Hair cortisol concentrations and cortisol stress reactivity predict PTSD symptom increase after trauma exposure during military deployment
Abstract
Background Previous evidence on endocrine risk markers for posttraumatic stress disorder (PTSD) has been inconclusive. Here, we report results of the first prospective study to investigate whether long-term hair cortisol levels and experimentally-induced cortisol stress reactivity are predictive of the development of PTSD symptomatology in response to trauma during military deployment.Methods Male soldiers were examined before deployment to Afghanistan and at a 12-month post-deployment follow-up using dimensional measures for psychopathological symptoms. The predictive value of baseline (i) hair cortisol concentrations (HCC, N=90) and (ii) salivary cortisol stress reactivity (measured by the Trier Social Stress Test, N=80) for the development of PTSD symptomatology after being exposed to new-onset traumatic events was analyzed.Results Baseline cortisol activity significantly predicted PTSD symptom change from baseline to follow-up upon trauma exposure. Specifically, our results consistently revealed that lower HCC and lower cortisol stress reactivity were predictive of a greater increase in PTSD symptomatology in soldiers who had experienced new-onset traumatic events (explaining 5% and 10.3% of variance, respectively). Longitudinal analyses revealed an increase in HCC from baseline to follow-up and a trend for a negative relationship between HCC changes and the number of new-onset traumatic events. Additional pre-deployment analyses revealed that trauma history was reflected in lower HCC (at trend level) and that HCC were negatively related to stressful load.Conclusions Our data indicate that attenuated cortisol secretion is a risk marker for subsequent development of PTSD symptomatology upon trauma exposure. Future studies are needed to confirm our findings in other samples.
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The initial sharp increase provides prospective validation of the hair cortisol method as a field-friendly biological marker of stress exposure.
“providing prospective validation of the hair cortisol method as a field-friendly biological marker of stress exposure”
From Chronic Stress, Hair Cortisol and Depression: A Prospective and Longitudinal Study of Medical Internship (2018) · cites this paper as Steudte-Schmiedgen et al., 2015
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“With regard to PTSD, studies have found associations between lower hair cortisol levels and PTSD diagnostic risk and symptom severity (Mouthaan et al., 2014; Steudte-Schmiedgen et al., 2015).”
Hoffman, A. N., & Taylor, A. N. (2019) · Behavioural Pharmacology · doi:10.1097/fbp.0000000000000461 · Cited by 40 · see citing works
Monteleone, A. M., Monteleone, P., Volpe, U., De Riso, F., Fico, G., Giugliano, R., Nigro, M., & Maj, M. (2018) · Psychological Medicine · doi:10.1017/s0033291717002409 · Cited by 38 · see citing works
“…literature data showing negative correlations between the number of different lifetime traumatic events and hair cortisol concentrations (HCC) in patients with posttraumatic stress disorder as well as in traumatized healthy individuals (Steudte et al. 2013; Steudte-Schmiedgen et al. 2015).”
BackgroundDoes trauma event type matter in the assessment of traumatic load?
Conrad, D., Wilker, S., Pfeiffer, A., Lingenfelder, B., Ebalu, T. I., Lanzinger, H., Elbert, T. R., Kolassa, I., & Kolassa, S. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2017.1344079 · Cited by 39 · see citing works
The 24-hour urinary cortisol in post-traumatic stress disorder: A meta-analysis
Pan, X., Kaminga, A. C., Wen, S. W., Wang, Z., Wu, X., & Liu, A. (2020) · PLoS ONE · doi:10.1371/journal.pone.0227560 · Cited by 38 · see citing works
The Pathways between Cortisol-Related Regulation Genes and PTSD Psychotherapy
Castro-Vale, I., & Carvalho, D. M. (2020) · Healthcare · doi:10.3390/healthcare8040376 · Cited by 38 · see citing works
Gifford, R. M., O’Leary, T. J., Double, R. L., Wardle, S. L., Wilson, K. S., Boyle, L. D., Homer, N. Z. M., Kirschbaum, C., Greeves, J. P., Woods, D. R., et al. (2019) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2019.104432 · Cited by 36 · see citing works
Predicting Posttraumatic Stress Disorder Among Survivors of Recent Interpersonal Violence
Morris, M. C., Sánchez‐Sáez, F., Bailey, B., Hellman, N. M., Williams, A., Schumacher, J. A., & Rao, U. (2020) · Journal of Interpersonal Violence · doi:10.1177/0886260520978195 · Cited by 31 · see citing works
“Pre-trauma cortisol reactivity has also been associated with elevated risk for posttraumatic stress symptoms among soldiers exposed to traumatic events during deployment (Steudte-Schmiedgen et al., 2015).”
