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

只有相对少数的人谁经历了创伤性事件的发展创伤后应激障碍（PTSD）的临床条件。增加个体对PTSD易感性的一个重要因素似乎是具有精神活性的糖皮质激素皮质醇的分泌减弱。然而，由于缺乏足够动力的纵向前瞻性研究，以及先前采用的测量方法的局限性，皮质醇产生失调是否是PTSD的诱发因素，或者，这种内分泌变化是否主要包括对创伤暴露的长期反应。这项建议包括第一个纵向前瞻性队列研究，和创伤后头发皮质醇浓度（HCC）为随后的创伤后应激障碍症状的发展在一个大样本的严重创伤妇女。女性强奸受害者（n = 580）将在创伤后立即进行评估，并在随后的一年中每隔3个月进行随访（强奸后3、6、9和12个月）。将平行研究年龄和位置匹配的非暴露对照组（n = 580）。在每个时间点，将收集两组的毛发样本以及详细的临床、心理社会和健康相关数据。HCC评估的性质，捕获激素水平在过去的3个月期间，将首次使创伤暴露前皮质醇分泌的作用的回顾性检查。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新的见解PTSD的心理内分泌决定因素，并告知未来以人为本的方法，以防止创伤后应激障碍的发展。

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.