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Cited by 108Stress Responses and CortisolMigration, Health and TraumaPosttraumatic Stress Disorder Research

The DOI matches its Crossref record; 59 of the 59 references it cites were found in a registry or an index.

Hair cortisol concentrations in war-affected adolescents: A prospective intervention trial

Open access
Dajani, Rana, Hadfield, Kristin, van Uum, Stan, Greff, Michael, Panter-Brick, Catherine·2018·Psychoneuroendocrinology
DOI 10.1016/j.psyneuen.2017.12.012
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Abstract

Temporal examinations of the biological signature of stress or trauma in war-affected populations are seldom undertaken. Moreover, few studies have examined whether stress biomarkers track biological sensitivity to brief interventions targeting the improvement of psychosocial wellbeing. Our study is the first to prospectively examine, in war-affected adolescents, the associations between hair cortisol concentrations (HCC) and self-reports of stress, insecurity, posttraumatic reactions, and lifetime trauma. We conducted a randomized controlled trial to test the impact of an 8-week intervention based on profound stress attunement. We collected data for a gender-balanced sample of 733 Syrian refugee (n = 411) and Jordanian non-refugee (n = 322) adolescents (12-18 years), at three time-points. We used growth mixture models to classify cortisol trajectories, and growth models to evaluate intervention impact on stress physiology. We observed three trajectories of HCC: hypersecretion, medium secretion, and hyposecretion (9.6%, 87.5% and 2.9% of the cohort, respectively). For every one percent increase in levels of insecurity, adolescents were 0.02 times more likely to have a trajectory of hypersecretion (95% CI: 1.00, 1.03, p = 0.01). For each additional symptom of posttraumatic stress reported, they were 0.07 times less likely to show hyposecretion (95% CI: 0.89, 0.98, p = 0.01). Indeed, stronger posttraumatic stress reactions were associated with a pattern of within-individual cortisol dysregulation and medium secretion. Overall, HCC decreased by a third in response to the intervention (95% CI: -0.19, -0.03, p = 0.01). While the intervention decreased HCC for youth with hypersecretion and medium secretion, it increased HCC for youth with hyposecretion (95% CI: 0.22, 1.16, p = 0.004), relative to controls. This suggests a beneficial regularization of cortisol levels, corroborating self-reports of improved psychosocial wellbeing. We did not find evidence to suggest that gender, resilience, or posttraumatic stress disorder influenced the strength or direction of responses to the intervention. This robust impact evaluation exemplifies the utility of biomarkers for tracking physiological changes in response to interventions over time. It enhances the understanding of trajectories of endocrine response in adverse environments and patterns of stress responsivity to ecological improvement.

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Fig. 2 Impacts of the psychosocial intervention on hair cortisol concentration . Across time, the intervention signi fi cantly reduced hair cortisol concentration for those who were in the treatment group, relative to wait-listed controls (a 37.8% decrease). The fi gure shows within-subjects change over time when taking part in the intervention. Growth curve model controls for gender, age, site, and household wealth. * p < 0.05, error bars are ± 1SE.
Fig. 2 Impacts of the psychosocial intervention on hair cortisol concentration . Across time, the intervention signi fi cantly reduced hair cortisol concentration for those who were in the treatment group, relative to wait-listed controls (a 37.8% decrease). The fi gure shows within-subjects change over time when taking part in the intervention. Growth curve model controls for gender, age, site, and household wealth. * p < 0.05, error bars are ± 1SE.CC-BY-NC-ND · From the PDF
Fig. 3 Impacts of the psychosocial intervention on hair cortisol concentration (HCC). The interaction (intervention*cortisol trajectory) was signi fi cant ( p < 0.05). Across time, growth curve models showed that the intervention reduced HCC for adolescents with a hypersecretion and medium secretion trajectory (by 15.2% and 43.2%, respectively), but increased HCC for those with a hyposecretion trajectory (by 59.7%). Model controls for gender, age, site, and household wealth.
Fig. 3 Impacts of the psychosocial intervention on hair cortisol concentration (HCC). The interaction (intervention*cortisol trajectory) was signi fi cant ( p < 0.05). Across time, growth curve models showed that the intervention reduced HCC for adolescents with a hypersecretion and medium secretion trajectory (by 15.2% and 43.2%, respectively), but increased HCC for those with a hyposecretion trajectory (by 59.7%). Model controls for gender, age, site, and household wealth.CC-BY-NC-ND · From the PDF

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  1. Haushofer, 2017, Peace of mind: health insurance reduces stress and cortisol levels – evidence from a randomized experiment in Kenya, JEL

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Metadata

Authors
Dajani, R., Hadfield, K., van Uum, S., Greff, M., & Panter-Brick, C.
Affiliations
  • Harvard University (US)
  • Queen Mary University of London (GB)
  • Western University (CA)
ORCID
Venue
Psychoneuroendocrinology
Publisher
Elsevier BV
Published
2018-03
Volume
89
Pages
138-146
ISSN
0306-4530 (ISSN-L)
DOI
10.1016/j.psyneuen.2017.12.012
OpenAlex
W2780117356
Cited by
108
References
59
Citations by year
2026: 7 · 2025: 12 · 2024: 16 · 2023: 9 · 2022: 20 · 2021: 10 · 2020: 17 · 2019: 14 · 2018: 3
FWCI
5.06
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychoneuroendocrinology (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
Funders
  • Elrha’s Research for Health in Humanitarian Crises
  • Wellcome Trust
  • UK Government
Topics
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords
hair cortisol, Syrian refugees, trauma exposure, post-traumatic stress, hypersecretion, hyposecretion, stress biomarkers, psychosocial well-being, resilience, gender differences, cortisol dysregulation, intervention impact evaluation, Jordanian adolescents, post-traumatic stress disorder
MeSH terms
Armed Conflicts, Adolescent, Female, Hair, Humans, Hydrocortisone, Male, Prospective Studies, Refugees, Sex Factors, Stress, Physiological, Stress Disorders, Post-Traumatic, Stress, Psychological, Biomarkers

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