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Diurnal salivary cortisol in pediatric posttraumatic stress disorder
Victor G Carrion1, Carl F Weems, Rebecca D Ray
1Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry and Child Development, Stanford University School of Medicine, Stanford, CA 94305-5719, USA.
Insights
Children with posttraumatic stress disorder (PTSD) exhibit heightened cortisol levels, indicating increased adrenal activity. This finding sheds light on the hypothalamic-pituitary-adrenal axis
Area of Science:
- Neuroendocrinology
- Child Psychology
- Trauma Studies
Background:
- The hypothalamic-pituitary-adrenal (HPA) axis is linked to the development of posttraumatic stress disorder (PTSD).
- Understanding basal cortisol levels in children with trauma exposure and PTSD symptoms is crucial for elucidating the HPA axis' role.
Purpose of the Study:
- To investigate basal cortisol levels in children experiencing PTSD symptoms following trauma exposure.
- To compare cortisol levels between children with PTSD symptoms and healthy controls.
Main Methods:
- Salivary cortisol was measured in 51 children with trauma exposure and PTSD symptoms and 31 matched healthy controls.
- Cortisol samples were collected four times daily for up to three consecutive days during home-based measurements.
Main Results:
- Children with PTSD symptoms showed significantly elevated cortisol levels compared to the control group.
- Girls with PTSD symptoms exhibited higher cortisol levels than boys with PTSD symptoms.
Conclusions:
- Children with a history of trauma and PTSD symptoms display heightened adrenal activity.
- These findings suggest a distinct physiological response pattern in pediatric PTSD.
Background:
The hypothalamic-pituitary-adrenal (HPA) axis has been implicated in the pathophysiology of posttraumatic stress disorder (PTSD). Additional information on basal cortisol levels in children exposed to trauma and experiencing PTSD symptoms may contribute to the understanding of the role of this axis in PTSD.
Methods:
Fifty-one children (30 boys and 21 girls, mean age 10.7 years) with a history of exposure to trauma and PTSD symptoms were compared with 31 age- and gender-matched healthy control subjects. Salivary cortisol was obtained from participants during home measurements and was collected four times a day (prebreakfast, prelunch, predinner, and prebed) for up to 3 consecutive days.
Results:
The clinical group demonstrated significantly elevated cortisol levels when compared with the control group. In addition, exploratory analyses revealed that girls with PTSD symptoms had significantly elevated cortisol levels when compared with boys with PTSD symptoms.
Conclusions:
The physiologic response of children with history of trauma and with PTSD symptoms may be characterized by heightened adrenal activity.