MacMillan Harriet L, Georgiades Katholiki, Duku Eric K, Shea Alison, Steiner Meir, Niec Anne, Tanaka Masako, Gensey Susan, Spree Sandra, Vella Emily, Walsh Christine A, De Bellis Michael D, Van der Meulen John, Boyle Michael H, Schmidt Louis A
Department of Psychiatry & Behavioural Neurosciences, McMaster University, Ontario, Canada.
Biol Psychiatry. 2009 Jul 1;66(1):62-8. doi: 10.1016/j.biopsych.2008.12.014. Epub 2009 Feb 12.
Few studies have examined stress reactivity and its relationship to major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) among maltreated youth. We examined differences between maltreated and control participants in heart rate and cortisol resting and reactivity levels in response to a psychosocial stressor.
We recruited 67 female youths aged 12 to 16 with no prior history of depression from child protection agencies and a control group of 25 youths matched on age and postal code. Child maltreatment was measured with two self-report instruments. Psychiatric status was assessed using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children.
Piecewise multilevel growth curve analysis was used to model group differences in resting and reactivity cortisol levels and heart rate in response to the Trier Social Stress Test (TSST). During the resting period, both the maltreated and control groups showed a similar decline in levels of cortisol. During the reactivity phase, youth in the control group showed an increase in cortisol levels following the TSST and a gradual flattening over time; maltreated youth exhibited an attenuated response. This blunted reactivity was not associated with current symptoms of MDD or PTSD. There were no group differences in resting and reactivity levels of heart rate.
These findings provide further support for hypothalamic-pituitary-adrenal axis dysregulation among maltreated youth. Since the ability to respond to acute stressors by raising cortisol is important for health, these findings may assist in understanding the vulnerability of maltreated youth to experience physical and mental health problems.
很少有研究探讨受虐待青少年的应激反应及其与重度抑郁症（MDD）和创伤后应激障碍（PTSD）的关系。我们研究了受虐待青少年与对照组参与者在静息心率和皮质醇水平以及对心理社会应激源的反应性方面的差异。
我们从儿童保护机构招募了67名年龄在12至16岁之间且无抑郁症病史的女性青少年，以及一个由25名年龄和邮政编码匹配的青少年组成的对照组。使用两种自我报告工具测量儿童虐待情况。使用学龄儿童情感障碍和精神分裂症量表评估精神状态。
采用分段多级生长曲线分析来模拟在特里尔社会应激测试（TSST）中静息和反应性皮质醇水平以及心率的组间差异。在静息期，受虐待组和对照组的皮质醇水平均呈现相似的下降。在反应期，对照组青少年在TSST后皮质醇水平升高，并随时间逐渐趋于平稳；受虐待青少年的反应减弱。这种反应迟钝与MDD或PTSD的当前症状无关。心率的静息和反应性水平在两组之间没有差异。
这些发现为受虐待青少年下丘脑 - 垂体 - 肾上腺轴功能失调提供了进一步的支持。由于通过升高皮质醇来应对急性应激源的能力对健康很重要，这些发现可能有助于理解受虐待青少年易出现身心健康问题的原因。
