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Titolo:
Psychogenic lowering of urinary cortisol levels linked to increased emotional numbing, and a shame-depressive syndrome in combat-related posttraumatic stress disorder
Autore:
Mason, JW; Wang, S; Yehuda, R; Riney, S; Charney, DS; Southwick, SM;
Indirizzi:
Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA Yale Univ New Haven CT USA iv, Sch Med, Dept Psychiat, New Haven, CT USA Vet Affairs Med Ctr, Natl Ctr PTSD, Clin Neurosci Div, W Haven, CT USA VetAffairs Med Ctr W Haven CT USA D, Clin Neurosci Div, W Haven, CT USA Mt Sinai Sch Med, Dept Psychiat, New York, NY USA Mt Sinai Sch Med New York NY USA ch Med, Dept Psychiat, New York, NY USA Bronx Vet Affairs Hosp, Bronx, NY USA Bronx Vet Affairs Hosp Bronx NY USA ronx Vet Affairs Hosp, Bronx, NY USA Menlo Pk Vet Affairs Med Ctr, Nalt Ctr PTSD, Clin & Educ Div, Palo Alto, CA USA Menlo Pk Vet Affairs Med Ctr Palo Alto CA USA duc Div, Palo Alto, CA USA
Titolo Testata:
PSYCHOSOMATIC MEDICINE
fascicolo: 3, volume: 63, anno: 2001,
pagine: 387 - 401
SICI:
0033-3174(200105/06)63:3<387:PLOUCL>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
MISSISSIPPI SCALE; GUILT; PTSD; MODEL;
Keywords:
posttraumatic stress disorder; cortisol; emotional numbing; shame; guilt; depression;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Life Sciences
Citazioni:
51
Recensione:
Indirizzi per estratti:
Indirizzo: Mason, JW 32 Maple Vale Dr, Woodbridge, CT 06525 USA 32 Maple Vale Dr Woodbridge CT USA 06525 odbridge, CT 06525 USA
Citazione:
J.W. Mason et al., "Psychogenic lowering of urinary cortisol levels linked to increased emotional numbing, and a shame-depressive syndrome in combat-related posttraumatic stress disorder", PSYCHOS MED, 63(3), 2001, pp. 387-401

Abstract

Objective: The purpose of the study was to search for the intrapsychic correlates of individual differences in cortisol levels in male Vietnam combatveterans with posttraumatic stress disorder. Methods: The study involved measurement of urinary cortisol levels and clinical assessment with a broad profile of psychometric tests during a single 48-hour period in 30 inpatients. Results: The main finding by both correlation and t test analyses was asignificant inverse relationship between urinary cortisol levels and a symptom complex composed of two closely interrelated clinical subgroupings, "disengagement" (principally involving emotional numbing) and "shame-laden depression. " Conclusions: The findings support the concept that cortisol levels reflect the ongoing balance between the undifferentiated emotional arousal state of engagement (associated with higher cortisol levels) and opposing antiarousal disengagement defense mechanisms (associated with lower cortisol levels). It appears that the low cortisol levels often seen in patientswith posttraumatic stress disorder are psychogenic and reflect a dominating effect of disengagement coping strategies, which represent secondary compensatory adaptations during the chronic course of this disorder to counteract primary arousal symptoms, especially those related to an intractable shame-laden depressive syndrome. The psychoendocrine findings suggest that therelatively inconspicuous clinical feature of shame resulting from both theprimary and secondary traumatizations is a particularly powerful, preoccupying, and overwhelming source of emotional engagement, Shame may represent a "sleeper" that is worthy of greater attention in both research and clinical efforts to understand the pathogenesis and psychopathology of this devastating stress-related disorder.

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Documento generato il 26/01/20 alle ore 16:09:30