Hostname: page-component-745bb68f8f-lrblm Total loading time: 0 Render date: 2025-01-23T18:29:51.672Z Has data issue: false hasContentIssue false
  • English
  • Français

Recent Developments in the Neuroendocrinology of Posttraumatic Stress Disorder

Published online by Cambridge University Press:  07 November 2014

Rachel Yehuda
Get access Rights & Permissions [Opens in a new window]

Extract

In 1980, the diagnosis of posttraumatic stress disorder (PTSD) was established to recognize that exposure to events such as rape, physical assault, torture, or combat can leave long-lasting psychological scars in persons who undergo these experiences. The intention of the diagnosis was to acknowledge that exposure to a traumatic event was a sufficient explanation for the occurrence of longterm psychological problems. Prior to this formulation, stressful events were thought to precipitate symptoms that would resolve over time. The symptoms manifested by persons following adverse events were characterized as transient adjustment reactions. Longerterm symptoms were considered to be a reflection of underlying neurosis, rather than stress exposure per se.

The diagnosis of PTSD provided a paradigm for acknowledging that exposure to devastating trauma can produce symptoms that can be quite severe and chronic in nature. Although many of the symptoms of PTSD were similar to those that occur in other anxiety or mood disorders, the hallmark of PTSD appeared to be a preoccupation with the traumatic event and a resultant set of behavioral changes that occurred because of attempts to avoid reminders of the event.

Type
Supplement Monograph
Information
CNS Spectrums , Volume 3 , Issue S2: Posttraumatic Stress Disorder: The Hidden Epidemic of Modern Times , August 1998 , pp. 22 - 29
Copyright
Copyright © Cambridge University Press 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Rivier, CL, Plotsky, CM. Mediation by corticotropin releasing factor (CRF) of adenohyopophysis hormone secretion. Ann Rev Physiol. 1986;48:475–494.CrossRefGoogle ScholarPubMed
2.Cannon, WB. Emergency function of adrenal medulla in pain and major emotions. Am J Physiology. 1914;3:356–372.CrossRefGoogle Scholar
3.Mountcastle, ZB. Medical Physiology. 13th ed. St. Louis, MO: Moseby Publishing; 1973.Google Scholar
4.Munck, A, Guyre, PM, Holbrook, NJ. Physiological functions of glucocorticoids in stress and their relation to pharmacological actions. Endocrine Rev. 1984;93:9779–9783.Google Scholar
5.Nemeroff, CB, Widerlov, E, Bissette, G, et al.Elevated concentrations of CSF corticotropin releasing factorlike immunoreactivity in depressed patients. Science. 1984;226:1342–1344.CrossRefGoogle ScholarPubMed
6.Bremner, JD, Licinio, J, Darnell, A, et al.Elevated CSF corticotropin-releasing factor concentrations in posttraumatic stress disorder. Am J Psychiatry. 1997;154:624–629.Google ScholarPubMed
7.Kathol, RG, Jaeckle, RS, Lopez, WF. Pathophysiology of HPA axis abnormalities in patients with major depression: an update. Am J Psychiatry. 1989;1246:311–317.Google Scholar
8.Mason, JW, Giller, EL, Kosten, TR, et al.Urinary-free cortisol levels in posttraumatic stress disorder patients. J Nerv Ment Dis. 1986;174:145–159.CrossRefGoogle ScholarPubMed
9.Sacher, EJ, Hellman, L, Roffwarg, HP. Disrupted 24-hour patterns of cortisol secretion in psychotic depression. Arch Gen Psychiatry. 1973;28:19–24.CrossRefGoogle Scholar
10.Whalley, LJ, Borthwick, N, Copolov, D. Glucocorticoid receptors and depression. Br Med J. 1986;292:859–861.CrossRefGoogle ScholarPubMed
11.Gormley, GJ, Lowy, MT, Reder, AT, et al.Glucocorticoid receptors in depression: relationship to the dexamethasone suppression test. Am J Psychiatry. 1985;142:1278–1284.Google Scholar
12.Lowy, MT, Gormley, GJ, Reder, AT. Immune function, glucocorticoid receptor regulation and depression. In: Miller, AH, ed. Depressive Disorders and Immunity. Washington, DC: American Psychiatric Association Press; 1989:105–134.Google Scholar
13.American Psychiatric Association Task Force on Laboratory Tests in Psychiatry. The dexamethasone suppression test: an overview of its current status in psychiatry. Am J Psychiatry. 1987;144:1253–1562.CrossRefGoogle Scholar
14.Carroll, BJ. The dexamethasone suppression test for melancholia. Br J Psychiatry. 1982;140:292–304.CrossRefGoogle ScholarPubMed
15.Stokes, PE, Pick, GR, Stoll, PM, Nunn, WD. Pituitary-adrenal functioning in depressed patients: resistance to dexamethasone suppression. J Psychiatr Res. 1975;12:271–281.CrossRefGoogle Scholar
16.Stokes, PE, Sikes, CR. Hypothalamic-pituitary-adrenal axis in affective disorders. In: Meltzer, HY, ed. Psychopharmacology: The Third Generation of Progress. New York: Raven Press; 1987:589–607.Google Scholar
17.Holsboer, F, von Bardeleben, U, Gerken, A, et al.Blunted corticotropin and normal cortisol responses to human corticotropin-releasing factor in depression. N Engl J Med. 1984;311:1127.Google ScholarPubMed
18.Yehuda, R, Southwick, SM, Nussbaum, G, et al.Low urinary cortisol excretion in patients with PTSD. J Nerv Ment Dis. 1990;178:366–309.CrossRefGoogle Scholar
19.Yehuda, R, Boisoneau, D, Mason, JW, Giller, EL. Relationship between lymphocyte glucocorticoid receptor number and urinary-free cortisol excretion in mood, anxiety, and psychotic disorder. Biol Psychiatry. 1993;34:18–25.CrossRefGoogle Scholar
20.Yehuda, R, Kahana, B, Binder-Brynes, K, et al.Low urinary cortisol excretion in Holocaust survivors with PTSD. Am J Psychiatry. 1995;152:7–12.Google Scholar
21.Yehuda, R, Southwick, SM, Krystal, JM, Charney, DS, Mason, JW. Enhanced suppression of cortisol following dexamethasone administration in combat veterans with posttraumatic stress disorder and major depressive disorder. Am J Psychiatry. 1993;150:83–86.Google Scholar
22.Yehuda, R, Boisoneau, D, Lowy, MT, Giller, EL. Doseresponse changes in plasma cortisol and lymphocyte glucocorticoid receptors following dexamethasone administration in combat veterans with and without posttraumatic stress disorder. Arch Gen Psychiatry. 1995;52:583–593.CrossRefGoogle ScholarPubMed
23.Arato, M, Banki, CM, Bissette, G, Nemeroff, CB. Elevated CSF CRF in suicide victims. Biol Psychiatry. 1989;25:355–359.CrossRefGoogle ScholarPubMed
24.Banki, CM, Bissette, G, Arato, M, O'Connor, L, Nemeroff, CB. CSF corticotropin-releasing factor-like immunore-activity in depression and schizophrenia. Am J Psychiatry. 1987;144:873–877.Google Scholar
25.Krishnan, RR, Ritchie, JC, Reed, D, et al.CRF stimulation test results before and after dexamethasone in depressed patients and normal controls. J Neuropsychiatry Clin Neurosci. 1991.Google Scholar
26.DeBellis, M, Chrousos, GP, Dorn, LD, et al.Hypothalamic-pituitary-adrenal axis dysregulation in sexually abused girls. J Clin Endo Metabol. 1994;78:249–255.Google Scholar
27.Heim, C, Owens, MJ, Plotsky, PM, Nemeroff, CB. The role of early adverse life events in the etiology of depression and posttraumatic stress disorder: focus on corticotropin-releasing factor. In: Yehuda, R, McFarlane, AC, eds. Psychobiology of Posttraumatic Stress Disorder. New York: New York Academy of Sciences; 1997:194–207.Google Scholar
