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The study investigated the relationship between the acute psychological and psychobiological trauma response and the subsequent development of posttraumatic stress disorder (PTSD) and depressive symptoms in 53 accident survivors attending an emergency department. Lower levels of salivary cortisol measured in the emergency room predicted greater symptom levels of PTSD and depression 6 months later, and lower diastolic blood pressure, past emotional problems, greater dissociation and data-driven processing predicted greater PTSD symptoms. Heart rate was not predictive. Low cortisol levels correlated with data-driven processing during the accident, and, in female participants only, with prior trauma and prior emotional problems. Higher evening cortisol 6 months after the accident correlated with PTSD and depressive symptoms at 6 months, but this relationship was no longer significant when levels of pain were controlled. The results support the role of the acute response to trauma in the development and maintenance of PTSD and provide promising preliminary evidence for a meaningful relationship between psychobiological and psychological factors in the acute trauma phase.

Original publication




Journal article


Psychiatry Res

Publication Date





67 - 75


Accidents, Traffic, Adult, Arousal, Circadian Rhythm, Depressive Disorder, Female, Humans, Hydrocortisone, Injury Severity Score, Life Change Events, Male, Middle Aged, Personality Inventory, Prognosis, Risk Factors, Saliva, Sex Factors, Stress Disorders, Post-Traumatic, Wounds and Injuries