A.E. Bennett Research Award. Developmental traumatology. Part I: Biological stress systems.
BACKGROUND
This investigation examined the relationship between trauma, psychiatric symptoms and urinary free cortisol (UFC) and catecholamine (epinephrine [EPI], norepinephrine [NE], dopamine [DA]) excretion in prepubertal children with posttraumatic stress disorder (PTSD) secondary to past child maltreatment experiences (n = 18), compared to non-traumatized children with overanxious disorder (OAD) (n = 10) and healthy controls (n = 24).


METHODS
Subjects underwent comprehensive psychiatric and clinical assessments and 24 hour urine collection for measurements of UFC and urinary catecholamine excretion. Biological and clinical measures were compared using analyses of variance.


RESULTS
Maltreated subjects with PTSD excreted significantly greater concentrations of urinary DA and NE over 24 hours than OAD and control subjects and greater concentrations of 24 hour UFC than control subjects. Post hoc analysis revealed that maltreated subjects with PTSD excreted significantly greater concentrations of urinary EPI than OAD subjects. Childhood PTSD was associated with greater co-morbid psychopathology including depressive and dissociative symptoms, lower global assessment of functioning, and increased incidents of lifetime suicidal ideation and attempts. Urinary catecholamine and UFC concentrations showed positive correlations with duration of the PTSD trauma and severity of PTSD symptoms.


CONCLUSIONS
These data suggest that maltreatment experiences are associated with alterations of biological stress systems in maltreated children with PTSD. An improved psychobiological understanding of trauma in childhood may eventually lead to better treatments of childhood PTSD.
De Bellis
M D
MD
Developmental Traumatology Laboratory, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA 15213, USA.
Baum
A S
AS
Birmaher
B
B
Keshavan
M S
MS
Eccard
C H
CH
Boring
A M
AM
Jenkins
F J
FJ
Ryan
N D
ND
D000293:Adolescent; D000704:Analysis of Variance; D002395:Catecholamines / Q000652:urine*; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000706:statistics & numerical data; D015897:Comorbidity; D004298:Dopamine / Q000652:urine; D004837:Epinephrine / Q000652:urine; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000652:urine*; D008297:Male; D009638:Norepinephrine / Q000652:urine; D010555:Personality Inventory / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000652:urine; D013405:Suicide / Q000523:psychology; D013406:Suicide, Attempted / Q000706:statistics & numerical data
D002395:Catecholamines; D004298:Dopamine; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine