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HPA-Axis Activation as a Key Moderator of Childhood Trauma Exposure and Adolescent Mental Health

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Abstract

Individual differences in a child’s sensitivity to stress may influence whether youth exposed to trauma develop symptoms of psychopathology. We examined the interaction between HPA-axis reactivity to an acute stressor and exposure to different types of childhood trauma as predictors of mental health symptoms in a sample of youth. Youth (n = 121, ages 9–16; 47% female) completed a standardized stress task, including 5 post-stress salivary cortisol samples. Parents also completed the Child Behavior Checklist as a measure of child internalizing and externalizing symptoms in the past month, and completed the Early Trauma Inventory (ETI) as a measure of their child’s trauma exposure. More emotional abuse and non-intentional trauma were associated with greater internalizing symptoms. Youth exposed to physical abuse who demonstrated slower HPA-axis reactivity had elevated internalizing and externalizing symptoms. Youth exposed to emotional abuse or non-intentional traumatic events who demonstrated faster HPA-axis reactivity had elevated internalizing and externalizing symptoms. Profiles of exaggerated or attenuated HPA-axis reactivity to acute stress may be risk factors for psychopathology in children facing different stressful social environments.

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Notes

  1. Previous investigations using this sample found exposure to any trauma during infancy was related to patterns of within-subject change in HPA-axis reactivity, however the pattern of results in the adjusted models remain unchanged when accounting for exposure to any trauma during infancy (Kuhlman et al. 2015b).

References

  • Abelson, J. L., Khan, S., Young, E. A., & Liberzon, I. (2010). Cognitive modulation of endocrine responses to CRH stimulation in healthy subjects. Psychoneuroendocrinology, 35, 451–459. doi:10.1016/j.psyneuen.2009.08.007.

    Article  PubMed  Google Scholar 

  • Achenbach, T. M. (1991). Child behavior checklist/4–18. Burlington: University of Vermont, Department of Psychiatry.

    Google Scholar 

  • Bernet, C. Z., & Stein, M. B. (1999). Relationship of childhood maltreatment to the onset and course of major depression in adulthood. Depression and Anxiety, 9, 169–174. doi:10.1002/(SICI)1520-6394(1999)9:4<169::AID-DA4>3.0.CO;2-2.

    Article  PubMed  Google Scholar 

  • Bremner, J. D., Vermetten, E., & Mazure, C. M. (2000). Development and preliminary psychometric properties of an instrument for the measurement of childhood trauma: the early trauma inventory. Depression and Anxiety, 12, 1–12. doi:10.1002/1520-6394(2000)12.

    Article  PubMed  Google Scholar 

  • Brewin, C. R., Andrews, B., & Gotlib, I. H. (1993). Psychopathology and early experience: a reappraisal of retrospective reports. Psychological Bulletin, 113, 82–98. doi:10.1037/0033-2909.113.1.82.

    Article  PubMed  Google Scholar 

  • Briggs-Gowan, M. J., Carter, A. S., Clark, R., Augustyn, M., McCarthy, K. J., & Ford, J. D. (2010). Exposure to potentially traumatic events in early childhood: differential links to emergent psychopathology. Journal of Child Psychology and Psychiatry, 51, 1132–1140. doi:10.1111/j.1469-7610.2010.02256.x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carpenter, L. L., Tyrka, A. R., Ross, N. S., Khoury, L., Anderson, G. M., & Price, L. H. (2009). Effect of childhood emotional abuse and age on cortisol responsivity in adulthood. Biological Psychiatry, 66, 69–75. doi:10.1016/j.biopsych.2009.02.030.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chapman, D. P., Dube, S. R., & Anda, R. F. (2007). Adverse childhood events as risk factors for negative mental health outcomes. Psychiatric Annals, 37, 359–364.

    Google Scholar 

  • Colich, N. L., Kircanski, K., Foland-Ross, L. C., & Gotlib, I. H. (2015). HPA-axis reactivity interacts with stage of pubertal development to predict the onset of depression. Psychoneuroendocrinology, 55, 94–101. doi:10.1016/j.psyneuen.2015.02.004.

    Article  PubMed  PubMed Central  Google Scholar 

  • Copeland, W. E., Keeler, G., Angold, A., & Costello, E. (2007). Traumatic events and posttraumatic stress in childhood. Archives of General Psychiatry, 64, 577–584. doi:10.1001/archpsyc.64.5.577.

