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Basal activity of the HPA axis with or without PTSD. CRH secretion from the hypothalamus increases in PTSD (represented by a thicker black line). The release of ACTH from the anterior pituitary, and hence cortisol from the adrenal cortex, is decreased in PTSD (represented by a thinner black line). Cortisol’s negative feedback inhibition of the HPA axis is increased in PTSD (represented by thicker red lines).
