Cortisol Production Rate in Posttraumatic Stress Disorder

Wheler, G. H. T.; Brandon, David D.; Clemons, Aaron; Riley, Crystal M.; Kendall, John W.; Loriaux, D. Lynn; Kinzie, J. David

doi:10.1210/jc.2006-0061

Cited by 32 publications

(19 citation statements)

References 18 publications

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“…The absence of group difference in ACTH levels is consistent with other negative studies of ACTH in PTSD (Kanter et al, 2001 ;Newport et al, 2004), and with a recent finding of similar cortisol production rates in PTSD patients and normal subjects (Wheler et al, 2006). Lower ACTH in women was found by Yehuda et al (2004), and is consistent with the theory that adrenal glands in women are more sensitive to ACTH (Horrock et al, 1990).…”

Section: Discussionsupporting

confidence: 90%

Stress hormones and post-traumatic stress disorder in civilian trauma victims: a longitudinal study. Part I: HPA axis responses

Shalev

Videlock

Peleg

et al. 2007

Int. J. Neuropsychopharm.

124

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The aim of the study was to evaluate the association between post-traumatic disorder (PTSD) and hypothalamic-pituitary-adrenal (HPA) axis responses to the triggering trauma. A companion paper evaluates the adrenergic response and interactions between the two. We measured plasma and saliva cortisol, hourly urinary excretion of cortisol, plasma levels of adrenocorticotropin (ACTH), and the leukocyte glucocorticoid receptor (GR) density of 155 non-injured survivors of traumatic events (91 males and 64 females; 125 road traffic accidents, 19 terrorist attacks, 11 others). Measurements were taken during survivors' admissions to an emergency room (ER) of a general hospital, and in the mornings, 10 d, 1 month, and 5 months later. Symptoms of peri-traumatic dissociation, PTSD, and depression were assessed on each follow-up session. The clinician-administered PTSD scale (CAPS) conferred a diagnosis of PTSD at 5 months. Survivors with (n=31) and without (n=124) PTSD at 5 months had similar levels of hormones at all times. Plasma cortisol levels decreased with time in both groups. Female subjects had lower ACTH levels than males. PTSD in females was associated with higher levels of ACTH. In unselected cohorts of trauma survivors, PTSD is not preceded by a detectable abnormality of peripheral HPA axis hormones.

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Section: Discussionsupporting

confidence: 90%

Stress hormones and post-traumatic stress disorder in civilian trauma victims: a longitudinal study. Part I: HPA axis responses

Shalev

Videlock

Peleg

et al. 2007

Int. J. Neuropsychopharm.

124

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“…In addition to the paucity of studies using multiple measures of stress over the life course, many did not include as many indicators of neuroendocrine system function as in the paper here and most made use of considerably smaller, non-population-based samples. Although it is difficult to summarize these varied papers, on the whole results appear mixed, with some supporting (Evans, 2003; Janicki-Deverts et al, 2007; Lemieux & Coe, 1995; Yehuda et al, 1995), some not supporting (Kubzansky et al, 1998; Powell et al, 2002) and others providing evidence for and against (Babisch, 2003; Luecken et al, 1997; Olff et al, 2006; Wheler et al, 2006) the connection between life stress and dysregulated neuroendocrine biomarker levels.…”

Section: Discussionmentioning

confidence: 99%

“…And although negative findings have also been found by others (Babisch et al, 2001; Powell et al, 2002), these studies typically have only examined one particular type of stressor (e.g., marital disruption or noise exposure) instead of multiple stressors that span the life course. A further limitation of these studies is that they have often investigated one particular biomarker (instead of a grouping representative of a physiological system or systems) and have been conducted on small, non-population-based samples (Babisch et al, 2001; Luecken et al, 1997; Powell et al, 2002; Wheler et al, 2006). In sum, there is a paucity of studies (the 2000 SEBAS and perhaps one or two others) that can claim to have tested in a rigorous way the hypothesis that markers of life history stress are correlated with higher levels of AL.…”