    Article  PubMed  Google Scholar 

  • Del Giudice, M., Ellis, B., & Shirtcliff, E. A. (2011). The adaptive calibration model of stress responsivity. Neuroscience & Biobehavioral Reviews, 35, 1562–1592. doi:10.1016/j.neubiorev.2010.1.007.

    Article  Google Scholar 

  • Ellis, B. J., & Boyce, W. T. (2008). Biological sensitivity to context. Current Directions in Psychological Science, 17, 183–187. doi:10.1111/j.1467-8721.2008.00571.x.

    Article  Google Scholar 

  • Finkelhor, D., Vanderminden, J., Turner, H., Hamby, S., & Shattuck, A. (2014). Child maltreatment rates assessed in a national household survey of caregivers and youth. Child Abuse & Neglect, 38, 1421–1435. doi:10.1016/j.chiabu.2014.05.005.

    Article  Google Scholar 

  • Goenjian, A. K., Yehuda, R., Pynoos, R. S., Steinberg, A. M., Tashjian, M., Yang, R. K., et al. (1996). Basal cortisol, dexamethasone suppression of cortisol, and MHPG in adolescents after the 1988 earthquake in Armenia. The American Journal of Psychiatry, 153, 929–934. doi:10.1176/ajp.153.7.929.

    Article  PubMed  Google Scholar 

  • Gunnar, M. R., & Quevedo, K. M. (2007). Early care experiences and HPA axis regulation in children: a mechanism for later trauma vulnerability. In R. De Kloet, M. S. Oitzl, & E. Vermetten (Eds.), Progress in brain research (Vol. 167, pp. 137–149). Amsterdam, The Netherlands: Elsevier B.V.

    Google Scholar 

  • Hagan, M. J., Roubinov, D. S., Gress-Smith, J., Luecken, L. J., Sandler, I. N., & Wolchik, S. (2010). Positive parenting during childhood moderates the impact of recent negative events on cortisol activity in parentally bereaved youth. Psychopharmacology, 214, 231–238. doi:10.1007/s00213-010-1889-5.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hagan, M. J., Roubinov, D. S., Mistler, A. K., & Luecken, L. J. (2014). Mental health outcomes in emerging adults exposed to childhood maltreatment the moderating role of stress reactivity. Child Maltreatment, 19, 156–167. doi:10.1177/1077559514539753.

    Article  PubMed  Google Scholar 

  • Hammen, C. L. (2015). Stress and depression: old questions, new approaches. Current Opinion in Psychology, 4, 80–85. doi:10.1016/j.copsyc.2014.12.024.

    Article  Google Scholar 

  • Hammerfald, K., Eberle, C., Grau, M., Kinsperger, A., Zimmermann, A., Ehlert, U., & Gaab, J. (2006). Persistent effects of cognitive-behavioral stress management on cortisol responses to acute stress in healthy subjects—a randomized controlled trial. Psychoneuroendocrinology, 31, 333–339. doi:10.1016/j.psyneuen.2005.08.007.

    Article  PubMed  Google Scholar 

  • Hardt, J., & Rutter, M. (2004). Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. Journal of Child Psychology and Psychiatry, 45, 260–273. doi:10.1111/j.1469-7610.2004.00218.x.

    Article  PubMed  Google Scholar 

  • Herman, J. P., & Cullinan, W. E. (1997). Neurocircuitry of stress: central control of the hypothalamo–pituitary–adrenocortical axis. Trends in Neurosciences, 20, 78–84. doi:10.1016/S0166-2236(96)10069-2.

    Article  PubMed  Google Scholar 

  • Hofstra, M. B., Van der Ende, J., & Verhulst, F. C. (2000). Continuity and change of psychopathology from childhood into adulthood: a 14-year follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 850. doi:10.1097/00004583-200007000-00013.

    Article  PubMed  Google Scholar 

  • Hussey, J. M., Chang, J. J., & Kotch, J. B. (2006). Child maltreatment in the United States: prevalence, risk factors, and adolescent health consequences. Pediatrics, 118, 933–942. doi:10.1542/peds.2005-2452.

    Article  PubMed  Google Scholar 

  • Johnston, C. A., Steele, R. G., Herrera, E. A., & Phipps, S. (2003). Parent and child reporting of negative life events: discrepancy and agreement across pediatric samples. Journal of Pediatric Psychology, 28, 579.

    Article  PubMed  Google Scholar 

  • Kuhlman, K. R., Olson, S. L., & Lopez-Duran, N. L. (2014). Predicting developmental changes in internalizing symptoms: examining the interplay between parenting and neuroendocrine stress reactivity. Developmental Psychobiology, 56, 908–923. doi:10.1002/dev.21166.

    Article  PubMed  Google Scholar 

  • Kuhlman, K. R., Geiss, E. G., Vargas, I., & Lopez-Duran, N. L. (2015a). Differential associations between childhood trauma subtypes and adolescent HPA-axis functioning. Psychoneuroendocrinology, 54, 103–114. doi:10.1016/j.psyneuen.2015.01.020.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kuhlman, K. R., Vargas, I., Geiss, E. G., & Lopez-Duran, N. L. (2015). Age of trauma onset and HPA Axis dysregulation among trauma-exposed youth. Journal of Traumatic Stress, 28. doi:10.1002/jts.22054/full.

  • Lansford, J. E., Dodge, K. A., Pettit, G. S., Bates, J. E., Crozier, J., & Kaplow, J. (2002). A 12-year prospective study of the long-term effects of early child physical maltreatment on psychological, behavioral, and academic problems in adolescence. Archives of Pediatrics and Adolescent Medicine, 156, 824–830.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lopez-Duran, N. L., Mayer, S. E., & Abelson, J. L. (2014). Modeling neuroendocrine stress reactivity in salivary cortisol: adjusting for peak latency variability. Stress, 17, 285–295. doi:10.3109/10253890.2014.915517.

    Article  PubMed  Google Scholar 

  • Lopez-Duran, N. L., McGinnis, E. G., Kuhlman, K. R., Geiss, E. G., Vargas, I., & Mayer, S. E. (2015). HPA-axis stress reactivity in youth depression: evidence of impaired regulatory processes in depressed boys. Stress, 18, 545–553. doi:10.3109/10253890.2015.1053455.

    Article  PubMed  PubMed Central  Google Scholar 

  • MacMillan, H. L., Fleming, J. E., Streiner, D. L., Lin, E., Boyle, M. H., Jamieson, E., et al. (2001). Childhood abuse and lifetime psychopathology in a community sample. American Journal of Psychiatry, 158, 1878–1883. doi:10.1176/appi.ajp.158.11.1878.

    Article  PubMed  Google Scholar 

  • McLaughlin, K. A., Sheridan, M. A., & Lambert, H. K. (2014). Childhood adversity and neural development: deprivation and threat as distinct dimensions of early experience. Neuroscience and Biobehavioral Reviews, 47, 578. doi:10.1016/j.neubiorev.2014.10.012.

    Article  PubMed  PubMed Central  Google Scholar 

  • McLaughlin, K. A., Sheridan, M. A., Tibu, F., Fox, N. A., Zeanah, C. H., & Nelson, C. A. (2015). Causal effects of the early caregiving environment on development of stress response systems in children. Proceedings of the National Academy of Sciences, 112, 5637–5642. doi:10.1073/pnas.1423363112.

    Article  Google Scholar 

  • Miller, R., & Plessow, F. (2013). Transformation techniques for cross-sectional and longitudinal endocrine data: application to salivary cortisol concentrations. Psychoneuroendocrinology, 38, 941–946. doi:10.1016/j.psyneuen.2012.09.013.

    Article  PubMed  Google Scholar 

  • Nanni, V., Uher, R., & Danese, A. (2012). Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression: a meta-analysis. American Journal of Psychiatry, 169, 141–151. doi:10.1176/appi.ajp.2011.11020335.

    Article  PubMed  Google Scholar 

  • Pruessner, J. C., Kirschbaum, C., Meinlschmid, G., & Hellhammer, D. H. (2003). Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology, 28, 916–931. doi:10.1016/S0306-4530(02)00108-7.

    Article  PubMed  Google Scholar 

  • Saxbe, D. E., Margolin, G., Spies Shapiro, L. A., & Baucom, B. R. (2012). Does dampened physiological reactivity protect youth in aggressive family environments? Child Development, 83, 821–830. doi:10.1111/j.1467-8624.2012.01752.x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schwabe, L., Haddad, L., & Schachinger, H. (2008). HPA axis activation by a socially evaluated cold-pressor test. Psychoneuroendocrinology, 33, 890–895. doi:10.1016/j.psyneuen.2008.03.001.

