Childhood Life Events Research Articles

The comorbidity of traumatic life events in childhood age with adult obsessive-compulsive disorder

PurposeObsessive-Compulsive Disorder (OCD) is a mental disorder characterized by obsessions and/or compulsions. Although some epidemiological studies take part in literature, which claim that traumatic life events in childhood ages are observed more in patients with OCD compared to healthy population, the number of these studies is limited. In this study, it is aimed to compare OCD patients with healthy volunteers in terms of traumatic life events in childhood ages.MethodWith 25 consecutive patients who are diagnosed as OCD and whose treatment continues, 25 healthy controls equivalent in terms of sociodemographic features are included in the study. Sociodemographic Data Form, Childhood Age Trauma Quarter (CTQ) and Maudley Obsessive Compulsive Question List (MOCQL) are applied to the participants. Significance Value in statistical level is accepted as P < 0.05.FindingsIn OCD patient group, CTQ scores are found high in statistical level compared to healthy controls. It has been determined that there is a significant relationship between total score of MOCQL slowness subscale scores, subscale scores of sexual and emotional abuse, MOCQL rumination subscale scores and CTQ sexual abuse scores.ResultCompared to healthy controls, more findings of traumatic life event in childhood age are observed within OCD patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Family preferences for home or hospital care at diagnosis for children with diabetes in the DECIDE study.

AimsA diagnosis of Type 1 diabetes in childhood can be a difficult life event for children and families. For children who are not severely ill, initial home rather than hospital‐based care at diagnosis is an option although there is little research on which is preferable. Practice varies widely, with long hospital stays in some countries and predominantly home‐based care in others. This article reports on the comparative acceptability and experience of children with Type 1 diabetes and their parents taking part in the DECIDE study evaluating outcomes of home or hospital‐based treatment from diagnosis in the UK.MethodsSemi‐structured interviews with 11 (pairs of) parents and seven children were conducted between 15 and 20 months post diagnosis. Interviewees were asked about adaptation to, management and impact of the diabetes diagnosis, and their experience of initial post‐diagnosis treatment.ResultsThere were no differences between trial arms in adaptation to, management of or impact of diabetes. Most interviewees wanted to be randomized to the ‘home’ arm initially but expressed a retrospective preference for whichever trial arm they had been in, and cited benefits relating to learning about diabetes management.ConclusionsThe setting for early treatment did not appear to have a differential impact on families in the long term. However, the data presented here describe different experiences of early treatment settings from the perspective of children and their families, and factors that influenced how families felt initially about treatment setting. Further research could investigate the short‐term benefits of both settings.

Stressful Life Events in Children With Functional Defecation Disorders.

The aim of the study was to determine the prevalence of stressful life events including (sexual) abuse in children with functional defecation disorders by performing a systematic review. We searched MEDLINE, EMBASE, and PsycINFO for cohort, case-control and cross-sectional studies investigating the prevalence of stressful life events, including (sexual) abuse in children with functional defecation disorders. The search yielded 946 articles, of which 8 were included with data from 654 children with functional constipation and 1931 children with (constipation-associated) fecal incontinence (FI). Overall, children with functional defecation disorders had been significantly more exposed to stressful life events than healthy children, with prevalence rates ranging from 1.6% to 90.9%. Being bullied, being a relational victim, interruption of toilet training, punishment by parents during toilet training, and hospitalization were significantly related to FI, whereas separation from the best friend, failure in an examination, severe illness in a close family member, loss of job by a parent, frequent punishment, and living in a war-affected area were significantly related to constipation. Only 1 study measured the prevalence of child abuse, which reported a significantly higher prevalence of child (sexual) abuse in children with FI compared with controls. The prevalence of stressful life events, including (sexual) abuse is significantly higher in children with functional defecation disorders compared with healthy children. To gain more insight into the true prevalence of child (sexual) abuse in children with functional defecation disorders, more studies are clearly needed.

The Association of Early and Recent Psychosocial Life Stress With Leukocyte Telomere Length.

Chronic exposure to psychosocial stressors is related to worse somatic health. This association applies both to stressors early in life, such as childhood adversities, and more recent life stress, such as stressful life events. This study examined whether accelerated telomere shortening, as an indicator of cellular aging, might be an explanatory mechanism. We examined whether childhood adversities and recent stressful life events were associated with shorter telomeres in 2936 participants (mean [standard deviation] age = 41.8 [13.1] years, 66% women, 57% current depression) of the Netherlands Study of Depression and Anxiety. Telomeres are specialized nucleic acid-protein complexes at the ends of linear DNA that shorten with age; telomere length (TL) was measured with quantitative polymerase chain reaction. Childhood life events (β = .004, p = .805) and childhood trauma (β = -.023, p = .205) were not related to shorter TL. However, we found negative associations between recent stressful life events and TL. Persons had shorter telomeres if they reported more stressful life events in the past year (β = -.039, p = .028) and 1 to 5 years ago (β = -.042, p = .018, adjusted for sociodemographics). The relationship between stressful life events and TL became borderline significant when further adjusted for smoking status. No associations with TL were found when stressful life events occurred more than 6 years ago (p > .10). Results show that recent stressful life events are associated with shorter TL. This association is not observed for psychosocial stressors that occur earlier in life. Whether these results are indicative of physiological resiliency remains to be explored by future longitudinal research.

Accumulation of Major Life Events in Childhood and Adult Life and Risk of Type 2 Diabetes Mellitus.

BackgroundThe aim of the study was to estimate the effect of the accumulation of major life events (MLE) in childhood and adulthood, in both the private and working domains, on risk of type 2 diabetes mellitus (T2DM). Furthermore, we aimed to test the possible interaction between childhood and adult MLE and to investigate modification of these associations by educational attainment.MethodsThe study was based on 4,761 participants from the Copenhagen City Heart Study free of diabetes at baseline and followed for 10 years. MLE were categorized as 0, 1, 2, 3 or more events. Multivariate logistic regression models adjusted for age, sex, education and family history of diabetes were used to estimate the association between MLE and T2DM.ResultsIn childhood, experiencing 3 or more MLE was associated with a 69% higher risk of developing T2DM (Odds Ratio (OR) 1.69; 95% Confidence Interval (CI) 1.60, 3.27). The accumulation of MLE in adult private (p-trend = 0.016) and work life (p-trend = 0.049) was associated with risk of T2DM in a dose response manner. There was no evidence that experiencing MLE in both childhood and adult life was more strongly associated with T2DM than experiencing events at only one time point. There was some evidence that being simultaneously exposed to childhood MLE and short education (OR 2.28; 95% C.I. 1.45, 3.59) and work MLE and short education (OR 2.86; 95% C.I. 1.62, 5.03) was associated with higher risk of T2DM, as the joint effects were greater than the sum of their individual effects.ConclusionsFindings from this study suggest that the accumulation of MLE in childhood, private adult life and work life, respectively, are risk factors for developing T2DM.

Psychosocial adversity, delinquent pathway and internalizing psychopathology in juvenile male offenders

The main aim of the present study was to investigate the presence of a set of risk factors relating to childhood life events and other psychosocial factors that may be associated with criminal indicators and with the prevalence of internalizing psychopathology in a sample of adolescent offenders. Fifty male adolescents in the custody of the Portuguese Juvenile Justice System participated in the study (M=15.8years of age). The Adolescent Psychopathology Scale — Short Form (APS-SF) was administered in a structured interview format, and the sociodemographic, family and criminal data questionnaire was filled in by the justice professional after consulting the adolescent's file. Forty-six percent of all subjects had previous delinquent behavior. About 32% of the boys had committed violent offenses and 88% acted with peers. Also, the persistence of the delinquent behavior (50% of the offenders), coupled with the increase in the severity of the crimes committed (38% of the sample), suggests that these adolescents were at risk for serious and chronic delinquency at the time of the intervention. About 32% of the participants reported posttraumatic stress disorder symptoms, 20% had suicide ideation, and a lower percentage reported other internalizing problems. Institutionalization, maltreatment and conduct problems in childhood, and family risk factors (parental conflict, absence of a father figure, lack of parental control and family substance addiction) were related with the report of internalizing problems. Moreover, the increase in the severity of criminal offenses and living in a correctional facility were associated with higher levels of posttraumatic stress, interpersonal problems, anxiety and depression. This study draws attention to the importance of assessing indicators of psychopathology and of psychosocial risk in intervention programs with young offenders, but also to the need of family focused interventions in order to help prevent recidivism.

The structural equation analysis of childhood abuse, adult stressful life events, and temperaments in major depressive disorders and their influence on refractoriness.

BackgroundPrevious studies have shown the interaction between heredity and childhood stress or life events on the pathogenesis of a major depressive disorder (MDD). In this study, we tested our hypothesis that childhood abuse, affective temperaments, and adult stressful life events interact and influence the diagnosis of MDD.Patients and methodsA total of 170 healthy controls and 98 MDD patients were studied using the following self-administered questionnaire surveys: the Patient Health Questionnaire-9 (PHQ-9), the Life Experiences Survey, the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire, and the Child Abuse and Trauma Scale (CATS). The data were analyzed with univariate analysis, multivariable analysis, and structural equation modeling.ResultsThe neglect scores of the CATS indirectly predicted the diagnosis of MDD through cyclothymic and anxious temperament scores of the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire in the structural equation modeling. Two temperaments – cyclothymic and anxious – directly predicted the diagnosis of MDD. The validity of this result was supported by the results of the stepwise multivariate logistic regression analysis as follows: three factors – neglect, cyclothymic, and anxious temperaments – were significant predictors of MDD. Neglect and the total CATS scores were also predictors of remission vs treatment-resistance in MDD patients independently of depressive symptoms.LimitationsThe sample size was small for the comparison between the remission and treatment-resistant groups in MDD patients in multivariable analysis.ConclusionThis study suggests that childhood abuse, especially neglect, indirectly predicted the diagnosis of MDD through increased affective temperaments. The important role as a mediator of affective temperaments in the effect of childhood abuse on MDD was suggested.

Self-Perceived Competence and Social Acceptance of Children who Stutter

PurposeThis study examined self-perceived general competence and social acceptance in young children who stutter (CWS) as compared to children who do not stutter (CWNS), and assessed the extent to which temperament, speech disfluency, language abilities, and home environment both co-vary and predict children's perception of their own competence. MethodsData were collected from 16 CWS and 16 CWNS between the ages of 4; 0 and 5;10. Standardized assessments of perceived competence and social acceptance, temperament, expressive language, receptive language, and home environment were collected from each child, as well as stuttering severity ratings for the CWS. ResultsResults indicated that CWS and CWNS did not significantly differ in self-perceived general competence or perceived social acceptance. Regression analyses revealed that for CWS and CWNS combined a) surgency and negative affectivity best predicted perceived competence, and (b) negative affectivity and receptive language best predicted perceived social acceptance. For CWS only, stuttering severity was added to the analysis and results revealed that (c) surgency and expressive language best predicted perceived competence, and (d) stuttering severity and receptive language best predicted perceived social acceptance. Results approached significance. ConclusionsThese findings propose that children's speech and language skills seem to be linked to their perception of peer acceptance, while a tendency for risk taking and a generally positive view of new situations may play an important role for self-perception of overall competence in the world. Further, the results implicate a “normal” self-perception on behalf of the CWS in this study, which mirrors the tendency for young children to view themselves in an overly positive light. This inflated sense of ability may serve as a “buffer” between the child's life events (e.g., stuttering) and social-emotional development. Therefore, determining a child's degree of self-perceived competence could be an important contributing factor to a successful therapeutic outcome.

E-Mental Health Care Among Young Adults and Help-Seeking Behaviors: A Transversal Study in a Community Sample

BackgroundThe Internet is widely used by young people and could serve to improve insufficient access to mental health care. Previous information on this topic comes from selected samples (students or self-selected individuals) and is incomplete.ObjectiveIn a community sample of young adults, we aimed to describe frequency of e-mental health care study-associated factors and to determine if e-mental health care was associated with the use of conventional services for mental health care.MethodsUsing data from the 2011 wave of the TEMPO cohort study of French young adults (N=1214, aged 18-37 years), we examined e-mental health care and associated factors following Andersen’s behavioral model: predisposing factors (age, sex, educational attainment, professional activity, living with a partner, children, childhood negative events, chronic somatic disease, parental history of depression), enabling factors (social support, financial difficulties, parents’ income), and needs-related factors (lifetime major depression or anxiety disorders, suicidal ideation, ADHD, cannabis use). We compared traditional service use (seeking help from a general practitioner, a psychiatrist, a psychologist; antidepressant or anxiolytics/hypnotics use) between participants who used e-mental health care versus those who did not.ResultsOverall, 8.65% (105/1214) of participants reported seeking e-mental health care in case of psychological difficulties in the preceding 12 months and 15.7% (104/664) reported psychological difficulties. Controlling for all covariates, the likelihood of e-mental health care was positively associated with 2 needs-related factors, lifetime major depression or anxiety disorder (OR 2.36, 95% CI 1.36-4.09) and lifetime suicidal ideation (OR 1.91, 95% CI 1.40-2.60), and negatively associated with a predisposing factor: childhood life events (OR 0.60, 95% CI 0.38-0.93). E-mental health care did not hinder traditional care, but was associated with face-to-face psychotherapy (66.2%, 51/77 vs 52.4%, 186/355, P=.03).ConclusionsE-mental health care represents an important form of help-seeking behavior for young adults. Professionals and policy makers should take note of this and aim to improve the quality of online information on mental health care and to use this fact in clinical care.

Genetic and childhood trauma interaction effect on age of onset in bipolar disorder: An exploratory analysis

IntroductionThis study investigated whether early life trauma mediates genetic effects on the age at onset (AAO) of bipolar disorder. MethodData from the BiGS Consortium case samples (N=1119) were used. Childhood traumatic events were documented using the Childhood Life Events Scale (CLES). Interaction between occurrence of childhood trauma and common genetic variants throughout the genome was tested to identify single nucleotide polymorphic gene variants (SNPs) whose effects on bipolar AAO differ between individuals clearly exposed (CLES≥2) and not exposed (CLES=0) to childhood trauma. ResultsThe modal response to the CLES was 0 (N=480), but an additional 276 subjects had CLES=1, and 363 subjects reported 2 or more traumatic lifetime events. The distribution of age at onset showed a broad peak between ages 12 and 18, with the majority of subjects having onset during that period, and a significant decrease in age of onset with the number of traumatic events. No single SNP showed a statistically significant interaction with the presence of traumatic events to impact bipolar age at onset. However, SNPs in or near genes coding for calcium channel activity-related proteins (Gene Ontology: 0005262) were found to be more likely than other SNPs to show evidence of interaction using the INRICH method (p<0.001). LimitationsRetrospective ascertainment of trauma and AAO. ConclusionInteraction effects of early life trauma with genotype may have a significant effect on the development and manifestation of bipolar disorder. These effects may be mediated in part by genes involved in calcium signaling.

Glucocorticoid and mineralocorticoid receptor polymorphisms and recurrence of major depressive disorder

Previous research found that variants of the glucocorticoid receptor (GR) (9β, ER22/23EK, BclI, TthIIIl, NR3C1-1 and N363S) and mineralocorticoid receptor (MR) gene polymorphism (-2 C/G and I180V) are associated with both glucocorticoid (GC) sensitivity and major depressive disorder (MDD). There are no data which investigated prospectively whether these variants are associated with recurrence of MDD. Data were derived from the Netherlands Study of Depression and Anxiety (NESDA) which used the Composite International Diagnostic Interview (CIDI) to determine MDD. Polymorphisms in the GR and MR gene were determined and haplotypes were characterized. We analyzed in retrospect whether recurrent MDD (n=951) in comparison with first onset MDD (n=919) was associated with polymorphisms in the GR and MR gene. Furthermore, we analyzed prospectively for 4 years the time to recurrence among 683 subjects with a remitted MDD diagnosis. Time to recurrence of MDD was assessed using the CIDI and a life chart interview. Additionally, we analyzed interactions of the investigated polymorphisms with childhood trauma and recent negative life events. GR and MR gene polymorphisms and derived haplotypes were not associated with recurrence of depression in both retrospective and prospective analyses. In addition, no consistent interactions between GR and MR polymorphisms and childhood trauma or life events were found. This study did not find consistent associations between GR and MR gene polymorphisms, interactions between GR and MR haplotypes and stressful conditions and recurrence of MDD.

Associations between life stress and subclinical cardiovascular disease are partly mediated by depressive and anxiety symptoms

BackgroundStress experienced during childhood or adulthood has been associated with cardiovascular disease (CVD), but it is not clear whether associations are already prevalent on a subclinical cardiovascular level. This study investigates associations between indicators of life stress and subclinical CVD, and whether these are mediated by depression and anxiety. MethodsSubjects were 650 participants of the Netherlands Study of Depression and Anxiety, aged 20–66years, with or without (27.5%) depressive and anxiety disorders. Life stress included childhood trauma, negative life events and recently experienced daily hassles or job strain. Subclinical CVD was measured as 1) carotid atherosclerosis (intima–media thickness and the presence of plaques) using B-mode ultrasonography, and 2) central arterial stiffness (heart rate normalized augmentation index) using calibrated radial applanation tonometry. ResultsIncreased central arterial stiffness was shown in subjects who had experienced childhood trauma (per SD increase: β=.07; p=.01), or reported recently experienced daily hassles (per SD increase: β=.06; p=.02), negative life events (per SD increase: β=.05; p=.03), or job strain (high versus low: β=.09; p=.01). Associations between life stress and arterial stiffness appeared to be partly mediated by severity of depressive and anxiety symptoms. No significant associations were found for childhood life events, nor between indicators of life stress and carotid atherosclerosis. ConclusionsChildhood trauma and recent life stress were associated with increased central arterial stiffness. This suggests that life stress – partly via depression and anxiety – might enhance the development and progression of CVD.

Impact of childhood life events and childhood trauma on the onset and recurrence of depressive and anxiety disorders.

To investigate the effect of childhood life events and childhood trauma on the onset and recurrence of depressive and/or anxiety disorders over a 2-year period in participants without current psychopathology at baseline. Longitudinal data in a large sample of participants without baseline DSM-IV depressive or anxiety disorders (n = 1,167, aged 18 to 65 years; assessed between 2004-2007) were collected in the Netherlands Study of Depression and Anxiety (NESDA). Childhood life events and childhood trauma were assessed at baseline with a semistructured interview. The Composite International Diagnostic Interview, based on DSM-IV criteria, was used to diagnose first onset or recurrent depressive and/or anxiety disorders over a 2-year period. At baseline, 172 participants (14.7%) reported at least 1 childhood life event, and 412 (35.3%) reported any childhood trauma. During 2 years of follow-up, 226 participants (19.4%) developed a new (n = 58) or recurrent (n = 168) episode of a depressive and/or anxiety disorder. Childhood life events did not predict the onset and recurrence of depressive or anxiety disorders. Emotional neglect and psychological, physical, and sexual abuse were all associated with an increased risk of first onset and recurrence of either depressive or comorbid disorders (P < .001), but not of anxiety disorders. In multivariate models, emotional neglect was the only significant independent predictor of first onset and recurrence of any depressive or comorbid disorder (P = .002). These effects were primarily mediated by the severity of (subclinical) depressive symptoms at baseline and, to a lesser extent, by a prior lifetime diagnosis of a depressive and/or anxiety disorder. Childhood maltreatment is a key environmental risk factor, inducing vulnerability to develop new and recurrent depressive and comorbid anxiety and depressive episodes.

