Dissociation versus posttraumatic stress: Cortisol and physiological correlates in adults highly exposed to the World Trade Center attack on 9/11
Abstract
Nine months on average after the World Trade Center (WTC) attack, 21 highly exposed adults and 10 healthy controls without major exposure did not differ in cortisol and physiologic measures. Dissociation and posttraumatic stress symptoms were quantified in the exposed group. Dissociation was associated with greater peritraumatic dissociation and, marginally, childhood trauma, lower plasma cortisol levels at 08.00h, and blunted heart rate reactivity to psychosocial stress. Posttraumatic stress was associated with exposure, peritraumatic distress, and early posttraumatic stress, and marginally associated with peritraumatic dissociation; it was not associated with cortisol or physiologic measures. Urinary cortisol differed significantly in its relationship to dissociation versus posttraumatic stress. This small study emphasizes the importance of dissecting the neurobiology of posttraumatic stress versus dissociative traumatic responses.
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Trait dissociation is negatively correlated with heart rate during experimentally-induced social stress.
“studies which have proven that trait dissociation is negatively correlated with heart rate during experimentally-induced social stress (Powers et al., 2021; Simeon et al., 2008).”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Simeon et al., 2008
Simeon et al. (2008) found that trait dissociation correlated negatively and with moderate effect to heart rate (r = −.48, p < .050) measured during the Trier Social Stress Test, but not at baseline (r = −.08, p > .050).
“Using general stress stimuli, Simeon et al. (2008) found that trait dissociation correlated negatively and with moderate effect to HR (r = −.48, p < .050) measured during the TSST but not at baseline (r = −.08, p > .050; for baseline see Supplemental Table S2).”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Simeon et al. (2008)
Simeon et al. (2008) showed neither a correlation for systolic blood pressure (r = −.24, p > .050) nor for diastolic blood pressure (r = −.37, p > .050) during the Trier Social Stress Test.
“One study examining blood pressure under a more general stress stimulus (Simeon et al., 2008) showed neither a correlation for SBP (r = −.24, p > .050) nor for DBP (r = −.37, p > .050) during TSST.”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Simeon et al. (2008)
Simeon et al. (2008) demonstrated a correlation between trait dissociation and systolic blood pressure at baseline (r = −.54, p < .010), but not with diastolic blood pressure (r = −.24, p > .050).
“However, this study demonstrated a correlation between trait dissociation and SBP at baseline (r = −.54, p < .010), but not with DBP (r = −.24, p > .050; for baseline see Supplemental Table S2).”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Simeon et al. (2008)
Two studies using the TSST found a decrease in heart rate during stress induction that was associated with trait dissociation.
“Two studies using TSST (Powers et al., 2021; Simeon et al., 2008) found a decrease in heart rate during stress induction which was associated with trait dissociation”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Simeon et al., 2008
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Objective assessment of peritraumatic dissociation: psychophysiological indicators
(1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.8.1081 · Cited by 347 · see citing works
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Simeon, D., Greenberg, J., Nelson, D., Schmeidler, J., & Hollander, E. (2005) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v66n0212 · Cited by 84 · see citing works
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Evaluation of the evidence for the trauma and fantasy models of dissociation.
Dalenberg, C. J., Brand, B. L., Gleaves, D. H., Dorahy, M. J., Loewenstein, R. J., Cardeña, E., Frewen, P. A., Carlson, E. B., & Spiegel, D. (2012) · Psychological Bulletin · doi:10.1037/a0027447 · Cited by 667 · see citing works
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“which have proven that trait dissociation is negatively correlated with heart rate during experimentally-induced social stress (Powers et al., 2021; Simeon et al., 2008).”
BackgroundResultInfluentialTrauma Sequelae and Cortisol Levels in Women Exposed to Intimate Partner Violence
Basu, A., Levendosky, A. A., & Lonstein, J. S. (2013) · Psychodynamic Psychiatry · doi:10.1521/pdps.2013.41.2.247 · Cited by 44 · see citing works
Prior Peritraumatic Dissociative Experiences Affect Autonomic Reactivity During Trauma Recall
Sledjeski, E. M., & Delahanty, D. L. (2012) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2011.608628 · Cited by 14 · see citing works
- Authors
- Simeon, D., Yehuda, R., Knutelska, M., & Schmeidler, J.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- United States Department of Veterans Affairs (US)
- Corresponding author
- Simeon, Daphne
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2008-12
- Volume
- 161
- Issue
- 3
- Pages
- 325-329
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2067994755
- Cited by
- 38
- References
- 3
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 1 · 2018: 2 · 2017: 3 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 2 · 2012: 10
- FWCI
- 3.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01MH062414, R01 MH62414)
- National Center for Research Resources (MO1-RR-0071, M01RR000071)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- dissociation, post-traumatic stress disorder, World Trade Center attacks, September 11 attacks, cortisol, urinary cortisol, heart rate reactivity, peritraumatic dissociation, peritraumatic distress, childhood trauma, trauma exposure, autonomic nervous system, psychosocial stress
- MeSH terms
- Adult, Arousal, Blood Pressure, Dexamethasone, Dissociative Disorders, Female, Follow-Up Studies, Heart Rate, Humans, Hydrocortisone, Male, New York City, Personality Inventory, Stress Disorders, Post-Traumatic, September 11 Terrorist Attacks
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