PSYCHOBIOLOGY OF TRAUMATIC STRESS IN SEXUALLY ABUSED GIRLS

儿童性虐待（CSA）可以定义为年龄较大的犯罪者在18岁之前进行严重和/或反复的涉及生殖器接触的不良性经历。据估计，女性中性虐待的发生率高达33% （Peters, Wyatt & Finkelhor, 1988; Whitwell, 1990）。本研究的目的是研究6 - 12岁性侵女孩慢性创伤应激的心理生物学特征。我们的目标是在参与这项研究前至少3个月，但不到12个月经历过性爱抚事件的女孩。遭受性侵的女孩年龄从8岁到11岁不等。1年，平均9.0年。遭受性虐待的女孩要么被抚摸生殖器和口腔，要么只被抚摸生殖器。没有人经历过阴茎插入。所有女孩都经历过多次虐待。因此，这一群体最符合慢性压力人群，而不是急性压力人群。比较女孩是从调查人员已知的家庭中招募的，这些家庭在人口统计学变量上大致相似。年龄介乎8.0至11.4岁，平均8.1岁。创伤后应激是在经历了强烈的痛苦事件（如性虐待）后发展起来的。在强烈压力下，内源性应激反应神经激素，包括儿茶酚胺、下丘脑-垂体-肾上腺轴激素和内源性阿片类物质被释放。机体利用这些应激激素以各种方式激活处理应激源所需的能量，包括增加葡萄糖释放和提高觉醒。然而，机体对持续应激的适应可能会抑制应激反应的效果，导致脱敏。我们假设性虐待的创伤后应激导致下丘脑-垂体-肾上腺轴的改变，特别是糖皮质激素水平的降低，这与记忆、注意力和情感状态的缺陷有关。

Child sexual abuse (CSA) may be defined as severe and/or repeated adverse sexual experience(s) involving genital contact before the age of 18 years by an older perpetrator. The prevalence of sexual abuse in females has been estimated at up to 33% (Peters, Wyatt & Finkelhor, 1988; Whitwell, 1990). The objective of this proposal was to study the psychobiology of chronic traumatic stress in sexually abused girls ages 6 through 12 years. We targeted girls who experienced incidents of sexual fondling at least 3 months, but less than 12 months prior to participation in this study. Sexually abused girls ranged in age from 8.0 to 11. 1 years, with a mean of 9.0 years. Sexually abused girls were either genitally and orally fondled or just genitally fondled. None had experienced penile penetration. All girls experienced multiple abuse episodes. Therefore, this group is most consistent with a chronically stressed rather than an acutely stressed population. Comparison girls were recruited from families known to the investigators who were generally similar in demographic variables. Their ages ranged from 8.0 to 11.4, with a mean of 8.1 years. Post-traumatic stress develops following exposure to intensely distressing events, such as sexual abuse. In the presence of intense stress, endogenous stress-responsive neurohormones including catecholamines, hormones of the hypothalamic-pituitary-adrenal axis, and endogenous opioids are released. The organism utilizes these stress hormones to activate the energy necessary to handle the stressor in various ways, including increased glucose release and heightened arousal. However, the body's adaptation to persistent stress may inhibit the efficacy of the stress response and lead to desensitization. We hypothesized that the posttraumatic stress of sexual abuse causes alterations in the hypothalamic-pituitary-adrenal axis, specifically decreased glucocorticoid levels, which are related to deficits in memory, attention and affective status.