Altered pituitary-adrenal axis responses to provocative challenge tests in adult survivors of childhood abuse

Christine Marcelle Heim, D. J. Newport, R. Bonsall, A. H. Miller, C. B. Nemeroff

Research output: Contribution to journalArticle

525 Citations (Scopus)

Abstract

Objective: Early adverse life events may predispose individuals to the development of mood and anxiety disorders in adulthood, perhaps by inducing persistent changes in corticotropin-releasing factor (CRF) neuronal systems. The present study sought to evaluate pituitary-adrenal responses to standard hypothalamic-pituitary-adrenal axis challenge tests in adult female survivors of childhood abuse with and without major depressive disorder. Method: Plasma ACTH and cortisol responses to the administration of 1 μg/kg ovine CRF and plasma cortisol responses to the administration of 250 μg ACTH1-24 were measured in healthy women without early life stress (N=20), women with childhood abuse without major depressive disorder (N=20), women with childhood abuse and major depressive disorder (N=15), and women with major depression but no early life stress (N=11). Results: Abused women without major depressive disorder exhibited greater than usual ACTH responses to CRF administration, whereas abused women with major depressive disorder and depressed women without early life stress demonstrated blunted ACTH responses. In the ACTH1-24 stimulation test, abused women without major depressive disorder exhibited lower baseline and stimulated plasma cortisol concentrations. Abused women with comorbid depression more often suffered from posttraumatic stress disorder and reported more recent life stress than abused women without major depressive disorder. Conclusions: These findings suggest sensitization of the anterior pituitary and counterregulative adaptation of the adrenal cortex in abused women without major depressive disorder. On subsequent stress exposure, women with a history of childhood abuse may hypersecrete CRF, resulting in down-regulation of adenohypophyseal CRF receptors and symptoms of depression and anxiety.

Original languageEnglish (US)
Pages (from-to)575-581
Number of pages7
JournalAmerican Journal of Psychiatry
Volume158
Issue number4
DOIs
StatePublished - Apr 23 2001

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Major Depressive Disorder
Battered Women
Survivors
Corticotropin-Releasing Hormone
Psychological Stress
Adrenocorticotropic Hormone
Hydrocortisone
Depression
Corticotropin-Releasing Hormone Receptors
Adrenal Cortex
Post-Traumatic Stress Disorders
Anxiety Disorders
Mood Disorders
Sheep
Down-Regulation
Anxiety

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health

Cite this

Heim, Christine Marcelle ; Newport, D. J. ; Bonsall, R. ; Miller, A. H. ; Nemeroff, C. B. / Altered pituitary-adrenal axis responses to provocative challenge tests in adult survivors of childhood abuse. In: American Journal of Psychiatry. 2001 ; Vol. 158, No. 4. pp. 575-581.
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Altered pituitary-adrenal axis responses to provocative challenge tests in adult survivors of childhood abuse. / Heim, Christine Marcelle; Newport, D. J.; Bonsall, R.; Miller, A. H.; Nemeroff, C. B.

In: American Journal of Psychiatry, Vol. 158, No. 4, 23.04.2001, p. 575-581.

Research output: Contribution to journalArticle

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