The interactive effects of elevated mid-afternoon cortisol and trauma history on PTSD symptoms in children: A preliminary study

Given the alarming frequency and severity of trauma exposure among children, identifying contextual and biologic factors that increase risk for symptomatic responses to trauma is an essential step toward preventing psychopathology. Basal functioning of the hypothalamic pituitary adrenal axis was evaluated to determine its role in relations between trauma exposure and PTSD symptoms among 66 children (M age = 10.7 years). Exposure to recent trauma (within the past year), previously experienced trauma (more than 1 year ago), and basal mid-afternoon cortisol levels were each positively related to PTSD symptoms. Further, these factors interacted in an additive manner to account for a significant proportion of the variance in PTSD symptoms. Implications for the early identification of children at risk for symptomatic responses to trauma are discussed.