Higher cortisol levels following exposure to traumatic reminders in abuse-related PTSD
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Animal studies have found that prior stressful events can result in increased reactivity in the HPA-axis. However, baseline function of the HPA-axis has typically been normal or decreased in post-traumatic stress disorder (PTSD). The first purpose of this study was to assess cortisol responsivity to traumatic reminders in women with PTSD related to childhood abuse. The second aim was to assess the relationship between stress-induced cortisol levels and neutral and emotional memory. Salivary cortisol levels were measured before, during and after exposure to personalized trauma scripts in abused women with (N=12) and without current PTSD (N=12). Memory for neutral and emotional material was assessed immediately after trauma scripts exposure and 3 days later. PTSD patients had 122% higher cortisol levels during script exposure, 69% higher cortisol levels during recovery, and 60% higher levels in the period leading up to the script exposure compared to controls. PTSD symptoms were highly predictive of cortisol levels during trauma script exposure (r=0.70), but not during periods of rest. Both in PTSD patients and controls, memory consolidation after the trauma scripts was impaired relative to baseline (P<0.001), with no differences between the two groups on memory performance. There was no association between memory performance and cortisol levels. These results are consistent with higher cortisol levels following exposure to traumatic stressors in PTSD.
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Adults with early abuse and PTSD have low baseline and increased stress-induced cortisol responses and increased norepinephrine at baseline.
“while adults with early abuse and PTSD have low baseline (Bremner 2003b) and increased stress-induced cortisol responses (Elzinga 2003; Bremner 2003c) and increased norepinephrine at baseline (Lemieux and Coe 1995; El-Sheikh 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 Elzinga 2003
The Abstract and Discussion report higher cortisol levels in women with abuse-related PTSD than in abused controls during exposure to trauma scripts. However, the Discussion says that, without a proper baseline, the authors could not determine with certainty whether cortisol rose in response to the scripts rather than in anticipation of them. The low-baseline cortisol and baseline norepinephrine claims are attributed to other citations, not Elzinga (2003). (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn the clinical population, the amygdala has been implicated in the pathogenesis of psychiatric sequelae.
“In the clinical population, the amygdala has also been implicated in the pathogenesis of psychiatric sequelae.”
From Early life adversity during the infant sensitive period for attachment: Programming of behavioral neurobiology of threat processing and social behavior (2017) · cites this paper as Elzinga et al., 2003
Patients with depression show alterations in amygdala function and its connectivity with other brain areas.
“For instance, patients with depression also show alterations in amygdala function and its connectivity with other brain areas (Elzinga et al., 2003, Frijling et al., 2016, Jedd et al., 2015, McEwen, 2003, Ressler and Mayberg, 2007, Savitz and Drevets, 2009, Sibille et al., 2009, Teicher et al., 2003).”
From Early life adversity during the infant sensitive period for attachment: Programming of behavioral neurobiology of threat processing and social behavior (2017) · cites this paper as Elzinga et al., 2003
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- Authors
- Elzinga, B. M., Schmahl, C. G., Vermetten, E., van Dyck, R., & Bremner, J. D.
- Affiliations
- Leiden University (NL)
- University of Freiburg (DE)
- Central Military Hospital (NL)
- Emory University (US)
- Corresponding author
- Elzinga, Bernet M
- Venue
- Neuropsychopharmacology
- Published
- 2003-05-16
- Volume
- 28
- Issue
- 9
- Pages
- 1656-1665
- ISSN
- 0893-133X (ISSN-L)
- 1740-634X
- OpenAlex
- W2073376147
- Cited by
- 341
- References
- 75
- Citations by year
- 2026: 9 · 2025: 9 · 2024: 6 · 2023: 8 · 2022: 16 · 2021: 14 · 2020: 20 · 2019: 12 · 2018: 8 · 2017: 15 · 2016: 25 · 2015: 17 · 2014: 18 · 2013: 15 · 2012: 19
- FWCI
- 20.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- National Center for PTSD, U.S. Department of Veterans Affairs
- National Institute of Mental Health (MH 56120, R01MH056120, R01MH56120)
- 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, childhood abuse, cortisol, hypothalamic-pituitary-adrenal axis, memory consolidation, emotional memory, salivary cortisol, women
- MeSH terms
- Adult, Child, Child Abuse, Female, Humans, Hydrocortisone, Memory, Middle Aged, Neuropsychological Tests, Psychiatric Status Rating Scales, Saliva, Severity of Illness Index, Stress Disorders, Post-Traumatic, Time Factors, Case-Control Studies, Battered Women
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