Characterizing Psychological Consequences of Childhood Trauma

Sponsor

Emory University (Other)

Overall Status

Completed

CT.gov ID

NCT00209105

Collaborator

National Institute of Mental Health (NIMH) (NIH)

113

Enrollment

Location

73.9

Duration (Months)

1.5

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

This study will characterize the mental health consequences of early-life trauma.

Condition or Disease	Intervention/Treatment	Phase
Major Depressive Disorder	Drug: DEX-CRF stimulation test Behavioral: Psychosocial stress induction Procedure: Brain imaging of sad mood , self-reference, reward Behavioral: Acoustic startle

Detailed Description

This primary goal of this Center is to characterize the neurobiological consequences of early-life trauma. The Center comprises 6 projects that include human subjects. Human subjects are recruited through Project 6.

Project 2: Psychoimmunology (PI A.H. Miller) Project 4: A Model of Learned Safety(PI: M. Davis) Project 6: Clinical Psychobiology(PI: C. Heim) Project 7: Children of Depressed Mothers(PI: Z. Stowe) Project 8: Functional Brain Imaging (PIs: H.S. Mayberg, G. Berns) Project 9: Structural & Anatomical Connectivity Studies (PI: C.Kilts, X. Hu).

Project 2: The study seeks to examine the impact of psychosocial stress on neuroendocrine and immune signaling pathways of adult men and women with and without major depression who have experienced serious trauma (abuse, loss) during development. Serial blood samples will be collected at baseline and after an acute speech/math stressor (see Project 6). Assessments include IL-1alpha, and beta, IL-6, TNF alpha as well as DNS binding of relevant neuroendocrine-immune transcription factors, i.e. GR, CREB, and NFkB.

Project 4: This study uses a model of that allows for the independent evaluation of excitation and inhibition of fear-conditioning measured with the acoustic startle reflex. In addition, a dark-enhanced startle paradigm will be used that tests for anxiety. The effects of early-life stress will be evaluated in humans with and without major depressive disorder.

Project 6: This study assesses neuroendocrine and autonomic responses to stress and pharmacological challenge in subjects with and without major depression who have or have nor experienced early life stress. We seek to identify causes of variability in neuroendocrine-autonomic outcome after early life stress. To achieve this principle aim, we study the role of moderating and mediating factors including gender, genotype, type/timing of childhood trauma, as well as the role of adulthood trauma, comorbidity and cognitive dysfunction. The projects serves as a human subjects core for the other projects.

Project 7: This project characterizes effects of maternal depression on offspring in a longitudinal study. Women with and without depression will be prospectively followed through pregnancy and the first 6 months post-partum. Maternal stress and psychopathology, pregnancy and birth complications, medications and infants' physiological and behavioral stress responses will be assessed.

Project 8: This study uses PET and fMRI to characterize the impact of early-life stress on functional neural pathways mediating mood reactivity, self reference and reward-processing in patients with major depression. Cortical-limbic-striatal changes in cases with early stress but no psychopathology that define vulnerability to depression are also identified.

Project 9: This Project uses data obtained in Project 8 as well as diffusion tensor imaging to define the influence of early-life trauma on brain anatomical and functional connectivity.

Study Design

Study Type:

Observational

Actual Enrollment :

113 participants

Observational Model:

Case-Only

Time Perspective:

Prospective

Official Title:

Emory Conte Center for the Neuroscience of Mental Disorders: Psychobiology of Childhood Trauma

Study Start Date :

Jan 1, 2005

Actual Primary Completion Date :

Dec 1, 2009

Actual Study Completion Date :

Mar 1, 2011

Arms and Interventions

Arm	Intervention/Treatment
1 Participants who have experienced early-life trauma will undergo a series of diagnostic tests.	Drug: DEX-CRF stimulation test 1 ug/kg body weight of CRF for determining hpa response post dexamethasone ingestion Behavioral: Psychosocial stress induction Laboratory stress induction, no drug administration Procedure: Brain imaging of sad mood , self-reference, reward Brain imaging Behavioral: Acoustic startle No drugs involved

Arm

Intervention/Treatment

Participants who have experienced early-life trauma will undergo a series of diagnostic tests.

Drug: DEX-CRF stimulation test

1 ug/kg body weight of CRF for determining hpa response post dexamethasone ingestion

Behavioral: Psychosocial stress induction

Laboratory stress induction, no drug administration

Procedure: Brain imaging of sad mood , self-reference, reward

Brain imaging

Behavioral: Acoustic startle

No drugs involved

Outcome Measures

Primary Outcome Measures

Pathophysiological pathways (e.g., blood chemicals, physiological measures, brain images, behavioral measures), as assessed by diagnostic tests [Measured at Day 2.5]

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years to 45 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

Inclusion Criteria:

For participants assigned to the MDD groups: current DSM-IV diagnosis of MDD
For participants assigned to the early-life stress group: repeated (once per month or more for at least year) sexual or physical abuse before the age of 13 years by a perpetrator at least 5 years older at the time
For female participants: regular menstrual cycle and assessment in the early follicular phase as verified by sex steroid measures

Exclusion Criteria:

Meets DSM-IV criteria for a gender identity disorder
For all participants assigned to non-MDD groups: DSM-IV diagnosis of current MDD
For all participants assigned to the group without early-life stress: major stress experiences before the age of 12 years, such as separation from parents, neglect, parental loss, accidents, severe illness, or natural disaster
Significant medical illness, such as gastrointestinal, neurological, hormonal, heart, lung, kidney, liver, immunological or hematological disease, organic brain disease, or cancer as determined by history, physical examination, ECG, and laboratory tests
Pregnant or breastfeeding
Past or current presence of psychotic symptoms or bipolar disorder
Current presence of psychoactive substance abuse/dependency or eating disorders
Currently taking hormonal medication
Taking psychotropic medication within 4 weeks of study entry
General exclusion criteria for PET and fMRI