Cited by 466Posttraumatic Stress Disorder ResearchStress Responses and CortisolChild Abuse and Trauma

The DOI matches its Crossref record; 173 of the 173 references it cites were found in a registry or an index.

Relations among posttraumatic stress disorder, comorbid major depression, and HPA function: A systematic review and meta-analysis

Open access

Morris, Matthew C., Compas, Bruce E., Garber, Judy·2012·Clinical Psychology Review

DOI 10.1016/j.cpr.2012.02.002PMC PMC3340453

Open this paper in CoChat — free account

Abstract

Exposure to traumatic stress is associated with increased risk for posttraumatic stress disorder (PTSD) and alterations of hypothalamic-pituitary-adrenocortical (HPA) function. Research linking traumatic stress with HPA function in PTSD has been inconsistent, however, in part due to (a) the inclusion of trauma-exposed individuals without PTSD (TE) in control groups and (b) a failure to consider comorbid major depressive disorder (MDD) and moderating variables. This meta-analysis of 47 studies (123 effect sizes, N=6008 individuals) revealed that daily cortisol output was lower for PTSD (d=-.36, SE=.15, p=.008) and PTSD+MDD (d=-.65, SE=.25, p=.008) groups relative to no trauma controls (NTC); TE and NTC groups did not differ significantly from each other. Afternoon/evening cortisol was lower in TE (d=-.25, SE=.09, p=.007) and PTSD (d=-.27, SE=.12, p=.021) groups and higher in PTSD+MDD groups (d=.49, SE=.24, p=.041) relative to NTC. Post-DST cortisol levels were lower in PTSD (d=-.40, SE=.12, p<.001), PTSD+MDD (d=-.65, SE=.14, p<.001), and TE groups (d=-.53, SE=.14, p<.001) relative to NTC. HPA effect sizes were moderated by age, sex, time since index event, and developmental timing of trauma exposure. These findings suggest that enhanced HPA feedback function may be a marker of trauma-exposure rather than a specific mechanism of vulnerability for PTSD, whereas lower daily cortisol output may be associated with PTSD in particular.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1016/j.cpr.2012.02.002

Cites

173 of 173 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences
Cohen, P., Cohen, P., West, S. G., & Aiken, L. S. (2014) · Psychology Press eBooks · doi:10.4324/9781410606266 · Cited by 20,870
Diagnostic and Statistical Manual of Mental Disorders.
Widiger, T. A. (2000) · Oxford University Press eBooks · doi:10.1037/10518-009 · Cited by 19,766
Diagnostic and Statistical Manual of Mental Disorders
&NA; (1988) · Alzheimer Disease & Associated Disorders · doi:10.1097/00002093-198802020-00022 · Cited by 12,603
Posttraumatic Stress Disorder in the National Comorbidity Survey
Kessler, R. C. (1995) · Archives of General Psychiatry · doi:10.1001/archpsyc.1995.03950240066012 · Cited by 10,379
Book Reviews: Statistical Methods for Meta-Analysis Larry V. Hedges and Ingram Olkin New York: Academic Press, 1985. xxii + 369 pp
Wasserman, S. S., Hedges, L. V., & Olkin, I. (1988) · Journal of Educational Statistics · doi:10.2307/1164953 · Cited by 10,377
Untitled work
(2000) · Cited by 9,198
How do glucocorticoids influence stress responses? Integrating permissive, suppressive, stimulatory, and preparative actions
Sapolsky, R. M., Romero, L. M., & Munck, A. U. (2000) · Endocrine Reviews · doi:10.1210/edrv.21.1.0389 · Cited by 7,541
How Do Glucocorticoids Influence Stress Responses? Integrating Permissive, Suppressive, Stimulatory, and Preparative Actions
Sapolsky, R. M. (2000) · Endocrine Reviews · doi:10.1210/er.21.1.55 · Cited by 7,533

Flagged first, then by citations

Show all 173 references

Research works printed but not linked: 1

*Lemieux, A.M. (1998). Abuse-related posttraumatic stress disorder: Challenge to the norepinephrine-to-cortisol hypothesis (Doctoral dissertation, University of Wisconsin, Madison). Dissertation Abstracts International, 59(2B), 0908.

Sorted by citations

Items 301–400 of 466

Lifetime stress and war exposure timing may predict methylation changes at NR3C1 based on a pilot study in a warrior cohort in a small‐scale society in Kenya
Straight, B., Fisher, G., Needham, B. L., Naugle, A. E., Olungah, C. O., Wanitjirattikal, P., Root, C., Farman, J., Barkman, T. J., & Lalancette, C. (2020) · American Journal of Human Biology · doi:10.1002/ajhb.23515 · Cited by 9
Associations of trauma and posttraumatic stress disorder with aldosterone in women
Nishimi, K. M., Adler, G. K., Roberts, A. L., Sumner, J. A., Jung, S. J., Chen, Q., Tworoger, S. S., Koenen, K. C., & Kubzansky, L. D. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105341 · Cited by 11
Psychoneuroendocrinology and Clinical Psychology
Fischer, S., & Ehlert, U. (2019) · Clinical Psychology in Europe · doi:10.32872/cpe.v1i2.33030 · Cited by 10
Adverse childhood experiences as precursors to cannabis use in adulthood: A systematic review
Collazos, K. S. G., Havanur, A., Santis, J. P. D., Baral, A., & Vidot, D. C. (2024) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.106889 · Cited by 9
Early prenatal but not postnatal glucocorticoid exposure is associated with enhanced HPA axis activity into adulthood in a wild primate
Anzà, S., Heistermann, M., Ostner, J., & Schülke, O. (2025) · Proceedings of the Royal Society B Biological Sciences · doi:10.1098/rspb.2024.2418 · Cited by 8
“Likewise, in humans blunted HPA axis responses are found in post-traumatic stress disorder [62], high life event schedule score individuals [63] and after suffering adverse parenting [64].”
Stress hormone response to the DEX–CRH test and its relation to psychotherapy outcome in panic disorder patients with and without agoraphobia
Wichmann, S., Bornstein, S. R., Lorenz, T., & Petrowski, K. (2018) · Translational Psychiatry · doi:10.1038/s41398-017-0081-7 · Cited by 11
Adrenocorticotrophin
Soto-Rivera, C. L., & Majzoub, J. A. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-804169-7.00003-9 · Cited by 9
Progress in Personalized Psychiatric Therapy with the Example of Using Intranasal Oxytocin in PTSD Treatment
Szafoni, S., & Piegza, M. J. (2022) · Journal of Personalized Medicine · doi:10.3390/jpm12071067 · Cited by 10
Characteristics of objective daytime sleep among individuals with earthquake-related posttraumatic stress disorder: A pilot community-based polysomnographic and multiple sleep latency test study
Zhang, Y., Li, Y., Zhu, H., Cui, H., Qiu, C., Tang, X., & Zhang, W. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.09.030 · Cited by 10
Circumcision does not alter long-term glucocorticoids accumulation or psychological effects associated with trauma- and stressor-related disorders
Ullmann, E., Licinio, J., Barthel, A., Petrowski, K., Oratovski, B., Tobias Stalder, A., Kirschbaum, C., & Bornstein, S. R. (2017) · Translational Psychiatry · doi:10.1038/tp.2017.23 · Cited by 9
Co-occurring childhood maltreatment exposure and depressive symptoms in adulthood: Testing differential effects of stress dysregulation and perceived stress
Mishra, A. A., & Marceau, K. (2019) · Aging & Mental Health · doi:10.1080/13607863.2019.1619166 · Cited by 9
The researcher's guide to selecting biomarkers in mental health studies
Verhoeven, J. E., Wolkowitz, O. M., Satz, I. B., Conklin, Q. A., Lamers, F., Lavebratt, C., Lin, J., Lindqvist, D., Mayer, S. E., Melas, P. A., et al. (2024) · BioEssays · doi:10.1002/bies.202300246 · Cited by 10
“[52] Heterogeneous findings may result from sample variations in clinical subtypes, [53] comorbidity, [54] and trauma exposure and its timing.”
Post-Traumatic Stress Disorder (PTSD) and Cardiovascular Diseases: A Systematic Review and Meta-Analysis
Nakhebi, O. A. S. A., Kalinovic, R., Neda-Stepan, O., Giurgi-Oncu, C., Crișan, C., ENĂTESCU, V. R., & Marinescu, I. P. (2025) · European Psychiatry · doi:10.1192/j.eurpsy.2026.10241 · Cited by 8
The Relationship between Allostasis and Mental Health Patterns in a Pre-Deployment French Military Cohort
Trousselard, M., Claverie, D., Fromage, D., Becker, C., Houël, J.-G., Benoliel, J. J., & Canini, F. (2021) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe11040090 · Cited by 10
“An increase in nocturnal urinary cortisol excretion is difficult to detect in PTSD subjects [76], and the archetypal description suggests low HPA activity [77,78].”
Background
Basal blood DHEA-S/cortisol levels predicts EMDR treatment response in adolescents with PTSD
Usta, M. B., Gumus, Y., Say, G. N., Bozkurt, A., Şahin, B., & Karabekiroğlu, K. (2017) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2017.1406984 · Cited by 8
“In a meta-analysis of 16 studies that examined the effects on the HPA axis of comorbid MDD in adult patients with PTSD, high morning cortisol levels were determined in the group with PTSD and comorbid MDD compared to a group not exposed to trauma and low cortisol levels were determined in the group with PTSD only comp…”
Method
Mathematical modeling of depressive disorders: Circadian driving, bistability and dynamical transitions
Cheng, X., D'Orsogna, M. R., & Chou, T. (2020) · Computational and Structural Biotechnology Journal · doi:10.1016/j.csbj.2020.10.035 · Cited by 8
The association between body mass index and recovery from post-traumatic stress disorder after the nuclear accident in Fukushima
Nagai, M., Ohira, T., Maeda, M., Yasumura, S., Miura, I., Itagaki, S., Harigane, M., Takase, K., Yabe, H., Sakai, A., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-84644-5 · Cited by 8
Post-Traumatic Stress Disorder: An Under-Diagnosed and Under-Treated Entity
Wimalawansa, S. S. (2013) · Cited by 8
Hair Cortisol as a Marker of Intergenerational Heritage of War? A Study of Veterans and Their Offspring
Castro-Vale, I., van Rossum, E. F. C., Staufenbiel, S. M., Severo, M., Mota‐Cardoso, R., & Carvalho, D. M. (2020) · Psychiatry Investigation · doi:10.30773/pi.2020.0212 · Cited by 9
Shyness, hormones, and quality of life among adults with schizophrenia
Khalesi, Z., Jetha, M. K., Poole, K. L., Goldberg, J. O., Lieshout, R. J. V., & Schmidt, L. A. (2018) · International Journal of Neuroscience · doi:10.1080/00207454.2018.1543293 · Cited by 8
“Previous literature has also found that relatively lower baseline cortisol levels are associated with documented exposure to trauma and is thought to reflect an eventual downregulation of the HPA axis after its prolonged overactivation (which leads to high cortisol levels) [26,29].”
BackgroundResult
The use of biomarkers as measures of PTSD treatment efficacy and predictors of treatment outcomes: A systematic review
Cao-Noya, J. A., Canovas, C. A., & Benuto, L. T. (2025) · Clinical Psychology Review · doi:10.1016/j.cpr.2025.102579 · Cited by 7
Effect of post-traumatic stress disorder on type 2 diabetes and the mediated effect of obesity: a Mendelian randomization study
Yu, Y., Hu, G., Yang, X., Bai, S., Wu, J., Tong, K., & Yu, R. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1375068 · Cited by 7
“Secondly, dysregulation of the HPA axis was identi ﬁ ed as one of the mechanisms involved in the development and progression of PTSD (35), and it is similarly implicated in the pathogenesis of T2D.”
Background
A cluster analytic approach to examining the role of cortisol in the development of post-traumatic stress and dysphoria in adult traumatic injury survivors
Jayan, D., deRoon‐Cassini, T. A., Sauber, G., Hillard, C. J., & Fitzgerald, J. M. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105450 · Cited by 7
“For instance, systematic reviews of cross-sectional research suggest that individuals diagnosed with PTSD have lower cortisol (e.g., hypocortisolism) measured in saliva, urine, and blood compared to non-traumatized and/or traumatized controls (Morris et al., 2012, Pitman et al., 2012).”
BackgroundResultInfluential
Development of a pain neuroscience education program for post-traumatic stress disorder and pain
Benedict, T., Nitz, A. J., Abt, J. P., & Louw, A. (2019) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2019.1633717 · Cited by 7
“…examples; 2) sensitization of the nervous system (Louw and Puentedura, 2013); 3) hypervigilance from stress hormones (Hannibal and Bishop, 2014; Morris, Compas, and Garber, 2012; Schell, Marshall, and Jaycox, 2004); 4) re-experiencing trauma and pain memories from a neuromatrix perspective…”
Background
A Preliminary Examination of Endogenous Peripheral Oxytocin in a Pilot Randomized Clinical Trial of Oxytocin-Enhanced Psychotherapy for Posttraumatic Stress Disorder
Sippel, L. M., King, C. E., Wahlquist, A. E., & Flanagan, J. C. (2020) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000001226 · Cited by 7
Self-compassion and social stress: Links with subjective stress and cortisol responses
Ketay, S., Beck, L. A., & Dajci, J. (2022) · Self and Identity · doi:10.1080/15298868.2022.2117733 · Cited by 6
“For example, a majority of studies have shown blunted cortisol reactivity in people with posttraumatic stress disorder (Morris et al., 2012).”
Background
Cortisol Responses to Psychosocial Stress: The Role of Childhood Maltreatment and Depression.
Rao, U., & Morris, M. C. (2015) · PubMed · Cited by 6
Self-citation
The Dehydroepiandrosterone Awakening Response as a Possible Index of Subjective Sleep Quality
Hasegawa‐Ohira, M., Suguri, K., & Nomura, S. (2016) · Advanced Biomedical Engineering · doi:10.14326/abe.5.132 · Cited by 6
“On the other hand, the response decreases in patients with post-traumatic stress disorder [4] and chronic fatigue syndrome [5].”
Background
Psychological factors of cardiometabolic risk: History and modern state
Alekhin, A. N., & Трифонова, Е. А. (2012) · Arterial’naya Gipertenziya (Arterial Hypertension) · doi:10.18705/1607-419x-2012-18-4-278-291 · Cited by 6
Supplementary Pharmacotherapy for the Behavioral Abnormalities Caused by Stressors in Humans, Focused on Post-Traumatic Stress Disorder (PTSD)
Fessel, J. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12041680 · Cited by 6
“Further, a meta-analysis involving 47 studies and 6008 subjects showed that those with PTSD had a lower daily cortisol output [62].”
Background
Using experimental methodologies to assess posttraumatic stress
Jovanovic, T., Rauch, S. A., Rothbaum, A. O., & Rothbaum, B. O. (2017) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2016.10.001 · Cited by 5
Transcutaneous vagal nerve stimulation for the treatment of trauma- and stressor-related disorders: systematic review of randomised controlled studies
Benzouak, T., Danyluck, C. M., Gunpat, S., Amougou, S. E., Hamoudeh, R. A., Prudencio-Brunello, M. A., Nachabe, J., Edwin, F., Kisely, S. R., & Rao, S. (2025) · BJPsych Open · doi:10.1192/bjo.2025.10057 · Cited by 5
“21,29,30 Indeed, both SNS and PNS systems are known to modulate stress 31 and trauma responses, and alterations in their activity within the context of PTSD result in greater symptom severity.”
From shared mechanisms to treatment gaps: a review of the comorbidity between eating disorders and PTSD
Ouyang, H., Wang, Y., & Chen, J. (2025) · Journal of Eating Disorders · doi:10.1186/s40337-025-01454-0 · Cited by 6
“Several studies have also reported increased glucocorticoid receptor sensitivity in individuals with PTSD, contributing to a blunted stress response and exaggerated negative feedback inhibition [37–40].”
Exogenous glucocorticoids to improve extinction learning for post-traumatic stress disorder patients with hypothalamic–pituitary–adrenal-axis dysregulation: a study protocol description
de Nooij, L., Wirz, L., Heling, E., Pais, M., Hendriks, G., Verkes, R., Roozendaal, B., & Hermans, E. J. (2024) · European Journal of Psychotraumatology · doi:10.1080/20008066.2024.2364441 · Cited by 5
“Although most meta-analyses support this notion of HPA-axis dysregulation (Meewisse et al., 2007; Morris et al., 2012; Pan et al., 2018), another meta-analysis (Klaassens et al., 2012) and multiple studies that failed to replicate these findings suggest that low cortisol may only be observed under…”
Result
Somatic Health Issues in Trauma-Related Disorders: Effects on Psychobiological Axes Affecting Mental and Physical Health
King, A. P. J. (2018) · Integrating psychiatry and primary care · doi:10.1007/978-3-319-74736-1_10 · Cited by 6
Maternal Behavior Affects Child’s Attachment-Related Cortisol Stress Response
Köhler‐Dauner, F., Fegert, J. M., Buchheim, A., Krause, S., Gündel, H., Waller, C., Waller, C., & Ziegenhain, U. (2019) · Journal of Child and Adolescent Psychiatry · doi:10.14302/issn.2643-6655.jcap-19-2737 · Cited by 8
The Psychiatric Comorbidity in Disaster Victims with PTSD: Comorbidity Rates, Severity of Psychological Disorders and Factors Predicting Comorbidities
Sim, K. (2019) · Korean Journal of Stress Research · doi:10.17547/kjsr.2019.27.3.259 · Cited by 6
“반면, PTSD 집단과 PTSD와 주요우울증 공존 집단에 서는 증가한 HPA 피드백 억제가 관찰된다(Morris et al., 2012).”
Influential
Long-term consequences of interpersonal violence experiences on treatment engagement and health status in people living with HIV.
Budd, A. S., Krentz, H., Rubin, L., Power, C., Gill, M., & Fujiwara, E. (2020) · AIDS (London) · doi:10.1097/qad.0000000000002798 · Cited by 4
“Chronic HPA axis activation has been linked to the development of posttraumatic stress disorder and major depressive disorder, conditions that amplify further HPA axis dysregulation [31].”
Background
Maternal stress and mental health before pregnancy and offspring diurnal cortisol in early childhood
Guardino, C. M., Rahal, D., Rinne, G. R., Mahrer, N. E., Davis, E. P., Adam, E. K., Shalowitz, M. U., Ramey, S. L., & Schetter, C. D. (2022) · Developmental Psychobiology · doi:10.1002/dev.22314 · Cited by 5
A systematic review of the pharmacological modulation of autobiographical memory specificity
Cawley, E., Piazza, G. G., Das, R., & Kamboj, S. K. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.1045217 · Cited by 5
“PTSD with and without MDD is associated with lower daily cortisol output relative to non-trauma exposed controls, with general trauma exposure associated with enhanced HPA feedback (Morris et al., 2012; Rauch et al., 2020).”
Background
It’s all in the hair: Association between changes in hair cortisol concentrations in reaction to the COVID-19 pandemic and post-traumatic stress symptoms in children over time
Bilodeau-Houle, A., Raymond, C., & Marin, M. (2024) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2024.107019 · Cited by 4
“Although findings differ across studies, daily cortisol is generally reduced in adults with PTSD compared to non-trauma-exposed individuals (Morris et al., 2012).”
Background
Cardiovascular events in insomnia patients with post-traumatic stress disorder
El-Solh, A., Lawson, Y., & Attai, P. (2022) · Sleep Medicine · doi:10.1016/j.sleep.2022.07.014 · Cited by 4
Trauma-induced human glucocorticoid receptor expression increases predict subsequent HPA-axis blunting in a prospective longitudinal design
de Voogd, L. D., Kampen, R. A., Kaldewaij, R., Zhang, W., Hashemi, M. M., Koch, S. B. J., Klumpers, F., Glennon, J. C., & Roelofs, K. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105909 · Cited by 4
Perceived parental depression, intrusive rumination, and internalizing problems: A three-wave longitudinal study in adolescents
Wang, X., Yang, X., & Zhou, X. (2023) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2023.100366 · Cited by 5
Trauma Exposure: Consequences to Maternal and Offspring Stress Systems
Martinez‐Torteya, C., D’Amico, J., & Gilchrist, M. (2017) · Integrating psychiatry and primary care · doi:10.1007/978-3-319-65724-0_6 · Cited by 3
Psychobiologische Aspekte der Traumafolgestörungen
Ehrenthal, J. C., Stoffel, M., & Ditzen, B. (2019) · PiD - Psychotherapie im Dialog · doi:10.1055/a-0771-4890 · Cited by 4
“Im Gegenzug sind insbesondere traumatische Kindheitserfahrungen mit einer Hypoaktivität der Kortisolreaktion assoziiert [8].”
Background
Four Decades after War: Incident Diabetes among Women Vietnam-Era Veterans in the HealthViEWS Study
Schmidt, E. M., Magruder, K. M., Kilbourne, A. M., Stock, E. M., Cypel, Y., Félix, S. E. B., Serpi, T., Kimerling, R. E., Cohen, B. E., Spiro, A., et al. (2019) · Women s Health Issues · doi:10.1016/j.whi.2019.08.002 · Cited by 4
Psychological and Sociodemographic Variables related to Cortisol in Hair in Spanish Healthy Population
García, L. A., Pérez, R. G., Extremera, A. H., García‐León, M. Á., & Peralta‐Ramírez, M. I. (2020) · The Spanish Journal of Psychology · doi:10.1017/sjp.2020.16 · Cited by 4
How insights from posttraumatic stress disorder can inform treatment of functional neurological disorder
Putica, A., Agathos, J. A., & Felmingham, K. L. (2025) · Nature Reviews Psychology · doi:10.1038/s44159-025-00479-1 · Cited by 6
Blunted arginine vasopressin secretion in individuals experiencing a major depressive episode with comorbid post‐traumatic stress disorder: Results from an exploratory study using copeptin as a surrogate marker
Hu, H., Lee, Y., Tillman, A. N., Ballard, E. D., Waldman, L. R., Yuan, P., Johnston, J. N., Peng, S., Kvarta, M. D., Verbalis, J. G., et al. (2026) · Journal of Neuroendocrinology · doi:10.1111/jne.70133 · Cited by 3
“67 If the latter, vasopressi-nergic attenuation may be another biological imprinting effect of traumatic stress accompanying HPA-axis changes, particularly when the traumatic stress occurs in vulnerable individuals who develop post-traumatic stress and affective symptoms.”
Endocannabinoids, cortisol, and development of post-traumatic psychopathological trajectories
Jayan, D., Timmer‐Murillo, S. C., Fitzgerald, J. M., Hillard, C. J., & deRoon‐Cassini, T. A. (2023) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2023.11.002 · Cited by 3
Exploring the dissociative subtype of PTSD: The role of early-life trauma, cortisol, and inflammatory profiles
Jarkas, D., Robillard, R., Malenfant, C.-R., Richards, C., Lanthier, M., Beaurepaire, C., Nicholson, A. A., Jaworska, N., Cassidy, C., Shlik, J., et al. (2025) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2025.107406 · Cited by 4
“In line with these findings, evening cortisol levels in individuals with comorbid depression and PTSD was higher compared to no trauma controls (Morris et al., 2012).”
The Neurobiology of Bullying Victimization
Vaillancourt, T. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316847992.011 · Cited by 3
Intact GR dimerization is critical for restraining plasma ACTH levels during chronic psychosocial stress
Langgartner, D., Koenen, M., Kupfer, S., Glogger, L., Kurz, L., Perez‐Rivas, L. G., Theodoropoulou, M., Noll‐Hussong, M., Vettorazzi, S., Tuckermann, J. P., et al. (2023) · Neurobiology of Stress · doi:10.1016/j.ynstr.2023.100541 · Cited by 3
“In contrast, PTSD patients typically show decreased baseline and 24h average plasma cortisol concentrations, probably mediated by an increased negative feedback sensitivity of the HPA axis (Lehrner et al., 2016; Morris et al., 2012; de Kloet et al., 2006).”
Background
The Neuroimmune System in Psychiatric Disorders
Hassan, Y., ESTEVES, S. C., Leyrer‐Jackson, J. M., & Thomas, M. P. (2024) · Springer eBooks · doi:10.1007/978-3-031-68237-7_56 · Cited by 2
Effects of Subanesthetic Intravenous Ketamine Infusion on Stress Hormones and Synaptic Density in Rats with Mild Closed-Head Injury
Boese, M., Berman, R. Y., Spencer, H. F., Rujan, O. L., Metz, E., Radford, K. D., & Choi, K. H. (2025) · Biomedicines · doi:10.3390/biomedicines13040787 · Cited by 3
Intimate Partner Violence, Mental Health, and HPA Axis Functioning
Bogat, G. A., Martinez‐Torteya, C., Levendosky, A. A., von Eye, A., & Lonstein, J. S. (2016) · Journal for Person-Oriented Research · doi:10.17505/jpor.2016.11 · Cited by 3
Epigenetics in Posttraumatic Stress Disorder
Hunter, R. G. (2014) · Elsevier eBooks · doi:10.1016/b978-0-12-417114-5.00016-4 · Cited by 3
Examining the Relationships Between Chronic Stress, HPA Axis Activity, and Depression in a Prospective and Longitudinal Study of Medical Internship
Mayer, S. E. (2017) · Deep Blue (University of Michigan) · Cited by 4
Relationships Among Number of Stressors, Perceived Stress, and Salivary Cortisol Levels During the Third Trimester of Pregnancy
Salomon, R. E., & Weiss, S. J. (2023) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1016/j.jogn.2023.11.005 · Cited by 2
Corticosteroid-induced gene expression is attenuated in the hippocampus of mice with model of post-traumatic stress disorder
Vasyl, R. R., Haran, B., Lahuta, T., Liberzon, I., & Dosenko, V. (2025) · Brain Research · doi:10.1016/j.brainres.2025.149760 · Cited by 2
Everyday stress-induced neurobehavioral dysregulation: therapeutic targets for management with Neurexan
Duller, S., Clarke, G. A., Herculano‐Houzel, S., von Känel, R., Kirsch, P., Landolt, H., Naschold, B., Reber, S. O., Schreiber, R., Walter, M., et al. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1577689 · Cited by 7
“Increased HPA activity has been observed in anxiety, schizophrenia, and bipolar disorder, whereas decreased HPA activity has been observed in burnout, some forms of depression, and PTSD (93 – 95).”
Epidemiological Link Between Post-traumatic Stress Disorder and Cardiovascular Disease: Evidence, Mechanisms, and Clinical Implications
Al-Ariki, M. K., Karpenko, I. G., Esion, G., Djumanov, A. K., Dadaev, S., Saghir, H., Khorunzhaya, D., Kurant, Z., Gevorgian, V., Badlaeva, A. V., et al. (2025) · Cureus · doi:10.7759/cureus.100379 · Cited by 2
“A meta-analysis of HPA axis activity in PTSD found consistent evidence of reduced morning cortisol concentrations and heightened sensitivity of the glucocorticoid receptor system, suggesting altered negative feedback regulation [53].”
Early Cortisol and Inflammatory Responses to Parental Cancer and Their Impact on Functional Impairment in Youth
Hayes, B., Brent, J., Zhong, Y., Bazmi, S., Porta, G., Bovbjerg, D. H., Tarhini, A. A., Kirkwood, J. M., Brent, D. A., Marsland, A. L., et al. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10040576 · Cited by 2
The Neuroimmune System in Psychiatric Disorders
