Retrospective Hair Cortisol Concentrations from Pretreatment to Early Recovery in Alcohol Use Disorder

Cortisol profiles are known to vary across phases of alcohol use disorder (AUD; e.g. chronic use, withdrawal and early/sustained recovery). These patterns have largely been established through between-subjects contrasts. Using a segmental hair cortisol concentrations (HCC) approach, retrospective longitudinal analyses are feasible. Here, we examine monthly cortisol secretion in treatment-seekers with AUD from alcohol use to abstinence. At ~6 weeks of recovery we collected hair samples from individuals with moderate-to-severe AUD. We examined HCC from three consecutive segments; proximal to the scalp representing the most recent month (sustained abstinence from alcohol), the midsegment representing the previous month in which abstinence was attained, and the distal segment representing 2 months prior during active drinking. Analyses examined main and interactive effects of segment and sex, controlling for monthly alcohol consumption. Best fit by a quadratic shape, within-subject change was significant (F1,15 = 5.27, P = 0.04, ηpartial2 = 0.26). The distal and midsegments did not differ from one another (P = 0.51). The proximal segment was significantly lower than both the distal (M∆ = 0.200, P = 0.004) and mid (M∆ = 0.175, P < 0.001) segments. An effect of sex approached significance suggesting women had modestly higher HCC than men (MWOMEN = 1.37 vs. MMEN = 1.02, P = 0.10). Consistent with previous cross-sectional reports, these data confirm nonlinear patterns of cortisol accumulation with elevations apparent during periods of alcohol consumption and a decrease in abstinence. Capturing these within-subject patterns via HCC trajectories may serve as a valuable resource in identifying profiles associated with increased risk and post-treatment outcomes.