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Association of DHEA, DHEAS, and cortisol with childhood trauma exposure and post-traumatic stress disorder

Van Voorhees, Elizabeth E.a,b,c; Dennis, Michelle F.c; Calhoun, Patrick S.a,b,c; Beckham, Jean C.a,b,c

International Clinical Psychopharmacology: January 2014 - Volume 29 - Issue 1 - p 56–62
doi: 10.1097/YIC.0b013e328364ecd1
Original Articles

There has been a great deal of interest in the role of the neuroendocrine hormones of the hypothalamic–pituitary–adrenal (HPA) axis in the expression of stress-related psychopathology such as post-traumatic stress disorder (PTSD). This investigation examined the association of PTSD and childhood maltreatment with three key HPA axis hormones: cortisol, dehydroepiandrosterone (DHEA), and dehydroepiandrosterone sulfate (DHEAS). Regression analyses were undertaken on a sample of 43 participants with and 57 participants without PTSD. Results demonstrated that after controlling for age, sex, and PTSD status, exposure to childhood maltreatment was significantly associated with cortisol secretion [F(4,95)=11.68, ΔR 2=0.11, P=0.0009] and cortisol/DHEA ratio [F(4,95)=6.20, ΔR 2=0.05, P=0.01]. PTSD status was not associated with any of these neuroendocrine variables. Findings are discussed in the context of the complexity of the relationship of these neuroendocrine variables with trauma exposure and trauma-related psychopathology. It is suggested that DHEA(S) or cortisol/DHEA(S) ratios may not be biomarkers of specific forms of psychopathology per se, but that, instead, the severity and developmental timing of trauma may set the HPA axis in ways that are reflected in interactions among these neuroendocrine hormones. In adulthood, these HPA axis hormones may continue to be dynamically affected by personal and environmental resources.

aMid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC)

bDurham Veterans Affairs Medical Center

cDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA

Correspondence to Elizabeth E. Van Voorhees, PhD, Building 5, Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC 27705, USA Tel: +1 919 286 0411 x6435; fax: +1 919 416 5912; e-mail:

Received February 5, 2013

Accepted July 8, 2013

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins