Dissociation versus posttraumatic stress: cortisol and physiological correlates in adults highly exposed to the World Trade Center attack on 9/11

Psychiatry Res. 2008 Dec 15;161(3):325-9. doi: 10.1016/j.psychres.2008.04.021. Epub 2008 Oct 17.


Nine months on average after the World Trade Center (WTC) attack, 21 highly exposed adults and 10 healthy controls without major exposure did not differ in cortisol and physiologic measures. Dissociation and posttraumatic stress symptoms were quantified in the exposed group. Dissociation was associated with greater peritraumatic dissociation and, marginally, childhood trauma, lower plasma cortisol levels at 08.00h, and blunted heart rate reactivity to psychosocial stress. Posttraumatic stress was associated with exposure, peritraumatic distress, and early posttraumatic stress, and marginally associated with peritraumatic dissociation; it was not associated with cortisol or physiologic measures. Urinary cortisol differed significantly in its relationship to dissociation versus posttraumatic stress. This small study emphasizes the importance of dissecting the neurobiology of posttraumatic stress versus dissociative traumatic responses.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Arousal / physiology*
  • Blood Pressure / physiology*
  • Dexamethasone
  • Dissociative Disorders / diagnosis
  • Dissociative Disorders / physiopathology*
  • Dissociative Disorders / psychology
  • Female
  • Follow-Up Studies
  • Heart Rate / physiology*
  • Humans
  • Hydrocortisone / metabolism*
  • Male
  • New York City
  • Personality Inventory
  • September 11 Terrorist Attacks*
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / physiopathology*
  • Stress Disorders, Post-Traumatic / psychology


  • Dexamethasone
  • Hydrocortisone