1
|
Wong JYH, Zhu S, Ma H, Ip P, Chan KL, Leung WC. Intimate partner violence during pregnancy: To screen or not to screen? Best Pract Res Clin Obstet Gynaecol 2024; 97:102541. [PMID: 39270545 DOI: 10.1016/j.bpobgyn.2024.102541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 07/23/2024] [Accepted: 09/02/2024] [Indexed: 09/15/2024]
Abstract
Intimate partner violence (IPV) during pregnancy emerges as a compelling and urgent concern within the domain of public health, casting a long shadow over a substantial cohort of women. Its pernicious consequences extend beyond the individual, enveloping the well-being of both the mother and the fetus, giving rise to an elevated risk of preterm birth, low birth weight, fetal harm, and maternal psychological distress, including depression, anxiety, post-traumatic stress disorder, and, tragically, maternal mortality. Despite the prevalence of IPV being comparable to other conditions like gestational diabetes and preeclampsia, a universal screening protocol for IPV remains absent globally. We reviewed the clinical guidelines and practices concerning IPV screening, painstakingly scrutinizing their contextual nuances across diverse nations. Our study unveils multifaceted challenges of implementing universal screening. These hurdles encompass impediments to victim awareness and disclosure, limitations in healthcare providers' knowledge and training, and the formidable structural barriers entrenched within healthcare systems. Concurrently, we delve into the potential biomarkers intricately entwined with IPV. These promising markers encompass inflammatory indicators, epigenetic and genetic influences, and a diverse array of chemical compounds and proteins. Lastly, we discussed various criteria for universal screening including (1) valid and reliable screening tool; (2) target population as pregnant women; (3) scientific evidence of screening programme; and (4) integration of education, testing, clinical services, and programme management to minimise the challenges, which are paramount. With the advancement of digital technology and various biomarkers identification, screening and detecting IPV in clinical settings can be conducted systemically. A systems-level interventions with academia-community-indutrial partnerships can help connect pregnant women to desire support services to avoid adverse maternal and child health outcomes.
Collapse
Affiliation(s)
- Janet Yuen-Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Kowloon, Hong Kong SAR, China.
| | - Shiben Zhu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Kowloon, Hong Kong SAR, China
| | - Haixia Ma
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Kowloon, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics & Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ko Ling Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Wing Cheong Leung
- Department of Obstetrics & Gynaecology, Kwong Wah Hospital, Hospital Authority, Hong Kong SAR, China
| |
Collapse
|
2
|
Puigvert L, Flecha R, Racionero-Plaza S. Evidence-Based Reconstruction of Memories of a Disdainful Hookup: Identifying Risk Factors and Preventing Further Victimization. Behav Sci (Basel) 2024; 14:367. [PMID: 38785858 PMCID: PMC11117761 DOI: 10.3390/bs14050367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/16/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Autobiographical memories of close relationships have been shown to have strong influence in health and life. Yet, there is no research published about longitudinal memory reconstruction of violent sporadic relationships while reading and discussing scientific evidence on gender violence victimization. This article presents a novel case of the reconstruction throughout time of the memory of a disdainful hookup experienced by a young woman. The victim's diary and an interview were the sources of data collection. The analytical categories were developed in dialogue with the participant. The results indicate that, as the subject learned scientific evidence on gender violence in sporadic relationships, she progressively recalled details of the episode that she had self-censored before, became aware of the very violent nature of the hookup, rejected the relationship, and freed her desire for satisfactory romantic relationships.
Collapse
Affiliation(s)
| | | | - Sandra Racionero-Plaza
- Department of Sociology, University of Barcelona, 08034 Barcelona, Spain; (L.P.); (R.F.)
| |
Collapse
|
3
|
Levendosky AA, Martinez-Torteya C, Ballinger AL, Cochran KA, Bogat GA, Nuttall AK, Muzik M, Lonstein JS. The effects of IPV and mental health symptoms on HPA axis functioning during early pregnancy. Arch Womens Ment Health 2024; 27:285-292. [PMID: 37991597 DOI: 10.1007/s00737-023-01399-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023]
Abstract
Maternal HPA axis dysregulation during early pregnancy can negatively affect maternal functioning. However, findings are mixed regarding how intimate partner violence (IPV), a common traumatic stressor, impacts HPA axis regulation during pregnancy. Interactions between IPV and mental health symptoms as they influence cortisol production are rarely examined, especially among pregnant women. Therefore, this study examined the impact of IPV, mental health symptoms, and their interactions on the maternal HPA axis during early pregnancy; 255 pregnant women, oversampled for experiences of IPV, completed a laboratory stressor and measures of depressive and post-traumatic stress symptoms (PTSS) at 15-18 weeks of pregnancy. Participants provided saliva samples following the Trier Social Stress Test that were assayed for cortisol; the area under the curve with respect to ground (AUCg) was computed as a measure of cortisol reactivity. The interactive effects of IPV, depressive symptoms, and PTSS on AUCg were significant, but the main effects were not. At low levels of depressive symptoms, the association between IPV and AUCg was negative; at moderate levels of depressive symptoms, it was not significant, and at high levels, it was positive. At low and moderate levels of PTSS, the effects of IPV on cortisol AUCg were not significant, but at high levels, the association was positive. IPV during early pregnancy was associated with both hyperactive and blunted stress reactivity, depending on the type and severity of mental health symptoms. These patterns of dysregulation of the HPA axis may have differential effects both for women's functioning throughout pregnancy as well as for the offspring.
Collapse
Affiliation(s)
- Alytia A Levendosky
- Department of Psychology, Michigan State University, East Lansing, MI, 48824, USA.
| | | | | | - Kara A Cochran
- Department of Psychology, Michigan State University, East Lansing, MI, 48824, USA
| | - G Anne Bogat
- Department of Psychology, Michigan State University, East Lansing, MI, 48824, USA
| | - Amy K Nuttall
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI, 48824, USA
| | - Maria Muzik
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI, 48105, USA
| | - Joseph S Lonstein
- Department of Psychology, Michigan State University, East Lansing, MI, 48824, USA
| |
Collapse
|
4
|
Greyling CF, Ganguly A, Sardesai AU, Churcher NKM, Lin KC, Muthukumar S, Prasad S. Passive sweat wearable: A new paradigm in the wearable landscape toward enabling "detect to treat" opportunities. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2024; 16:e1912. [PMID: 37356818 DOI: 10.1002/wnan.1912] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 04/11/2023] [Accepted: 05/27/2023] [Indexed: 06/27/2023]
Abstract
Growing interest over recent years in personalized health monitoring coupled with the skyrocketing popularity of wearable smart devices has led to the increased relevance of wearable sweat-based sensors for biomarker detection. From optimizing workouts to risk management of cardiovascular diseases and monitoring prediabetes, the ability of sweat sensors to continuously and noninvasively measure biomarkers in real-time has a wide range of applications. Conventional sweat sensors utilize external stimulation of sweat glands to obtain samples, however; this stimulation influences the expression profile of the biomarkers and reduces the accuracy of the detection method. To address this limitation, our laboratory pioneered the development of the passive sweat sensor subfield, which allowed for our progress in developing a sweat chemistry panel. Passive sweat sensors utilize nanoporous structures to confine and detect biomarkers in ultra-low sweat volumes. The ability of passive sweat sensors to use smaller samples than conventional sensors enable users with sedentary lifestyles who perspire less to benefit from sweat sensor technology not previously afforded to them. Herein, the mechanisms and strategies of current sweat sensors are summarized with an emphasis on the emerging subfield of passive sweat-based diagnostics. Prospects for this technology include discovering new biomarkers expressed in sweat and expanding the list of relevant detectable biomarkers. Moreover, the accuracy of biomarker detection can be enhanced with machine learning using prediction algorithms trained on clinical data. Applying this machine learning in conjunction with multiplex biomarker detection will allow for a more holistic approach to trend predictions. This article is categorized under: Diagnostic Tools > Diagnostic Nanodevices Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Diagnostic Tools > Biosensing.
Collapse
Affiliation(s)
| | - Antra Ganguly
- Department of Bioengineering, The University of Texas at Dallas, Richardson, Texas, USA
| | - Abha Umesh Sardesai
- Department of Computer Engineering, The University of Texas at Dallas, Richardson, Texas, USA
| | | | - Kai-Chun Lin
- Department of Bioengineering, The University of Texas at Dallas, Richardson, Texas, USA
| | | | - Shalini Prasad
- Department of Bioengineering, The University of Texas at Dallas, Richardson, Texas, USA
| |
Collapse
|
5
|
Goldberg X, Espelt C, Nadal R, Alon Y, Palao D, Bar-Haim Y, Armario A. Blunted neurobiological reactivity and attentional bias to threat underlie stress-related disorders in women survivors of intimate partner violence. Psychol Med 2023; 53:7329-7340. [PMID: 37194497 DOI: 10.1017/s0033291723000910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
BACKGROUND Intimate partner violence (IPV) alters women's neurobiological stress response systems. We propose that individual differences early in the attentional processing of threats are associated with these neurobiological mechanisms and contribute to mental illness in this population. METHODS We assessed attentional bias in relation to threat (AB) in women survivors of IPV (n = 69) and controls (n = 36), and examined overall cortisol secretion using hair cortisol (HC), and stress responsiveness measuring salivary cortisol and α-amylase (sAA) before (T0), and after (T1, T2) an acute psychosocial stress task (Trier Social Stress Test). We used repeated-measures ANCOVAs to explore the associations between Group (IPV, control) and AB with acute stress response, and regression models to examine the associations with mental health symptoms. RESULTS There were no between-group differences in HC levels. An interaction between Group and AB was found regarding cortisol reactivity (p < 0.05). IPV women with threat avoidance AB showed a blunted cortisol response compared to controls and to IPV participants with threat vigilance AB. The association between sAA reactivity and the interaction between Group, AB, and time approached significance (p = 0.07), with a trend to lower sAA levels particularly in IPV women with threat avoidance AB. Group and cortisol reactivity were associated with symptoms of depression, generalized anxiety, and post-traumatic stress disorder (8-20% explained variance). CONCLUSIONS Threat avoidance AB is associated with blunted acute cortisol response among women exposed to chronic stress (IPV). Experiencing IPV and acute cortisol response appear to be clearly implicated in long-term mental health problems.
Collapse
Affiliation(s)
- X Goldberg
- Mental Health Department, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, Spain
- ISGlobal, Barcelona, Spain
| | - C Espelt
- Mental Health Department, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, Spain
| | - R Nadal
- Psychobiology Unit (School of Psychology), Institut de Neurociències, Universitat Autònoma de Barcelona, CIBERSAM, Cerdanyola del Vallès, Barcelona, Spain
- Institut de Neurociències, Barcelona, Spain
- Unitat de Neurociència Traslacional, Barcelona, Spain
| | - Y Alon
- School of Psychological Sciences and Sagol Schoold of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - D Palao
- Mental Health Department, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, CIBERSAM, Sabadell, Spain
- Institut de Neurociències, Barcelona, Spain
- Unitat de Neurociència Traslacional, Barcelona, Spain
| | - Y Bar-Haim
- School of Psychological Sciences and Sagol Schoold of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - A Armario
- Institut de Neurociències, Barcelona, Spain
- Unitat de Neurociència Traslacional, Barcelona, Spain
- Animal Physiology Unit (School of Biosciences), Universitat Autònoma de Barcelona, CIBERSAM, Cerdanyola del Vallès, Barcelona, Spain
| |
Collapse
|
6
|
Calle-Guisado V, Adsuar JC, Barrios-Fernandez S, Mendoza-Muñoz M, Muñoz-Bermejo L, Domínguez-Muñoz FJ, Ortiz-González L, Rojo-Ramos J. Effects of a Multicomponent Programme for Improving Physical and Psychological Health in Victims of Intimate Partner Violence: Study Protocol for a Randomised Control Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2815. [PMID: 36833510 PMCID: PMC9956252 DOI: 10.3390/ijerph20042815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
Intimate partner violence (IPV) is a public health problem that psychologically and physically affects the women who suffer from it. In this article, we propose an intervention protocol based on therapeutic tourism through adventure physical activities and psychological therapy that could improve the psychological and physical health of women participants. We propose a randomized study where participants will be separated into two groups, control and experimental, and we will perform measurements including self-concept, self-image, depression, and perceived stress, combining these with physiological measurements of stress level by determining stress-related hormones (Cortisol and DHEA), as well as the overall cost-effectiveness of the program. All data collected at the end of the protocol will be statistically analysed. If the final data are positive and it is feasible, this protocol could be proposed as a measure for the treatment of the sequelae of victims of gender violence.
