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Published on: November 30, 2015
A.E. Bennett Research Award. Developmental traumatology. Part I: Biological stress systems
M D De Bellis1, A S Baum, B Birmaher
1Developmental Traumatology Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA 15213, USA.
Insights
Childhood trauma and PTSD are linked to altered stress hormone levels, including dopamine, norepinephrine, and cortisol. These biological changes correlate with symptom severity in maltreated children.
Area of Science:
- Child Psychology
- Neuroendocrinology
- Trauma Studies
Background:
- Investigated the link between child maltreatment, posttraumatic stress disorder (PTSD), and biological stress markers.
- Compared prepubertal children with PTSD, overanxious disorder (OAD), and healthy controls.
Purpose of the Study:
- To examine the relationship between trauma, psychiatric symptoms, and urinary stress hormone excretion (cortisol and catecholamines) in children.
- To understand the psychobiological impact of childhood maltreatment and PTSD.
Main Methods:
- Comprehensive psychiatric and clinical assessments were performed.
- Collected 24-hour urine samples to measure urinary free cortisol (UFC) and catecholamines (epinephrine, norepinephrine, dopamine).
- Compared biological and clinical measures using analyses of variance.
Main Results:
- Children with PTSD excreted significantly higher levels of urinary dopamine and norepinephrine compared to OAD and control groups.
- Higher urinary epinephrine excretion was observed in maltreated children with PTSD versus OAD.
- PTSD in childhood was associated with increased comorbid psychopathology, lower functioning, and suicidal ideation.
- Urinary catecholamine and UFC concentrations positively correlated with trauma duration and PTSD symptom severity.
Conclusions:
- Child maltreatment experiences are associated with significant alterations in biological stress systems in children with PTSD.
- Findings suggest a psychobiological basis for trauma responses in childhood.
- Improved understanding may lead to enhanced therapeutic interventions for childhood PTSD.
Background:
This investigation examined the relationship between trauma, psychiatric symptoms and urinary free cortisol (UFC) and catecholamine (epinephrine [EPI], norepinephrine [NE], dopamine [DA]) excretion in prepubertal children with posttraumatic stress disorder (PTSD) secondary to past child maltreatment experiences (n = 18), compared to non-traumatized children with overanxious disorder (OAD) (n = 10) and healthy controls (n = 24).
Methods:
Subjects underwent comprehensive psychiatric and clinical assessments and 24 hour urine collection for measurements of UFC and urinary catecholamine excretion. Biological and clinical measures were compared using analyses of variance.
Results:
Maltreated subjects with PTSD excreted significantly greater concentrations of urinary DA and NE over 24 hours than OAD and control subjects and greater concentrations of 24 hour UFC than control subjects. Post hoc analysis revealed that maltreated subjects with PTSD excreted significantly greater concentrations of urinary EPI than OAD subjects. Childhood PTSD was associated with greater co-morbid psychopathology including depressive and dissociative symptoms, lower global assessment of functioning, and increased incidents of lifetime suicidal ideation and attempts. Urinary catecholamine and UFC concentrations showed positive correlations with duration of the PTSD trauma and severity of PTSD symptoms.
Conclusions:
These data suggest that maltreatment experiences are associated with alterations of biological stress systems in maltreated children with PTSD. An improved psychobiological understanding of trauma in childhood may eventually lead to better treatments of childhood PTSD.
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