Participants were classified into current PTSD (Current, N = 40) vs. never-had PTSD (Never, N = 43) based on the CAPS results. Current co-morbid Axis I disorders for nurses with current PTSD included 14 major depressive, 4 dysthymic, 5 panic, 2 agoraphobic, 5 social phobic, 6 specific phobic, 1 obsessive compulsive, 1 undifferentiated somatoform, and 2 binge eating. Current disorders for nurses who never met criteria for PTSD included 1 major depressive, 1 dysthymic, 1 social phobic, and 3 specific phobic. (Some participants had more than one current co-morbid disorder.) About half the women with current PTSD had past MDD (N = 21). Thirteen participants in the Never PTSD group also met criteria for past MDD. Demographic and clinical data are presented in .
Demographic, Psychometric and Biologic Measures in Female Nurse Veterans with and without PTSD.
Results of ANCOVAR for Day-1 baseline cortisol levels, adjusting for BMI, indicated the expected main effect of Time (F(1,74) = 17.4, p < 0.001). There was a non-significant trend for the Group main effect (F(1,74) = 3.3, p = .07) reflecting that in combining the two time points, there was a tendency for higher salivary cortisol in the Current, compared to Never, PTSD participants. However, there was no Group × Time interaction (F(1,74) < 1) (see and ). The covariate BMI accounted for a significant portion of the variance in Day-1 baseline cortisol levels (F(1,74) = 4.2, p= .04). When presence or absence of Depression was added as an additional covariate, the trend for the Group main effect was no longer present (F(1,73) = 1.1, p = .29).
Group Mean (SE) Untransformed Salivary Cortisol Levels (ng/dl) in Female Nurse Vietnam Veterans with N = 40 and without N = 43 PTSD.
Results of ANCOVAR examining morning cortisol suppression, adjusting for BMI and DEX levels, revealed the expected significant effect for Day (F(1,72) = 18.9, p < .001) reflecting lower 0800h POST-DEX cortisol levels across groups (see and ), but no Group × Day interaction (F(1,72) <1). A non-significant trend for a Group main effect (F(1,72) = 3.3, p = .07), was present but disappeared when depression was added as a covariate (F(1,71)<1). The covariate BMI accounted for a nearly significant portion of the variance in this model (F(1,72) = 3.9, p = .05), but 0800h DEX level did not (F(1,72) < 1).
Results of ANCOVAR examining afternoon cortisol suppression, adjusting for BMI and DEX levels, showed a similar pattern, i.e., a significant Day main effect (F(1,75) = 4.4, p = .04), but no Group × Day interaction (F(1,75) < 1), and a trend level main effect of Group (F(1,75) = 2.9, p < .10) which was reduced by the addition of Depression as a covariate (F(1,74) < 1). In this model, however, BMI and DEX levels did not account for a significant portion of the variance (all p’s > .36). When the data were expressed as percent cortisol suppression, no group differences were observed ().