Trial reportPsychoneuroendocrinology2020
Cortisol awakening response in PTSD treatment: Predictor or mechanism of change.
Trial report in Psychoneuroendocrinology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of the pharmacological modulation of autobiographical memory specificity.Frontiers in psychology · 2022Pooled it
- The cortisol awakening response in a 3 month clinical trial of service dogs for veterans with posttraumatic stress disorder.Scientific reports · 2024Trial
- Change in posttraumatic stress disorder-related thoughts during treatment: Do thoughts drive change when pills are involved?Journal of traumatic stress · 2022Trial
- Hypothalamic-pituitary-adrenal axis attenuation following child sexual abuse distinguishes posttraumatic stress trajectories from late adolescence to midlife.Psychoneuroendocrinology · 2026Article
- Flight-associated cortisol dynamics and subjective assessments of pain and stress in fighter pilots: an exploratory study.European journal of applied physiology · 2025Article
- Connectometry reveals differing associations of cortisol and PACAP with dorsal cingulum microstructure in posttraumatic stress.medRxiv : the preprint server for health sciences · 2025Article
- Awakening not associated with an increased rate of cortisol secretion.Proceedings. Biological sciences · 2025Article
- Core features and inherent diversity of post-acute infection syndromes.Frontiers in immunology · 2025Review
- Blunted Cortisol Awakening Response Is Associated with External Attribution Bias Among Individuals with Personality Disorders.Brain sciences · 2024Article
- Study protocol and rationale for a pilot randomized clinical trial comparing processing of positive memories technique with supportive counseling for PTSD.Contemporary clinical trials · 2024Article
- Dynamics of diurnal cortisol and alpha-amylase secretion and their associations with PTSD onset in recent interpersonal trauma survivors.Psychological medicine · 2023Article
- Changes in the Serum Concentration Levels of Serotonin, Tryptophan and Cortisol among Stress-Resilient and Stress-Susceptible Individuals after Experiencing Traumatic Stress.International journal of environmental research and public health · 2022Article
- Acquisition, extinction, and return of fear in veterans in intensive outpatient prolonged exposure therapy: A fear-potentiated startle study.Behaviour research and therapy · 2022Article
- Time of trauma prospectively affects PTSD symptom severity: The impact of circadian rhythms and cortisol.Psychoneuroendocrinology · 2022Article
- MicroRNAs as biomarker and novel therapeutic target for posttraumatic stress disorder in Veterans.Psychiatry research · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
PTSD is associated with abnormalities in hypothalamic-pituitary-adrenal (HPA) axis activity. This includes enhanced HPA axis negative feedback, attenuated cortisol awakening response, and attenuated cortisol response to personal trauma script. Whether HPA axis function predicts treatment response or treatment related symptom reduction in PTSD remains unclear. In addition, the relative effects of different treatment modalities (i.e., medication and psychotherapy) on HPA axis is unclear. To address this gap in knowledge, the PROGrESS study examined cortisol awakening response across treatment in Veterans with chronic PTSD randomized to receive Prolonged Exposure + Placebo (PE + PLB), Sertraline + PE (SERT + PE) or Sertraline + Enhanced Medication Management (SERT + EMM). Salivary cortisol awakening response (CAR) was assessed at baseline, mid-treatment (week 6 and 12), post-treatment (week 24) and follow-up (week 36 and 52). Among males at baseline, combat veterans with PTSD showed lower CAR Area Under the Curve Increase (AUCi; M = 3.15, SD = 9.57) than Combat controls (M = 7.63, SD = 9.07; p = .02), demonstrating combat veterans with PTSD have a less responsive system than combat controls. Higher PTSD severity was also related to lower CAR AUCi (r = -0.52, p = .03). When controlling for PTSD severity, higher baseline CAR AUCi was related to attenuated reduction in PTSD and lower likelihood of high treatment response over treatment (z = -2.06, p = .04).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.