Cited by 279Stress Responses and CortisolChild Abuse and TraumaPersonality Disorders and Psychopathology

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Hyperresponsiveness of hypothalamic-pituitary-adrenal axis to combined dexamethasone/corticotropin-releasing hormone challenge in female borderline personality disorder subjects with a history of sustained childhood abuse

Rinne, Thomas, de Kloet, E.Ronald, Wouters, Luuk, Goekoop, Jaap G, DeRijk, Roel H, van den Brink, Wim·2002·Biological Psychiatry

DOI 10.1016/s0006-3223(02)01395-1

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Abstract

Background High coincidence of childhood abuse, major depressive disorder (MDD), and posttraumatic stress disorder (PTSD) has been reported in patients with borderline personality disorder (BPD). Animals exposed to early trauma show increased stress-induced hypothalamic-pituitary-adrenal (HPA) axis activity due to an enhanced corticotropin-releasing hormone (CRH) drive and glucocorticoid feedback resistance. In humans, PTSD and MDD are associated with decreased and increased resistance to glucocorticoid feedback, respectively, which might reflect persistent changes in neuroendocrine sequelae following childhood abuse. Methods We investigated the relationship between childhood abuse and HPA axis function using a combined dexamethasone/CRH (DEX/CRH) test in 39 BPD patients with (n = 24) and without (n = 15) sustained childhood abuse and comorbid PTSD (n = 12) or MDD (n = 11) and 11 healthy control subjects. Results Chronically abused BPD patients had a significantly enhanced corticotropin (ACTH) and cortisol response to the DEX/CRH challenge compared with nonabused subjects. Comorbid PTSD significantly attenuated the ACTH response. Conclusions Hyperresponsiveness of the HPA axis in chronically abused BPD subjects might be due to the enhanced central drive to pituitary ACTH release. Sustained childhood abuse rather than BPD, MDD, or PTSD pathology accounts for this effect. Possibly due to an enhanced efficacy of HPA suppression by dexamethasone, PTSD attenuates the ACTH response…

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Authors: Rinne, T., de Kloet, E. R., Wouters, L., Goekoop, J. G., DeRijk, R. H., & van den Brink, W.
Affiliations: Vrije Universiteit Amsterdam (NL)
Leiden University Medical Center (NL)
Amsterdam UMC Location University of Amsterdam (NL)
Corresponding author: Rinne, Thomas
ORCID: de Kloet, E.Ronald
Wouters, Luuk
van den Brink, Wim
Venue: Biological Psychiatry
Publisher: Elsevier BV
Published: 2002-12
Volume: 52
Issue: 11
Pages: 1102-1112
ISSN: 0006-3223 (ISSN-L)
DOI: 10.1016/s0006-3223(02)01395-1
OpenAlex: W2068221498
Cited by: 279
References: 74
Citations by year: 2026: 1 · 2025: 2 · 2024: 3 · 2023: 7 · 2022: 4 · 2021: 4 · 2020: 9 · 2019: 8 · 2018: 8 · 2017: 10 · 2016: 11 · 2015: 14 · 2014: 20 · 2013: 19 · 2012: 10
FWCI: 5.72
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Biological Psychiatry (publishedVersion)
PubMed (publishedVersion)
Pure Amsterdam UMC (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Funders: Nationaal Fonds Geestelijke Volksgezondheid (4820)
Topics: Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Keywords: borderline personality disorder, childhood abuse, hypothalamic-pituitary-adrenal axis, ACTH response, cortisol, post-traumatic stress disorder, major depressive disorder, trauma exposure
MeSH terms: Adolescent, Adrenocorticotropic Hormone, Adult, Borderline Personality Disorder, Child Abuse, Corticotropin-Releasing Hormone, Dexamethasone, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Middle Aged, Pituitary-Adrenal System, Stress Disorders, Post-Traumatic, Case-Control Studies

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Hyperresponsiveness of hypothalamic-pituitary-adrenal axis to combined dexamethasone/corticotropin-releasing hormone challenge in female borderline personality disorder subjects with a history of sustained childhood abuse

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