title: Gender differences in the effect of early life trauma on hypothalamic-pituitary-adrenal axis functioning.
abstract: BACKGROUND
  The objective of this study was to examine the modifying effect of gender on the association between early life trauma and the hypothalamic-pituitary-adrenal (HPA) axis response to a pharmacologic challenge and a social stress task in men and women. Participants (16 men, 23 women) were the control sample of a larger study examining HPA axis function. Individuals with major depressive disorder, posttraumatic stress disorder, bipolar disorder, or psychotic or eating disorders were excluded.
  
  
  METHODS
  In two test sessions, subjects received 1 µg/kg of corticotropin-releasing hormone (CRH) intravenously and participated in the Trier Social Stress Test (TSST). Primary outcomes included plasma cortisol and corticotropin levels measured at baseline and more than five time points following the challenges. Predictors included gender and early life trauma, as measured by the Early Trauma Index. Using factor analysis, the domains general trauma, severe trauma, and the effects of trauma were established. Using regression, these constructs were used to predict differential HPA reactivity in men and women following the challenges.
  
  
  RESULTS
  The three factors accounted for the majority of the variance in the ETI. Following the CRH challenge, women had higher overall corticotropin response as dictated by the area under the curve analysis. There were no significant associations between trauma and neuroendocrine response to the TSST.
  
  
  CONCLUSIONS
  CRH challenge results indicate that gender differences in the impact of early trauma may help explain the differential gender susceptibility to psychopathology following adverse childhood events. This may help explain gender differences in some stress-sensitive psychiatric disorders.
authors.affiliation: Department of Medicine, Division of Biostatistics and Epidemiology, Medical University of South Carolina, 135 Cannon Street, Charleston, SC 29425, USA. desantis@musc.edu
authors.forename: Stacia M
authors.initials: SM
authors.lastname: DeSantis
authors.forename: Nathaniel L
authors.initials: NL
authors.lastname: Baker
authors.forename: Sudie E
authors.initials: SE
authors.lastname: Back
authors.forename: Eve
authors.initials: E
authors.lastname: Spratt
authors.forename: Jody D
authors.initials: JD
authors.lastname: Ciolino
authors.forename: Megan
authors.initials: M
authors.lastname: Moran-Santa Maria
authors.forename: Bandyopadhyay
authors.initials: B
authors.lastname: Dipankar
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Brady
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D001143:Arousal / Q000502:physiology*; D003346:Corticotropin-Releasing Hormone; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D012737:Sex Factors
chemical_list: D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone