ArticlePsychoneuroendocrinology2022
Time of trauma prospectively affects PTSD symptom severity: The impact of circadian rhythms and cortisol.
Article in Psychoneuroendocrinology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- FKBP5 methylation, temperament, and chronotype in adolescent posttraumatic stress disorder: a preliminary case-control study.European journal of psychotraumatology · 2026Article
- Early life social isolation stress and pain vulnerability: unraveling neuroimmune mechanisms and central sensitization.Frontiers in pharmacology · 2026Review
- Neurobiological and Existential Profiles in Posttraumatic Stress Disorder: The Role of Serotonin, Cortisol, Noradrenaline, and IL-12 Across Chronicity and Age.International journal of molecular sciences · 2025Article
- PTSD course and predictors in a 15 year longitudinal cohort following suspected serious injury.Npj mental health research · 2025Article
- Blind Mice, African Clawed Frogs, and the Missing Link Between Circadian Rhythms and Psychiatry.Biological psychiatry · 2025Article
- The relationship between hair cortisol and trauma sequelae in motor vehicle crash survivors: the role of childhood trauma experiences.Translational psychiatry · 2025Article
- Analysis of the correlation between serum vitamin D and hypothalamic-pituitary-adrenal axis hormone levels in patients with post-traumatic stress disorder.Frontiers in neuroscience · 2025Article
- Little evidence that posttraumatic stress is associated with diurnal hormone dysregulation in Turkana pastoralists.Evolution, medicine, and public health · 2025Article
- Neighborhood Poverty Prospectively Predicts PTSD Symptoms Six-Months Following Trauma Exposure.Mental health science · 2023Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
A key feature of posttraumatic stress disorder (PTSD) is a disruption of hypothalamic-pituitary-adrenal (HPA) axis feedback sensitivity and cortisol levels. Despite known diurnal rhythmicity of cortisol, there has been little exploration of the circadian timing of the index trauma and consequent cortisol release. Stress-related glucocorticoid pulses have been shown to shift clocks in peripheral organs but not the suprachiasmatic nucleus, uncoupling the central and peripheral clocks. A sample of 425 participants was recruited in the Emergency Department following a DSM-IV-TR Criterion A trauma. The Zeitgeber time of the trauma was indexed in minutes since sunrise, which was hypothesized to covary with circadian blood cortisol levels (high around sunrise and decreasing over the day). Blood samples were collected M(SD)= 4.0(4.0) hours post-trauma. PTSD symptoms six months post-trauma were found to be negatively correlated with trauma time since sunrise (r(233) = -0.15, p = 0.02). The effect remained when adjusting for sex, age, race, clinician-rated severity, education, pre-trauma PTSD symptoms, and time of the blood draw (β = -0.21, p = 0.00057). Cortisol levels did not correlate with blood draw time, consistent with a masking effect of the acute stress response obscuring the underlying circadian rhythm. Interactions between trauma time and expression of NPAS2 (p
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