Childhood trauma associated with chronic fatigue syndrome

Jan 05, 2009

Individuals who experience trauma during childhood appear more likely to develop chronic fatigue syndrome as adults, according to a report in the January issue of Archives of General Psychiatry, one of the JAMA/Archives journals. In addition, neuroendocrine dysfunction—or abnormalities in the interaction between the nervous system and endocrine system—appears to be associated with childhood trauma in those with chronic fatigue syndrome, suggesting a biological pathway by which early experiences influence adult vulnerability to illness.

Chronic fatigue syndrome affects as many as 2.5 percent of U.S. adults, according to background information in the article. Little is known about the causes and development of the condition. Risk factors include female sex, genetic predisposition, certain personality traits and physical and emotional stress. "Stress in interaction with other risk factors likely triggers chronic fatigue syndrome symptoms through its effects on central nervous, neuroendocrine and immune systems, resulting in functional changes that lead to fatigue and associated symptoms such as sleep disruption, cognitive impairment and pain," the authors write. "However, obviously not every individual exposed to a stressor goes on to develop chronic fatigue syndrome, and it is therefore of critical importance to understand sources of individual differences in vulnerability to the pathogenic effects of stress."

Christine Heim, Ph.D., of Emory University School of Medicine, Atlanta, and colleagues studied 113 patients with chronic fatigue syndrome and 124 healthy individuals who served as controls. Participants—who were drawn from a general sample of 19,381 adults residents of Georgia—reported whether they had experienced childhood trauma, including sexual, physical and emotional abuse or emotional and physical neglect. They also underwent screening for depression, anxiety and post-traumatic stress disorder and were tested for levels of the hormone cortisol in their saliva. Low levels may indicate decreased function of the body's main neuroendocrine stress response system, the authors note.

Individuals with chronic fatigue syndrome reported higher levels of childhood trauma—exposure to trauma was associated with a six-fold increase in the risk of having the condition. Sexual abuse, emotional abuse and emotional neglect were most closely associated with chronic fatigue syndrome. Patients with the syndrome also were more likely than controls to have depression, anxiety and post-traumatic stress disorder.

Cortisol levels were decreased in patients with chronic fatigue syndrome who experienced childhood trauma, but not in those with chronic fatigue syndrome who had not been subjected to trauma. Therefore, stress early in life may cause a biological susceptibility to chronic fatigue syndrome, the authors note.

"Our results confirm childhood trauma as an important risk factor of chronic fatigue syndrome," they write. "In addition, neuroendocrine dysfunction, a hallmark feature of chronic fatigue syndrome, appears to be associated with childhood trauma. This possibly reflects a biological correlate of vulnerability due to early developmental insults. Our findings are critical to inform pathophysiological research and to devise targets for the prevention of chronic fatigue syndrome."

Source: JAMA and Archives Journals

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not rated yet Feb 09, 2009
As a CFS suffer myself, it makes me very angry to see that people are still trying to pin this condition on psychological causes.

However, this child abuse story has raised my interest, because paradoxically it may help support the viral etiology and explanation of chronic fatigue syndrome!

Having had a respiratory and neurological virus myself, and having seen this virus slowly spread to all my family members, and some friends too, I have noticed how it has caused mental state changes in nearly everybody that caught it, to some degree. However, only one person (myself) actually got full chronic fatigue syndrome from this virus. Most people got off much more lightly, but nevertheless did display some permanent mental state changes.

So it is clear to me that such neurological viruses can cause subtle, subclinical mental state changes, as well as full CFS.

Most of the subclinical mental state changes I have observed in my family and friends have made people act a little strangely. In short: the virus causes subclinical but sub-optimal mental states.

Therefore, it is possible that as a virus slowly infects a whole family, some members will get CFS, but other members may experience these slightly abnormal mental states - and in very rare cases, it is these abnormal states that contributes to creating the abhorrent mind state that can go on to commit child abuse.

In other words, in etiological terms, it is not the experience of having been abused as a child that later causes CFS, but rather it is a neurological virus that, having spread around the family, caused CFS in some members, and also kicked off the brain changes that, in susceptible people, then led to the extreme behavior of child abuse.

Thus, read this way, rather than support the psychological causal theories of CFS, this data from Emory University on child abuse is more likely to support a viral etiology of CFS.

In general, more research should be done on people that have one or more neurological viruses in their systems, even if they are apparently without overt symptoms. These neurological viruses may well be connected to all sort of subtle abnormal and subnormal behaviors and mental states, not just CFS.

The connection between neurological pathogens and mental heath is very well established as regards to curable bugs like toxoplasma and syphilis, simply because mental state problems caused by these tend to resolve when the people are given the cure (antibiotics), thus proving the connection. Once effective antivirals are developed, the same will almost certainly be found true for CFS.

In summary: although people with full CFS might be the worst off in terms of mental state changes, these same neurological viruses that cause CFS (which are very commonly found in the general population) may be responsible for many more mental state aberrations other than just those of chronic fatigue syndrome.

For more details and examples on how a neurological virus can cause mental state changes, see my blog: