Alterations in HPA-axis and autonomic nervous system activity have been associated with posttraumatic stress disorder (PTSD) development and maintenance and are potentially associated with trauma-focused cognitive behavioral therapy (TF-CBT) outcomes. We examined the role of salivary cortisol (sCort) and alpha-amylase (sAA) in PTSD and TF-CBT outcomes in German Armed Forces service members (N = 100). Participants categorized as PTSD patients (n = 39), previously deployed healthy controls (n = 33), and nondeployed healthy controls (n = 28) provided diurnal profiles of sCort and sAA; PTSD patients provided samples before, immediately after, and 3 months after an internet-based TF-CBT intervention. No group differences emerged regarding total daily sCort and sAA output or daily slopes, ps = .224–.897, fs = 0.05–0.24. Participants with PTSD demonstrated a significantly attenuated sCort awakening response compared to deployed, p = .021, d = 0.59, but not nondeployed controls, p = .918, d = 0.08. Moreover, a significantly steeper sAA awakening response emerged in PTSD patients, p = .034, d = 0.67, and deployed controls, p = .014, d = 0.80, compared to nondeployed controls. From pretreatment to posttreatment (n = 21) and posttreatment to follow-up (n = 14), stable sCort, ps = .282–.628, fs = 0.34–0.49, and sAA concentrations, ps = .068–.758, fs = 0.24–1.13 paralleled a nonsignificant treatment effect. Both PTSD and trauma exposure were associated with alterations in awakening responses, but further investigation is needed to determine whether the observed correspondence remains when PTSD symptoms significantly decline.

中文翻译：

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创伤后应激障碍中的唾液皮质醇和 α-淀粉酶及其在评估认知行为治疗结果中的潜在作用

HPA 轴和自主神经系统活动的改变与创伤后应激障碍 (PTSD) 的发展和维持有关，并且可能与以创伤为中心的认知行为疗法 (TF-CBT) 的结果有关。我们检查了唾液皮质醇 (sCort) 和 α-淀粉酶 (sAA) 在德国武装部队服役人员 ( N = 100) 的 PTSD 和 TF-CBT 结果中的作用。参与者分为 PTSD 患者 ( n = 39)、先前部署的健康对照 ( n = 33) 和未部署的健康对照 ( n= 28) 提供了 sCort 和 sAA 的昼夜概况；PTSD 患者在基于互联网的 TF-CBT 干预之前、之后和 3 个月后提供样本。在每日总 sCort 和 sAA 输出或每日斜率方面没有出现组间差异，p s = .224–.897，f s = 0.05–0.24。与已部署的对照组相比，患有 PTSD 的参与者表现出显着减弱的 sCort 觉醒反应，p = .021 ，d = 0.59，但未部署的对照组则没有，p = .918，d = 0.08。此外，在 PTSD 患者中出现明显更陡峭的 sAA 觉醒反应，p = .034，d = 0.67，部署对照组，p= .014，d = 0.80，与未部署的控件相比。从治疗前到治疗后 ( n = 21) 和治疗后到随访 ( n = 14)，sCort 稳定，p s = .282–.628，f s = 0.34–0.49，sAA 浓度，p s = .068– .758，f s = 0.24–1.13 与不显着的治疗效果平行。PTSD 和创伤暴露都与觉醒反应的改变有关，但需要进一步调查以确定当 PTSD 症状显着下降时观察到的对应关系是否仍然存在。