Lee Royce J, Fanning Jennifer R, Coccaro Emil F
Clinical Neuroscience & Psychopharmacology Research Unit, Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
J Psychiatr Res. 2016 May;76:38-43. doi: 10.1016/j.jpsychires.2015.11.009. Epub 2015 Dec 23.
Childhood trauma is a risk factor for personality disorder. We have previously shown that childhood trauma is associated with increased central corticotrophin-releasing hormone concentration in adults with personality disorder. In the brain, the release of corticotrophin-releasing hormone can be stimulated by noradrenergic neuronal activity, raising the possibility that childhood trauma may affect the hypothalamic-pituitary adrenal (HPA) axis by altering brain noradrenergic function. In this study, we sought to test the hypothesis that childhood trauma is associated with blunted growth hormone response to the α-2 adrenergic autoreceptor agonist clonidine.
All subjects provided written informed consent. Twenty personality disordered and twenty healthy controls (without personality disorder or Axis I psychopathology) underwent challenge with clonidine, while plasma Growth Hormone (GH) concentration was monitored by intravenous catheter. On a different study session, subjects completed the Childhood Trauma Questionnaire and underwent diagnostic interviews.
Contrary to our a priori hypothesis, childhood trauma was associated with enhanced GH response to clonidine. This positive relationship was present in the group of 40 subjects and in the subgroup 20 personality disordered subjects, but was not detected in the healthy control subjects when analyzed separately. The presence of personality disorder was unrelated to the magnitude of GH response.
Childhood trauma is positively correlated with GH response to clonidine challenge in adults with personality disorder. Enhanced rather that blunted GH response differentiates childhood trauma from previously identified negative predictors of GH response, such as anxiety or mood disorder.
童年创伤是人格障碍的一个风险因素。我们之前已经表明,童年创伤与患有人格障碍的成年人中枢促肾上腺皮质激素释放激素浓度升高有关。在大脑中,去甲肾上腺素能神经元活动可刺激促肾上腺皮质激素释放激素的释放,这增加了童年创伤可能通过改变大脑去甲肾上腺素能功能来影响下丘脑-垂体-肾上腺(HPA)轴的可能性。在本研究中,我们试图检验童年创伤与生长激素对α-2肾上腺素能自受体激动剂可乐定反应迟钝有关这一假设。
所有受试者均提供了书面知情同意书。20名患有人格障碍的受试者和20名健康对照者(无人格障碍或轴I精神病理学问题)接受了可乐定激发试验,同时通过静脉导管监测血浆生长激素(GH)浓度。在另一次研究期间,受试者完成了童年创伤问卷并接受了诊断访谈。
与我们的先验假设相反,童年创伤与对可乐定的生长激素反应增强有关。这种正相关关系在40名受试者的组中以及20名患有人格障碍的受试者亚组中均存在,但在单独分析时,健康对照受试者中未检测到。人格障碍的存在与生长激素反应的幅度无关。
在患有人格障碍的成年人中,童年创伤与对可乐定激发试验的生长激素反应呈正相关。生长激素反应增强而非迟钝将童年创伤与先前确定的生长激素反应的负面预测因素(如焦虑或情绪障碍)区分开来。