BASAL CORTISOL, DEXAMETHASONE SUPPRESSION OF CORTISOL, AND MHPG IN ADOLESCENTS AFTER THE 1988 EARTHQUAKE IN ARMENIA

Objective: This study evaluated basal salivary cortisol, 3-methoxy-4-h ydroxyphenylglycol (MHPG), and cortisol suppression following dexameth asone administration in adolescents exposed to two levels of earthquak e-related trauma. Method: Five years after the 1988 earthquake, saliva samples were obtained from 37 adolescents from two cities in Armenia at different distances from the epicenter. Baseline saliva samples wer e obtained at 8:00 a.m., 4:00 p.m., and 11:00 p.m., following which 0. 5 mg of dexamethasone was administered. Nine and 17 hours later, saliv a samples were again obtained. Subjects were evaluated for posttraumat ic stress and depressive reactions through use of self-report instrume nts. Results: Significantly lower mean baseline 8:00 a.m. cortisol lev els and greater day 2 4:00 p.m. cortisol suppression following dexamet hasone were observed in the more symptomatic adolescents living in the city closer to the epicenter. Of the three symptom categories of post traumatic stress disorder (PTSD), only intrusion (category B) symptoms were significantly correlated with basal morning cortisol levels and percent suppression by dexamethasone. The more highly exposed adolesce nts also exhibited a more rapid decline in MHPG levels over the course of day 1. Conclusions: The findings indicate that chronic posttraumat ic stress reactions among adolescents exposed to catastrophic disaster are associated with hypothalamic-pituitary-adrenal (HPA) axis alterat ions. The findings are congruent with those previously described in ad ults with chronic PTSD. Persistent intrusion (category B) symptoms may constitute continued episodes of distress and evoke repented physiolo gical stress responses, which, over time, after HPA axis function. The MHPG findings suggest that there may be diurnal changes associated wi th severity of posttraumatic stress symptoms.