title: The Cortisol Paradox of Trauma-Related Disorders: Lower Phasic Responses but Higher Tonic Levels of Cortisol Are Associated with Sexual Abuse in Childhood.
abstract: OBJECTIVE
  Inconsistent findings exist for the activity of the hypothalamic-pituitary-adrenal (HPA) axis in patients with stress related disorders. Recent studies point towards early life stress as a potential modulator.
  
  
  METHODS
  We investigated the impact of childhood sexual abuse on phasic (saliva cortisol reactivity) and tonic (hair cortisol) regulation. Furthermore, we assessed predictors on cortisol accumulation in hair. Women (N = 43) with stress-related disorders underwent a standardized assessment of idiographic adverse and traumatic experiences and psychopathology, while measuring salivary cortisol and, heart rate and blood pressure.
  
  
  RESULTS
  Comparing women with and without childhood sexual abuse revealed lower rates of responders and distinct levels of salivary cortisol to the interview in conjunction with a lower heart rate for the abused group. Childhood adversities, traumatic experiences, and depression contributed to higher hair cortisol levels.
  
  
  CONCLUSIONS
  Our finding of lower response rate and distinct salivary cortisol pattern in individuals with childhood sexual abuse compared to individuals without early sexual abuse supports the role of environmental programming for the HPA axis. Both, childhood adversities and traumatic stress emerge as crucial factors for long-term cortisol secretion. Lower or suppressed phasic cortisol responses to trauma-related stimuli may therefore be associated with higher tonic values. Thus, early exposure to adversities may result in a biological distinct phenotype in adult patients with stress-related disorders.
authors: Clinical Psychology, Department of Psychology, University of Konstanz, Konstanz, Germany.
authors: Inga
authors: I
authors: Schalinski
authors: Clinical Psychology, Department of Psychology, University of Konstanz, Konstanz, Germany.
authors: Thomas
authors: T
authors: Elbert
authors: Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany.
authors: Susann
authors: S
authors: Steudte-Schmiedgen
authors: Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany.
authors: Clemens
authors: C
authors: Kirschbaum
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D002648:Child; D002650:Child Abuse, Sexual / Q000208:ethnology / Q000523:psychology*; D005260:Female; D005858:Germany / Q000208:ethnology; D006197:Hair / Q000737:chemistry*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007406:Interview, Psychological / Q000379:methods / Q000592:standards; D008875:Middle Aged; D012463:Saliva / Q000737:chemistry*; D013315:Stress, Psychological / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology; D055815:Young Adult
chemical_list: D006854:Hydrocortisone