Impact of Childhood Trauma on Hypothalamus-Pituitary-Adrenal Axis Activity in Alcohol-Dependent Patients

Abstract

Aims: Studies in animals and humans suggest that early life stress alters hypothalamus-pituitary-adrenal (HPA) axis activity. The same alterations are related to the symptoms and course of alcohol dependence. This study examined relationships between childhood trauma and HPA axis activity in alcohol-dependent patients controlling for psychopathology and characteristics of dependence. Methods: Thirty-eight consecutive patients (42% female) were examined at admission to detoxification (t1) and 14 days later (t2). Morning plasma levels of cortisol and adrenocorticotropin-releasing hormone (ACTH) were determined. Participants completed the Childhood Trauma Questionnaire (CTQ) and measures of anxiety, depression, and posttraumatic stress disorder. Results: Sexual abuse was related to higher levels of cortisol during acute withdrawal (r = 0.38, p = 0.02). Levels of ACTH were negatively correlated with the CTQ total score (t2: r = –0.42, p < 0.01), emotional abuse (t2: r = –0.33, p = 0.04), emotional neglect (t2: r = –0.33, p = 0.04), and physical neglect (t2: r = –0.33, p = 0.05) controlling for psychopathology and characteristics of dependence. Conclusions: Our findings suggest, that childhood trauma is related to blunted ACTH and increased cortisol during withdrawal in alcohol-dependent patients. Early life stress might be a confounding variable in studies of HPA function in alcohol dependence and future studies should examine potential clinical consequences of these relationships.