Study Results
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Basic Information
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COMPLETED
214 participants
OBSERVATIONAL
2012-08-31
2014-10-31
Brief Summary
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This study tests the hypothesis that compared to non-abused women all abuse victims have altered diurnal rhythm in cortisol secretion and that the pattern of this alteration is predicted by abuse characteristics, such as its type, severity, duration, and cessation. To examine the hypothesis the following research questions will be addressed: 1) whether cortisol levels are related to mental health state; 2) whether cortisol levels are related to type, severity, duration and cessation of DVA; 3) whether there is any difference in cortisol concentrations between those women exposed to both childhood abuse and DVA and those who have experienced only the latter; 4) whether cortisol levels vary between women, living in refuge and those not living in refuge?
To answer these research questions 214 women will be recruited in a domestic violence agency. Baseline and 3-monthly follow-up measures will be taken over 6 months after recruitment. Women will be asked to fill in a questionnaire to evaluate their demographics, health, experience of childhood abuse and DVA. Women's weight and height will be taken. In addition participants will be asked to take three saliva samples: 1st in the evening in bed, 2nd - next morning immediately upon awakening, and the 3rd - in thirty minutes after awakening. Saliva will be collected by chewing (for 2 minutes) the cotton pledget provided with plastic tube and returned by post or via collection by the researcher. Then the saliva samples will be tested for cortisol and cortisone.
Results of the study will increase our understanding of the biological mechanisms of DVA impact on a woman's health and tell researchers and practitioners about the possibility of using cortisol as an indicator to diagnose abuse-related health problems and assess effectiveness of medical care for abuse survivors.
Detailed Description
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Study objectives:
* To evaluate the profiles of the awakening response of cortisol, the diurnal variation and the mean salivary cortisol concentration in women with experience of DVA and in non-abused controls
* To estimate whether cortisol secretion is associated with type, severity, duration and cessation of DVA
* To investigate whether cortisol acts as mediator between DVA and mental health state
* To examine whether there is any distinction in cortisol levels between those women exposed to both childhood abuse and DVA and those experienced only the latter
* To explore whether cortisol secretion differs between women, living in a domestic violence refuge/safe house and those still living in the community (after adjustment for confounding effects of abuse severity and continuing contact with abuser).
This 6-month study will consist of 3 measurements every 3 months. Each assessment will last approximately 30-45 minutes and will include:
1. Numerous standardized self-administered psychological questionnaires
2. Weight and height measurement
3. Self-completion of 3 saliva samples using Salivette tubes:
1. evening sample - at bedtime
2. awakening sample - in the morning immediately upon wakening
3. post-awakening sample - 30 mins after awakening sample
Tubes with saliva will be returned by post or by researcher to an accredited laboratory for cortisol assay. The analysis also simultaneously measures cortisone a breakdown product of cortisol. This measurement is used to confirm the integrity of the sample.
Conditions
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Study Design
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CASE_CONTROL
PROSPECTIVE
Study Groups
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Cases
women who have experienced DVA
No interventions assigned to this group
Controls
women who have not experienced DVA
No interventions assigned to this group
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
* current use of steroid-based medications
* pregnancy
* presence of adrenal and/or pituitary gland disorder
* symptomatic psychotic illness.
18 Years
FEMALE
Yes
Sponsors
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National Institute for Health Research, United Kingdom
OTHER_GOV
University College, London
OTHER
University Hospitals Bristol and Weston NHS Foundation Trust
OTHER
Survive South Gloucestershire and Bristol
UNKNOWN
University of Bristol
OTHER
Responsible Party
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Gene Feder
Professor of Primary Health Care, Centre for Academic Primary Care
Principal Investigators
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Gene Feder, Professor
Role: PRINCIPAL_INVESTIGATOR
University of Bristol, Centre for Academic Primary Care
Stafford Lightman, Professor
Role: STUDY_CHAIR
University of Bristol, School of Clinical Sciences
Natalia Lokhmatkina, PhD
Role: STUDY_DIRECTOR
University of Bristol, School of Clinical Sciences
Locations
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Survive South Gloucestershire and Bristol
Kingswood, Bristol, United Kingdom
Next Link
Bristol, , United Kingdom
Countries
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References
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Feder G, Ramsay J, Dunne D, Rose M, Arsene C, Norman R, Kuntze S, Spencer A, Bacchus L, Hague G, Warburton A, Taket A. How far does screening women for domestic (partner) violence in different health-care settings meet criteria for a screening programme? Systematic reviews of nine UK National Screening Committee criteria. Health Technol Assess. 2009 Mar;13(16):iii-iv, xi-xiii, 1-113, 137-347. doi: 10.3310/hta13160.
Campbell JC. Health consequences of intimate partner violence. Lancet. 2002 Apr 13;359(9314):1331-6. doi: 10.1016/S0140-6736(02)08336-8.
Coid J, Petruckevitch A, Chung WS, Richardson J, Moorey S, Feder G. Abusive experiences and psychiatric morbidity in women primary care attenders. Br J Psychiatry. 2003 Oct;183:332-9; discussion 340-1. doi: 10.1192/bjp.183.4.332.
Golding JM. Intimate partner violence as a risk factor for mental disorders: A meta-analysis. Journal of Family Violence 14(2):99-132, 1999.
Kernic MA, Holt VL, Stoner JA, Wolf ME, Rivara FP. Resolution of depression among victims of intimate partner violence: is cessation of violence enough? Violence Vict. 2003 Apr;18(2):115-29. doi: 10.1891/vivi.2003.18.2.115.
Anderson DK, Saunders DG. Leaving an abusive partner: an empirical review of predictors, the process of leaving, and psychological well-being. Trauma Violence Abuse. 2003 Apr;4(2):163-91. doi: 10.1177/1524838002250769.
Lightman SL. The neuroendocrinology of stress: a never ending story. J Neuroendocrinol. 2008 Jun;20(6):880-4. doi: 10.1111/j.1365-2826.2008.01711.x.
Mirescu C, Gould E. Stress and adult neurogenesis. Hippocampus. 2006;16(3):233-8. doi: 10.1002/hipo.20155.
Pico-Alfonso MA, Garcia-Linares MI, Celda-Navarro N, Herbert J, Martinez M. Changes in cortisol and dehydroepiandrosterone in women victims of physical and psychological intimate partner violence. Biol Psychiatry. 2004 Aug 15;56(4):233-40. doi: 10.1016/j.biopsych.2004.06.001.
Seedat S, Stein MB, Kennedy CM, Hauger RL. Plasma cortisol and neuropeptide Y in female victims of intimate partner violence. Psychoneuroendocrinology. 2003 Aug;28(6):796-808. doi: 10.1016/s0306-4530(02)00086-0.
McFarlane AC, Barton CA, Yehuda R, Wittert G. Cortisol response to acute trauma and risk of posttraumatic stress disorder. Psychoneuroendocrinology. 2011 Jun;36(5):720-7. doi: 10.1016/j.psyneuen.2010.10.007. Epub 2010 Nov 19.
Heim C, Ehlert U, Hanker JP, Hellhammer DH. Abuse-related posttraumatic stress disorder and alterations of the hypothalamic-pituitary-adrenal axis in women with chronic pelvic pain. Psychosom Med. 1998 May-Jun;60(3):309-18. doi: 10.1097/00006842-199805000-00017.
Dutton MA, Green BL, Kaltman SI, Roesch DM, Zeffiro TA, Krause ED. Intimate partner violence, PTSD, and adverse health outcomes. J Interpers Violence. 2006 Jul;21(7):955-68. doi: 10.1177/0886260506289178.
Lokhmatkina NV, Feder G, Blake S, Morris R, Powers V, Lightman S. Longitudinal measurement of cortisol in association with mental health and experience of domestic violence and abuse: study protocol. BMC Psychiatry. 2013 Jul 13;13:188. doi: 10.1186/1471-244X-13-188.
Related Links
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protocol paper in Open Access
Other Identifiers
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NF110946
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
SOCSRG2594
Identifier Type: OTHER
Identifier Source: secondary_id
insurance/CT1349
Identifier Type: OTHER
Identifier Source: secondary_id
1678
Identifier Type: -
Identifier Source: org_study_id