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November 8, 2000

Long-term Neuroendocrine Effects of Childhood Maltreatment—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(18):2321. doi:10.1001/jama.284.18.2317

In Reply: We agree with Dr Bartlett that the neuroendocrine consequences of early childhood abuse in men warrants further investigation. There is reason to assume that men with a history of childhood abuse may demonstrate similar neurobiological alterations to those observed in abused women. In fact, the vast majority of reports in animal models suggesting increased stress vulnerability as a consequence of early stress has been conducted in males.1 We chose to investigate women exclusively, not only because this study was conducted under the auspices of our National Institutes of Health grant on early abuse in women, but because males differ from females in their neuroendocrine responses to stress. Women in their reproductive years exhibit lower adrenocorticotropin responses to laboratory stress than men, most likely due to effects of gonadal steroids on hypothalamic releasing–factor activity.2 Control of the effects of sex in our study would have required a considerably larger sample size. We look forward to addressing this important question in a subsequent study.

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