Leyrer‐Jackson, J. M., DeKrey, G. K., & Thomas, M. P. (2016) · Springer eBooks · doi:10.1007/978-3-319-44022-4_39 · Cited by 2
Physiological and Biological Testing and Assessment of Post-Traumatic Stress Disorder
Bulut, S., Salmanova, K., Crescenzo, P., & Bulut, N. (2023) · Avances en Psicología Latinoamericana · doi:10.12804/revistas.urosario.edu.co/apl/a.8258 · Cited by 2
“In contrast, this issue has become an increasing concern of biological researchers in the last decade (Morris et al., 2012; Zoladz & Diamond, 2013).”
Background
Silymarin Potentiates the Effect of Buspirone on Anxiety and Depressive-Like Behaviors Induced by Chronic Restraint Stress in Male Mice
Rajabi, S., Nayebi, A. M., Khabbaz, A., Hosseinzadeh, N., Hosseini, L., & Naebi, S. M. (2023) · Biomedical Research Bulletin · doi:10.34172/biomedrb.2023.09 · Cited by 2
“51 Previous studies have pointed out that stressful events, especially chronic RS, can cause the dysregulation of this axis by disrupting the harmful feedback activity.”
Background
A comparative study on hair cortisol concentration among generalized anxiety disorder patients with and without alcohol dependence syndrome presenting to a tertiary care center: A pilot study
Bijjal, S. S., Huchegowda, R., Gowda, S. H., Harbishettar, V., Deshpande, S., Sharma, M. K., & Raju, G. M. (2024) · Indian Journal of Psychiatry · doi:10.4103/indianjpsychiatry.indianjpsychiatry_520_24 · Cited by 2
“[8] Use of behavioral rehabilitation and pharmacological treatments for GAD has resulted in lowering cortisol levels.”
Fight or Flight: A Temporal-Causal Analysis of the Behavior of a Bully-Victim
Hirzalla, N. A., Maaiveld, T. M., & Jabeen, F. (2019) · Lecture notes in computer science · doi:10.1007/978-3-030-28377-3_13 · Cited by 2
A Review of the Effects of Prolonged Exposure to Cortisol on the Regulation of the HPA Axis: Implications for the Development and Maintenance of Posttraumatic Stress Disorder
Cranston, C. C. (2014) · The New School psychology bulletin · Cited by 2
Understanding and Treating Posttraumatic Stress Disorder (PTSD) in Veterans
McCaslin, S. E., Ortigo, K. M., Simon, E., & Ruzek, J. I. (2018) · Springer eBooks · doi:10.1007/978-1-4939-7438-2_15 · Cited by 2
Physiology and miRNA expression in confined sows with different pupillary light reflex
Wang, L., Yu, L., & Yin, G. (2021) · Italian Journal of Animal Science · doi:10.1080/1828051x.2021.1895680 · Cited by 2
“This leads to increased activity of the hypothalamic–pituitary–adrenal axis and the release of glucocorticoids (Morris et al. 2012).”
Background
Neurobiological Changes in Posttraumatic Stress Disorder and Their Reversibility by Psychotherapy
Fischer, S., Schumacher, S., & Daniels, J. K. (2022) · Zeitschrift für Klinische Psychologie und Psychotherapie · doi:10.1026/1616-3443/a000650 · Cited by 2
Future Directions in Vitamin D Research in Psychiatry
Ross, C. A. (2017) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000731 · Cited by 2
“, 2011; McCann and Ames, 2008); and 2) vitamin D blood levels are frequently deficient in the general population throughout the world, and in psychiatric populations, irrespective of diagnosis (Alazzeh et al., 2015; Cannell, 2008; Gracious et al., 2012; Humble et al., 2010; Jorde et al., 2008; Kjaergaard et al., 2012;…”
Background
Hypothalamic-Pituitary-Adrenal Axis, Psychobiology of
Kuepper, Y. (2015) · Elsevier eBooks · doi:10.1016/b978-0-08-097086-8.55028-4 · Cited by 2
Case of Asperger's Syndrome and Lesion of the Right Amygdala: Deficits in Implicit and Explicit Fearful Face Recognition
Koelkebeck, K., Bauer, J., Suslow, T., & Ohrmann, P. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.677549 · Cited by 1
“(fearful and angry emotional faces) (Morris et al., 2012; Todorov, 2012) especially when stimuli are masked and thus presented subliminally (Whalen et al.”
Background
Mothers’ psychopathology and their adult offspring’s cortisol level in a Rwandan sample
Ingabire, M., Caparos, S., Rutembesa, E., & Blanchette, I. (2025) · South African Journal of Psychiatry · doi:10.4102/sajpsychiatry.v31i0.2410 · Cited by 1
“22,23 Several studies have shown lower basal cortisol levels among offspring of Holocaust survivors whose parents had PTSD in comparison to control groups of Jews.”
Pre-Reproductive Excessive Alcohol and Maternal Immune Activation Differentially Affect Offspring Behavior, Neurobiology, and Brain Volume in a Sex-Dependent Manner
Ott, A., Ghiradello, O., Tanev, K. S., Altschueler, J., Gül, A. Z., Kruschke, Z., Müller, S., Koch, S., Boehm‐Sturm, P., Winter, C., et al. (2025) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2025.111550 · Cited by 1
Factors Associated with Posttraumatic Stress Disorder in Patients with Major Depressive Disorder
Zinchuk, M., Druzhkova, T. A., Mishin, I. N., Zhanina, M. Y., Popova, S. B., Guekht, A. B., & Gulyaeva, N. V. (2025) · Neurochemical Journal · doi:10.1134/s1819712425700540 · Cited by 1
Functional state of women with psycho-emotional disorders during the russian-ukrainian war
Наскалова, С., Bondarenko, O. V., Mekhova, L., & Solonko, L. P. (2025) · Fìzìologìčnij žurnal · doi:10.15407/fz71.05.013 · Cited by 1
Posttraumatic Stress Disorder: A Milligram of Prevention for a Life-Long Problem?
Parker, R. O., & Sappenfield, J. W. (2025) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000007890 · Cited by 1
Hair cortisol concentrations among youth in Ukraine: Associations with war experiences and post-traumatic-stress symptoms
