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Original Article
September 2007

Parental Posttraumatic Stress Disorder as a Vulnerability Factor for Low Cortisol Trait in Offspring of Holocaust Survivors

Author Affiliations

Author Affiliations: Traumatic Stress Studies Program, Department of Psychiatry, Mount Sinai School of Medicine and James J. Peters Veterans Affairs Medical Center, Bronx, New York (Drs Yehuda, Grossman, and Bierer and Mr Morris); Department of Psychiatry, Harvard Medical School, Boston, and the Developmental Biopsychiatry Research Program, McLean Hospital, Belmont (Dr Teicher), Massachusetts; and Endocrinology Unit, Queen's Medical Research Institute, Edinburgh University, Edinburgh, Scotland (Dr Seckl).

Arch Gen Psychiatry. 2007;64(9):1040-1048. doi:10.1001/archpsyc.64.9.1040

Context  Lower cortisol levels in posttraumatic stress disorder (PTSD) may reflect a preexisting vulnerability associated with developing the disorder after trauma exposure. Because offspring of trauma survivors with PTSD have a greater prevalence of PTSD after their own life events than offspring of trauma survivors without PTSD and offspring of nonexposed persons, examination of patterns of basal cortisol secretion in such offspring provides an opportunity to test this hypothesis.

Objective  To characterize the patterns of basal cortisol secretion in offspring of Holocaust survivors with and without parental PTSD and children of nonexposed parents.

Design  Cortisol secretion was measured every 30 minutes for 24 hours. The raw hormonal data were subjected to a chronobiological analysis by applying single-oscillator and multioscillator cosinor analyses, a nonlinear least squares curve-fitting program, to determine circadian and ultradian regulatory dynamics.

Setting  The study was conducted under controlled conditions at the General Clinical Research Center at the Mount Sinai School of Medicine.

Participants  Twenty-three Holocaust offspring with parental PTSD and 10 without parental PTSD were compared with 16 children of nonexposed parents. No participant had PTSD.

Main Outcome Measures  Mean cortisol levels during the 24-hour cycle and other chronobiological parameters (amplitude, acrophase, circadian quotient, and goodness-of-fit coefficient) derived from single-oscillator and multioscillator models.

Results  Offspring with parental PTSD displayed lower mean cortisol levels, reflected by the circadian mesor and reduced cortisol amplitude, compared with offspring without parental PTSD and children of nonexposed parents. This effect seemed to be specifically related to the presence of maternal PTSD.

Conclusions  Low cortisol levels and other chronobiological alterations in offspring are associated with the risk factor of maternal PTSD, raising the possibility that these alterations are acquired via glucocorticoid programming either from in utero exposures or in response to maternal behaviors early in life.