Cortisol response to traumatic stress to predict PTSD symptom development – a systematic review and meta-analysis of experimental studies

The present study investigated the extent to which heart rate (HR) levels soon after a traumatic event predicted posttraumatic stress disorder (PTSD) symptom severity assessed 6 weeks and 6 months later in child trauma victims. Participants consisted of 82 children (56 boys, 26 girls) aged 8-18 who were admitted to a Midwestern trauma center. HR data were recorded from emergency medical services (EMS) records, upon admission to the emergency department (ED), for the first 20 minutes following admission, and upon discharge. Subsequent PTSD and depressive symptoms were assessed 6-weeks and 6-months post-trauma. HR recorded during EMS transport was significantly correlated with PTSD symptoms at 6 weeks (r = .42) and at 6 months (r = .35). After removing the variance associated with demographic variables and depressive symptoms, HR during EMS transport and averaged over the first 20 minutes following admission significantly predicted 6-week PTSD symptoms. The first recorded EMS HR measure significantly predicted 6-month PTSD symptoms. HR averaged over the first 20 minutes of EMS transport and averaged over the first 20 minutes following admission marginally predicted 6-month PTSD symptoms (ps = .051 and .079, respectively). The present findings suggest that physiological arousal soon after a traumatic event may be associated with increased risk for the development of PTSD symptoms in child trauma victims. These findings provide preliminary support for the use of acute cardiovascular levels as markers of child trauma victims at higher risk of developing symptoms of PTSD.

The behavioral and cortisol responses of Japanese infants and Caucasian American infants, 4 months of age, were observed during and following routine inoculation. The Caucasian American group showed a more intense initial affective response and a longer latency to quiet than the Japanese group; the Japanese group showed a greater cortisol response. A 4-group taxonomy was created based on high or low behavioral and cortisol response: high behavior-high cortisol, low behavior-low cortisol, high behavior-low cortisol, and low behavior--high cortisol. There were significant differences between the 2 groups of infants using this taxonomy: Infants in the Caucasian American group were more likely to fall in the high behavior-low cortisol group, while infants in the Japanese group were more likely to fall in the low behavior-high cortisol group.

ABSTRACTBackground and Objectives: There is growing research indicating that event centrality strongly predicts posttraumatic stress disorder (PTSD). However, there is not much research on what makes a traumatic event central to one’s life story. One reason a traumatic memory becomes a reference point for one’s life story is that it brings about significant changes in one’s life. This study investigated the relationships between transitional impact of an event, event centrality, and PTSD symptoms. Specifically, it tested whether higher negative changes were associated with higher levels of event centrality and PTSD symptoms. It also investigated whether event centrality mediated the relationship between transitional impact and PTSD severity.Methods: 101 individuals diagnosed with PTSD completed the Transitional Impact Scale (TIS), Centrality of Event Scale, and Impact of Event Scale-Revised regarding their traumatic experiences. Furthermore, they responded to the Posttraumatic Stress Disorder Symptom Scale-Self Report (PSS-SR), Traumatic Events Checklist (TELC), and Beck Anxiety Inventory (BAI).Results and Conclusions: Results indicate that (a) the TIS had valid and reliable psychometric properties in a PTSD sample, (b) most of the traumatic events received high negative psychological and material change scores, and (c) event centrality mediated the relationship between transitional impact and PTSD severity.

This study analyzed the role of moral injury, self-awareness of mental states, self-integration of moral injury in personal schemas, and perceived social on the severity of Posttraumatic Stress Disorder (PTSD) and depression symptoms. The sample was composed of Portuguese war veterans (n 60) divided into 2 groups: 30 experienced chronic PTSD (nonrecovered) and 30 had remission from PTSD (recovered). A cross-sectional study was conducted using both qualitative and quantitative methods. Qualitative data were obtained through 2 interviews per participant, and the quantitative data were collected using the Impact of Event Scale–Revised and Brief Symptom Inventory. Content analysis was performed to analyze qualitative data. Multiple linear regression analyses were conducted predicting both PTSD and depression symptoms. Recovered participants showed higher frequencies on moral injury, high selfawareness of mental states, high self-integration of moral injury in personal schemas, and high perceived social support. Differences in moral injury (yes vs. no) showed no differences in both PTSD and depression symptoms. Participants who reported low self-awareness of mental states and self-integration of moral injury in personal schemas showed higher mean value for both PTSD and depression symptoms. Participants who reported low perceived social support showed higher mean value on depression symptoms. Self-integration of moral injury in personal schemas and self-awareness of mental states were predictors of both PTSD and depression symptoms. Combat exposure was a predictor of PTSD symptoms. The authors discuss the role of reconciliation of morally incongruent experiences in personal schemas and the ability to perceive and understand psychological states as key achievements in recovery from PTSD and depression symptoms among veterans.

The Role of the Hippocampus in Predicting Future Posttraumatic Stress Disorder Symptoms in Recently Traumatized Civilians

ABSTRACTPrevious research has established self-efficacy as essential to postdeployment adjustment among Veterans, and perceived transformational leadership is well known for its positive effects on follower outcomes across contexts. However, little is known regarding how transformational leadership may relate to posttraumatic growth and self-efficacy in fostering psychological wellbeing among combat Veterans. The purpose of this study was to examine the role of transformational leadership in predicting posttraumatic stress disorder (PTSD) and depression symptoms among combat Veterans, as well as how posttraumatic growth and postdeployment coping self-efficacy may influence these relations. The study sample consisted of 130 combat Veterans recruited from a university, Veterans Affairs medical center, and the greater community. Path analysis based on bootstrapped resampling revealed postdeployment coping self-efficacy and perceived transformational leadership as predictors of lower PTSD and depression symptom severity. In addition, mediation modeling revealed that postdeployment coping self-efficacy mediated the relation between transformational leadership and both PTSD and depression, while posttraumatic growth did not predict PTSD symptoms. These findings may aid in the prediction of PTSD and depression symptoms among Veterans, which may then influence pre-deployment leadership training among military personnel as well as clinical treatment protocols for Veterans.

Little is known about how chronic exposure to stress affects mental health among American Indian (AI) children. The current study aimed to fill this gap by exploring if hair cortisol concentration (HCC), an indicator of chronic stress, predicted post-traumatic stress disorder (PTSD) symptoms through deficits in executive function (EF) skills commonly referred to as inhibitory control, working memory, and cognitive flexibility. A total of 163 urban AI children between 8- and 15-years old participated in the study (92 girls, 56.4%; M age = 11.19, SD = 1.98). Chronic stress was measured as the concentration of cortisol in children’s hair. EF deficits and PTSD symptoms were reported by primary caregivers using the Behavior Rating Inventory of Executive Function and the Trauma Symptom Checklist for Young Children. The results demonstrated that higher HCC was indirectly associated with more PTSD symptoms through deficits in EF skills. Specifically, higher levels of HCC were related to more symptoms of PTSD arousal through impaired working memory, and more symptoms of PTSD avoidance and Intrusion through deficits in cognitive flexibility. The findings suggest interventions that reduce or buffer chronic stress, or that focus on improving EF skills, may promote not only cognitive development but also the mental health of AI children.

The authors prospectively examined the power of peritraumatic dissociation and acute stress symptoms in predicting posttraumatic stress disorder (PTSD) symptoms. Thirty-five assault victims were assessed with the Peritraumatic Dissociative Experiences Questionnaire within 24 hours of the assault. Participants were reassessed 2 weeks after the trauma with the Stanford Acute Stress Reaction Questionnaire and 3 months after the trauma with the Clinician-Administered PTSD Scale and the Impact of Event Scale. Correlational analyses and a hierarchical multiple regression were conducted. Peritraumatic dissociation and acute stress symptoms were correlated with later PTSD symptoms and diagnosis. Together, peritraumatic dissociation and acute stress symptoms accounted for 33% of the variance in PTSD symptoms. These results support earlier findings that peritraumatic dissociative experiences and acute stress are robust predictors of PTSD. Such symptoms may be of use for identifying at an early stage individuals at highest risk of remaining symptomatic. Future studies should investigate the predictive power of specific peritraumatic and acute stress disorder symptom clusters.

Family over-involvement, defined as emotions, thoughts, and behaviors indicating an over-protection of family members and preoccupation with family legacy, is recognized as a unique yet underexplored mechanism in the intergenerational effects of trauma. The study examined the role of family over-involvement in predicting post-traumatic stress disorder (PTSD) symptoms among Holocaust descendants following the October 7 attack and during the Israel-Hamas War. Using a longitudinal prospective design, Israeli Jew descendants from two generations (second and third generation to those who were living during WWII) completed questionnaires via a web-based survey company a year before the October 7, 2023 attack (W1, 2022, N = 1071) and two and 9 months during the war (W3, December 2023, N = 582, and W4, July 2024, N = 405). Results showed significantly higher levels of family over-involvement (i.e., descendants' efforts to compensate for their ancestors' suffering, shield ancestors from further suffering, and care for family continuation) in Holocaust descendants relative to comparisons. Path analysis showed that family over-involvement mediated the effect of having a Holocaust background on PTSD symptoms in W3 and the effect of having a Holocaust background on PTSD symptoms in W4 via PTSD symptoms in W3. Moderated mediation analysis revealed that the mediation effect of the compensation subscale of family over-involvement was stronger among the second generation relative to the third generation. The findings have crucial implications by highlighting family over-involvement as a unique interpersonal mechanism behind the intergenerational effects of Holocaust trauma, which clinicians should integrate in multi-generational interventions with Holocaust families, particularly when descendants face adversity.

