Decreased adrenocorticotropic hormone and cortisol responses to stress in healthy adults reporting significant childhood maltreatment
Decreased adrenocorticotropic hormone and cortisol responses to stress in healthy adults reporting significant childhood maltreatment
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DOI：
10.1016/j.biopsych.2007.05.002
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发表时间：
2007-11-15
影响因子：
10.6
通讯作者：
Price, Lawrence H.
中科院分区：
文献类型：
--
作者：
Carpenter, Linda L.;Carvalho, John P.;Price, Lawrence H.
背景：临床前研究结果表明，在早期发育过程中暴露于压力以及伴随的下丘脑-垂体-肾 (HPA) 轴激活可能会产生永久性和潜在的有害影响。早年受虐待或忽视的历史似乎会增加患情绪障碍和焦虑症的风险。据报道，患有重度抑郁症和创伤后应激障碍的成年患者对压力挑战的 HPA 反应异常。 方法：在目前没有精神病理学的健康成年人 (n = 50) 中检查血浆促肾上腺皮质激素 (ACTH) 和皮质醇对特里尔社会压力测试的反应性。通过童年创伤问卷测量，具有自我报告的中度至重度儿童虐待史 (MAL) (n = 23) 的受试者与没有此类历史的受试者 (CTL) (n = 27) 进行比较。结果：与 CTL 相比，MAL 受试者表现出显着较低的皮质醇和 ACTH 基线峰值增量。在（重复测量）皮质醇对压力挑战的反应中发现了显着的群体效应，反映出 MAL 受试者中皮质醇的浓度较低。显着的 X 组时间效应表征了 MAL 组的 ACTH 反应相对迟钝。情感忽视 (-.34, p = .02) 和性虐待 (.31, p = .03) 强烈预测最大皮质醇释放。结论：在没有可诊断精神病理学的成年人中，童年虐待与 HPA 轴对心理社会压力源的反应减弱有关。讨论了对这一发现的可能解释。
Background: Preclinical research findings suggest that exposure to stress and concomitant hypothalamus-pituitary-ad renal (HPA) axis activation during early development can have permanent and potentially deleterious effects. A history of early-life abuse or neglect appears to increase risk for mood and anxiety disorders. Abnormal HPA response to stress challenge has been reported in adult patients with major depressive disorder and posttraumatic stress disorder.Methods: Plasma adrenocorticotropin hormone (ACTH) and cortisol reactivity to the Trier Social Stress Test were examined in healthy adults (n = 50) without current psychopathology. Subjects with a self-reported history of moderate to severe childhood maltreatment (MAL) (n = 23) as measured by the Childhood Trauma Questionnaire were compared with subjects without such a history (CTL) (n = 27).Results: Compared with CTLs, MAL subjects exhibited significantly lower cortisol and ACTH baseline-to-peak deltas. A significant group effect was seen in the (repeated measures) cortisol response to the stress challenge, reflecting lower concentrations among MAL subjects. A significant group X time effect characterized the relatively blunted ACTH response of the MAL group. Emotional neglect (-.34, p = .02) and sexual abuse (.31, p = .03) strongly predicted maximal cortisol release.Conclusions: In adults without diagnosable psychopathology, childhood maltreatment is associated with diminished HPA axis response to a psychosocial stressor. Possible explanations for the finding are discussed.