Griffin Michael G, Resick Patricia A, Yehuda Rachel
University of Missouri-St. Louis, Center for Trauma Recovery, St. Louis, MO 63121, USA.
Am J Psychiatry. 2005 Jun;162(6):1192-9. doi: 10.1176/appi.ajp.162.6.1192.
The authors compared responses of female domestic violence survivors and a matched group of nontraumatized participants to a low-dose (0.5 mg) dexamethasone suppression test (DST).
Seventy female domestic violence survivors and 14 nontraumatized women matched for age and race were recruited. Participants were assessed for trauma severity, severity of PTSD and depressive symptoms, and DST cortisol response. Of the domestic violence survivors who were DST-compliant, comparisons were made among those with PTSD (N=15), those with PTSD plus depression (N=27), and those with no PTSD or depression diagnosis (N=8) along with the nontraumatized comparison subjects (N=14).
Domestic violence survivors with PTSD, regardless of whether or not they had comorbid depression, had significantly lower baseline cortisol levels at 9:00 a.m. than the healthy subjects and trauma survivors with no diagnosis. Survivors with a sole diagnosis of PTSD showed significantly greater cortisol suppression to dexamethasone than did healthy subjects or the group diagnosed with PTSD plus depression.
These findings agree with previous studies showing hypothalamic-pituitary-adrenal (HPA) axis abnormalities in PTSD. The findings suggest that the chronic nature of domestic violence leads to a severe dysregulation of the HPA axis.
作者比较了遭受家庭暴力的女性幸存者与一组匹配的未受创伤参与者对低剂量(0.5毫克)地塞米松抑制试验(DST)的反应。
招募了70名遭受家庭暴力的女性幸存者和14名在年龄和种族上匹配的未受创伤女性。对参与者进行创伤严重程度、创伤后应激障碍(PTSD)和抑郁症状严重程度以及DST皮质醇反应的评估。在符合DST标准的家庭暴力幸存者中,对患有PTSD的人(N = 15)、患有PTSD加抑郁症的人(N = 27)、未被诊断患有PTSD或抑郁症的人(N = 8)以及未受创伤的对照受试者(N = 14)进行比较。
患有PTSD的家庭暴力幸存者,无论是否合并抑郁症,上午9点时的基线皮质醇水平均显著低于健康受试者和未被诊断的创伤幸存者。仅被诊断患有PTSD的幸存者对地塞米松的皮质醇抑制作用明显大于健康受试者或被诊断患有PTSD加抑郁症的组。
这些发现与先前显示PTSD中下丘脑 - 垂体 - 肾上腺(HPA)轴异常的研究一致。研究结果表明,家庭暴力的长期性导致HPA轴严重失调。