Dental fear and previous childhood traumatic experiences, life events, and parental bonding

We aimed to determine whether adult dental fear is associated with traumas, life events, and perceived parental bonding. Pilot data for the FinnBrain Cohort study were used. Of the 254 families expecting a baby, 80% agreed to participate. At 32-34 wk of pregnancy, 125 women and 81 men completed a Modified Dental Anxiety Scale questionnaire and were included in this study. Other instruments used were the Trauma and Distress Scale (TADS), the Life Event Checklist, and the Parental Bonding Index. All scales were analyzed as summated rating scale scores. Associations between dental fear, TADS domains, and life events were evaluated using Spearman correlation coefficients. The association between dental fear and parental bonding was evaluated using the Kruskal-Wallis test. Among women, dental fear did not correlate with trauma measures, but among men dental fear correlated with emotional neglect and abuse. Dental fear correlated positively with the number of life events among women. Life events and dental fear did not correlate among men. Dental fear was not associated with parental bonding among women or men. The association between traumas, life events, and dental fear seems to be different in women and men.

Can General Strain Theory Help Us Understand Violent Behaviors Among People with Mental Illnesses?

Recent work suggests that violence among people with mental illnesses is not simply due to the symptoms and comorbidities that define mental illness. We further this work by examining the extent to which strains or stressors explain the link between mental illness and violence. Specifically, we apply general strain theory (GST) to a longitudinal sample of adults with mental illnesses to investigate the lagged effects on violence of several strain measures, while controlling for mental illness symptoms, substance abuse, past violence, and other key variables. Parental drug abuse from childhood and stressful life events across the life course predict violence in adulthood. In a prospective model, relationship strain from an earlier time period significantly predicts changes in later self-reported violence. The results shed light on the ability of criminological frameworks to explain violence among people with mental illnesses.

The effect of childhood stress on the development of mental disorders in adults

There is evidence that not only severe stressful events, but also common low-threat events, in particular chronic ones, may cause or provoke some mental disorders. The literature data on the degree of pathogenicity of stress factors are insufficient. Authors attempted to summarize the established facts in the following aspects: current conceptions on the physiology and pathology of stress in the frames of the problem of psychosomatic disorders, deprivation in childhood, neurobiological consequences of childhood stress, psychiatric consequences of stress in childhood. Authors believe that this problem demands further investigation to find possible predictors of mental disorders in patients who had experienced stressful life events in childhood.

Psychological distress and stressful life events in pediatric complex regional pain syndrome.

There is little knowledge regarding the association between psychological factors and complex regional pain syndrome (CRPS) in children. Specifically, it is not known which factors precipitate CRPS and which result from the ongoing painful disease. To examine symptoms of depression and anxiety as well as the experience of stressful life events in children with CRPS compared with children with chronic primary headaches and functional abdominal pain. A retrospective chart study examined children with CRPS (n=37) who received intensive inpatient pain treatment between 2004 and 2010. They were compared with two control groups (chronic primary headaches and functional abdominal pain; each n=37), who also received intensive inpatient pain treatment. Control groups were matched with the CRPS group with regard to admission date, age and sex. Groups were compared on symptoms of depression and anxiety as well as stressful life events. Children with CRPS reported lower anxiety and depression scores compared with children with abdominal pain. A higher number of stressful life events before and after the onset of the pain condition was observed for children with CRPS. Children with CRPS are not particularly prone to symptoms of anxiety or depression. Importantly, children with CRPS experienced more stressful life events than children with chronic headaches or abdominal pain. Prospective long-term studies are needed to further explore the potential role of stressful life events in the etiology of CRPS.

Type and severity of intimate partner violence and its relationship with PTSD in HIV-infected women

HIV has an impact on the presence and severity of both intimate partner violence (IPV) and posttraumatic stress disorder (PTSD) in infected women. However, the relationship of type and severity of IPV with PTSD in this population has not been adequately explored. We focus on the association between the type and severity of IPV and HIV status and PTSD in a sample of South African women. One hundred and sixty-nine women (114 HIV-positive and 55 HIV-negative controls), matched for geographical area, education, and socio-economic status, were recruited from HIV clinics. Clinical and demographic data were collected, including data on childhood trauma, other traumatic life events, IPV, posttraumatic stress symptoms, problematic alcohol use, and depressive symptoms. HIV-positive women had significantly more depressive symptoms, alcohol abuse, and childhood trauma exposure as well as significantly higher rates of PTSD (25.4%) when compared with uninfected women (10.9%). No significant group differences in the rate, pattern, and severity of physical, sexual, psychological, injury, and negotiation IPV were found. In logistic regression analysis, the rate and severity category of IPV did not significantly predict PTSD in HIV-positive women when childhood trauma and life events were controlled for. Our results indicate the need for screening for alcohol abuse, PTSD and depressive symptoms at HIV wellness, and ARV clinics. The high rates of PTSD in HIV-positive women indicate the need for specialized programs to manage PTSD and minimize negative sequelae in this population. These results also highlight the need for improved screening and prevention of childhood trauma and IPV both in infected and uninfected women.

Blunted endocrine and cardiovascular reactivity in young healthy women reporting a history of childhood adversity.

Chronic or prolonged stress exposure in childhood can alter structural and functional brain development, leading to mental and physical illness and alterations of psychobiological stress systems in adulthood. Recently, attenuation in stress reactivity of the hypothalamic-pituitary-adrenal (HPA) axis and cardiovascular system have been related to the number of adverse childhood experiences (ACEs). We set out to investigate the association of ACE duration and age of ACE occurrence on stress reactivity. 104 women in the age range 18-25 years (mean=21.7) free of mental and physical illness underwent psychosocial stress testing with the Montreal Imaging Stress Task (MIST). Free saliva cortisol and heart rate were assessed repeatedly before and after the MIST. Number of ACEs was associated with attenuated cortisol and heart rate responses to stress in a dose-response relationship. Whereas overall duration of ACEs was significantly associated with an attenuated cortisol response, the specific age of first ACE occurrence did not contribute further to the dampened stress response. ACEs are associated with blunted endocrine and cardiovascular stress reactivity in young and healthy women. Adverse life events in childhood, particularly if they occur repeatedly and chronically, show a strong association with alterations in stress reactivity in adulthood, potentially predisposing for later mental or physical disorders.

Increased cortisol awakening response was associated with time to recurrence of major depressive disorder.

Although HPA-axis activity has been studied extensively in relation to depression, there is no consensus whether HPA-axis parameters predicts major depressive disorder (MDD) recurrence. We investigated whether HPA-axis parameters (cortisol awakening response (CAR), the dexamethasone suppression test (DST) and evening cortisol) predict time to recurrence in remitted subjects with a history of MDD and whether childhood trauma and life events interact with HPA-axis parameters in increasing the risk for recurrence. Data were derived from 549 subjects with a lifetime diagnosis of MDD in remission for at least six months preceding the baseline assessment of the Netherlands Study of Depression and Anxiety (NESDA). Subjects were followed up with two interviews over the course of four years to assess recurrence. DSM-IV based diagnostic interviews were used to assess time to recurrence of MDD. Seven salivary cortisol samples collected at baseline with information on CAR, evening cortisol and the DST. Hazard ratios were calculated using Cox regression analysis, adjusted for covariates. A higher CAR was associated with time to recurrence of MDD (HR=1.03, 95%CI 1.003-1.060, p=0.03) whereas evening cortisol and DST were not. No interactions between HPA-axis parameters and stress-related factors were found. Our data support previous studies reporting that subjects with a higher CAR are more vulnerable to recurrence of MDD.