Cortisol levels following a laboratory stressor among female adolescents with PTSD

Adolescent females are twice more likely to develop post-traumatic stress disorder (PTSD) after significant trauma. Little is known about stress-related cortisol reactivity among traumatized adolescents. Women with PTSD due to childhood or adolescent sexual abuse showed lower basal cortisol negatively associated with severity of abuse. Using an ecologically valid laboratory stressor, this pilot study explored cortisol trajectories in high-risk female adolescents. We hypothesize that teen females with PTSD are more likely to show hypothalamic-pituitary-adrenal-axis dysregulated cortisol reactivity. We recruited 20 females, mean age was 16.9 (.9) years, from waiting areas at the Mount Sinai Adolescent Health Center. Subjects reported high levels of family violence, risky behaviors, and psychological distress. Participants completed a 2-hour visit including self-reports of PTSD, exposure to laboratory stressor, and collection of 6 cortisol samples (3 pre-/3 post-stressor). Controlling for time of day and history of sexual abuse, we found main effects for time at resting (B = -.009; SE=. 003; p<.000), reactivity (B = .008; SE = .003; p<.006) and group (B = -.629; SE = .319; p<.04). Twenty-two percent met partial or full criteria for PTSD (UCLA PTSD Index). Both PTSD and non-PTSD groups showed changes in slope, suggesting that subjects were reactive to the stressor designed to assess neuroendocrine cortisol response. Those with PTSD had significantly lower levels of cortisol to the stressor (regardless of timing) suggesting a flattened cortisol slope. Findings in this high-risk sample are consistent with those found for female adolescents with childhood trauma and PTSD.