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

MacMillan, Harriet L.; Georgiades, Katholiki; Duku, Eric K.; Shea, Alison; Steiner, Meir; Niec, Anne; Tanaka, Masako; Gensey, Susan; Spree, Sandra; Vella, Emily; Walsh, Christine A.; De Bellis, Michael D.; Van der Meulen, John; Boyle, Michael H.; Schmidt, Louis A.

doi:10.1016/j.biopsych.2008.12.014

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

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

Harriet L. MacMillan
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Ontario, Canada
- Department of Pediatrics, McMaster University, Ontario, Canada
- Address reprint requests to Harriet L. MacMillan, M.D., Offord Centre for Child Studies, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Patterson Building, Chedoke Hospital, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5
Katholiki Georgiades
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Ontario, Canada
Eric K. Duku
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Ontario, Canada
Alison Shea
- Women's Health Concerns Clinic, St. Joseph's Healthcare, Ontario, Canada
Meir Steiner
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Ontario, Canada
- Women's Health Concerns Clinic, St. Joseph's Healthcare, Ontario, Canada
Anne Niec
- Department of Pediatrics, McMaster University, Ontario, Canada
Masako Tanaka
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Ontario, Canada
Susan Gensey
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Ontario, Canada
Sandra Spree
- McMaster Children's Hospital, Hamilton Health Sciences, Ontario, Canada
Emily Vella
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Ontario, Canada
Christine A. Walsh
- Faculty of Social Work, University of Calgary, Alberta, Canada
Michael D. De Bellis
- Healthy Childhood Brain Development and Traumatology Research Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
John Van der Meulen
- Department of Pediatrics, McMaster University, Ontario, Canada
Michael H. Boyle
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Ontario, Canada
Louis A. Schmidt
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Ontario, Canada

Received 13 March 2008; received in revised form 11 December 2008; accepted 11 December 2008. published online 13 February 2009.

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.

Key Words: Child maltreatment, hypothalamic-pituitary-adrenal axis