Relationship between cortisol and age-related memory impairments in Holocaust survivors with PTSD
ABSTRACT Holocaust survivors with PTSD appear to show an accelerated aging effect as evidenced by their performance on tests of explicit memory, and also show more exaggerated patterns on age-related alterations in cortisol release over the diurnal cycle than Holocaust survivors without PTSD and nonexposed subjects. To investigate the implications of age-related HPA axis alterations on cognition, we examined correlations between parameters reflecting circadian cortisol release and implicit and explicit memory performance.
Nineteen Holocaust survivors with PTSD (7 men, 12 women), 16 Holocaust survivors without PTSD (7 men, 9 women), and 28 non-exposed healthy comparison subjects (13 men, 15 women) collected salivary samples at six times over the diurnal cycle, and were tested with Paired Associates and Word Stem Completion Tests.
Negative correlations were observed between several measures of salivary cortisol concentrations and explicit memory in Holocaust survivors with PTSD after adjusting for IQ, years of education and current age reflecting poorer performance in association with higher cortisol levels. This relationship was absent in Holocaust survivors without PTSD and in demographically-comparable subjects who were not exposed to the Holocaust or other extremely traumatic events.
The significantly different relationship between cortisol and memory performance in these groups suggests that the neuropsychological impairments observed in Holocaust survivors with PTSD may reflect an interaction of PTSD and aging effects.
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- "Variations in this diurnal profile have been shown to be related to a number of clinical conditions . In particular, a flatter profile has been observed in people with depression , breast cancer , PTSD , and under severe parenting stress . Despite the demonstrated sensitivity of the cortisol diurnal rhythm to psychosocial factors and clinical conditions, it has not attracted due attention in geriatric research until recently . "
ABSTRACT: Psychobiological research on aging in humans has been confounded by individual differences that have not been adequately characterized in the literature. This paper is an attempt to shed light on this issue by examining the impact of social network characteristics predictive of successful aging on salivary cortisol among 78 older Chinese people in Hong Kong. Eight salivary cortisol samples were collected each day for two consecutive days from immediately after awakening to 12 hours later. Two components of the cortisol diurnal cycle, response to awakening and diurnal decline, were examined in relation to social network characteristics including size, emotional support, and cultivation. ANOVAs with repeated measured were run to examine influences of the three social network characteristics on the cortisol awakening response and diurnal decline, with the effects of gender, age, socioeconomic status, and waking time controlled. Results indicated that those who spent more time and effort in developing and strengthening their social ties (i.e., those high in "cultivation") exhibited a significantly greater rise in cortisol in the morning and a significantly steeper decline over the day, thus attesting to more effective activation and deactivation of the HPA axis. Network cultivation reflected a positive motivation to nurture social relationships more than the other two network characteristics. Its effect on cortisol might stem from the positivity underlying the motivation.The Scientific World Journal 03/2012; 2012:929067. DOI:10.1100/2012/929067 · 1.73 Impact Factor
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- "Studies that included trauma-exposed participants with current MDD were excluded unless only a small minority (<10%) of TE participants met criteria for current MDD (Yehuda et al., 2005); for studies in which current MDD was not assessed, TE groups were included if they represented a sufficiently large sample size (n >70) for expected rates of MDD to exert minimal influence on cortisol outcomes (Boscarino, 1996; Pervanidou et al., 2007). One study included TE participants with current dysthymia (De Bellis et al., 1994); removing this study did not significantly alter results. "
