Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center/Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Developmental Psychology, VU University Amsterdam, Amsterdam, The Netherlands.
Psychoneuroendocrinology. 2013 Oct;38(10):2109-20. doi: 10.1016/j.psyneuen.2013.03.021. Epub 2013 May 24.
Children of parents with a substance use disorder (CPSUDs) are at increased risk for the development of substance use disorders later in life, and therefore may manifest vulnerability markers for these disorders at a higher level than children from the general population. Our aim was to examine hypothalamic-pituitary-adrenal (HPA) axis activity as a potential vulnerability marker in CPSUDs as compared to healthy controls. We further examined whether having experienced more adverse life events (ALEs) accounted for differences in cortisol levels between CPSUDs and controls.
83 CPSUDs were matched to 83 controls on the basis of age, sex and socioeconomic status. Salivary cortisol was assessed at four time points during a normal day and at six time points during a psychosocial stress procedure, during which perceived stress was also measured. We implemented piecewise multilevel growth curve modeling to examine group differences in diurnal and stress-evoked cortisol levels.
Diurnal cortisol levels of CPSUDs did not differ from those of controls. Only stress-evoked cortisol levels at onset of the experiment were explained by group status, such that CPSUDs exhibited lower cortisol levels at onset of the stress procedure. CPSUDs reported experiencing significantly more ALEs, yet number of ALEs was not related to cortisol levels. CPSUDs furthermore reported less perceived stress than controls at onset of the procedure.
HPA axis dysregulation may be a vulnerability marker for substance use disorders, as CPSUDs show blunted activation in anticipation of stress. These blunted cortisol levels were not the result of having experienced more stressful experiences during their lifetimes, thus might reflect an inborn vulnerability to substance use disorders.
父母有物质使用障碍（CPSUD）的儿童在以后的生活中发展物质使用障碍的风险增加，因此与一般人群的儿童相比，他们可能表现出更高水平的这些障碍的脆弱性标志物。我们的目的是检查下丘脑-垂体-肾上腺（HPA）轴活动作为 CPSUD 与健康对照组相比的潜在脆弱性标志物。我们进一步研究了经历更多不良生活事件（ALEs）是否会导致 CPSUD 和对照组之间皮质醇水平的差异。
根据年龄、性别和社会经济地位，将 83 名 CPSUD 与 83 名对照相匹配。在正常一天的四个时间点和心理社会应激过程的六个时间点评估唾液皮质醇，在此期间还测量了感知压力。我们实施分段多水平增长曲线模型，以检查组间日间和应激诱导皮质醇水平的差异。
CPSUD 的日间皮质醇水平与对照组没有差异。只有实验开始时的应激诱导皮质醇水平受群体状态解释，因此 CPSUD 在应激程序开始时表现出较低的皮质醇水平。CPSUD 报告经历了更多的 ALE，但 ALE 的数量与皮质醇水平无关。CPSUD 在实验开始时报告的感知压力明显低于对照组。
HPA 轴失调可能是物质使用障碍的脆弱性标志物，因为 CPSUD 在预期压力时表现出激活减弱。这些皮质醇水平的降低不是由于他们一生中经历了更多的压力体验，因此可能反映了对物质使用障碍的天生脆弱性。
