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Journal of Pediatric Psychology Advance Access originally published online on August 9, 2008
Journal of Pediatric Psychology 2009 34(4):389-395; doi:10.1093/jpepsy/jsn087
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©The Author 2008. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Brief Report: Diurnal Salivary Cortisol in Youth—Clarifying the Nature of Posttraumatic Stress Dysregulation

Carl F. Weems, PhD1 and Victor G. Carrión, MD2

1University of New Orleans and 2Stanford University School of Medicine

All correspondence concerning this article should be addressed to Carl F. Weems, Department of Psychology, University of New Orleans, New Orleans, LA 70148, USA. E-mail: cweems{at}uno.edu


  Abstract

Objective The purpose of this study was to clarify the nature of diurnal salivary cortisol dysregulation in youth who experience posttraumatic stress (PTS). Method Diurnal trends in salivary cortisol secretion were examined in a sample of 41 youth aged 10–16 years (26 youth exposed to interpersonal traumas and 15 control participants with no PTS) using hierarchical linear modeling. Results Cortisol levels were characterized by curvilinear trends in secretion (i.e., sharp declines from prebreakfast to prelunch followed by smaller decreases from prelunch to predinner with a leveling-off or slight increase from predinner to prebed assessment). Results further indicated that youth with PTS had sharper morning declines and relatively higher evening levels (i.e., a greater curve in the daily trend) than nontraumatized youth. Conclusions Findings help to elucidate the physiological basis for altered arousal patterns in youth with PTS. Traumatized youth showed wider daily fluctuations in cortisol levels when these trends were modeled in a curvilinear fashion. The findings help to describe the nature of stress dysregulation in trauma-exposed youth and may have implications for clarifying some of the apparent inconsistencies in the literature.

Key words: cortisol; posttraumatic stress; hierarchical linear modeling.

Received February 10, 2008; revision received July 13, 2008; accepted July 16, 2008


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