Low Cortisol Levels in Children of Parents with PTSD

Summary and Comment |
December 10, 2007

Low Cortisol Levels in Children of Parents with PTSD

  1. Steven Dubovsky, MD

New evidence supports the hypothesis that susceptibility to developing PTSD may be acquired.

  1. Steven Dubovsky, MD

Post-traumatic stress disorder is often associated with low production of cortisol. This study examined cortisol levels in children with at least one parent with PTSD.

Researchers made repeated cortisol determinations over the course of 1 day among adult children of Holocaust survivors (23 with parental PTSD and 10 without parental PTSD) as well as 16 age-matched individuals from the same Jewish community whose parents had not been directly exposed to the events of the Holocaust or other traumatic events.

Mood and anxiety disorders were reported in about half of Holocaust survivor offspring versus about 20% of controls and children of survivors without PTSD. Plasma cortisol levels were significantly lower at several times over the 24-hour cycle in children of Holocaust survivors with PTSD than in the other groups. Having a mother with PTSD more strongly predicted the cortisol finding than did having a father with PTSD.


Several intriguing questions are raised by the observation that adult children of individuals (especially mothers) with PTSD have the same reduction of cortisol production as do people with PTSD — even though many offspring in this group suffered from mood disorders, which typically elevate cortisol levels. If activity in the hypothalamic-pituitary-adrenal (HPA) axis is altered in pregnant women with PTSD, would their fetuses also have altered HPA function? Is a tendency toward low cortisol an inherited susceptibility marker to PTSD, and are subjects with low cortisol more likely to develop PTSD if they are exposed to a traumatic event? Do subtle changes in parenting affect the offspring’s HPA activity, which is highly sensitive to environmental influence? (A previous study in rats demonstrated that early experience altered genetic expression of systems regulating the stress response.) While these questions are under exploration, a lesson for clinicians is that children of patients with PTSD (or with low cortisol) should also be evaluated for PTSD.


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