title: PTSD and the HPA axis: differences in response to the cold pressor task among individuals with child vs. adult trauma.
abstract: Hypothalamic pituitary adrenal (HPA) axis and subjective stress response to a cold-water immersion task, the cold pressor task (CPT), in individuals (N=89) with post-traumatic stress disorder (PTSD) were examined. All tests were conducted at 08:00h after an overnight hospital stay. Plasma adrenocorticotrophin hormone (ACTH), cortisol, and subjective stress were examined at baseline and five post-task time points in controls (n=31), subjects with PTSD as a result of an index trauma during childhood (i.e. before age 18; n=25), and subjects with PTSD as a result of an index trauma as an adult (n=33). Approximately, 50% of individuals in both trauma groups were alcohol dependent, and the impact of this comorbidity was also examined. Subjects with PTSD, regardless of age of index trauma, had a less robust ACTH response as compared to controls. Regardless of the presence or absence of comorbid alcohol dependence, subjects with childhood trauma had lower cortisol at baseline and at all post-task measurement points and did not demonstrate the decrease in cortisol over the course of the 2h monitoring period seen in subjects with adult index trauma and controls. The findings reveal differences in the neuroendocrine response to the CPT in individuals with PTSD compared to control subjects, and differences in PTSD subjects when examined by age of index trauma.
authors.affiliation: Division of Clinical Neuroscience, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President Street, P.O. Box 250861, Charleston, SC 29425, USA.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Santa Ana
authors.forename: Michael E
authors.initials: ME
authors.lastname: Saladin
authors.forename: Sudie E
authors.initials: SE
authors.lastname: Back
authors.forename: Angela E
authors.initials: AE
authors.lastname: Waldrop
authors.forename: Eve G
authors.initials: EG
authors.lastname: Spratt
authors.forename: Aimee L
authors.initials: AL
authors.lastname: McRae
authors.forename: Steven D
authors.initials: SD
authors.lastname: LaRowe
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Timmerman
authors.forename: Himanshu
authors.initials: H
authors.lastname: Upadhyaya
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Brady
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000097:blood / Q000150:complications / Q000503:physiopathology; D000704:Analysis of Variance; D002649:Child Abuse / Q000523:psychology; D002940:Circadian Rhythm / Q000502:physiology; D003080:Cold Temperature; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D012016:Reference Values; D013313:Stress Disorders, Post-Traumatic / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D013312:Stress, Physiological / Q000097:blood* / Q000523:psychology; D013697:Thermosensing
chemical_list: D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone