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Li Piani L, Somigliana E, Micci LG, Spinelli G, Barbara G. Going Beyond Childhood and Gender-Based Violence: Epigenetic Modifications and Inheritance. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:473-484. [PMID: 39035135 PMCID: PMC11257107 DOI: 10.1089/whr.2024.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/28/2024] [Indexed: 07/23/2024]
Abstract
Being exposed to childhood or gender-based violence is associated with subsequent adverse events in individual lives. Not only can it cause psychological distress but violence survivors suffer from a range of long-term adverse health outcomes, including higher morbidity, higher mortality, and higher risk of chronic diseases. Epigenetics may be involved in the determinisms of these long-term detrimental effects. A large body of evidence supports this biological mechanism to explain violence-related health impairment in the long term. However, studies specifically focusing on violence are scant and nonunivocal. Epigenetic modifications of genes involved in stress response and in the hypothalamus-pituitary-adrenal axis regulation are the most commonly and consistently reported. Promising evidence also emerged for the use of epigenetic clocks. Finally, although very limited, there is evidence supporting the notion that long-term health impairment may be transmitted from one generation to the other. Overall, despite promising, available evidence is yet incomplete. The overlap with pure psychological mechanisms of health impairment exposes the findings to confounders and hampers strong conclusions. Based on a literature search on PubMed/Embase, our narrative review aims to illustrate the evidence concerning the potential bond between epigenetics and violence, including also possible impacts on later generations. The goal is to encourage further research to help the development of a more holistic approach for such a vulnerable and often neglected population. Further research is warranted to precisely disentangle the role of epigenetics in mediating the long-term health impairment associated with childhood or gender-based violence. Advances in this area may open new avenues of treatment. Epigenetic modifications may indeed be reversible and could be an attractive therapeutic target to minimize the long-term consequences of childhood or gender-based violence.
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Affiliation(s)
- Letizia Li Piani
- Dept of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Edgardo Somigliana
- Dept of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- SVSeD - Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laila Giorgia Micci
- SVSeD - Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gaia Spinelli
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- SVSeD - Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giussy Barbara
- Dept of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
- SVSeD - Service for Sexual and Domestic Violence, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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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.
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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
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Sanderson M, Cook M, Brown LL, Mallett V, Coker AL. Lifetime Interpersonal Violence or Abuse and Diabetes Rates by Sex and Race. Am J Prev Med 2023; 65:783-791. [PMID: 37302511 PMCID: PMC10592556 DOI: 10.1016/j.amepre.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Lifetime exposure to interpersonal violence or abuse has been associated with several chronic diseases, including adult-onset diabetes, yet this pattern has not been confirmed by sex and race within a large cohort. METHODS Data from the Southern Community Cohort Study collected between 2002-2009 and 2012-2015 were used to explore the relationship between lifetime interpersonal violence or abuse and diabetes (N=25,251). Prospective analyses of lower-income people living in the southeastern U.S. were conducted in 2022 to examine the risk of adult-onset diabetes associated with lifetime interpersonal violence or abuse by sex and race. Lifetime interpersonal violence or abuse was defined as (1) physical or psychological violence, threats, or abuse in adulthood (adult interpersonal violence or abuse) and (2) childhood abuse or neglect. RESULTS After adjustment for potentially confounding factors, adult interpersonal violence or abuse was associated with a 23% increased risk of diabetes (adjusted hazard ratio=1.23; 95% CI=1.16, 1.30). Diabetes risks associated with childhood abuse or neglect were 15% (95% CI=1.02, 1.30) for neglect and 26% (95% CI=1.19, 1.35) for abuse. When combining adult interpersonal violence or abuse and childhood abuse or neglect, the risk of diabetes was 35% higher (adjusted hazard ratio=1.35; 95% CI=1.26, 1.45) than those experiencing no violence, abuse, or neglect. This pattern held among Black and White participants, and among women and men. CONCLUSIONS Both adult interpersonal violence or abuse and childhood abuse or neglect increased the risk of adult-onset diabetes in a dose-dependent pattern for men and women, and by race. Intervention and prevention efforts to reduce adult interpersonal violence or abuse and childhood abuse or neglect could not only reduce the risk of lifetime interpersonal violence or abuse but may also reduce one of the most prevalent chronic diseases, adult-onset diabetes.
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Affiliation(s)
- Maureen Sanderson
- Department of Family & Community Medicine, Meharry Medical College, Nashville, Tennessee.
| | - Mekeila Cook
- Division of Public Health Practice, Meharry Medical College, Nashville, Tennessee
| | - L Lauren Brown
- Department of Psychiatry & Behavioral Sciences, Meharry Medical College, Nashville, Tennessee
| | - Veronica Mallett
- Department of Obstetrics & Gynecology and Common Spirit Health, Morehouse School of Medicine, Atlanta, Georgia
| | - Ann L Coker
- Department of Obstetrics and Gynecology, College of Medicine, University of Kentucky, Lexington, Kentucky; Center for Research on Violence Against Women, University of Kentucky, Lexington, Kentucky
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Goldstein SC, Schick MR, Weyandt LL, Sullivan TP, Cadely HSE, Weiss NH. Posttraumatic stress as a moderator of the association between HPA-axis functioning and alcohol use disorder among a community sample of women currently experiencing intimate partner violence. Exp Clin Psychopharmacol 2023; 31:163-173. [PMID: 35113644 PMCID: PMC10829849 DOI: 10.1037/pha0000543] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Women experiencing intimate partner violence (IPV) experience a heightened prevalence of alcohol use disorder (AUD). Hypothalamic-pituitary-adrenal (HPA)-axis functioning has been associated with increased risk for AUD in other populations, including individuals with posttraumatic stress disorder (PTSD) symptoms. The goal of the present study was to determine whether PTSD symptom severity exacerbates the relationship between HPA-axis functioning and AUD. Participants were 151 community women who had experienced physical or sexual IPV in the past 30 days by their current male partners and used any amount of alcohol or drugs. A two-phase emotion induction protocol was utilized: Neutral mood induction followed by randomly assigned negative, positive, or neutral emotion induction. Saliva cortisol samples were obtained immediately following the neutral mood induction (baseline HPA-axis functioning), 20 min following the individualized emotion induction script (HPA-axis reactivity), and 40 min post the emotionally evocative cue (HPA-axis recovery). Findings revealed that PTSD symptom severity moderated the relations between baseline HPA-axis functioning and HPA-axis recovery and log odds of meeting criteria for AUD. Specifically, baseline HPA-axis functioning was positively associated with log odds of meeting criteria for AUD at high (but not low) PTSD symptom severity, whereas HPA-axis recovery was negatively associated with log odds of meeting criteria for AUD at high (but not low) PTSD symptom severity. Results contribute to our understanding of the biological processes involved in the etiology and maintenance of AUD among women experiencing IPV-specifically the prominent role of PTSD symptom severity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Melissa R. Schick
- Department of Psychology, University of Rhode Island
- Department of Psychiatry and Behavioral Sciences and the Department of Veterans Affairs Medical Center Mental Health Service, Medical University of South Carolina
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Jayan D, deRoon-Cassini TA, Sauber G, Hillard CJ, Fitzgerald JM. A cluster analytic approach to examining the role of cortisol in the development of post-traumatic stress and dysphoria in adult traumatic injury survivors. Psychoneuroendocrinology 2022; 135:105450. [PMID: 34775251 PMCID: PMC8686692 DOI: 10.1016/j.psyneuen.2021.105450] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 10/10/2021] [Accepted: 10/11/2021] [Indexed: 01/03/2023]
Abstract
Identification of specific risk factors for posttraumatic stress disorder (PTSD) versus depression after trauma has been challenging, in part due to the high comorbidity of these disorders. As exposure to trauma triggers activation of the hypothalamic-pituitary-adrenal (HPA)-axis, examining atypical stress responses via HPA-axis hormones, namely cortisol, may help in the delineation of these disorders. Indeed, extant research demonstrates that, following stress, individuals with chronic PTSD exhibit hypocortisolism (e.g., lower cortisol response than controls), while those with chronic depression exhibit hypercortisolism (e.g., higher response than controls). Less is known about the role of cortisol and these seemingly disparate profiles immediately following traumatic injury as well as whether cortisol can be used as a predictor of future development of PTSD versus depression symptoms. In this study cortisol was measured blood from 172 traumatic injury survivors during hospitalization (on average 2.5 days post-injury). PTSD and depression severity were assessed from Clinician Assessed PTSD Scale (CAPS-5) six-eight months later using a two-factor dimensional approach that measures trauma-specific symptoms of PTSD versus dysphoria (akin to depression). Cluster analysis was used to group individuals based on post-injury cortisol, PTSD, and dysphoria. Results demonstrated that trauma survivors who only developed symptoms of dysphoria at six months (with minimal symptoms of PTSD) were differentiated by high post-injury cortisol compared to other groups. By contrast, individuals who developed symptoms of both PTSD and dysphoria were differentiated by low post-injury cortisol and most severe symptoms of PTSD. Findings provide support for the presence of subgroups of trauma survivors defined, in part, by post-trauma cortisol.
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Affiliation(s)
- Devi Jayan
- Department of Psychology, Marquette University, 317 Cramer Hall, Milwaukee 53233, USA
| | - Terri A deRoon-Cassini
- Departments of Trauma & Acute Care Surgery, Psychiatry & Behavioral Medicine, and the Institute for Health & Equity, Comprehensive Injury Center, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Garrett Sauber
- Department of Pharmacology and Toxicology and Neuroscience Research Center, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Cecilia J Hillard
- Department of Pharmacology and Toxicology and Neuroscience Research Center, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Jacklynn M Fitzgerald
- Department of Psychology, Marquette University, 317 Cramer Hall, Milwaukee 53233, USA.
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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.
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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
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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.
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Weitzman A, Goosby BJ. Intimate partner violence, circulating glucose, and non-communicable Disease: Adding insult to injury? SSM Popul Health 2021; 13:100701. [PMID: 33364298 PMCID: PMC7750577 DOI: 10.1016/j.ssmph.2020.100701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 10/24/2022] Open
Abstract
Analyzing data from the 2015-2016 Indian Demographic and Health Survey (N = 41,768), we investigate how women's circulating glucose varies with the severity of intimate partner violence (IPV) they have experienced in the last year and how their likelihoods of corresponding noncommunicable diseases vary with IPV severity in their lifetime. Consistent with a physiological stress response, women who have recently experienced severe IPV exhibit higher glucose levels and are more likely to have extremely high levels-forewarning of disease development-than women who have not experienced IPV. Correspondingly, women who have ever experienced severe IPV in their lifetime have 33%-200% higher probabilities of diabetes, heart disease, thyroid disorders, and cancer and are 70% more likely to have any of these diseases and 175% more likely to have multiple than women who have experienced none.
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9
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Wadji DL, Gaillard C, Ketcha Wanda GJM, Wicky C, Morina N, Martin-Soelch C. HPA-axis activity and the moderating effect of self-esteem in the context of intimate partner violence in Cameroon. Eur J Psychotraumatol 2021; 12:1930897. [PMID: 34290846 PMCID: PMC8279150 DOI: 10.1080/20008198.2021.1930897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND The experience of intimate partner violence (IPV) is stressful. One objective way to monitor it is to assess victims' stress response by measuring the concentration of their salivary cortisol, the major stress hormone released by the hypothalamic-pituitary-adrenal axis. OBJECTIVE We investigated how the IPV experienced by women in Cameroon affects their stress levels and those of their children. METHOD We recruited 50 mother-child dyads exposed to IPV and a control group of 25 mother-child dyads. All mothers completed questionnaires, including the Revised Conflict Tactics Scale to assess IPV, the Sense of Coherence Scale, and the Self-Esteem Scale, to assess their psychological resources. Mothers were asked to collect 3 saliva samples from themselves and 3 from their children on a single weekday: immediately after waking up, 30 minutes after waking up, and 45 minutes after waking up. The total cortisol secretion over the first hour after awakening was determined by calculating the area under the curve with respect to the ground (AUCg). RESULTS Mothers exposed to IPV exhibited higher total post-awakening cortisol concentrations compared with those in the control group. However, no significant difference was found between exposed and non-exposed children. In addition, higher IPV, specifically injuries, was significantly and positively associated with greater AUCg among mothers exhibiting lower self-esteem. When self-esteem was high, however, no significant effect of IPV on AUCg was observed. CONCLUSIONS Of particular clinical significance is that self-esteem can modulate the stress levels of women exposed to IPV, a valuable insight into the development of effective psychosocial interventions to support IPV victims in sub-Saharan Africa.
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Affiliation(s)
- Dany Laure Wadji
- I-Reach Lab, Unit of Clinical and Health Psychology, University of Fribourg, Fribourg, Switzerland
| | - Claudie Gaillard
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health (NIMH), Bethesda, MD, USA
| | | | - Chantal Wicky
- Department of Biology, University of Fribourg, Fribourg, Switzerland
| | - Naser Morina
- Department of Consultant-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Chantal Martin-Soelch
- I-Reach Lab, Unit of Clinical and Health Psychology, University of Fribourg, Fribourg, Switzerland
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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.
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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.
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11
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Castro-Vale I, van Rossum EFC, Staufenbiel SM, Severo M, Mota-Cardoso R, Carvalho D. Hair Cortisol as a Marker of Intergenerational Heritage of War? A Study of Veterans and Their Offspring. Psychiatry Investig 2020; 17:976-986. [PMID: 33017887 PMCID: PMC7596280 DOI: 10.30773/pi.2020.0212] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 08/06/2020] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) has been associated with lower circulating cortisol levels in specific subgroups, which have also been found in the offspring of people with PTSD. The analysis of hair cortisol concentrations (HCC) is a recent methodology which is used to assess long-term systemic cortisol levels. We aimed to study veterans with war-related lifetime PTSD and their respective offspring with regards to HCC. We also studied the influence of lifetime major depressive disorder (MDD), war experiences, and childhood adversities on HCC in these groups. METHODS 31 male veterans with PTSD and 28 without PTSD and 69 adult offspring were studied. HCC were quantified by liquid chromatography tandem-mass spectrometry. RESULTS No differences in HCC were found between veterans with and without PTSD, or between their respective offspring. Veterans without MDD showed a positive association between total war exposure and HCC. Veterans reporting more frequent childhood physical abuse had lower HCC. Veterans-with-PTSD's offspring with MDD had increased HCC compared to offspring without MDD. Offspring's exposure to more frequent childhood physical abuse was negatively associated with HCC in those without MDD. CONCLUSION HCC did not appear to constitute a marker of intergenerational heritage of war-related PTSD, except in the case of veteranswith-PTSD's offspring with MDD. Our data suggest that HCC is a marker of adult reported childhood physical abuse.
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Affiliation(s)
- Ivone Castro-Vale
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal.,i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Sabine M Staufenbiel
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Milton Severo
- Department of Clinical Epidemiology, Predictive Medicine and Public Health and Department of Medical Education and Simulation, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rui Mota-Cardoso
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Davide Carvalho
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,Department of Endocrinology, Diabetes and Metabolism, São João University Hospital Centre, Faculty of Medicine, University of Porto, Porto, Portugal
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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.
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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
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Boss L, Branson S, Hagan H, Krause-Parello C. A Systematic Review of Equine-Assisted Interventions in Military Veterans Diagnosed with PTSD. JOURNAL OF VETERANS STUDIES 2019. [DOI: 10.21061/jvs.v5i1.134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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14
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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.
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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
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15
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Dekel R, Shaked OZ, Ben-Porat A, Itzhaky H. Posttraumatic Stress Disorder Upon Admission to Shelters Among Female Victims of Domestic Violence: An Ecological Model of Trauma. VIOLENCE AND VICTIMS 2019; 34:329-345. [PMID: 31019015 DOI: 10.1891/0886-6708.vv-d-16-00200] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The study used the ecological model of trauma and recovery (Harvey, 1996) to examine the rates of probable posttraumatic stress disorder (PTSD) among female victims of domestic violence. Five hundred and five participants completed questionnaires upon entering shelters in Israel. Analysis showed that 61% of the participants reported probable PTSD. Childhood exposure to violence, violence severity, and feeling helpless were all associated with high PTSD levels. By contrast, Ethiopian ethnicity, social support, and a stronger sense of control were associated with lower PTSD levels. However, the interaction between social support and violence duration showed that social support did not moderate PTSD when exposure to violence endured. The study emphasizes that resources deteriorate, and that policy-augmenting prevention programs would increase treatment potential to strengthen survivors' coping capacities.
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16
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Jarnecke AM, Barden E, Back SE, Brady KT, Flanagan JC. Intimate partner violence moderates the association between oxytocin and reactivity to dyadic conflict among couples. Psychiatry Res 2018; 270:404-411. [PMID: 30308464 PMCID: PMC6292734 DOI: 10.1016/j.psychres.2018.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/15/2018] [Accepted: 10/01/2018] [Indexed: 12/23/2022]
Abstract
Emerging literature indicates individual and contextual differences impact response to oxytocin (OT). Intimate partner violence (IPV) is one chronic stressor that may moderate OT response. To test the hypothesis that IPV moderates the association between OT and reactivity to a dyadic conflict task, data from a larger randomized controlled study was collected from heterosexual couples (N = 60 individuals; 30 couples) at high risk for IPV due to substance misuse. Partners within each dyad completed a 10-minute dyadic conflict task in the laboratory, and then self-administered a single dose of OT (40 IU) or placebo. Forty-five minutes later, participants completed another 10-minute dyadic conflict task. Stress reactivity was measured before and after the second conflict task using neuroendocrine (i.e., salivary cortisol), physiological (i.e., skin conductance), and subjective responses. Couple conflict behaviors were observed during the conflict tasks and assessed using a validated coding system. Among women, physical IPV modulated skin conductance in those administered OT, and OT interacted with physical and psychological IPV to yield less positive subjective and behavioral responses. No main or moderating effects were found for men. Findings support emerging literature on sex differences in response to OT. Future research is needed to effectively translate OT into therapeutic intervention.
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Affiliation(s)
- Amber M Jarnecke
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Eileen Barden
- Department of Psychology, Binghamton University - State University of New York, Binghamton, NY, USA
| | - Sudie E Back
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
| | - Kathleen T Brady
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
| | - Julianne C Flanagan
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Brunst KJ, Sanchez Guerra M, Gennings C, Hacker M, Jara C, Bosquet Enlow M, Wright RO, Baccarelli A, Wright RJ. Maternal Lifetime Stress and Prenatal Psychological Functioning and Decreased Placental Mitochondrial DNA Copy Number in the PRISM Study. Am J Epidemiol 2017; 186:1227-1236. [PMID: 28595325 PMCID: PMC5859981 DOI: 10.1093/aje/kwx183] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 01/12/2017] [Accepted: 01/26/2017] [Indexed: 12/17/2022] Open
Abstract
Psychosocial stress contributes to placental oxidative stress. Mitochondria are vulnerable to oxidative stress, which can lead to changes in mitochondrial DNA copy number (mtDNAcn). We examined associations of maternal lifetime stress, current negative life events, and depressive and posttraumatic-stress-disorder symptom scores with placental mtDNAcn in a racially/ethnically diverse sample (n = 147) from the Programming of Intergenerational Stress Mechanisms (PRISM) study (Massachusetts, March 2011 to August 2012). In linear regression analyses adjusted for maternal age, race/ethnicity, education, prenatal fine particulate matter exposure, prenatal smoking exposure, and the sex of the child, all measures of stress were associated with decreased placental mtDNAcn (all P values < 0.05). Weighted-quantile-sum (WQS) regression showed that higher lifetime stress and depressive symptoms accounted for most of the effect on mtDNAcn (WQS weights: 0.25 and 0.39, respectively). However, among white individuals, increased lifetime stress and posttraumatic stress disorder symptoms explained the majority of the effect (WQS weights: 0.20 and 0.62, respectively) while among nonwhite individuals, lifetime stress and depressive symptoms accounted for most of the effect (WQS weights: 0.27 and 0.55, respectively). These analyses are first to link increased maternal psychosocial stress with reduced placental mtDNAcn and add to literature documenting racial/ethnic differences in the psychological sequelae of chronic stress that may contribute to maternal-fetal health.
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Affiliation(s)
- Kelly J Brunst
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Marco Sanchez Guerra
- Laboratory of Environmental Epigenetics, Exposure Epidemiology and Risk Program, Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Developmental Neurobiology, National Institute of Perinatology, Mexico City, Mexico
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Michele Hacker
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Calvin Jara
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Michelle Bosquet Enlow
- Program for Behavioral Science, Department of Psychiatry, Boston Children’s Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Andrea Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, New York
| | - Rosalind J Wright
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, New York
- Institute for Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, New York
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Boggero IA, Hostinar CE, Haak EA, Murphy MLM, Segerstrom SC. Psychosocial functioning and the cortisol awakening response: Meta-analysis, P-curve analysis, and evaluation of the evidential value in existing studies. Biol Psychol 2017; 129:207-230. [PMID: 28870447 DOI: 10.1016/j.biopsycho.2017.08.058] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 07/05/2017] [Accepted: 08/29/2017] [Indexed: 01/13/2023]
Abstract
Cortisol levels rise immediately after awakening and peak approximately 30-45min thereafter. Psychosocial functioning influences this cortisol awakening response (CAR), but there is considerable heterogeneity in the literature. The current study used p-curve and meta-analysis on 709 findings from 212 studies to test the evidential value and estimate effect sizes of four sets of findings: those associating worse psychosocial functioning with higher or lower cortisol increase relative to the waking period (CARi) and to the output of the waking period (AUCw). All four sets of findings demonstrated evidential value. Psychosocial predictors explained 1%-3.6% of variance in CARi and AUCw responses. Based on these effect sizes, cross-sectional studies assessing CAR would need a minimum sample size of 617-783 to detect true effects with 80% power. Depression was linked to higher AUCw and posttraumatic stress to lower AUCw, whereas inconclusive results were obtained for predictor-specific effects on CARi. Suggestions for future CAR research are discussed.
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Affiliation(s)
- Ian A Boggero
- Department of Psychology, University of Kentucky, 125 Kastle Hall, Lexington, KY 40506, United States.
| | - Camelia E Hostinar
- Department of Psychology, University of California, Davis, 103 Young Hall, Davis, CA 95616, United States.
| | - Eric A Haak
- Department of Psychology, University of Kentucky, 125 Kastle Hall, Lexington, KY 40506, United States.
| | - Michael L M Murphy
- Department of Psychology, Carnegie Mellon University, 5000 Forbes Ave, Pittsburgh, PA 15213, United States.
| | - Suzanne C Segerstrom
- Department of Psychology, University of Kentucky, 125 Kastle Hall, Lexington, KY 40506, United States.
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Cortisol stress reactivity across psychiatric disorders: A systematic review and meta-analysis. Psychoneuroendocrinology 2017; 77:25-36. [PMID: 28012291 DOI: 10.1016/j.psyneuen.2016.11.036] [Citation(s) in RCA: 427] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 11/25/2016] [Accepted: 11/28/2016] [Indexed: 12/25/2022]
Abstract
The hypothalamus-pituitary-adrenal (HPA) axis and its end product cortisol are essential for an adequate response to stress. Considering the role of stress as a risk factor for psychiatric disorders, it is not surprising that cortisol stress reactivity has frequently been investigated in patients versus healthy individuals. However, the large heterogeneity in measures of the cortisol stress response has hampered a systematic evaluation of the evidence. We here report of a systematic literature review and meta-analysis on cortisol reactivity to psychosocial stress across psychiatric disorders. Original data from authors were obtained to construct standardized cortisol outcomes (the areas under the curve with respect to increase (AUCi) and ground (AUCg)) and to examine the influence of sex and symptomatic state on cortisol stress reactivity. Fourteen studies on major depressive disorder (MDD) (n=1129), 9 on anxiety disorders (n=732, including social anxiety disorder (SAD), posttraumatic stress disorder, panic disorder and mixed samples of anxiety disorders) and 4 on schizophrenia (n=180) were included that used the Trier Social Stress Test or an equivalent psychosocial stress task. Sex-dependent changes in stress reactivity were apparent in MDD and anxiety disorders. Specifically, women with current MDD or an anxiety disorder exhibited a blunted cortisol stress response, whereas men with current MDD or SAD showed an increased cortisol response to psychosocial stress. In individuals with remitted MDD, altered cortisol stress reactivity was less pronounced in women and absent in men. For schizophrenia, cortisol stress reactivity was blunted in both men and women, but the number of studies was limited and showed evidence for publication bias. These findings illustrate that sharing individual data to disentangle the effects of sex, symptom levels and other factors is essential for further understanding of the alterations in cortisol stress reactivity across psychiatric disorders.
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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.
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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
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Jaworska N, Yücel K, Courtright A, MacMaster FP, Sembo M, MacQueen G. Subgenual anterior cingulate cortex and hippocampal volumes in depressed youth: The role of comorbidity and age. J Affect Disord 2016; 190:726-732. [PMID: 26600415 DOI: 10.1016/j.jad.2015.10.064] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 10/03/2015] [Accepted: 10/15/2015] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Many studies have reported that adults with recurrent major depressive disorder (MDD) have smaller hippocampal volumes than control participants. The data are more variable in youth with MDD, where findings have been inconsistent and the effects of factors such as age and co-morbidity have not been systematically examined. This study therefore assessed hippocampus and subgenual anterior cingulate (sgACC) morphometry in 168 youth, aged 12-25, with or without MDD and comorbid anxiety. METHODS Structural magnetic resonance imaging (MRI) scans and clinical assessments were obtained from 80 participants with MDD (36 with comorbid anxiety disorder) and 88 age-matched control participants. RESULTS Participants with MDD had smaller right hippocampi than controls (p=.013). Older depressed participants (20.1-25 years) had smaller hippocampal volumes than younger ones (<20.1 years; p=.05); this age effect was not apparent in controls (p=.46). Depression scores, indexed by the HAMD17, correlated with hippocampal volumes in older depressed youth. Depressed participants with comorbid anxiety had smaller sgACC, but not hippocampal, volumes than those without anxiety (p=.042). LIMITATIONS Longitudinal, versus cross-sectional, studies can most optimally assess the influence of depression on neurodevelopmental profiles. Though our participants were largely treatment-naïve or in their first week of pharmacotherapy, a handful had extensive treatment histories; thus, treatment history may have influenced brain morphometry. CONCLUSIONS Age effects were apparent when hippocampal volumes of older and younger participants with MDD were compared; such differences were not apparent in healthy participants. Comorbid anxiety was associated with decreased sgACC volumes suggesting delayed or altered neurodevelopment in a key emotion regulation region.
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Affiliation(s)
- Natalia Jaworska
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Kaan Yücel
- Department of Anatomy, Yeditepe University, Istanbul, Turkey
| | - Allegra Courtright
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Frank P MacMaster
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Mariko Sembo
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Glenda MacQueen
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
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Fragkaki I, Thomaes K, Sijbrandij M. Posttraumatic stress disorder under ongoing threat: a review of neurobiological and neuroendocrine findings. Eur J Psychotraumatol 2016; 7:30915. [PMID: 27511448 PMCID: PMC4980518 DOI: 10.3402/ejpt.v7.30915] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 07/07/2016] [Accepted: 07/08/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Although numerous studies have investigated the neurobiology and neuroendocrinology of posttraumatic stress disorder (PTSD) after single finished trauma, studies on PTSD under ongoing threat are scarce and it is still unclear whether these individuals present similar abnormalities. OBJECTIVE The purpose of this review is to present the neurobiological and neuroendocrine findings on PTSD under ongoing threat. Ongoing threat considerably affects PTSD severity and treatment response and thus disentangling its neurobiological and neuroendocrine differences from PTSD after finished trauma could provide useful information for treatment. METHOD Eighteen studies that examined brain functioning and cortisol levels in relation to PTSD in individuals exposed to intimate partner violence, police officers, and fire fighters were included. RESULTS Hippocampal volume was decreased in PTSD under ongoing threat, although not consistently associated with symptom severity. The neuroimaging studies revealed that PTSD under ongoing threat was not characterized by reduced volume of amygdala or parahippocampal gyrus. The neurocircuitry model of PTSD after finished trauma with hyperactivation of amygdala and hypoactivation of prefrontal cortex and hippocampus was also confirmed in PTSD under ongoing threat. The neuroendocrine findings were inconsistent, revealing increased, decreased, or no association between cortisol levels and PTSD under ongoing threat. CONCLUSIONS Although PTSD under ongoing threat is characterized by abnormal neurocircuitry patterns similar to those previously found in PTSD after finished trauma, this is less so for other neurobiological and in particular neuroendocrine findings. Direct comparisons between samples with ongoing versus finished trauma are needed in future research to draw more solid conclusions before administering cortisol to patients with PTSD under ongoing threat who may already exhibit increased endogenous cortisol levels.
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Affiliation(s)
- Iro Fragkaki
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands; ,
| | - Kathleen Thomaes
- VU University Medical Center, VU University Amsterdam, Amsterdam, The Netherlands
| | - Marit Sijbrandij
- Department of Clinical Psychology, EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands
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