Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA; Bob Shapell School of Social Work, Tel-Aviv University, Tel Aviv, Israel.
J Trauma Stress. 2013 Oct;26(5):621-5. doi: 10.1002/jts.21839. Epub 2013 Sep 12.
Only a few studies have examined cortisol response to trauma-related stressors in relation to posttraumatic stress disorder (PTSD). We followed a sample of high-exposure survivors of the attacks on September 11, 2001 (9/11; 32 men and 29 women) and examined their cortisol response after recalling the escape from the attack, 7 and 18 months post-9/11. PTSD symptoms and saliva cortisol levels were assessed before and after trauma recollection. Hierarchical regression analyses revealed that PTSD symptoms and male sex predicted increased cortisol response following recollections. For men, elevated cortisol was associated with greater severity of reexperiencing symptoms (p < .001) and lower severity of avoidance symptoms (p < .001). For women, recall-induced cortisol was minimal and unrelated to PTSD symptoms (p = .164 and p = .331, respectively). These findings suggest that augmented cortisol response to trauma-related stressors may be evident in men reporting symptoms of PTSD. Thus, as cortisol abnormalities related to PTSD symptoms appear sex-specific, future research on mechanisms of sex differences in response to trauma is warranted.
仅有少数研究调查了创伤相关应激源与创伤后应激障碍（PTSD）之间皮质醇反应的关系。我们对 2001 年 9 月 11 日袭击事件中的高暴露幸存者（32 名男性和 29 名女性）进行了随访，并在 9/11 事件后 7 个月和 18 个月评估了他们对逃离袭击的回忆后的皮质醇反应。创伤回忆前后评估 PTSD 症状和唾液皮质醇水平。分层回归分析表明，PTSD 症状和男性性别预测回忆后皮质醇反应增加。对于男性，皮质醇升高与再体验症状的严重程度增加（p <.001）和回避症状的严重程度降低（p <.001）相关。对于女性，回忆引起的皮质醇水平较低，与 PTSD 症状无关（p =.164 和 p =.331）。这些发现表明，报告 PTSD 症状的男性中可能存在与创伤相关应激源相关的皮质醇反应增强。因此，由于与 PTSD 症状相关的皮质醇异常似乎具有性别特异性，因此有必要对创伤反应中性别差异的机制进行进一步研究。
