Cortisol Awakening Response Prospectively Predicts Peritraumatic and Acute Stress Reactions in Police Officers

被引:55
作者
Inslicht, Sabra S. [1 ,2 ]
Otte, Christian [4 ]
McCaslin, Shannon E. [1 ,2 ]
Apfel, Brigitte A. [1 ,2 ]
Henn-Haase, Clare [5 ]
Metzler, Thomas [1 ,3 ]
Yehuda, Rachel [6 ]
Neylan, Thomas C. [1 ,2 ]
Marmar, Charles R. [5 ]
机构
[1] San Francisco VA Med Ctr, PTSD Res Program, San Francisco, CA USA
[2] Univ Calif San Francisco, Dept Psychiat, San Francisco, CA USA
[3] No Calif Inst Res & Educ, San Francisco, CA USA
[4] Charite, Dept Psychiat & Psychotherapy, Ctr Berlin, D-13353 Berlin, Germany
[5] NYU, Sch Med, Dept Psychiat, New York, NY USA
[6] Mt Sinai Sch Med, Traumat Stress Div, Bronx, NY USA
关键词
Acute stress disorder; cortisol; peritraumatic dissociation; police stress; posttraumatic stress disorder; POSTTRAUMATIC-STRESS; SALIVARY CORTISOL; PTSD SYMPTOMS; PSYCHOMETRIC PROPERTIES; SLEEP QUALITY; HPA AXIS; TRAUMA; SEVERITY; DISORDER; HORMONES;
D O I
10.1016/j.biopsych.2011.06.030
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Background: The hypothalamic-pituitary-adrenal axis is a major stress response system hypothesized to be involved in the pathogenesis of posttraumatic stress disorder (PTSD). However, few studies have prospectively examined the relationships among pre-exposure hypothalamic-pituitary-adrenal activity, acute stress reactions and PTSD. Methods: Two hundred ninety-six police recruits were assessed during academy training before critical incident exposure and provided salivary cortisol at first awakening and after 30 minutes. A measure of cortisol awakening response (CAR) was computed as the change in cortisol level from the first to the second collection. At 12, 24, and 36 months following the start of active police service, officers were assessed for peritraumatic distress, peritraumatic dissociation, acute stress disorder (ASD) symptoms, and PTSD symptoms to their self-identified worst duty-related critical incident. Mixed models for repeated measures were used to analyze the effects of CAR on the outcome variables pooled across the three follow-up assessments. Results: After controlling for time of awakening, first awakening cortisol levels, and cumulative critical incident stress exposure, CAR during academy training was associated with greater peritraumatic dissociation, beta = .14, z = 3.49, p < .0001, and greater ASD symptoms during police service assessed at 12, 24, and 36 months, beta = .09, Z = 2.03, p < .05, but not with peritraumatic distress, beta = .03, z = .81, p = .42, or PTSD symptoms, beta = -.004, z = -.09, p = .93. Conclusions: These findings suggest that greater cortisol response to awakening is a pre-exposure risk factor for peritraumatic dissociation and ASD symptoms during police service.
引用
收藏
页码:1055 / 1062
页数:8
相关论文
共 66 条
[21]  
Derogatis L.R., 1997, SCL-90-R Administration scoring and procedures manual -1-
[22]  
Derogatis L.R., 1983, SCL 90 R, V2nd
[23]   No effects of repeated forced wakings during three consecutive nights on morning cortisol awakening responses (CAR): A preliminary study [J].
Dettenborn, Lucia ;
Rosenloecher, Franziska ;
Kirschbaum, Clemens .
PSYCHONEUROENDOCRINOLOGY, 2007, 32 (8-10) :915-921
[24]   Exploration of the awakening cortisol response in relation to diurnal cortisol secretory activity [J].
Edwards, S ;
Clow, A ;
Evans, P ;
Hucklebridge, F .
LIFE SCIENCES, 2001, 68 (18) :2093-2103
[25]   EFFECTS OF CORTICOTROPIN-RELEASING FACTOR AND GROWTH HORMONE-RELEASING FACTOR ON SLEEP AND ACTIVITY IN RATS [J].
EHLERS, CL ;
REED, TK ;
HENRIKSEN, SJ .
NEUROENDOCRINOLOGY, 1986, 42 (06) :467-474
[26]  
First M. B., 1996, Structured clinical interview for DSM-IV axis II personality disorders (SCID II)
[27]   THE INFLUENCE OF ENDOCRINE HORMONES ON THE AUTONOMIC NERVOUS-SYSTEM [J].
GIBSON, A .
JOURNAL OF AUTONOMIC PHARMACOLOGY, 1981, 1 (04) :331-358
[28]   The cortisol awakening response: A pilot study on the effects of shift work, morningness and sleep duration [J].
Griefahn, Barbara ;
Robens, Sibylle .
PSYCHONEUROENDOCRINOLOGY, 2008, 33 (07) :981-988
[29]   Predicting posttraumatic stress symptoms from pretraumatic risk factors: A 2-year prospective follow-up study in firefighters [J].
Heinrichs, M ;
Wagner, D ;
Schoch, W ;
Soravia, LM ;
Hellhammer, DH ;
Ehlert, U .
AMERICAN JOURNAL OF PSYCHIATRY, 2005, 162 (12) :2276-2286
[30]   Several daily measurements are necessary to reliably assess the cortisol rise after awakening: State- and trait components [J].
Hellhammer, J. ;
Fries, E. ;
Schweisthal, O. W. ;
Schlotz, W. ;
Stone, A. A. ;
Hagemann, D. .
PSYCHONEUROENDOCRINOLOGY, 2007, 32 (01) :80-86