Salivary Cortisol Lower in Posttraumatic Stress Disorder

Helané Wahbeh · Barry Oken

86 citations0/0 files storedJournal of Traumatic Stress

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Posttraumatic Stress Disorder Research Child Abuse and Trauma Stress Responses and Cortisol

Abstract

Altered cortisol has been demonstrated to be lower in those with posttraumatic stress disorder (PTSD) in most studies. This cross-sectional study evaluated salivary cortisol at waking and 30 minutes after, and at bedtime in 51 combat veterans with PTSD compared to 20 veterans without PTSD. It also examined the relationship of cortisol to PTSD symptoms using 2 classifications: the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994) and the more recent 4-factor classification proposed for DSM-5. The PTSD group had lower cortisol values than the control group, F(6, 69) = 3.35, p = .006. This significance did not change when adding age, body mass index, smoking, medications affecting cortisol, awakening time, sleep duration, season, depression, perceived stress, service era, combat exposure, and lifetime trauma to the model. Post hoc analyses revealed that the PTSD group had lower area-under-the-curve ground and waking, 30 min, and bedtime values; the cortisol awakening response and area-under-the-curve increase were not different between groups. The 4-factor avoidance PTSD symptom cluster was associated with cortisol, but not the other symptom clusters. This study supports the finding that cortisol is lower in people with PTSD.

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References

1983A Global Measure of Perceived Stress 1995The development of a Clinician-Administered PTSD Scale 2002Post-Traumatic Stress Disorder 1989Clinical evaluation of a measure to assess combat exposure.2007Cortisol and post-traumatic stress disorder in adults 2010Considering PTSD for DSM-5 1995Low urinary cortisol excretion in Holocaust survivors with posttraumatic stress disorder 2012Relations among posttraumatic stress disorder, comorbid major depression, and HPA function: A systematic review and meta-analysis

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