Enhanced cortisol suppression in response to dexamethasone administration in traumatized veterans with and without posttraumatic stress disorder
PsychoneuroendocrinologyPublished 13 February 2007
Carien S. de Kloet, Eric Vermetten, Cobi J. Heijnen, E. Geuze, Eef G.W.M. Lentjes, H.G.M. Westenberg
Citations175
SJR quartileQ1
SJR score1.45
SNIP1.16
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The data suggest that enhanced cortisol suppression to dexamethasone is related to trauma exposure and not specifically to PTSD, and suggests that a flattened ACR may be a result of clinical symptoms.
Abstract
These data suggest that enhanced cortisol suppression to dexamethasone is related to trauma exposure and not specifically to PTSD. The correlation between the ACR and PTSD severity suggests that a flattened ACR may be a result of clinical symptoms.
Keywords
PsychologyMedicineNeuroscience
Encyclopedia of Social WorkDiagnostic and Statistical Manual of Mental Disorders
109,983 Citations2013Janet B. W. Williams, Michael B. First
Journal of Traumatic StressThe development of a Clinician-Administered PTSD Scale
4,442 Citations1995Dudley David Blake, Frank W. Weathers +5 more
The Clinician-Administered PTSD Scale (CAPS-1) is a structured interview for assessing core and associated symptoms of PTSD and is intended for use by experienced clinicians, and also can be administered by appropriately trained paraprofessionals.
Journal of Traumatic StressThe development of a clinician‐administered PTSD scale
3,664 Citations1995Dudley David Blake, Frank W. Weathers +5 more
PsychoneuroendocrinologyTwo formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change
3,635 Citations2003Jens C. Pruessner, Clemens Kirschbaum +2 more
It is shown that depending on which formula is used, different associations with other variables may emerge, and it is recommended to employ both formulas when analyzing data sets with repeated measures.
The British Journal of PsychiatryThe SCL-90 and the MMPI: A Step in the Validation of a New Self-Report Scale
2,307 Citations1976Leonard R. Derogatis, Karl Rickels +1 more
Comparisons of the nine primary symptom dimensions of the SCL-90 with the set of MMPI scales reflected very high convergent validity for the Scl-90, with secondary patterns of correlations showing high interpretative consistency.
American Journal of PsychiatryWhen Not Enough Is Too Much: The Role of Insufficient Glucocorticoid Signaling in the Pathophysiology of Stress-Related Disorders
1,194 Citations2003Charles L. Raison, Andrew H. Miller
Neuroendocrine data provide evidence of insufficient glucocorticoid signaling in stress-related neuropsychiatric disorders, including alterations in behavior, insulin sensitivity, bone metabolism, and acquired immune responses.
StressThe Awakening Cortisol Response: Methodological Issues and Significance
856 Citations2004Angela Clow, Leslie Ann Thorn +2 more
A review explores reasons for discrepancies in normative data including confounding factors such as gender, age, awakening time, light and participant adherence that suggest the awakening cortisol response is under a distinct regulatory influence different from the rest of the diurnal cortisol secretory cycle.
American Journal of PsychiatryAltered Pituitary-Adrenal Axis Responses to Provocative Challenge Tests in Adult Survivors of Childhood Abuse
736 Citations2001Christine Heim, D. Jeffrey Newport +3 more
Abused women without major depressive disorder exhibited greater than usual ACTH responses to CRF administration, whereas abused women with major de...
American Journal of PsychiatryElevated CSF corticotropin-releasing factor concentrations in posttraumatic stress disorder
717 Citations1997J. Douglas Bremner, Júlio Licinio +6 more
Higher CSFCRF concentrations in patients with PTSD may reflect alterations in stress-related neurotransmitter systems, and the higher CSF CRF concentrations may play a role in disturbances of arousal in Patients with PTSD.
Annals of the New York Academy of SciencesPosttraumatic Stress Disorder and Physical Illness: Results from Clinical and Epidemiologic Studies
692 Citations2004Joseph A. Boscarino
Assessment of the association between chronic PTSD in a national sample of Vietnam veterans and the prevalence of common autoimmune diseases suggests that chronic PTSD, particularly comorbid PTSD or complex PTSD, is associated with all of these conditions.
