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- Women who suffer physical and or sexual abuse as young
girls may carry the scars of that trauma into adulthood as a severe oversensitivity
to stress.
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- An early history of frequent abuse produces much sharper
hormonal and physical responses to mildly stressful events later in life,
according to a new study by Georgia researchers. The findings suggest that
the brain patterns laid during childhood trauma persist long after the
trauma has ceased.
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- "We need to be able to rise to the occasion when
a stressor comes along," says Dr. Jeffrey Newport, an Emory University
psychiatrist and a co-author of the study, which appears in this week's
issue of the Journal of the American Medical Association. "The problem
comes when events that are not experienced by most people as particularly
noxious [spark] an exaggerated response. That's when you run into problems
with developing illness."
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- Scientists have long known, for example, that women with
a history of sexual and physical abuse experience more emotional and physical
problems than other women.
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- Women abused as children have four times the normal risk
of depression when they reach adulthood and are far more prone to anxiety
disorders. Recent work also suggests that even emotional abuse can leave
lasting physical scars, including gastric distress, arthritis and pelvic
pain.
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- Even mild things trigger stress
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- One explanation for the link between early abuse and
later problems is the so-called Stress-Diathesis model of mood disorders.
This theory argues that episodes of abuse in childhood stimulate stress
hormones that eventually become acutely sensitive even to benign stimuli.
And since life is an obstacle course of these aggravations, the stress
machinery is nearly always working overtime.
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- In the latest study, the researchers compared stress
reactions in 49 women, ages 18 to 45, split into four groups: those who
had suffered regular abuse as children and were in the throes of a major
depression; those who suffered abuse but had no current emotional troubles;
women who had not been abused but were seriously depressed; and a control
group of women who had suffered neither abuse nor depression.
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- To stimulate their stress responses, the women were asked
to give 10-minute talks and perform trying mental math tests in front of
a stone-faced audience of observers. During the exercises, their hormone
concentrations were read through a catheter that had been inserted hours
earlier.
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- Women who had never been abused had similarly slight
hormonal reactions to the stressful situations, the researchers found,
regardless of their current emotional state.
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- But those with a history of abuse had marked spikes in
cortisol and ACTH, two critical stress response chemicals. These two hormones
reflect activity in the corticotropin-releasing factor system, a more basic
chemical pathway closely tied to the imprinting of early childhood trauma
on stress response in adulthood.
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- Levels of ACTH in abused, depressed women were six times
greater than in women of similar ages in the control group. Victims of
past abuse also had greater increases in heart rate, a physical marker
of anxiety, than did non-abused women.
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- All this raises the question: How long after abuse has
occurred, if ever, can treatment minimize the imprint on the stress system
of the trauma?
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- "There may be a window of opportunity in the immediate
aftermath when we could make a difference," Newport says.
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- He and his colleagues are now testing the effectiveness
of antidepressants on soothing the hair-trigger stress responses of abused
women. If those drugs succeed, perhaps similar therapies could be used
in children as ways to prevent overreactive patterns from setting in, he
says.
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