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Cited by 741Child Abuse and TraumaPosttraumatic Stress Disorder ResearchStress Responses and Cortisol

Developmental traumatology part I: biological stress systems∗∗See accompanying Editorial, in this issue.

De Bellis, Michael D, Baum, Andrew S, Birmaher, Boris, Keshavan, Matcheri S, Eccard, Clayton H, Boring, Amy M, Jenkins, Frank J, Ryan, Neal D·1999·Biological Psychiatry
DOI 10.1016/s0006-3223(99)00044-x
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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.

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Authors
De Bellis, M. D., Baum, A. S., Birmaher, B., Keshavan, M. S., Eccard, C. H., Boring, A. M., Jenkins, F. J., & Ryan, N. D.
Affiliations
  • University of Pittsburgh (US)
  • University of Pittsburgh Medical Center (US)
ORCID
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
1999-05
Volume
45
Issue
10
Pages
1259-1270
ISSN
0006-3223 (ISSN-L)
DOI
10.1016/s0006-3223(99)00044-x
OpenAlex
W1965376635
Cited by
741
References
69
Citations by year
2026: 5 · 2025: 7 · 2024: 6 · 2023: 11 · 2022: 12 · 2021: 18 · 2020: 19 · 2019: 17 · 2018: 16 · 2017: 21 · 2016: 32 · 2015: 51 · 2014: 30 · 2013: 45 · 2012: 41
FWCI
30.81
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (5 T32 MH18951, P01MH041712, MH-41712, K08MH001324, 5 K08 MHO1324-02, T32MH018951)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords
child abuse, urinary free cortisol, urinary catecholamines, epinephrine, norepinephrine, dopamine, prepubertal children, overanxious disorder, dissociative symptoms, suicidal ideation
MeSH terms
Adolescent, Analysis of Variance, Catecholamines, Child, Child Abuse, Dopamine, Epinephrine, Female, Humans, Hydrocortisone, Male, Norepinephrine, Personality Inventory, Psychiatric Status Rating Scales, Severity of Illness Index, Stress Disorders, Post-Traumatic, Suicide, Suicide, Attempted, Comorbidity

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