Elsevier

Biological Psychiatry

Volume 62, Issue 10, 15 November 2007, Pages 1080-1087
Biological Psychiatry

Original Article
Decreased Adrenocorticotropic Hormone and Cortisol Responses to Stress in Healthy Adults Reporting Significant Childhood Maltreatment

https://doi.org/10.1016/j.biopsych.2007.05.002Get rights and content

Background

Preclinical research findings suggest that exposure to stress and concomitant hypothalamus-pituitary-adrenal (HPA) axis activation during early development can have permanent and potentially deleterious effects. A history of early-life abuse or neglect appears to increase risk for mood and anxiety disorders. Abnormal HPA response to stress challenge has been reported in adult patients with major depressive disorder and posttraumatic stress disorder.

Methods

Plasma adrenocorticotropin hormone (ACTH) and cortisol reactivity to the Trier Social Stress Test were examined in healthy adults (n = 50) without current psychopathology. Subjects with a self-reported history of moderate to severe childhood maltreatment (MAL) (n = 23) as measured by the Childhood Trauma Questionnaire were compared with subjects without such a history (CTL) (n = 27).

Results

Compared with CTLs, MAL subjects exhibited significantly lower cortisol and ACTH baseline-to-peak deltas. A significant group effect was seen in the (repeated measures) cortisol response to the stress challenge, reflecting lower concentrations among MAL subjects. A significant group × time effect characterized the relatively blunted ACTH response of the MAL group. Emotional neglect (−.34, p = .02) and sexual abuse (.31, p = .03) strongly predicted maximal cortisol release.

Conclusions

In adults without diagnosable psychopathology, childhood maltreatment is associated with diminished HPA axis response to a psychosocial stressor. Possible explanations for the finding are discussed.

Section snippets

Subjects

Fifty adults, ages 20 to 59, were selected for participation. Advertisements for “healthy adults with a history of early life stress” were posted in the community. We included only those who scored moderate to severe on at least one of the five subscales of the Childhood Trauma Questionnaire (CTQ) (40, 41, 42) and did not meet current DSM-IV criteria for MDD or PTSD (n = 23). A second cohort of healthy volunteers (n = 27) was recruited via advertisements for “healthy research subjects.” We

Demographic and Clinical Characteristics

Clinical characteristics of the groups are displayed in Table 1. Subjects reporting moderate or severe childhood maltreatment (MAL, n = 23) were, on average, older than the control subjects (CTL), but sex distribution was equivalent. The distribution of female subjects across three categories used to approximate relevant hormone status on the day of the TSST (i.e., [1] cycle days 1 to 14; [2] cycle days 15 to 28; [3] taking daily hormone therapy) did not differ statistically between groups,

Discussion

The main finding of this study was suppression of cortisol response to a standardized laboratory psychosocial stressor among healthy adults reporting significant childhood maltreatment relative to healthy control subjects reporting none. Corresponding with this dampened cortisol reactivity, our subjects with early life abuse or neglect had a blunted ACTH response curve when compared with the nontraumatized counterparts. Subjective ratings of emotional responses suggested both groups experienced

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