2 - (SYM 77) Psychophysiological Correlates of PTSD Risk and Resilience Among Transgender Trauma Survivors

Transgender and nonbinary individuals (TNBI) are disproportionately burdened by chronic discrimination and traumatic victimization, both of which are associated with disparities in lifetime PTSD prevalence (U.S. general population: 6.8%; transgender samples; 18%-61%). Studies on both acute, traumatic victimization and chronic and persistent threats to one’s identity in the form of everyday discrimination suggest that these experiences may produce similar physiological stress responses. Individuals with PTSD show autonomic reactivity indicated by alterations in neuroendocrine activity associated with the HPA axis—specifically, a pattern of low basal cortisol levels. Studies examining cortisol responsiveness within the context of minority stress show an analogous pattern of neuroendocrine response. However, the interactive effects of these pathophysiological stress processes remain poorly understood. The current study examines associations among recent and ongoing discrimination experiences, pathophysiological stress markers, and PTSD symptoms in a diverse community sample of TNBI Criterion-A trauma-exposed individuals. Participants (N = 95, M_age = 30.7 years; 54.9% White; 51.6% nonbinary) completed self-report measures assessing acute and chronic exposure to identity-based stress and Criterion A trauma, alongside structured clinical interviews (i.e., Clinician-Administered PTSD scale [CAPS-5] at baseline and 3-month (n = 26), 6-month (n = 15), and 12-month (n = 39) follow-ups, with data collection ongoing. To collect data on cortisol response, participants provided multiple saliva samples at each study session, during and after description of the Criterion A traumatic experience to which their CAPS-5 was anchored. Participants also completed a 30-day daily diary survey assessing exposure to daily discrimination between each study session. A series of change score predictors and latent growth curve models will be used to test the following hypotheses: 1) exposure to naturalistic trauma reminder (i.e., Criterion A description) will be associated with a blunted cortisol response; 2) individuals who experience more frequent daily and past-year discrimination will be significantly more likely to demonstrate this response; 3) latent slope change in PTSD symptoms over 12-months will be attenuated by blunted cortisol reactivity. Findings will be discussed in terms of the pathophysiological manifestations of the interaction between acute and chronic stressors on the etiology and course of PTSD among TNBI.