Cortisol at the emergency room rape visit as a predictor of PTSD and depression symptoms over time

PSYCHONEUROENDOCRINOLOGY

卷:38

Article

Walsh, Kate¹  Nugent, Nicole R.^2,3  Kotte, Amelia^4,5  Amstadter, Ananda B.⁶  Wang, Sheila⁷  Guille, Constance⁸  Acierno, Ron⁸  Kilpatrick, Dean G.⁸  Resnick, Heidi S.⁸ 

[1] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, New York, NY USA

[2] Hasbro Childrens Res Ctr, DPHB Alpert Brown Med Sch, Providence, RI USA

[3] Hasbro Childrens Res Ctr, RIH Bradley, Providence, RI USA

[4] Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA

[5] Massachusetts Gen Hosp, Boston, MA 02114 USA

[6] Virginia Commonwealth Univ, Virginia Inst Psychiat & Behav Genet, Dept Psychiat, Richmond, VA USA

[7] Childrens Mem Hosp, Feinberg Sch Med, Dept Pediat, Chicago, IL 60614 USA

[8] Med Univ S Carolina, Natl Crime Victims Res & Treatment Ctr, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA

关键词: Cortisol;    Hypothalamic-pituitary-adrenal axis;    Sexual assault;    Early intervention;    PTSD;   

DOI  :  10.1016/j.psyneuen.2013.05.017

来源: Elsevier

【 摘 要 】

Background: Dysregulation of the hypothalamic-pituitary-adrenal axis, typically reflected by alterations in cortisol responsivity, has been associated with exposure to traumatic events and the development of stress-related disorders such as posttraumatic stress disorder (PTSD) and depression. Methods: Serum cortisol was measured at the time of a post sexual assault medical exam among a sample of 323 female victims of recent sexual assault. Analyses were conducted among 235 participants who provided data regarding history of previous assault as well as PTSD and depression symptoms during at least one of the three follow-ups. Results: Growth curve models suggested that prior history of assault and serum cortisol were positively associated with the intercept and negatively associated with the slope of PTSD and depression symptoms after controlling for covariates. Prior history of assault and serum cortisol also interacted to predict the intercept and slope of PTSD and depression symptoms such that women with a prior history of assault and lower ER cortisol had higher initial symptoms that decreased at a slower rate relative to women without a prior history and those with higher ER cortisol. Conclusions: Prior history of assault was associated with diminished acute cortisol responsivity at the emergency room visit. Prior assault history and cortisol both independently and interactively predicted PTSD and depression symptoms at first follow-up and over the course a 6-month follow-up. (C) 2013 Elsevier Ltd. All rights reserved.

【 授权许可】

Free