title: Salivary cortisol levels and the cortisol response to dexamethasone before and after EMDR: a case report.
abstract: Trauma survivors with posttraumatic stress disorder (PTSD) have been shown to have lower basal cortisol levels in the urine, plasma, and saliva than in trauma survivors without PTSD, nontraumatized mentally ill, or healthy subjects. We report on a case study in which we measured pre- and post-Eye Movement Desensitization and Reprocessing (EMDR) treatment salivary cortisol levels and salivary cortisol response to 0.50 mg of dexamethasone in a 41-year-old female with chronic PTSD symptoms. Our goal was to determine whether symptom improvement following trauma-focused treatment (EMDR) is associated with changes in basal salivary cortisol or in the cortisol response to dexamethasone administration. Our findings show moderate symptom improvement, an increase in basal cortisol levels, and a more attenuated cortisol hypersuppression in response to the dexamethasone suppression test following EMDR treatment. These results suggest the potential utility of including neuroendocrine measures in the assessment of treatment outcome in PTSD.
authors.affiliation: Mount Sinai School of Medicine, USA. rthbr@bellatlantic.net
authors.forename: Ruth
authors.initials: R
authors.lastname: Heber
authors.forename: Michael
authors.initials: M
authors.lastname: Kellner
authors.forename: Rachel
authors.initials: R
authors.lastname: Yehuda
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D015415:Biomarkers / Q000032:analysis; D003887:Desensitization, Psychologic; D003907:Dexamethasone / Q000494:pharmacology*; D005133:Eye Movements; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy; D012463:Saliva / Q000737:chemistry; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D003907:Dexamethasone; D006854:Hydrocortisone