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

只有相对少数经历过创伤性事件的人会发展成创伤后应激障碍（PTSD）的临床症状。增加个体对PTSD易感性的一个重要因素似乎是精神活性糖皮质激素皮质醇的分泌减弱。然而，由于缺乏关于这一主题的足够有力的纵向前瞻性研究以及先前使用的测量方法的局限性，仍然不清楚皮质醇分泌失调是否是创伤后应激障碍的易感因素，或者，这种内分泌变化是否主要是对创伤暴露的长期反应。本研究包括首个纵向前瞻性队列研究，在大量严重创伤妇女样本中，研究创伤前和创伤后毛发皮质醇浓度（HCC）对随后PTSD症状发展的预测价值。女性强奸受害者（n = 580）将在创伤后立即接受评估，并在随后的一年（强奸后3、6、9和12个月）每隔3个月进行随访。同时研究年龄和地点匹配的非暴露对照组（n = 580）。在每个时间点，将收集两组的头发样本以及详细的临床、社会心理和健康相关数据。HCC评估的性质，捕获前3个月期间的激素水平，将首次能够在创伤暴露前对皮质醇分泌的作用进行回顾性检查。此外，独特的研究设计将允许揭示创伤诱导的皮质醇变化的模式和时间过程。该项目的结果可能会导致对创伤后应激障碍心理内分泌决定因素的新见解，并为未来以人为本的方法提供信息，以防止创伤后应激障碍在创伤个体中的发展。

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.