Carpenter Linda L, Tyrka Audrey R, Ross Nicole S, Khoury Lamya, Anderson George M, Price Lawrence H
Mood Disorders Research Program and Laboratory for Clinical Neuroscience, Butler Hospital, Brown Department of Psychiatry and Human Behavior, Providence, Rhode Island 02906, USA.
Biol Psychiatry. 2009 Jul 1;66(1):69-75. doi: 10.1016/j.biopsych.2009.02.030. Epub 2009 Apr 17.
The dexamethasone/corticotropin releasing hormone (Dex/CRH) test has been proposed as a potential tool for identifying endophenotypes relevant to mood disorders. Several studies have shown abnormal cortisol reactivity in phenotypically healthy adults without psychiatric disorders as a function of exposure to adverse early environments.
After a battery of self-report and interview assessments, 230 adults without major Axis I Disorders completed the Dex/CRH test. Childhood maltreatment was evaluated with the Childhood Trauma Questionnaire. Effect of childhood emotional abuse (EA) on cortisol responses to the Dex/CRH test was examined with repeated measures general linear models, including age, gender, and other types of maltreatment. Post hoc models examined the significant interaction between EA and age and tested the stability of the main findings with selected covariates.
A history of self-reported childhood EA independently and significantly diminished cortisol response. This effect was amplified with advancing subject age and was independent of the effects of other types of childhood maltreatment, lifetime diagnoses, and symptom scores.
Dampened cortisol reactivity might be a consequence of childhood EA that is cumulative over time. Prospective longitudinal investigation is needed to evaluate the potential of this proposed endophenotype.
地塞米松/促肾上腺皮质激素释放激素(Dex/CRH)试验已被提议作为一种识别与情绪障碍相关的内表型的潜在工具。多项研究表明,在没有精神疾病的表型健康成年人中,皮质醇反应异常是暴露于不良早期环境的一个函数。
在进行一系列自我报告和访谈评估后,230名无主要轴I障碍的成年人完成了Dex/CRH试验。使用儿童创伤问卷评估童年期虐待情况。采用重复测量一般线性模型,包括年龄、性别和其他类型的虐待,研究童年期情感虐待(EA)对Dex/CRH试验中皮质醇反应的影响。事后模型检验了EA与年龄之间的显著交互作用,并用选定的协变量检验了主要发现的稳定性。
自我报告的童年期EA史独立且显著地降低了皮质醇反应。随着受试者年龄的增长,这种效应会增强,并且独立于其他类型的童年期虐待、终生诊断和症状评分的影响。
皮质醇反应减弱可能是童年期EA随时间累积的结果。需要进行前瞻性纵向研究来评估这种提议的内表型的潜力。