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Lev-Wiesel R, Amir M. Posttraumatic stress disorder symptoms, psychological distress, personal resources, and quality of life in four groups of Holocaust child survivors. FAMILY PROCESS 2000; 39:445-459. [PMID: 11143598 DOI: 10.1111/j.1545-5300.2000.39405.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The objective of the present study was to inquire into the long-term effects of child survivors' Holocaust experience. To this end, 170 Holocaust survivors who were born after 1926 completed questionnaires with regard to psychological distress, Posttraumatic Stress Disorder (PTSD), Quality of Life (QoL), Self-identity, and Potency. The survivors were divided into four groups based on the setting of their experience during the Holocaust: Catholic Institutions, Christian foster families, concentration camps, and hiding in the woods and/or with partisans. Results showed that survivors who had been with foster families scored significantly higher on several of the measures of distress, whereas survivors who had been in the woods and/or with partisans scored significantly higher on several of the positive measures, QoL, potency, and self-identity. The discussion focuses on understanding the different experiences according to developmental theory and sense of control. It was concluded that there are group differences between child survivors according to their Holocaust experience.
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Affiliation(s)
- R Lev-Wiesel
- Department of Social Work, Ben-Gurion University of the Negev, 84105, Beer-Sheva, Israel.
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252
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Aardal-Eriksson E, Eriksson TE, Holm AC, Lundin T. Salivary cortisol and serum prolactin in relation to stress rating scales in a group of rescue workers. Biol Psychiatry 1999; 46:850-5. [PMID: 10494455 DOI: 10.1016/s0006-3223(98)00381-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Rescue service personnel are often exposed to traumatic events as part of their occupation, and higher prevalence rates of psychiatric illness have been found among this group. METHODS In 65 rescue workers, salivary cortisol at 8 AM and 10 PM and serum prolactin at 8 AM were related to the psychiatric self-rating scale General Health Questionnaire (GHQ-28) measuring psychiatric health, and the Impact of Events Scale (IES) and Post Traumatic Symptom Scale (PTSS) measuring posttraumatic symptoms. RESULTS Seventeen percent of the study population scored above the GHQ-28 cut-off limit but none scored beyond the cut-off limit in the IES and PTSS questionnaires. Salivary cortisol concentration at 10 PM correlated with statistical significance to anxiety (p < .005) and depressive symptoms (p < .01) measured with GHQ-28, as well as to posttraumatic symptoms, with avoidance behavior measured with IES (p < .01) and PTSS (p < .005). Two of the rescue workers were followed over time with the same sampling procedure after a major rescue commission. CONCLUSIONS The correlation between evening salivary cortisol and anxiety, depressiveness, and posttraumatic avoidance symptoms indicates that these parameters can be used in screening and follow-up after traumatic stress events.
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Affiliation(s)
- E Aardal-Eriksson
- Department of Biomedicine and Surgery, Faculty of Health Sciences, Linköping University, Sweden
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253
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Kellner M, Yehuda R. Do panic disorder and posttraumatic stress disorder share a common psychoneuroendocrinology? Psychoneuroendocrinology 1999; 24:485-504. [PMID: 10378237 DOI: 10.1016/s0306-4530(99)00012-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- M Kellner
- University Hospital Eppendorf, Clinic of Psychiatry and Psychotherapy, Hamburg, Germany
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254
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Capitanio JP, Mendoza SP, Baroncelli S. The relationship of personality dimensions in adult male rhesus macaques to progression of simian immunodeficiency virus disease. Brain Behav Immun 1999; 13:138-54. [PMID: 10373278 DOI: 10.1006/brbi.1998.0540] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Studies of nonhuman primate personality have suggested that physiological correlates of relevant behavioral dimensions exist. The present study examined personality using techniques similar to those employed in human personality research. Adult male rhesus monkeys were each rated on 25 adjectives while living in their natal groups. Approximately 1.5 years later, 18 animals were inoculated with the simian immunodeficiency virus (SIV) and exposed to socially stable or socially unstable conditions. Behavior, viral load (SIV RNA), plasma cortisol concentrations, and the IgG response to SIV and to rhesus cytomegalovirus were measured at regular intervals. Multiple regression analyses revealed that the four personality dimensions (Sociability, Confidence, Equability, Excitability) were correlated with various measures. Following inoculation with SIV, animals higher in Sociability showed a more rapid decline in plasma cortisol concentrations, elevations in the anti-RhCMV IgG response, and a decline in SIV RNA. The results indicate that personality factors in rhesus monkeys do have physiological correlates that have significance for disease processes and that in the context of a social manipulation, Sociability, reflecting the tendency to engage in affiliative interactions, is an important factor in explaining outcome measures at early time points.
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Affiliation(s)
- J P Capitanio
- California Regional Primate Research Center, University of California, Davis, California 95616, USA
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255
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De Bellis MD, Baum AS, Birmaher B, Keshavan MS, Eccard CH, Boring AM, Jenkins FJ, Ryan ND. A.E. Bennett Research Award. Developmental traumatology. Part I: Biological stress systems. Biol Psychiatry 1999; 45:1259-70. [PMID: 10349032 DOI: 10.1016/s0006-3223(99)00044-x] [Citation(s) in RCA: 440] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
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.
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Affiliation(s)
- M D De Bellis
- Developmental Traumatology Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA 15213, USA
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256
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Moss HB, Vanyukov M, Yao JK, Kirillova GP. Salivary cortisol responses in prepubertal boys: the effects of parental substance abuse and association with drug use behavior during adolescence. Biol Psychiatry 1999; 45:1293-9. [PMID: 10349035 DOI: 10.1016/s0006-3223(98)00216-9] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND The purpose of this investigation was three-fold. First, we extended our original observation of decreased cortisol reactivity to an anticipated stressor in sons of fathers with a substance use disorder (SUD). Second, we examined the hypothesis that salivary cortisol underresponsivity in these high-risk prepubertal boys is an adaptation to the stress associated with having a father with a current, rather than remitted, SUD. Third, we tested the hypothesis that prepubertal cortisol underreactivity might be associated with subsequent drug use behavior during adolescence. METHODS Preadolescent salivary cortisol responses were examined in the context of risk-group status, paternal substance abuse offsets, and subsequent adolescent drug use behavior. RESULTS The results confirmed a decreased salivary cortisol response to an anticipated stressor among sons of SUD fathers in our expanded sample. In addition, sons of fathers with a current SUD and boys whose fathers had a SUD offset from their 3rd to 6th birthdays had lower anticipatory stress cortisol levels compared with sons of control fathers. Finally, lower preadolescent anticipatory cortisol responses were associated with regular monthly cigarette smoking and regular monthly marijuana use during adolescence. CONCLUSIONS Hyporeactivity as an adaptation to chronic stress may be salient to the intergenerational transmission of substance abuse liability.
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Affiliation(s)
- H B Moss
- Center for Education and Drug Abuse Research, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA 15213, USA
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257
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Boscarino JA, Chang J. Higher abnormal leukocyte and lymphocyte counts 20 years after exposure to severe stress: research and clinical implications. Psychosom Med 1999; 61:378-86. [PMID: 10367620 DOI: 10.1097/00006842-199905000-00019] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Research suggests that individuals with posttraumatic stress disorder (PTSD) are more likely to develop medical conditions and other stress-related psychiatric disorders. Given these findings and others suggesting that PTSD victims may have altered neuroendocrine and immune systems, the hypothesis that Vietnam veterans with PTSD have abnormally high leukocyte and lymphocyte counts was tested. METHODS The leukocyte and lymphocyte status of male Vietnam "theater" veterans with current partial posttraumatic stress (N = 286), anxiety (N = 274), and depression disorders (N = 192) were compared with those of Vietnam veterans without these disorders 20 years after military service (N = 2190), controlling for intelligence, race, age, income, education, type of enlistment, Vietnam volunteer status, region of birth, cigarette smoking, illicit drug use, body mass index, and alcohol consumption. Abnormal values were defined using standard laboratory reference ranges. Adjusted mean differences also were compared. RESULTS Based on the results of two-tailed tests, PTSD-positive veterans are more likely to have adjusted leukocyte (OR = 1.83, p = .04) and T-cell (OR = 1.82, p = .045) counts above the normal range and higher mean adjusted leukocyte (p = .042), lymphocyte (p = .01), T-cell (p = .008), and CD4 cell (p = .027) counts. Those with anxiety disorders have adjusted lymphocyte (OR = 1.68, p = .048) and T-cell (OR = 2.06, p = .011) counts above range. They also have test results indicating reactive delayed cutaneous hypersensitivity (OR = 1.77, p = .006), which suggests the presence of highly sensitized T-cell lymphocytes. Finally, depressed veterans are less likely to have B-cell counts above the reference range (OR = 0.55, p = .006). Results of one-tailed tests further suggest that PTSD-positive men also have abnormally high CD4 and CD8 T-cell lymphocyte counts as well (p < .05). CONCLUSIONS Our findings suggest that chronic, primarily combat-related PTSD is associated with clinically elevated leukocyte and total T-cell counts. Those with current anxiety also have some of these abnormalities in addition to highly sensitized T-cell lymphocytes. Additional research is needed to specify the mechanisms involved here and to investigate the health risks associated with these findings.
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Affiliation(s)
- J A Boscarino
- Center for Outcomes Measurement and Performance Assessment, Merck-Medco Managed Care, L.L.C., Montvale, New Jersey 07645-1753, USA.
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258
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Baker DG, West SA, Nicholson WE, Ekhator NN, Kasckow JW, Hill KK, Bruce AB, Orth DN, Geracioti TD. Serial CSF corticotropin-releasing hormone levels and adrenocortical activity in combat veterans with posttraumatic stress disorder. Am J Psychiatry 1999; 156:585-8. [PMID: 10200738 DOI: 10.1176/ajp.156.4.585] [Citation(s) in RCA: 165] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to carefully test, by using a technique of continuous CSF sampling, the hypothesis that basal elevations in CSF corticotropin-releasing hormone (CRH) concentrations exist in patients with posttraumatic stress disorder (PTSD). They also sought to assess the relationship among PTSD symptoms, adrenocortical activity, and CSF CRH levels. METHOD CSF was withdrawn by means of a flexible, indwelling subarachnoid catheter over a 6-hour period, and hourly CSF concentrations of CRH were determined for 11 well-characterized combat veterans with PTSD and 12 matched normal volunteers. Twenty-four-hour urinary-free cortisol excretion was also determined. PTSD and depressive symptoms were correlated with the neuroendocrine data. RESULTS Mean CSF CRH levels were significantly greater in PTSD patients than in normal subjects (55.2 [SD = 16.4] versus 42.3 pg/ml [SD = 15.6]). No correlation was found between CSF CRH concentrations and PTSD symptoms. While there was no significant difference between groups in 24-hour urinary-free cortisol excretion, the correlation between 24-hour urinary-free cortisol excretion and PTSD symptoms was negative and significant. CONCLUSIONS By using a serial CSF sampling technique, the authors found high basal CSF CRH concentrations and normal 24-hour urinary-free cortisol excretion in combat veterans with PTSD, a combination that appears to be unique among psychiatric conditions studied to date.
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Affiliation(s)
- D G Baker
- Psychiatry Service, Cincinnati VA Medical Center, OH, USA.
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259
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Lauc G, Peter-Katalinić J, Dabelić S, Flögel M. Purification and MALDI-MS characterization of stressin, a stress-associated glycoprotein. Biol Chem 1999; 380:443-50. [PMID: 10355630 DOI: 10.1515/bc.1999.058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Glycoconjugates have a whole spectrum of biological roles, from those that appear trivial to those that are crucial. Results accumulated in the past years indicate they might also play an important role in the response to stress, a complex physiological response of the human organism to various threats. We have recently identified stressin, a human serum glycoprotein, which was found to be increased under stress conditions. Here we report the purification of stressin from sera of professional soldiers and partial characterization of its protein and carbohydrate parts using lectin blotting and matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). Stressin was purified using a combination of ammonium sulfate precipitation, ion exchange chromatography, preparative gel electrophoresis and reverse-phase HPLC. It was found to be a highly glycosylated protein. Only 21.9 kDa (out of 36.7 kDa) was the protein part, whereas the remaining 40% of the mass originated from N-linked oligosaccharides. The carbohydrate part contained 12 sialic acids moieties, nearly 90% of which were lost due to post-source decay in the field-free tube. Tryptic fragments were produced from glycosylated and deglycosylated stressin, separated by reverse-phase HPLC and their exact molecular masses were determined using MALDI-MS. Comparison with tryptic maps of other proteins in computer databases indicated that stressin does not correspond to any already described protein.
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Affiliation(s)
- G Lauc
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Croatia
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260
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Yehuda R. Biological factors associated with susceptibility to posttraumatic stress disorder. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 1999; 44:34-9. [PMID: 10076739 DOI: 10.1177/070674379904400104] [Citation(s) in RCA: 137] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Because only a proportion of persons exposed to traumatic events develop posttraumatic stress disorder (PTSD), it has become important to elucidate the factors that increase the risk for the development of PTSD following trauma exposure as well as the factors that might serve to protect individuals from developing this condition. Putative risk factors for PTSD may describe the index traumatic event or characteristics of persons who experience those events. Recent data have implicated biological and familial risk factors for PTSD. For example, our recent studies have demonstrated an increased prevalence of PTSD in the adult children of Holocaust survivors, even though these children, as a group, do not report a greater exposure to life-threatening (Diagnostic and Statistical Manual of Mental Disorders [DSM-IV] Criterion A) events. These studies are reviewed. It is difficult to know to what extent the increased vulnerability to PTSD in family members of trauma survivors is related to biological or genetic phenomena, as opposed to experiential ones, because of the large degree of shared environment in families. In particular, at-risk family members, such as children, may be more vulnerable to PTSD as a result of witnessing the extreme suffering of a parent with chronic PTSD rather than because of inherited genes. But even if the diathesis for PTSD were somehow "biologically transmitted" to children of trauma survivors, the diathesis is still a consequence of the traumatic stress in the parent. Thus, even the most biological of explanations for vulnerability must at some point deal with the fact that a traumatic event has occurred.
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Affiliation(s)
- R Yehuda
- Mount Sinai School of Medicine, USA.
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261
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Abstract
Sustained stress can have numerous pathophysiological effects. Adrenal glucocorticoid hormones are principal effectors in the stress response. They have profound effects on mood and behavior and affect neurochemical transmission and neuroendocrine control. We have used the experimental paradigm of chronic psychosocial stress in tree shrews to investigate the impact of aversive social encounters on brain structures. Chronic stress in male tree shrews which is accompanied by constantly elevated levels of glucocorticoids leads to structural changes in hippocampal neurons. Whereas dendritic atrophy of hippocampal pyramidal neurons and impairment of neurogenesis in the dentate gyrus could be demonstrated in chronically stressed tree shrews, a loss of hippocampal neurons was not observed in this animal model. The present review summarizes recent results on the question which structural changes occur during chronic stress in neurons of the brain and whether glucocorticoids might be responsible for such stress effects. The role of transmitter systems in stress-related neuronal plasticity is also discussed.
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Affiliation(s)
- E Fuchs
- Division of Neurobiology, German Primate Center, Göttingen
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262
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Yehuda R, McFarlane AC, Shalev AY. Predicting the development of posttraumatic stress disorder from the acute response to a traumatic event. Biol Psychiatry 1998; 44:1305-13. [PMID: 9861473 DOI: 10.1016/s0006-3223(98)00276-5] [Citation(s) in RCA: 295] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Posttraumatic stress disorder (PTSD) is a psychiatric condition that is directly precipitated by an event that threatens a person's life or physical integrity and that invokes a response of fear, helplessness, or horror. In recent years it has become clear that only a proportion of those exposed to fear-producing events develop or sustain PTSD. Thus, it seems that an important challenge is to elucidate aberrations in the normal fear response that might precipitate trauma-related psychiatric disorder. This paper summarizes the findings from recent studies that examined the acute and longer term biological response to traumatic stress in people appearing to the emergency room immediately following trauma exposure. In the aggregate, these studies have demonstrated increased heart rate and lower cortisol levels at the time of the traumatic event in those who have PTSD at a follow-up time compared to those who do not. In contrast, certain features associated with PTSD, such as intrusive symptoms and exaggerated startle responses, are only manifest weeks after the trauma. The findings suggest that the development of PTSD may be facilitated by an atypical biological response in the immediate aftermath of a traumatic event, which in turn leads to a maladaptive psychological state.
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Affiliation(s)
- R Yehuda
- Psychiatry Department, Mount Sinai School of Medicine, Bronx Veterans Affairs Hospital, New York, New York 10468, USA
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263
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Maes M, Lin A, Bonaccorso S, van Hunsel F, Van Gastel A, Delmeire L, Biondi M, Bosmans E, Kenis G, Scharpé S. Increased 24-hour urinary cortisol excretion in patients with post-traumatic stress disorder and patients with major depression, but not in patients with fibromyalgia. Acta Psychiatr Scand 1998; 98:328-35. [PMID: 9821456 DOI: 10.1111/j.1600-0447.1998.tb10092.x] [Citation(s) in RCA: 161] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
There is now firm evidence that major depression is accompanied by increased baseline activity of the hypothalamic-pituitary-adrenal (HPA) axis, as assessed by means of 24-h urinary cortisol (UC) excretion. Recently, there were some reports that fibromyalgia and post-traumatic stress disorder (PTSD), two disorders which show a significant amplitude of depressive symptoms, are associated with changes in the baseline activity of the HPA axis, such as low 24-h UC excretion. The aim of the present study was to examine 24-h UC excretion in fibromyalgia and PTSD patients compared to normal controls and patients with major depression. In the three patient groups, severity of depressive symptoms was measured by means of the Hamilton Depression Rating Scale (HDRS) score. Severity of fibromyalgia was measured using a dolorimetrically obtained myalgic score, and severity of PTSD was assessed by means of factor analytical scores computed on the items of the Composite International Diagnostic Interview (CIDI), PTSD Module. Patients with PTSD and major depression had significantly higher 24-h UC excretion than normal controls and fibromyalgia patients. At a threshold value of > or = 240 micrograms/24 h, 80% of PTSD patients and 80% of depressed patients had increased 24 h UC excretion with a specificity of 100%. There were no significant differences in 24-h UC excretion either between fibromyalgia patients and normal controls, or between patients with major depression and PTSD patients. In the three patient groups, no significant correlations were found between 24-h UC excretion and the HDRS score. In fibromyalgia, no significant correlations were found between 24-h UC excretion and the myalgic score. In PTSD, no significant correlations were found between 24-h UC excretion and severity of either depression-avoidance or anxiety-arousal symptoms. In conclusion, this study found increased 24-h UC excretion in patients with PTSD comparable to that in patients with major depression, whereas in fibromyalgia no significant changes in 24-h UC were found.
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Affiliation(s)
- M Maes
- Clinical Research Center for Mental Health, Antwerp, Belgium
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264
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Lipschitz DS, Rasmusson AM, Southwick SM. Childhood Posttraumatic Stress Disorder: A Review of Neurobiologic Sequelae. Psychiatr Ann 1998. [DOI: 10.3928/0048-5713-19980801-09] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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265
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Cwikel J, Rozovski U. Coping with the stress of immigration among new immigrants to Israel from Commonwealth of Independent States (CIS) who were exposed to Chernobyl: the effect of age. Int J Aging Hum Dev 1998; 46:305-18. [PMID: 9650067 DOI: 10.2190/7vrq-ebw0-vrw7-d0u9] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study examined the differential effect of age on coping and psychological measures among immigrants from Commonwealth of Independent States (CIS) to Israel. Some of these immigrants originated in the Republics adjacent to the Chernobyl Power Plant, site of the 1986 accident. The sample consisted of 708 immigrants who were interviewed between the years 1993-1995 with an average age of 47.5 (sd 11.8). This sample was reinterviewed approximately a year and three months later (n = 520). The sample included two exposure groups--high exposed and low exposed based on the estimated levels of ground cesium contamination from the IAEA maps and a comparison group matched by age, gender, and year of immigration. Those over the age of sixty-five were disadvantaged, compared to those aged fifty to sixty-four, and younger, when it came to the tasks of immigrant absorption; learning the language, working and acquiring an income, and establishing alternative social networks which could offer support in times of illness. The psychological variables showed that over time, somatization, depression, and post-traumatic stress disorder (PTSD) symptoms related to Chernobyl improved, however at a much slower pace for older immigrants (aged 55 and over) compared to younger ones.
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Affiliation(s)
- J Cwikel
- Spitzer Dept. of Social Work, Ben-Gurion University of the Negev, Beer Sheba, Israel
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266
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Yehuda R, Resnick HS, Schmeidler J, Yang RK, Pitman RK. Predictors of cortisol and 3-methoxy-4-hydroxyphenylglycol responses in the acute aftermath of rape. Biol Psychiatry 1998; 43:855-9. [PMID: 9611677 DOI: 10.1016/s0006-3223(97)00554-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Prospective studies of trauma survivors can provide information about the relationship between rape characteristics and the development of subsequent symptoms. METHODS The present study examined the relationship of prior assault, rape severity, posttraumatic stress disorder (PTSD) symptoms following rape, and subsequent PTSD diagnosis, to the acute cortisol and 3-methoxy-4-hydroxyphenylglycol (MHPG) response to this traumatic event in 20 women. RESULTS Women with a history of prior physical or sexual assault showed a significantly attenuated cortisol response to the acute stress of rape compared to women without such a history. MHPG appeared to be associated with injury-related rape characteristics, and symptoms of active avoidance, but not prior history. PTSD status at the 3-month follow-up was predicted by both a prior history of assault and high injury rape, but was not directly predicted by either cortisol or MHPG levels. MHPG and cortisol were not correlated in the sample as a whole, but were correlated among individuals who did not subsequently develop PTSD (p = .04) CONCLUSIONS The results suggest that different neuroendocrine systems may mediate different components of the response to traumatic stress.
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Affiliation(s)
- R Yehuda
- Psychiatry Department, Mount Sinai School of Medicine, Bronx VA Medical center, New York 10468, USA
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267
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Yehuda R, Schmeidler J, Giller EL, Siever LJ, Binder-Brynes K. Relationship between posttraumatic stress disorder characteristics of Holocaust survivors and their adult offspring. Am J Psychiatry 1998; 155:841-3. [PMID: 9619162 DOI: 10.1176/ajp.155.6.841] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE There is controversy regarding the long-lasting effects of the Holocaust on the adult children of Holocaust survivors. In the present study the authors examined the relationship between posttraumatic stress disorder (PTSD) characteristics of Holocaust survivors and their adult children to determine whether differences in symptom severity or diagnostic status of parents would be associated with similar characteristics in their adult children. METHOD Holocaust survivors (N = 22) and their offspring (N = 22) were interviewed with several instruments to assess lifetime trauma history, effect of trauma on one's life, level of intrusive and avoidance symptoms in response to reminders of the Holocaust, current and lifetime PTSD, and current and lifetime axis I psychiatric disorder other than PTSD. RESULTS There were significant relationships between parents and children regarding the effect of trauma on one's life and level of intrusive, but not avoidance, symptoms in response to reminders of the Holocaust. Offspring with traumatic events were more likely to develop PTSD if their parents had PTSD. CONCLUSIONS Symptoms in offspring may be related to presence and severity of symptoms in the parent. Furthermore, PTSD in the parent may be a risk factor for PTSD in offspring.
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Affiliation(s)
- R Yehuda
- Psychiatry Department, Mount Sinai School of Medicine, New York
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268
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Irwin M, Hauger R, Patterson TL, Semple S, Ziegler M, Grant I. Alzheimer caregiver stress: basal natural killer cell activity, pituitary-adrenal cortical function, and sympathetic tone. Ann Behav Med 1998; 19:83-90. [PMID: 9603682 DOI: 10.1007/bf02883324] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The association between Alzheimer caregiving and natural killer (NK) cell activity and basal plasma levels of adrenocorticotropic hormone (ACTH), cortisol, beta-endorphin, prolactin, epinephrine, norepinephrine, and neuropeptide Y was determined in 100 spousal Alzheimer caregivers and 33 age- and gender-comparable control volunteers upon intake into a study of the psychological and physiologic impact of caregiving. The relationship between these physiologic measures and individual characteristics such as age, gender, medical status, severity of stress, severity of depressive symptoms, and caregiver burden was tested. In addition, the association between NK activity and alterations of the neuroendocrine measures was investigated. As compared to controls, the Alzheimer caregivers had similar levels of NK activity and of basal plasma neuroendocrine hormones and sympathetic measures. While older age and male gender status were associated with increased levels of ACTH, neither medical caseness, severity of life stress, nor severity of depressive symptoms was associated with alterations in any of the multiple physiologic domains. Classification of Alzheimer caregiver burden identified caregivers who were mismatched in terms of the amount of care they were required to provide and the amount of respite time received. The mismatched caregivers had significantly higher basal plasma ACTH but no change in other physiological measures, as compared to non-mismatched caregivers. NK activity was negatively correlated with plasma levels of neuropeptide Y but not with any of the other neuroendocrine measures. Based on this cross-sectional evaluation of NK activity and neuroendocrine and sympathetic measures, we conclude that most Alzheimer caregivers do not show evidence of altered basal physiology.
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Affiliation(s)
- M Irwin
- University of California, San Diego, USA
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269
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Heim C, Ehlert U, Hanker JP, Hellhammer DH. Abuse-related posttraumatic stress disorder and alterations of the hypothalamic-pituitary-adrenal axis in women with chronic pelvic pain. Psychosom Med 1998; 60:309-18. [PMID: 9625218 DOI: 10.1097/00006842-199805000-00017] [Citation(s) in RCA: 234] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Although numerous organic conditions may cause chronic pelvic pain (CPP), diagnostic laparoscopy reveals a normal pelvis in many patients with CPP. However, psychological studies yield a high frequency of psychopathology and increased prevalences of chronic stress and traumatic life events, ie, sexual and physical abuse, in women with CPP, suggesting a relationship between posttraumatic stress disorder (PTSD) and CPP. As chronic stress and PTSD have been associated with specific alterations of the hypothalamic-pituitary-adrenal (HPA) axis, we explored stress history, psychopathology and HPA axis alterations in women with CPP. METHOD We recruited 16 patients with CPP and 14 painfree, infertile controls from a general hospital where diagnostic laparoscopy was performed. Psychological assessment included standardized interviews on clinical symptoms, abuse experiences and major life events as well as psychometric testing for PTSD-like symptoms and depression. Endocrinological evaluation involved determinations of diurnal salivary cortisol levels and hormonal responses to a corticotropin-releasing factor (CRF) stimulation test (100 microg human CRF) and a low-dose dexamethasone suppression test (0.5 mg). RESULTS We observed increased prevalences of abuse experiences and PTSD in women with CPP as well as a higher total number of major life events, whereas the mean extent of depression was within the normal range. With respect to endocrine measures, women with CPP demonstrated normal to low diurnal salivary cortisol levels, normal plasma-adrenocorticotropin (ACTH), but reduced salivary cortisol levels in the CRF stimulation test, and an enhanced suppression of salivary cortisol by dexamethasone. CONCLUSION Women with CPP demonstrate HPA axis alterations, that partly parallel and partly contrast neuroendocrine correlates of PTSD, but show marked similarity to findings in patients with other stress-related bodily disorders. These findings suggest that a lack of protective properties of cortisol may be of relevance for the development of bodily disorders in chronically stressed or traumatized individuals.
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Affiliation(s)
- C Heim
- Center for Psychobiological and Psychosomatic Research, University of Trier, Germany
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270
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Capitanio JP, Mendoza SP, Lerche NW, Mason WA. Social stress results in altered glucocorticoid regulation and shorter survival in simian acquired immune deficiency syndrome. Proc Natl Acad Sci U S A 1998; 95:4714-9. [PMID: 9539804 PMCID: PMC22556 DOI: 10.1073/pnas.95.8.4714] [Citation(s) in RCA: 140] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/1997] [Accepted: 02/09/1998] [Indexed: 02/07/2023] Open
Abstract
From early in the AIDS epidemic, psychosocial stressors have been proposed as contributors to the variation in disease course. To test this hypothesis, rhesus macaques were assigned to stable or unstable social conditions and were inoculated with the simian immunodeficiency virus. Animals in the unstable condition displayed more agonism and less affiliation, shorter survival, and lower basal concentrations of plasma cortisol compared with stable animals. Early after inoculation, but before the emergence of group differences in cortisol levels, animals receiving social threats had higher concentrations of simian immunodeficiency virus RNA in plasma, and those engaging in affiliation had lower concentrations. The results indicate that social factors can have a significant impact on the course of immunodeficiency disease. Socially induced changes in pituitary-adrenal hormones may be one mechanism mediating this relationship.
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Affiliation(s)
- J P Capitanio
- California Regional Primate Research Center, University of California, One Shields Avenue, Davis, CA 95616, USA.
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271
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Schulkin J, Gold PW, McEwen BS. Induction of corticotropin-releasing hormone gene expression by glucocorticoids: implication for understanding the states of fear and anxiety and allostatic load. Psychoneuroendocrinology 1998; 23:219-43. [PMID: 9695128 DOI: 10.1016/s0306-4530(97)00099-1] [Citation(s) in RCA: 317] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Evidence supports the idea of two distinct corticotropin-releasing hormone (CRH) systems in the brain: one which is constrained by glucocorticoids and the other which is not. It is this latter system that includes two primary sites (central nucleus of the amygdala and the lateral bed nucleus of the stria terminalis) in which the regulation of CRH gene expression can be disassociated from that of the paraventricular nucleus of the hypothalamus. It is this other system that we think is linked to fear and anxiety and to clinical syndromes (excessively shy fearful children, melancholic depression, post-traumatic stress disorder and self-administration of psychotropic drugs). The excess glucocorticoids and CRH, and the state of anticipatory anxiety, contribute to allostatic load, a new term that refers to the wear and tear on the body and brain arising from attempts to adapt to adversity.
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Affiliation(s)
- J Schulkin
- Department of Physiology and Biophysics, Georgetown University, Washington, DC, USA.
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272
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Frederick SL, Reus VI, Ginsberg D, Hall SM, Munoz RF, Ellman G. Cortisol and response to dexamethasone as predictors of withdrawal distress and abstinence success in smokers. Biol Psychiatry 1998; 43:525-30. [PMID: 9547932 DOI: 10.1016/s0006-3223(97)00423-x] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Glucocorticoids have been linked to self-administration of a wide range of drugs in animals and are increased endogenously by chronic nicotine intake. Corticosteroids have also been shown to regulate nicotine receptor sensitivity and to be involved in behavioral sensitization to nicotine. METHODS Cortisol levels and cortisol suppression in response to dexamethasone were measured in a sample of smokers participating in a smoking cessation treatment trial. RESULTS Cortisol levels dropped significantly during the early quitting process (2 weeks post-quit) and returned to a level below baseline 1 month post-quit. The magnitude of the initial drop in cortisol was strongly related to post-quit distress and marginally predictive of abstinence. Neither baseline nor post-quit changes in percent cortisol suppression after dexamethasone were related to abstinence success or withdrawal distress. CONCLUSIONS Withdrawal from cigarette smoking is marked by a reduction in cortisol levels that appears to be related to the degree of distress experienced during the early quitting period. Further work is needed to determine whether withdrawal-related cortisol changes or distress are predictive of abstinence success.