BackgroundMonari, S., de Suduiraut, I. G., Grosse, J., Zanoletti, O., Walker, S. E., Mesquita, M. S., Wood, T., Cash, D., Astori, S., & Sandi, C. (2023) · Biological Psychiatry · doi:10.1016/j.biopsych.2023.09.015 · Cited by 32 · see citing works
Dual-hormone stress reactivity predicts downstream war-zone stress-evoked PTSD
Josephs, R. A., Cobb, A. R., Lancaster, C. L., Lee, H.-J., & Telch, M. J. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.01.013 · Cited by 30 · see citing works
Buchmüller, T., Lembcke, H., Busch, J., Kumsta, R., Wolf, O. T., & Leyendecker, B. (2020) · Stress · doi:10.1080/10253890.2020.1737008 · Cited by 27 · see citing works
Lalonde, C. S., Mekawi, Y., Ethun, K. F., Beurel, E., Gould, F., Dhabhar, F. S., Schultebraucks, K., Galatzer‐Levy, I. R., Maples‐Keller, J. L., ROTHBAUM, B. O., et al. (2021) · Chronic Stress · doi:10.1177/24705470211032208 · Cited by 28 · see citing works
Pacella‐LaBarbara, M. L., Hruska, B. J., Steudte‐Schmiedgen, S., George, R. L., & Delahanty, D. L. (2017) · Social Science & Medicine · doi:10.1016/j.socscimed.2016.12.046 · Cited by 28 · see citing works
“The majority of extant literature regarding the relationship between HCC and PTSD/PTSS has been conducted in non-civilian samples (Steudte-Schmiedgen et al., 2015), treatment-seeking samples (Steudte et al., 2013), individuals undergoing chronic or ongoing stress exposure (e.g., severely…”
BackgroundWittgens, C., Muehlhan, M., Kräplin, A., Wolff, M., & Trautmann, S. (2022) · BMC Psychology · doi:10.1186/s40359-022-00942-1 · Cited by 31 · see citing works
“Self-control Brief self-control scale (BSCS) [82, 85]”
BackgroundSbisa, A. M., Madden, K., Toben, C. G., McFARLANE, A. C., Dell, L., & Lawrence‐Wood, E. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105954 · Cited by 27 · see citing works
Izawa, S., Miki, K., Tsuchiya, M., Yamada, H., & Nagayama, M. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2018.11.021 · Cited by 26 · see citing works
Danan, D., Todder, D., Zohar, J., & Cohen, H. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22116050 · Cited by 26 · see citing works
“in pre-deployment soldiers was predictive of a greater increase in PTSD symptomatology in soldiers who had experienced a new onset of traumatic events [47].”
BackgroundOn making (and turning adaptive to) maladaptive aversive memories in laboratory rodents
Gazarini, L., Stern, C. A. J., & Bertoglio, L. J. (2023) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2023.105101 · Cited by 25 · see citing works
The Relationship between Allostatic Load and Psychosocial Characteristics among Women Veterans
Beckie, T. M., Duffy, A., & Groer, M. E. (2016) · Women s Health Issues · doi:10.1016/j.whi.2016.05.008 · Cited by 26 · see citing works
“…long-term cortisol levels and may measure chronic stress more reliably than a single saliva or blood measure because confounding by circadian rhythm and acute stress is minimized (Kuehl et al., 2015; Staufenbiel, Penninx, Spijker, Elzinga, & van Rossum, 2013; Steudte-Schmiedgen et al., 2015).”