    Article  PubMed  Google Scholar 

  • Silverman, M. N., & Sternberg, E. M. (2012). Glucocorticoid regulation of inflammation and its functional correlates: from HPA axis to glucocorticoid receptor dysfunction. Annals of the New York Academy of Sciences, 1261, 55–63. doi:10.1111/j.1749-6632.2012.06633.x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Slopen, N., McLaughlin, K. A., & Shonkoff, J. P. (2014). Interventions to improve cortisol regulation in children: a systematic review. Pediatrics, 133, 312–326. doi:10.1542/peds.2013-1632.

    Article  PubMed  PubMed Central  Google Scholar 

  • Steeger, C. M., Cook, E. C., & Connell, C. M. (2016). The interactive effects of stressful family life events and cortisol reactivity on adolescent externalizing and internalizing behaviors. Child Psychiatry and Human Development. doi:10.1007/s10578-016-0635-6.

    Google Scholar 

  • Sterba, S. K., Prinstein, M. J., & Cox, M. J. (2007). Trajectories of internalizing problems across childhood: heterogeneity, external validity, and gender differences. Development and Psychopathology, 19, 345–366. doi:10.1017/S0954579407070174.

    Article  PubMed  Google Scholar 

  • Suomi, S. J. (1997). Early determinants of behaviour: evidence from primate studies. British Medical Bulletin, 53, 170–184.

    Article  PubMed  Google Scholar 

  • Teicher, M. H., Samson, J. A., Anderson, C. M., & Ohashi, K. (2016). The effects of childhood maltreatment on brain structure, function and connectivity. Nature Reviews Neuroscience, 17, 652–666. doi:10.1038/nrn.2016.111.

    Article  PubMed  Google Scholar 

  • Yehuda, R. (1997). Sensitization of the hypothalamic-pituitary-adrenal axis in posttraumatic stress disorder. Annals of the New York Academy of Sciences, 821, 57–75. doi:10.1111/j.1749-6632.1997.tb48269.x.

    Article  PubMed  Google Scholar 

  • Yehuda, R., McFarlane, A., & Shalev, A. (1998). Predicting the development of posttraumatic stress disorder from the acute response to a traumatic event. Biological Psychiatry, 44, 1305–1313. doi:10.1016/S0006-3223(98)00276-5.

    Article  PubMed  Google Scholar 

  • Yehuda, R., Bierer, L. M., Schmeidler, J., Aferiat, D. H., Breslau, I., & Dolan, S. (2000). Low cortisol and risk for PTSD in adult offspring of holocaust survivors. The American Journal of Psychiatry, 157, 1252. doi:10.1176/appi.ajp.157.8.1252.

    Article  PubMed  Google Scholar 

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Acknowledgements

This research would not be possible if not for the support of several individuals and organizations. Among them are the team at MichiganPAL for collecting this data 7 days a week for two years, the families who gave their time to improve our understanding of anxiety and depression, the faculty and fellows of the International Max Planck Research School on the Life Course who have provided valuable insight on the development of this project, and the following organizations for their financial support of this research: Blue Cross Blue Shield of Michigan Foundation, Barbara A. Oleshansky Memorial Award, American Psychological Foundation, and Rackham Graduate School at University of Michigan. The composition of this manuscript was made possible by the National Institute of Mental Health (15750) awarded to Dr. Kuhlman.

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Authors and Affiliations

  1. Department of Psychology, University of California Los Angeles, Los Angeles, CA, 90095, USA

    Kate R. Kuhlman

  2. Department of Social Science, Olivet College, Olivet, MI, USA

    Elisa G. Geiss

  3. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Ivan Vargas

  4. Department of Psychology, University of Michigan, Ann Arbor, MI, USA

    Nestor Lopez-Duran

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  1. Kate R. Kuhlman
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  2. Elisa G. Geiss
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  4. Nestor Lopez-Duran
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Correspondence to Kate R. Kuhlman.

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Kuhlman, K.R., Geiss, E.G., Vargas, I. et al. HPA-Axis Activation as a Key Moderator of Childhood Trauma Exposure and Adolescent Mental Health. J Abnorm Child Psychol 46, 149–157 (2018). https://doi.org/10.1007/s10802-017-0282-9

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