No abstract

Enhanced cortisol negative feedback inhibition may be associated with PTSD because it is related to the PTSD risk factor of parental PTSD.

RA. Ten-year follow-up study of PTSD diagnosis, symptom severity and psychosocial indices in aging holocaust survivors.Objective: We performed a longitudinal study of holocaust survivors with and without post-traumatic stress disorder (PTSD) by assessing symptoms and other measures at two intervals, approximately 10 years apart. Method: The original cohort consisted of 63 community-dwelling subjects, of whom 40 were available for follow-up. Results: There was a general diminution in PTSD symptom severity over time. However, in 10% of the subjects (n = 4), new instances of delayed onset PTSD developed between time 1 and time 2. Self-report ratings at both assessments revealed a worsening of trauma-related symptoms over time in persons without PTSD at time 1, but an improvement in those with PTSD at time 1. Conclusion: The findings suggest that a nuanced characterization of PTSD trajectory over time is more reflective of PTSD symptomatology than simple diagnostic status at one time. The possibility of delayed onset trajectory complicates any simplistic overall trajectory summarizing the longitudinal course of PTSD. Significant outcomes• Post-traumatic stress disorder (PTSD) symptom severity generally diminishes over time; however, in a small subsample, there is a delayed onset of new PTSD developed between time 1 and time 2, even in an elderly cohort exposed decades earlier. Thus, although there is a general diminution of symptoms in those with PTSD at time 1, those without PTSD at time 1 tended to show a worsening in PTSD and general symptomatology.• All survivors showed a decline in morale and physical health over time.• The findings suggest that longitudinal information over time provides a more powerful indicator of symptom severity than cross-sectional diagnostic evaluations. Limitations• The small sample size, particularly in some of the subgroups, is a limitation of the study.• The attrition of subjects from time 1 to time 2 owing to death, illness or disability is a limitation.• Information about PTSD prior to the time 1 assessment was obtained retrospectively at time 1.

While observant Jewish women live in a culture defined by a high degree of adherence to specific laws of conduct, including rules designed to regulate sexual contact, sexual abuse of various types still exists among them.

To investigate the longitudinal course of mean 24-hour urinary cortisol excretion in posttraumatic stress disorder (PTSD), the authors evaluated 24-hour cortisol excretion in 28 Holocaust survivors 10 years after obtaining an initial estimate. Cortisol levels increased in participants whose PTSD had remitted (n = 3) but declined in participants who developed PTSD (n = 3) or whose PTSD status did not change over time (PTSD+: n = 14, PTSD-: n = 8). Cortisol levels at Time 1 predicted diagnostic status change better than psychological variables, including exposure to traumatic events between assessments. The authors conclude that cortisol levels are affected by change in PTSD status and age.