The utility of hair cortisol concentrations in the prediction of PTSD symptoms following traumatic physical injury.
*Acute physical injury; *Avoidance; *Hair cortisol concentrations; *Numbing; *PTSD; *PTSD symptoms; 80 and over; Adult; Aged; Biological Markers; Female; Hair Analysis; Hair/*chemistry; Human; Humans; Hydrocortisone; Hydrocortisone/*analysis; Male; Middle Aged; Midwestern United States; Post-Traumatic – Risk Factors; Post-Traumatic/*diagnosis/*etiology; Prospective Studies; Regression; Retrospective Design; Retrospective Studies; Risk Factors; Saliva; Stress Disorders; Trauma Centers – Midwestern United States; Wounds and Injuries/*complications
RATIONALE: Although cortisol alterations have been associated with posttraumatic stress disorder (PTSD) and PTSD symptoms (PTSS), the direction of association is mixed. Cortisol which is measured in blood, saliva, or urine is subject to transient factors that may confound results. Recent advances in cortisol sampling techniques provide novel opportunities to address these inconsistencies. Hair cortisol sampling is a non-invasive method for the retrospective assessment of long-term integrated cortisol, yet its utility at predicting PTSS has not been assessed in acute injury victims. OBJECTIVE: The aim of this prospective study was to examine whether higher levels of hair cortisol concentrations (HCC) were associated with increases in PTSS following traumatic physical injury. METHOD: From January 2012 to May 2013, injury victims admitted to a level-1 Midwestern trauma center were recruited during their routine trauma clinic appointment within 30-days post-injury. Thirty participants had sufficient hair length to obtain 3-cm hair samples for cortisol assay. These participants completed PTSS assessments in relation to their recent injury at both the baseline and follow-up assessments (within 30- and 60-days post-injury, respectively). RESULTS: Hierarchical regression analyses - which controlled for baseline PTSS, age, and sex - revealed that higher HCC predicted significant increases in overall PTSS at follow-up. Higher HCC also predicted increases in the avoidance/numbing subscale symptoms of PTSS. Dividing the avoidance symptoms and numbing symptoms into two separate clusters (consistent with the 4-factor DSM-5 model of PTSD) revealed that HCC was only marginally associated with numbing, but not with avoidance symptoms. CONCLUSION: Hair sampling is a feasible method for assessing integrated cortisol levels soon after traumatic physical injury. This study suggests that elevated HCC may serve as a biomarker of risk for the development of posttraumatic symptomatology, and identifies specific symptoms that may be targeted for intervention in those with high HCC in the aftermath of injury.
Pacella Maria L; Hruska Bryce; Steudte-Schmiedgen Susann; George Richard L; Delahanty Douglas L
Social science & medicine (1982)
2017
2017-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.socscimed.2016.12.046" target="_blank" rel="noreferrer noopener">10.1016/j.socscimed.2016.12.046</a>
Andrew Jackson's exposure to mercury and lead: poisoned president?
*Cause of Death; *Famous Persons; 19th Century; Atomic; Chronic/history; Hair/*chemistry; History; Humans; Kidney Failure; Lead Poisoning/etiology/*history; Lead/*analysis; Mercury Compounds/adverse effects/therapeutic use; Mercury Poisoning/etiology/*history; Mercury/*analysis; Organometallic Compounds/adverse effects/therapeutic use; Spectrophotometry; United States
Historians have suggested that US president Andrew Jackson (1767-1845) experienced lead and mercury poisoning following his therapeutic use of calomel (mercurous chloride) and sugar of lead (lead acetate). To evaluate these claims, we performed direct physical measurement of 2 samples of Jackson's hair (1 from 1815, 1 from 1839). Following pretreatment and acid digestion, mercury was measured using cold vapor generation techniques, while lead levels were measured by electrothermal atomic absorption spectrophotometry. Mercury levels of 6.0 and 5.6 ppm were obtained from the 1815 and 1839 hair specimens, respectively. Lead levels were significantly elevated in both the 1815 sample (mean lead level, 130.5 ppm) and the 1839 sample (mean lead level, 44 ppm). These results suggest that Jackson had mercury and lead exposure, the latter compatible with symptomatic plumbism in the 1815 sample. However, Jackson's death was probably not due to heavy metal poisoning.
Deppisch L M; Centeno J A; Gemmel D J; Torres N L
JAMA
1999
1999-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1001/jama.282.6.569" target="_blank" rel="noreferrer noopener">10.1001/jama.282.6.569</a>