Multi-level modeling examined the association between cortisol awakening responses (CAR) and different PTSD symptom clusters in a sample of 158 female participants presenting with intimate partner violence-related PTSD. Results revealed that arousal over the past week and month, respectively ([β = -.124, z = -2.33, p = .028; β = -.147, z = -2.19, p = .028]) significantly moderated the trajectory of cortisol levels, and emotional numbing symptom severity (over the past week [β = -.122, z = -2.07, p = .076]) was found to be trending toward significance. In each case higher symptom severity was associated with flatter CAR slopes compared to those with lower symptom severity. Assessing PTSD symptom clusters in relation to cortisol may better inform future interventions compared to studies that assess PTSD globally. Our findings suggest a subtype of PTSD patients displaying higher levels of arousal may be more likely to experience alterations in HPA axis functioning.

中文翻译：

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亲密伴侣暴力背景下PTSD症状对皮质醇觉醒反应的中介影响

在 158 名患有亲密伴侣暴力相关 PTSD 的女性参与者的样本中，多级建模检查了皮质醇觉醒反应 (CAR) 与不同 PTSD 症状群之间的关联。结果显示，过去一周和一个月的觉醒分别（[β = -.124, z = -2.33, p = .028; β = -.147, z = -2.19, p = .028]）显着缓和了皮质醇水平的轨迹和情绪麻木症状的严重程度（过去一周 [β = -.122, z = -2.07, p = .076]）被发现趋于显着。在每种情况下，与症状严重程度较低的患者相比，较高的症状严重程度与更平坦的 CAR 斜率相关。与在全球范围内评估 PTSD 的研究相比，评估与皮质醇相关的 PTSD 症状群可能会更好地为未来的干预措施提供信息。