151. Day-to-day dynamics of associations between childhood adversity and cortisol diurnal rhythm in women diagnosed with breast cancer

Abstract

A dysregulated cortisol diurnal rhythm is associated with a poorer prognosis for women with metastatic breast cancer. The purpose of this study was to investigate whether adversity experienced during childhood influences the dynamics of the cortisol rhythm in women newly diagnosed with early stage breast cancer. Women ( N = 98) were evaluated after their diagnosis but before surgery. Women completed the Perceived Stress Scale and the Childhood Trauma Questionnaire to assess their levels of psychological stress and the degree of exposure to childhood adversity, respectively. Over two consecutive days, women collected saliva five times per day for cortisol measurement, while also completing sleep diaries to assess prior-night sleep quality, including nocturnal awakenings, and morning restfulness. Multilevel growth curve modeling was used to examine whether childhood adversity contributed to the day-to-day variations in the cortisol diurnal rhythm. Emotional and physical abuse were significant predictors of the cortisol quadratic slope, indicating that women who reported greater exposure to such childhood adversity had greater levels of cortisol at bedtime. These effects were independent of daily variation in prior-night sleep quality, perceived stress levels, as well as demographic and cancer disease factors. These findings demonstrate childhood adversity to be a preexisting risk factor for dysregulation of the cortisol diurnal rhythm in women experiencing the stress associated with breast cancer diagnosis. Such dysregulation may negatively impact cancer control.