Collapse
Affiliation(s)
- Violeta Calle-Guisado
- Faculty of Medicine and Health Sciences, University of Extremadura, 06006 Badajoz, Spain
- Research Group on Physical and Health Literacy and Health-Related Quality of Life (PHYQOL), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Jose Carmelo Adsuar
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Sabina Barrios-Fernandez
- Occupation, Participation, Sustainability and Quality of Life (Ability Research Group), Nursing and Occupational Therapy College, University of Extremadura, 10003 Caceres, Spain
| | - María Mendoza-Muñoz
- Research Group on Physical and Health Literacy and Health-Related Quality of Life (PHYQOL), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
| | - Laura Muñoz-Bermejo
- Social Impact and Innovation in Health (InHEALTH), University Centre of Mérida, University of Extremadura, 06800 Mérida, Spain
| | - Francisco Javier Domínguez-Muñoz
- Physical Activity and Quality of Life (AFYCAV) Research Group, Faculty of Sport Science, University of Extremadura, 10003 Caceres, Spain
| | - Luis Ortiz-González
- Faculty of Medicine and Health Sciences, University of Extremadura, 06006 Badajoz, Spain
| | - Jorge Rojo-Ramos
- Physical Activity for Education, Performance and Health, Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| |
Collapse
|
7
|
Likitlersuang J, Salat DH, Fortier CB, Iverson KM, Werner KB, Galovski T, McGlinchey RE. Intimate partner violence and brain imaging in women: A neuroimaging literature review. Brain Inj 2023; 37:101-113. [PMID: 36729954 DOI: 10.1080/02699052.2023.2165152] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PRIMARY OBJECTIVE Despite a high prevalence of intimate partner violence (IPV) and its lasting impacts on individuals, particularly women, very little is known about how IPV may impact the brain. IPV is known to frequently result in traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). In this overview of literature, we examined literature related to neuroimaging in women with IPV experiences between the years 2010-2021. RESEARCH DESIGN Literature overview. METHODS AND PROCEDURES A total of 17 studies were included in the review, which is organized into each imaging modality, including magnetic resonance imaging (structural, diffusion, and functional MRI), Electroencephalography (EEG), proton magnetic resonance spectroscopy (pMRS), and multimodal imaging. MAIN OUTCOMES AND RESULTS Research has identified changes in brain regions associated with cognition, emotion, and memory. Howeverto date, it is difficult to disentangle the unique contributions of TBI and PTSD effects of IPV on the brain. Furthermore, experimental design elements differ considerably among studies. CONCLUSIONS The aim is to provide an overview of existing literature to determine commonalities across studies and to identify remaining knowledge gaps and recommendations for implementing future imaging studies with individuals who experience IPV.
Collapse
Affiliation(s)
- Jirapat Likitlersuang
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, Massachusetts, USA.,Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - David H Salat
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, Massachusetts, USA.,Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, Massachusetts, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital Department of Radiology, Charlestown, Massachusetts, USA
| | - Catherine B Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Katherine M Iverson
- Women' Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Kimberly B Werner
- College of Nursing, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Tara Galovski
- Women' Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Regina E McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.,Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA
| |
Collapse
|
8
|
Seidenbecher S, Dobrowolny H, Wolter S, Klemen J, Meyer-Lotz G, Gescher DM, Steiner J, Frodl T. Consequences of the Lockdown: Domestic Violence During the COVID-19 Pandemic. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1412:53-72. [PMID: 37378761 DOI: 10.1007/978-3-031-28012-2_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
BACKGROUND The global pandemic of the coronavirus disease 2019 (COVID-19) has presented many unique challenges to health systems. The hidden impact of COVID-19 and its associated lockdown have been an increased prevalence of domestic violence. OBJECTIVE To increase our understanding of the connection between COVID-19 containment measures, domestic violence, and mental health in Germany, we conducted an online self-assessment survey of 98 domestic violence victims and 276 controls. All participants answered questions concerning domestic violence, emotional regulation skills, limitations due to and acceptance of containment measures, and quality of their contact experiences. RESULTS There was no significant effect of "gender" x "domestic violence." Among victims of domestic violence, the number of women was considerably higher than the number of men. In addition, the factors "negative contact quality," "emotional regulation," and "resilience" differed significantly between the victims of domestic violence and the control group. CONCLUSIONS The COVID-19 outbreak and associated containment and quarantine measures resulted in a "hidden pandemic" of domestic violence for which prevention programs and early victim assistance through the expansion of digital technologies are urgently needed. Prospective studies should expand empirical data to focus on the long-term psychological effects of domestic violence and biomarkers that can serve as warning signs of stress-related disorders.
Collapse
Affiliation(s)
- Stephanie Seidenbecher
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
| | - Henrik Dobrowolny
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Sarah Wolter
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Jane Klemen
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Gabriela Meyer-Lotz
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Dorothee Maria Gescher
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Clinic for Psychiatry, Psychotherapy and Psychosomatic, University Hospital RWTH Aachen, Magdeburg, Germany
| | - Johann Steiner
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Thomas Frodl
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Clinic for Psychiatry, Psychotherapy and Psychosomatic, University Hospital RWTH Aachen, Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| |
Collapse
|
9
|
Campbell KA. The neurobiology of childhood trauma, from early physical pain onwards: as relevant as ever in today's fractured world. Eur J Psychotraumatol 2022; 13:2131969. [PMID: 36276555 PMCID: PMC9586666 DOI: 10.1080/20008066.2022.2131969] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: The situation in the world today, encompassing multiple armed conflicts, notably in Ukraine, the Coronavirus pandemic and the effects of climate change, increases the likelihood of childhood exposure to physical injury and pain. Other effects of these worldwide hardships include poverty, malnutrition and starvation, also bringing with them other forms of trauma, including emotional harm, neglect and deliberate maltreatment. Objective: To review the neurobiology of the systems in the developing brain that are most affected by physical and emotional trauma and neglect. Method: The review begins with those that mature first, such as the somatosensory system, progressing to structures that have a more protracted development, including those involved in cognition and emotional regulation. Explored next are developing stress response systems, especially the hypothalamic-pituitary-adrenal axis and its central regulator, corticotropin-releasing hormone. Also examined are reward and anti-reward systems and genetic versus environmental influences. The behavioural consequences of interpersonal childhood trauma, focusing on self-harm and suicide, are also surveyed briefly. Finally, pointers to effective treatment are proffered. Results: The low-threshold nature of circuitry in the developing brain and lack of inhibitory connections therein result in heightened excitability, making the consequences of both physical and emotional trauma more intense. Sensitive and critical periods in the development of structures such as the amygdala render the nervous system more vulnerable to insults occurring at those points, increasing the likelihood of psychiatric disorders, culminating in self-harm and even suicide. Conclusion: In view of the greater excitability of the developing nervous system, and its vulnerability to physical and psychological injuries, the review ends with an exhortation to consider the long-term consequences of childhood trauma, often underestimated or missed altogether when faced with adults suffering mental health problems.
Collapse
|
10
|
Cerda-De la O B, Cerda-Molina AL, Mayagoitia-Novales L, de la Cruz-López M, Biagini-Alarcón M, Hernández-Zúñiga EL, Borráz-León JI, Whaley-Sánchez JA. Increased Cortisol Response and Low Quality of Life in Women Exposed to Intimate Partner Violence With Severe Anxiety and Depression. Front Psychiatry 2022; 13:898017. [PMID: 35832594 PMCID: PMC9271849 DOI: 10.3389/fpsyt.2022.898017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/06/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is one of the most prevalent forms of violence against women globally and it is considered a public health problem. Because the experience of IPV is stressful and traumatic for victims, they are at high risk of developing alteration of the Hypothalamus-Pituitary-Adrenal (HPA) axis functioning as well as anxiety and depression symptoms. The aim of this study was to compare the quality of life and changes in cortisol response to an acute stressor between women exposed to IPV and non-exposed women. Differences according to symptoms of anxiety and depression including the risk of suicide thoughts, were also analyzed. METHOD Our sample size consisted of 130 women (ages 18-68) grouped as follows: 71 women experiencing IPV and 59 women without history of IPV as control group. All participants completed a battery of questionnaires including IPV exposure, anxiety, and depression symptoms (Beck Inventories), as well as quality of life (WHOQOL-BREF). Salivary cortisol levels in response to a cognitive test with verbal, mathematical, and abstract reasoning were measured at four time points. RESULTS Women exposed to IPV, with severe anxiety and depression symptoms as well as suicide thoughts, exhibited heightened cortisol response after the cognitive test and reported lower quality of life compared to (i) women experiencing IPV with moderate symptoms of anxiety and depression, who showed a blunted response, and (ii) women without history of IPV with minimal to moderate symptoms, who showed a decreased cortisol profile. Social relationships dimension was in particular the most affected aspect of quality of life. CONCLUSIONS Our findings highlight the role of cortisol responses as a complementary biological marker to be associated with severe psychiatric disturbances in women exposed to IPV.
Collapse
Affiliation(s)
- Beatriz Cerda-De la O
- Clínica de Género y Sexualidad, Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Ana Lilia Cerda-Molina
- Departamento de Etología, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Lilian Mayagoitia-Novales
- Departamento de Etología, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Margarita de la Cruz-López
- Clínica de Género y Sexualidad, Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Marcela Biagini-Alarcón
- Clínica de Género y Sexualidad, Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Erika Lucia Hernández-Zúñiga
- Clínica de Género y Sexualidad, Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Javier I Borráz-León
- Departamento de Etología, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Jesús Alfredo Whaley-Sánchez
- Clínica de Género y Sexualidad, Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| |
Collapse
|
11
|
Non-communicable diseases among women survivors of intimate partner violence: Critical review from a chronic stress framework. Neurosci Biobehav Rev 2021; 128:720-734. [PMID: 34252471 DOI: 10.1016/j.neubiorev.2021.06.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 06/24/2021] [Accepted: 06/26/2021] [Indexed: 01/02/2023]
Abstract
A neurobiological framework of chronic stress proposes that the stress-response system can be functionally altered by the repeated presentation of highly stressful situations over time. These functional alterations mainly affect brain processing and include the dysregulation of the hypothalamic-pituitary-adrenal axis and associated processes. In the present critical review, we translate these results to inform the clinical presentation of women survivors of intimate partner violence (IPV). We approach IPV as a scenario of chronic stress where women are repetitively exposed to threat and coping behaviours that progressively shape their neurobiological response to stress. The changes at the central and peripheral levels in turn correlate with the phenotypes of non-communicable diseases. The reviewed studies clarify the extent of the impact of IPV on women's health in large (N > 10,000) population-based designs, and provide observations on experimental neuroendocrine, immune, neurocognitive and neuroimaging research linking alterations of the stress-response system and disease. This evidence supports the prevention of violence against women as a fundamental action to reduce the prevalence of non-communicable diseases.
Collapse
|
12
|
Cannabinoid receptor 1 signalling modulates stress susceptibility and microglial responses to chronic social defeat stress. Transl Psychiatry 2021; 11:164. [PMID: 33723234 PMCID: PMC7961142 DOI: 10.1038/s41398-021-01283-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/28/2021] [Accepted: 02/18/2021] [Indexed: 01/31/2023] Open
Abstract
Psychosocial stress is one of the main environmental factors contributing to the development of psychiatric disorders. In humans and rodents, chronic stress is associated with elevated inflammatory responses, indicated by increased numbers of circulating myeloid cells and activation of microglia, the brain-resident immune cells. The endocannabinoid system (ECS) regulates neuronal and endocrine stress responses via the cannabinoid receptor 1 (CB1). CB1-deficient mice (Cnr1-/-) are highly sensitive to stress, but if this involves altered inflammatory responses is not known. To test this, we exposed Cnr1+/+ and Cnr1-/- mice to chronic social defeat stress (CSDS). Cnr1-/- mice were extremely sensitive to a standard protocol of CSDS, indicated by an increased mortality rate. Therefore, a mild CSDS protocol was established, which still induced a behavioural phenotype in susceptible Cnr1-/- mice. These mice also showed altered glucocorticoid levels after mild CSDS, suggesting dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Mild CSDS induced weak myelopoiesis in the periphery, but no recruitment of myeloid cells to the brain. In contrast, mild CSDS altered microglial activation marker expression and morphology in Cnr1-/- mice. These microglial changes correlated with the severity of the behavioural phenotype. Furthermore, microglia of Cnr1-/- mice showed increased expression of Fkbp5, an important regulator of glucocorticoid signalling. Overall, the results confirm that CB1 signalling protects the organism from the physical and emotional harm of social stress and implicate endocannabinoid-mediated modulation of microglia in the development of stress-related pathologies.
Collapse
|
13
|
Alhalal E, Falatah R. Intimate partner violence and hair cortisol concentration: A biomarker for HPA axis function. Psychoneuroendocrinology 2020; 122:104897. [PMID: 33068953 DOI: 10.1016/j.psyneuen.2020.104897] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/21/2020] [Accepted: 09/22/2020] [Indexed: 02/07/2023]
Abstract
Intimate partner violence (IPV) is associated with various health issues, which may be explained by hypothalamic-pituitary-adrenal (HPA) axis dysfunction. There is a lack of research examining hair cortisol concentrations as a biomarker of HPA function alterations in the context of IPV with consideration to women's resilience. The study assessed whether IPV severity and resilience are associated with hair cortisol concentrations among Saudi women. This cross-sectional explanatory design used a convenience sample of 156 Saudi women from health care settings. A structured interview that included self-reported responses was performed, and hair samples were collected. The samples were analyzed using a salivary ELISA kit. The result showed a significant difference in hair cortisol concentration between women who have experienced IPV and women who have not experienced IPV. As well, controlling for depressive and post-traumatic stress disorder, IPV severity (β = -.281, 95 % CI = -.046 to -.003) and resilience (β = -.225, 95 % CI = -.038 to -.005) were significant predictors of lower hair cortisol concentrations. The effect of IPV severity on cortisol levels as a biomarker of HPA axis function could explain the poor health conditions among IPV survivors. This study highlights that IPV victimization leads to physiological changes and that hair cortisol is an indicator of women's health status.
Collapse
Affiliation(s)
- Eman Alhalal
- Community and Mental Health Nursing Department, Nursing College, King Saud University, Saudi Arabia.
| | - Rawaih Falatah
- Nursing Administration and Education Department, Nursing College, King Saud University, Saudi Arabia.
| |
Collapse
|
14
|
Female university students' preferences for different types of sexual relationships: implications for gender-based violence prevention programs and policies. BMC WOMENS HEALTH 2020; 20:266. [PMID: 33256734 PMCID: PMC7708146 DOI: 10.1186/s12905-020-01131-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 11/18/2020] [Indexed: 01/10/2023]
Abstract
Background Gender-based violence among young women is a growing problem worldwide. The consequences of this victimization have been well reported in the scientific literature, among which negative health outcomes stand out. The factors influencing this problem are many; one highlighted by research is socialization into a dominant coercive discourse that associates sexual-affective attraction to males with violent attitudes and behaviors, while in turn, such discourse empties males with egalitarian behaviors from sexual attractiveness. This coercive discourse may be shaping the sexual preferences of female youth. The current paper explores young women’s preferences for different types of sexual relationships and, more particularly, for what type of sexual affective relationships they coercively preferred men with violent attitudes and behavior. Methods A quantitative, mixed-design vignette study was conducted with 191 college females in Spain. We focused the analysis only on responses about vignettes including narratives of men with violent attitudes and behaviors. In addition, we examined whether participants would report higher coerced preferences for violent men when asked about the coerced preferences of their female friends than when asked about their own preferences. Results Only 28.95% of participants responded that their female friends would prefer a young man with violent behavior for a stable relationship, meanwhile 58.42% would do it for hooking up. When reporting about themselves, the difference was greater: 28.42% would prefer a young man with violent behavior for hooking up and just 5.78% for a stable relationship. Conclusions The dominant coercive discourse that links attractiveness to people with violent attitudes and behaviors may be explaining the results obtained in this study. The findings can help eliminate the stereotype largely adopted by some intervention and prevention programs which assume that gender-based violence occurs mainly in stable relationships, considering that falling in love is the reason that lead women to suffer from violence. Our results can also support health professionals and others serving young women to enhance their identification of gender violence victimization, as well as our findings point to the need to include the evidence of gender violence in sporadic relationships in prevention programs and campaigns addressed to young women.
Collapse
|
15
|
Pheiffer C, Dias S, Adam S. Intimate Partner Violence: A Risk Factor for Gestational Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217843. [PMID: 33114711 PMCID: PMC7663316 DOI: 10.3390/ijerph17217843] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/14/2020] [Accepted: 10/19/2020] [Indexed: 12/30/2022]
Abstract
The early detection and management of gestational diabetes mellitus (GDM) is an important public health goal. GDM, which is defined as a glucose intolerance that develops during pregnancy, affects about 14% of pregnancies globally, and without effective treatment, it is associated with adverse short- and long-term maternal and neonatal outcomes. Risk-factor screening is an acceptable and affordable strategy to enable risk stratification and intervention. However, common biological risk factors such as overweight or obesity, excessive gestational weight gain, and family history of diabetes often have poor predictive ability, failing to identify a large proportion of women at risk of developing GDM. Accumulating evidence implicate psychosocial factors in contributing to GDM risk. As such, intimate partner violence (IPV), through its contributing effects on maternal stress and depression, presents a plausible risk factor for GDM. Experiencing IPV during pregnancy may dysregulate the hypothalamus-pituitary-adrenal (HPA) axis, leading to increased cortisol secretion and insulin resistance. These effects may exacerbate the insulin-resistant environment characteristic of pregnancy, thus increasing GDM risk. This review explores the relationship between IPV and GDM. We highlight studies that have linked IPV with GDM and propose a biological mechanism that connects IPV and GDM. Recommendations for IPV screening strategies to prevent GDM are discussed.
Collapse
Affiliation(s)
- Carmen Pheiffer
- Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council, P.O. Box 19070, Tygerberg, Cape Town 7505, South Africa;
- Division of Medical Physiology, Faculty of Health Sciences, Stellenbosch University, P.O. Box 19063, Tygerberg, Cape Town 7505, South Africa
- Correspondence: ; Tel.: +27-21-938-0292
| | - Stephanie Dias
- Biomedical Research and Innovation Platform (BRIP), South African Medical Research Council, P.O. Box 19070, Tygerberg, Cape Town 7505, South Africa;
| | - Sumaiya Adam
- Department of Obstetrics and Gynecology, University of Pretoria, Private Bag X169, Pretoria 0001, South Africa;
| |
Collapse
|
16
|
Nahvi RJ, Sabban EL. Sex Differences in the Neuropeptide Y System and Implications for Stress Related Disorders. Biomolecules 2020; 10:biom10091248. [PMID: 32867327 PMCID: PMC7564266 DOI: 10.3390/biom10091248] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/16/2022] Open
Abstract
The neuropeptide Y (NPY) system is emerging as a promising therapeutic target for neuropsychiatric disorders by intranasal delivery to the brain. However, the vast majority of underlying research has been performed with males despite females being twice as susceptible to many stress-triggered disorders such as posttraumatic stress disorder, depression, anorexia nervosa, and anxiety disorders. Here, we review sex differences in the NPY system in basal and stressed conditions and how it relates to varied susceptibility to stress-related disorders. The majority of studies demonstrate that NPY expression in many brain areas under basal, unstressed conditions is lower in females than in males. This could put them at a disadvantage in dealing with stress. Knock out animals and Flinders genetic models show that NPY is important for attenuating depression in both sexes, while its effects on anxiety appear more pronounced in males. In females, NPY expression after exposure to stress may depend on age, timing, and nature and duration of the stressors and may be especially pronounced in the catecholaminergic systems. Furthermore, alterations in NPY receptor expression and affinity may contribute to the sex differences in the NPY system. Overall, the review highlights the important role of NPY and sex differences in manifestation of neuropsychiatric disorders.
Collapse
|
17
|
Garcia MA, Junglen A, Ceroni T, Johnson D, Ciesla J, Delahanty DL. The mediating impact of PTSD symptoms on cortisol awakening response in the context of intimate partner violence. Biol Psychol 2020; 152:107873. [PMID: 32105797 DOI: 10.1016/j.biopsycho.2020.107873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 01/01/2020] [Accepted: 02/22/2020] [Indexed: 10/24/2022]
Abstract
Multi-level modeling examined the association between cortisol awakening responses (CAR) and different PTSD symptom clusters in a sample of 158 female participants presenting with intimate partner violence-related PTSD. Results revealed that arousal over the past week and month, respectively ([β = -0.124, z = -2.33, p = .028; β = -.147, z = -2.19, p = .028]) significantly moderated the trajectory of cortisol levels, and emotional numbing symptom severity (over the past week [β = -0.122, z = -2.07, p = .076]) was found to be trending toward significance. In each case higher symptom severity was associated with flatter CAR slopes compared to those with lower symptom severity. Assessing PTSD symptom clusters in relation to cortisol may better inform future interventions compared to studies that assess PTSD globally. Our findings suggest a subtype of PTSD patients displaying higher levels of arousal may be more likely to experience alterations in HPA axis functioning.