Section: Introductionmentioning

confidence: 99%

Stressors Over the Life Course and Neuroendocrine System Dysregulation in Costa Rica

2010

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Objectives A key aspect of the increasingly popular allostatic load (AL) framework is that stressors experienced over the entire life course result in physiological dysregulation. Although core to AL theory, this idea has been little tested and where it has been tested the results have been mixed. Methods We analyze the CRELES, a new, cross-sectional, and nationally representative survey of older Costa Rican men and women (ages 60-109). The survey was conducted in 2004-2006 and has a sample size of 2,827. This paper focuses on the relation between a variety of stressors experienced over the life course and cortisol, dehydroepiandrosterone sulfate (DHEAS), epinephrine, and norepinephrine analyzed separately and in an index. Results Some links were found between certain stressors and worse cortisol levels, but overall almost all of the stressors examined were not associated with riskier neuroendocrine biomarker profiles. Discussion More work is needed to attempt to establish the connection between stressors experienced over the life course and resting levels of the neuroendocrine markers.

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“…Data on baseline cortisol levels in PTSD have been somewhat inconsistent (see recent review by Yehuda, 2009), with several studies reporting low levels in PTSD (Yehuda et al, 1990, 2000; Young et al, 2004) and others finding no diagnostic differences (Shalev et al, 2008; Wheler et al, 2006). A recent meta-analysis concluded that cortisol levels were only reduced if serum or plasma levels were measured (Meewisse et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Cortisol suppression by dexamethasone reduces exaggerated fear responses in posttraumatic stress disorder

Jovanović

Phifer

Sicking

et al. 2011

Psychoneuroendocrinology

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Summary PTSD symptoms are associated with heightened fear responses in laboratory fear conditioning paradigms. This study examined the effects of dexamethasone administration on hypothalamic–pituitary–adrenal (HPA) function and fear-potentiated startle (FPS) in trauma-exposed individuals with and without PTSD. We used an established fear discrimination procedure, in which one visual stimulus (CS+, danger cue) was paired with aversive airblasts to the throat (unconditioned stimulus, US), and another stimulus (CS−, safety cue) was presented without airblasts. In addition to FPS, the dexamethasone suppression test (DST) was performed. The study sample (N = 100) was recruited from a highly traumatized civilian population in Atlanta, GA. Half of the subjects (n = 54, 16 PTSD, 38 controls) underwent conditioning at baseline and the other half (n = 46, 17 PTSD, 29 controls) after DST, in a cross-sectional design. We found a significant interaction effect of diagnostic group and dexamethasone treatment. Under baseline conditions, subjects with PTSD showed more than twice as much fear-potentiated startle to the danger cue compared to traumatized controls, F(1,53) = 8.08, p = 0.006. However, there was no group difference in subjects tested after dexamethasone suppression. Furthermore, there was a significant treatment effect in PTSD subjects but not in controls, with dexamethasone reducing fear-potentiated startle to the CS+, F(1,32) = 4.00, p = 0.05. There was also a positive correlation between PTSD subjects’ FPS and cortisol levels, r = 0.46, p = 0.01. These results suggest that transient suppression of HPA function via dexamethasone suppression may reduce exaggerated fear in patients with PTSD.

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Cortisol Production Rate in Posttraumatic Stress Disorder

Abstract: The data indicate that PTSD in the chronic and unprovoked state is not characterized by an acute biological stress response.

Cited by 32 publications

References 18 publications

Stress hormones and post-traumatic stress disorder in civilian trauma victims: a longitudinal study. Part I: HPA axis responses

Stress hormones and post-traumatic stress disorder in civilian trauma victims: a longitudinal study. Part I: HPA axis responses

Stressors Over the Life Course and Neuroendocrine System Dysregulation in Costa Rica

Cortisol suppression by dexamethasone reduces exaggerated fear responses in posttraumatic stress disorder

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