Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jul 1;72(1):19-24.
doi: 10.1016/j.biopsych.2012.02.031. Epub 2012 Apr 12.

Estrogen levels are associated with extinction deficits in women with posttraumatic stress disorder

Ebony M Glover  1 , Tanja Jovanovic, Kristina B Mercer, Kimberly Kerley, Bekh Bradley, Kerry J Ressler, Seth D Norrholm
Affiliations

Estrogen levels are associated with extinction deficits in women with posttraumatic stress disorder

Ebony M Glover et al. Biol Psychiatry. .

Abstract

Background: Women are twice as likely to develop posttraumatic stress disorder (PTSD) than men. As shown in our previous work, the inability to suppress fear responses in safe conditions may be a biomarker for PTSD. Low estrogen in naturally cycling women is associated with deficits in fear extinction. On the basis of these findings, we have now examined the influence of estrogen levels on fear extinction in women with and without PTSD.

Methods: We measured fear-potentiated startle during fear conditioning and extinction in women. The study sample (N = 81) was recruited from an urban, highly traumatized civilian population at Grady Memorial Hospital in Atlanta, Georgia. We assayed serum estrogen levels and used a median split to divide the sample into high and low estradiol (E(2)) groups. Seventeen of 41 women (41.5%) in the low E(2) group and 15 of 40 women (37.5%) met criteria for PTSD in the high E(2) group.

Results: The results showed that all groups had equivalent levels of fear conditioning. However, we found significant interaction effects between high versus low E(2) groups and PTSD diagnosis [F(1,71) = 4.55, p < .05] on extinction. Among women with low estrogen levels, fear-potentiated startle was higher during extinction in the PTSD group compared with traumatized control women [F(1,38) = 5.04, p < .05]. This effect was absent in the High E(2) group.

Conclusion: This study suggests that low estrogen may be a vulnerability factor for development of PTSD in women with trauma histories. Research on the role of estrogen in fear regulation may provide insight into novel treatment strategies for PTSD.

PubMed Disclaimer

Conflict of interest statement

The authors report no biomedical financial interests or potential conflicts of interest.

Figures

Figure 1
Figure 1
Schematic illustration of the experimental paradigm. The previously reinforced conditioned stimulus (CS+) in the extinction session did not include the air blast (aversive stimulus [US]). CA−, nonreinforced conditioned stimulus; NA, noise probe alone.
Figure 2
Figure 2
Mean ± SE fear-potentiated startle during extinction across diagnostic and estrogen groups. *p < .05. E2, estradiol; PTSD, posttraumatic stress disorder.
Figure 3
Figure 3
Mean ± SE fear-potentiated startle across extinction phases comparing diagnostic groups within each estrogen group. Data shown are covaried for trauma exposure. All groups demonstrated a significant linear effect of Phase, p < .001. (A) Low estradiol (E2) groups. (B) High E2 groups. *p < .05; **p < .01. PTSD, posttraumatic stress disorder.
See this image and copyright information in PMC

Comment in

References

    1. Breslau N. The epidemiology of posttraumatic stress disorder: What is the extent of the problem? J Clin Psychiatry. 2001;62:16–22. - PubMed
    1. Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the national comorbidity survey. Arch Gen Psychiatry. 1995;52:1048–1060. - PubMed
    1. Olff M, Langeland W, Draijer N, Gersons BPR. Gender differences in posttraumatic stress disorder. Psychol Bull. 2007;133:183–204. - PubMed
    1. Tolin DF, Foa EB. Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. Psychol Bull. 2006;132:959–992. - PubMed
    1. Breslau N, Chilcoat HD, Kessler RC, Peterson EL, Lucia VC. Vulnerability to assaultive violence: Further specification of the sex difference in post-traumatic stress disorder. Psychol Med. 1999;29:813–821. - PubMed

Publication types