Citation

Witteveen AB, Huizink AC, Slottje P, Bramsen I, Smid T, van der Ploeg HM. Psychoneuroendocrinology 2010; 35(7): 1113-1118.

Affiliation

EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, Academic Medical Center, University of Amsterdam.

Copyright

(Copyright © 2010, Elsevier Publishing)

DOI

10.1016/j.psyneuen.2009.12.013

PMID

20083359

Abstract

Given the inconsistent associations of cortisol with posttraumatic stress disorder (PTSD), analysis of basal functioning of the hypothalamic-pituitary-adrenal (HPA) axis in subjects frequently exposed to trauma and critical incidents with a range of PTSD symptomatology, may be valuable. In an epidemiological sample of 1880 police officers and firefighters, associations of salivary cortisol with PTSD, negative life events (NLE) and exposure to a major air disaster more than 8 years earlier, was explored. Probable PTSD was unrelated to cortisol level while past (>8 years earlier) and more recently experienced NLE were associated with lower cortisol levels even after adjustment for confounders. Disaster exposure interacted significantly with PTSD symptoms on cortisol level. In the disaster-exposed subgroup, PTSD symptomclusters of intrusion and hyperarousal (in particular sleep disturbances), were associated with lower and higher cortisol levels, respectively. A final model using backward elimination strategy, retained time of saliva sampling, smoking, gender, and NLE>8 years earlier in the total sample, and additionally symptomclusters of intrusion and hyperarousal in the disaster-exposed subgroup. The final model explained 10% of the variance in cortisol. The findings are discussed in relation to literature on posttraumatic stress and basal functioning of the HPA-axis.

Language: en