Elsevier

Biological Psychiatry

Volume 66, Issue 1, 1 July 2009, Pages 62-68
Biological Psychiatry

Archival Report
Cortisol Response to Stress in Female Youths Exposed to Childhood Maltreatment: Results of the Youth Mood Project

https://doi.org/10.1016/j.biopsych.2008.12.014Get rights and content

Background

Few studies have examined stress reactivity and its relationship to major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) among maltreated youth. We examined differences between maltreated and control participants in heart rate and cortisol resting and reactivity levels in response to a psychosocial stressor.

Methods

We recruited 67 female youths aged 12 to 16 with no prior history of depression from child protection agencies and a control group of 25 youths matched on age and postal code. Child maltreatment was measured with two self-report instruments. Psychiatric status was assessed using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children.

Results

Piecewise multilevel growth curve analysis was used to model group differences in resting and reactivity cortisol levels and heart rate in response to the Trier Social Stress Test (TSST). During the resting period, both the maltreated and control groups showed a similar decline in levels of cortisol. During the reactivity phase, youth in the control group showed an increase in cortisol levels following the TSST and a gradual flattening over time; maltreated youth exhibited an attenuated response. This blunted reactivity was not associated with current symptoms of MDD or PTSD. There were no group differences in resting and reactivity levels of heart rate.

Conclusions

These findings provide further support for hypothalamic-pituitary-adrenal axis dysregulation among maltreated youth. Since the ability to respond to acute stressors by raising cortisol is important for health, these findings may assist in understanding the vulnerability of maltreated youth to experience physical and mental health problems.

Section snippets

Participants

Female youths between the ages of 12 and 16 from three local child protection agencies (CPA) qualified for eligibility review. Two trained undergraduate research assistants, who signed confidentiality agreements with the agencies, reviewed the 243 qualifying cases and summarized the files of the 201 female youths who had open cases with a history of maltreatment. Two members of the research team and two clinical researchers independently adjudicated the summaries for eligibility and to

Results

Table 1 presents selected sociodemographic and clinical characteristics of the maltreated and control groups. Significant group differences on all sociodemographic characteristics emerged, with the exception of age and ethnicity. Compared with the control group, youth exposed to maltreatment live in families with lower levels of SES and are less likely to live with at least one biological parent (32.8% vs. 100%). In terms of clinical characteristics, youth exposed to child maltreatment are more

Discussion

We found a blunted cortisol response (but no difference in heart rate response) to a psychosocial stressor among maltreated female youth even after controlling for SES and Tanner pubertal staging, as well as current symptoms of MDD and PTSD. This suggests that in adolescents, the blunted cortisol reactivity to a psychological stressor is associated with exposure to child maltreatment, regardless of the presence of internalizing symptoms. Our findings support the habituation effect discussed by

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