Posttraumatic Stress Symptoms Related to Community Violence and Children’s Diurnal Cortisol Response in an Urban Community-Dwelling Sample
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
While community violence has been linked to psychological morbidity in urban youth, data on the physiological correlates of violence and associated posttraumatic stress symptoms are sparse. We examined the influence of child posttraumatic stress symptoms reported in relationship to community violence exposure on diurnal salivary cortisol response in a population based sample of 28 girls and 15 boys ages 7–13, 54% self-identified as white and 46% as Hispanic.
Mothers’ reported on the child’s exposure to community violence using the Survey of Children’s Exposure to Community Violence and completed the Checklist of Children’s Distress Symptoms (CCDS) which captures factors related to posttraumatic stress; children who were eight years of age or greater reported on their own community violence exposure. Saliva samples were obtained from the children four times a day (after awakening, lunch, dinner and bedtime) over three days. Mixed models were used to assess the influence of posttraumatic stress symptoms on cortisol expression, examined as diurnal slope and area under the curve (AUC), calculated across the day, adjusting for socio-demographics.
In adjusted analyses, higher scores on total traumatic stress symptoms (CCDS) were associated with both greater cortisol AUC and with a flatter cortisol waking to bedtime rhythm. The associations were primarily attributable to differences on the intrusion, arousal and avoidance CCDS subscales.
Posttraumatic stress symptomatology reported in response to community violence exposure was associated with diurnal cortisol disruption in these community-dwelling urban children.
- Thomson CC, Roberts K, et al. Caretaker-child concordance for child’s exposure to violence in a preadolescent inner-city population. Arch Pediatr Adolesc Med. 2002;156(8):818–23.
- Margolin G, Gordis EB. The effects of family and community violence on children. Annu Rev Psychol. 2000;51:445–79. CrossRef
- Osofsky JD, Wewers S, et al. Chronic community violence: what is happening to our children? Psychiatry. 1993;56(1):36–45.
- Schubiner H, Scott R, et al. Exposure to violence among inner-city youth. J Adolesc Health. 1993;14(3):214–9. CrossRef
- Sheehan K, DiCara JA, et al. Children’s exposure to violence in an urban setting. Arch Pediatr Adolesc Med. 1997;151(5):502–4.
- Wright RJ. Health effects of socially toxic neighborhoods: the violence and urban asthma paradigm. Clin Chest Med. 2006;27(3):413–21. CrossRef
- Campbell C, Schwarz DF. Prevalence and impact of exposure to interpersonal violence among suburban and urban middle school students. Pediatrics. 1996;98(3 Pt 1):396–402.
- Freeman LN, Mokros H, et al. Violent events reported by normal urban school-aged children: characteristics and depression correlates. J Am Acad Child Adolesc Psychiatry. 1993;32(2):419–23. CrossRef
- Martinez P, Richters JE. The NIMH community violence project: II. Children’s distress symptoms associated with violence exposure. Psychiatry. 1993;56(1):22–35.
- Mazza JJ, Reynolds WM. Exposure to violence in young inner-city adolescents: relationships with suicidal ideation, depression, and PTSD symptomatology. J Abnorm Child Psychol. 1999;27(3):203–13. CrossRef
- Schwab-Stone M, Chen C, et al. No safe haven. II: the effects of violence exposure on urban youth. J Am Acad Child Adolesc Psychiatry. 1999;38(4):359–67. CrossRef
- Sanchez MM. The impact of early adverse care on HPA axis development: nonhuman primate models. Horm Behav. 2006;50(4):623–31. CrossRef
- Sanchez MM, Ladd CO, et al. Early adverse experience as a developmental risk factor for later psychopathology: evidence from rodent and primate models. Dev Psychopathol. 2001;13(3):419–49. CrossRef
- Sanchez MM, Noble PM, et al. Alterations in diurnal cortisol rhythm and acoustic startle response in nonhuman primates with adverse rearing. Biol Psychiatry. 2005;57(4):373–81. CrossRef
- Gunnar MR. Quality of early care and buffering of neuroendocrine stress reactions: potential effects on the developing human brain. Prev Med. 1998;27(2):208–11. CrossRef
- Gunnar MR, Donzella B. Social regulation of the cortisol levels in early human development. Psychoneuroendocrinology. 2002;27(1–2):199–220. CrossRef
- Gunnar MR, Bruce J, et al. Salivary cortisol response to stress in children. Adv Psychosom Med. 2001;22:52–60. CrossRef
- Tarullo AR, Gunnar MR. Child maltreatment and the developing HPA axis. Horm Behav. 2006;50(4):632–9. CrossRef
- Cicchetti D, Rogosch FA. The impact of child maltreatment and psychopathology on neuroendocrine functioning. Dev Psychopathol. 2001;13(4):783–804.
- Carrion VG, Weems CF, et al. Diurnal salivary cortisol in pediatric posttraumatic stress disorder. Biol Psychiatry. 2002;51(7):575–82. CrossRef
- Gunnar MR, Morison SJ, et al. Salivary cortisol levels in children adopted from romanian orphanages. Dev Psychopathol. 2001;13(3):611–28. CrossRef
- Gunnar MR, Vazquez DM. Low cortisol and a flattening of expected daytime rhythm: potential indices of risk in human development. Dev Psychopathol. 2001;13(3):515–38. CrossRef
- Heim C, Ehlert U, et al. The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders. Psychoneuroendocrinology. 2000;25(1):1–35. CrossRef
- Clark R, Benkert RA, et al. Violence exposure and optimism predict task-induced changes in blood pressure and pulse rate in a normotensive sample of inner-city black youth. Psychosom Med. 2006;68(1):73–9. CrossRef
- Kliewer W. Violence exposure and cortisol responses in urban youth. Int J Behav Med. 2006;13(2):109–20. CrossRef
- Murali R, Chen E. Exposure to violence and cardiovascular and neuroendocrine measures in adolescents. Ann Behav Med. 2005;30(2):155–63. CrossRef
- Wilson DK, Kliewer W, et al. Violence exposure, catecholamine excretion, and blood pressure nondipping status in African American male versus female adolescents. Psychosom Med. 2002;64(6):906–15. CrossRef
- Breslau N. Neurobiological research on sleep and stress hormones in epidemiological samples. Ann N Y Acad Sci. 2006;1071:221–30. CrossRef
- Young EA, Breslau N. Saliva cortisol in posttraumatic stress disorder: a community epidemiologic study. Biol Psychiatry. 2004;56(3):205–9. CrossRef
- Young EA, Tolman R, et al. Salivary cortisol and posttraumatic stress disorder in a low-income community sample of women. Biol Psychiatry. 2004;55(6):621–6. CrossRef
- Hanrahan JP, Tager IB, et al. The effect of maternal smoking during pregnancy on early infant lung function. Am Rev Respir Dis. 1992;145(5):1129–35.
- Richters JE, Saltzman W. Survey of children’s exposure to community violence: parent report. Rockville, MD: National Institute of Mental Health; 1990.
- Selner-O’Hagan MB, Kindlon DJ, et al. Assessing exposure to violence in urban youth. J Child Psychol Psychiatry. 1998;39(2):215–24. CrossRef
- Suglia SF, Ryan L, et al. Violence exposure, a chronic psychosocial stressor, and childhood lung function. Psychosom Med. 2008;70:160–9. CrossRef
- Franco Suglia S, Ryan L, et al. Creation of a community violence exposure scale: accounting for what, who, where and how often. J Trauma Stress. 2008;21:479–86. CrossRef
- Horton NJ, Roberts K, et al. A maximum likelihood latent variable regression model for multiple informants. Stat Med. 2008;27:4992–5004. CrossRef
- Howard DE, Cross SI, et al. Parent-youth concordance regarding violence exposure: relationship to youth psychosocial functioning. J Adolesc Health. 1999;25(6):396–406. CrossRef
- Kuo M, Mohler B, et al. Assessing exposure to violence using multiple informants: application of hierarchical linear model. J Child Psychol Psychiatry. 2000;41(8):1049–56. CrossRef
- Richters JE, Martinez P. The NIMH community violence project: I. Children as victims of and witnesses to violence. Psychiatry. 1993;56(1):7–21.
- American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Washington DC: American Psychiatric Association; 1987.
- Howard DE, Feigelman S, et al. The relationship among violence victimization, witnessing violence, and youth distress. J Adolesc Health. 2002;31(6):455–62. CrossRef
- Li X, Howard D, et al. Distress symptoms among urban African American children and adolescents: a psychometric evaluation of the Checklist of Children’s Distress Symptoms. Arch Pediatr Adolesc Med. 1998;152(6):569–77.
- Wilson J, Keane TM. Assessing psychological trauma and PTSD. New York, NY: Guilford; 1997.
- Kirschbaum C, Hellhammer DH. Salivary cortisol in psychoneuroendocrine research: recent developments and applications. Psychoneuroendocrinology. 1994;19(4):313–33. CrossRef
- Strazdins L, Meyerkort S, et al. Impact of saliva collection methods on sIgA and cortisol assays and acceptability to participants. J Immunol Methods. 2005;307(1–2):167–71. CrossRef
- Ellison P. Human salivary steroids: methodological considerations and applications in physical anthropology. Yearb Phys Anthropol. 1988;31:115–42. CrossRef
- Cohen S, Schwartz JE, et al. Socioeconomic status, race, and diurnal cortisol decline in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Psychosom Med. 2006;68(1):41–50. CrossRef
- Polk DE, Cohen S, et al. State and trait affect as predictors of salivary cortisol in healthy adults. Psychoneuroendocrinology. 2005;30(3):261–72. CrossRef
- Cohen S, Doyle WJ, et al. Socioeconomic status is associated with stress hormones. Psychosom Med. 2006;68(3):414–20. CrossRef
- Nader K, Pynoos R, et al. Children’s PTSD reactions one year after a sniper attack at their school. Am J Psychiatry. 1990;147(11):1526–30.
- De Bellis M, Baum A, et al. Development traumatology: I. Biological Psychiatry. 1999;45:1259–70. CrossRef
- Goenjian AK, Yehuda R, et al. Basal cortisol, dexamethasone suppression of cortisol, and MHPG in adolescents after the 1988 earthquake in Armenia. Am J Psychiatry. 1996;153(7):929–34.
- Miller GE, Chen E, et al. If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans. Psychol Bull. 2007;133(1):25–45. CrossRef
- Posttraumatic Stress Symptoms Related to Community Violence and Children’s Diurnal Cortisol Response in an Urban Community-Dwelling Sample
International Journal of Behavioral Medicine
Volume 17, Issue 1 , pp 43-50
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Community violence
- Cortisol rhythm
- Posttraumatic stress symptoms
- Author Affiliations
- 1. Department of Environmental Health, Harvard School of Public Health, Landmark 415W, 401 Park Drive, Boston, MA, 02215, USA
- 2. Department of Mathematics and Statistics, University of Massachusetts, Amherst, MA, USA
- 3. Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
- 4. Channing Laboratory, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA