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
. 2014 May;27(3):253-69.
doi: 10.1080/10615806.2013.852185. Epub 2013 Nov 28.

PTSD, comorbid depression, and the cortisol waking response in victims of intimate partner violence: preliminary evidence

Keri L M Pinna  1 , Dawn M Johnson, Douglas L Delahanty
Affiliations

PTSD, comorbid depression, and the cortisol waking response in victims of intimate partner violence: preliminary evidence

Keri L M Pinna et al. Anxiety Stress Coping. 2014 May.

Abstract

Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) are two highly comorbid and debilitating disorders experienced by more than half of intimate partner violence victims (IPV). Hypothalamic-pituitary-adrenal (HPA) abnormalities are common in both disorders, though the direction of abnormalities often differs. The present study examined the relationship between comorbid PTSD and MDD, and the (salivary) cortisol waking response in 104 recently abused IPV victims. Waking cortisol levels, area under the waking curve with respect to ground (AUCg), and AUC with respect to increase (AUCi) were examined to determine the relation of HPA dynamics to comorbidity for basal versus more dynamic measures. Prior to accounting for comorbidity, women with PTSD or MDD showed significantly greater AUCi than women without the respective disorder. Accounting for comorbidity, PTSD only did not differ from other groups, while MDD only and PTSD + MDD showed greater AUCi than women with neither disorder. Results were nonsignificant for waking cortisol levels or AUCg. Results suggest that MDD drives elevated waking cortisol response, but not basal cortisol activity in recently abused IPV victims. Results demonstrate the importance of examining comorbid diagnoses and HPA activity from a dynamic perspective. Therapeutic implications are discussed.

PubMed Disclaimer

Conflict of interest statement

Author Disclosure Statement

No competing financial interests exist.

Figures

Figure 1
Figure 1
Waking Cortisol Curve by Comorbidity Status
See this image and copyright information in PMC

References

    1. Ambrosini PJ, Metz C, Bianchi MD, Rabinovich H, Undie A. Concurrent validity and psychometric properties of the beck depression inventory in outpatient adolescents. American Journal of Child & Adolescent Psychiatry. 1991;30:51–57. - PubMed
    1. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Archive of General Psychiatry. 1961;4:561–571. - PubMed
    1. Bhagwagar Z, Hafizi S, Cowen PJ. Increased salivary cortisol after waking in depression. Psychopharmacology. 2005;182:54–57. doi: 10.1007/s00213-005-0062-z. - DOI - PubMed
    1. Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusman FD, Charney DS, Keane TM. A clinician rating scale for assessing current and lifetime PTSD: The CAPS-I. The Behaviour Therapist. 1990;13:187–188.
    1. Breslau N, Chilcoat HD, Kessler RC, Davis GC. Vulnerability to assaultive violence: further specification of the sex difference in post-traumatic stress disorder. American Journal of Psychiatry. 1999;156:902–907. - PubMed

Publication types

MeSH terms