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October 23, 2000

NIMH study links childhood abuse,
adult stress

By Lillian Kim

Women who were sexually or physically abused as children show significantly elevated hormonal responses to stress compared to women with no history of childhood abuse, according to a study by researchers at Emory’s Conte Center for the Neuroscience of Mental Disorders, funded by the National Institute of Mental Health (NIMH) and led by Charles Nemeroff.

The study’s findings, which appeared recently in the Journal of the American Medical Association, suggest that childhood abuse is associated with persistent sensitization or hyperactivity of the pituitary-adrenal and autonomic stress response, which in turn may contribute to greater vulnerability to psychiatric disorder.

The findings support the hypothesis that aberrant brain chemistry produced by adverse early-life experiences plays a major role in the later development of mood and anxiety disorders.

This hypothesis, the Stress-Diathesis Model of Mood Disorders, was put forth several years ago by Nemeroff and his colleagues. Nemeroff is chair and Reunette W. Harris Professor of Psychiatry and Behavioral Sciences in the School of Medicine and the study’s principal investigator. The study’s lead author is Christine Heim, currently of the University of Trier in Germany.

“Essentially, we’re trying to understand the biological basis behind the risk for developing psychiatric disorders in adulthood,” Nemeroff explained. In the study, 49 adult female subjects, between 18 and 45, were divided into four groups: Those who were abused as children and diagnosed with depression in adulthood; those who were abused in childhood but had not experienced depression; depressed women who did not suffer child abuse; and a control group with no history of childhood abuse or depression.

“We sought to distinguish the effects of depression versus the effects of early childhood trauma on the stress hormonal systems,” Nemeroff said.

All subjects underwent the Trier social stress test—named after the university where it was developed—which involves 10 minutes of public speaking and a tricky mental math exercise, performed before a panel of poker-faced observers who purposely do not evince any supportive expressions or gestures.

During the test, the subjects’ stress hormonal responses were measured using blood samples taken through an intravenous catheter. The catheter was inserted two hours before the stress test to avoid incurring any needle sticks during the actual test performance.

The researchers found that both groups of women who were abused as children showed exaggerated stress hormonal responses.

The effect was especially pronounced in women who were abused as children and who had current major depression, while women who were depressed but had not experienced child abuse showed hormonal responses similar to those in the control group.

Previous research has shown that adults who were abused as children may be at greater risk of developing anxiety disorders, including post-traumatic stress disorder and depression.

In an ongoing follow-up study, the researchers are evaluating the effectiveness of antidepressant medication aimed at blocking some of the measured hormonal responses.

Researchers hope to learn whether such novel drugs could not only treat but also prevent adult psychiatric disorders associated with early-life stress.

“If we find that this is the case, antidepressants potentially could have prophylactic benefit,” Dr. Nemeroff said.

Other Emory researchers involved in the study are Jeffrey Newport, Stacey Heit, Yolanda Graham, Molly Wilcox, Robert Bonsall and Andrew Miller.


Back to Emory Report Oct. 23, 2000