@article{ref1,
title="Assessment of the hypothalamic-pituitary-adrenal axis over a 24-hour diurnal period and in response to neuroendocrine challenges in women with and without childhood sexual abuse and posttraumatic stress disorder",
journal="Biological psychiatry",
year="2003",
author="Bremner, J. Douglas and Vythilingam, Meena and Anderson, George and Vermetten, Eric and McGlashan, Thomas and Heninger, George and Rasmusson, Ann and Southwick, Steven M. and Charney, Dennis S.",
volume="54",
number="7",
pages="710-718",
abstract="BACKGROUND: Preclinical studies showed that early stress results in long-term alterations in the hypothalamic-pituitary-adrenal (HPA) axis. We performed a comprehensive assessment of the HPA axis in women with and without a history of early childhood sexual abuse and posttraumatic stress disorder (PTSD). METHODS: Fifty-two women with and without a history of early childhood sexual abuse and PTSD underwent a comprehensive assessment of the HPA axis, including measurement of cortisol in plasma every 15 min over a 24-hour period and cortisol and corticotropin (ACTH) following corticotropin-releasing factor (CRF) and ACTH challenge. RESULTS: Abused women with PTSD had lower levels of cortisol during the afternoon hours (12:00-8:00 PM) of a 24-hour period compared with non-PTSD women. Their ACTH response to a CRF challenge was blunted compared with nonabused non-PTSD (but not abused non-PTSD) women. There were no differences in cortisol response to CRF and ACTH challenges between the groups. Increased PTSD symptom levels were associated with low afternoon cortisol levels. CONCLUSIONS: These findings suggest that early abuse is associated with increased CRF drive as evidenced by decreased pituitary sensitivity to CRF, whereas in abuse with PTSD there is a specific hypocortisolemia that is most pronounced in the afternoon hours.<p /><p>Language: en</p>",
language="en",
issn="0006-3223",
doi="",
url="http://dx.doi.org/"
}