Effects of early childhood trauma on HPA axis function in CFS patients

[daisybell]

Have there been studies looking at this in healthy controls?

 

[Sean]

I can't count the number of times in the past I've seen questionnaire responses interpreted in a most convenient way. Each time from my own experience I found that there were potentially other very sound and valid reasons for a very different interpretation.

To me, selective use and interpretation of evidence is a serious red flag about the quality of research. Good science takes fair account of all the possible interpretations, especially ones not favourable to the author's preferred interpretation.

 

[Simon]

Sorry to be slow replying, after writing the initial posts I didn't really have any energy left yesterday.

I believe many of these psych endeavors are not about pure Science and genuine scientific inquiry...

Plus, they are flat out wrong.

That's a bit of a red rag to this bull: as a self-confessed science-geek I'm always deeply suspicious of simply rejecting a study without reading it. It also implies 'others are right' without appropriate scrutiny. I think a bg reason there has been so little progress in mecfs research during the tweny years I've been ill is that the standard of research has been so poor, and that sadly applies to biomedical research too (lack of funds is a major issue of course, but poor studies are still poor studies). I don't believe in giving anyone an easy ride: mediocre research won't find the answers to our illness, whatever the motivations of the researchers. Though I am much more optimistic now than I've ever been, with large rigorous studies breaking out all over the place.

 

[Simon]

Differences in the wakening cortisol levels can be caused by simple differences, like different sleeping rhythms. Far deeper biological investigations are needed if the hypothesis (of disrupted HPA axis) is to be investigated.

Measuring coritsol levels is just a pretend way of linking bio to psycho, but it never does it in a convincing way.

Well, it certainly wasn't convincing in this study! What kind of investigations of the HPA axis do you think are needed?

 

[adreno]

Well, it certainly wasn't convincing in this study! What kind of investigations of the HPA axis do you think are needed?

At least the discussion should include other factors besides trauma that could plausibly account for HPA dysfunction (infections, head injury, autoimmunity, etc).

Imagine for example that early emotional trauma is associated with risk-seeking behavior, which is then associated with head injuries, which is associated with HPA dysfunction.

 

[Sidereal]

Another thing with this type of studies is that reduced HPA axis function might make people more prone to a gloomy anxious mood. Cortisol is known to improve mood. This could easily affect how they respond to questionnaires. "emotional abuse" and "emotional neglect" are much more open to interpretation than the other scores.

Yeah, hypocortisolemia is actually associated with the symptom known as interpersonal rejection sensitivity (a common finding in atypical depression and other states where the HPA axis is blunted) so I wouldn't take as gospel self-reported emotional neglect from such patients.

 

[alex3619]

Have there been studies looking at this in healthy controls?

I don't know about this test specifically, but there are indeed studies where psychs were told the case files were psych cases and asked to diagnose them. They were actually healthy controls. They found reasons to find psych disorders in most of them. Diagnosis is often highly problematic. I cited such a study a few weeks back, back in the 60s I think.

 

[chipmunk1]

Yeah, hypocortisolemia is actually associated with the symptom known as interpersonal rejection sensitivity (a common finding in atypical depression and other states where the HPA axis is blunted) so I wouldn't take as gospel self-reported emotional neglect from such patients.

neglect can occur when parents have some undiagnosed or poorly treatable illness/disorder(example:alcoholism or ME) some of this may have organic causes and their may be some genetic causes which can affect the child as well.

 

[duncan]

Simon: "That's a bit of a red rag to this bull: as a self-confessed science-geek I'm always deeply suspicious of rejecting a study without reading it."

Agreed. All I had to go on was the abstract; the actual study was behind a pay wall. So, admittedly, my inferences were drawn from the abstract. But if the abstract could not stand on its own legs, by virtue of its own integrity, then it should not have been put out for scrutiny.

Simon: "It also implies others are right without appropriate scrutiny."

No. That statement is incorrect. It MAY imply that at times, but sometimes the error is unrelated to anything else, and is simply reflective of crappy workmanship.

 

[Iquitos]

I'm not sure why you feel that way.

HPA axis has long been implicated with CFS.
A study to investigate the HPA axis in patients is something I'd even donate to support.

The HPA axis is located in the midbrain and compromises of three glands which affect and regulate the body in vast number of ways.

You really think studies linking dysfunction of the midbrain with CFS/ME are redundant?

It's the attempt to make it into a psychosocial cause that is objectionable. There are other biomedical reasons for HPA axis problems. This "study" is just another waste of money, paid out to the psychobabblers.

Just think of all the groups whose members have been "abused" in one way or another, and who do not get ME/CFS: children abused by priests, children abused in war zones, the "lost boys" of Africa, etc.

 

[Snow Leopard]

Well, it certainly wasn't convincing in this study! What kind of investigations of the HPA axis do you think are needed?

Measurements of the other related hormones either directly/indirectly (within reason), within the same group of patients. Eg Vasopressin levels have never really been measured.

 

[Sidereal]

Measurements of the other related hormones either directly/indirectly (within reason), within the same group of patients. Eg Vasopressin levels have never really been measured.

True. There was one very small study (N=9) back in the 1990s which showed vasopressin problems but I can't think of any others.

http://www.ncbi.nlm.nih.gov/pubmed/8475696

Acta Neurol Scand. 1993 Mar;87(3):234-8.
Abnormal arginine-vasopressin secretion and water metabolism in patients with postviral fatigue syndrome.
Bakheit AM1, Behan PO, Watson WS, Morton JJ.
Author information

Abstract
Water metabolism and the responses of the neurohypophysis to changes in plasma osmolality during the water loading and water deprivation tests were studied in nine patients with postviral fatigue syndrome (PVFS) and eight age and six-matched healthy control subjects. Secretion of arginine-vasopressin (AVP) was erratic in these patients as shown by lack of correlation between serum and urine osmolality and the corresponding plasma AVP levels. Patients with PVFS had significantly low baseline arginine-vasopressin levels when compared with healthy subjects. Patients with PVFS as a group also showed evidence of increased total body water content. These results may be indicative of hypothalamic dysfunction in patients with PVFS.

 

[biophile]

Looks like the HPA axis link to "unexplained disorders" is falling apart?

-

Eur J Pain. 2014 Mar;18(3):447-54. doi: 10.1002/j.1532-2149.2013.00413.x. Epub 2013 Oct 23.

Functioning of the hypothalamic-pituitary-adrenal and growth hormone axes in frequently unexplained disorders: Results of a population study.

Aggarwal VR, Macfarlane GJ, Tajar A, Mulvey MR, Power A, Ray D, McBeth J.

School of Dentistry, Manchester Biomedical Research Centre, University of Manchester, UK.

BACKGROUND: The aim of the study was to test the hypothesis that associations with specific stress systems [hypothalamic-pituitary-adrenal (HPA) and growth hormone (GH) axes] would increase as the number of unexplained disorders increased while accounting for the possible confounding effects of psychosocial factors.

METHODS: A cross-sectional study identified those reporting chronic widespread pain, irritable bowel syndrome, chronic orofacial pain and chronic fatigue. Of the 1315 subjects, disorder status was available for 1180 (89.7%), of whom 766 (64.9%) reported no disorders, 277 (23.5%) reported one and 137 (11.6%) reported two or more. Eighty subjects were sought from each group for assessment of HPA (morning 8:00 a.m. and evening 10:00 p.m. saliva, and post-dexamethasone serum cortisol levels) and GH [serum insulin-like growth factor 1 (IGF-1) level] axis function. Validated questionnaires informed current psychological state.

RESULTS: Two hundred twenty-seven subjects participated [79 (35%) with no disorders, 78 (34%) with one disorder and 70 (31%) with two or more disorders]. There were no significant associations (p < 0.05) between individual disorders or an increasing disorder load with any of the neuroendocrine levels measured: saliva/serum cortisol, IGF-1 and dehydroepiandrosterone. Psychosocial factors were independently associated with disorders and with an increasing disorder load: health anxiety p < 0.01, anxiety p < 0.01, depression p < 0.01, life events p = 0.03.

CONCLUSION: Although previous studies have shown that stress axis function acts to moderate the risk of onset of some of these disorders, the present study shows that the degree of dysfunction is not correlated with a corresponding increasing load of disorders. The uncertainty surrounding the role of these biomarkers in the aetiology of unexplained disorders needs further investigation.

http://www.ncbi.nlm.nih.gov/pubmed/25764228

 

[Jon_Tradicionali]

It's the attempt to make it into a psychosocial cause that is objectionable. There are other biomedical reasons for HPA axis problems. This "study" is just another waste of money, paid out to the psychobabblers.

