TY - JOUR
T1 - Gender moderates diurnal cortisol in relation to trauma and PTSD symptoms
T2 - A study in Sri Lankan adolescents
AU - Nicolson, Nancy A.
AU - Ponnamperuma, Thyagi
N1 - Funding Information:
This work was supported by Cordaid, the Netherlands , and the School for Mental Health and Neuroscience (MHeNs), Maastricht University .
Publisher Copyright:
© 2019
PY - 2019/6
Y1 - 2019/6
N2 - Trauma exposure and posttraumatic stress disorder (PTSD) have been linked to aspects of diurnal cortisol secretion in adolescents, but little is known about gender differences in these associations. A school-based sample of Sri Lankan adolescents aged 13-16 years took part in this study 4.5 years after the 2004 tsunami had impacted many of their lives to varying degrees. Saliva samples were obtained 4 times a day for 3 days in 84 participants, who also completed measures of lifetime trauma, current stressors, and posttraumatic stress symptoms (PTSS). We used multilevel regression to estimate effects of trauma exposure and symptoms on cortisol level, diurnal slope, and awakening response (CAR). Results indicated higher cortisol in girls and older adolescents. Although trauma, PTSS, and recent PTSD had non-significant main effects, these three variables interacted with gender, with higher cortisol in girls than in similarly traumatized or symptomatic boys. Co-occurrence of internalizing symptoms and PTSS was also associated with higher cortisol. The 28 adolescents with recent PTSD displayed flatter diurnal slopes, reflecting relatively low morning cortisol. Among the 56 trauma-exposed participants, negative trauma appraisals were associated with higher cortisol. Girls were more likely than boys to display elevated cortisol in relation to re-experiencing and hyperarousal symptoms. In contrast to significant findings for cortisol level and diurnal slope, the CAR showed no association with either trauma or PTSS, irrespective of gender. Findings, viewed in light of normative gender differences in HPA activity during adolescence, can contribute to understanding heightened female vulnerability to posttraumatic stress disorder.
AB - Trauma exposure and posttraumatic stress disorder (PTSD) have been linked to aspects of diurnal cortisol secretion in adolescents, but little is known about gender differences in these associations. A school-based sample of Sri Lankan adolescents aged 13-16 years took part in this study 4.5 years after the 2004 tsunami had impacted many of their lives to varying degrees. Saliva samples were obtained 4 times a day for 3 days in 84 participants, who also completed measures of lifetime trauma, current stressors, and posttraumatic stress symptoms (PTSS). We used multilevel regression to estimate effects of trauma exposure and symptoms on cortisol level, diurnal slope, and awakening response (CAR). Results indicated higher cortisol in girls and older adolescents. Although trauma, PTSS, and recent PTSD had non-significant main effects, these three variables interacted with gender, with higher cortisol in girls than in similarly traumatized or symptomatic boys. Co-occurrence of internalizing symptoms and PTSS was also associated with higher cortisol. The 28 adolescents with recent PTSD displayed flatter diurnal slopes, reflecting relatively low morning cortisol. Among the 56 trauma-exposed participants, negative trauma appraisals were associated with higher cortisol. Girls were more likely than boys to display elevated cortisol in relation to re-experiencing and hyperarousal symptoms. In contrast to significant findings for cortisol level and diurnal slope, the CAR showed no association with either trauma or PTSS, irrespective of gender. Findings, viewed in light of normative gender differences in HPA activity during adolescence, can contribute to understanding heightened female vulnerability to posttraumatic stress disorder.
KW - Cortical
KW - Trauma
KW - Posttraumatic stress
KW - Adolescents
KW - Gender differences
KW - Appraisals
KW - POSTTRAUMATIC-STRESS-DISORDER
KW - PITUITARY-ADRENAL ACTIVITY
KW - SALIVARY ALPHA-AMYLASE
KW - HAIR CORTISOL
KW - PSYCHOMETRIC PROPERTIES
KW - CHILD MALTREATMENT
KW - AWAKENING RESPONSE
KW - LIFE STRESS
KW - AXIS
KW - PSYCHOPATHOLOGY
U2 - 10.1016/j.psyneuen.2019.02.012
DO - 10.1016/j.psyneuen.2019.02.012
M3 - Article
C2 - 30844606
SN - 0306-4530
VL - 104
SP - 122
EP - 131
JO - Psychoneuroendocrinology
JF - Psychoneuroendocrinology
ER -