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Affiliation(s)
- S L Frederick
- Department of Psychiatry, University of California, San Francisco, USA
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273
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Scott LV, Dinan TG. Urinary free cortisol excretion in chronic fatigue syndrome, major depression and in healthy volunteers. J Affect Disord 1998; 47:49-54. [PMID: 9476743 DOI: 10.1016/s0165-0327(97)00101-8] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Urinary free cortisol excretion (UFC) was compared in 21 patients with chronic fatigue syndrome (CFS), in 10 melancholic depressives and in 15 healthy controls. Patients with depression had UFC values which were significantly higher than healthy comparison subjects, whereas UFC excretion of CFS patients was significantly lower than the comparison group. These findings are in keeping with currently held hypotheses of hyperactivity and hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis in depression and chronic fatigue syndrome respectively. Five of the 21 CFS patients had a co-morbid depressive illness. This sub-group retained the profile of UFC excretion of those with CFS alone, suggesting a different pathophysiological basis for depressive symptoms in CFS.
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Affiliation(s)
- L V Scott
- Department of Psychological Medicine, St. Bartholomew's Hospital and the Royal London School of Medicine, West Smithfield, UK
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274
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Boscarino JA. Diseases among men 20 years after exposure to severe stress: implications for clinical research and medical care. Psychosom Med 1997; 59:605-14. [PMID: 9407579 DOI: 10.1097/00006842-199711000-00008] [Citation(s) in RCA: 247] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Epidemiologic studies have linked exposure to severe environmental stress, such as natural disasters and combat operations, to the onset of specific psychiatric disorders. Some research also suggests that these exposures may be associated with the onset of chronic diseases as well. However, these chronic disease outcome studies often have been obscured by bias and confounding. METHOD The medical histories of 1399 male Vietnam veterans approximately 20 years after combat exposure (mean years = 17) were analyzed by lifetime posttraumatic stress disorder (PTSD) status (lifetime PTSD = 332 cases). These men were included in a national, random in-person study of United States Army veterans of the Vietnam War (study completion rate = 65%). RESULTS After controlling for preservice, in-service, and postservice factors (including intelligence, race, region of birth, enlistment status, volunteer status, Army marital status, Army medical profile, hypochondriasis, age, smoking history, substance abuse, education, and income), associations were found for reported circulatory [odds ratio (OR) = 1.62, p = .007], digestive (OR = 1.47, p = .036), musculoskeletal (OR = 1.78, p = .008), endocrine-nutritional-metabolic (OR = 1.58, p = .10), nervous system (OR = 2.47, p < .001), respiratory (OR = 1.54, p = .042), and nonsexually transmitted infectious diseases (OR = 2.14, p < .004) after military service. CONCLUSION Although this study has some limitations, it suggests that there is a direct link between severe stress exposures and a broad spectrum of human diseases. In the future, medical researchers and clinicians should focus more on the medical consequences of exposure to severe environmental stress and seek to better integrate psychobiologic models of disease pathogenesis.
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Affiliation(s)
- J A Boscarino
- Department of Outcomes Research, Catholic Health Initiatives-Southeast Region, Louisville, Kentucky, USA.
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275
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Abstract
Stressful experiences can cause disturbances in the hypothalamic-pituitary-adrenocortical axis and the sympathetic-adrenomedullary system. The authors hypothesized that assessments of adrenal function made in the circumstances of stressful losses would predict outcome 1 or 2 years later. The authors collected 24-hour urinary free cortisol, serum cortisol, and 24-hour urinary catecholamines 2 months after intake and used these measures as predictors of depression, anxiety, hopelessness/helplessness, unresolved grief, self-rated health, and help-seeking behavior on follow-up at 13 and 25 months. Adrenal function in the circumstances of a loss predicted only demoralization scores (hopelessness/helplessness) on follow-up.
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Affiliation(s)
- S Jacobs
- Department of Psychiatry, Connecticut Mental Health Center, New Haven 06519, USA
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276
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Stein MB, Yehuda R, Koverola C, Hanna C. Enhanced dexamethasone suppression of plasma cortisol in adult women traumatized by childhood sexual abuse. Biol Psychiatry 1997; 42:680-6. [PMID: 9325561 DOI: 10.1016/s0006-3223(96)00489-1] [Citation(s) in RCA: 227] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A study was undertaken to determine if female survivors of childhood and/or adolescent sexual abuse (CSA) would exhibit hypothalamic-pituitary-adrenal (HPA) axis abnormalities characteristic of patients with combat-related posttraumatic stress disorder (PTSD)--i.e., enhanced cortisol suppression to low-dose dexamethasone and increased density of lymphocyte glucocorticoid receptors. Nineteen women who reported experiencing severe CSA and 21 nonvictimized women participated in a low-dose (0.5 mg) dexamethasone suppression test and donated blood for measurement of lymphocyte glucocorticoid receptor binding. Women with CSA had significantly enhanced suppression of plasma cortisol in response to 0.5 mg dexamethasone compared to the nonvictimized women. These observations are consistent with findings in male veterans with combat-related PTSD. They suggest that this pattern of HPA axis dysfunction may be a characteristic sequel of psychiatric disorders that occur following a range of traumatic experiences. This HPA axis profile is different than that associated with acute stress or with major depressive disorder.
