Highlights
- •Childhood sexual abuse survivors (CSA) are at increased risk for substance abuse and dependence
- •Biologically, CSA may alter interactions between the brain’s stress and reward systems, increasing risk for substance abuse
- •Novel approach used to test this hypothesis: adults in residential treatment for substance use disorders studied over time
- •High compliance demonstrated for morning cortisol level and the dexamethasone suppression test procedures
- •Correlations among CSA, basal cortisol, and dexamethasone suppression suggest effect sizes are small
Abstract
An environmental risk factor for substance abuse and dependence is childhood sexual
abuse (CSA). We piloted an approach we developed to test the hypothesis that hypothalamic-pituitary-adrenal
(HPA) axis dysregulation from the stress of CSA is a biological mediator. We based
our hypothesis on the allostasis model. New admissions to residential treatment for
substance use disorders (N = 41) were evaluated for CSA history and two HPA axis regulation measures at baseline,
one month, and two months. The two HPA axis regulation measures were morning cortisol
level and the dexamethasone suppression test. Five potential covariates were also
measured to increase reliability of the findings. Feasibility outcomes were mostly
favorable, and included rates of participation (57 %), attrition (46 % at one month
and 71 % at two months), and compliance with data collection procedures (87 % for
morning cortisol level and 84 % for the dexamethasone suppression test). High attrition
rates at one and two months were entirely attributable to high rates of leaving treatment,
an important consideration for future studies. Baseline correlations among variables
showed a significant negative correlation between dexamethasone suppression and perceived
stress, a potential covariate (rho = −0.458). This finding suggests that individuals
with lower stress levels have better negative feedback regulation of the HPA axis,
which results in the benefit of lower cortisol exposure—a finding congruent with the
allostasis model.
Keywords
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Article info
Publication history
Published online: December 07, 2022
Accepted:
December 5,
2022
Received in revised form:
September 25,
2022
Received:
September 1,
2021
Identification
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© 2022 Published by Elsevier Inc.