PsychoneuroendocrinologyStress-restress: Effects on ACTH and fast feedback
541 Citations1997Israel Liberzon, Melissa Krstov +1 more
Pretreatment with cortisol, in the first stress session, did not prevent the development of the enhanced fast feedback when restressed, suggesting that stress-restress paradigm might serve as a good animal model for HPA abnormalities found in PTSD patients.
American Journal of PsychiatrySerial CSF Corticotropin-Releasing Hormone Levels and Adrenocortical Activity in Combat Veterans With Posttraumatic Stress Disorder
526 Citations1999Dewleen G. Baker, Scott A. West +7 more
High basal CSF CRH concentrations and normal 24-hour urinary-free cortisol excretion in combat veterans with PTSD, a combination that appears to be unique among psychiatric conditions studied to date are found.
American Journal of PsychiatryEnhanced suppression of cortisol following dexamethasone administration in posttraumatic stress disorder
518 Citations1993Rachel Yehuda, Steven M. Southwick +4 more
The data support earlier studies showing that HPA abnormalities in PTSD are different from those seen in depression and suggest that the low-dose dexamethasone suppression test may be a potentially useful tool for differentiating the two syndromes and further exploring differences in their pathophysiology.
Psychiatric Clinics of North AmericaCurrent status of cortisol findings in post-traumatic stress disorder
510 Citations2002Rachel Yehuda
Findings of hypothalamic-pituitary-adrenal axis alterations in post-traumatic stress disorder are summarized and disparate findings are explained as illustrating a more complex neuroendocrinology of PTSD than has previously been described.
Journal of Psychiatric ResearchAssessment of HPA-axis function in posttraumatic stress disorder: Pharmacological and non-pharmacological challenge tests, a review
500 Citations2005Carien S. de Kloet, Eric Vermetten +4 more
All English-language, human subject, data driven, pharmacological and non-pharmacological challenge studies pertaining to the HPA axis, and in vitro leukocyte glucocorticoid receptor studies in adult PTSD subjects are reviewed.
Archives of General PsychiatryDose-Response Changes in Plasma Cortisol and Lymphocyte Glucocorticoid Receptors Following Dexamethasone Administration in Combat Veterans With and Without Posttraumatic Stress Disorder
449 Citations1995Rachel Yehuda
The data support the hypothesis of an enhanced negative feedback sensitivity of the hypothalamic-pituitary-adrenal axis in PTSD and combat veterans with PTSD suppressed cortisol to a greater extent than did combat veterans without PTSD and normal controls in response to both doses of dexamethasone.
Biological PsychiatryHypocortisolism and increased glucocorticoid sensitivity of pro-Inflammatory cytokine production in Bosnian war refugees with posttraumatic stress disorder
391 Citations2004Nicolas Rohleder, Ljiljana Joksimović +2 more
In refugees with PTSD, hypocortisolism is associated with increased GC sensitivity of immunologic tissues, whether this pattern reflects an adaptive mechanism and whether this is sufficient to protect from detrimental effects of low cortisol remains to be investigated.
PsychoneuroendocrinologyChild maltreatment and HPA axis dysregulation: relationship to major depressive disorder and post traumatic stress disorder in females
379 Citations2004Alison K. Shea, Christine A. Walsh +2 more
The role of HPA axis dysregulation in the link between child maltreatment and MDD/PTSD among women is explored and the strongest evidence to date suggesting that the development of the HPAaxis may be affected by early life stressful experiences comes from pre-clinical animal studies.
Life SciencesThe cortisol response to awakening in relation to different challenge tests and a 12-hour cortisol rhythm
365 Citations1999Astrid K. Schmidt-Reinwald, Jens C. Pruessner +5 more
It is concluded that the morning cortisol response to awakening can provide important information on the (re)activity of the HPA axis in addition to more 'traditional' methods like hCRH or Synacthen challenge tests.
Psychosomatic MedicineDiseases Among Men 20 Years After Exposure to Severe Stress
354 Citations1997Joseph A. Boscarino
There is a direct link between severe stress exposures and a broad spectrum of human diseases, and medical researchers and clinicians should focus more on the medical consequences of exposure to severe environmental stress and seek to better integrate psychobiologic models of disease pathogenesis.
