Department of Medicine, Division of Biostatistics and Epidemiology, Medical University of South Carolina, 135 Cannon Street, Charleston, SC 29425, USA.
Depress Anxiety. 2011 May;28(5):383-92. doi: 10.1002/da.20795. Epub 2011 Feb 16.
The objective of this study was to examine the modifying effect of gender on the association between early life trauma and the hypothalamic-pituitary-adrenal (HPA) axis response to a pharmacologic challenge and a social stress task in men and women. Participants (16 men, 23 women) were the control sample of a larger study examining HPA axis function. Individuals with major depressive disorder, posttraumatic stress disorder, bipolar disorder, or psychotic or eating disorders were excluded.
In two test sessions, subjects received 1 µg/kg of corticotropin-releasing hormone (CRH) intravenously and participated in the Trier Social Stress Test (TSST). Primary outcomes included plasma cortisol and corticotropin levels measured at baseline and more than five time points following the challenges. Predictors included gender and early life trauma, as measured by the Early Trauma Index. Using factor analysis, the domains general trauma, severe trauma, and the effects of trauma were established. Using regression, these constructs were used to predict differential HPA reactivity in men and women following the challenges.
The three factors accounted for the majority of the variance in the ETI. Following the CRH challenge, women had higher overall corticotropin response as dictated by the area under the curve analysis. There were no significant associations between trauma and neuroendocrine response to the TSST.
CRH challenge results indicate that gender differences in the impact of early trauma may help explain the differential gender susceptibility to psychopathology following adverse childhood events. This may help explain gender differences in some stress-sensitive psychiatric disorders.
本研究旨在探讨性别对早期生活创伤与下丘脑-垂体-肾上腺（HPA）轴对药物挑战和社会应激任务反应之间关联的调节作用，分别在男性和女性中进行研究。参与者（16 名男性，23 名女性）是一项更大规模研究 HPA 轴功能的对照组样本。排除了患有重性抑郁障碍、创伤后应激障碍、双相情感障碍或精神病性或饮食障碍的个体。
在两次测试中，受试者接受了 1µg/kg 的促肾上腺皮质激素释放激素（CRH）静脉内给药，并参加了 Trier 社会应激测试（TSST）。主要结果包括在基线和挑战后五个以上时间点测量的血浆皮质醇和促皮质素水平。预测因子包括性别和早期生活创伤，由早期创伤指数（ETI）测量。使用因子分析，确定了一般创伤、严重创伤和创伤影响三个领域。使用回归分析，这些结构被用于预测男性和女性在挑战后的 HPA 反应差异。
三个因素解释了 ETI 的大部分方差。在 CRH 挑战后，女性的整体促皮质素反应更高，这是由曲线下面积分析决定的。创伤与 TSST 对神经内分泌反应之间没有显著关联。
CRH 挑战的结果表明，早期创伤影响的性别差异可能有助于解释儿童期不良事件后精神病理学的不同性别易感性。这可能有助于解释一些应激敏感精神障碍的性别差异。
