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Psychogenic Lowering of Urinary Cortisol Levels Linked to Increased Emotional Numbing and a Shame-Depressive Syndrome in Combat-Related Posttraumatic Stress Disorder

From the Department of Psychiatry, Yale University School of Medicine, New Haven, and the National Center for PTSD, Clinical Neuroscience Division, Veterans Affairs Medical Center (J.W.M., S.W., D.S.C., S.M.S.), West Haven, Connecticut; the Department of Psychiatry, Mount Sinai Medical School, New York, and Bronx Veterans Affairs Hospital (R.Y.), Bronx, NY; and the National Center for PTSD, Clinical and Educational Division, Menlo Park Veterans Affairs Medical Center (S.R.), Palo Alto, California.

View larger version (17K): [in a new window]   Fig. 1. Correlation between urinary cortisol levels and the use of emotional numbing-disengagement coping strategies in male Vietnam combat veterans with PTSD. DISF = sum of factors from CAPS-2, Mississippi, and BPRS scales (including emotional numbing, avoidance, and withdrawal measures).

View larger version (32K): [in a new window]   Fig. 2. Clinical psychometric differences between high- and low-cortisol subgroups in male Vietnam combat veterans with PTSD implicating the same clinical symptom complex of emotional numbing-disengagement and shame-depression that was revealed by correlation analysis. = high-cortisol subgroup (N = 14); = low-cortisol subgroup (N = 16).