Biological PsychiatryEnhanced Dexamethasone Suppression of Plasma Cortisol in Adult Women Traumatized by Childhood Sexual Abuse
348 Citations1997Murray B. Stein, Rachel Yehuda +2 more
Women with CSA had significantly enhanced suppression of plasma cortisol in response to 0.5 mg dexamethasone compared to the nonvictimized women, suggesting that this pattern of HPA axis dysfunction may be a characteristic sequel of psychiatric disorders that occur following a range of traumatic experiences.
Life SciencesExploration of the awakening cortisol response in relation to diurnal cortisol secretory activity
338 Citations2001Sue Edwards, Angela Clow +2 more
A comprehensive study of the diurnal free cortisol cycle designed to analyse its components and to investigate their reliability and inter-relatedness is reported.
American Journal of PsychiatryBasal cortisol, dexamethasone suppression of cortisol, and MHPG in adolescents after the 1988 earthquake in Armenia
312 Citations1996Armen Goenjian, Rachel Yehuda +6 more
The findings indicate that chronic posttraumatic stress reactions among adolescents exposed to catastrophic disaster are associated with hypothalamic-pituitary-adrenal (HPA) axis alterations and are congruent with those previously described in adults with chronic PTSD.
PsychopharmacologyIncreased salivary cortisol after waking in depression
282 Citations2005Zubin Bhagwagar, Sepehr Hafizi +1 more
Depressed patients in the community appear to have increased early morning cortisol secretion, but the demonstration of this effect requires control for time of waking.
PsychoneuroendocrinologyAltered cortisol awakening response in posttraumatic stress disorder
280 Citations2005Michèle Wessa, Nicolas Rohleder +2 more
A significant negative correlation between the overall cortisol secretion (AUC(G)) and overall PTSD symptomatology and hyper-arousal symptoms was found, and the expected cortisol increase to awakening 15-60 min later was significantly lower in PTSD patients compared to non-PTSD subjects and healthy controls.
Biological PsychiatryHyperresponsiveness of hypothalamic-pituitary-adrenal axis to combined dexamethasone/corticotropin-releasing hormone challenge in female borderline personality disorder subjects with a history of sustained childhood abuse
276 Citations2002Thomas Rinne, E. R. de Kloet +4 more
Hyperresponsiveness of the HPA axis in chronically abused BPD subjects might be due to the enhanced central drive to pituitary ACTH release, possibly due to an enhanced efficacy of HPA suppression by dexamethasone, PTSD attenuates the ACTH response to DEX/CRH.
Biological PsychiatryBlunted HPA Axis Response to Stress Influences Susceptibility to Posttraumatic Stress Response in Rats
272 Citations2006Hagit Cohen, Joseph Zohar +6 more
The results suggest that a blunted HPA response to stress may play a causal role in this model of PTSD and that this susceptibility may be prevented by administration of cortisol before stress exposure.
Biological PsychiatryThe relevance of differential response to trauma in an animal model of posttraumatic stress disorder
270 Citations2003Hagit Cohen, Joseph Zohar +1 more
Animals can be divided into distinct groups according to magnitude of response and be studied accordingly, and maladapted rats exhibited significantly higher plasma corticosterone and corticotropin concentrations, increased sympathetic activity, diminished vagal tone, and increased sympathovagal balance.
PharmacopsychiatryStress Responsive Neurohormones in Depression and Anxiety
264 Citations2003Andreas Ströhle, Florian Holsboer
The role of the HPA system in major depression, panic disorder and posttraumatic stress disorder is reviewed and preclinical and clinical data on its anxiolytic activity suggest that non-peptidergic ANP receptor ligands may be of potential use in the treatment of anxiety disorders.
NeuropsychopharmacologySetting Apart the Affected: The Use of Behavioral Criteria in Animal Models of Post Traumatic Stress Disorder
257 Citations2004Hagit Cohen, Joseph Zohar +4 more
Prevalence rates of maladaptive vs adaptive responses determined according to a more stringent approach to the concept of inclusion/exclusion criteria (cutoff behavioral criteria—CBC) were assessed in rats exposed to stressors in two different paradigms; exposure to a predator and underwater trauma.
PsychopharmacologyNicotine from cigarette smoking increases circulating levels of cortisol, growth hormone, and prolactin in male chronic smokers
229 Citations1982Jeffrey Wilkins, Harold E. Carlson +4 more
Results of this study indicate that nicotine from cigarette smoking increases circulating levels of cortisol, growth hormone, and prolactin in male chronic smokers, indicating that nicotine itself plays a predominate role in smoking-induced hormone increases.
PsychoneuroendocrinologyEffects of trauma exposure on the cortisol response to dexamethasone administration in PTSD and major depressive disorder
205 Citations2003Rachel Yehuda, Sarah L. Halligan +3 more
Cortisol hypersuppression in PTSD appears not to be dependent on the presence of traumatic events prior to the focal trauma, however, prior trauma exposure may affect cortisol suppression in MDD.
The Journal of Clinical Endocrinology & MetabolismSex Differences in Endocrine and Psychological Responses to Psychosocial Stress in Healthy Elderly Subjects and the Impact of a 2-Week Dehydroepiandrosterone Treatment1
196 Citations1998Brigitte M. Kudielka, Juliane Hellhammer +6 more
It is concluded that elderly men show larger HPA responses than women to psychosocial stress, as studied in the TSST, and DHEA treatment did not result in an improvement of subjective well-being.
NeuroendocrinologyShort Inescapable Stress Produces Long-Lasting Changes in the Brain-Pituitary-Adrenal Axis of Adult Male Rats
182 Citations2008Hielke H. van Dijken, Dimphena C.E. de Goeij +4 more
It is concluded that a single and short session of inescapable footshocks has long-lasting effects on brain-pituitary-adrenal functioning concomitant with behavioural alterations.
Biological PsychiatryPituitary-adrenal responses to standard and low-dose dexamethasone suppression tests in adult survivors of child abuse
181 Citations2003D. Jeffrey Newport, Christine Heim +3 more
Cortisol supersuppression is evident in psychiatrically ill trauma survivors, but not in nondepressed abuse survivors, indicating that enhanced glucocorticoid feedback is not an invariable consequence of childhood trauma but is more related to the resultant psychiatric illness in traumatized individuals.
American Journal of PsychiatryThe ACTH Response to Dexamethasone in PTSD
181 Citations2004Rachel Yehuda, Julia A. Golier +3 more
The data support the hypothesis of enhanced cortisol negative feedback inhibition of ACTH secretion at the level of the pituitary in PTSD, which is implicated as a likely mechanism for this effect.
American Journal of PsychiatryCircadian Rhythm of Salivary Cortisol in Holocaust Survivors With and Without PTSD
179 Citations2005Rachel Yehuda, Julia A. Golier +1 more
Evidence of differential neuroendocrine alterations in geriatric PTSD is found in Holocaust survivors with PTSD, resulting in a flatter circadian rhythm, similar to what has been observed in aging but different from what has be reported in younger subjects with PTSD.
PsychoneuroendocrinologyBehavioral and physiological characterization of male mice under chronic psychosocial stress
173 Citations2003Alessandro Bartolomucci, Tiziana Pederzani +4 more
In conclusion, social status and territory ownership were factors determining individual vulnerability to stress exposure, and the model could be regarded as a valid model to investigate the biological basis of the individual differences in the response to stressful events.
Biological PsychiatryThe cortisol and glucocorticoid receptor response to low dose dexamethasone administration in aging combat veterans and holocaust survivors with and without posttraumatic stress disorder
170 Citations2002Rachel Yehuda, Sarah L. Halligan +3 more
The response to DEX is generally similar in older and younger trauma survivors, but the findings suggest that age, symptom severity, and lifetime trauma exposure characteristics may influence this response.
The Journal of ImmunologyDiurnal rhythmicity of human cytokine production: a dynamic disequilibrium in T helper cell type 1/T helper cell type 2 balance?
