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J Child Psychol Psychiatry. 2017 Sep;58(9):998-1007. doi: 10.1111/jcpp.12700. Epub 2017 Feb 28.

Reduced hair cortisol after maltreatment mediates externalizing symptoms in middle childhood and adolescence.

Author information

1
Department of Child and Adolescent Psychiatry, University of Leipzig, Leipzig, Germany.
2
Max Planck Institute of Psychiatry, Munich, Germany.
3
Department of Developmental Psychology, University of Jena, Jena, Germany.
4
Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
5
Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
6
University of Leipzig, Leipzig, Germany.
7
Mt. Hope Family Center, University of Rochester, Rochester, NY, USA.
8
Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
9
Institute of Psychology, TU Dresden, Dresden, Germany.
10
Clinical Psychology, University of Siegen, Siegen, Germany.

Abstract

BACKGROUND:

The enduring impact of childhood maltreatment on biological systems and ensuing psychopathology remains incompletely understood. Long-term effects of stress may be reflected in cumulative cortisol secretion over several months, which is now quantifiable via hair cortisol concentrations (HCC). We conducted a first comprehensive investigation utilizing the potential of hair cortisol analysis in a large sample of maltreated and nonmaltreated children and adolescents.

METHOD:

Participants included 537 children and adolescents (3-16 years; 272 females) with maltreatment (n = 245) or without maltreatment histories (n = 292). Maltreated subjects were recruited from child protection services (CPS; n = 95), youth psychiatric services (n = 56), and the community (n = 94). Maltreatment was coded using the Maltreatment Classification System drawing on caregiver interviews and complemented with CPS records. Caregivers and teachers reported on child mental health. HCC were assessed in the first 3 cm hair segment.

RESULTS:

Analyses uniformly supported that maltreatment coincides with a gradual and dose-dependent reduction in HCC from 9 to 10 years onwards relative to nonmaltreated controls. This pattern emerged consistently from both group comparisons between maltreated and nonmaltreated subjects (27.6% HCC reduction in maltreated 9-16-year-olds) and dimensional analyses within maltreated subjects, with lower HCC related to greater maltreatment chronicity and number of subtypes. Moreover, both group comparisons and dimensional analyses within maltreated youth revealed that relative HCC reduction mediates the effect of maltreatment on externalizing symptoms.

CONCLUSIONS:

From middle childhood onwards, maltreatment coincides with a relative reduction in cortisol secretion, which, in turn, may predispose to externalizing symptoms.

KEYWORDS:

Hair cortisol; externalizing symptoms; maltreatment; neglect

PMID:
28244601
PMCID:
PMC5570647
[Available on 2018-09-01]
DOI:
10.1111/jcpp.12700
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