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Yehuda R et al. – Lower 5alpha–reductase activity is associated with avoidance severity and predicts non–responsiveness to psychological treatment for PTSD symptomatology. Relatively diminished 5alpha–reductase activity may mark a state of primary vulnerability, perhaps via attenuated peripheral catabolism of cortisol resulting in the suppression of hypothalamic–pituitary–adrenal axis responsiveness. Lower cortisol levels appear later in the progression to chronic, treatment–resistant PTSD.

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