BackgroundKoch, S. B. J., Klumpers, F., Zhang, W., Hashemi, M. M., Kaldewaij, R., van Ast, V. A., Smit, A. S., & Karin Roelofs, A. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2017.1412226 · Cited by 25 · see citing works
Schindler‐Gmelch, L., Capito, K., Steudte‐Schmiedgen, S., Kirschbaum, C., & Berking, M. (2023) · Current Neuropharmacology · doi:10.2174/1570159x21666230807112425 · Cited by 25 · see citing works
van Zuiden, M., Savas, M., Koch, S. B. J., Nawijn, L., Staufenbiel, S. M., Frijling, J. L., Veltman, D. J., van Rossum, E. F. C., & Olff, M. (2019) · Journal of Traumatic Stress · doi:10.1002/jts.22395 · Cited by 26 · see citing works
“Although our study had no longitudinal design, this fits with previously observed low pretrauma HCC (Steudte-Schmiedgen et al., 2015) and high pretrauma glucocorticoid receptor function (van Zuiden et al., 2012) as predictive of PTSD symptom development in male soldiers.”
BackgroundResultBehnke, A., Karabatsiakis, A., Krumbholz, A., Karrasch, S., Schelling, G., Kolassa, I., & Rojas, R. (2020) · Scientific Reports · doi:10.1038/s41598-020-79859-x · Cited by 25 · see citing works
Fischer, S., King, S., Papadopoulos, A., Hotopf, M., Young, A. H., & Cleare, A. J. (2018) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12970 · Cited by 27 · see citing works
“3 months) rather than short-term (12 h or 24 h) cortisol secretion (17, 18).”
BackgroundSimpson, T. L., Kaysen, D. L., Fleming, C. B., Rhew, I. C., Jaffe, A. E., Desai, S. A., Hien, D. A., Berliner, L., Donovan, D. M., & Resick, P. A. (2022) · PLoS ONE · doi:10.1371/journal.pone.0276111 · Cited by 24 · see citing works
van Ockenburg, S. L., Schenk, H., van der Veen, A., van Rossum, E. F. C., Kema, I. P., & Rosmalen, J. G. M. (2016) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2016.07.220 · Cited by 24 · see citing works
Tamman, A. J. F., Sippel, L. M., Han, S., Neria, Y., Krystal, J. H., Southwick, S. M., Gelernter, J. E., & Pietrzak, R. H. (2017) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2017.1376114 · Cited by 23 · see citing works
Taylor, B. K., Fung, M. H., Frenzel, M. R., Johnson, H. J., Willett, M. P., Badura-Brack, A. S., White, S. F., & Wilson, T. W. (2022) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-022-00967-5 · Cited by 25 · see citing works
“, larger increases from basal levels following stress exposure) tend to be associated with greater perceived psychological distress, including increasing negative affect, depressive and anxiety symptoms, and post-traumatic stress (Phan et al., 2020; Stalder et al., 2017; Steudte-Schmiedgen et al., 2015).”
BackgroundResultZantvoord, J. B., Ensink, J. B. M., den Kelder, R. O., Wessel, A. M. A., Lok, A., & Lindauer, R. (2019) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2019.104380 · Cited by 23 · see citing works
“Furthermore, lower hair cortisol concentrations and lower cortisol stress reactivity before deployment were predictive of a greater PTSD symptom increase in soldiers who had experienced new-onset traumatic events (Steudte-Schmiedgen et al., 2015).”
