Hair cortisol concentrations and cortisol stress reactivity predict PTSD symptom increase after trauma exposure during military deployment

Psychoneuroendocrinology. 2015 Sep;59:123-33. doi: 10.1016/j.psyneuen.2015.05.007. Epub 2015 May 23.


Background: Previous evidence on endocrine risk markers for posttraumatic stress disorder (PTSD) has been inconclusive. Here, we report results of the first prospective study to investigate whether long-term hair cortisol levels and experimentally-induced cortisol stress reactivity are predictive of the development of PTSD symptomatology in response to trauma during military deployment.

Methods: Male soldiers were examined before deployment to Afghanistan and at a 12-month post-deployment follow-up using dimensional measures for psychopathological symptoms. The predictive value of baseline (i) hair cortisol concentrations (HCC, N=90) and (ii) salivary cortisol stress reactivity (measured by the Trier Social Stress Test, N=80) for the development of PTSD symptomatology after being exposed to new-onset traumatic events was analyzed.

Results: Baseline cortisol activity significantly predicted PTSD symptom change from baseline to follow-up upon trauma exposure. Specifically, our results consistently revealed that lower HCC and lower cortisol stress reactivity were predictive of a greater increase in PTSD symptomatology in soldiers who had experienced new-onset traumatic events (explaining 5% and 10.3% of variance, respectively). Longitudinal analyses revealed an increase in HCC from baseline to follow-up and a trend for a negative relationship between HCC changes and the number of new-onset traumatic events. Additional pre-deployment analyses revealed that trauma history was reflected in lower HCC (at trend level) and that HCC were negatively related to stressful load.

Conclusions: Our data indicate that attenuated cortisol secretion is a risk marker for subsequent development of PTSD symptomatology upon trauma exposure. Future studies are needed to confirm our findings in other samples.

Keywords: Cortisol; Hair; Posttraumatic stress disorder; Saliva; Traumatization; Trier Social Stress Test.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Afghan Campaign 2001-*
  • Hair / chemistry
  • Hair / metabolism*
  • Humans
  • Hydrocortisone / analysis
  • Hydrocortisone / metabolism*
  • Life Change Events
  • Longitudinal Studies
  • Male
  • Military Personnel*
  • Predictive Value of Tests
  • Prospective Studies
  • Psychometrics
  • Risk Factors
  • Saliva / chemistry
  • Saliva / metabolism
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / metabolism*
  • Stress Disorders, Post-Traumatic / psychology
  • Stress, Psychological
  • Wounds and Injuries / metabolism*
  • Wounds and Injuries / psychology


  • Hydrocortisone