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dc.contributor.authorSmeeth, Demelzaen_US
dc.contributor.authorMcEwen, Fiona Sen_US
dc.contributor.authorPopham, Cassandra Men_US
dc.contributor.authorKaram, Elie Gen_US
dc.contributor.authorFayyad, Johnen_US
dc.contributor.authorSaab, Dahliaen_US
dc.contributor.authorRieder, Michael Jen_US
dc.contributor.authorElzagallaai, Abdelbaset Aen_US
dc.contributor.authorvan Uum, Stanen_US
dc.contributor.authorPluess, Michaelen_US
dc.description.abstractAltered secretion of cortisol, the primary effector of the hypothalamus-pituitary-adrenal axis, has been proposed as a means by which traumatic experiences compromise later mental health. However, despite the popularity of cortisol as a potential biomarker for stress and adversity, findings are inconsistent, and little is known about the impact of war-related trauma on stress physiology of children and adolescents. Here we aimed to evaluate the relationships between war exposure, current living conditions, hair cortisol concentrations (HCC) and post-traumatic stress disorder (PTSD) symptoms in a large cohort of Syrian refugee children and adolescents (6-18 years) and their caregiver. This longitudinal observational study assessed Syrian refugee children and adolescents in two waves, 1 year apart, within informal tented settlements in Lebanon. The relationships between war exposure, time since leaving Syria, PTSD symptoms and HCC were investigated using linear mixed-model regression utilising both waves of data collected (Y1: N = 1574, Y2: N = 923). Hair cortisol concentration was positively, but weakly associated with the number of war-related events experienced. This was limited to those who were at least 12 years old at the time of war exposure. Conversely, HCC decreased with time since leaving Syria. HCC was also associated with PTSD symptoms but not with the quality of their current living conditions. This study revealed that changes to hypothalamic-pituitary-adrenal axis activity may accompany both earlier war exposure and current PTSD symptoms in children and adolescents. Additionally, early adolescence may be a particularly sensitive time in terms of trauma-related changes to the hypothalamic-pituitary-adrenal axis.en_US
dc.titleWar exposure, post-traumatic stress symptoms and hair cortisol concentrations in Syrian refugee childrenen_US
dc.typeJournal Articleen_US
dc.contributor.affiliationFaculty of Medicineen_US
dc.relation.ispartoftextMolecular Psychiatryen_US
dc.description.campusSGH campusen_US
Appears in Collections:Faculty of Medicine
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