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Access Type
WSU Access
Date of Award
January 2024
Degree Type
Dissertation
Degree Name
Ph.D.
Department
Psychology
First Advisor
Francesca M. Pernice
Abstract
Trauma is associated with significant physiological and psychological risks; thus, identifying the mechanisms through which these complications occur is critical to improving treatments. Though prior studies have documented a potential link between trauma exposure and a blunted cortisol response to psychosocial stress—a condition associated with increased risk of anxiety, PTSD, and other pathologies—results to date are largely inconsistent. Notably, despite accumulating evidence that subjective perceptions of trauma impact health outcomes differently than trauma exposure itself, this factor has yet to be investigated regarding cortisol function. Prior research in this area has included only objective definitions of trauma, thus potentially contributing to heterogeneous results. The current study investigated subjective perception of trauma (i.e., event centrality) as a potential moderator of the relationship between potentially traumatic events and cortisol reactivity. Adult volunteers (n=67) participated in the Trier Social Stress Test, completed measures of subjective and objective trauma, and provided salivary cortisol samples. Hierarchical multiple regression was performed to assess for potential associations between event centrality (high/low) and cortisol reactivity (operationalized as area under the curve in respect to ground (AUCG) and increase (AUCI)). Potentially moderating effects of developmental timing of trauma exposure (childhood vs. adulthood) and type of trauma (interpersonal vs. non-interpersonal) were also examined. Analyses were conducted first in the total sample, and subsequently in sex-disaggregated data to account for unique endocrinological milieus. A significant positive association was identified between high event centrality and cortisol AUCI (b = 5.82, SE = 2.36, t = 2.47, p = .017) in the full sample. Sensitivity analyses in sex-disaggregated data revealed this association to be driven by female participants (b = 7.46, SE = 2.59, t = 2.88, p = .007); there was no relation between these variables in the male participant group. Analyses of trauma type and developmental timing revealed blunted cortisol reactivity in female participants endorsing childhood trauma (b = -8.72, SE = 2.77, t = 2.93, p = .004); notably, this association held only when the childhood trauma event was rated as highly impactful. Considering the persistent lack of clarity in the literature regarding whether blunted cortisol reactivity is in fact associated with psychological trauma and risk of psychopathology, these findings provide needed clarity regarding the circumstances under which these psychophysiological changes may occur. These insights have potential to improve our ability to prospectively assess risk for HPA-axis dysfunction based on perception of traumatic events; leverage cortisol dysregulation as a biomarker of trauma-related pathology in clinical and research settings; and inform focused clinical trials in the field of personalized precision medicine—perhaps to further investigate the utility of supplementary cortisol for augmenting fear extinction therapies.
Recommended Citation
Hinchey, Liza Marie Emilie, "Not Small Men: A Study Of Sex-Specific Dynamics In Cortisol Reactivity To Psychosocial Stress Following Trauma, And The Value Of Subjectivity In Assessing Trauma-Related Neurobiology" (2024). Wayne State University Dissertations. 4039.
https://digitalcommons.wayne.edu/oa_dissertations/4039
