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Characterizing Psychological Consequences of Childhood Trauma
This study is currently recruiting participants.
Verified by National Institute of Mental Health (NIMH), April 2008
Sponsored by: National Institute of Mental Health (NIMH)
Information provided by: National Institute of Mental Health (NIMH)
ClinicalTrials.gov Identifier: NCT00209105
  Purpose

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


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

MedlinePlus related topics: Depression Injuries Mental Health Wounds
Drug Information available for: Dexamethasone Dexamethasone acetate Dexamethasone Sodium Phosphate Doxiproct plus Epinephrine Epinephrine bitartrate
U.S. FDA Resources
Study Type: Observational
Study Design: Case-Only, Prospective
Official Title: Emory Conte Center for the Neuroscience of Mental Disorders: Psychobiology of Childhood Trauma

Further study details as provided by National Institute of Mental Health (NIMH):

Primary Outcome Measures:
  • Pathophysiological pathways (e.g., blood chemicals, physiological measures, brain images, behavioral measures), as assessed by diagnostic tests [ Time Frame: Measured at Day 2.5 ] [ Designated as safety issue: No ]

Biospecimen Retention:   None Retained

Biospecimen Description:

Estimated Enrollment: 240
Study Start Date: January 2005
Estimated Study Completion Date: January 2010
Estimated Primary Completion Date: December 2009 (Final data collection date for primary outcome measure)
Groups/Cohorts Assigned Interventions
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

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.B. Nemeroff) 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.

  Eligibility

Ages Eligible for Study:   18 Years to 45 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Sampling Method:   Probability Sample
Study Population

This study will include participants who have experienced early-life trauma.

Criteria

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
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00209105

Contacts
Contact: Christine M. Heim, PhD 404-727-5835 cmheim@emory.edu

Locations
United States, Georgia
General Clinical Research Center at Emory University Hospital Recruiting
Atlanta, Georgia, United States, 30322
Contact: Christine M. Heim, PhD     404-727-5835     cmheim@emory.edu    
Contact: Tanja C. Mletzko, MA     404-727-9939     tmletzk@emory.edu    
Sponsors and Collaborators
Investigators
Principal Investigator: Charles B. Nemeroff, MD/PhD Emory University SOM - Dept. of Psychiatry and Behavioral Sciences
  More Information

Responsible Party: Emory University ( Charles B. Nemeroff, MD/PhD )
Study ID Numbers: P50 MH58922, 572-2004, DATR A3-NSC
Study First Received: September 13, 2005
Last Updated: April 24, 2008
ClinicalTrials.gov Identifier: NCT00209105  
Health Authority: United States: Federal Government

Keywords provided by National Institute of Mental Health (NIMH):
Child Abuse
Hypothalamic-Pituitary-Adrenal Axis
Brain Imaging
Depression

Study placed in the following topic categories:
Dexamethasone
Depression
Mental Disorders
Mood Disorders
Wounds and Injuries
Depressive Disorder, Major
Epinephrine
Depressive Disorder
Dexamethasone acetate
Behavioral Symptoms

Additional relevant MeSH terms:
Pathologic Processes
Disease

ClinicalTrials.gov processed this record on January 30, 2009