Serotonergic functioning in depressed abused children: clinical and familial correlates

BACKGROUND: The goal of this study was to examine serotonergic functioning and concomitant clinical and familial correlates in depressed abused children. METHODS: L-5-Hydroxytryptophan (L-5-HTP) (0.8 mg/kg) was administered intravenously to 10 depressed abused (MDD-AB), 10 depressed nonabused (MDD-NA), and 10 normal control nonabused (NC-NA) children. The children in the two nonabused cohorts represent a small matched subset of children from a larger interlocking study of the psychobiology of depression. Blood samples for prolactin and cortisol were collected from 30 min before to 2.5 hours after L-5-HTP infusion. RESULTS: The MDD-AB children secreted significantly more prolactin post-L-5-HTP than the children in the other two groups. There were no differences in baseline prolactin or any of the cortisol measures. Total prolactin post-L-5-HTP was significantly correlated with clinical ratings of aggressive behavior (rho = .48). In addition, children with a family history positive for suicide attempt (MDD-AB: n = 7; MDD-NA: n = 5; NC-NA: n = 2) secreted significantly more prolactin post-L-5-HTP than children with no family history of suicide. CONCLUSIONS: Dysregulation in the serotonergic system in abused children appears to be related to both familial and experiential factors.     

Behavioral comparisons of children from abusive and distressed families.

Investigated the problem behaviors of 35 physically abused 6–16 yr olds in comparison with 36 nonabused children from a child welfare agency and 35 nonabused children in the community. Parental report of behavioral strengths and weaknesses was examined by administering the Child Behavior Profile. Results concur with those of previous reports that abused children display a significantly greater number of behavior problems and fewer social competencies than normals. The behavior patterns of abused Ss closely resembled the range of behavior problems shown by Ss from distressed families in which abuse was not present. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexually and physically abused foster care children and posttraumatic stress disorder.

Considerable debate exists regarding the possible relationship between child abuse and posttraumatic stress disorder (PTSD). In this study, 3 groups of foster care children were compared. The groups included 50 sexually abused, 50 physically abused, and 50 nonabused foster care children. Participants completed the Child Post-Traumatic Stress Reaction Index, the Childhood PTSD Interview, and the Modified Stroop Procedure (MSP), which included sexual abuse and nonsexual abuse stimuli. The MSP has not been previously used in child abuse research. Results indicated that sexually and physically abused children demonstrated PTSD at a high level. The MSP discriminated between the sexually abused children with PTSD and those without PTSD. Responses to the MSP sexual abuse stimuli resulted in significantly longer color-naming times than responses to nonsexual abuse stimuli. Preadolescents demonstrated more severe PTSD than early adolescent children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological testing in evaluation of child sexual abuse

In order to assess the utility of psychological testing in evaluating allegations of child sexual abuse, the empirical literature is reviewed in an attempt to answer two questions. First, are there systematic and significant differences on psychological tests between sexually abused and nonabused children? Second, are these differences on psychological testing a direct result of sexual abuse, or are they a result of other coexisting factors that might cause psychological distress? Cognitive measures, personality inventories, symptomatology checklists, and projective tests with sexually abused children are reviewed. While a variety of standardized instruments have been administered to sexually abused children, relatively few have been utilized in empirical studies. Findings have been mixed, with stronger differences between sexually abused and nonabused children generally found on measures completed by parents than on measures administered directly to children. Sexually abused children often fall between nonabused and psychiatric groups. Use of measures specific to sexual abuse is advocated. While psychological tests may currently have limited use in validating suspected sexual abuse, they may be extremely useful in the clinical treatment of the child.     

Interpersonal processes in friendship: A comparison of abused and nonabused children's experiences.

Although parental maltreatment has been presumed to have deleterious effects on children's abilities to form close relationships, observations of abused children with their best friends have rarely been conducted. Sixteen 9- to 14-year-old physically abused children and 32 matched nonabused children were observed during a 1.5-hr sequence of unstructured and structured tasks. Coding focused primarily on intimacy, conflict, and affective expression. Abused children and their friends displayed less overall intimacy than nonabused children and their friends, although peak levels of intimacy were similar for the 2 groups. Dyads containing an abused child were more conflictual than dyads without abused children, especially during game-playing activities. Abused boys and their friends also displayed more negative affect during game playing than did dyads of nonabused friends. Abused girls and their friends displayed less positive affect than other friendship dyads during activities involving primarily conversation and discussion. Several effects of gender and context not specific to abuse were also obtained. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive symptoms among physically abused and psychiatrically disturbed children.

