Low anti-Müllerian hormone mediates the association between childhood trauma and PTSD in women but not in men

Abstract

Women experience differential risk for childhood trauma and posttraumatic stress disorder (PTSD) when compared to men. Recent research has indicated lasting effects of childhood trauma across the lifespan and a bidirectional relationship between gonadal hormones like anti-Müllerian hormone (AMH) and PTSD that may help explain sex differences in PTSD. However, there is little data to support this hypothesized relationship, the potential direction of this relationship, or its effect in women and men across a large age range. The current study utilized a lifespan approach to examine the association between childhood trauma exposure and adulthood levels of AMH and PTSD symptoms. The current sample included 68 trauma-exposed veteran and non-veteran women (n = 27) and men (n = 41) aged 18–50 with clinical interview, self-report, and blood serum data, including 31 (47.0 %) participants with subthreshold-to-full PTSD. Adult trauma-exposed women had lower AMH levels (M=3.27 sqrt ng/mL) compared to trauma-exposed men (M=8.64 sqrt ng/mL; Hedge’s g=1.26). Overall, sex was a critical moderator of the association between AMH and PTSD, demonstrating significant AMH-related effects for women but not for men. To evaluate the potential developmental impact of childhood trauma and bidirectional relationship between AMH and lifetime PTSD symptoms, two moderated mediation analyses were conducted, examining sex as the moderator and 1) AMH and 2) PTSD symptoms as alternative mediators. AMH levels (Indirect Effect β=.391) mediated the relationship between childhood trauma and lifetime PTSD symptom severity for women but not for men. Alternatively, lifetime PTSD symptoms did not significantly mediate the relationship between childhood trauma and AMH levels. Findings from this small trauma-exposed cohort offer preliminary evidence that links developmental exposures to premature gonadal dysfunction and stress pathophysiology across the lifespan, revealing a potentially unidirectional relationship in which greater childhood trauma exposure is associated with reduced AMH levels in adult women and may confer greater lifetime PTSD symptom severity.