Salivary Cortisol Responses to Dexamethasone in Adolescents with Posttraumatic Stress Disorder

• NCJ Number: 202607
• Journal: Journal of the American Academy of Child & Adolescent Psychiatry Volume: 42 Issue: 11 Dated: November 2003 Pages: 1310-1317
• Author(s): Deborah S. Lipschitz; Ann M. Rasmusson M.D.; Rachel Yehuda Ph.D.; Sheila Wang Ph.D.; Walter Anyan M.D.; Ralitza Gueoguieva Ph.D.; Carlos M. Grilo Ph.D.; Dwain C. Fehon PSY.D; Steven M. Southwick M.D.
• Editor(s): Mina K. Dulcan M.D.
• Date Published: November 2003
• Length: 8 pages
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

This study examined whether adolescents with current posttraumatic stress disorder (PTSD) exhibit altered suppression of cortisol, within the hypothalamic-pituitary-adrenal axis, after the administration of low-dose dexamethasone.

Abstract

Over the years there has been increased awareness of high rates of intrafamilial and community-based trauma and posttraumatic stress disorder (PTSD) in adolescents. Prior studies of adults with PTSD have found various abnormalities in the regulation of the hypothalamic-pituitary adrenal axis (HPA), including enhanced suppression of cortisol following low-dose dexamethasone. This study examined salivary cortisol responses to low-dose dexamehtasone in adolescents with PTSD. The study hypothesized that adolescents with current PTSD would show enhanced cortisol suppression to dexamethasone compared to traumatized adolescents without PTSD and healthy, nontraumatized adolescents. Study participants consisted of 48 adolescents which included; 20 with PTSD, 9 trauma controls without PTSD, and 19 healthy, nontraumatized controls. On the first day baseline saliva samples were obtained at 8 A.M and 0.5 mg of dexamethasone was administered at 11 P.M. Cortisol and dexamethasone levels were assessed at 8 A.M. the next day. The study did not find evidence for enhanced suppression of 8 A.M salivary cortisol following low-dose (0.5 mg) dexamethasone in multiply traumatized adolescents with or without PTSD. Adolescents with current PTSD, traumatized adolescents without PTSD, and healthy, nontraumatized adolescents responded similarly to the low-dose dexamethasone test. Adolescents in this study with current PTSD and depression had significantly higher levels of posttraumatic stress symptoms and were functioning more poorly than teens with PTSD alone. Study limitations and implications are discussed. References