Abstract
Background: This investigation examined the relationship between trauma, psychiatric
symptoms and urinary free cortisol (UFC) and catecholamine (epinephrine [EPI], norepinephrine
[NE], dopamine [DA]) excretion in prepubertal children with posttraumatic stress disorder
(PTSD) secondary to past child maltreatment experiences (n = 18), compared to non-traumatized
children with overanxious disorder (OAD) (n = 10) and healthy controls (n = 24).
Methods: Subjects underwent comprehensive psychiatric and clinical assessments and
24 hour urine collection for measurements of UFC and urinary catecholamine excretion.
Biological and clinical measures were compared using analyses of variance.
Results: Maltreated subjects with PTSD excreted significantly greater concentrations
of urinary DA and NE over 24 hours than OAD and control subjects and greater concentrations
of 24 hour UFC than control subjects. Post hoc analysis revealed that maltreated subjects
with PTSD excreted significantly greater concentrations of urinary EPI than OAD subjects.
Childhood PTSD was associated with greater co-morbid psychopathology including depressive
and dissociative symptoms, lower global assessment of functioning, and increased incidents
of lifetime suicidal ideation and attempts. Urinary catecholamine and UFC concentrations
showed positive correlations with duration of the PTSD trauma and severity of PTSD
symptoms.
Conclusions: These data suggest that maltreatment experiences are associated with
alterations of biological stress systems in maltreated children with PTSD. An improved
psychobiological understanding of trauma in childhood may eventually lead to better
treatments of childhood PTSD.
Keywords
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Article Info
Publication History
Accepted:
February 19,
1999
Received in revised form:
December 15,
1998
Received in revised form:
February 16,
1999
Received:
June 18,
1998
Identification
Copyright
© 1999 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