ABSTRACT: Exposure to traumatic stress is associated with increased risk for posttraumatic stress disorder (PTSD) and alterations of hypothalamic-pituitary-adrenocortical (HPA) function. Research linking traumatic stress with HPA function in PTSD has been inconsistent, however, in part due to (a) the inclusion of trauma-exposed individuals without PTSD (TE) in control groups and (b) a failure to consider comorbid major depressive disorder (MDD) and moderating variables. This meta-analysis of 47 studies (123 effect sizes, N=6008 individuals) revealed that daily cortisol output was lower for PTSD (d=-.36, SE=.15, p=.008) and PTSD+MDD (d=-.65, SE=.25, p=.008) groups relative to no trauma controls (NTC); TE and NTC groups did not differ significantly from each other. Afternoon/evening cortisol was lower in TE (d=-.25, SE=.09, p=.007) and PTSD (d=-.27, SE=.12, p=.021) groups and higher in PTSD+MDD groups (d=.49, SE=.24, p=.041) relative to NTC. Post-DST cortisol levels were lower in PTSD (d=-.40, SE=.12, p<.001), PTSD+MDD (d=-.65, SE=.14, p<.001), and TE groups (d=-.53, SE=.14, p<.001) relative to NTC. HPA effect sizes were moderated by age, sex, time since index event, and developmental timing of trauma exposure. These findings suggest that enhanced HPA feedback function may be a marker of trauma-exposure rather than a specific mechanism of vulnerability for PTSD, whereas lower daily cortisol output may be associated with PTSD in particular.Clinical psychology review 02/2012; 32(4):301-15. DOI:10.1016/j.cpr.2012.02.002 · 7.18 Impact Factor
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- "None of the studies used time-monitoring devices. Twentyfive studies checked for potential confounders (Yehuda et al., 2005a), adjusted for potential confounders (Yehuda et al., 2002, 2004b, 2005b, 2009; Bonne et al., 2003; Neylan et al., 2003b; Pico-Alfonso et al., 2004; Rohleder et al., 2004; Young et al., 2004; Young and Breslau, 2004; Griffin et al., 2005; Golier et al., 2006, 2007; Inslicht et al., 2006; Olff et al., 2006; Wessa et al., 2006; de Kloet et al., 2007; Shalev et al., 2008; Gill et al., 2008; Johnson et al., 2008; Metzger et al., 2008; Klaassens et al., 2010a,b) or excluded participants on potentially confounding variables such as smoking (Eckart et al., 2009). Of the 37 included studies, 19 excluded all psychotropic medication, seven did not mention medication use (Neylan et al., 2003b; Lauc et al., 2004; Young et al., 2004; Bierer et al., 2006; Roth et al., 2006; Shalev et al., 2008; Metzger et al., 2008). "
ABSTRACT: Hypothalamic-pituitary-adrenal (HPA)-axis dysregulation has inconsistently been associated with posttraumatic stress disorder (PTSD). Yet, trauma exposure rather than PTSD may be responsible for HPA-axis dysregulation. In two meta-analyses, we assessed the association of adulthood trauma exposure and HPA-axis functioning in healthy subjects with and without PTSD. A literature search in Pubmed and PsychInfo, using keywords and MeSH terms such as cortisol, emotional trauma, and PTSD, was performed. Only studies that included mentally healthy trauma-exposed (TE) individuals as well as non-exposed (NE) healthy individuals and/or PTSD patients (PTSD) were selected. This resulted in 1511 studies of which ultimately, 37 studies (21 TE versus NE and 34 TE versus PTSD, N=2468) were included. Methodological quality of all studies was assessed according to specific quality criteria. Pooled effect sizes (Hedges's g) on cortisol levels were compared. For all analyses, random effect models were used. Cortisol levels were neither significantly different between TE versus NE subjects (-0.029; 95%CI: -0.145; 0.088) nor between TE subjects versus PTSD patients (0.175; 95%CI: -0.012; -0.362). Subgroup analyses showed an increased cortisol suppression after the low dose dexamethasone suppression test (DST) in TE versus NE subjects (-0.509; 95%CI: -0.871; -0.148). This meta-analysis was limited by the fact that lifetime psychiatric illness and childhood trauma were not an exclusion criterion in all 37 studies. Neither adulthood trauma exposure nor PTSD were associated with differences in HPA-axis functioning, although adulthood trauma may augment cortisol suppression after the DST. More evidence on other dynamic tests of HPA-axis functioning in PTSD and adulthood trauma exposure is needed.Psychoneuroendocrinology 07/2011; 37(3):317-31. DOI:10.1016/j.psyneuen.2011.07.003 · 5.59 Impact Factor