Longitudinal measurement of cortisol in association with mental health and experience of domestic violence and abuse: study protocol

BMC Psychiatry

Stafford Lightman⁴  Victoria Powers¹  Richard Morris³  Sarah Blake²  Gene Feder²  Natalia V Lokhmatkina² 

[1] Department of Clinical Biochemistry, Bristol Royal Infirmary, Marlborough Street, Bristol, UK;Centre for Academic Primary Care, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, UK;Primary Care and Population Health Department, University College London, Royal Free Campus, Rowland Hill Street, London, UK;School of Clinical Sciences, University of Bristol, Dorothy Hodgkin Building, Whitson Street, Bristol, UK

关键词: Posttraumatic stress disorder;    Anxiety;    Depression;    Mental health;    Cortisol;    Abused women;    Battered women;    Spousal abuse;    Partner abuse;    Domestic violence;   

Others  :  1124005
DOI  :  10.1186/1471-244X-13-188

 received in 2013-01-14, accepted in 2013-07-10,  发布年份 2013

【 摘 要 】

Background

Domestic violence and abuse is threatening behavior, violence/abuse used by one person to control the other within an intimate or family-type relationship. Women experience more severe physical and sexual domestic violence and abuse and more mental health consequences than men. The current study aims at exploring of the role of hypothalamic-pituitary-adrenocortical axis activity in abuse impact on women's mental health. Study objectives: 1) To evaluate diurnal cortisol slope, cortisol awakening response, and the mean cortisol concentration in women with a current or recent experience of abuse; 2) To estimate whether cortisol secretion is associated with type, severity, duration and cessation of abuse; 3) To investigate whether cortisol acts as mediator between abuse and mental health condition; 4) To examine whether there is any distinction in cortisol levels between those women exposed to both childhood abuse and domestic violence and abuse and those experienced only the latter. 4) To explore whether cortisol secretion differs between women living in refuge and those still living in the community.

Methods/Design

To meet study objectives 128 women will be recruited in a domestic violence agency and local communities. Baseline and 3-month follow-up measures will be taken over 6 months after recruitment. Each assessment will include: (1) standardized self-administered questionnaires to evaluate socio-demographics, experience of violence and abuse, mental and physical health; (2) weight and height measurement; (3) self-completion of wakening, post-wakening and evening saliva samples. Saliva will be analysed for cortisol and cortisone using Ultra performance liquid chromatography – tandem mass spectrometry.

We will compare diurnal cortisol parameters between non-abused controls and abuse survivors with and without mental health conditions. First following descriptive statistics for all the cortisol and mental health outcomes, relationships between them will be investigated using appropriate regression models. Second, these techniques will be used to investigate the extent to which cortisol measures act as potential mediators between type, severity, duration of abuse and mental disorders.

Discussion

Results of the study will increase our understanding of the pathophysiological mechanisms of abuse-related mental health disorders in women and inform researchers and practitioners on the possibility of using salivary cortisol as a biological marker for prognosis, diagnosis, and treatment evaluation among abuse survivors.

Trial registration

ClinicalTrials.gov registration NCT01632553

【 授权许可】

   
2013 Lokhmatkina et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Rutherford A, Zwi AB, Grove NJ, Butchart A: Violence: a glossary. J Epidemiol Community Health 2007, 61(8):676-680.
• [2]Feder G, Ramsay J, Dunne D, Rose M, Arsene C, Norman R, Kuntze S, Spencer A, Bacchus L, Hague G, et al.: How far does screening women for domestic (partner) violence in different health-care settings meet criteria for a screening programme? Systematic reviews of nine UK National Screening Committee criteria. Health Technol Assess 2009, 13(16):iii-xiii. 1
• [3]Campbell JC: Health consequences of intimate partner violence. Lancet 2002, 359(9314):1331-1336.
• [4]Coid J, Petruckevitch A, Chung WS, Richardson J, Moorey S, Feder G: Abusive experiences and psychiatric morbidity in women primary care attenders. Br J Psychiatry 2003, 183:332-339.
• [5]Howard LM, Trevillion K, Khalifeh H, Woodall A, Agnew-Davies R, Feder G: Domestic violence and severe psychiatric disorders: prevalence and interventions. Psychol Med 2010, 40(6):881-893.
• [6]Golding JM: Intimate partner violence as a risk factor for mental disorders: A meta-analysis. J Fam Violence 1999, 14(2):99-132.
• [7]Prosman GJ, Lo Fo Wong SH, Bulte E, Lagro-Janssen AL: Healthcare utilization by abused women: A case control study. Eur J Gen Pract 2012, 18(2):107-113.
• [8]Kernic MA, Holt VL, Stoner JA, Wolf ME, Rivara FP: Resolution of depression among victims of intimate partner violence: is cessation of violence enough? Violence Vict 2003, 18(2):115-129.
• [9]Anderson DK: Leaving an abusive partner: An empirical review of predictors, the process of leaving, and psychological well-being. Trauma Violence Abuse 2003, 4(2):163-191.
• [10]Blasco-Ros C, Sanchez-Lorente S, Martinez M: Recovery from depressive symptoms, state anxiety and post-traumatic stress disorder in women exposed to physical and psychological, but not to psychological intimate partner violence alone: a longitudinal study. BMC Psychiatry 2010, 10:98.
• [11]Miller GE, Chen E, Parker KJ: Psychological stress in childhood and susceptibility to the chronic diseases of aging: moving toward a model of behavioral and biological mechanisms. Psychol Bull 2011, 137(6):959-997.
• [12]Pariante CM, Lightman SL: The HPA axis in major depression: classical theories and new developments. Trends Neurosci 2008, 31(9):464-468.
• [13]Yehuda R, Seckl J: Minireview: Stress-related psychiatric disorders with low cortisol levels: a metabolic hypothesis. Endocrinology 2011, 152(12):4496-4503.
• [14]Trickett PK, Noll JG, Susman EJ, Shenk CE, Putnam FW: Attenuation of cortisol across development for victims of sexual abuse. Dev Psychopathol 2010, 22(1):165-175.
• [15]Lightman SL: The neuroendocrinology of stress: a never ending story. J Neuroendocrinol 2008, 20(6):880-884.
• [16]Miller GE, Chen E, Zhou ES: If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans. Psychol Bull 2007, 133(1):25-45.
• [17]Hellhammer DH, Wust S, Kudielka BM: Salivary cortisol as a biomarker in stress research. Psychoneuroendocrinology 2009, 34(2):163-171.
• [18]Kudielka BM, Gierens A, Hellhammer DH, Wust S, Schlotz W: Salivary cortisol in ambulatory assessment–some dos, some don'ts, and some open questions. Psychosom Med 2012, 74(4):418-431.
• [19]King AP, Leichtman JN, Abelson JL, Liberzon I, Seng JS: Ecological salivary cortisol analysis– part 2: relative impact of trauma history, posttraumatic stress, comorbidity, chronic stress, and known confounds on hormone levels. J Am Psychiatr Nurses Assoc 2008, 14(4):285-296.
• [20]Powell LH, Lovallo WR, Matthews KA, Meyer P, Midgley AR, Baum A, Stone AA, Underwood L, McCann JJ, Janikula Herro K, et al.: Physiologic markers of chronic stress in premenopausal, middle-aged women. Psychosom Med 2002, 64(3):502-509.
• [21]Seng JS, King AP, Gabriel C, Reed CD, Sperlich M, Dunbar S, Fraker E, Ronis DL: Ecological salivary cortisol specimen collection–part 1: methodological consideration of yield, error, and effects of sampling decisions in a perinatal mental health study. J Am Psychiatr Nurses Assoc 2008, 14(4):273-284.
