Childhood sexual abuse, HPA axis regulation, and mental health: an integrative review.

Adults who experienced childhood sexual abuse (CSA) are at increased risk for major depressive disorder (MDD) and posttraumatic stress disorder (PTSD). Animal studies suggest that dysregulated biological stress systems are a potential mechanism, but there are multiple challenges involved in conducting translational studies in humans. The purpose of this integrative literature review was to determine the state of the science of hypothalamic-pituitary-adrenal (HPA) axis regulation in adults who experienced CSA, with a focus on the health outcomes of MDD and PTSD. A variety of methods for HPA axis measurement were used in the 10 reviewed studies. The results suggested that changes in HPA axis regulation are present in many adults who experienced CSA-with and without a current MDD or PTSD diagnosis. Further research is needed to verify these findings. The review results can help researchers determine research strategies that will optimize scarce subject and financial resources.