Mohammad Irfan-ul Akbar Yousufzai, Raheela Adil, Erum Afaq, Muhammad Sajid, Tehseen Iqbal, Maria Gill.
Stress hormone levels among children bereaved by terror attack.
Pak J Physiol Jan ;19(3):11-4.

Background: Terrorism is characterized by the use of violence against civilians, with the expressed desire of causing terror or panic in the population. Since the Soviet invasion of Afghanistan in 1979, the Khyber Pakhtunkhwa (formerly NWFP) province of Pakistan has suffered the most from unrest and terrorist activities. Terror related bereavement is more stressful and difficult to recover compared from that of bereavement from natural death. Methods: This retrospective study was carried out in the Department of Physiology, IBMS, Khyber Medical University, Peshawar, Pakistan. Salivary Cortisol Levels were estimated in Non-Bereaved and Bereaved Groups of children. Results: Children in the Bereaved Group showed a statistically significant (p=0.005) higher levels of salivary cortisol in the morning sample (Log Cortisol M=14.43) as compared with the children in the Non-Bereaved Group (Log Cortisol M=6.44). Children in the Bereaved Group showed a statistically non-significant (p=0.164) decrease in the levels of salivary cortisol in the post-dexamethasone sample (Log Cortisol M=8.85) as compared with the children in the Non-Bereaved Group (Log Cortisol M=4.25). Conclusion: Terror bereavement causes long-term activation of the Hypothalmo-Pituitary-Adrenal (HPA) axis, elevating the cortisol levels even 3–4 years after the traumatic bereavement. Chronic elevation of cortisol results in the manifestations of depression related signs and symptoms in bereaved children.

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