Skinner, A. T., Павлова, Ю., Godwin, J. W., Reilly, E. B., & Georgiades, A. (2026) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2026.107761 · Cited by 1
Hypothalamic-pituitary-adrenal axis attenuation following child sexual abuse distinguishes posttraumatic stress trajectories from late adolescence to midlife
Swerbenski, H. G., Li, Z., Putnam, F. W., Russotti, J. M., & Noll, J. G. (2026) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2026.107782 · Cited by 1
Cumulative trauma, neural circuits, and burnout: an integrative model of healthcare worker post-traumatic stress syndromes
Taren, A. A., & Paulus, M. P. (2026) · European Journal of Psychotraumatology · doi:10.1080/20008066.2026.2636453 · Cited by 1
“Acute trauma typically provokes an increase in cortisol, but PTSD has been paradoxically associated with lower basal cortisol and exaggerated negative feedback sensitivity over time (Morris et al., 2012; Pan et al., 2018).”
The emerging role of T cells in depression
Wang, H., Tao, H., Yuan, M., & Zhang, W. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1780383 · Cited by 1
A genome‐wide association study of post‐traumatic stress disorder in traumatised Chinese populations
Zhang, K., Gao, M., Cao, C., Yuwei, H. A. N., Liu, P., Bi, Y., Yang, H., Xu, L., & Wang, L. (2026) · General Psychiatry · doi:10.1002/gps3.70006 · Cited by 1
“8 Other associations, such as the association between PTSD and kidney tissue gene expression profiles, are novel and need to be further explored and validated.”
A Universal, Neurodiversity Affirming, and Trauma-Informed Model for IVF Psychological Support: Bancroft's Hope Affirm Thrive Model
Bancroft, E., & Spicer, L. (2026) · Neurodiversity · doi:10.1177/27546330261428233 · Cited by 1
Biological and neurocognitive correlates of comorbid post-traumatic stress disorder and alcohol use disorder: a systematic review
Towers, E., Hoffman, J., Louie, E., Dali, G., Logge, W., Mills, K., & Morley, K. C. (2026) · European Journal of Psychotraumatology · doi:10.1080/20008066.2026.2640736 · Cited by 2
“Abnormalities in this neuroendocrine sys-tem have been found in PTSD (Metz et al., 2020; Morris et al., 2012; Yehuda et al., 1995), AUD (Bernardy et al., 1996; Errico et al., 1993; Sinha et al., 2009), and PTSD & AUD (Brady, Waldrop, et al., 2006; Forkus et al., 2024).”
Stress and resilience: cortisol hypo-response to acute stress in non-resilient individuals
Riske, N. D., Schenk, C., Ahrens, K. F., Kollmann, B., Weichert, D., Steinbach, N., Burlage, J. F., Freudenberg, F., Lieb, K., Kalisch, R., et al. (2026) · Journal of Neural Transmission · doi:10.1007/s00702-026-03218-9 · Cited by 1
“Overall, the predominant finding is a dysregulated HPA axis in PTSD patients, characterized by lower cortisol output and hypo-responsiveness (Morris et al. 2012).”
Corticotropin-Releasing Hormone Receptor 1 (CRHR1) Polymorphisms and Post-Traumatic Stress Disorder
Lind, M. J., Sawyers, C. K., Sheerin, C. M., & Amstadter, A. B. (2016) · Springer eBooks · doi:10.1007/978-3-319-08359-9_9 · Cited by 1
„Old Friends“, Immunregulation und Stressresilienz
Langgartner, D., Lowry, C. A., & Reber, S. O. (2020) · Nervenheilkunde · doi:10.1055/a-1037-0710 · Cited by 1
Rôle des mécanismes épigénétiques dans le développement et la transmission des traumas psychiques
Benarous, X., & Cohen, D. (2020) · Corps & Psychisme · doi:10.3917/cpsy2.075.0023 · Cited by 1
Adjustment Disorder
Bachem, R. (2022) · Springer eBooks · doi:10.1007/978-3-662-64057-9_5 · Cited by 1
Anpassungsstörung
Bachem, R. (2019) · Springer eBooks · doi:10.1007/978-3-662-58470-5_5 · Cited by 1
Posttraumatic stress disorder in patients with cardiovascular diseases
Solonovych, A. S., Solonovych, O. S., & Yepanchintseva, O. A. (2023) · Cardiac Surgery and Interventional Cardiology · doi:10.31928/2305-3127-2022.3-4.1525 · Cited by 1
Do weighted blankets improve sleep among children with a history of maltreatment? A randomized controlled crossover trial
Cifre, A. B., Vieira, A., Baker, C. D., Myers, A. M., Rech, M., Kim, J., Zhang, Y., & Alfano, C. A. (2024) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.11152 · Cited by 1
“31,32 Accordingly, hyperarousal is one pathway through which adversity is theo-rized to give rise to insomnia and other forms of sleep-wake dysregulation.”
Disorders Specifically Associated with Stress: PTSD, Complex PTSD, Prolonged Grief Disorder, Acute Stress Reaction, Adjustment Disorder
Blakey, S. M., Dillon, K. H., McFARLANE, A. C., & Beckham, J. C. (2024) · Springer eBooks · doi:10.1007/978-3-030-51366-5_59 · Cited by 1
Female Wistar Kyoto More Immobile rats with genetic stress hyper‐reactivity show enhanced contextual fear memory without deficit in extinction of fear
Harter, A. M., Nemesh, M., Ji, M. T., Lee, L., Yamazaki, A., Kim, C., & Redei, E. E. (2024) · European Journal of Neuroscience · doi:10.1111/ejn.16595 · Cited by 1
Pandemic Stress and Mediation of Depression Symptoms After Traumatic Brain Injury in Women Veterans: A Cross-Sectional Study
Corry, D. T., Sadler, A. G., Mengeling, M. A., Cook, B. L., Smith, J. L., Hamilton, A. B., Platt, J., & Torner, J. C. (2025) · Military Medicine · doi:10.1093/milmed/usaf391 · Cited by 1
Déficit en habilidades gráficas en niños víctimas de maltrato intrafamiliar institucionalizados / Deficit on graphic skills in children victims of institutionalized domestic abuse
Cobos-Cali, M., Ladera, V., Bartolomé, M. V. P., & Garcia, R. G. (2016) · Ciencia Unemi · doi:10.29076/issn.2528-7737vol9iss19.2016pp55-60p · Cited by 1

Authors: Morris, M. C., Compas, B. E., & Garber, J.
Affiliations: Meharry Medical College (US)
Vanderbilt University (US)
Corresponding author: Morris, Matthew C.
ORCID: Morris, Matthew C.
Compas, Bruce E.
Garber, Judy
Venue: Clinical Psychology Review
Publisher: Elsevier BV
Published: 2012-06
Volume: 32
Issue: 4
Pages: 301-315
ISSN: 0272-7358 (ISSN-L)
DOI: 10.1016/j.cpr.2012.02.002
PMC: PMC3340453
OpenAlex: W2158809703
Cited by: 466
References: 173
Citations by year: 2026: 20 · 2025: 21 · 2024: 21 · 2023: 26 · 2022: 30 · 2021: 39 · 2020: 47 · 2019: 42 · 2018: 49 · 2017: 36 · 2016: 40 · 2015: 28 · 2014: 33 · 2013: 30 · 2012: 4
FWCI: 4.39
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Clinical Psychology Review (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Vanderbilt Institute for Clinical and Translational Research
Georgia Clinical and Translational Science Alliance
Department of Science and Technology, Ministry of Science and Technology, India
Commercializations Promotion Agency for R and D Outcomes
National Institutes of Health
Centers for Disease Control and Prevention (R01HM069940)
Institute for Clinical and Translational Research, University of Wisconsin, Madison
National Institute of Mental Health (T32 MH 18921, RC1MH088329, R01MH068391, T32MH018921, R01MH069940, R01MH64735, F31MH084425, R01MH064735)
National Institute on Drug Abuse (R01DA017805)
National Center for Research Resources (G12RR003032, KL2RR024977, TL1RR024978, UL1RR024975)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords: post-traumatic stress disorder, major depressive disorder, comorbidities, hypothalamic-pituitary-adrenal axis, cortisol, trauma exposure, diurnal cortisol rhythm, sex differences, age differences, time since trauma
MeSH terms: Circadian Rhythm, Depressive Disorder, Major, Major Depressive Disorder, Dexamethasone, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Pituitary-Adrenal System, Stress Disorders, Post-Traumatic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Relations among posttraumatic stress disorder, comorbid major depression, and HPA function: A systematic review and meta-analysis

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Self-check

Citations

Cites

Cited by

Related

Metadata

Record

About these checks