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Affiliation(s)
- M B Stein
- Department of Psychiatry, University of California, San Diego, USA
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277
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Affiliation(s)
- A M Rasmusson
- Psychiatry Service, Connecticut VA Healthcare System, West Haven 06516, USA
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278
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Kellner M, Baker DG, Yehuda R. Salivary cortisol and PTSD symptoms in Persian Gulf War combatants. Ann N Y Acad Sci 1997; 821:442-3. [PMID: 9238225 DOI: 10.1111/j.1749-6632.1997.tb48300.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- M Kellner
- Department of Psychiatry, Mount Sinai School of Medicine, Bronx Veterans Affairs Medical Center, New York 10468, USA
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279
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280
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Dykman RA, McPherson B, Ackerman PT, Newton JE, Mooney DM, Wherry J, Chaffin M. Internalizing and externalizing characteristics of sexually and/or physically abused children. INTEGRATIVE PHYSIOLOGICAL AND BEHAVIORAL SCIENCE : THE OFFICIAL JOURNAL OF THE PAVLOVIAN SOCIETY 1997; 32:62-74. [PMID: 9105915 DOI: 10.1007/bf02688614] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study evaluates the behavioral consequences of childhood abuse (sexual, physical, or both), with particular focus on prevalence of posttraumatic stress disorder (PTSD). Three abuse type groups and nonabused controls were contrasted on behavioral rating scales and on structured psychiatric interview data. The participants (109 abused children and 16 normal control children) were recruited from Arkansas Children's Hospital and local agencies for abused children. As expected, proportionately more females than males were sexually abused. Overall, males were rated as more disturbed than females. Type of abuse did not consistently influence behavioral ratings. Externalizing scores were significantly higher than internalizing scores in all abused groups. PTSD was diagnosed in 50% of the abused children, with a higher rate for boys who had been sexually abused as opposed to physically abused only (58% versus 13%). The most frequent comorbid condition with PTSD was Separation Anxiety. Sexually abused boys were hospitalized for psychiatric treatment at a higher rate than were other abused children.
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Affiliation(s)
- R A Dykman
- Center for Applied Research & Evaluation (C.A.R.E.) Department of Pediatrics, Arkansas Children's Hospital, Little Rock 72202, USA
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281
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Glod CA, Teicher MH. Relationship between early abuse, posttraumatic stress disorder, and activity levels in prepubertal children. J Am Acad Child Adolesc Psychiatry 1996; 35:1384-93. [PMID: 8885593 DOI: 10.1097/00004583-199610000-00026] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the relationship between early physical and sexual abuse, posttraumatic stress disorder (PTSD), major depression, and activity levels in prepubertal children. METHOD Nineteen unmedicated children with documented abuse (9.4 +/- 2.3 years; 6 girls, 13 boys) were compared with 15 healthy controls (8.3 +/- 1.9 years; 6 girls, 9 boys). Diagnoses were derived from structured interviews (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version). Motionlogger actigraphs collected activity data for 72 continuous hours in 1-minute epochs. RESULTS Overall, abused children were 10% more active than normal children (p < .05) and displayed a paucity of periods of low-level daytime activity (p < .01). Abused children with PTSD were largely responsible for the increase in activity. Abused children with PTSD had a robust and normal circadian activity rhythm. Abused children in whom PTSD failed to develop had an attenuated circadian amplitude compared with subjects with PTSD (101% versus 93%, p < .01) and were phase-delayed by 61 minutes versus controls (p = .01). Early onset of abuse was significantly associated with greater likelihood of the development of PTSD and hyperactivity. Later age of abuse was associated with circadian dysregulation. CONCLUSIONS These preliminary observations indicate that abused children with PTSD have activity profiles similar to those of children with attention-deficit hyperactivity disorder, while abused children without PTSD have activity profiles more similar to those of depressed children.
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Affiliation(s)
- C A Glod
- College of Nursing, Northeastern University, Boston, MA 02116, USA
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282
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Sheline YI, Wang PW, Gado MH, Csernansky JG, Vannier MW. Hippocampal atrophy in recurrent major depression. Proc Natl Acad Sci U S A 1996; 93:3908-13. [PMID: 8632988 PMCID: PMC39458 DOI: 10.1073/pnas.93.9.3908] [Citation(s) in RCA: 1313] [Impact Index Per Article: 46.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Hippocampal volumes of subjects with a history of major depressive episodes but currently in remission and with no known medical comorbidity were compared to matched normal controls by using volumetric magnetic resonance images. Subjects with a history of major depression had significantly smaller left and right hippocampal volumes with no differences in total cerebral volumes. The degree of hippocampal volume reduction correlated with total duration of major depression. In addition, large (diameter > or = 4.5 mm)-hippocampal low signal foci (LSF) were found within the hippocampus, and their number also correlated with the total number of days depressed. These results suggest that depression is associated with hippocampal atrophy, perhaps due to a progressive process mediated by glucocorticoid neurotoxicity.
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Affiliation(s)
- Y I Sheline
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
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