Alcohol Use Disorder Masks the Effects of Childhood Adversity, Lifetime Trauma, and Chronic Stress on Hypothalamic-Pituitary-Adrenal Axis Reactivity.
Alcohol Use Disorder Masks the Effects of Childhood Adversity, Lifetime Trauma, and Chronic Stress on Hypothalamic-Pituitary-Adrenal Axis Reactivity.
复制标题
酒精使用障碍掩盖了童年逆境、一生创伤和慢性压力对下丘脑-垂体-肾上腺轴反应性的影响。
DOI：
10.1111/acer.14334
复制
发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Adinoff,Bryon
中科院分区：
文献类型：
--
作者：
Zhang,Alice;Price,JulianneL;Leonard,David;North,CarolS;Suris,Alina;Javors,MartinA;Adinoff,Bryon
研究背景酒精使用障碍（AUD）患者和经历过创伤或慢性应激的患者表现出下丘脑-垂体-肾上腺（HPA）轴反应性失调。是否以及如何创伤和压力的历史互动与AUD影响HPA轴reactivity.MethodsIn本研究中，26名健康男性对照组和70禁欲的男性与AUD进行了管理的药理学探针[绵羊促肾上腺皮质激素释放激素（oCRH）]和社会心理应激，以评估HPA轴的反应。每10-20分钟评估一次血浆促肾上腺皮质激素（ACTH）和皮质醇。多项创伤和压力指标的层次聚类确定了3个不同的聚类：童年逆境、终身创伤和慢性压力。一般线性模型的程序被用来检查组（AUD/控制）的主要影响和净集成ACTH和cortisol response.ResultsWe发现，更高水平的童年逆境，终身创伤，慢性压力与钝化oCRH诱导的ACTH反应性在控制组，但不是在AUD组的3个集群的相互作用。最近的慢性压力在前6个月内有最强的影响ACTH反应在对照组，和终身创伤，least.ConclusionsChildhood逆境，终身创伤，慢性压力可能会产生持久的，可测量的影响HPA轴功能在健康对照组。在AUD患者中，这种关联似乎被掩盖，可能混淆了研究压力、逆境和/或创伤对这一人群在恢复的长期戒断期HPA轴的影响。未来针对压力暴露和反应的工作应该考虑以前饮酒相对于过去逆境和创伤的影响。
BackgroundIndividuals with alcohol use disorder (AUD) and those who have experienced traumas or chronic stress exhibit dysregulated hypothalamic–pituitary–adrenal (HPA) axis reactivity. Whether and how trauma and stress histories interact with AUD to affect HPA axis reactivity has not been assessed.MethodsIn the present study, 26 healthy male controls and 70 abstinent men with AUD were administered a pharmacologic probe [ovine corticotropin–releasing hormone (oCRH)] and psychosocial stressor to assess HPA axis reactivity. Plasma adrenocorticotropin hormone (ACTH) and cortisol were assessed every 10–20 minutes. Hierarchical clustering of multiple measures of trauma and stress identified 3 distinct clusters: childhood adversity, lifetime trauma, and chronic stress. General linear model procedures were used to examine main effects of group (AUD/control) and interaction effects of the 3 clusters upon net‐integrated ACTH and cortisol response.ResultsWe found that higher levels of childhood adversity, lifetime trauma, and chronic stress were each associated with blunted oCRH‐induced ACTH reactivity in controls, but not in the AUD group. Recent chronic stress within the prior 6 months had the strongest influence upon ACTH reactivity in the control group, and lifetime trauma, the least.ConclusionsChildhood adversity, lifetime trauma, and chronic stress likely exert persistent, measurable effects upon HPA axis functioning in healthy controls. This association appears to be masked in individuals with AUD, potentially confounding studies examining the effects of stress, adversity, and/or trauma upon the HPA axis in this population during the protracted withdrawal phase of recovery. Future work targeting stress exposure and reactivity should consider the heightened effect of previous alcohol use relative to past adversity and trauma.