A.E. Bennett Research Award. Developmental traumatology. Part I: Biological stress systems.
A.E. Bennett Research Award. Developmental traumatology. Part I: Biological stress systems.
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DOI：
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发表时间：
1999
影响因子：
10.6
通讯作者：
M. D. Bellis;A. Baum;B. Birmaher;M. Keshavan;Clayton H. Eccard;A. Boring;F. Jenkins;N. Ryan
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文献类型：
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作者：
M. D. Bellis;A. Baum;B. Birmaher;M. Keshavan;Clayton H. Eccard;A. Boring;F. Jenkins;N. Ryan
背景 这项调查检查了因过去儿童虐待经历继发的创伤后应激障碍 (PTSD) 的青春期前儿童 (n = 18) 与患有过度焦虑症 (OAD) 的非创伤儿童 (n = 10) 相比，创伤、精神症状与尿游离皮质醇 (UFC) 和儿茶酚胺（肾上腺素 [EPI]、去甲肾上腺素 [NE]、多巴胺 [DA]）排泄之间的关系。和健康对照 (n = 24)。方法 受试者接受全面的精神病学和临床评估，并收集 24 小时尿液以测量 UFC 和尿儿茶酚胺排泄量。使用方差分析比较生物学和临床测量结果。结果 遭受虐待的 PTSD 受试者在 24 小时内排泄的尿 DA 和 NE 浓度显着高于 OAD 和对照受试者，并且 24 小时 UFC 浓度显着高于对照受试者。事后分析显示，遭受虐待的 PTSD 受试者比 OAD 受试者排出的尿 EPI 浓度明显更高。儿童期创伤后应激障碍（PTSD）与更多的共病精神病理学相关，包括抑郁和解离症状、整体功能评估较低以及终生自杀意念和企图的事件增加。尿儿茶酚胺和 UFC 浓度与 PTSD 创伤持续时间和 PTSD 症状严重程度呈正相关。结论 这些数据表明，遭受虐待的 PTSD 儿童的虐待经历与生物应激系统的改变有关。对童年创伤的心理生物学理解的提高最终可能会导致儿童创伤后应激障碍 (PTSD) 的更好治疗。
BACKGROUND This investigation examined the relationship between trauma, psychiatric symptoms and urinary free cortisol (UFC) and catecholamine (epinephrine [EPI], norepinephrine [NE], dopamine [DA]) excretion in prepubertal children with posttraumatic stress disorder (PTSD) secondary to past child maltreatment experiences (n = 18), compared to non-traumatized children with overanxious disorder (OAD) (n = 10) and healthy controls (n = 24). METHODS Subjects underwent comprehensive psychiatric and clinical assessments and 24 hour urine collection for measurements of UFC and urinary catecholamine excretion. Biological and clinical measures were compared using analyses of variance. RESULTS Maltreated subjects with PTSD excreted significantly greater concentrations of urinary DA and NE over 24 hours than OAD and control subjects and greater concentrations of 24 hour UFC than control subjects. Post hoc analysis revealed that maltreated subjects with PTSD excreted significantly greater concentrations of urinary EPI than OAD subjects. Childhood PTSD was associated with greater co-morbid psychopathology including depressive and dissociative symptoms, lower global assessment of functioning, and increased incidents of lifetime suicidal ideation and attempts. Urinary catecholamine and UFC concentrations showed positive correlations with duration of the PTSD trauma and severity of PTSD symptoms. CONCLUSIONS These data suggest that maltreatment experiences are associated with alterations of biological stress systems in maltreated children with PTSD. An improved psychobiological understanding of trauma in childhood may eventually lead to better treatments of childhood PTSD.