title: Hair cortisol concentrations and cortisol stress reactivity predict PTSD symptom increase after trauma exposure during military deployment.
abstract: BACKGROUND
  Previous evidence on endocrine risk markers for posttraumatic stress disorder (PTSD) has been inconclusive. Here, we report results of the first prospective study to investigate whether long-term hair cortisol levels and experimentally-induced cortisol stress reactivity are predictive of the development of PTSD symptomatology in response to trauma during military deployment.
  
  
  METHODS
  Male soldiers were examined before deployment to Afghanistan and at a 12-month post-deployment follow-up using dimensional measures for psychopathological symptoms. The predictive value of baseline (i) hair cortisol concentrations (HCC, N=90) and (ii) salivary cortisol stress reactivity (measured by the Trier Social Stress Test, N=80) for the development of PTSD symptomatology after being exposed to new-onset traumatic events was analyzed.
  
  
  RESULTS
  Baseline cortisol activity significantly predicted PTSD symptom change from baseline to follow-up upon trauma exposure. Specifically, our results consistently revealed that lower HCC and lower cortisol stress reactivity were predictive of a greater increase in PTSD symptomatology in soldiers who had experienced new-onset traumatic events (explaining 5% and 10.3% of variance, respectively). Longitudinal analyses revealed an increase in HCC from baseline to follow-up and a trend for a negative relationship between HCC changes and the number of new-onset traumatic events. Additional pre-deployment analyses revealed that trauma history was reflected in lower HCC (at trend level) and that HCC were negatively related to stressful load.
  
  
  CONCLUSIONS
  Our data indicate that attenuated cortisol secretion is a risk marker for subsequent development of PTSD symptomatology upon trauma exposure. Future studies are needed to confirm our findings in other samples.
authors.affiliation: Institute of Biological Psychology, Technische Universität Dresden, 01062 Dresden, Germany. Electronic address: susann.schmiedgen@tu-dresden.de.
authors.forename: Susann
authors.initials: S
authors.lastname: Steudte-Schmiedgen
authors.affiliation: Institute of Biological Psychology, Technische Universität Dresden, 01062 Dresden, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Stalder
authors.affiliation: Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, 01187 Dresden, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Schönfeld
authors.affiliation: Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, 01187 Dresden, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
authors.affiliation: Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, 01187 Dresden, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Trautmann
authors.affiliation: Institute of Biological Psychology, Technische Universität Dresden, 01062 Dresden, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Alexander
authors.affiliation: Institute of Biological Psychology, Technische Universität Dresden, 01062 Dresden, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Miller
authors.affiliation: Institute of Biological Psychology, Technische Universität Dresden, 01062 Dresden, Germany.
authors.forename: Clemens
authors.initials: C
authors.lastname: Kirschbaum
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D006197:Hair / Q000737:chemistry / Q000378:metabolism*; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis / Q000378:metabolism*; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008889:Military Personnel; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011594:Psychometrics; D012307:Risk Factors; D012463:Saliva / Q000737:chemistry / Q000378:metabolism; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000378:metabolism* / Q000523:psychology; D013315:Stress, Psychological; D014947:Wounds and Injuries / Q000378:metabolism* / Q000523:psychology
chemical_list: D006854:Hydrocortisone
keywords: Cortisol; Hair; Posttraumatic stress disorder; Saliva; Traumatization; Trier Social Stress Test