Examined the relation of physical abuse and depressive symptoms among 79 6–13 yr old child psychiatric inpatients. Childhood depression, hopelessness, and self-esteem were assessed through questionnaire or interview measures administered to the children. 79 25–52 yr old mothers or maternal guardians also completed measures to evaluate their children's dysfunction. As predicted, the 33 physically abused children, compared with the 46 nonphysically abused patient controls, evinced significantly lower self-esteem and greater depression and negative expectations toward their futures. Among abused children, those with both past and current abuse showed more severe symptoms of depression that did those with either past or current abuse only. The differences in depressive symptoms between abused and nonabused children could not be accounted for by differences in child psychiatric diagnosis, age, race, gender, IQ, or severity of psychopathology or parent psychiatric diagnoses, marital, or SES. Results suggest that physical abuse, at least for a psychiatric patient sample, is related to symptoms of depression. The possible basis for this relation and the treatment implications are discussed. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

False allegations and false denials in child sexual abuse.

The amicus brief in the Kelly Michaels case ignores the risks that abused children will fail to reveal abuse unless direct and sometimes leading questions are asked. Although the brief correctly criticizes previous research for understating the risks that aggressive interviewing practices will lead young children to make false allegations of abuse, it overstates the likelihood that false allegations occur by overlooking the aspects of the Kelly Michaels case and the research it inspired that are unlike the typical abuse case. The author discusses factors that lead abused children to falsely deny abuse and that minimize the likelihood that nonabused children will allege abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Presenting problems of sexually abused girls receiving psychiatric services.

Twenty-three behaviors among those suggested in the literature to be associated with sexual abuse were studied in 195 girls, ages 2–18 years, who were consecutive admissions to three Midwestern mental health agencies. Results indicated that sexually inappropriate behaviors, sleep disturbance, depressed mood, and delinquent behavior occurred more frequently in young abuse victims than in clinic comparisons. Sexually inappropriate behaviors and running away appeared more often in older sexually abused girls, than they appeared in older clinic comparisons. These comparisons of the presenting problems of sexually abused and nonabused girls suggest there are few behavioral "markers' of sexual abuse in clinical samples and that sexual abuse may not be a unique contributing factor in the ontogeny of childhood psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Characteristics of women physically abused by their spouses and who seek treatment regarding marital conflict.

Abused women (23 physically vs 25 marital discordant nonabused) reported significantly more fear of their spouses and reported that their spouses were significantly more coercive and psychologically aggressive than women in the 2 matched nonabused groups. Abused women did not report higher rates of abuse as a child, nor did they report higher rates of past psychopathology than women in the nonabused groups. However, abused women and nonabused discordant women reported higher rates of emotional abuse in childhood than maritally satisfied nonabused women. Result suggests that childhood abuse and a history of depression may be risk factors for women in abusive and nonabusive discordant relationships. Abused women reported higher rates of posttraumatic stress disorder than women in the discordant-only and community control groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recognition and posing of emotional expressions by abused children and their mothers.

Twenty abused and 20 nonabused pairs of children (3 to 7 years of age) and their mothers participated in a facial expression posing task and a facial expression recognition task. The expressions produced by subjects were judged on emotion content by naive raters and were coded using Friesen and Ekman's (1984) Emotion Facial Action Coding System (EMFACS). Data analysis indicated that abused children and their mothers pose less recognizable expressions than nonabused children and mothers. Although abused children were less accurate than nonabused children in recognizing emotional expressions, there was no difference in recognition accuracy between the two groups of mothers. A significant correlation between mothers' posing scores and children's recognition scores was also obtained. These results suggest that abused children may not observe easily interpreted voluntary displays of emotion by their mothers as often as nonabused children. This may partially explain the difference in recognition (and production) abilities of abused and nonabused children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood victimization and drug abuse: A comparison of prospective and retrospective findings.

This study examined whether childhood victimization increases risk for drug abuse using prospective and retrospective victimization information. Substantiated cases of child abuse/neglect from 1967 to 1971 were matched on gender, age, race, and approximate social class with nonabused/nonneglected children and followed prospectively into young adulthood. Between 1989 and 1995, 1,196 participants (676 abused/neglected and 520 control) were administered a 2-hr interview, including measures of self-reported childhood victimization and drug use/abuse (the National Institute of Mental Health Diagnostic Interview Schedule—Version III—Revised). Prospectively, abused/neglected individuals were not at increased risk for drug abuse. In contrast, retrospective self-reports of childhood victimization were associated with robust and significant increases in risk for drug abuse. The relationship between childhood victimization and subsequent drug problems is more complex than originally anticipated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tuft-to-capsule adhesions and their precursors: differences between the vascular and tubular poles of the human glomerulus

The hypothalamo-pituitary-adrenal (HPA) axis is modulated by sex hormones. Few data exist on the relation between acute estrogen deficit and HPA axis response to corticotropin-releasing hormone (CRH). The effects of a sudden drop in estradiol levels on basal and CRH-stimulated levels of ACTH, cortisol, testosterone, androstenedione and 17-hydroxyprogesterone (17-OHP) were assessed in nine premenopausal women (44-48 years of age), before and after ovariectomy. The CRH test was performed before and 8 days after ovariectomy. A significant reduction in ACTH and adrenal steroids but not in cortisol response to CRH was observed after ovariectomy. The ratio of deltamax androstenedione/17-OHP after CRH stimulation was substantially the same before and after ovariectomy, whereas deltamax 17-OHP/cortisol was significantly lower in ovariectomized women showing increased 21- and 11beta-hydroxylase activity. The results show that the acute estrogen deficit induces changes in the HPA axis characterized by reduced stimulated secretion of ACTH and steroids but normal stimulated cortisol production.     

Effects of acute inhalation exposure to isoamyl nitrite on the hypothalamo-pituitary-adrenal axis in male Sprague-Dawley rats

Isoamyl nitrite (IAN) is a member of the family of volatile organic nitrites that exert vasodilatory effects and have recently exhibited a considerable potential for inhalation abuse. In an effort to provide mechanistic insight into the neurotoxic effects and abuse potential of these agents, the present study was designed to evaluate the acute effects of IAN on the hypothalamo-pituitary-adrenal (HPA) axis. Attempts were also made to correlate the neuroendocrine effects of IAN with its pharmacokinetic profile. Male Sprague-Dawley rats were exposed to 600 or 1200 ppm IAN by inhalation for 10 or 30 min. Following exposure, adrenocorticotropic hormone (ACTH) and corticosterone in plasma and corticotropin-releasing factor (CRF) in three brain regions (hypothalamus, hippocampus, and frontal cortex) were determined by radioimmunoassay. Levels of IAN in the three brain regions as well as in blood were measured by gas chromatography to determine the target tissue concentrations responsible for neuroendocrine changes. Uptake of IAN into blood and all brain regions was very rapid, as stable concentrations were achieved within 10 min of exposure and maintained for 30 min of continuous inhalation. Plasma corticosterone decreased significantly after 10 min inhalation of both IAN doses, and returned to control levels after 30 min. Moreover, plasma ACTH was significantly increased by 10 and 30 min of exposure to 600 and 1200 ppm IAN, while hypothalamic CRF increased significantly after 30 min of exposure to the 600 ppm dose. These latter findings suggest activation of the hypothalamus and pituitary due to a reduction in negative feedback resulting from the initial decrease in corticosterone. Although plasma ACTH was greatly increased after 30 min, plasma corticosterone levels were unchanged, indicating that IAN primarily acts to inhibit the synthesis or secretion of adrenal steroids and that activation of the HPA axis is not involved in the behavioral manifestations of IAN inhalation. These compensatory effects of HPA axis regulation, and possibly the vasodilatory properties of IAN, also likely precluded the establishment of definitive relationships between observed changes in hormone levels and blood or regional brain concentrations of the inhalant.     

Is there a relationship between child abuse and learning disability?

Reviews 7 studies on the possible relationship between child abuse and learning disability. It is concluded that despite case reports linking child abuse with learning disability in some cases, there is no evidence either that abused children are more likely than nonabused children to have a learning disability or that learning disabled children are more likely than children without learning disabilities to be abused. The studies that have been done included diverse definitions, a variety of small and unrepresented samples, an absence group, and a lack of information about the children's pre-abuse characteristics. It is suggested that case studies may be the most useful method. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of sexual abuse on children: A review and synthesis of recent empirical studies.

A review of 45 studies clearly demonstrates that sexually abused children have more symptoms than nonabused children, with abuse accounting for 15–45% of the variance. Fears, posttraumatic stress disorder (PTSD), behavior problems, sexualized behaviors, and poor self-esteem occurred most frequently among a long list of symptoms noted, but no one symptom characterized a majority of sexually abused children. Some symptoms were specific to certain ages, and approximately one-third of victims had no symptoms. Penetration, the duration and frequency of the abuse, force, the relationship of the perpetrator to the child, and maternal support affected the degree of symptomatology. About two-thirds of the victimized children showed recovery during the 1st 12–28 mo. The findings suggest the absence of any specific syndrome in children who have been sexually abused and no single traumatizing process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child sexual and physical abuse and alcoholism: a review

OBJECTIVE: To examine possible relations between child sexual or physical abuse and adult alcoholism. METHOD: Studies reviewed included prospective studies, retrospective studies on the prevalence of child sexual or physical abuse in alcoholics and nonalcoholics, and retrospective studies in mental health clients and in population samples comparing the prevalence of alcohol use disorders in abused and nonabused subjects. RESULTS: Prospective studies do not indicate a significant association between child sexual or physical abuse and alcoholism. In contrast, studies among alcoholic women do suggest a relationship. Also, a significantly higher prevalence of alcohol problems in abused women than in nonabused women is found in population samples. The results of studies among mental health clients are inconclusive. In addition, several methodological limitations should be taken into consideration when evaluating results of the available studies. CONCLUSIONS: Current evidence is insufficient to draw conclusions about relationships between child sexual or physical abuse and alcoholism among men. Among females, however, there is a higher likelihood of alcohol problems if they were sexually or physically abused as children.     

Lesion load quantification in serial MR of early relapsing multiple sclerosis patients in azathioprine treatment. A retrospective study

Interactions between the hypothalamic-pituitary-adrenocortical (HPA) system and melatonin secretion have been demonstrated, but only the effects of melatonin on the activity of the HPA system have been studied in man. Alterations of melatonin secretion described as low-melatonin syndrome have been demonstrated in patients suffering from a major depressive episode, and an inhibitory factor on melatonin secretion has been postulated. We investigated whether corticotropin-releasing hormone (CRH), which is thought to be involved in HPA abnormalities in depressed patients, can also suppress melatonin secretion in healthy volunteers. Ten healthy male human volunteers in a double-blind study design received randomized hourly intravenous injections from 08.00 to 18.00 h that contained 10 micrograms human CRH, 1 microgram adrenocorticotropic hormone (ACTH), or placebo to simulate pulsatile hormone secretion. Plasma melatonin and cortisol responses during the treatment and nocturnal sleep electroencephalograms after the treatment were recorded. Administration of CRH reduced melatonin secretion significantly below values obtained after administration of placebo and ACTH. Cortisol secretion was significantly enhanced by ACTH in comparison to both placebo and CRH. Electroencephalographic sleep parameters revealed no treatment effects. Our findings suggest that CRH has an inhibitory effect on the pineal secretion of melatonin in normal man. A mechanism via a release of cortisol was not supported by our results. Secondary hormonal effects from changes in nocturnal sleep architecture were excluded. Further investigation of the action of CRH on melatonin secretion as well as the mutual feedback between the HPA system and the pineal gland may extend our knowledge of neuroendocrine alterations mediating the adaptive response to stress and the eventual involvement in the pathogenesis of depression.     

Responses of abused and disadvantaged toddlers to distress in agemates: A study in the day care setting.

