Abstract
BackgroundChildhood trauma (CT) is a risk factor for depressive and anxiety disorders. Although dysregulated biological stress systems may underlie the enduring effect of CT, the relation between CT and separate and cumulative activity of the major stress systems, namely, the hypothalamic-pituitary-adrenal (HPA)-axis, the immune-inflammatory system, and the autonomic nervous system (ANS), remains inconclusive. MethodsIn the Netherlands Study of Depression and Anxiety (NESDA, n = 2778), we determined whether self-reported CT (as assessed by the Childhood Trauma Interview) was associated with separate and cumulative markers of the HPA-axis (cortisol awakening response, evening cortisol, dexamethasone suppression test cortisol), the immune-inflammatory system (C-reactive protein, interleukin-6, tumor necrosis factor-α), and the ANS (heart rate, respiratory sinus arrhythmia, pre-ejection period) in adulthood. ResultsAlmost all individuals with CT (n = 1330) had either current or remitted depressive and/or anxiety disorder (88.6%). Total-sample analyses showed little evidence for CT being significantly associated with the separate or cumulative stress systems’ activity in adulthood. These findings were true for individuals with and without depressive and/or anxiety disorders. To maximize contrast, individuals with severe CT were compared to healthy controls without CT. This yielded slight, but significantly higher levels of cortisol awakening response (AUCg, β = .088, p = .007; AUCi, β = .084, p = .010), cumulative HPA-axis markers (β = .115, p = .001), C-reactive protein (β = .055, p = .032), interleukin-6 (β = .053, p = .038), cumulative inflammation (β = .060, p = .020), and cumulative markers across all systems (β = .125, p = .0003) for those with severe CT, partially explained by higher rates of smoking, body mass index, and chronic diseases. ConclusionWhile our findings do not provide conclusive evidence on CT directly dysregulating stress systems, individuals with severe CT showed slight indications of dysregulations, partially explained by an unhealthy lifestyle and poorer health.
Highlights
Childhood trauma (CT), such as emotional and physical neglect or emotional, physical, and sexual abuse before the age of 18, has been increasingly recognized as a prominent risk factor for mental and so matic disorders occurring across the lifespan (Felitti et al, 2019; Hughes et al, 2017; Teicher and Samson, 2013; Wegman and Stetler, 2009)
Significant correlations were observed between the DST cortisol and IL-6, AUCg, and respiratory sinus arrhythmia (RSA), as well as of evening cortisol with C-reactive protein (CRP), RSA, and pre-ejection period (PEP) (p < .05)
When zooming in on individuals with severe CT compared to healthy controls without CT, were most stress systems’ dysregulations observed, which concerned slightly heightened levels of HPA-axis markers, inflammation markers, and cumulative markers across all systems
Summary
Childhood trauma (CT), such as emotional and physical neglect or emotional, physical, and sexual abuse before the age of 18, has been increasingly recognized as a prominent risk factor for mental and so matic disorders occurring across the lifespan (Felitti et al, 2019; Hughes et al, 2017; Teicher and Samson, 2013; Wegman and Stetler, 2009). With regard to depressive and anxiety disorders, adults with a history of CT have an earlier onset and chronic course, with higher rates of co morbidity, and poorer treatment outcomes than those without CT (Hovens et al, 2012; Nanni et al, 2012; Wiersma et al, 2009) This long-lasting effect has been partially explained by biological stress-induced alterations such as dysregulation of stress systems (Berens et al, 2017; Otte et al, 2016). Methods: In the Netherlands Study of Depression and Anxiety (NESDA, n = 2778), we determined whether selfreported CT (as assessed by the Childhood Trauma Interview) was associated with separate and cumulative markers of the HPA-axis (cortisol awakening response, evening cortisol, dexamethasone suppression test cortisol), the immune-inflammatory system (C-reactive protein, interleukin-6, tumor necrosis factor-α), and the ANS (heart rate, respiratory sinus arrhythmia, pre-ejection period) in adulthood. Conclusion: While our findings do not provide conclusive evidence on CT directly dysregulating stress systems, individuals with severe CT showed slight indications of dysregulations, partially explained by an unhealthy lifestyle and poorer health
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