• [22]Adam EK, Kumari M: Assessing salivary cortisol in large-scale, epidemiological research. Psychoneuroendocrinology 2009, 34(10):1423-1436.
• [23]Lovell B, Wetherell MA: The cost of caregiving: endocrine and immune implications in elderly and non elderly caregivers. Neurosci Biobehav Rev 2011, 35(6):1342-1352.
• [24]Meewisse ML, Reitsma JB, de Vries GJ, Gersons BP, Olff M: Cortisol and post-traumatic stress disorder in adults: systematic review and meta-analysis. Br J Psychiatry 2007, 191:387-392.
• [25]Vreeburg SA, Zitman FG, van Pelt J, Derijk RH, Verhagen JC, van Dyck R, Hoogendijk WJ, Smit JH, Penninx BW: Salivary cortisol levels in persons with and without different anxiety disorders. Psychosom Med 2010, 72(4):340-347.
• [26]Stetler C, Miller GE: Depression and hypothalamic-pituitary-adrenal activation: a quantitative summary of four decades of research. Psychosom Med 2011, 73(2):114-126.
• [27]Pico-Alfonso MA, Garcia-Linares MI, Celda-Navarro N, Herbert J, Martinez M: Changes in cortisol and dehydroepiandrosterone in women victims of physical and psychological intimate partner violence. Biol Psychiatry 2004, 56(4):233-240.
• [28]Seedat S, Stein MB, Kennedy CM, Hauger RL: Plasma cortisol and neuropeptide Y in female victims of intimate partner violence. Psychoneuroendocrinology 2003, 28(6):796-808.
• [29]Griffin MG, Resick PA, Yehuda R: Enhanced cortisol suppression following dexamethasone administration in domestic violence survivors. Am J Psychiatry 2005, 162(6):1192-1199.
• [30]Inslicht SS, Marmar CR, Neylan TC, Metzler TJ, Hart SL, Otte C, McCaslin SE, Larkin GL, Hyman KB, Baum A: Increased cortisol in women with intimate partner violence-related posttraumatic stress disorder. Psychoneuroendocrinology 2006, 31(7):825-838.
• [31]Heim C, Ehlert U, Hanker JP, Hellhammer DH: Abuse-related posttraumatic stress disorder and alterations of the hypothalamic-pituitary-adrenal axis in women with chronic pelvic pain. Psychosom Med 1998, 60(3):309-318.
• [32]Dutton MA, Green BL, Kaltman SI, Roesch DM, Zeffiro TA, Krause ED: Intimate partner violence, PTSD, and adverse health outcomes. J InterpersViolence 2006, 21(7):955-968.
• [33]Bernstein DP, Fink L, Handelsman L, Foote J, Lovejoy M, Wenzel K, Sapareto E, Ruggiero J: Initial reliability and validity of a new retrospective measure of child abuse and neglect. Am J Psychiatry 1994, 151(8):1132-1136.
• [34]Hegarty K, Fracgp , Bush R, Sheehan M: The composite abuse scale: further development and assessment of reliability and validity of a multidimensional partner abuse measure in clinical settings. Violence Vict 2005, 20(5):529-547.
• [35]Kroenke K, Spitzer RL, Williams JB, Lowe B: The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. Gen Hosp Psychiatry 2010, 32(4):345-359.
• [36]Kroenke K, Spitzer RL, Williams JB: The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001, 16(9):606-613.
• [37]Foa EB, Riggs DS, Dancu CV, Rothbaum BO: Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. J Trauma Stress 1993, 6(4):459-473.
• [38]Rush AJ, First MB, Blacker D, American Psychiatric Association: Task Force for the Handbook of Psychiatric Measures.: Handbook of psychiatric measures. 2nd edition. Washington, DC: American Psychiatric Pub; 2008.
• [39]Cohen S, Williamson G: Perceived Stress in a Probability Sample of the United States. In The Social Psychology of Health. Edited by Spacapan S, Oskamp S. Newbury, CA: Sage; 1988.
• [40]Campbell J, Jones AS, Dienemann J, Kub J, Schollenberger J, O'Campo P, Gielen AC, Wynne C: Intimate partner violence and physical health consequences. Arch Intern Med 2002, 162(10):1157-1163.
• [41]Holder G: Measurement of glucocorticoids in biological fluids. Methods Mol Biol 2006, 324:141-157.
• [42]Raff H, Findling JW: Biomarkers: Salivary cortisol or cortisone? Nat Rev Endocrinol 2010, 6(12):658-660.
• [43]Miller GE, Rohleder N, Stetler C, Kirschbaum C: Clinical depression and regulation of the inflammatory response during acute stress. Psychosom Med 2005, 67(5):679-687.
• [44]Whitley E, Ball J: Statistics review 2: samples and populations. Crit Care 2002, 6(2):143-148.
• [45]Sterne JA, White IR, Carlin JB, Spratt M, Royston P, Kenward MG, Wood AM, Carpenter JR: Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ 2009, 338:b2393.