Dual-hormone stress reactivity predicts downstream war-zone stress-evoked PTSD.
The crucial role of the hypothalamic-pituitary-adrenal axis (HPA) in stress-related homeostasis suggests dysregulated HPA involvement in the pathogenesis of post-traumatic stress disorder (PTSD), yet most studies examining linkages between HPA axis measures and PTSD have yielded null findings. One untested explanation for this inconsistency is a failure to account for simultaneous adrenal and gonadal influence. Here we tested the singular and interactive effects of cortisol (CR) and testosterone (TR) reactivity as moderators of war-zone stress evoked PTSD emergence in the war-zone.



U.S. soldiers (N=120) scheduled for deployment to Iraq completed pre-deployment measures of CRand TRstress reactivity to a CO2inhalation challenge. Once deployed, monthly assessments of exposure to traumatic war-zone stressors and PTSD symptoms were collected via a web-based assessment system.



Cortisol hypo-reactivity potentiated the pathogenic impact of war-zone stressors only in soldiers for whom the CO2challenge did not elevate testosterone, suggesting that the dual hormone stress reactivity profile of blunted cortisol and testosterone may confer increased risk for PTSD emergence by potentiating the pathogenic effects of war-zone stressors.



Findings underscore the utility of assessing both HPA and HPG stress reactivity when assessing PTSD vulnerability and may help inform efforts for enhanced soldier screening and inoculation to war-zone stressors.
Department of Psychology, University of Texas at Austin, Austin, TX 78712, USA; Institute for Mental Health Research, University of Texas at Austin, Austin, TX 78712, USA; Clinical Neuroendocrinology Laboratory, University of Texas at Austin, Austin, TX 78712, USA.
Robert A
RA
Josephs
Department of Psychology, University of Texas at Austin, Austin, TX 78712, USA; Institute for Mental Health Research, University of Texas at Austin, Austin, TX 78712, USA.
Adam R
AR
Cobb
Department of Psychology, University of Texas at Austin, Austin, TX 78712, USA; Institute for Mental Health Research, University of Texas at Austin, Austin, TX 78712, USA.
Cynthia L
CL
Lancaster
Department of Psychology, University of Texas at Austin, Austin, TX 78712, USA; Laboratory for the Study of Anxiety Disorders, University of Texas at Austin, Austin, TX 78712, USA.
Han-Joo
HJ
Lee
Department of Psychology, University of Texas at Austin, Austin, TX 78712, USA; Institute for Mental Health Research, University of Texas at Austin, Austin, TX 78712, USA; Laboratory for the Study of Anxiety Disorders, University of Texas at Austin, Austin, TX 78712, USA. Electronic address: Telch@austin.utexas.edu.
Michael J
MJ
Telch
D000328:Adult; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D012463:Saliva / Q000737:chemistry; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000503:physiopathology; D013739:Testosterone / Q000032:analysis*
D013739:Testosterone; D006854:Hydrocortisone
Cortisol; Military; PTSD; Stress-reactivity; Testosterone; War-zone assessment