Refugee mother-child dyads’ hair cortisol, post-traumatic stress, and affectionate parenting
Lembcke, H., Buchmüller, T., & Leyendecker, B. (2019) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2019.104470 · Cited by 24 · see citing works
Botschek, T., Hußlein, V., Peters, E. M. J., & Brosig, B. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1227153 · Cited by 23 · see citing works
Psychobiology of cumulative trauma: hair cortisol as a risk marker for stress exposure in women
Morris, M. C., Abelson, J. L., Mielock, A. S., & Rao, U. (2017) · Stress · doi:10.1080/10253890.2017.1340450 · Cited by 21 · see citing works
A UHPLC-MS/MS method for profiling multifunctional steroids in human hair
Dong, Z., Wang, C., Zhang, J., & Wang, Z. (2017) · Analytical and Bioanalytical Chemistry · doi:10.1007/s00216-017-0419-2 · Cited by 21 · see citing works
Sopp, M. R., Michael, T., Lass‐Hennemann, J., Haim‐Nachum, S., & Lommen, M. J. J. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105449 · Cited by 20 · see citing works
Raper, J., Wilson, M., Sánchez, M. M., Payne, C. D., & Bachevalier, J. (2016) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2016.11.018 · Cited by 21 · see citing works
Scheeringa, M. S. (2020) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1864 · Cited by 19 · see citing works
Ahrens, K. F., Neumann, R. J., von Werthern, N. M., Kranz, T. M., Kollmann, B., Mattes, B., Puhlmann, L. M. C., Weichert, D., Lutz, B., Basten, U., et al. (2022) · Translational Psychiatry · doi:10.1038/s41398-022-02165-9 · Cited by 18 · see citing works
Trautmann, S., Muehlhan, M., Kirschbaum, C., Wïttchen, H., Höfler, M., Tobias Stalder, A., & Steudte‐Schmiedgen, S. (2017) · Addiction Biology · doi:10.1111/adb.12487 · Cited by 18 · see citing works
“Cortisol concentrations were quantified via liquid chromatography tandem mass spectrometry (as in Steudte-Schmiedgen et al. 2015), which is considered the current gold standard methodology for hair steroid analysis (Gao et al. 2013).”
MethodResultHair cortisol in relation to acute and post-traumatic stress symptoms in children and adolescents
Straub, J., Klaubert, L. M., Steudte‐Schmiedgen, S., Kirschbaum, C., & Goldbeck, L. (2017) · Anxiety Stress & Coping · doi:10.1080/10615806.2017.1355458 · Cited by 18 · see citing works
“Steudte-Schmiedgen et al. (2015) found that HCC levels in male soldiers before deployment to Afghanistan significantly predicted PTSD symptoms 12 months after their return.”
BackgroundResultInfluentialHilberdink, C. E., de Rooij, S. R., Olff, M., Bosch, J. A., & van Zuiden, M. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105686 · Cited by 18 · see citing works
Way, B. M., Brown, K. W., Quaglia, J. T., McCain, N. L., & Taylor, S. E. (2016) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2016.04.022 · Cited by 16 · see citing works
Ginty, A., Young, D. A., Tyra, A. T., Hurley, P. E., Brindle, R. C., & Williams, S. E. (2020) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000848 · Cited by 10 · see citing works
Morris, M. C., Bailey, B., Hellman, N. M., Williams, A., Lannon, E. W., Kutcher, M., Schumacher, J. A., & Rao, U. (2020) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2020.104899 · Cited by 15 · see citing works
“Prior work suggests that pretraumatic alterations in cortisol reactivity are associated with risk for developing PTSD (Steudte-Schmiedgen et al., 2015) and could be used to identify high-risk individuals who may benefit from preventive interventions.”
BackgroundSteudte‐Schmiedgen, S., Schälicke, S., Bergunde, L., Karl, M., Weise, V., Junge‐Hoffmeister, J., Schumacher, S., von Soest, T., Weidner, K., Kirschbaum, C., et al. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105973 · Cited by 15 · see citing works
Working Memory Predicts Hypothalamus-Pituitary-Adrenal Axis Response to Psychosocial Stress in Males
Lin, L., Wu, J., Yuan, Y., Sun, X., & Zhang, L. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00142 · Cited by 14 · see citing works
“In the recent decade, blunted cortisol response was found in adolescents with moderate or severe depression (13) and soldiers who showed greater increase in PTSD symptomatology (14).”
BackgroundEngel, S., van Zuiden, M., Frijling, J. L., Koch, S. B. J., Nawijn, L., Yildiz, R. L. W., Schumacher, S., Knaevelsrud, C., Bosch, J. A., Veltman, D. J., et al. (2020) · European Journal of Psychotraumatology · doi:10.1080/20008198.2020.1761622 · Cited by 14 · see citing works
“Prospective studies assessing pretrauma hair cortisol concentrations in male military populations found negative associations with subsequent PTSD development when intermittent trauma exposure was adequately accounted for (Steudte-Schmiedgen et al., 2015).”
BackgroundNeuroendocrinology of Posttraumatic Stress Disorder
Bowers, M. E., & Yehuda, R. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-802175-0.00016-4 · Cited by 14 · see citing works
Shapira, I., Richman, J., Pace, T. W. W., Lim, K. O., Polusny, M. A., Hamner, M. B., Bremner, J. D., Mumba, M. N., Jacobs, M. L., Pilkinton, P. D., et al. (2022) · Mindfulness · doi:10.1007/s12671-022-01969-6 · Cited by 12 · see citing works
Binge drinking in adolescence predicts an atypical cortisol stress response in young adulthood
Hagan, M. J., Modecki, K. L., Tan, L. M., Luecken, L. J., Wolchik, S. A., & Sandler, I. N. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2018.10.002 · Cited by 12 · see citing works
“, 2013), greater risk of developing post-traumatic stress disorder following a traumatic event (Steudte-Schmiedgen et al., 2015), poor executive functioning (Blair et al.”
BackgroundPetrowski, K., Wichmann, S., Pyrc, J., Steudte‐Schmiedgen, S., & Kirschbaum, C. (2020) · Stress · doi:10.1080/10253890.2020.1714585 · Cited by 12 · see citing works
Mažeikienė, A., Bekešienė, S., Karčiauskaitė, D., Mazgelytė, E., Larsson, G., Petrėnas, T., Kaminskas, A., Songailienė, J., Utkus, A., Vaičaitienė, R., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182212239 · Cited by 12 · see citing works
The Neurobiological Links between Stress and Traumatic Brain Injury: A Review of Research to Date
Zheng, L., Pang, Q., Xu, H., Guo, H., Liu, R., & Wang, T. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23179519 · Cited by 11 · see citing works
“In a prior study [160], male soldiers were examined before deployment to Afghanistan and at a 12-month post-deployment follow-up.”
BackgroundInfluentialThe predictive role of hair cortisol concentrations for treatment outcome in PTSD inpatients
Hummel, K. V., Schellong, J., Trautmann, S., Kummer, S., Hürrig, S., Klose, M., Croy, I., Weidner, K., Kirschbaum, C., & Steudte‐Schmiedgen, S. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105326 · Cited by 11 · see citing works
The role of cortisol in development and treatment of PTSD among service members: A narrative review.
Buccellato, K., & Peterson, A. L. (2024) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2024.107152 · Cited by 4 · see citing works
Affective profiling for anxiety-like behavior in a rodent model of mTBI
Statz, J. K., Ciarlone, S. L., Goodrich, J. A., McCarron, R. M., Walker, P. B., Norris, J. N., Ahlers, S. T., & Tschiffely, A. E. (2019) · Behavioural Brain Research · doi:10.1016/j.bbr.2019.04.009 · Cited by 9 · see citing works
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 8 · see citing works
“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].”
BackgroundTrautmann, S., Wittgens, C., Muehlhan, M., & Kanske, P. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.830218 · Cited by 8 · see citing works
“Biological risk factors include genetic and epigenetic variations (6), alterations in the function of the hypothalamic pituitary adrenal (HPA) axis (7, 8) and the autonomic nervous system (9) as well as changes in brain structure and functioning (10).”
BackgroundKasama, E., Moriya, M., Kamimura, R., Matsuki, T., & Seki, K. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23116286 · Cited by 7 · see citing works
“Although it has been shown that either cortisol or corticosterone secretion is typically enhanced after the traumatic event, and is followed by suppression of HPA axis activity [22], most individ‐ uals with PTSD show low cortisol excretion [43,45,46].”
BackgroundCastro-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 8 · see citing works
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“Reduced long-term hair cortisol levels and lower cortisol stress reactivity predicts a significant increase in PTSD symptoms [32].”
BackgroundRothe, J., Buse, J., Uhlmann, A., Bodmer, B., Kirschbaum, C., Hoekstra, P. J., Dietrich, A., & Roessner, V. (2023) · Biomedicines · doi:10.3390/biomedicines11061561 · Cited by 7 · see citing works
Pharmacological treatments for co-occurring PTSD and substance use disorders: A systematic review
Swannell, M., Bradlow, R. C. J., Pham, D., Gabriel, J., Manahan, Y., & Arunogiri, S. (2024) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2024.209601 · Cited by 7 · see citing works
Kaplan, J., Colgan, D. D., Klee, D., Hanes, D. A., & Oken, B. (2023) · Psychological Reports · doi:10.1177/00332941231171887 · Cited by 6 · see citing works
“…et al., 2007; Matthews et al., 2006), addiction (Phillips et al., 2013), symptoms of depression (Phillips et al., 2013) and anxiety (Yuenyongchaiwat & Shef fi eld, 2017), poor sleep quality (Yuenyongchaiwat & Shef fi eld, 2017), and PTSD symptoms in combat veterans (Steudte-Schmiedgen et al., 2015).”
Szöllősi, Á., Kéri, S., & Racsmány, M. (2021) · Learning & Memory · doi:10.1101/lm.053452.121 · Cited by 8 · see citing works
“…reactivity and symptom severity of depression (e.g., Burke et al. 2005), anxiety (e.g., Furlan et al. 2001), and post-traumatic stress (e.g., Steudte-Schmiedgen et al. 2015), we aimed to verify that there is no difference between the groups in levels of symptoms of depression, anxiety, and…”
BackgroundFriedman, M. R., Badri, S. M., Bowleg, L., Haberlen, S., Jones, D. L., Kempf, M.-C., Konkle‐Parker, D. J., Kwait, J., Martinson, J. J., Mimiaga, M. J., et al. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-075368 · Cited by 5 · see citing works
- Authors
- Steudte-Schmiedgen, S., Stalder, T., Schönfeld, S., Wittchen, H.-U., Trautmann, S., Alexander, N., Miller, R., & Kirschbaum, C.
- Affiliations
- Technische Universität Dresden (DE)
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2015-09
- Volume
- 59
- Pages
- 123-133
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W1483199116
- Cited by
- 130
- References
- 47
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 12 · 2023: 9 · 2022: 15 · 2021: 13 · 2020: 20 · 2019: 13 · 2018: 10 · 2017: 20 · 2016: 7 · 2015: 2
- FWCI
- 16.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- 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, hair cortisol, salivary cortisol, Trier Social Stress Test, military deployment, military personnel, trauma exposure, stress load, trauma history
- MeSH terms
- Adult, Hair, Humans, Hydrocortisone, Life Change Events, Longitudinal Studies, Male, Military Personnel, Predictive Value of Tests, Prospective Studies, Psychometrics, Risk Factors, Saliva, Stress Disorders, Post-Traumatic, Stress, Psychological, Wounds and Injuries, Afghan Campaign 2001-
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