Enhanced cortisol suppression following dexamethasone administration in domestic violence survivors.
OBJECTIVE
The authors compared responses of female domestic violence survivors and a matched group of nontraumatized participants to a low-dose (0.5 mg) dexamethasone suppression test (DST).


METHODS
Seventy female domestic violence survivors and 14 nontraumatized women matched for age and race were recruited. Participants were assessed for trauma severity, severity of PTSD and depressive symptoms, and DST cortisol response. Of the domestic violence survivors who were DST-compliant, comparisons were made among those with PTSD (N=15), those with PTSD plus depression (N=27), and those with no PTSD or depression diagnosis (N=8) along with the nontraumatized comparison subjects (N=14).


RESULTS
Domestic violence survivors with PTSD, regardless of whether or not they had comorbid depression, had significantly lower baseline cortisol levels at 9:00 a.m. than the healthy subjects and trauma survivors with no diagnosis. Survivors with a sole diagnosis of PTSD showed significantly greater cortisol suppression to dexamethasone than did healthy subjects or the group diagnosed with PTSD plus depression.


CONCLUSIONS
These findings agree with previous studies showing hypothalamic-pituitary-adrenal (HPA) axis abnormalities in PTSD. The findings suggest that the chronic nature of domestic violence leads to a severe dysregulation of the HPA axis.
Griffin
Michael G
MG
University of Missouri-St. Louis, Center for Trauma Recovery, St. Louis, MO 63121, USA. michael_griffin@umsl.edu
Resick
Patricia A
PA
Yehuda
Rachel
R
D000328:Adult; D018585:Battered Women / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D003866:Depressive Disorder / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D003907:Dexamethasone; D017579:Domestic Violence / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data
D003907:Dexamethasone; D006854:Hydrocortisone