTSD at follow-up. In all 24 patients, total PTSD symptoms (p = 0.001), re-experiencing symptoms (p < 0.001), avoidance symptoms (p = 0.015), and, with borderline significance, hyperarousal symptoms (p < 0.06) had all decreased over time. However, in the subgroup of the 16 patients who had retained PTSD diagnostic status at follow-up, symptoms of avoidance (p = 0.23) and of hyperarousal (p = 0.48) showed no longitudinal decline. Longer duration of follow-up was associated with a greater decrease in avoidance symptoms (p = 0.029) and, with borderline significance, in re-experiencing symptoms (p < 0.07) across all patients. Conclusion: Although PTSD symptomatology waned over time and in relation to longer follow-up, two-thirds of patients still qualified for a diagnosis of PTSD 2 years after the initial diagnosis. In post-MI patients, clinical PTSD is a considerably persistent condition.

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Section: Discussionmentioning

confidence: 99%

“…Moreover, in severely injured accident victims the prevalence of an interviewer-rated diagnosis of PTSD (full and subthreshold PTSD combined) was 12% after 1 year and 13% after 3 years [24]. Of 16 Holocaust survivors with the diagnosis of an interviewer-assessed PTSD, only three had remitted 10 years later [25].…”

Section: Introductionmentioning

confidence: 99%

Trajectory of Posttraumatic Stress Disorder Caused by Myocardial Infarction: A Two-Year Follow-up Study

Abbas

Schmid

Guler

et al. 2009

Int J Psychiatry Med

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“…Other studies, however, indicate that children exposed to early life stress may have normal or subnormal HPA reactivity to experimental stressors such as the Trier Social Stress Test (e.g., Gunnar et al, 2009;Tarullo and Gunnar, 2006). Studies of posttraumatic stress disorder (PTSD) also suggest subnormal cortisol levels (Yehuda et al, 2007). Attenuation of initial hypercortisolemia is often followed by reduction of cortisol levels associated with comorbid social withdrawal and depressive symptoms.…”

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confidence: 98%

Are cortisol profiles a stable trait during child development?

Flinn

2009

American J Hum Biol

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Exposure to stressful experiences can increase vulnerability to adverse health outcomes. A potential neuroendocrine mechanism mediating the link between stress and health is the hypothalamic-pituitary-adrenal (HPA) system, with a key role attributed to the glucocorticoid hormone cortisol. Retrospective and cross sectional clinical studies of humans and experimental studies with nonhuman primates and rodents suggest that traumatic experiences during critical periods in development may have permanent effects on HPA regulation, which in turn can have deleterious effects on health. Here I report results from a continuous 20-year study (1988-2009) of children in a rural community on Dominica. Sequential data on cortisol levels, social stressors, and health in naturalistic, everyday conditions are examined to assess developmental trajectories of HPA functioning. Saliva aliquots were assayed for cortisol in concert with monitoring of growth, morbidity, and social environment. Analyses here include data from 1989 to 1999 for 147 children aged 3-16 years with >100 saliva samples each. Cortisol values were standardized by elapsed time since wake-up. Results do not support the hypothesis that traumatic stress during childhood causes permanent general elevation of cortisol levels.

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“…A resposta do cortisol é considerada adaptativa ao estresse, e a desregulação desse eixo tem sido relacionada com uma série de patologias, entre elas o TEPT, em que os níveis de cortisol se encontram reduzidos 6 .…”

Section: Introductionunclassified

Marcadores neurobiológicos e psicométricos da eficácia da terapia cognitivo-comportamental no transtorno de estresse pós-traumático associado a sintomas dissociativos: relato de caso

Lages

Norte

Pedrozo

et al. 2011

Rev. psiquiatr. Rio Gd. Sul

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Marcadores neurobiológicos e psicométricos da efi cácia da terapia cognitivo-comportamental no transtorno de estresse pós-traumático associado a sintomas dissociativos: relato de caso ResumoIntrodução: O transtorno de estresse pós-traumático (TEPT) tem sido associado à desregulação de diversos parâmetros psicofi siológicos e pode apresentar comorbidade com diversas psicopatologias, inclusive a dissociação, podendo difi cultar o tratamento. O objetivo do presente trabalho foi investigar os efeitos da terapia cognitivo-comportamental em um paciente com TEPT e sintomas dissociativos com base em medidas psicofi siológicas e psicométricas em diferentes momentos do tratamento. Descrição do caso: O paciente é um homem de 38 anos, com diagnósticos de TEPT e transtorno depressivo maior recorrente com sintomas dissociativos e resistência ao tratamento farmacológico. O tratamento psicoterápico teve duração de 4 meses, sendo composto por uma sessão semanal de terapia e três sessões semanais de coterapia. Os parâmetros fi siológicos (frequência cardíaca, tônus vagal, balanço simpático e cortisol) e psicométricos (afeto negativo e positivo, resiliência e sintomas de estresse pós-traumático, depressão, ansiedade e dissociação) foram medidos antes, durante (uma vez ao mês) e após o tratamento. Comentários: Os resultados mostraram diminuição do balanço simpático e aumento do tônus vagal, da frequência cardíaca e dos níveis de cortisol ao longo do tratamento. O tratamento também promoveu redução no afeto negativo e nos sintomas de estresse pós-traumático, depressão, ansiedade e dissociação, além de um aumento nos escores de resiliência, apoio social e afeto positivo. Esses resultados sugerem que a terapia cognitivocomportamental é um tratamento efi caz para o TEPT com sintomas dissociativos. Além disso, parece promover a normalização das alterações fi siológicas do sistema nervoso autônomo e neuroendócrino relacionadas ao TEPT. Descritores: Transtornos de estresse pós-traumáticos, psicofi siologia, transtornos dissociativos, psicometria. AbstractIntroduction: Post-traumatic stress disorder (PTSD) has been associated with dysregulation of many psychophysiological parameters and may present comorbidity with different psychopathologies, including dissociation, potentially affecting treatment outcome. The aim of this study was to evaluate the effects of cognitive behavioral therapy in a patient with PTSD and dissociative symptoms based on psychophysiological and psychometric measures at different time points throughout the course of treatment. Case description: Our patient is a 38-year old man diagnosed with PTSD, major depression, and dissociative symptoms, resistant to pharmacotherapy. Psychological treatment lasted for 4 months and consisted of one weekly therapy session and three weekly coaching sessions. Physiological (heart rate, vagal tone, sympathovagal balance, and cortisol) and psychometric measures (negative and positive affect, resilience, and post-traumatic stress, depression, anxiety, and dissociative symptoms) were ob...

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Ten‐year follow‐up study of cortisol levels in aging holocaust survivors with and without PTSD

Cited by 53 publications

References 14 publications

Trajectory of Posttraumatic Stress Disorder Caused by Myocardial Infarction: A Two-Year Follow-up Study

Trajectory of Posttraumatic Stress Disorder Caused by Myocardial Infarction: A Two-Year Follow-up Study

Are cortisol profiles a stable trait during child development?

Marcadores neurobiológicos e psicométricos da eficácia da terapia cognitivo-comportamental no transtorno de estresse pós-traumático associado a sintomas dissociativos: relato de caso

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