Trauma appraisals, emotion regulation difficulties, and self-compassion predict posttraumatic stress symptoms following childhood abuse

Peritraumatic dissociation consistently predicts posttraumatic stress disorder (PTSD). Avoidant coping may serve as a mechanism through which peritraumatic dissociation contributes to PTSD symptoms. Path analysis was used to examine whether avoidant coping assessed 6 weeks following a motor vehicle accident mediated the relationship between in-hospital peritraumatic dissociation and 6-month (n = 193) and 12-month (n = 167) chronic PTSD symptoms. Results revealed that, after controlling for age, gender, depression, and 6-week PTSD symptoms, avoidant coping remained a partial mediator between peritraumatic dissociation and chronic PTSD symptoms 6- and 12-months postaccident. Post-hoc multigroup analyses suggested that at 6-months posttrauma, the mediation was significant in women, but not in men. Gender-specific results were not significant at 12-months posttrauma. Interventions targeted at reducing avoidant coping in high dissociators may aid in reducing PTSD symptoms.

Abstract: Event centrality is defined as the extent to which a memory of a traumatic event forms a reference point for people’s identity and attribution of meaning to other experiences in their life. Event centrality is typically measured with the Centrality of Event Scale (CES; Berntsen & Rubin, 2006 ). The present study’s first aim was to investigate the underlying factor structure and construct validity of the Dutch 20-item CES (CES-20) in undergraduates ( N = 1,091). The second aim was to test whether the CES-20 could prospectively predict posttraumatic stress disorder (PTSD) symptoms four months later. The data supported a one-factor structure of the CES with a high internal consistency (α = .95), which is not in line with the theoretical model of event centrality but aligns with previous empirical research. Furthermore, high construct validity was evidenced by positive and significant relations between the CES and PTSD symptoms, depressive symptoms, DSM-5 trauma A criterion, and the number of experienced negative life events. Event centrality was not a significant predictor of PTSD symptoms four months later when controlling for PTSD symptoms at time 1, which questions the prospective relation between event centrality and later PTSD symptoms for those events.

Narcissistic and psychopathic traits in romantic partners predict post-traumatic stress disorder symptomology: Evidence for unique impact in a large sample

Pretrauma internalizing and externalizing behaviors have been found to predict posttraumatic stress disorder (PTSD) symptoms (PTSS) in children following injury. However, child in-hospital self-report of pretrauma symptoms may be impacted by their injury and associated medical care (e.g., sedation/pain medications). Parental report of child pretrauma risk factors may be easier to capture; however, mothers and fathers differ in the extent to which they report, and agree on, internalizing versus externalizing behaviors in their child. The present study examined the differential utility of maternal versus paternal ratings of child preinjury internalizing, externalizing, and prosocial behaviors in predicting child PTSS 3- and 6-months postinjury. Eighty-four children were recruited from an emergency department after emergency medical services transport following injury, along with their parent(s). Dyadic (one parent and a child) analyses revealed that maternal reports of internalizing behaviors were significantly associated with child PTSS 3 months, F(5, 64) = 9.48, p < .001; ß = .44, p = .01, and 6 months, F(5, 48) = 5.57, p < .001; ß = .42, p = .03, postinjury. Paternal reports were not associated with child PTSS at either time point. In a subsample of triads (mother-father-child), mothers' and fathers' reports were only moderately correlated (rs = .30-.53), and neither maternal nor paternal ratings individually predicted child PTSS when both parents' reports were included in the model. Exploratory analyses revealed that family conflict and maternal initial PTSS moderated the relationship between maternal ratings of internalizing behaviors and child 3-month PTSS. Results suggest that maternal reports of child preinjury internalizing behaviors should be considered as predictors of later child PTSS development. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Inter-individual and -family differences in the cortisol responsiveness of Atlantic cod ( Gadus morhua)