title: Cortisol response to a cognitive stress challenge in posttraumatic stress disorder (PTSD) related to childhood abuse.
abstract: Preclinical studies show that animals with a history of chronic stress exposure have increased hypothalamic-pituitary-adrenal (HPA) axis reactivity following reexposure to stress. Patients with posttraumatic stress disorder (PTSD) have been found to have normal or decreased function of the HPA axis, however no studies have looked at the HPA response to stress in PTSD. The purpose of this study was to assess cortisol responsivity to a stressful cognitive challenge in patients with PTSD related to childhood abuse. Salivary cortisol levels, as well as heart rate and blood pressure, were measured before and after a stressful cognitive challenge in patients with abuse-related PTSD (N=23) and healthy comparison subjects (N=18). PTSD patients had 61% higher group mean cortisol levels in the time period leading up to the cognitive challenge, and 46% higher cortisol levels during the time period of the cognitive challenge, compared to controls. Both PTSD patients and controls had a similar 66-68% increase in cortisol levels from their own baseline with the cognitive challenge. Following the cognitive challenge, cortisol levels fell in both groups and were similar in PTSD and control groups. PTSD patients appeared to have an increased cortisol response in anticipation of a cognitive challenge relative to controls. Although cortisol has been found to be low at baseline, there does not appear to be an impairment in cortisol response to stressors in PTSD.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory Center for Positron Emission Tomography, Emory University School of Medicine, 1364 Briarcliff Road, Atlanta, GA 30322, USA. jdbremn@emory.edu
authors.forename: J D
authors.initials: JD
authors.lastname: Bremner
authors.forename: M
authors.initials: M
authors.lastname: Vythilingam
authors.forename: E
authors.initials: E
authors.lastname: Vermetten
authors.forename: J
authors.initials: J
authors.lastname: Adil
authors.forename: S
authors.initials: S
authors.lastname: Khan
authors.forename: A
authors.initials: A
authors.lastname: Nazeer
authors.forename: N
authors.initials: N
authors.lastname: Afzal
authors.forename: T
authors.initials: T
authors.lastname: McGlashan
authors.forename: B
authors.initials: B
authors.lastname: Elzinga
authors.forename: G M
authors.initials: GM
authors.lastname: Anderson
authors.forename: G
authors.initials: G
authors.lastname: Heninger
authors.forename: S M
authors.initials: SM
authors.lastname: Southwick
authors.forename: D S
authors.initials: DS
authors.lastname: Charney
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001794:Blood Pressure; D002649:Child Abuse / Q000523:psychology*; D003071:Cognition; D005260:Female; D006339:Heart Rate; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D012463:Saliva / Q000737:chemistry; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology* / Q000523:psychology; D013315:Stress, Psychological / Q000503:physiopathology* / Q000523:psychology
chemical_list: D006854:Hydrocortisone