Cortisol response to a cognitive stress challenge in posttraumatic stress disorder (PTSD) related to childhood abuse

Bremner, J. Douglas; Vythilingam, Meena; Vermetten, Eric; Adil, Jahangir; Khan, Sheraz Ahmad; Nazeer, Ahsan; Afzal, Nadeem; McGlashan, Thomas H.; Elzinga, Bernet M.; Anderson, George M.; Heninger, George R.; Southwick, Steven M.; Charney, Dennis S.

doi:10.1016/s0306-4530(02)00067-7

Cited by 252 publications

(162 citation statements)

References 85 publications

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“…Previous studies have demonstrated that anticipation of a stressful event may be a potent activator of HPA activity, with HPA activation often starting even before an acute stressor is applied (Kirschbaum et al, 1993;Richter et al, 1996). Moreover, elevated levels of cortisol were also found in PTSD patients in anticipation of a cognitive stress challenge (Bremner et al, 2003b). Owing to this lack of a proper baseline, it could not be determined with certainty whether cortisol levels had increased in PTSD patients in response to the trauma scripts (starting already prior to the experiment).…”

Section: Discussionmentioning

confidence: 98%

Higher Cortisol Levels Following Exposure to Traumatic Reminders in Abuse-Related PTSD

Elzinga

Schmahl

Vermetten

et al. 2003

Neuropsychopharmacol

290

153

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Animal studies have found that prior stressful events can result in increased reactivity in the HPA-axis. However, baseline function of the HPA-axis has typically been normal or decreased in post-traumatic stress disorder (PTSD). The first purpose of this study was to assess cortisol responsivity to traumatic reminders in women with PTSD related to childhood abuse. The second aim was to assess the relationship between stress-induced cortisol levels and neutral and emotional memory. Salivary cortisol levels were measured before, during and after exposure to personalized trauma scripts in abused women with (N ¼ 12) and without current PTSD (N ¼ 12). Memory for neutral and emotional material was assessed immediately after trauma scripts exposure and 3 days later. PTSD patients had 122% higher cortisol levels during script exposure, 69% higher cortisol levels during recovery, and 60% higher levels in the period leading up to the script exposure compared to controls. PTSD symptoms were highly predictive of cortisol levels during trauma script exposure (r ¼ 0.70), but not during periods of rest. Both in PTSD patients and controls, memory consolidation after the trauma scripts was impaired relative to baseline (Po0.001), with no differences between the two groups on memory performance. There was no association between memory performance and cortisol levels. These results are consistent with higher cortisol levels following exposure to traumatic stressors in PTSD.

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Section: Discussionmentioning

confidence: 98%

Higher Cortisol Levels Following Exposure to Traumatic Reminders in Abuse-Related PTSD

Elzinga

Schmahl

Vermetten

et al. 2003

Neuropsychopharmacol

290

153

View full text Add to dashboard Cite

show abstract

“…In this context, earlier studies also investigated cortisol reactivity in PTSD patients in response to trauma reminders, yielding inconsistent results. Whereas a study by Elzinga et al (2003) reported a pronounced cortisol response in sexually abused women when confronted with personal trauma scripts, other studies examining cortisol reactivity after assessing individual traumatic experiences in male torture victims (Kolassa et al, 2007) or in response to combat noise in male Vietnam veterans (Liberzon et al, 1999) found no such response. Based on current theoretical models of PTSD (Lang, 1979;Foa and Kozak, 1986;Schauer et al, 2011), studies investigating physiological responses to trauma-related cues generally assume that the physiological reactivity in response to trauma reminders observed in the laboratory should recapitulate the physiological reactivity that occurred during the trauma (Keane et al, 1985;Pole, 2007).…”

Section: Introductionmentioning

confidence: 92%

Victims of rape show increased cortisol responses to trauma reminders: A study in individuals with war- and torture-related PTSD

Gola

Engler

Schauer

et al. 2012

Psychoneuroendocrinology

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Previous work on the cortisol response to stressors related to previous traumas in PTSD has yielded inconsistent results. We investigated whether the type of the trauma experienced has an effect on cortisol responses to trauma reminders. Raped and non-raped survivors of war and torture with PTSD were confronted with a clinical interview touching on their individual traumatic experiences, and basal plasma as well as saliva cortisol was assessed at three time points. Groups did not differ in baseline cortisol, but cortisol responses to trauma reminders differed between raped and non-raped participants, controlling for traumatic load and PTSD symptom severity: non-raped participants exhibited a reduction in salivary cortisol, while raped participants showed an increase in salivary cortisol levels during the interview. No effect was found in plasma cortisol. Thus, the type of trauma experienced appears to have an effect on subsequent cortisol dynamics.

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“…In this reaction, the brain is engaging in what seems to be an exaggerated form of pattern recognition, a common form of learning in which similar patterns of stimuli call forth a similar neuroendocrine (and, thus, behavioral) response. 4,5 Symptoms can be grouped into 3 main behavioral clusters: (1) reexperiencing through intrusive thoughts, dreams, and "flashback" recollections; (2) avoidance of reminders and numbing of responsiveness, including social withdrawal, restricted range of affect, and constriction of play; and (3) physiological hyperarousal in the form of hypervigilance and exaggerated startle response, attention and concentration problems, and sleep disturbance. When disordered stress responses persist long after the trauma, the condition is termed PTSD.…”

Section: When Traumatic Stress Will Not Go Awaymentioning

confidence: 99%

Understanding the Behavioral and Emotional Consequences of Child Abuse

Stirling¹,

Amaya-Jackson²

2008

Pediatrics

114

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Children who have suffered early abuse or neglect may later present with significant behavior problems including emotional instability, depression, and a tendency to be aggressive or violent with others. Troublesome behaviors may persist long after the abusive or neglectful environment has changed or the child has been in foster care placement. Neurobiological research has shown that early abuse results in an altered physiological response to stressful stimuli, a response that deleteriously affects the child's subsequent socialization. Pediatricians can assist caregivers by helping them recognize the abused or neglected child's altered responses, formulate more effective coping strategies, and mobilize available community resources.

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Cortisol response to a cognitive stress challenge in posttraumatic stress disorder (PTSD) related to childhood abuse

Cited by 252 publications

References 85 publications

Higher Cortisol Levels Following Exposure to Traumatic Reminders in Abuse-Related PTSD

Higher Cortisol Levels Following Exposure to Traumatic Reminders in Abuse-Related PTSD

Victims of rape show increased cortisol responses to trauma reminders: A study in individuals with war- and torture-related PTSD

Understanding the Behavioral and Emotional Consequences of Child Abuse

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