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. 2023 Apr;53(6):2263-2273.
doi: 10.1017/S0033291721004050. Epub 2021 Oct 12.

Dynamics of diurnal cortisol and alpha-amylase secretion and their associations with PTSD onset in recent interpersonal trauma survivors

Kerry L Kinney  1 , Uma Rao  2   3 , Brooklynn Bailey  4 , Natalie Hellman  5 , Chris Kelly  1 , Nicholas W McAfee  1 , Matthew C Morris  1
Affiliations

Dynamics of diurnal cortisol and alpha-amylase secretion and their associations with PTSD onset in recent interpersonal trauma survivors

Kerry L Kinney et al. Psychol Med. 2023 Apr.

Abstract

Background: Dysfunction in major stress response systems during the acute aftermath of trauma may contribute to risk for developing posttraumatic stress disorder (PTSD). The current study investigated how PTSD diagnosis and symptom severity, depressive symptoms, and childhood trauma uniquely relate to diurnal neuroendocrine secretion (cortisol and alpha-amylase rhythms) in women who recently experienced interpersonal trauma compared to non-traumatized controls (NTCs).

Method: Using a longitudinal design, we examined diurnal cortisol and alpha-amylase rhythms in 98 young women (n = 57 exposed to recent interpersonal trauma, n = 41 NTCs). Participants provided saliva samples and completed symptom measures at baseline and 1-, 3-, and 6-month follow-up.

Results: Multilevel models (MLMs) revealed lower waking cortisol predicted the development of PTSD in trauma survivors and distinguished at-risk women from NTCs. Women with greater childhood trauma exposure exhibited flatter diurnal cortisol slopes. Among trauma-exposed individuals, lower waking cortisol levels were associated with higher concurrent PTSD symptom severity. Regarding alpha-amylase, MLMs revealed women with greater childhood trauma exposure exhibited higher waking alpha-amylase and slower diurnal alpha-amylase increase.

Conclusions: Results suggest lower waking cortisol in the acute aftermath of trauma may be implicated in PTSD onset and maintenance. Findings also suggest childhood trauma may predict a different pattern of dysfunction in stress response systems following subsequent trauma exposure than the stress system dynamics associated with PTSD risk; childhood trauma appears to be associated with flattened diurnal cortisol and alpha-amylase slopes, as well as higher waking alpha-amylase.

Keywords: Alpha-amylase; PTSD; cortisol; interpersonal trauma.

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Conflict of interest statement

Competing Interests

The authors report no conflicts of interest.

Figures

Figure 1.
Figure 1.. Salivary Cortisol Levels Over Time
Note. Spaghetti plots depict Assessment Time Point 1 (Panel A) and Assessment Time Point 2 (Panel B) within-person changes in mean salivary cortisol levels for each participant, averaged across both collection days (depicted in gray). The diurnal cortisol trajectory defined by the mean parameters for each group are depicted in green (non-traumatized controls), blue (IPV without PTSD), and red (IPV with PTSD). Shaded area surrounding the trajectory defined by the mean parameters represents the standard error. NTC = non-traumatized control; IPV = interpersonal violence; PTSD = posttraumatic stress disorder.
Figure 2.
Figure 2.. Effect of Childhood Trauma on Diurnal Cortisol Slope
Note. CTQ = Childhood Trauma Questionnaire. For illustrative purposes, graph depicts the simple diurnal cortisol slopes (collapsed across all groups) for individuals with lower (−1 SD) and higher (+1 SD) levels of childhood trauma, based on the Childhood Trauma Questionnaire. Additionally, values were defined at 0 and 960 minutes from waking to illustrate the effect of childhood trauma on the diurnal cortisol slope.
See this image and copyright information in PMC

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