Cortisol awakening response over the course of humanitarian aid deployment: a prospective cohort study. Issue 1 (31st December 2020)

• Record Type: Journal Article
• Authors: Qing, Yulan; van Zuiden, Mirjam; Eriksson, Cynthia; Lopes Cardozo, Barbara; Simon, Winnifred; Ager, Alastair; Snider, Leslie; Sabin, Miriam Lewis; Scholte, Willem; Kaiser, Reinhard; Rijnen, Bas; Olff, Miranda
• Is Part Of: European journal of psychotraumatology. Volume 11:Issue 1(2020)
• Publication Date: 2020-12-31
• Subjects: Humanitarian aid -- prospective study -- HPA axis -- trauma history -- deployment -- perceived social support -- PTSD -- depression -- anxiety -- cortisol; Ayuda humanitaria -- estudio prospectivo -- eje HPA -- historia de trauma -- desplazamiento -- apoyo social percibido -- TEPT -- Depresión -- ansiedad -- cortisol; 人道主义援助 -- 前瞻性研究 -- HPA轴 -- 创伤史 -- 部署 -- 可感知的社会支持 -- PTSD -- 抑郁 -- 焦虑 -- 皮质醇; Post-traumatic stress disorder -- Periodicals; Stress Disorders, Post-Traumatic; Post-traumatic stress disorder; Electronic journals; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 616.8521
• DOI: 10.1080/20008198.2020.1816649
• Languages: English
• ISSNs: 2000-8198

Abstract

ABSTRACT: Background : Internationally deployed humanitarian aid (HA) workers are routinely confronted with potentially traumatic stressors. However, it remains unknown whether HA deployment and related traumatic stress are associated with long-term changes in hypothalamic-pituitary-adrenal (HPA) axis function. Therefore, we investigated whether cortisol awakening response (CAR) decreased upon deployment and whether this was moderated by previous and recent trauma exposure and parallel changes in symptom severity and perceived social support. Methods : In this prospective study, n = 86 HA workers (68% females) completed questionnaires regarding trauma exposure, posttraumatic stress disorder (PTSD), anxiety and depressive symptoms and perceived social support, as well as salivary cortisol assessments at awakening and 30 minutes post-awakening at before, early and 3–6 months post-deployment. Results : Linear mixed models showed significantly decreased CAR ( b(SE) = −.036(.011), p = .002) and awakening cortisol over time ( b(SE) = −.007(.003), p = .014). The extent of awakening cortisol change was significantly moderated by interactions between previous and recent trauma exposure. Also, a steeper awakening cortisol decrease was significantly associated with higher mean anxiety and PTSD symptoms across assessments. No significant effects were found for social support. Conclusions : We observed attenuated CAR and awakening cortisol upon HA deployment, with a dose-response effect between trauma exposure before and during the recent deployment on awakening cortisol. Awakening cortisol change was associated with PTSD and anxiety symptom levels across assessments. Our findings support the need for organizational awareness that work-related exposures may have long-lasting biological effects. Further research assessing symptoms and biological measures in parallel is needed to translate current findings into guidelines on the individual level. Abstract : HIGHLIGHTS: Humanitarian aid work can have long-lasting biological effects. Cortisol awakening response and awakening cortisol (AC) decreased upon deployment. AC change was associated with prior and recent trauma combined. AC change was associated with PTSD and anxiety symptoms.