Trauma exposure in relation to basal salivary cortisol and the hormone response to the dexamethasone/CRH test in male railway employees without lifetime psychopathology

SummaryBackgroundDysregulation of the hypothalamic–pituitary–adrenal (HPA)-axis is hypothesized to underlie stress-related psychiatric disorders such as post-traumatic stress disorder (PTSD). We aimed to explore whether trauma exposure is associated with alterations in HPA-axis functioning in the absence of lifetime psychiatric morbidity.MethodWe included 39 trauma-exposed healthy male subjects (mean age = 47 years; SD = 9.2) and 24 non-exposed healthy male controls (mean age = 47.4 years; SD = 14.5). All subjects were free of lifetime psychopathology. Basal salivary cortisol levels (on two consecutive days) as well as the cortisol and adrenocorticotropic hormone (ACTH) response to the combined dexamethasone/corticotropin releasing hormone (Dex/CRH) challenge test were analyzed using general linear models (GLM) adjusted for body mass index, age and smoking status.ResultsA blunted salivary cortisol awakening response was found in the exposed group compared to the non-exposed group (F(1,57) = 5.46, p = .02). Consistent with these findings, salivary diurnal cortisol was lower in the trauma-exposed versus non-exposed group (F(1,57) = 4.04, p = .05). No differences, however, were found between both groups for plasma cortisol or ACTH responses to the Dex/CRH test.ConclusionLow basal cortisol levels were found in trauma-exposed men, suggesting that HPA-axis alterations in men are associated with trauma exposure during adulthood, also in the absence of psychopathology.