Scars of Child Abuse Becoming More Visible

From the WebMD Archives

Aug. 1, 2000 -- Although it's been known for some time that being sexually or physically abused as a child can increase your risk of developing psychiatric problems such as depression and anxiety as an adult, new research is finally showing us why and how this happens.

The explanation lies in the body's response to stress. Scientists say women who were abused as children have different hormonal reactions to stress than non-abused women.

"Women who were victims of abuse, whether they were depressed or not, had a heightened biological response to the stressful situation," says D. Jeffrey Newport, MD. "The degree of their response correlated with the severity of the childhood trauma."

Newport and colleagues from Emory University School of Medicine in Atlanta studied four groups of women aged 18 to 45 years. They included 1) those who were sexually or physically abused as children and were diagnosed with depression as adults; 2) those who were abused in childhood but did not develop depression; 3) adult women with depression who were not abused in childhood; and 4) a control group of healthy women who neither were abused nor suffered depression.

As part of the study, which appears in the Aug. 2 issue of TheJournal of the American Medical Association, the women were put in a situation that would produce stress: They underwent a test that involved a 10 minute interview similar to a typical job interview and a difficult math exercise performed before a panel of poker-faced observers who did not give any supportive expressions or gestures.

During the test, the researchers measured levels of two stress-related hormones in the women's blood: cortisol and adrenocorticotropic hormone (ACTH). Depressed women who were abused as children had ACTH levels six times higher than healthy women. They also had higher levels of cortisol than all other groups.

"What we found was that the depressed [women] had the same response to the [stressful] social situation as healthy volunteers; however, both of the abuse groups exhibited much higher response [to the stress]," Newport tells WebMD.

Benjamin E. Saunders, PhD, tells WebMD the findings are important to researchers looking for clues in the brain for biologic damage caused by abuse. But, he says, no one has yet proven if the changes described in the study are permanent or if they simply flare up when the abused person is upset or stressed. They also do not prove conclusively that having these changes in the brain is an automatic indicator that the person will develop depression or other psychiatric problems. Saunders is with the National Crime Victims Research and Treatment Center at the Medical University of South Carolina in Charleston.

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"It's sort of like rumbling around in somebody's trashcan looking for beer bottles to prove that they're an alcoholic," says Saunders.

"If you rumbled through 100 trashcans and in 20 cases you found 30 beer bottles and everyone else only had one or two, then there is a greater likelihood that someone in [the houses with more bottles] in an alcoholic. But you don't know if they had a party that weekend or what went on just by looking at a particular marker," Saunder says.

But, he says, the research is promising and may someday allow researchers to reduce the impact of abuse with early treatment to prevent psychiatric problems.

Newport agrees. He says the findings give hope that drugs used to treat depression may actually be used to prevent depression in women with a history of childhood abuse. Currently, his team is continuing to follow the women in the study and treat them with antidepressants.

"We're investigating the use of an [antidepressant] to see if it not only would provide symptomatic improvement to women who are depressed, but might also reverse these biological changes we've detected in women who were survivors of child abuse, whether they are depressed or not," Newport says.

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