Just think of all the groups whose members have been "abused" in one way or another, and who do not get ME/CFS: children abused by priests, children abused in war zones, the "lost boys" of Africa, etc.

I've been quite clear in my objection to psychology. I am a firm believer of the notion that there is a biological reason for everything.

However, to clump the groups you've just mentioned into one and saying that just because they all haven't been diagnosed with ME/CFS then two are unrelated is plain ignorant.

Stress has long been related with CFS. There's been many cases of CFS onset after a traumatic event. In some people, stress is handled fine by the different pathways. However, in a select few, the high stress triggers an abnormal reaction by the body which results in CFS.

Who has actually looked into how many "lost boys of Africa" have been diagnosed with ME or exhibit ME-like symptoms?

 

[biophile]

Stress has long been related with CFS. There's been many cases of CFS onset after a traumatic event. In some people, stress is handled fine by the different pathways. However, in a select few, the high stress triggers an abnormal reaction by the body which results in CFS.

Anecdotally and retrospectively, perhaps. But I'm not aware of any well-conducted prospective studies which support it, and I've spent a significant amount of time looking. For all we know, it's coincidental (traumatic events and periods of stress aren't that uncommon in wider society), or the high stress happens to occur for some people during a prodromal phase (revealing a PEM-like vulnerability) rather than being the primary cause of their CFS.

 

[Snow Leopard]

Stress has long been related with CFS. There's been many cases of CFS onset after a traumatic event. In some people, stress is handled fine by the different pathways. However, in a select few, the high stress triggers an abnormal reaction by the body which results in CFS.

What do you mean by "stress". I mean disease by definition involves stress at a cellular level, resulting in lesions, but I'm guessing this is not what you meant.

If you mean a specific type of psychological stress, then you need to say that, rather than use the non-specific 'stress'.

As for psychological stress, it is potentially a risk factor for many diseases. But studies have shown that it is not a specific nor sensitive predictor for ME/CFS, nor has such pathology been indicated through medical studies, hence it cannot (at this time) be considered a cause for ME/CFS.

 

[Jon_Tradicionali]

What do you mean by "stress". I mean disease by definition involves stress at a cellular level, resulting in lesions, but I'm guessing this is not what you meant.

If you mean a specific type of psychological stress, then you need to say that, rather than use the non-specific 'stress'.

As for psychological stress, it is potentially a risk factor for many diseases. But studies have shown that it is not a specific nor sensitive predictor for ME/CFS, nor has such pathology been indicated through medical studies, hence it cannot (at this time) be considered a cause for ME/CFS.

This thread is about a psychological study.

You have conveniently sectioned off a part of my post. If you'd have read the whole thing you would seen it was in reference to another users comment about abused groups of children.

Stress HAS been linked with CFS/ME for decades. To deny that is ridiculous. Whether you agree with it or not is another point.

In regards to ME/CFS, what exactly HAS been proven this far?

Not much.

That's why all we can is speculate at this moment in time.

 

[A.B.]

Stress HAS been linked with CFS/ME for decades. To deny that is ridiculous. Whether you agree with it or not is another point.

Just because some psychobabblers keep saying that CFS is caused by psychological stress doesn't make it so. It's an unfalsifiable claim. A correlation between psychological stress and onset of symptoms doesn't mean much - correlation doesn't imply causation. It could easily be that the underlying disease impairs patients ability to handle stress or responsibilities of daily living so that they do indeed experience more psychological stress. In fact hypocortisolism does just that.

 

[Jon_Tradicionali]

Just because some psychobabblers keep saying that CFS is caused by psychological stress doesn't make it so. It's an unfalsifiable claim. A correlation between psychological stress and onset of symptoms doesn't mean much - correlation doesn't imply causation. It could easily be that the underlying disease impairs patients ability to handle stress or responsibilities of daily living so that they do indeed experience more psychological stress. In fact hypocortisolism does just that.

I said LINKED.

As per causation/consequence?

I'd go for consequence every day of the week.

But the link is there nevertheless.

 

[A.B.]

But the link is there nevertheless.

How many sufficiently severe diseases aren't associated with psychological stress?