Tuesday, April 28, 2009

Trauma Neglect Abuse Corticotrophin Releasing Factor

Mental health care providers have long known that there is a relationship between early life abuse or neglect and the later development of adult psychiatric problems. We have known it is related to the stress response system but the the mechanisms of how this happens had not previously been shown. A presentation given at the annual meeting of the American Psychiatric Association sheds a bit more light on this issue.

Early life trauma and/or neglect is associated with higher levels of corticotrophin releasing factor (CRF) which sets the stage for sensitizing the nervous system. CRF is secreted both by the amygdala as well as the hypothalamus. The amygdala is a structure that exists in each temporal lobe and is the main center in our brain where fear responses are organized. Stress induces hyperexitability in the amygdala and leads to greater release of CRF. The hypothalamus is a structure in the middle of the brain that regulates hormone activity as well as basic functions such as the sleep -wake cycle, heart rate and temperature. Secretion of CRF causes the pituitary gland to increase secretion of aderenocorticotropic hormone (ACTH) which in turn causes the adrenal glands to secrete more cortisol which is the main stress hormone in our body. Normally cortisol will then enter the brain causing inhibition of CRF which leads to the ending of the stress response. This is called a negative feedback cycle. In people who have been exposed to early life trauma and neglect however this feedback inhibition fails to work leading to persistent high levels of CRF secretion and the continuation on an ongoing basis of the stress response. Because of the high levels of CRF the CRF receptors downregulate causing the brain to secrete even more CRF.

The knowledge of the central role of corticotrophin releasing factor leads to exciting possibilities of not only treatment but possible ways to reduce the potential of adult psychiatric problems in individuals who have been exposed to early life trauma and neglect.

Thought for the day

An act of kindness causes a ripple effect of which we can never be fully aware.

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