Amnesia, neuroendocrine levels and PTSD in motor vehicle accident victims.

PRIMARY OBJECTIVE: To examine the initial neuroendocrine responses and subsequent PTSD symptomatology among amnesic and non-amnesic victims of motor vehicle accidents. It was hypothesized that amnesic patients would be less likely to meet PTSD criteria at 1 month follow-up and would display lower catechalomine levels and higher basal cortisol than non-amnesics. METHODS AND PROCEDURE: Fifteen-hour urinary hormone samples were collected from 70 MVA victims upon hospital admission. Participants were assessed for PTSD symptomatology 1 month later. MAIN OUTCOMES AND RESULTS: Amnesic patients displayed lower NE/cortisol ratios than non-amnesics, were less likely than non-amnesics to develop PTSD, and displayed fewer PTSD symptoms than non-amnesics. CONCLUSIONS: Amnesics may physiologically experience a motor vehicle accident differently from non-amnesics and have lower subsequent PTSD incidence. These results provide partial support for the hypothesis that amnesia for a traumatic event can serve as a buffering function in the development of subsequent PTSD among MVA victims.

Initial posttraumatic urinary cortisol levels predict subsequent PTSD symptoms in motor vehicle accident victims.

BACKGROUND: This study was designed to examine the relationship between urinary hormone levels collected upon admission to the trauma unit following a motor vehicle accident and posttraumatic stress disorder symptomatology 1 month later. METHODS: Fifteen-hour urine samples were collected from 63 male and 36 female motor vehicle accident victims and were used to assess levels of catecholamines and cortisol reflecting peritraumatic and acute-phase posttraumatic levels. Presence of posttraumatic stress disorder symptomatology was assessed 1 month after the accident. RESULTS: Motor vehicle accident victims subsequently diagnosed with acute posttraumatic stress disorder excreted significantly lower levels of cortisol in 15-hour urines collected upon admission to the hospital. In addition, urinary levels of cortisol predicted a significant percentage of the variance in intrusive and avoidant thoughts 1 month after the accident. CONCLUSIONS: The results of our study suggest that initial cortisol levels in the immediate aftermath of a traumatic event contribute, in part, to subsequent symptoms of posttraumatic stress disorder.