Altered Pituitary-Adrenal Axis Responses to Provocative Challenge Tests in Adult Survivors of Childhood Abuse

Heim, Christine; Newport, D. Jeffrey; Bonsall, Robert W.; Miller, Andrew H.; Nemeroff, Charles B.

doi:10.1176/appi.ajp.158.4.575

Cited by 649 publications

(317 citation statements)

References 38 publications

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“…Increased central HPA axis activity with higher expression of CRH has been reported in women with a history of childhood abuse [8]. The hypothesized peripheral hypocortisolism is in accordance with findings in animal models of early life stress [44], findings of reduced cortisol secretion in groups with history of early life stress [45, 46], reports of reduced adrenocortical activation during psychological stress [47-49] and pharmacological challenge [50]. Such mechanism could explain a more recent report of reduced hair cortisol in patients with depression [51] and the role in mediating the effects of childhood trauma on development of externalizing symptoms [52].…”

Section: Discussionsupporting

confidence: 65%

Recurrence of Depression in Relation to History of Childhood Trauma and Hair Cortisol Concentration in a Community-Based Sample

et al. 2019

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Background: Childhood trauma represents a risk factor for developing depression with increased rates of recurrence. Mechanisms involved include a disturbed regulation of the hypothalamic–pituitary–adrenal (HPA) axis. Hair cortisol concentration (HCC) is a measure of long-term HPA axis activity with less interference from circadian and confounding factors. However, no study has so far used HCC to investigate the role of childhood trauma in recurrent pattern of depressive symptoms. Methods: A community-based sample of 500 participants was recruited, and depression was assessed at 3 time points using the Revised Clinical Interview Schedule. The Childhood Trauma Questionnaire was administered to identify a history of childhood trauma. Hair samples were obtained from 144 participants for analysis of cortisol. Results: Patients with recurrent depression had higher rates of childhood trauma compared to participants with no depression. Participants with current-only depression had increased HCC compared to the no depression group, while this was absent in participants with recurrent depression. Within the depressed group (both current-only and recurrent depression), those with a history of childhood physical abuse had lower HCC when compared to those with no such history. Conclusions: Our findings show that retrospectively reported childhood trauma is associated with protracted trajectories of depression and a distinct pattern of long-term HPA axis activity.

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Section: Discussionsupporting

confidence: 65%

Recurrence of Depression in Relation to History of Childhood Trauma and Hair Cortisol Concentration in a Community-Based Sample

et al. 2019

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“…These findings suggest sensitization of the anterior pituitary and counterregulative adaptation of the adrenal cortex in abused women without major depressive disorder. On subsequent stress exposure, women with a history of childhood abuse may hypersecrete CRH, resulting in down-regulation of adenohypophyseal CRH receptors and symptoms of depression and anxiety [127]. …”

Section: The Interplay Of Genetic and Developmental Predisposition Amentioning

confidence: 99%

Pediatric Stress: Hormonal Mediators and Human Development

et al. 2003

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Stress activates the central and peripheral components of the stress system, i.e., the hypothalamic-pituitary-adrenal (HPA) axis and the arousal/sympathetic system. The principal effectors of the stress system are corticotropin-releasing hormone (CRH), arginine vasopressin, the proopiomelanocortin-derived peptides α-melanocyte-stimulating hormone and β-endorphin, the glucocorticoids, and the catecholamines norepinephrine and epinephrine. Appropriate responsiveness of the stress system to stressors is a crucial prerequisite for a sense of well-being, adequate performance of tasks and positive social interactions. By contrast, inappropriate responsiveness of the stress system may impair growth and development, and may account for a number of endocrine, metabolic, autoimmune and psychiatric disorders. The development and severity of these conditions primarily depend on the genetic vulnerability of the individual, the exposure to adverse environmental factors and the timing of the stressful event(s), given that prenatal life, infancy, childhood and adolescence are critical periods characterized by increased vulnerability to stressors. The developing brain undergoes rapid growth and is characterized by high turnover of neuronal connections during the prenatal and early postnatal life. These processes and, hence, brain plasticity, slow down during childhood and puberty, and plateau in young adulthood. Hormonal actions in early life, and to a much lesser extent later, can be organizational, i.e., can have effects that last for long periods of time, often for the entire life of the individual. Hormones of the stress system and sex steroids have such effects, which influence the behavior and certain physiologic functions of individuals for life. Exposure of the developing brain to severe and/or prolonged stress may result in hyperactivity/hyperreactivity of the stress system, with resultant amygdala hyperfunction (fear reaction), decreased activity of the hippocampus (defective glucocorticoid-negative feedback, cognition), and the mesocorticolimbic dopaminergic system (dysthymia, novelty-seeking, addictive behaviors), hyperactivation of the HPA axis (hypercortisolism), suppression of reproductive, growth, thyroid and immune functions, and changes in pain perception. These changes may be accompanied by abnormal childhood, adolescent and adult behaviors, including excessive fear (‘inhibited child syndrome’) and addictive behaviors, dysthymia and/or depression, and gradual development of components of the metabolic syndrome X, including visceral obesity and essential hypertension. Prenatal stress exerted during the period of sexual differentiation may be accompanied by impairment of this process with behavioral and/or somatic sequelae. The vulnerability of individuals to develop varying degrees and/or components of the above life-long syndrome is defined by as yet unidentified genetic factors, which account for up to 60% of the variance. CRH has marked kindling and glucocorticoids have strong consolidating properties, hence ...

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“…Our findings provide another example of the unique cortisol dysregulation profile, with low levels of cortisol coexisting with a greater responsiveness to specific stimuli, which is reminiscent of PTSD and some types of depression and job burnout (e.g., Bremner et al, 2003; Heim et al, 2001). In conclusion, this study reinforces the view that more social services and familial support should be available to those who provide sustained care for adolescents and adults with DD.…”

Section: Discussionmentioning

confidence: 81%

“…However, there is evidence that different types of stressors may exert different effects. For instance, in some studies, individuals with PTSD display low cortisol levels in response to “reminder triggers” of the original traumatizing event, but conversely they can have an elevated cortisol response to stressful stimuli that are not related to the precipitating traumatic event (Bremner et al, 2003; Heim, Newport, Bonsall, Miller, & Nemeroff, 2001). The complexity of the linkage between psychological and physiological functioning highlights the need to better understand how parents of adolescents or adults with a DD react physiologically to different types of stress.…”

Section: Work Stress On Physiological Functioningmentioning

confidence: 99%

Daily Work Stress and Awakening Cortisol in Mothers of Individuals with Autism Spectrum Disorders or Fragile X Syndrome

et al. 2014

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The effect of daily work stress on the next morning’s awakening cortisol level was determined in a sample of 124 mothers (M age = 49.89, SD= 6.33) of adolescents and adults with developmental disabilities and compared to 115 mothers (M age = 46.19, SD = 7.08) of individuals without disabilities. Mothers participated in 8 days of diary telephone interviews and provided saliva samples. Multilevel models revealed that mothers of individuals with developmental disabilities had lower awakening cortisol levels than comparison mothers. Work stress interacted with parental status to predict the awakening cortisol level on the following morning. When mothers of individuals with developmental disabilities experienced a work stressor, their awakening cortisol level was significantly higher on the subsequent morning, but for comparison mothers, work stressors were not significantly associated with cortisol level. Findings extend understanding of the differential impacts of specific types of stressors on physiological functioning of mothers of individuals with and without developmental disabilities.

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Altered Pituitary-Adrenal Axis Responses to Provocative Challenge Tests in Adult Survivors of Childhood Abuse

Cited by 649 publications

References 38 publications

Recurrence of Depression in Relation to History of Childhood Trauma and Hair Cortisol Concentration in a Community-Based Sample

Recurrence of Depression in Relation to History of Childhood Trauma and Hair Cortisol Concentration in a Community-Based Sample

Pediatric Stress: Hormonal Mediators and Human Development

Daily Work Stress and Awakening Cortisol in Mothers of Individuals with Autism Spectrum Disorders or Fragile X Syndrome

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