Collapse
Affiliation(s)
| | - Angela Junglen
- Kent State University
- Kent State University, United States
| | - Taylor Ceroni
- Kent State University
- Kent State University, United States
| | - Dawn Johnson
- Kent State University
- Kent State University, United States
| | - Jeffrey Ciesla
- Kent State University
- Kent State University, United States
| | | |
Collapse
|
18
|
Tural U, Iosifescu DV. Neuropeptide Y in PTSD, MDD, and chronic stress: A systematic review and meta-analysis. J Neurosci Res 2020; 98:950-963. [PMID: 32048334 DOI: 10.1002/jnr.24589] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/14/2020] [Accepted: 01/22/2020] [Indexed: 01/23/2023]
Abstract
Previous studies have suggested that neuropeptide Y (NPY) levels may be altered in patients with major depressive disorder (MDD), post-traumatic stress disorder (PTSD) and chronic stress. We investigated, through systematic review and meta-analysis, whether the mean levels of NPY are significantly different in patients with MDD, PTSD or chronic stress, compared to controls. The main outcome was the pooled standardized mean difference (SMD) with 95% confidence intervals between cases and controls, using the random-effects model. Heterogeneity and publication bias were evaluated. Thirty-five studies met eligibility criteria. Meta-regression determined that medication and sex could explain 27% of the between-study variance. Females and participants currently prescribed psychotropic medications had significantly higher levels of NPY. NPY levels were significantly lower in plasma and cerebrospinal fluid (CSF) in PTSD patients versus controls. Patients with MDD had significantly lower levels of NPY in plasma compared to controls, but not in the CSF. The magnitudes of the decrease in plasma NPY levels were not significantly different between PTSD and MDD. However, chronic stress patients had significantly higher plasma NPY levels compared to controls, PTSD or MDD. Our findings may imply a shared role of NPY in trauma and depression: nevertheless, it is not clear that the association is specific to these disorders. Psychotropic medications may help restore NPY levels. Further controlled studies are needed to better delineate the contribution of confounding variables such as type of depression, body mass index, appetite or sleep architecture.
Collapse
Affiliation(s)
- Umit Tural
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Dan V Iosifescu
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA.,Psychiatry Department, New York University School of Medicine, New York, NY, USA
| |
Collapse
|
19
|
Racionero-Plaza S, Piñero León JA, Morales Iglesias M, Ugalde L. Toxic Nightlife Relationships, Substance Abuse, and Mental Health: Is There a Link? A Qualitative Case Study of Two Patients. Front Psychiatry 2020; 11:608219. [PMID: 33584371 PMCID: PMC7874131 DOI: 10.3389/fpsyt.2020.608219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/15/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction and Aims: This article explores the role of toxic close relationships in night life on substance use disorders and mental health conditions. We also contrast the quality and effects of social relationships when doing drugs with those produced by a mental health program that fosters quality relationships between patients. Design and Methods: This qualitative case study was carried out at a mental health day care center of a hospital in Malaga (Spain). The cases of two patients with severe mental disorders and a history of drug addiction were analyzed. Data were collected through in-depth interviews with every patient, semi-structured interviews about each patient with the psychologist of the medical team of the program, and medical documentation. The analysis involved a combination of inductive and deductive approaches. Results: The analysis of the data revealed, on the one hand, the influence of toxic relationships in nightlife, including violent sporadic sexual relationships, in the initiation and persistence of substance use that took part of the mental health disorder in these patients. On the other hand, the findings show that these participants' current involvement in a mental health program, which fosters quality relationships between patients, has brought emotional benefits to both of them. Discussion and Conclusion: This paper points out the relevance of considering quality of social relationships when examining substance use disorders and related mental health problems. Additionally, the findings indicate the importance of fostering quality peer relationships in mental health rehabilitation programs addressed to patients with histories of drug addiction to improve treatment outcome.
Collapse
Affiliation(s)
| | | | | | - Leire Ugalde
- Department of Didactics and School Organization, University of the Basque Country, Bilbao, Spain
| |
Collapse
|
20
|
Hormonal Alterations in Victimized Women Explained by Their Hostile Reactions in Coping with Couple Violence. SPANISH JOURNAL OF PSYCHOLOGY 2019; 22:E40. [PMID: 31640831 DOI: 10.1017/sjp.2019.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Recent studies have highlighted the dysregulation of hypothalamic-pituitary-adrenal (HPA) axis activity and its end products, cortisol and dehydroepiandrosterone (DHEA), in women with a history of intimate partner violence (IPV) victimization. These studies analyzed several coping styles, but they neglected to examine the use of violent strategies to confront IPV and the way these strategies affect HPA functioning. This latter proposal would be based on the gender symmetry model of IPV, which sustains that IPV is generally symmetrical, but that women's violence tends to be a reaction to male violence. Hence, the main objective of the present study was to examine whether women's violent reactions to IPV would significantly predict salivary cortisol and DHEA levels, as well as the cortisol/DHEA ratio (assessed through two saliva samples per day on four consecutive work days), controlling for the women's prior IPV abuse, psychopathology, and demographic variables. Our data demonstrated that, specifically, psychological confrontation strategies predicted vespertine cortisol levels (adj R2 = .18, β = .447, p < .01) and the cortisol/DHEA ratio (adj R2 = .08, β = .322, p < .05), even after controlling several confounding variables, whereas physical and total confrontation in response to IPV did not predict these hormonal parameters.
Collapse
|
21
|
Mallart LP, García RF, Racionero-Plaza S, Sordé-Martí T. Socioneuroscience and its contributions to conscious versus unconscious volition and control. The case of gender violence prevention. AIMS Neurosci 2019; 6:204-218. [PMID: 32341977 PMCID: PMC7179364 DOI: 10.3934/neuroscience.2019.3.204] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 08/27/2019] [Indexed: 01/08/2023] Open
Abstract
Research in neuroscience is being very fruitful in providing evidence about the influence of social experience in the architecture and functioning of the brain. In so doing, neuroscience is posing new and fascinating research questions to examine in depth the social processes that produce those neural changes. To undertake the task of tackling such research questions, evidence from the social sciences are necessary to better understand how different types of social experiences produce different types of synaptic changes and even modify subcortical brain structures differently. It will be the dialogue between neuroscience, other natural sciences and the social sciences which will advance the scientific understanding of plastic changes in the brain which result from complex social experiences that have been traditionally studied by the social sciences. Socioneuroscience constitutes the arena for such interdisciplinary dialogue and research that can both advance the scientific understanding of the human brain and provide evidence-based solutions to most urgent social problems. Socioneuroscience studies the relations between the human brain and social interactions taking into account knowledge from all social sciences and the natural sciences. Processes of conscious versus unconscious social volition and control is one central area of inquiry in socioneuroscience. In this article, we discuss the dominant coercive discourse in society -which presents males with aggressive attitudes and behaviors as more attractive- as an example of social control of human volition which imprisons many individuals' sexual freedom. However, due to brain plasticity, certain experiences that question such dominant discourse and empty violence from attractiveness open up the possibility for the individual and the society to break free from the neural wiring imposed by the dominant coercive discourse and, in the words of Santiago Ramón y Cajal, be ourselves “the architects of our brain”, contributing to overcome violence against women.
Collapse
Affiliation(s)
- Lídia Puigvert Mallart
- Department of Sociology, University of Barcelona, Spain.,Centre for Community, Gender and Social Justice, Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
| | | | | | | |
Collapse
|
22
|
Yim IS, Kofman YB. The psychobiology of stress and intimate partner violence. Psychoneuroendocrinology 2019; 105:9-24. [PMID: 30170928 DOI: 10.1016/j.psyneuen.2018.08.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/03/2018] [Accepted: 08/10/2018] [Indexed: 12/22/2022]
Abstract
Exposure to intimate partner violence (IPV) negatively affects health outcomes, however, the biopsychosocial pathways underlying this relationship are not well understood. We conducted a systematic review of research published from 2000 through 2018 on biological and psychological stress-related correlates and consequences of IPV exposure. Fifty-three publications were included. The biological and psychological literatures have evolved separately and remain distinct. The biological literature provides emerging evidence of stress-related endocrine and immune-inflammatory dysregulations that are in line with patterns typically observed among chronically stressed individuals. The psychological literature provides strong evidence that IPV is associated with psychological stress, and that psychological stress follows new instances of IPV. Larger scale, integrative studies using prospective study designs are needed to more carefully map out how IPV influences victims both biologically and psychologically, and how these biopsychological changes, in turn, affect the health of victims over time.
Collapse
Affiliation(s)
- Ilona S Yim
- Department of Psychological Science, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, USA.
| | - Yasmin B Kofman
- Department of Psychological Science, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA 92697-7085, USA
| |
Collapse
|
23
|
Tsuyuki K, Cimino AN, Holliday CN, Campbell JC, Al-Alusi NA, Stockman JK. Physiological Changes from Violence-Induced Stress and Trauma Enhance HIV Susceptibility Among Women. Curr HIV/AIDS Rep 2019; 16:57-65. [PMID: 30762216 PMCID: PMC6420839 DOI: 10.1007/s11904-019-00435-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW This theoretical review identifies physiological mechanisms by which violence against women (VAW) may increase women's susceptibility to HIV through trauma, stress, and immune dysfunction. RECENT FINDINGS Research documents systemic and local immune responses are related to stress and trauma from abuse across the life course (i.e., childhood, IPV, adulthood re-victimization). Findings are interpreted within a theoretical framework grounded in the Social Stress Theory and the concept of toxic stress, and highlight the current state of the science connecting: (1) VAW to the physiological stress response and immune dysfunction, and (2) the physiological stress response and inflammation to HIV susceptibility and infection in the female reproductive tract. Despite a dearth of research in human subjects, evidence suggests that VAW plays a significant role in creating a physiological environment conducive to HIV infection. We conclude with a discussion of promising future steps for this line of research.
Collapse
Affiliation(s)
- Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA.
| | - Andrea N Cimino
- Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Charvonne N Holliday
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jacquelyn C Campbell
- Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Noor A Al-Alusi
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA
| | - Jamila K Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0507, La Jolla, CA, 92093-0507, USA
| |
Collapse
|
24
|
Sabri B, Granger DA. Gender-based violence and trauma in marginalized populations of women: Role of biological embedding and toxic stress. Health Care Women Int 2018; 39:1038-1055. [PMID: 30906110 PMCID: PMC6428086 DOI: 10.1080/07399332.2018.1491046] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 06/17/2018] [Accepted: 06/17/2018] [Indexed: 12/28/2022]
Abstract
Gender-based violence (GBV) and trauma can dysregulate and recalibrate environmentally sensitive physiological (i.e. central nervous, endocrine, and immune) systems placing survivors at risk for multiple health problems. The researchers build the case that the effects of GBV are likely to be particularly high impact and contribute to health disparities for marginalized survivors of GBV. Further, the researchers underscore a need for a multi-level bio-socio-ecological model that deciphers, characterizes, and explains individual differences in these effects and the need to establish an evidence base from which to derive interventions that address biological effects of toxic stress among marginalized survivors of GBV.
Collapse
Affiliation(s)
- Bushra Sabri
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine,CA, USA
- Department of Community and Public Health Nursing, Johns Hopkins University, School of Nursing, Baltimore, MD, USA
| | - Douglas A. Granger
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine,CA, USA
- Department of Community and Public Health Nursing, Johns Hopkins University, School of Nursing, Baltimore, MD, USA
- Department of Acute and Chronic Care, Johns Hopkins, University School of Nursing, Baltimore, MD, USA
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
25
|
Reijnen A, Geuze E, Eekhout I, Maihofer AX, Nievergelt CM, Baker DG, Vermetten E. Biological profiling of plasma neuropeptide Y in relation to posttraumatic stress symptoms in two combat cohorts. Biol Psychol 2018; 134:72-79. [DOI: 10.1016/j.biopsycho.2018.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 11/02/2017] [Accepted: 02/14/2018] [Indexed: 02/04/2023]
|
26
|
Winterdahl M, Miani A, Vercoe MJH, Ciovica A, Uber-Zak L, Rask CU, Zak PJ. Vulnerability to psychogenic non-epileptic seizures is linked to low neuropeptide Y levels. Stress 2017; 20:589-597. [PMID: 28927333 DOI: 10.1080/10253890.2017.1378638] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Psychogenic non-epileptic seizures (PNES) is a conversion disorder that reflects underlying psychological distress. Female patients with PNES often present with a history of prolonged stressors, especially sexual abuse. In the current study, we studied the relationship between neuropeptide Y (NPY) and PNES symptoms in women with a history of sexual abuse. NPY has been associated with resilience to stress and we hypothesized that low levels would increase the extent and severity of PNES symptoms in this patient population. Serum levels of NPY, and related hormones were measured in fifteen female PNES patients and sixty female controls. PNES patients reported more severe abuse histories, feeling of abandonment, and decreased perception of quality of life than controls. Importantly, they also had lower NPY levels. Our analysis indicates that low levels of NPY in PNES may confer greater vulnerability to exhibit seizure-like symptoms and lower quality of life.
Collapse
Affiliation(s)
- Michael Winterdahl
- a Department of Nuclear Medicine and PET Center , Aarhus University , Aarhus , Denmark
| | - Alessandro Miani
- a Department of Nuclear Medicine and PET Center , Aarhus University , Aarhus , Denmark
| | - Moana J H Vercoe
- b Center for Neuroeconomics Studies , Claremont Graduate University , Claremont , CA , USA
| | - Antonia Ciovica
- c Department of Psychiatry , Loma Linda University School of Medicine , Loma Linda , CA , USA
| | - Lori Uber-Zak
- d Department of Neurology , Loma Linda University Medical Center , Loma Linda , CA , USA
| | - Charlotte Ulrikka Rask
- e Research Clinic for Functional Disorders and Psychosomatics , Aarhus University Hospital , Aarhus , Denmark
- f Child and Adolescent Psychiatry Center , Aarhus University Hospital , Aarhus , Denmark
| | - Paul J Zak
- b Center for Neuroeconomics Studies , Claremont Graduate University , Claremont , CA , USA
| |
Collapse
|
27
|
Zapata Yance LF, Parra De La Rosa K, Barrios D, Rojas Santiago M. Efecto de los Esquemas Cognitivos en el Cortisol en Mujeres Violentadas por sus Parejas. UNIVERSITAS PSYCHOLOGICA 2017. [DOI: 10.11144/javeriana.upsy15-5.evec] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Este estudio tuvo como objetivo determinar el efecto del tipo de violencia de que son víctimas las mujeres por parte de su pareja y sus esquemas cognitivos en el nivel del cortisol. Para ello se aplicó una versión traducida de la Encuesta de Severidad de Violencia en contra de la Mujer, la forma corta del Cuestionario de Esquemas Cognitivos de Young y se extrajeron muestras de cortisol plasmático diurno a 43 mujeres participantes en un programa de intervención. Se estructuró un modelo de regresión el cual confirmó que las amenazas, las agresiones sexuales y esquemas cognitivos como Abandono, Aislamiento social, Apego, Fracaso, Vulnerabilidad al Daño, Subyugación y Estándares Inflexibles, afectaron el nivel del cortisol de esta población.
Collapse
|
28
|
Schutter N, Holwerda TJ, Stek ML, Dekker JJM, Rhebergen D, Comijs HC. Loneliness in older adults is associated with diminished cortisol output. J Psychosom Res 2017; 95:19-25. [PMID: 28314545 DOI: 10.1016/j.jpsychores.2017.02.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 01/30/2017] [Accepted: 02/02/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Loneliness in older adults has been associated with increased mortality and health problems. One of the assumed underlying mechanisms is dysregulation of the hypothalamic-pituitary-adrenocortical axis (HPA-axis). The purpose of this study was to investigate whether loneliness in older adults is associated with HPA-axis dysregulation and whether this association differs between depressed and non-depressed persons. METHODS Cross-sectional data of 426 lonely and non-lonely older adults in the Netherlands Study of Depression in Older Persons (NESDO) were used. Linear regression analyses and multinominal logistic regression analyses were performed to examine the association between loneliness and morning cortisol, cortisol awakening response, diurnal slope and dexamethasone suppression ratio. In all analyses, confounders were introduced. In order to examine whether the association between loneliness and cortisol measures is different in depressed versus non-depressed persons, an interaction term for loneliness x depression diagnosis was tested. RESULTS Cortisol output in the first hour after awakening and dexamethasone suppression ratio was lower in lonely participants. There were no significant interactions between loneliness and depression diagnosis in the association with the cortisol measures. CONCLUSION This study is the first to investigate the association between the HPA-axis and loneliness in a large group of older adults aged 60-93years. We found lower cortisol output in the first hour after awakening and lower dexamethasone suppression ratio in lonely older depressed and non-depressed adults. Whether diminished cortisol output is the underlying mechanism that leads to health problems in lonely older adults is an interesting object for further study.
Collapse
Affiliation(s)
- N Schutter
- Arkin Mental Health Care, Department of Geriatric Psychiatry, Nieuwe Kerkstraat 156, 1018 VM Amsterdam, The Netherlands.
| | - T J Holwerda
- Arkin Mental Health Care, Department of Geriatric Psychiatry, Nieuwe Kerkstraat 156, 1018 VM Amsterdam, The Netherlands
| | - M L Stek
- GGZ InGeest, Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, The Netherlands
| | - J J M Dekker
- Department of Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Department of Clinical Research, Arkin Mental Health Care, Amsterdam, The Netherlands
| | - D Rhebergen
- GGZ InGeest, Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, The Netherlands
| | - H C Comijs
- GGZ InGeest, Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, The Netherlands
| |
Collapse
|
29
|
Kim JY, Lee JH, Song HJ, Kim DG, Yim YS. Relationships between Psychosocial Difficulties and Oxidative Stress Biomarkers in Women Subject to Intimate Partner Violence. HEALTH & SOCIAL WORK 2017; 42:41-47. [PMID: 28395079 DOI: 10.1093/hsw/hlw053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 04/07/2016] [Indexed: 05/06/2023]
Abstract
Women subject to violence by their intimate partners often experience a range of psychosocial problems such as depression, excessive alcohol use, and stressful life events that, in turn, lead to health issues. This study examined psychosocial difficulties and oxidative stress levels in abused and non-abused Korean women and analyzed the relationship between psychosocial outcomes and oxidative stress levels. Markers were determined in 16 women (seven abused, nine non-abused). The two groups of women (abused and non-abused) were compared with respect to scores in depression, alcohol use, life stress events, and oxidative stress biomarkers using the Mann-Whitney U test. Correlations between depression, alcohol use, life stress events, and oxidative stress biomarkers were tested by the Spearman rank correlation coefficient. The abused women had significantly higher levels of oxidative stress markers and significantly lower levels of antioxidants than the non-abused women. Life stress events and oxidative biomarker levels were significantly correlated. These findings have implications for both social services providers and medical personnel when assessing abused women to ensure that they receive the most appropriate service.
Collapse
Affiliation(s)
- Jae Yop Kim
- Professor, School of Social Welfare, Yonsei University, Seoul, South Korea
| | - Ji Hyeon Lee
- Assistant professor, Department of Social Work, Presbyterian University and Theological Seminary, Seoul, South Korea
| | - Hyang Joo Song
- Researcher, Social Welfare Institute, Yonsei University, Seoul, South Korea
| | - Dong Goo Kim
- Professor, Department of Pharmacology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yeong Shin Yim
- McGovern Institute for Brain Research and Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| |
Collapse
|
30
|
Boeckel MG, Viola TW, Daruy-Filho L, Martinez M, Grassi-Oliveira R. Intimate partner violence is associated with increased maternal hair cortisol in mother-child dyads. Compr Psychiatry 2017; 72:18-24. [PMID: 27693887 DOI: 10.1016/j.comppsych.2016.09.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 08/25/2016] [Accepted: 09/15/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The chronic consequences of intimate partner violence (IPV) on HPA activation are a topic of debate. The current study investigated hair cortisol concentrations in female victims of IPV and their children. METHODS A total of 52 mother-child dyads were divided into two groups depending on exposure to IPV: IPV group (n=27 dyads) and control group (n=25 dyads). Hair cortisol concentration was measured in 1-cm-long hair strands, representing 30days of exposure before assessment. PTSD and depression symptoms were assessed in the mother and child. RESULTS Women reporting IPV presented with higher hair cortisol levels, depression and PTSD symptoms severity in comparison to control women. Children who witnessed IPV reported more severe PTSD symptoms, but depressive symptoms and hair cortisol were not statistically different than those in control children. Correlation analyses revealed a positive association between the number of injury events and the level of hair cortisol in children. No associations between the hair cortisol levels in mothers and those in their children were found. CONCLUSION Higher hair cortisol levels detected in women exposed to IPV reflected long-lasting changes in HPA axis functioning associated with chronic stress exposure. Children whose parents recurrently engage in violent conflicts with intimate partners may often feel threatened and consequently reporting more PTSD-related symptoms. Given that experiencing and witnessing violence during childhood and adolescence are predictive of intimate partner violence in adulthood, the need of early interventions is crucial.
Collapse
Affiliation(s)
- Mariana G Boeckel
- Developmental Cognitive Neuroscience Lab (DCNL), Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6681 Prédio 11 Sala 936, Porto Alegre, RS 90619-900, Brazil
| | - Thiago Wendt Viola
- Developmental Cognitive Neuroscience Lab (DCNL), Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6681 Prédio 11 Sala 936, Porto Alegre, RS 90619-900, Brazil
| | - Ledo Daruy-Filho
- Developmental Cognitive Neuroscience Lab (DCNL), Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6681 Prédio 11 Sala 936, Porto Alegre, RS 90619-900, Brazil
| | - Manuela Martinez
- Department of Psychobiology, Faculty of Psychology, University of Valencia, Avda Blasco Ibañez, Valencia 2146010, Spain
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Lab (DCNL), Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6681 Prédio 11 Sala 936, Porto Alegre, RS 90619-900, Brazil.
| |
Collapse
|
31
|
Ziaei S, Frith AL, Ekström EC, Naved RT. Experiencing Lifetime Domestic Violence: Associations with Mental Health and Stress among Pregnant Women in Rural Bangladesh: The MINIMat Randomized Trial. PLoS One 2016; 11:e0168103. [PMID: 27992478 PMCID: PMC5167379 DOI: 10.1371/journal.pone.0168103] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 11/25/2016] [Indexed: 12/27/2022] Open
Abstract
Background Experience of domestic violence has negative mental health consequences for women. The association of cumulative and specific forms of domestic violence, particularly emotional violence and controlling behavior, with common mental disorders and stress has rarely been studied in pregnant women. The aim of this study is to evaluate associations of specific and multiple forms of lifetime domestic violence and controlling behavior with distress and cortisol level during pregnancy in rural Bangladeshi women. Methods and findings In this observational sub-study of larger MINIMat trial, 3504 pregnant women were interviewed using a shortened Conflict Tactic Scale about their lifetime experience of domestic violence including physical, sexual, emotional domestic violence and controlling behavior. Women’s levels of emotional distress were assessed using the self-reported questionnaire (SRQ-20) developed by WHO, and levels of morning salivary cortisol were measured in a subsample (n = 1300) of women during week 28–32 of pregnancy. Regression analyses were used to estimate the associations of lifetime physical, sexual, emotional domestic violence and controlling behavior with levels of distress and cortisol during pregnancy. The prevalence of lifetime domestic violence was 57% and emotional distress was 35% in these pregnant women. All forms of domestic violence were associated with higher levels of emotional distress. Women who experienced either emotional violence or controlling behavior had the highest levels of emotional distress. There was a dose-response relationship between cumulative number of the different forms of domestic violence and women’s levels of emotional distress. There was no association between women’s experience of domestic violence and level of morning salivary cortisol. Conclusion Including emotional violence and controlling behavior as major types of violence in future research and health interventions is warranted. Furthermore, the extent of the negative impacts of domestic violence on pregnant women, multiple forms of violence and their cumulative effects need to be investigated.
Collapse
Affiliation(s)
- Shirin Ziaei
- Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden
- * E-mail:
| | - Amy Lynn Frith
- School of Health Sciences and Human Performance, Ithaca College, Ithaca, New York, United States of America
| | | | | |
Collapse
|
32
|
Pinto RJ, Correia-Santos P, Costa-Leite J, Levendosky AA, Jongenelen I. Cortisol awakening response among women exposed to intimate partner violence. Psychoneuroendocrinology 2016; 74:57-64. [PMID: 27587076 DOI: 10.1016/j.psyneuen.2016.08.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 08/20/2016] [Accepted: 08/24/2016] [Indexed: 01/29/2023]
Abstract
The studies of the effects of intimate partner violence (IPV) on the cortisol awakening response (CAR) are scarce and contradictory. While some of the studies suggested that female victims of IPV showed high CAR, other studies found low CAR. Mixed results may be related to differences in sample characteristics as well as other potential covariates associated with the cortisol, as femalés history of abuse, chronicity, severity and type of IPV, psychological distress, posttraumatic stress disorder, and social support. The study examined individual differences in CAR among 149 female victims of severe IPV reported to authorities, including 76 (51%) living in shelter and 73 (49%) living with the abusive partners. Results revealed several individual differences in CAR that may contribute to understanding the mixed results found in literature, including women with cortisol that decreased between the baseline and 30min later, women with no increase of cortisol, and women whose cortisol increased above baseline. Additionally, women without CAR experienced more chronic and severe violence, more psychological distress and PTSD symptoms. However, hierarchical multiple regression indicated that chronic severe violence was the only independent variable that significantly explained 13% of the variance in CAR, even after including all covariates in the model, and adjusting for sociodemographic variables. In conclusion, this study suggests that the HPA axis dysregulation is influenced by chronic severe violence among women victims of IPV.
Collapse
Affiliation(s)
- Ricardo J Pinto
- Faculty of Psychology, Education and Sports, University Lusófona of Porto, Rua Augusto Rosa, n° 24, Porto 4000-098, Portugal.
| | - Patrícia Correia-Santos
- Faculty of Psychology, Education and Sports, University Lusófona of Porto, Rua Augusto Rosa, n° 24, Porto 4000-098, Portugal
| | - Joana Costa-Leite
- Faculty of Psychology, Education and Sports, University Lusófona of Porto, Rua Augusto Rosa, n° 24, Porto 4000-098, Portugal
| | - Alytia A Levendosky
- Psychology Department, Michigan State University, US, Psychology Building 316 Physics Rm 262 East Lansing, MI 48824, United States
| | - Inês Jongenelen
- Faculty of Psychology, Education and Sports, University Lusófona of Porto, Rua Augusto Rosa, n° 24, Porto 4000-098, Portugal
| |
Collapse
|
33
|
Steudte-Schmiedgen S, Kirschbaum C, Alexander N, Stalder T. An integrative model linking traumatization, cortisol dysregulation and posttraumatic stress disorder: Insight from recent hair cortisol findings. Neurosci Biobehav Rev 2016; 69:124-35. [PMID: 27443960 DOI: 10.1016/j.neubiorev.2016.07.015] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 07/15/2016] [Accepted: 07/15/2016] [Indexed: 12/11/2022]
Abstract
Abundant evidence suggests links between trauma exposure, altered secretion of the glucocorticoid cortisol and the development/maintenance of posttraumatic stress disorder (PTSD), albeit with some inconsistency in findings. Further insight into the complex relations underlying this process may be derived from an increasing number of studies using hair cortisol analysis, a novel assessment strategy assumed to retrospectively capture long-term integrated cortisol secretion. Here, we evaluate the utility of hair cortisol analysis as a method in trauma/PTSD research and review current findings in this context. We compare hair cortisol data on the complex links between trauma, cortisol dysregulation and PTSD against the main findings obtained using traditional cortisol assessment methods. Finally, we integrate these data into a model which proposes that traumatization leads to dose and time-dependent changes in long-term cortisol output (initial post-traumatic increase, subsequent chronic attenuation) and that such dysregulation may partly mediate the link between traumatic load and the risk of PTSD development upon additional trauma exposure ("building block effect").
Collapse
Affiliation(s)
| | - Clemens Kirschbaum
- Department of Psychology, Technische Universität Dresden, 01062 Dresden, Germany
| | - Nina Alexander
- Department of Psychology, Technische Universität Dresden, 01062 Dresden, Germany
| | - Tobias Stalder
- Department of Psychology, Technische Universität Dresden, 01062 Dresden, Germany
| |
Collapse
|
34
|
Hébert JR, Braun KL, Kaholokula JK, Armstead CA, Burch JB, Thompson B. Considering the Role of Stress in Populations of High-Risk, Underserved Community Networks Program Centers. Prog Community Health Partnersh 2015. [PMID: 26213406 DOI: 10.1353/cpr.2015.0028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cancer disparities are associated with a broad range of sociocultural determinants of health that operate in community contexts. High-risk populations may be more vulnerable to social and environmental factors that lead to chronic stress. Theoretical and empirical research indicates that exposure to contextual and sociocultural stress alters biological systems, thereby influencing cancer risk, progression, and, ultimately, mortality. OBJECTIVE We sought to describe contextual pathways through which stress likely increases cancer risk in high-risk, underserved populations. METHODS This review presents a description of the link between contextual stressors and disease risk disparities within underserved communities, with a focus on 1) stress as a proximal link between biological processes, such as cytokine responses, inflammation, and cancer and 2) stress as a distal link to cancer through biobehavioral risk factors such as poor diet, physical inactivity, circadian rhythm or sleep disruption, and substance abuse. These concepts are illustrated through application to populations served by three National Cancer Institute-funded Community Networks Program Centers (CNPCs): African Americans in the Deep South (the South Carolina Cancer Disparities Community Network [SCCDCN]), Native Hawaiians ('Imi Hale-Native Hawaiian Cancer Network), and Latinos in the Lower Yakima Valley of Washington State (The Center for Hispanic Health Promotion: Reducing Cancer Disparities). CONCLUSIONS Stress experienced by the underserved communities represented in the CNPCs is marked by social, biological, and behavioral pathways that increase cancer risk. A case is presented to increase research on sociocultural determinants of health, stress, and cancer risk among racial/ethnic minorities in underserved communities.
Collapse
|
35
|
The influence of prenatal intimate partner violence exposure on hypothalamic–pituitary–adrenal axis reactivity and childhood internalizing and externalizing symptoms. Dev Psychopathol 2015; 28:55-72. [DOI: 10.1017/s0954579415000280] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
AbstractThis prospective longitudinal study examines the long-term influence of intimate partner violence (IPV) exposure in utero. We hypothesized that (a) prenatal IPV increases risk for internalizing and externalizing problems as well as for a profile of dysregulated cortisol reactivity, and (b) patterns of cortisol hyper- and hyporeactivity are differentially associated with internalizing and externalizing problems. The participants were 119 10-year-old children. Their mothers reported their IPV experiences and distress during pregnancy. Child and maternal reports of internalizing and externalizing problems as well as lifetime IPV exposure were obtained. Salivary cortisol was assessed at baseline, 20 min, and 40 min after challenge. The results partially supported our hypotheses: Exposure to IPV during pregnancy predicted child-reported internalizing and externalizing problems, mother ratings of child externalizing problems, and a profile of high cortisol secretion before and after stress challenge. The results were significant above and beyond the influence of maternal distress during pregnancy and IPV that occurred during the child's life. In addition, a profile of high cortisol secretion was associated with maternal reports of child internalizing behaviors. Findings support the growing consensus that prenatal stress can lead to lasting disruptions in adaptation and highlight the need for more longitudinal examinations of prenatal IPV exposure.
Collapse
|
36
|
|
37
|
Wingenfeld K, Whooley MA, Neylan TC, Otte C, Cohen BE. Effect of current and lifetime posttraumatic stress disorder on 24-h urinary catecholamines and cortisol: results from the Mind Your Heart Study. Psychoneuroendocrinology 2015; 52:83-91. [PMID: 25459895 PMCID: PMC4297502 DOI: 10.1016/j.psyneuen.2014.10.023] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 09/22/2014] [Accepted: 10/17/2014] [Indexed: 12/23/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with an increased risk of cardiovascular disease and several other chronic illnesses. Alterations in the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis in PTSD might contribute to these associations but findings regarding SNS and HPA activity in PTSD are heterogeneous. We measured 24-h urinary catecholamines and cortisol in a large cohort of adult outpatients recruited from 2 Veterans Affairs medical centers. 24-h urinary norepinephrine, epinephrine, dopamine and cortisol were measured by tandem mass spectrometry. Lifetime and current PTSD were assessed with the Clinician Administered PTSD Scale using DSM-IV-TR criteria. Out of 613 participants, 199 (32.5%) had current PTSD, 100 (16.3%) had lifetime but not current PTSD, and 314 (51.2%) never had PTSD. Patients with current PTSD had significantly higher norepinephrine secretion compared to those without PTSD. Patients in the lifetime PTSD group exhibited lower cortisol values compared to those without PTSD. Participants who never had PTSD showed the lowest norepinephrine and the highest cortisol values. All results remained stable when controlling for potentially confounding variables. This study provides evidence for increased norepinephrine secretion and decreased cortisol in PTSD. Future longitudinal studies are needed to determine whether these changes contribute to adverse health outcomes in patients with PTSD.
Collapse
Affiliation(s)
- Katja Wingenfeld
- Department of Psychiatry, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Mary A. Whooley
- General Internal Medicine, Veterans Affairs Medical Center, San Francisco, CA, USA, Department of Medicine, University of California, San Francisco, CA, USA, Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Thomas C. Neylan
- Department of Psychiatry, University of California, San Francisco, CA, USA, Mental Health Services, Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Christian Otte
- Department of Psychiatry, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Beth E. Cohen
- General Internal Medicine, Veterans Affairs Medical Center, San Francisco, CA, USA, Department of Medicine, University of California, San Francisco, CA, USA,Corresponding author: Beth Cohen, Department of Veterans Affairs Medical Center, General Internal Medicine, Box 111A1, 4150 Clement Street, San Francisco, CA, 94120, USA,
| |
Collapse
|
38
|
Kim HK, Tiberio SS, Capaldi DM, Shortt JW, Squires EC, Snodgrass JJ. Intimate partner violence and diurnal cortisol patterns in couples. Psychoneuroendocrinology 2015; 51:35-46. [PMID: 25286224 PMCID: PMC4268378 DOI: 10.1016/j.psyneuen.2014.09.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 09/12/2014] [Accepted: 09/15/2014] [Indexed: 11/24/2022]
Abstract
This study examined whether physical intimate partner violence (IPV) victimization was associated with diurnal patterns of salivary cortisol in a community sample of 122 couples in their 30s from predominantly lower socioeconomic status backgrounds. Findings indicate that women with higher levels of victimization exhibited flatter patterns of diurnal cortisol characterized by both higher midday levels and more attenuated decreases in cortisol levels across the day, compared to women with lower levels of victimization. However, men's victimization was not associated with their diurnal cortisol levels. This study advances our understanding of the association between physical IPV victimization and dysregulated hypothalamic-pituitary-adrenal (HPA) axis functioning in women, which is likely to have further implications for their subsequent mental and physical health.
Collapse
Affiliation(s)
- Hyoun K. Kim
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR 97401 USA,Correspondence to : Hyoun K. Kim Oregon Social Learning Center 10 Shelton McMurphey Blvd Eugene, OR 97401 USA 541-485-2711 541-485-7087 FAX
| | - Stacey S. Tiberio
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR 97401 USA
| | - Deborah M. Capaldi
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR 97401 USA
| | - Joann Wu Shortt
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR 97401 USA
| | | | | |
Collapse
|
39
|
Ojo JO, Greenberg MB, Leary P, Mouzon B, Bachmeier C, Mullan M, Diamond DM, Crawford F. Neurobehavioral, neuropathological and biochemical profiles in a novel mouse model of co-morbid post-traumatic stress disorder and mild traumatic brain injury. Front Behav Neurosci 2014; 8:213. [PMID: 25002839 PMCID: PMC4067099 DOI: 10.3389/fnbeh.2014.00213] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 05/26/2014] [Indexed: 01/12/2023] Open
Abstract
Co-morbid mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) has become the signature disorder for returning combat veterans. The clinical heterogeneity and overlapping symptomatology of mTBI and PTSD underscore the need to develop a preclinical model that will enable the characterization of unique and overlapping features and allow discrimination between both disorders. This study details the development and implementation of a novel experimental paradigm for PTSD and combined PTSD-mTBI. The PTSD paradigm involved exposure to a danger-related predator odor under repeated restraint over a 21 day period and a physical trauma (inescapable footshock). We administered this paradigm alone, or in combination with a previously established mTBI model. We report outcomes of behavioral, pathological and biochemical profiles at an acute timepoint. PTSD animals demonstrated recall of traumatic memories, anxiety and an impaired social behavior. In both mTBI and combination groups there was a pattern of disinhibitory like behavior. mTBI abrogated both contextual fear and impairments in social behavior seen in PTSD animals. No major impairment in spatial memory was observed in any group. Examination of neuroendocrine and neuroimmune responses in plasma revealed a trend toward increase in corticosterone in PTSD and combination groups, and an apparent increase in Th1 and Th17 proinflammatory cytokine(s) in the PTSD only and mTBI only groups respectively. In the brain there were no gross neuropathological changes in any groups. We observed that mTBI on a background of repeated trauma exposure resulted in an augmentation of axonal injury and inflammatory markers, neurofilament L and ICAM-1 respectively. Our observations thus far suggest that this novel stress-trauma-related paradigm may be a useful model for investigating further the overlapping and distinct spatio-temporal and behavioral/biochemical relationship between mTBI and PTSD experienced by combat veterans.
Collapse
Affiliation(s)
| | | | | | - Benoit Mouzon
- Roskamp Institute Sarasota, FL, USA ; Research and Development Service, James A. Haley Veterans' Hospital Tampa, FL, USA ; Department of Life sciences, The Open University Milton Keynes, UK
| | - Corbin Bachmeier
- Roskamp Institute Sarasota, FL, USA ; Research and Development Service, James A. Haley Veterans' Hospital Tampa, FL, USA ; Department of Life sciences, The Open University Milton Keynes, UK
| | - Michael Mullan
- Roskamp Institute Sarasota, FL, USA ; Research and Development Service, James A. Haley Veterans' Hospital Tampa, FL, USA ; Department of Life sciences, The Open University Milton Keynes, UK
| | - David M Diamond
- Research and Development Service, James A. Haley Veterans' Hospital Tampa, FL, USA ; Department of Psychology, Department of Molecular Pharmacology and Physiology, Center for Preclinical and Clinical Research on PTSD, University of South Florida Tampa, FL, USA
| | - Fiona Crawford
- Roskamp Institute Sarasota, FL, USA ; Research and Development Service, James A. Haley Veterans' Hospital Tampa, FL, USA ; Department of Life sciences, The Open University Milton Keynes, UK
| |
Collapse
|
40
|
Leggett AN, Zarit SH, Kim K, Almeida DM, Klein LC. Depressive Mood, Anger, and Daily Cortisol of Caregivers on High- and Low-Stress Days. J Gerontol B Psychol Sci Soc Sci 2014; 70:820-9. [PMID: 24924160 DOI: 10.1093/geronb/gbu070] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 05/05/2014] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This study examines the association of daily cortisol with depressive mood and anger. METHOD Depressive mood, anger and 2 markers of cortisol, area under the curve (AUC), and cortisol awakening response (CAR) were examined for caregivers (N = 164) of individuals with dementia (IWDs) across 8 days, some of which IWDs attended an adult day service (ADS) program. Caregivers were primarily female (86.7%) with a mean age of 61.99. First, multilevel models were run with CAR and AUC each as separate covariates of anger and depressive mood. A second set of models examined contextual factors of caregivers (i.e., care-related stressors and amount of ADS use) were added to the models for anger and depressive mood (Model 2). RESULTS On days where caregivers had AUCs below their average they expressed higher anger scores. However in Model 2, anger was associated with more care-related stressors, but not ADS use or daily cortisol. Caregivers who on average had smaller CARs were more likely to be depressed. In Model 2, depressed mood was associated with more care-related stressors and a low average CAR. DISCUSSION We found that hypocortisol patterns, reflective of chronic stress experienced by caregivers, are associated with negative mood.
Collapse
Affiliation(s)
- Amanda N Leggett
- Department of Psychiatry, The University of Michigan, Ann Arbor.
| | - Steven H Zarit
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park
| | - Kyungmin Kim
- Department of Human Development and Family Sciences, The University of Texas at Austin
| | - David M Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park
| | - Laura Cousino Klein
- Department of Biobehavioral Health and Penn State Institute of the Neurosciences, The Pennsylvania State University, University Park
| |
Collapse
|
41
|
Blasco-Ros C, Herbert J, Martinez M. Different profiles of mental and physical health and stress hormone response in women victims of intimate partner violence. JOURNAL OF ACUTE DISEASE 2014. [DOI: 10.1016/s2221-6189(14)60066-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
42
|
Steudte S, Kirschbaum C, Gao W, Alexander N, Schönfeld S, Hoyer J, Stalder T. Hair cortisol as a biomarker of traumatization in healthy individuals and posttraumatic stress disorder patients. Biol Psychiatry 2013; 74:639-46. [PMID: 23623187 DOI: 10.1016/j.biopsych.2013.03.011] [Citation(s) in RCA: 149] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 03/18/2013] [Accepted: 03/19/2013] [Indexed: 01/22/2023]
Abstract
BACKGROUND Previous evidence on endocrine correlates of posttraumatic stress disorder (PTSD) has been rather inconsistent. The analysis of cortisol in hair is a recent methodological development that may increase the quality of long-term cortisol assessments in such research. Here, we use this method to closely assess hair cortisol relationships with trauma-related characteristics and PTSD symptom patterns. METHODS Hair cortisol concentrations (HCC), diurnal salivary cortisol, and relevant psychometric data were assessed in matched groups of 28 PTSD patients and 27 traumatized and 32 nontraumatized healthy control subjects. Cortisol levels were quantified by liquid chromatography tandem mass spectrometry. RESULTS Posttraumatic stress disorder patients and traumatized control subjects exhibited 59% and 51% lower HCC than nontraumatized control subjects, respectively. Hair cortisol concentrations were found to be negatively related to the severity of intrusion symptoms, the number of different lifetime traumatic events, the frequency of traumatization, and the time interval since traumatization. The overall pattern of HCC associations was not reflected in short-term salivary cortisol findings. CONCLUSIONS Our results indicate that trauma exposure per se, either in the absence or presence of PTSD, is a crucial correlate of long-term basal cortisol levels. Particularly, the experience of multiple events with a longer time since traumatization and an increased severity of intrusion symptoms may be related to hypocortisolism. The fact that HCC findings were not consistently seen in salivary cortisol data underscores the importance of the method of cortisol assessment and highlights the utility of hair cortisol analyses for future biological psychiatry research.
Collapse
Affiliation(s)
- Susann Steudte
- Institute of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | | | | | | | | | | | | |
Collapse
|
43
|
Longitudinal measurement of cortisol in association with mental health and experience of domestic violence and abuse: study protocol. BMC Psychiatry 2013; 13:188. [PMID: 23849084 PMCID: PMC3716999 DOI: 10.1186/1471-244x-13-188] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 07/10/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Domestic violence and abuse is threatening behavior, violence/abuse used by one person to control the other within an intimate or family-type relationship. Women experience more severe physical and sexual domestic violence and abuse and more mental health consequences than men. The current study aims at exploring of the role of hypothalamic-pituitary-adrenocortical axis activity in abuse impact on women's mental health. STUDY OBJECTIVES 1) To evaluate diurnal cortisol slope, cortisol awakening response, and the mean cortisol concentration in women with a current or recent experience of abuse; 2) To estimate whether cortisol secretion is associated with type, severity, duration and cessation of abuse; 3) To investigate whether cortisol acts as mediator between abuse and mental health condition; 4) To examine whether there is any distinction in cortisol levels between those women exposed to both childhood abuse and domestic violence and abuse and those experienced only the latter. 4) To explore whether cortisol secretion differs between women living in refuge and those still living in the community. METHODS/DESIGN To meet study objectives 128 women will be recruited in a domestic violence agency and local communities. Baseline and 3-month follow-up measures will be taken over 6 months after recruitment. Each assessment will include: (1) standardized self-administered questionnaires to evaluate socio-demographics, experience of violence and abuse, mental and physical health; (2) weight and height measurement; (3) self-completion of wakening, post-wakening and evening saliva samples. Saliva will be analysed for cortisol and cortisone using Ultra performance liquid chromatography-tandem mass spectrometry. We will compare diurnal cortisol parameters between non-abused controls and abuse survivors with and without mental health conditions. First following descriptive statistics for all the cortisol and mental health outcomes, relationships between them will be investigated using appropriate regression models. Second, these techniques will be used to investigate the extent to which cortisol measures act as potential mediators between type, severity, duration of abuse and mental disorders. DISCUSSION Results of the study will increase our understanding of the pathophysiological mechanisms of abuse-related mental health disorders in women and inform researchers and practitioners on the possibility of using salivary cortisol as a biological marker for prognosis, diagnosis, and treatment evaluation among abuse survivors. TRIAL REGISTRATION ClinicalTrials.gov registration NCT01632553.
Collapse
|
44
|
Zoladz PR, Diamond DM. Current status on behavioral and biological markers of PTSD: a search for clarity in a conflicting literature. Neurosci Biobehav Rev 2013; 37:860-95. [PMID: 23567521 DOI: 10.1016/j.neubiorev.2013.03.024] [Citation(s) in RCA: 188] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 03/23/2013] [Accepted: 03/27/2013] [Indexed: 12/24/2022]
Abstract
Extensive research has identified stereotypic behavioral and biological abnormalities in post-traumatic stress disorder (PTSD), such as heightened autonomic activity, an exaggerated startle response, reduced basal cortisol levels and cognitive impairments. We have reviewed primary research in this area, noting that factors involved in the susceptibility and expression of PTSD symptoms are more complex and heterogeneous than is commonly stated, with extensive findings which are inconsistent with the stereotypic behavioral and biological profile of the PTSD patient. A thorough assessment of the literature indicates that interactions among myriad susceptibility factors, including social support, early life stress, sex, age, peri- and post-traumatic dissociation, cognitive appraisal of trauma, neuroendocrine abnormalities and gene polymorphisms, in conjunction with the inconsistent expression of the disorder across studies, confounds attempts to characterize PTSD as a monolithic disorder. Overall, our assessment of the literature addresses the great challenge in developing a behavioral and biomarker-based diagnosis of PTSD.
Collapse
Affiliation(s)
- Phillip R Zoladz
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, 525 S. Main St., Ada, OH, 45810, USA
| | | |
Collapse
|
45
|
Walsh K, Galea S, Koenen KC. Mechanisms Underlying Sexual Violence Exposure and Psychosocial Sequelae: A Theoretical and Empirical Review. ACTA ACUST UNITED AC 2012; 19:260-275. [PMID: 25762853 DOI: 10.1111/cpsp.12004] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Sexual violence is associated with a range of negative mental health and behavioral sequelae, including posttraumatic stress disorder (PTSD), depression, substance abuse/dependence, risky sexual behavior, and interpersonal relationship problems. However, mechanisms underlying these associations are not well understood. Identifying mechanisms that explain linkages between sexual violence and poor outcomes is of paramount importance in determining when and how to intervene to prevent or reduce the magnitude of these outcomes. This review focuses on theories that have been proposed to explain risk of negative outcomes among sexual violence victims, including the development of traumagenic dynamics and emotion dysregulation. We also review promising biological mechanisms that may explain the risk of negative outcomes among sexual violence victims, including studies concerned with epigenetic and neurobiological mechanisms.
Collapse
Affiliation(s)
- Kate Walsh
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina Columbia University Mailman School of Public Health
| | - Sandro Galea
- Columbia University Mailman School of Public Health
| | | |
Collapse
|
46
|
Morris MC, Compas BE, Garber J. Relations among posttraumatic stress disorder, comorbid major depression, and HPA function: a systematic review and meta-analysis. Clin Psychol Rev 2012; 32:301-15. [PMID: 22459791 PMCID: PMC3340453 DOI: 10.1016/j.cpr.2012.02.002] [Citation(s) in RCA: 321] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2011] [Revised: 12/31/2011] [Accepted: 02/03/2012] [Indexed: 12/16/2022]
Abstract
Exposure to traumatic stress is associated with increased risk for posttraumatic stress disorder (PTSD) and alterations of hypothalamic-pituitary-adrenocortical (HPA) function. Research linking traumatic stress with HPA function in PTSD has been inconsistent, however, in part due to (a) the inclusion of trauma-exposed individuals without PTSD (TE) in control groups and (b) a failure to consider comorbid major depressive disorder (MDD) and moderating variables. This meta-analysis of 47 studies (123 effect sizes, N=6008 individuals) revealed that daily cortisol output was lower for PTSD (d=-.36, SE=.15, p=.008) and PTSD+MDD (d=-.65, SE=.25, p=.008) groups relative to no trauma controls (NTC); TE and NTC groups did not differ significantly from each other. Afternoon/evening cortisol was lower in TE (d=-.25, SE=.09, p=.007) and PTSD (d=-.27, SE=.12, p=.021) groups and higher in PTSD+MDD groups (d=.49, SE=.24, p=.041) relative to NTC. Post-DST cortisol levels were lower in PTSD (d=-.40, SE=.12, p<.001), PTSD+MDD (d=-.65, SE=.14, p<.001), and TE groups (d=-.53, SE=.14, p<.001) relative to NTC. HPA effect sizes were moderated by age, sex, time since index event, and developmental timing of trauma exposure. These findings suggest that enhanced HPA feedback function may be a marker of trauma-exposure rather than a specific mechanism of vulnerability for PTSD, whereas lower daily cortisol output may be associated with PTSD in particular.
Collapse
Affiliation(s)
- Matthew C Morris
- Center for Molecular and Behavioral Neuroscience, Meharry Medical College, 1005 Dr. D.B. Todd, Jr., Boulevard, Nashville, TN 37208, USA.
| | | | | |
Collapse
|
47
|
Klaassens ER, Giltay EJ, Cuijpers P, van Veen T, Zitman FG. Adulthood trauma and HPA-axis functioning in healthy subjects and PTSD patients: a meta-analysis. Psychoneuroendocrinology 2012; 37:317-31. [PMID: 21802212 DOI: 10.1016/j.psyneuen.2011.07.003] [Citation(s) in RCA: 127] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2010] [Revised: 07/03/2011] [Accepted: 07/03/2011] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hypothalamic-pituitary-adrenal (HPA)-axis dysregulation has inconsistently been associated with posttraumatic stress disorder (PTSD). Yet, trauma exposure rather than PTSD may be responsible for HPA-axis dysregulation. In two meta-analyses, we assessed the association of adulthood trauma exposure and HPA-axis functioning in healthy subjects with and without PTSD. METHOD A literature search in Pubmed and PsychInfo, using keywords and MeSH terms such as cortisol, emotional trauma, and PTSD, was performed. Only studies that included mentally healthy trauma-exposed (TE) individuals as well as non-exposed (NE) healthy individuals and/or PTSD patients (PTSD) were selected. This resulted in 1511 studies of which ultimately, 37 studies (21 TE versus NE and 34 TE versus PTSD, N=2468) were included. Methodological quality of all studies was assessed according to specific quality criteria. Pooled effect sizes (Hedges's g) on cortisol levels were compared. For all analyses, random effect models were used. RESULTS Cortisol levels were neither significantly different between TE versus NE subjects (-0.029; 95%CI: -0.145; 0.088) nor between TE subjects versus PTSD patients (0.175; 95%CI: -0.012; -0.362). Subgroup analyses showed an increased cortisol suppression after the low dose dexamethasone suppression test (DST) in TE versus NE subjects (-0.509; 95%CI: -0.871; -0.148). This meta-analysis was limited by the fact that lifetime psychiatric illness and childhood trauma were not an exclusion criterion in all 37 studies. CONCLUSION Neither adulthood trauma exposure nor PTSD were associated with differences in HPA-axis functioning, although adulthood trauma may augment cortisol suppression after the DST. More evidence on other dynamic tests of HPA-axis functioning in PTSD and adulthood trauma exposure is needed.
Collapse
Affiliation(s)
- Ellen R Klaassens
- Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
| | | | | | | | | |
Collapse
|
48
|
Association between perceived racism and physiological stress indices in Native Hawaiians. J Behav Med 2011; 35:27-37. [PMID: 21360284 DOI: 10.1007/s10865-011-9330-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Accepted: 02/09/2011] [Indexed: 01/26/2023]
Abstract
The association between racism and the physical health of native U.S. populations has yet to be examined despite their high risk for stress-related disorders and a history of discrimination toward them. We examined the correlation between perceived racism and the two physiological stress indices of cortisol level and blood pressure in 146 adult Native Hawaiians. Attributed and felt racism were assessed with a 10-item shortened version of the Oppression Questionnaire. Height, weight, blood pressure, and salivary cortisol samples (AM and PM) were collected and analyzed along with information on Hawaiian ancestry, BMI, age, sex, marital status, education level, general psychological stress, and ethnic identity. The results indicated that Native Hawaiians reporting more attributed racism had significantly (P < .05) lower average cortisol levels than those reporting less attributed racism, after adjusting for socio-demographic, biological, and psychosocial confounders. Native Hawaiians reporting more felt racism had a significantly higher systolic blood pressure than those reporting less, but this association was not significant after adjusting for the aforementioned confounders. Racism appears to be a chronic stressor that can "get under the skin" of Native Hawaiians by affecting their physical health and risk for stress-related diseases, possibly, through mechanisms of cortisol dysregulation.
Collapse
|
49
|
Danielson AM, Matheson K, Anisman H. Cytokine levels at a single time point following a reminder stimulus among women in abusive dating relationships: Relationship to emotional states. Psychoneuroendocrinology 2011; 36:40-50. [PMID: 20598444 DOI: 10.1016/j.psyneuen.2010.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Revised: 05/27/2010] [Accepted: 06/02/2010] [Indexed: 10/19/2022]
Abstract
Stressful events and reminders of such events may influence circulating cytokine levels, just as they influence several neuroendocrine processes. However, these cytokine changes may vary with the severity and chronicity of the stressor experienced, as well as the specific mood responses that participants express. In the present investigation, women in abusive or non-abusive dating relationship (N=75) read a script about an abusive or non-abusive relationship and then reported their mood states, followed by the collection of a single blood sample 30 min later. The abused women who read the abuse-related script reported greater anger, sadness, shame, and anxiety than did the non-abused women. In non-abused women greater levels of anger and sadness, but not shame or anxiety, were associated with higher levels of the proinflammatory cytokine, interleukin-6 (IL-6), as well as the anti-inflammatory cytokine, IL-10, irrespective of whether they had read a script regarding an abusive relationship or a neutral script. In contrast, among abused women shown a neutral script, neither IL-6 nor IL-10 levels were related to their anger and sadness, whereas mood levels following the reading of a script regarding abuse were directly related to IL-6, although the extent of the association was lower than that evident in non-abused women. Levels of IL-10 in the abused women, unlike their non-abused counterparts, did not vary with mood state. These data suggest that cytokine levels and the relative balance of IL-6 and IL-10 ordinarily are associated with specific moods, but this relationship is not apparent among women in a chronic stress state.
Collapse
|
50
|
Suglia SF, Staudenmayer J, Cohen S, Enlow MB, Rich-Edwards JW, Wright RJ. Cumulative Stress and Cortisol Disruption among Black and Hispanic Pregnant Women in an Urban Cohort. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2010; 2:326-334. [PMID: 21423846 DOI: 10.1037/a0018953] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
While adult hypothalamic-pituitary-adrenocortical (HPA) axis functioning is thought to be altered by traumatic experiences, little data exist on the effects of cumulative stress on HPA functioning among pregnant women or among specific racial and ethnic groups. Individuals may be increasingly vulnerable to physiological alterations when experiencing cumulative effects of multiple stressors. These effects may be particularly relevant in urban poor communities where exposure to multiple stressors is more prevalent. The goal of this study was to explore the effects of multiple social stressors on HPA axis functioning in a sample of urban Black (n = 68) and Hispanic (n = 132) pregnant women enrolled in the Asthma Coalition on Community, Environment, and Social Stress (ACCESS). Pregnant women were administered the Revised Conflict Tactics Scale (R-CTS) survey to assess interpersonal violence, the Experiences of Discrimination (EOD) survey, the Crisis in Family Systems-Revised (CRISYS-R) negative life events survey, and the My Exposure to Violence (ETV) survey, which ascertains exposure to community violence. A cumulative stress measure was derived from these instruments. Salivary cortisol samples were collected five times per day over three days to assess area under the curve (AUC), morning change, and basal awakening response in order to characterize diurnal salivary cortisol patterns. Repeated measures mixed models, stratified by race/ethnicity, were performed adjusting for education level, age, smoking status, body mass index and weeks pregnant at time of cortisol sampling. The majority of Hispanic participants (57%) had low cumulative stress exposure, while the majority of Black participants had intermediate (35%) or high (41%) cumulative stress exposure. Results showed that among Black but not Hispanic women, cumulative stress was associated with lower morning cortisol levels, including a flatter waking to bedtime rhythm. These analyses suggest that the combined effects of cumulative stressful experiences are associated with disrupted HPA functioning among pregnant women. While the etiology of racial/ethnic differences in stress-induced HPA alterations is not clear, this warrants further research.
Collapse
|