Predictive role of long-term cortisol levels in hair for the development of posttraumatic stress disorder after rape exposure

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Only a relative minority of people who experience a traumatic event develop the clinical condition of posttraumatic stress disorder (PTSD). An important factor increasing individual vulnerability to PTSD appears to be attenuated secretion of the psychoactive glucocorticoid cortisol. However, due to a lack of adequately powered longitudinal prospective studies on this topic and limitations in previously employed measurement approaches, it is still unknown whether dysregulated cortisol production is a predisposing factor for PTSD or, alternatively, whether such endocrine changes mainly comprise a long-term response to trauma exposure.This proposal comprises a first longitudinal prospective cohort study examining the predictive value of pre- and post-traumatic hair cortisol concentrations (HCC) for subsequent PTSD symptom development in a large sample of severely traumatized women. Female rape victims (n = 580) will be assessed in the immediate aftermath of trauma and followed up at 3-months intervals over the subsequent year (3, 6, 9 and 12 months post-rape). An age and location-matched non-exposed control group (n = 580) will be studied in parallel. At each time point, hair samples will be collected together with detailed clinical, psychosocial and health-related data from both groups. The nature of HCC assessments, capturing hormone levels over the previous 3-month period, will for the first time enable a retrospective examination of the role of cortisol secretion before trauma exposure. In addition, the unique study design will allow for uncovering the pattern and time course of trauma-induced cortisol changes. The results of this project are likely to lead to novel insights into psychoendocrine determinants of PTSD and to inform future person-centered approaches to prevent the development of PTSD in traumatized individuals.