Examined responses to distress in agemates in observations of 10 abused toddlers (aged 1–3 yrs) and 10 unabused matched controls (aged 1–3 yrs) from families experiencing stress. Both groups of Ss were from disadvantaged families. Ss were observed in daycare settings. Nonabused, disadvantaged Ss responded to the distress of agemates with simple interest or with concern, empathy, or sadness. Their patterns of response were consistent with findings from other studies of middle-class, nonabused children. Not one abused S showed concern in response to the distress of an agemate. Instead, the abused Ss often reacted to an agemate's distress with disturbing behavior patterns not seen in the control Ss, such as with physical attacks, fear, or anger. Three of the abused Ss alternately attacked and attempted to comfort peers found in distress. Similar aversive and angry responses to distress in others have been described by investigators working with abusing parents. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hypoxia effects on hypothalamic corticotropin-releasing hormone and anterior pituitary cAMP

AIM: To study the effects of acute and chronic hypoxia on hypothalamus-anterior pituitary-adrenocortex axis. METHODS: Rats and pikas were exposed to different altitude and periods. Animals were injected with CRH, Arg and NE in the third ventricle of the brain of rats. RESULTS: Anterior pituitary cAMP and plasma corticosterone levels of rats obviously increased during 1 h of hypoxia. cAMP was increased from 2.23 +/- 0.13 of control group to 7.7 +/- 0.7 of 5 km and 13.4 +/- 1.9 nmol/g wet tissue of 8 km, respectively. i.c.v. CRH, Arg and NE all activated HPA axis. The effects of CRH were most potent. CRH 2 microL 0.75 nmol i.c.v increased anterior pituitary of cAMP from 3.5 +/- 0.4 of control to 22.4 +/- 2.2 nmol/kg wet tissue. Stimulating altitude of 5000 m resulted in a 16.9% decrease in corticosterone level (P < 0.05), 8000 m resulted in a 47.5% decrease (P < 0.01) after hypoxia for 25 d. Hypoxia did not activate HPA axis in pikas. CONCLUTION: 1) Hypoxia stress activates the secretion of corticotrophin (ACTH) via cAMP; 2) Adrenocotical function of rats decays during chronic hypoxia; 3) Arg and NE regulate the secretion of plasma corticosterone and synthesis of pituitary cAMP at the hypothalamus level; 4) Hypoxia tolerance of the pika was high.     

Endocrine profile and neuroendocrine challenge tests in transgenic mice expressing antisense RNA against the glucocorticoid receptor

A transgene expressing antisense RNA complementary to a fragment of the glucocorticoid receptor cDNA was incorporated into the mouse genome and resulted in a transgenic animal that has decreased glucocorticoid receptor function. The transgenic mice showed basal plasma ACTH and corticosterone levels similar to those of the normal control animals. We have further investigated changes in HPA axis regulation by use of different neuroendocrine challenge tests including a dexamethasone suppression test (DST). In comparison to normal mice, a tenfold higher dose of dexamethasone (i.e. 20 micrograms/100 g body weight) was required to suppress the basal corticosterone levels of transgenic mice. Dexamethasone (2 micrograms/100 g body weight) produced a long-lasting suppression of plasma ACTH and corticosterone levels in control mice, whereas in transgenic animals only a short-lasting decrease in ACTH levels was apparent. Corticotropin-releasing hormone (CRH) administration resulted in an enhanced response in plasma ACTH levels in transgenic mice, whereas the corticosterone response was markedly reduced. The discrepancy between ACTH and corresponding corticosterone secretions in transgenic mice could be attributed, in part, to a reduced sensitivity of the adrenal gland to stimulation by ACTH. Pituitaries of transgenic mice contained about 50% less proopiomelanocortin (POMC) mRNA than those of control animals. No significant differences were noted in the ACTH or protein contents of normal and transgenic mice pituitary glands although a slight increase in protein content of the transgenic mouse adrenal gland was apparent. In conclusion, transgenic mice with impaired GR function show major disturbances in HPA axis regulation which seem to be caused by the primary defect in conjunction with secondary modifications in, amongst others, pituitary CRH receptor system(s), sympathetic output and adrenal development. This mouse is therefore a useful model to study the consequences of life-long defective GR function and HPA axis regulation in general.