Cortisol response to acute trauma and risk of posttraumatic stress disorder
Abstract
This study sought to characterize the variability of the acute cortisol response following trauma and its relationship to posttraumatic stress disorder (PTSD). Forty eight participants were recruited within 24h of a traumatic accident requiring hospital admission. A saliva sample was collected at 08.00 h and 16.00 h 2 days, 1 month and 6 months after hospital admission, together with 24-h urine collection. Participants completed a dexamethasone suppression test (0.5mg DEX at 21.00 h) at each follow up, together with self-report questionnaires. The Clinician Administered PTSD Scale (CAPS) was administered at 1 and 6 months to identify PTSD. Prevalence of PTSD was 27% at 1 month and 21% at 6 months. PTSD symptoms at 6 months were negatively correlated with salivary cortisol at 08.00 h on day 2 (r=-0.36, p=0.04), but positively correlated with 16.00 h cortisols (r=0.41, p=0.03). A lower rise in cortisol at 08.00 h on day 2 was associated with an increase in risk of PTSD at both 1 month (OR=1.411 (1.017, 1.957)) and 6 months (OR=1.411 (1.066, 1.866)). At 1 month, 70% of participants with PTSD suppressed cortisol to more than 90% of pre-dex levels compared with 25% without PTSD (χ(2)=6.77, p=0.034). Urinary cortisol excretion was not different between groups at any time point. The findings support a hypothesis that sensitization of the HPA axis and enhanced suppression of cortisol following the dexamethasone suppression test are established early in the disease process.
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Increased risk of PTSD development is associated with pre-existing dysregulations of (para)sympathetic and hypothalamic-pituitary-adrenal axes.
“An increased risk of PTSD development is associated with pre-existing dysregulations of (para)sympathetic [17,18] and hypothalamic-pituitary-adrenal axes [20,21], as well as dysregulations of central fear responses prior to [22] and shortly after trauma exposure [23,24].”
From Efficacy of oxytocin administration early after psychotrauma in preventing the development of PTSD: study protocol of a randomized controlled trial (2014) · cites this paper as [21]
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- Authors
- McFarlane, A. C., Barton, C. A., Yehuda, R., & Wittert, G.
- Affiliations
- The University of Adelaide (AU)
- Icahn School of Medicine at Mount Sinai (US)
- Corresponding author
- Barton, Christopher A.
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2011-06
- Volume
- 36
- Issue
- 5
- Pages
- 720-727
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W1976650069
- Cited by
- 120
- References
- 22
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 2 · 2023: 3 · 2022: 7 · 2021: 8 · 2020: 11 · 2019: 6 · 2018: 4 · 2017: 8 · 2016: 16 · 2015: 7 · 2014: 11 · 2013: 9 · 2012: 13
- FWCI
- 9.11
- Type
- journal article
- Language
- en
- Update notices
- erratum (2011-11-01)
- Open access
- closed
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Funders
- Royal Adelaide Hospital
- 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, cortisol response, acute trauma, dexamethasone suppression test, salivary cortisol, urinary cortisol, trauma risk
- MeSH terms
- Adult, Algorithms, Dexamethasone, Diagnostic Techniques, Endocrine, Female, Follow-Up Studies, Humans, Hydrocortisone, Male, Middle Aged, Risk Factors, Saliva, Stress Disorders, Post-Traumatic, Wounds and Injuries, Prevalence, Young Adult
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