Physiological Sequelae
Dr. Noll working in her lab at Cincinnati Children's Hospital.
Early severe and chronic stress, as is associated with childhood abuse, has been linked with disruption in Hypothalamic Pituitary Adrenal (HPA) axis stress response function. In the acute phases following the trauma of childhood abuse, heightened basal cortisol levels may be indicative of physiological anticipatory systems that are essential to internal viability in the face of changing or threatening conditions. However, excessive cortisol secretion and hyper-reactivity over the long-term may signify allostatic overload and a maladaptive breakdown of regulatory capacities.
One primary objective of the 20-year longitudinal study of the effects of sexual abuse has been to assess and analyze cortisol reactivity data from the Time 1 through Time 6 samples. Results indicate differential patterns of dysregulated cortisol responses to stress varying by developmental stage, severity of abuse, and the presence or absence of additional confounds also associated with HPA axis functioning (e.g., smoking). The long-term effects of dysregulated cortisol are not well understood, but many have theorized that such dysregulation may have implications for the development of cognitive abilities, compromised immune systems, and complications for offspring due to pre-mature birth. Dr. Noll is working on analyses speaking to each of these issues.
Another major objective of the longitudinal study was to ascertain the general physiological health of abused and comparison females. Examining health histories, sexually abused subjects reported significantly poorer overall physical health, more digestive problems, more major illnesses, more hospitalizations, more headaches, higher BMIs.
Future Directions
Dr. Noll's current RO3 Grant will examine more closely Hypothalamic Pituitary Adrenal (HPA) axis dysregulation and allostatic overload, via cortisol concentration and reactivity data, for sexually abused and comparison subjects collected at six time-points over several distinct developmental stages (childhood, adolescence, and early adulthood). Specifically, the study may help sort out confusion stemming from methodological issues, differential links to various psychopathology and personality characteristics, and a lack of focus on extrahypothalamic systems which may be involved HPA axis dysregulation.
Relevant Publications
Sickel AS, Noll JG, Moore PJ, Putnam FW, Trickett PK. (2002) Long-term physical health and healthcare utilization of women who were sexually abused as children: A prospective study. Journal of Health Psychology, 7(5), 583-597.
Funding Sources
(Noll) Principal Investigator Cortisol Activity and Sexual Abuse: Effects across development. R03 National Institute of Child Health and Human Development, $147,000 direct and indirect costs, proposed period January 2005 - December, 2007.