168 Citations1997Nikolai Petrovsky, Leonard C. Harrison
The findings support the concept that plasma cortisol and possibly melatonin regulate diurnal variation in the IFN-gamma/IL-10 ratio, and imply that the nature of an immune response, e.g., to vaccination, may be modified by the time of day of Ag presentation and could be therapeutically manipulated by the administration of cortisol or melatonin.
PsychoneuroendocrinologyPTSD symptoms predict waking salivary cortisol levels in police officers
166 Citations2005Thomas C. Neylan, Alain Brunet +5 more
Findings replicate previous research indicating a relationship between greater PTSD symptoms and lower levels of basal cortisol on awakening, and extend this finding to a previously unstudied non-treatment seeking population, urban police.
Biological PsychiatryGlucocorticoid feedback sensitivity and adrenocortical responsiveness in posttraumatic stress disorder
152 Citations2001Evan D. Kanter, Charles W. Wilkinson +6 more
Observations suggest decreased adrenocortical responsiveness may be an additional or alternative mechanism accounting for low cortisol in PTSD.
Griffith Research Online (Griffith University, Queensland, Australia)Glucocorticoid receptor polymorphisms and post-traumatic stress disorder
151 Citations2005Anthony W. Bachmann, Teresa L. Sedgley +4 more
The N363S and BclI GR polymorphisms were not more frequent in PTSD patients than controls and reported population frequencies, and the PTSD group did not display GC hypersensitivity, as measured by the LD-DST and DVVA.
International Journal of Developmental NeuroscienceGender differences in sympathoadrenal activity in rats at rest and in response to footshock stress
146 Citations1998Marta Weinstock, Michal Razin +3 more
The data show that the female sympathoadrenal system is more reactive than that of the male to the stresses of a novel environment and footshock, and the finding that stress produces larger increments of plasma DOPA and DOPAC in female rats indicates that tyrosine hydroxylase in the sympathetic nerve terminals and adrenal medulla may also be higher in males.
Pharmacology Biochemistry and BehaviorGender, Sex Steroids, Corticotropin-Releasing Factor, Nitric Oxide, and the HPA Response to Stress
140 Citations1999Catherine Rivier
Evidence is provided for the influence of circulating sex steroids on pituitary and adrenal activity under some, but not all circumstances.
Journal of NeuroendocrinologyLong‐Lasting Deficient Dexamethasone Suppression of Hypothalamic‐Pituitary‐Adrenocortical Activation Following Peripheral CRF Challenge in Socially Defeated Rats
133 Citations1999Buwalda, de Sietse Boer +10 more
In rats short‐lasting stressors like defeat induce long‐lasting, temporal dynamic changes in the regulation of the HPA axis and since these changes in time are reflected in GRs and MRs in different brain areas an altered corticosteroid receptor binding might play an important role in the affected HPA activity following defeat.
American Journal of PsychiatryHigher Levels of Basal Serial CSF Cortisol in Combat Veterans With Posttraumatic Stress Disorder
132 Citations2005Dewleen G. Baker, Nosa N. Ekhator +5 more
Despite normal peripheral cortisol indexes in the veterans with PTSD, their CNS exposure to cortisol was greater than that of normal comparison subjects.
American Journal of PsychiatryEnhanced Cortisol Suppression Following Dexamethasone Administration in Domestic Violence Survivors
128 Citations2005Michael G. Griffin, Patricia A. Resick +1 more
It is suggested that the chronic nature of domestic violence leads to a severe dysregulation of the HPA axis, and survivors with a sole diagnosis of PTSD showed significantly greater cortisol suppression to dexamethasone than did healthy subjects or the group diagnosed with PTSD plus depression.
Biological PsychiatryBasal and dexamethasone suppressed salivary cortisol concentrations in a community sample of patients with posttraumatic stress disorder
109 Citations2004Steven E. Lindley, Eve B. Carlson +1 more
Neither low basal concentrations nor enhanced suppression of cortisol are consistent markers of a PTSD diagnosis.
PsychoneuroendocrinologyAlterations in cortisol negative feedback inhibition as examined using the ACTH response to cortisol administration in PTSD
108 Citations2005Rachel Yehuda, Ren-Kui Yang +2 more
Central as well as peripheral negative feedback inhibition may be altered in PTSD.
American Journal of PsychiatryDexamethasone Suppression Test Findings in Subjects With Personality Disorders: Associations With Posttraumatic Stress Disorder and Major Depression
89 Citations2003Robert Grossman, Rachel Yehuda +7 more
A high level of cortisol suppression was associated with PTSD in subjects with personality disorder, similar to published findings for PTSD subjects without personality disorders.
Perceptual and Motor SkillsSelf-Rating Inventory for Posttraumatic Stress Disorder: Review of the Psychometric Properties of a New Brief Dutch Screening Instrument
73 Citations2002Johannes E. Hovens, Inge Bramsen +1 more
The Inventory appears to be valuable for survey research on posttraumatic stress in nonselected populations and as a screening device, high sensitivity for PTSD symptoms is evident even when the traumatic event has not been defined.
PsychoneuroendocrinologyEffects of a single footshock followed by situational reminders on HPA axis and behaviour in the aversive context in male and female rats
69 Citations2005Hélène Louvart, Stefania Maccari +4 more
The results suggest that gender might be a key factor impacting the direction of the effects induced by an intense stress, as only females exhibited an increased negative feedback of the HPA axis response to stress, which could parallel endocrine changes of PTSD.
NeuropsychopharmacologyHypothalamic–Pituitary–Adrenal Axis Activity and Sleep in Posttraumatic Stress Disorder
65 Citations2005Christian Otte, Maryann Lenoci +4 more
It is suggested that increased cortisol is negatively associated with delta sleep, which may contribute to sleep abnormalities in conditions associated with elevated cortisol, possibly including PTSD.
Journal of Affective DisordersHormonal differences between psychotic and non-psychotic melancholic depression
64 Citations2006Fernando Contreras, José M. Menchón +4 more
Hormonal disturbances in depression are more evident when studying several axes, being the HPA and the GH axes the most prominents.
PsychoneuroendocrinologyIncreased adrenocorticotropin suppression following dexamethasone administration in sexually abused adolescents with posttraumatic stress disorder
59 Citations2004Fabrice Duval, Marc-Antoine Crocq +5 more
Journal of the American Academy of Child & Adolescent PsychiatrySalivary Cortisol Responses to Dexamethasone in Adolescents With Posttraumatic Stress Disorder
55 Citations2003Deborah S. Lipschitz, Ann M. Rasmusson +7 more
The present study did not find evidence for enhanced suppression of salivary cortisol at 8 a.m. following low-dose dexamethasone in multiply traumatized adolescents with PTSD, which differs from findings in adults with PTSD.
Physiology & BehaviorTemporal and spatial dynamics of corticosteroid receptor down-regulation in rat brain following social defeat
55 Citations2001Bauke Buwalda, Klára Felszeghy +5 more
The results show that brief but intense stress like social defeat induces a long-lasting down-regulation of corticosteroid receptors and that the temporal dynamics of these changes are not only differential for GRs and MRs but also for brain sites.
Psychiatric Clinics of North AmericaPost-traumatic stress disorder
44 Citations2002Cheryl M. Wong
The study of psychoneuroimmunology in PTSD is relevant not only for understanding the biological underpinnings of this disorder, but also for establishing the nature of the associations between PTSD and other medical and psychiatric illnesses.
Life SciencesThe relationship between circadian patterns of salivary cortisol and endogenous inhibitor of monoamine oxidase a
24 Citations1998Frank Hucklebridge, S. Sen +2 more
The circadian pattern of free cortisol, measured in saliva, was monitored in normal healthy adults for the first half hour immediately after awakening and in a smaller group at timed intervals throughout the day to explore the relationship between circadian activation of the hypothalamic-pituitary-adrenocortical (HPA) axis and MAO-AI.
Clinical ChemistryComparison of Two Automated Adrenocorticotropic Hormone Assays
13 Citations2000Michael Vogeser, Dieter Engelhardt +1 more
These assays investigated were solid-phase, sandwich immunoassays that use chemiluminescence for signal generation and are implemented on benchtop, multichannel, random-access analyzers with ready-to-use reagents.
