Early trauma and stress are seen to alter physiology of the affected individuals making them more vulnerable to stress, anxiety, depression and other psychological disorders in adulthood.
Data from several studies suggests that early stress results in long-term alterations in the hypothalamic-pituitary-adrenal (HPA) axis. Early abuse is associated with increased CRF drive as evidenced by decreased pituitary sensitivity to CRF (corticotropin releasing factor).
Data from several studies suggest that children may have an impaired HPA axis after early trauma. Early stressors produce long-term dysregulation of the HPA axis and that results in a differential response to stressors in adulthood.
Childhood sexual abuse is associated with an increased incidence of age-concurrent and adult psychopathology. Sexually abused girls had a greater incidence of suicidal ideation, suicidal attempts, and dysthymia than control girls.
Women with childhood sexual abuse had significantly enhanced suppression of plasma cortisol in response to 0.5 mg dexamethasone compared to the nonvictimized women. These observations are consistent with findings in male veterans with combat related PTSD. They suggest that this pattern of HPA axis dysfunction may be a characteristic sequel of psychiatric disorders that occur following a range of traumatic experiences.
These findings suggest that a lack of protective properties of cortisol may be of relevance for the development of bodily disorders in chronically stressed or traumatized individuals.
Early adverse life events may predispose individuals to the development of mood and anxiety disorders in adulthood, perhaps by inducing persistent changes in CRF neuronal systems. These findings suggest that sensitization of the anterior pituitary and counterregulative adaptation of the adrenal cortex in abused women without major depressive disorder. On subsequent stress exposure, women with a history of childhood abuse may hypersecrete CRF, resulting in down-regulation of adenohypophyseal CRF receptors and symptoms of depression and anxiety.
Women with a history of childhood abuse exhibited increased pituitary-adrenal and autonomic responses to stress compared with controls. This effect was particularly robust in women with current symptoms of depression and anxiety. Women with a history of childhood abuse and a current major depression diagnosis exhibited a more than 6-fold greater ACTH response to stress than age-matched controls. These findings suggest that HPA axis and autonomic nervous system hyperactivity, presumably due to CRF hypersecretion, is a persistent consequence of childhood abuse that may contribute to the diathesis for adulthood psychopathological conditions. Furthermore, these results imply a role for CRF receptor antagonists in the prevention and treatment of psychopathological conditions related to early-life stress. JAMA, 2000;284:592-597