Diurnal salivary cortisol in pediatric posttraumatic stress disorder
Abstract
Background The hypothalamic-pituitary-adrenal (HPA) axis has been implicated in the pathophysiology of posttraumatic stress disorder (PTSD). Additional information on basal cortisol levels in children exposed to trauma and experiencing PTSD symptoms may contribute to the understanding of the role of this axis in PTSD. Methods Fifty-one children (30 boys and 21 girls, mean age 10.7 years) with a history of exposure to trauma and PTSD symptoms were compared with 31 age- and gender-matched healthy control subjects. Salivary cortisol was obtained from participants during home measurements and was collected four times a day (prebreakfast, prelunch, predinner, and prebed) for up to 3 consecutive days. Results The clinical group demonstrated significantly elevated cortisol levels when compared with the control group. In addition, exploratory analyses revealed that girls with PTSD symptoms had significantly elevated cortisol levels when compared with boys with PTSD symptoms. Conclusions The physiologic response of children with history of trauma and with PTSD symptoms may be characterized by heightened adrenal activity.
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Early abuse and PTSD is associated with increased cortisol and norepinephrine levels in children, down-regulated platelet alpha-2 adrenergic receptors, and increased resting heart rate.
“early abuse and PTSD is associated with increased cortisol and norepinephrine levels in children (Carrion 2002; De Bellis 1999, Gunnar 2001), down-regulated platelet alpha-2 adrenergic receptors (Perry 1994), and increased resting heart rate (Perry 2001)”
From The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology (2006) · cites this paper as Carrion 2002
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- Authors
- Carrion, V. G., Weems, C. F., Ray, R. D., Glaser, B., Hessl, D., & Reiss, A. L.
- Affiliations
- Stanford Medicine (US)
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2002-04
- Volume
- 51
- Issue
- 7
- Pages
- 575-582
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W2036396063
- Cited by
- 330
- References
- 6
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 7 · 2023: 6 · 2022: 6 · 2021: 7 · 2020: 9 · 2019: 6 · 2018: 6 · 2017: 10 · 2016: 17 · 2015: 43 · 2014: 16 · 2013: 24 · 2012: 26
- FWCI
- 16.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01 MH 50047, R01MH050047)
- 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, children, salivary cortisol, diurnal cortisol rhythm, hypothalamic-pituitary-adrenal axis, trauma exposure, sex differences, adrenal function
- MeSH terms
- Adolescent, Arousal, Child, Circadian Rhythm, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Pituitary-Adrenal System, Reference Values, Saliva, Sex Factors, Social Environment, Stress Disorders, Post-Traumatic
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