Longitudinal Associations Between Peritraumatic Oestradiol and Fear Responding in Women and Men

Robyn A Ellis^{1

2}, Theresa K Webber¹, Natalie C Noble¹, Sarah D Linnstaedt³, Rebecca Hinrichs⁴, Charis Wiltshire⁵, Mariam H Reda⁶, William Davie⁵, Stacey L House⁷, Francesca L Beaudoin^{8

9}, Xinming An³, Thomas C Neylan¹⁰, Gari D Clifford^{11

12}, Laura T Germine^{2

13

14}, Scott L Rauch^{2

13

15}, John P Haran¹⁶, Alan B Storrow¹⁷, Christopher Lewandowski¹⁸, Paul I Musey Jr¹⁹, Phyllis L Hendry²⁰, Sophia Sheikh²⁰, Brittany E Punches^{21

22}, Jose L Pascual^{23

24}, Mark J Seamon^{24

25}, Elizabeth M Datner²⁶, Claire Pearson²⁷, David A Peak²⁸, Robert M Domeier²⁹, Niels K Rathlev³⁰, Brian J O'Neil³¹, Paulina Sergot³², Leon D Sanchez^{33

34}, Steven E Bruce³⁵, Jutta Joormann³⁶, Ronald C Kessler³⁷, Kerry J Ressler^{2

38}, Karestan C Koenen³⁹, Samuel A McLean^{40

41}, Jennifer S Stevens⁴, Tanja Jovanovic⁵, Antonia V Seligowski^{2

42}

Affiliations

¹ McLean Hospital, Belmont, Massachusetts, USA.
² Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
³ Department of Anesthesiology, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁴ Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.
⁵ Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA.
⁶ University of Michigan Medical School, Ann Arbor, Michigan, USA.
⁷ Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
⁸ Department of Epidemiology, Brown University, Providence, Rhode Island, USA.
⁹ Department of Emergency Medicine, Brown University, Providence, Rhode Island, USA.
¹⁰ Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, California, USA.
¹¹ Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia, USA.
¹² Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA.
¹³ Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.
¹⁴ The Many Brains Project, Belmont, Massachusetts, USA.
¹⁵ Department of Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.
¹⁶ Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
¹⁷ Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
¹⁸ Department of Emergency Medicine, Henry Ford Health System, Detroit, Michigan, USA.
¹⁹ Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
²⁰ Department of Emergency Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, Florida, USA.
²¹ Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, Ohio, USA.
²² Ohio State University College of Nursing, Columbus, Ohio, USA.
²³ Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
²⁴ Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
²⁵ Division of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
²⁶ Department of Emergency Medicine, Jefferson Einstein Hospital, Jefferson Health, Philadelphia, Pennsylvania, USA.
²⁷ Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, Michigan, USA.
²⁸ Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
²⁹ Department of Emergency Medicine, Trinity Health-Ann Arbor, Ypsilanti, Michigan, USA.
³⁰ Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts, USA.
³¹ Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, Michigan, USA.
³² Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, Texas, USA.
³³ Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
³⁴ Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA.
³⁵ Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, Missouri, USA.
³⁶ Department of Psychology, Yale University, New Haven, Connecticut, USA.
³⁷ Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
³⁸ Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts, USA.
³⁹ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.
⁴⁰ Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁴¹ Department of Psychiatry, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁴² Cardiovascular Imaging Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA.

PMID: 40119846
PMCID: PMC11991665 (available on 2026-04-01)
DOI: 10.1002/smi.3522

Multicenter Study

Longitudinal Associations Between Peritraumatic Oestradiol and Fear Responding in Women and Men

Robyn A Ellis et al. Stress Health. 2025 Apr.

. 2025 Apr;41(2):e3522.

doi: 10.1002/smi.3522.

Authors

Affiliations

¹ McLean Hospital, Belmont, Massachusetts, USA.
² Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
³ Department of Anesthesiology, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁴ Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.
⁵ Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA.
⁶ University of Michigan Medical School, Ann Arbor, Michigan, USA.
⁷ Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
⁸ Department of Epidemiology, Brown University, Providence, Rhode Island, USA.
⁹ Department of Emergency Medicine, Brown University, Providence, Rhode Island, USA.
¹⁰ Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, California, USA.
¹¹ Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia, USA.
¹² Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA.
¹³ Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.
¹⁴ The Many Brains Project, Belmont, Massachusetts, USA.
¹⁵ Department of Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.
¹⁶ Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.
¹⁷ Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
¹⁸ Department of Emergency Medicine, Henry Ford Health System, Detroit, Michigan, USA.
¹⁹ Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
²⁰ Department of Emergency Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, Florida, USA.
²¹ Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, Ohio, USA.
²² Ohio State University College of Nursing, Columbus, Ohio, USA.
²³ Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
²⁴ Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
²⁵ Division of Traumatology, Surgical Critical Care and Emergency Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
²⁶ Department of Emergency Medicine, Jefferson Einstein Hospital, Jefferson Health, Philadelphia, Pennsylvania, USA.
²⁷ Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, Michigan, USA.
²⁸ Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
²⁹ Department of Emergency Medicine, Trinity Health-Ann Arbor, Ypsilanti, Michigan, USA.
³⁰ Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts, USA.
³¹ Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, Michigan, USA.
³² Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, Texas, USA.
³³ Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
³⁴ Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA.
³⁵ Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, Missouri, USA.
³⁶ Department of Psychology, Yale University, New Haven, Connecticut, USA.
³⁷ Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
³⁸ Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts, USA.
³⁹ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.
⁴⁰ Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁴¹ Department of Psychiatry, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁴² Cardiovascular Imaging Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA.

PMID: 40119846
PMCID: PMC11991665 (available on 2026-04-01)
DOI: 10.1002/smi.3522

Abstract

PTSD is more prevalent in women than men and associated with autonomic dysfunction. Higher oestradiol levels have been associated with decreased PTSD severity, however, the impact of oestradiol on autonomic function is not well characterised. We examined associations among peritraumatic oestradiol levels and autonomic function in the multi-site AURORA study. Participants (n = 283, 69.6% female) were recruited from the emergency department (ED) following trauma exposure. Skin conductance (SC) was measured during trauma recall at the ED. Oestradiol was assayed from blood collected at ED, 2-week and 6-month. Fear conditioning, including fear potentiated startle (FPS), was completed at 2-week and 6-month. In women, ED oestradiol was significantly positively associated with ED SC and FPS at 6-month. In men, significant negative correlations between ED oestradiol and SC were found. Among women in the study, peritraumatic oestradiol was positively associated with fear responding 6-month. Findings suggest that the protective effects of oestradiol on PTSD may depend on other factors, such as time since trauma. Additional research is needed to elucidate how peritraumatic oestradiol and autonomic function may interact to confer risk for PTSD.

Keywords: PTSD; autonomic function; fear conditioning; gender; trauma.

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References

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Longitudinal Associations Between Peritraumatic Oestradiol and Fear Responding in Women and Men

Affiliations

Longitudinal Associations Between Peritraumatic Oestradiol and Fear Responding in Women and Men

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous