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. 2011 May;28(5):383-92.
doi: 10.1002/da.20795. Epub 2011 Feb 16.

Gender Differences in the Effect of Early Life Trauma on Hypothalamic-Pituitary-Adrenal Axis Functioning

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Free PMC article

Gender Differences in the Effect of Early Life Trauma on Hypothalamic-Pituitary-Adrenal Axis Functioning

Stacia M DeSantis et al. Depress Anxiety. .
Free PMC article

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.

Conflict of interest statement

The authors report they have no financial relationships within the past 3 years to disclose.

Figures

Figure 1
Figure 1
Relationship between baseline corticotropin and factor scores stratified by gender. Adjusting for potential confounders, significant interactions between gender, and the severe trauma factor (F = 7.46; P = .011), gender and the general trauma factor (F = 5.36; P = .028), and gender and the trauma effects factor (F = 8.96; P = .006) indicated that gender modifies the effect of trauma on baseline corticotropin. Specifically, reported trauma effects and the severity of trauma were both highly positively associated with baseline corticotropin in women but negatively associated with baseline corticotropin in men.
Figure 2
Figure 2
Corticotropin and cortisol response to CRH stimulation. Data are shown as mean ± standard error of the mean (SEM) of the base 10 logarithm transformed data. High and low trauma groups were determined using the median split of the total number of ETI occurring in the sample data. The median (range, IQR) number of total ETI occurring in the sample is 11 (range: 2–48, IQR: 5–18). Of the 39 total subjects, 20 are considered to have a high number of total ETI (median: 18, range: 11–48, IQR: 14–24) and 19 are considered to have a low number of total ETI (median: 5, range: 2–9, IQR: 4–7).
Figure 3
Figure 3
Corticotropin and cortisol response to the Trier Social Stress Task. Data are shown as mean ± standard error of the mean (SEM) of the base 10 logarithm transformed data. High and low trauma groups were determined using the median split of the total number of ETI occurring in the sample data. The median (range, IQR) number of total ETI occurring in the sample is 11 (range: 2–48, IQR: 5–18). Of the 39 total subjects, 20 are considered to have a high number of total ETI (median: 18, range: 11–48, IQR: 14–24) and 19 are considered to have a low number of total ETI (median: 5, range: 2–9, IQR: 4–7).

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