Alterations of hair cortisol and dehydroepiandrosterone in mother-infant-dyads with maternal childhood maltreatment.

BACKGROUND: Child maltreatment (CM) has severe effects on psychological and physical health. The hypothalamic-pituitary-adrenal (HPA) axis, the major stress system of the body, is dysregulated after CM. The analysis of cortisol and dehydroepiandrosterone (DHEA) in scalp hair presents a new and promising methodological approach to assess chronic HPA axis activity. This study investigated the effects of CM on HPA axis activity in the last trimester of pregnancy by measuring the two important signaling molecules, cortisol and DHEA in hair, shortly after parturition. In addition, we explored potential effects of maternal CM on her offspring's endocrine milieu during pregnancy by measuring cortisol and DHEA in newborns' hair. METHODS: CM was assessed with the Childhood Trauma Questionnaire (CTQ). Cortisol and DHEA were measured in hair samples of 94 mothers and 30 newborns, collected within six days after delivery. Associations of maternal CM on her own and her newborn's cortisol as well as DHEA concentrations in hair were analyzed with heteroscedastic regression models. RESULTS: Higher CM was associated with significantly higher DHEA levels, but not cortisol concentrations in maternal hair. Moreover, maternal CM was positively, but only as a non-significant trend, associated with higher DHEA levels in the newborns' hair. CONCLUSIONS: Results suggest that the steroid milieu of the mother, at least on the level of DHEA, is altered after CM, possibly leading to non-genomic transgenerational effects on the developing fetus in utero. Indeed, we observed on an explorative level first hints that the endocrine milieu for the developing child might be altered in CM mothers. These results need extension and replication in future studies. The measurement of hair steroids in mothers and their newborns is promising, but more research is needed to better understand the effects of a maternal history of CM on the developing fetus.

The grapes of war. Somatoform pain disorder and history of early war traumatization in older people.

Persistent pain is not a normal part of aging. Nevertheless, many older patients have long-lasting, more or less medically unexplained pain symptoms and, consequently, are often severely disabled, incur high health care costs, and have high comorbidity rates. Moreover, the effects of early traumatization, especially due to wars, and even below the level of posttraumatic stress disorder (PTSD) are apparent. However, the developmental and neurobiological underpinnings of somatoform pain disorder, especially in pain-prone elderly patients, and its correlations with a history of war traumatization even decades after the incident remain unclear. Furthermore, a management strategy for this disorder tailored to older people and their special needs is lacking. Adequate therapeutic regimens such as adjusted psychotherapeutic procedures for elderly patients can only be promoted through a better understanding of the neurobiological and biographical underpinnings of this still controversial disorder.

Childhood maltreatment, postnatal distress and the protective role of social support.

The postpartum period is a vulnerable period for women with a history of childhood maltreatment. This study investigated the association between childhood maltreatment and postnatal distress three months postpartum and examined the role of social support provided by different sources (intimate partner, parents, parents-in-law, and friends). Analyses are based on N=66 women, who were screened for maltreatment experiences shortly after parturition with the Childhood Trauma Questionnaire. Their levels of postnatal distress (symptoms of depression, anxiety, and stress; assessed with the Hospital Anxiety and Depression Scale and the 4-Item version of the Perceived Stress Scale) and postpartum social support (measured with the Postpartum Social Support Questionnaire) were assessed three months postpartum. Adjusting for educational level and the experience of a recent stressful event, childhood maltreatment was directly associated with higher levels of postnatal distress. Social support provided by friends moderated this association in a heteroscedastic regression analysis. No moderating effect was observed for support provided by the own parents, the intimate partner, or parents-in-law. The association between childhood maltreatment and postnatal distress was not mediated by social support. Additional analyses revealed no main, moderating, or mediating effects of satisfaction with support. Results suggest that support provided by friends may promote resilience during the postpartum period in women with a history of childhood maltreatment. Efforts to better understand the role of postpartum support and mechanisms that may enhance a mother's ability to develop and maintain supportive friendships may be promising for guiding preventive interventions.

I know the pain you feel-how the human brain's default mode predicts our resonance to another's suffering.

Introspective and self-referential in nature, the human brain's default mode network (DMN) is presumed to influence our behavior in response to the environment in predictive manner [Raichle ME, Gusnard DA (2005) J Comp Neurol 493:167-176; Bar M (2009) Philos Trans R Soc Lond B Biol Sci 364:1235-1243]. In the current study, we hypothesize that the strength of DMN-connectivity contributes to distinct introspective psychological processes in every-day social life such as the intuitive understanding of other people through inner representation of their affective states -e. g. his or her pain. 19 healthy individuals underwent functional MRI scanning, which consisted of a resting-state-scan followed by the presentation of visual stimuli depicting human limbs in painful and non-painful situations. After scanning, participants were asked to evaluate the stimuli in terms of pain intensity perceived from the first person perspective. Independent component analysis (ICA) demonstrated that higher integration of the left medial orbitofrontal cortex (BA 32) into the anterior default mode network (aDMN) was associated with higher post-scan pain ratings. Furthermore, the exposition to the "Pain"-pictures led to relative increases of aDMN-activity compared to "No Pain"-stimuli which were also correlated with the subjective pain intensity. The behaviorally predictive functional architecture during a task-free period supports the notion that the DMN serves as a "memory of the future" [Ingvar DH (1985) Hum Neurobiol 4:127-136] in terms of a neuronal cache, storing "a priori scripts," which are recalled to deal efficiently with upcoming environmental events. In addition, our results suggest that an individual predisposition to identify oneself with another's pain influences the automatic response of the DMN during the observation of painful situations.