97 Maltreated school-aged children with clinicallevel internalizing problems had elevated Cortisol compared with controls.98 Depressed preschool children showed increased Cortisol response

to separation stress.99 Adult women with a history of childhood abuse showed increased suppression of Cortisol with low-dose (0.5 mg) dexamethasone.100 Women with PTSD related to early childhood sexual abuse showed decreased baseline Cortisol based on 24-hour diurnal assessments of plasma, and exaggerated Cortisol response to Inhibitors,research,lifescience,medical stressors (traumatic stressors101 more than neutral cognitive stressors).102 We also found that patients with PTSD had less of an inhibition of memory function with synthetic Cortisol (dexamethasone) than normal subjects.103 Adult women with depression and a history of early childhood abuse had an increased Cortisol response to a stressful cognitive challenge Inhibitors,research,lifescience,medical relative to controls,104 and a blunted ACTH response to CRF challenge.105 These findings show longterm changes in stress responsive Inhibitors,research,lifescience,medical systems. Early in development, stress is associated with increased Cortisol and norepinephrine responsiveness, whereas with adulthood, resting Cortisol may be normal or low, but there continues to be increased

Cortisol and norepinephrine responsiveness to stressors. In addition, early stress is associated with alterations in hippocampal morphology which may not manifest until adulthood, as well as increased amygdala function and decreased medial prefrontal function. Cognitive function and brain structure in PTSD Studies in PTSD are consistent with changes in cognition and brain structure. Multiple Inhibitors,research,lifescience,medical studies have demonstrated verbal declarative memory deficits

in PTSD.53,106-108 Patients with PTSD secondary to combat109-113 and childhood abuse114,115 were found to have deficits in verbal declarative memory function based on neuropsychological testing. Studies, using a variety of measures (including Inhibitors,research,lifescience,medical the Wechsler Memory Scale, the visual and verbal components of the Selective Reminding Test, the Auditory Verbal Learning Test, Paired Associate Recall, others the California Verbal New Learning Test, and the Rivermead Behavioral Memory Test), found specific deficits in verbal declarative memory function, with a relative sparing of visual memory and IQ.109-113,115-124 These studies have been conducted in both patients with PTSD related to medical Vietnam combat,109-113,116,119-121,123 rape,117 the Holocaust,124-126 adults with early childhood abuse,115 and traumatized children.118 One study in adult rape survivors showed that verbal declarative memory deficits are specifically associated with PTSD, and are not a nonspecific effect of trauma exposure.