28.Smith, MA, Davidson, J, Ritchie, JC, et al.The corticotropin releasing hormone test in patients with PTSD. Biol Psychiatry. 1989;26:349–355.CrossRefGoogle Scholar
29.Lisansky, J, Peake, G, Strassman, RJ, et al.Augmented pituitary corticotropin response to a threshold dosage of human corticotropin-releasing hormone in depressive pretreated with metyrapone. Arch Gen Psychiatry. 1989;46:641–649.CrossRefGoogle ScholarPubMed
30.Tepperman, J. Metabolic and Endocrine Physiology. 4th ed. New York: Year Book Medical Publishers; 1981.Google Scholar
31.Young, EA, Haskett, RF, Grunhaus, L, Pande, A, Murphy-Weinberg, V, Watson, SJ. Increased evening activation of the hypothalamic-pituitary-adrenal axis in depressed patients. Arch Gen Psychiatry. 1994;51:701–707.CrossRefGoogle ScholarPubMed
32.Yehuda, R, Levengood, R, Schmeidler, J, Wilson, S, Guo, LS, Gerber, D. Increased pituitary activation following metyrapone administration in post-traumatic stress disorder. Psychoneuroendocrinology. 1996;21:1–16.CrossRefGoogle ScholarPubMed
33.Lemieux, AM, Coe, CL. Abuse-related posttraumatic stress disorder: evidence for chronic neuroendocrine activation in women. Psychosomatic Med. 1995;57:105–115.CrossRefGoogle ScholarPubMed
34.Pitman, RK, Orr, S. Twenty-four hour urinary cortisol and catecholamine excretion in combat-related PTSD. Biol Psychiatry. 1990;27:245–247.CrossRefGoogle Scholar
35.Goenjian, AK, Yehuda, R, Pynoos, RS, et al.Basal cortisol and dexamethasone suppression of cortisol among adolescents after the 1988 earthquake in Armenia. Am J Psychiatry. 1996;153:929–934.Google ScholarPubMed
36.Jensen, CF, Keller, TW, Peskind, ER, et al.Behavioral and plasma cortisol responses to sodium lactate infusion in posttraumatic stress disorder. In: Yehuda, R, McFarlane, AC, eds. Psychobiology of Posttraumatic Stress Disorder. New York: New York Academy of Sciences; 1997:444–447.Google Scholar
37.Dekaris, D, Sabioncello, A, Mazuran, R, et al.Multiple changes of immunologic parameters in prisoners of war. JAMA. 1993;270:595–599.CrossRefGoogle ScholarPubMed
38.Bauer, M, Priebe, S, Graf, KJ, et al.Psychological and endocrine abnormalities in refugees from East Germany. Part II. Serum levels of cortisol, prolactin, luteinizing hormone, follicle stimulating hormone and testosterone. Psychiatry Res. 1984;51:75–85.CrossRefGoogle Scholar
39.Yehuda, R, Teicher, MH, Trestman, RL, et al.Cortisol regulation in posttraumatic stress disorder and major depression: a chronobiological analysis. Biol Psychiatry. 1996;40:79–88.CrossRefGoogle ScholarPubMed
40.Svec, F. Minireview: glucocorticoid receptor regulation. Life Sci. 1985;35:2359–2366.CrossRefGoogle Scholar
41.Sapolsky, RM, Krey, LC, McEwen, BS. Stress down regulates corticosterone receptors in a site specific manner in the brain. Endocrinology. 1984;114:287–292.CrossRefGoogle Scholar
42.Yehuda, R, Lowy, MT, Southwick, SM, Shaffer, S, Giller, EL. Increased lymphocyte glucocorticoid receptor number in PTSD. Am J Psychiatry. 1991;149:499–504.Google Scholar
43.Stein, MB, Yehuda, R, Koverola, C, et al.HPA axis functioning in adult women who report experiencing severe childhood sexual abuse. Biol Psychiatry. 1997;42:680–686.CrossRefGoogle Scholar
44.Dinan, TG, Barry, S, Yatham, LN, Moyabed, M, Brown, I. A pilot study of a neuroendocrine test battery in posttraumatic stress disorder. Biol Psychiatry. 1990;28:665–672.CrossRefGoogle ScholarPubMed
45.Halbreich, U, Olympia, J, Carson, S, et al.Hypothalamic-pituitary-adrenal activity in endogenously depressed post-traumatic stress disorder patients. Psychoneuroendocrinology. 1989;14:365–370.CrossRefGoogle Scholar
46.Kosten, TR, Wahby, V, Giller, E, et al.The dexamethasone suppression test and thyrotropin-releasing hormone stimulation test in PTSD. Biol Psychiatry. 1990;28:657.CrossRefGoogle Scholar
47.Kudler, H, Davidson, J, Meador, K, et al.The DST and post-traumatic stress disorder. Am J Psychiatry. 1987;144:1068–1071.Google Scholar
48.Olivera, AA, Fero, D. Affective disorders, DST, and treatment in PTSD patients: clinical observations. J Trauma Stress. 1990;3:407–414.CrossRefGoogle Scholar
49.Kellner, M, Baker, DG, Yehuda, R. Salivary cortisol in Operation Desert Storm returnees. Biol Psychiatry. 1997;41:849–850.CrossRefGoogle Scholar
50.Bourne, PB, Rose, RM, Mason, JW. Urinary 17-OHCA levels: data on seven helicopter ambulance medics in combat. Arch Gen Psychiatry. 1967;17:104–110.CrossRefGoogle ScholarPubMed
51.Bourne, PB, Rose, RM, Mason, JW. 17-OHCS levels in combat: special forces “A” team under threat of attack. Arch Gen Psychiatry. 1968;19:135–140.CrossRefGoogle Scholar
52.McFarlane, AC, Atchison, M, Yehuda, R. The acute stress response following motor vehicle accidents and its relation to PTSD. In: Yehuda, R, McFarlane, AC, eds. Psychobiology of Posttraumatic Stress Disorder. New York: New York Academy of Sciences; 1997:437–439.Google Scholar
53.Resnick, HS, Yehuda, R, Pitman, RK, Foy, DW. Effect of previous trauma on acute plasma cortisol level following rape. Am J Psychiatry. 1995;152:1675–1677.Google ScholarPubMed
54.True, W, Rice, J, Eisen, S, et al.A twin study of genetic and environmental contributions to liability for posttraumatic stress symptoms. Arch Gen Psychiatry. 1993;50:257–264.CrossRefGoogle ScholarPubMed
55.Connor, KM, Davidson, JRT. Familial risk factors in posttraumatic stress disorder. In: Yehuda, R, McFarlane, AC, eds. Psychobiology of Posttraumatic Stress Disorder. New York: New York Academy of Sciences; 1997:52–56.Google Scholar