Children's responses to trauma: a study of cortisol and PTSD and a meta-analysis on the prevalence of panic disorder

Fraser, Haydn (2024) Children's responses to trauma: a study of cortisol and PTSD and a meta-analysis on the prevalence of panic disorder. Doctoral thesis, University of East Anglia.

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Abstract

A significant number of young people experience trauma exposure and a substantial minority of those develop post-traumatic stress disorder (PTSD). Both trauma exposure and PTSD are related to wide-ranging impacts. Two areas receiving significant attention are the extent to which trauma relates to physiological changes and wider psychopathology. There is increasing evidence linking early life trauma to the development of panic disorder. The wide heterogeneity in prevalence estimates for panic disorder following trauma exposure in youth requires further research to understand its prevalence. The HPA-axis plays an important role in our neurobiological response to stress with research often focussing on cortisol secretion. Research suggests that PTSD in youth is associated with elevated cortisol, however there is broad heterogeneity in findings.

This portfolio presents a systematic review and meta-analysis investigating the prevalence of panic disorder in trauma-exposed youth. Following this, an empirical paper presents analysis of pre-existing data to investigate differences in salivary cortisol in children and adolescents exposed to recent single incident trauma.
The meta-analysis identified a pooled prevalence rate of 7.1% (95% CI 2.7, 13.5) among thirteen studies involving 14,170 participants, exceeding general population estimates. Results of the empirical study found no significant differences in cortisol levels across different sample times or in total cortisol output across the morning and the day, but noted blunting of the Cortisol Awakening Response in the non-PTSD trauma exposed group relative to controls.

Findings of the meta-analysis suggested higher prevalence of panic disorder in trauma-exposed youth compared to general populations. This suggests that clinicians should routinely consider panic when assessing trauma exposed youth. Findings of the empirical study do not support the hypothesis that PTSD is characterised by elevated cortisol at around three months post trauma, reflecting the heterogeneity in existing literature. Future longitudinal research is required, closely adhering to guidelines for assessing and reporting cortisol data.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Kitty Laine
Date Deposited:	11 Nov 2024 14:30
Last Modified:	11 Nov 2024 14:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/97606
DOI:

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