Does quantity have a quality all its own? Cumulative adversity and up- and down-regulation of circadian salivary cortisol levels in healthy children
Abstract
Findings have been divergent regarding the direction of basal cortisol dysregulations resulting from stressor exposure, and seem to differ between young people and adults. Accumulated stress exposure has been suggested to be a risk factor for the development of hypocortisolism. This cross-sectional study aims to examine the impact of cumulative adversity, i.e., the number of adversities, on diurnal salivary cortisol levels, including the cortisol awakening response (CAR), in children without psychiatric disorder. The sample consisted of 130 children (mean age 12.8 years), representing one in each twin pair included in the population-based Child and Adolescent Twin Study in Sweden (CATSS). Information about socioeconomic disadvantage, negative life events and potentially traumatic life events were collected by telephone interview and questionnaires, with parents as informants. Salivary cortisol sampling was performed in the home during two school days: at awakening, +30 min post-awakening, and at bedtime. Results showed that the number of adversities was related to the CAR, diurnal decline and +30 min post-awakening cortisol levels. Children with a moderate amount of cumulative adversity displayed high cortisol measures, while those with a high amount (3 or more) of adversities instead showed levels similar to the non-exposed group, yielding an inverse U-pattern of the association between cortisol and adversity. These results indicate that the accumulation of adversity might be an explanation of patterns of basal cortisol up-regulation in children and that those most severely exposed can exhibit an early stage of down-regulation, an issue which should be further examined in longitudinal studies.
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The current study examined only linear effects, although some studies have described quadratic effects.
“A third limitation is that the current study only examined linear effects, despite some studies describing quadratic effects (Gustafsson et al., 2010).”
From Psychosocial functioning and the cortisol awakening response: meta-analysis, P-curve analysis, and evaluation of the evidential value in existing studies (2017) · cites this paper as Gustafsson et al., 2010
Cites
Evans, G. W., & English, K. (2002) · Child Development · doi:10.1111/1467-8624.00469 · Cited by 1,232 · see citing works
Fries, E., Hesse, J., Hellhammer, J., & Hellhammer, D. H. (2005) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.04.006 · Cited by 1,204 · see citing works
When more is not better: the role of cumulative risk in child behavior outcomes
Carmody, K. A., Egeland, B. R., van Dulmen, M. H. M., & Sroufe, L. A. (2004) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2004.00351.x · Cited by 1,144 · see citing works
Coddington, R. D. (1972) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(72)90045-1 · Cited by 949 · see citing works
GUNNAR, M. R., & VAZQUEZ, D. M. (2001) · Development and Psychopathology · doi:10.1017/s0954579401003066 · Cited by 900 · see citing works
De Bellis, M. D., Baum, A. S., Birmaher, B., Keshavan, M. S., Eccard, C. H., Boring, A. M., Jenkins, F. J., & Ryan, N. D. (1999) · Biological Psychiatry · doi:10.1016/s0006-3223(99)00044-x · Cited by 741 · see citing works
LUPIEN, S. J., King, S., Meaney, M. J., & McEwen, B. S. (2001) · Development and Psychopathology · doi:10.1017/s0954579401003133 · Cited by 594 · see citing works
The Swedish Twin Registry in the Third Millennium: An Update
Lichtenstein, P., Sullivan, P. F., Cnattingius, S., Gatz, M., Johansson, S., Carlström, E. L., Björk, C., Svartengren, M., Wolk, A., Klareskog, L., et al. (2006) · Twin Research and Human Genetics · doi:10.1375/183242706779462444 · Cited by 399 · see citing works
Self-citationDiurnal salivary cortisol in pediatric posttraumatic stress disorder
Carrion, V. G., Weems, C. F., Ray, R. D., Glaser, B., Hessl, D., & Reiss, A. L. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(01)01310-5 · Cited by 330 · see citing works
The Swedish Twin Registry in the Third Millennium: An Update
Lichtenstein, P., Sullivan, P. F., Cnattingius, S., Gatz, M., Johansson, S., Carlström, E. L., Björk, C., Svartengren, M., Wolk, A., Klareskog, L., et al. (2006) · Twin Research and Human Genetics · doi:10.1375/twin.9.6.875 · Cited by 327 · see citing works
Self-citationHansson, S. L., Svanströmröjvall, A., Rastam, M., Gillberg, C., Gillberg, C., & Anckarsäter, H. (2005) · British Journal of Psychiatry · doi:10.1192/bjp.187.3.262 · Cited by 208 · see citing works
Self-citationBiology of post-traumatic stress disorder in childhood and adolescence
Pervanidou, P. (2008) · Journal of Neuroendocrinology · doi:10.1111/j.1365-2826.2008.01701.x · Cited by 142 · see citing works
Early neglect and abuse predict diurnal cortisol patterns in adults
van der Vegt, E. J. M., van der Ende, J., Kirschbaum, C., Verhulst, F. C., & Tiemeier, H. W. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2008.11.004 · Cited by 140 · see citing works
Salivary Cortisol and Psychopathology in Children Bereaved by the September 11, 2001 Terror Attacks
Pfeffer, C. R., Altemus, M., Heo, M., & Jiang, H. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.07.037 · Cited by 128 · see citing works
Polytraumatization and psychological symptoms in children and adolescents
Gustafsson, P. E., Nilsson, D. K., & Svedin, C. G. (2009) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-008-0728-2 · Cited by 119 · see citing works
Self-citationBevans, K., Cerbone, A., & Overstreet, S. (2008) · Development and Psychopathology · doi:10.1017/s0954579408000126 · Cited by 110 · see citing works
Kendler, K. S., Pedersen, N. L., Farahmand, B. Y., & Persson, P. (1996) · Psychological Medicine · doi:10.1017/s0033291700035856 · Cited by 89 · see citing works
Life-course socioeconomic trajectories and diurnal cortisol regulation in adulthood
Gustafsson, P. E., Janlert, U., Theorell, T., & Hammarström, A. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2009.09.019 · Cited by 64 · see citing works
Self-citation
Flagged first, then by citations
1 of the 19 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Cumulative risk and child development.
Evans, G. W., Li, D., & Whipple, S. S. (2013) · Psychological Bulletin · doi:10.1037/a0031808 · Cited by 2,024 · see citing works
The Adaptive Calibration Model of stress responsivity
Del Giudice, M., Ellis, B. J., & Shirtcliff, E. A. (2011) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2010.11.007 · Cited by 1,373 · see citing works
Koss, K. J., & Gunnar, M. R. (2018) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12784 · Cited by 489 · see citing works
Cortisol and DHEA in development and psychopathology
Kamin, H. S., & Kertes, D. A. (2016) · Hormones and Behavior · doi:10.1016/j.yhbeh.2016.11.018 · Cited by 311 · see citing works
The Biology of Human Resilience: Opportunities for Enhancing Resilience Across the Life Span
Feder, A., Fred-Torres, S., Southwick, S. M., & Charney, D. S. (2019) · Biological Psychiatry · doi:10.1016/j.biopsych.2019.07.012 · Cited by 269 · see citing works
Differential associations between childhood trauma subtypes and adolescent HPA-axis functioning
Kuhlman, K. R., Geiss, E. G., Vargas, I., & Lopez-Duran, N. L. (2015) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2015.01.020 · Cited by 178 · see citing works
Ursache, A., Noble, K. G., & Blair, C. (2015) · Behavioral Medicine · doi:10.1080/08964289.2015.1024604 · Cited by 163 · see citing works
Vanaelst, B., Huybrechts, I., Bammann, K., Michels, N., Vriendt, T. D., Vyncke, K. E., Sioen, I., Iacoviello, L., Günther, K., Molnár, D., et al. (2012) · Psychophysiology · doi:10.1111/j.1469-8986.2012.01396.x · Cited by 101 · see citing works
Boggero, I. A., Hostinar, C. E., Haak, E. A., Murphy, M. L. M., & Segerstrom, S. C. (2017) · Biological Psychology · doi:10.1016/j.biopsycho.2017.08.058 · Cited by 97 · see citing works
“A third limitation is that the current study only examined linear effects, despite some studies describing quadratic effects (Gustafsson et al., 2010).”
BackgroundEllis, B. J., Oldehinkel, A. J., & Nederhof, E. (2016) · Development and Psychopathology · doi:10.1017/s0954579416000985 · Cited by 90 · see citing works
Routine Versus Catastrophic Influences on the Developing Child
Odgers, C. L., & Jaffee, S. R. (2013) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031912-114447 · Cited by 87 · see citing works
Morris, G., Berk, M., Maes, M. H. J., Carvalho, A. F., & Puri, B. K. (2019) · Molecular Neurobiology · doi:10.1007/s12035-019-1498-1 · Cited by 87 · see citing works
The Physiological Expression of Living in Disadvantaged Neighborhoods for Youth
Brenner, A. B., Zimmerman, M. A., Bauermeister, J. A., & Caldwell, C. H. (2012) · Journal of Youth and Adolescence · doi:10.1007/s10964-012-9838-8 · Cited by 68 · see citing works
Childhood Conditions and Multimorbidity Among Older Adults
Pavela, G., & Latham-Mintus, K. (2015) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbv028 · Cited by 64 · see citing works
Martin, C. G., Bruce, J., & Fisher, P. A. (2012) · Hormones and Behavior · doi:10.1016/j.yhbeh.2012.02.025 · Cited by 62 · see citing works
Shapero, B. G., & Steinberg, L. D. (2013) · Journal of Youth and Adolescence · doi:10.1007/s10964-013-9954-0 · Cited by 60 · see citing works
Gustafsson, P. E., Janlert, U., Theorell, T., Westerlund, H., & Hammarström, A. (2011) · Annals of Behavioral Medicine · doi:10.1007/s12160-011-9309-6 · Cited by 59 · see citing works
Self-citationLaurent, H. K., Neiderhiser, J. M., Natsuaki, M. N., Shaw, D. S., Fisher, P. A., Reiss, D., & Leve, L. D. (2013) · Developmental Psychobiology · doi:10.1002/dev.21103 · Cited by 54 · see citing works
Ouellet‐Morin, I., Robitaille, M.-P., Langevin, S., Cantave, C. Y., Brendgen, M. R., & LUPIEN, S. J. (2018) · Development and Psychopathology · doi:10.1017/s0954579418000123 · Cited by 56 · see citing works
Fragkaki, I., Cima, M., & Granic, I. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.11.005 · Cited by 52 · see citing works
Long-term stability of the cortisol awakening response over adolescence
Platje, E., Vermeiren, R. R. J. M., Branje, S., DORELEIJERS, T. A. H., Meeus, W., Koot, H. M., Frijns, T., van Lier, P. A. C., & Jansen, L. M. C. (2012) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2012.06.007 · Cited by 50 · see citing works
Psychological disorders and oral lichen planus: A systematic review
Cerqueira, J. D. M., Moura, J. R., Arsati, F., Lima‐Arsati, Y. B. D. O., Bittencourt, R. A., & Freitas, V. S. (2018) · Journal of Investigative and Clinical Dentistry · doi:10.1111/jicd.12363 · Cited by 51 · see citing works
Michels, N., Sioen, I., Huybrechts, I., Bammann, K., Vanaelst, B., De Vriendt, T., Iacoviello, L., Konstabel, K., Ahrens, W., & De Henauw, S. (2012) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2012.02.004 · Cited by 48 · see citing works
Barbosa, T. D. S., Castelo, P. M., Leme, M., & Gavião, M. (2012) · Oral Diseases · doi:10.1111/j.1601-0825.2012.01914.x · Cited by 48 · see citing works
Pesonen, A., Kajantie, E., Heinonen, K., Pyhälä, R., Lahti, J. M. T., Jones, A., Matthews, K. A., Eriksson, J. G., Strandberg, T. E., & Räikkönen, K. (2011) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.06.008 · Cited by 46 · see citing works
Shapero, B. G., Curley, E. E., Black, C. L., & Alloy, L. B. (2019) · Depression and Anxiety · doi:10.1002/da.22957 · Cited by 46 · see citing works
Butler, K., Klaus, K., Edwards, L., & Pennington, K. (2017) · Hormones and Behavior · doi:10.1016/j.yhbeh.2017.07.013 · Cited by 43 · see citing works
Rudolph, K. E., Wand Gary, S., Stuart, E. A., Glass, T. A., Marques, A. H., Dunčko, R., & Merikangas, K. R. (2013) · Health & Place · doi:10.1016/j.healthplace.2013.11.001 · Cited by 41 · see citing works
Monteleone, A. M., Monteleone, P., Volpe, U., De Riso, F., Fico, G., Giugliano, R., Nigro, M., & Maj, M. (2018) · Psychological Medicine · doi:10.1017/s0033291717002409 · Cited by 38 · see citing works
New Perspectives in the Model of Stress Response
Tonhajzerová, I., & Mestanik, M. (2017) · Physiological Research · doi:10.33549/physiolres.933674 · Cited by 39 · see citing works
A Framework for Treating Cumulative Trauma With Art Therapy
Naff, K. M. (2014) · Art Therapy · doi:10.1080/07421656.2014.903824 · Cited by 37 · see citing works
Starr, L. R., Dienes, K., Stroud, C. B., Shaw, Z. A., Li, Y. I., Mlawer, F., & Huang, M. (2017) · Development and Psychopathology · doi:10.1017/s0954579417001468 · Cited by 35 · see citing works
Cascino, G., & Monteleone, A. M. (2023) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2023.106665 · Cited by 34 · see citing works
Ly, J., McGrath, J. J., & Gouin, J. (2015) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2015.03.006 · Cited by 32 · see citing works
Psychoneuroendocrinology of Stress
Gunnar, M., Doom, J., & Esposito, E. A. (2015) · Wiley eBooks · doi:10.1002/9781118963418.childpsy304 · Cited by 14 · see citing works
Mother–infant cortisol attunement: Associations with mother–infant attachment disorganization
Nofech‐Mozes, J., Jamieson, B., González, A., & Atkinson, L. R. (2019) · Development and Psychopathology · doi:10.1017/s0954579418001396 · Cited by 27 · see citing works
Individual Differences in the Cortisol Responses of Neglected and Comparison Children
Sullivan, M. W., Bennett, D. S., & Lewis, M. (2012) · Child Maltreatment · doi:10.1177/1077559512449378 · Cited by 26 · see citing works
Zalewski, M., Lengua, L. J., Thompson, S. F., & Kiff, C. J. (2015) · Development and Psychopathology · doi:10.1017/s0954579415000474 · Cited by 25 · see citing works
Gingivitis, Psychological Factors and Quality of Life in Children.
da Silva, P. D. L., Barbosa, T. D. S., Amato, J. N., Montes, A. B. M., & Gavião, M. B. D. (2015) · PubMed · doi:10.3290/j.ohpd.a32344 · Cited by 25 · see citing works
Lengua, L. J., Thompson, S. F., Moran, L. R., Zalewski, M., Ruberry, E. J., Klein, M. R., & Kiff, C. J. (2019) · Development and Psychopathology · doi:10.1017/s0954579419000373 · Cited by 25 · see citing works
Franz, C. E., Spoon, K. M., Thompson, W. K., Hauger, R. L., Hellhammer, D. H., Jacobson, K. C., LUPIEN, S. J., Lyons, M. J., McCaffery, J. M., McKenzie, R. E., et al. (2013) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2013.04.001 · Cited by 24 · see citing works
Strini, P. J. S. A., Strini, P. J. S. A., Barbosa, T. D. S., & Gavião, M. B. D. (2011) · Archives of Oral Biology · doi:10.1016/j.archoralbio.2011.06.009 · Cited by 24 · see citing works
Pavela, G. (2017) · PLoS ONE · doi:10.1371/journal.pone.0168481 · Cited by 24 · see citing works
Heritability of Cortisol Regulation in Children
Gustafsson, P. A., Gustafsson, P. E., Anckarsäter, H. S., Lichtenstein, P., Ljung, T., Nelson, N., & Larsson, H. (2011) · Twin Research and Human Genetics · doi:10.1375/twin.14.6.553 · Cited by 17 · see citing works
Self-citationLawler, J. M., Bocknek, E. L., McGinnis, E. W., Martinez‐Torteya, C., Rosenblum, K. L., & Muzik, M. (2018) · Infancy · doi:10.1111/infa.12271 · Cited by 17 · see citing works
Souffrance au travail, répression psychique et troubles musculo-squelettiques
Davezies, P. (2013) · Perspectives interdisciplinaires sur le travail et la santé · doi:10.4000/pistes.3376 · Cited by 16 · see citing works
Xiang, Y., Zhou, Y., & Li, X. (2024) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2024.106715 · Cited by 16 · see citing works
Tung, I., Noroña, A. N., & Lee, S. S. (2018) · Development and Psychopathology · doi:10.1017/s0954579418000585 · Cited by 14 · see citing works
Cao, L., Wang, S., Li, Y., Li, Y., Yuan, M., Chang, J.-J., Wang, G., & Su, P. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.08.057 · Cited by 11 · see citing works
Risk and resilience in Syrian refugee children: A multisystem analysis
Smeeth, D. M., May, A. K., Karam, E. G., Rieder, M. J., Elzagallaai, A. A., Uum, S. H. M. V., & Pluess, M. (2023) · Development and Psychopathology · doi:10.1017/s0954579423000433 · Cited by 11 · see citing works
Meta-analysis of associations between childhood adversity and diurnal cortisol regulation
Perrone, L., Thorpe, D., Panahi, G. S., Kitagawa, Y., Lindhiem, O. J., & Bernard, K. (2023) · Development and Psychopathology · doi:10.1017/s0954579423000561 · Cited by 9 · see citing works
Willner, C. J., Morris, P., McCoy, D. C., & Adam, E. K. (2014) · Development and Psychopathology · doi:10.1017/s0954579414000558 · Cited by 9 · see citing works
Examining the role of socioeconomic status and temperament in the hair cortisol levels of infants
Ertekin, Z., Berument, S. K., & Gunnar, M. R. (2020) · Developmental Psychobiology · doi:10.1002/dev.22014 · Cited by 9 · see citing works
Cumulative Risk and Physiological Stress Responses in African American Adolescents
Kliewer, W. L., & Robins, J. L. W. (2017) · Biological Research For Nursing · doi:10.1177/1099800417702742 · Cited by 7 · see citing works
Ruttle, P. L., Serbin, L. A., Martin‐Storey, A., Stack, D. M., & Schwartzman, A. E. (2013) · Developmental Psychobiology · doi:10.1002/dev.21163 · Cited by 6 · see citing works
Willner, C. J., Morris, P., McCoy, D. C., & Adam, E. K. (2014) · Development and Psychopathology · doi:10.1017/s0954579414000819 · Cited by 6 · see citing works
Context, cortisol, and executive functions among children experiencing homelessness.
Cutuli, J. J. (2011) · University of Minnesota Digital Conservancy (University of Minnesota) · Cited by 6 · see citing works
The Adaptive Calibration Model of Stress Responsivity
Ellis, B. J., Giudice, M. D., & Shirtcliff, E. A. (2017) · Wiley eBooks · doi:10.1002/9781394258932.ch8 · Cited by 7 · see citing works
Wass, S. V., Smith, C. S., Mirza, F. U., Greenwood, E., & Goupil, L. (2024) · Child Development · doi:10.1111/cdev.14183 · Cited by 7 · see citing works
Vestergaard, M., Holm, S. K., Uldall, P. V., Siebner, H. R., Paulson, O. B., Baaré, W. F. C., & Madsen, K. S. (2017) · Developmental Psychobiology · doi:10.1002/dev.21559 · Cited by 3 · see citing works
Cardiac vagal tone in preschool children: Interrelations and the role of stress exposure
Messerli‐Bürgy, N., Meyer, A. H., Kakebeeke, T. H., Stülb, K., Arhab, A., Zysset, A. E., Leeger‐Aschmann, C. S., Schmutz, E. A., Thayer, J. F., Groene, M., et al. (2020) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2020.04.006 · Cited by 3 · see citing works
Trauma, adversity, the brain, & the body
Cox, L. J., & Marsh, A. N. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-818954-2.00032-8 · Cited by 1 · see citing works
Children's Cortisol in Preschool and Aggression One Year Later in Kindergarten
Reinecke, D. M. (2011) · Cited by 1 · see citing works
Cortisol : Aufwachreaktion bei gesunden Kindern und Kindern mit ADHS
Seitz, C. (2010) · Publications of the UdS (Saarland University) · doi:10.22028/d291-21433
Ruttle, P. L. (2011) · Spectrum Research Repository (Concordia University)
An Exploration of Art Therapy as a Treatment for Cumulative Trauma
Naff, K. M. (2013)
Examining Resilience In Relation to PTSD Symptomatology In Maltreated Youth
Day, T. L. (2020) · Digital Scholarship - UNLV (University of Nevada Reno) · doi:10.34917/8220098
Cao, L., Wang, S., Li, Y., Li, Y., Yuan, M., Chang, J.-J., Wang, G., & Su, P. (2022) · Research Square · doi:10.21203/rs.3.rs-2220874/v1
- Authors
- Gustafsson, P. E., Anckarsäter, H., Lichtenstein, P., Nelson, N., & Gustafsson, P. A.
- Affiliations
- Umeå University (SE)
- University of Gothenburg (SE)
- Karolinska Institutet (SE)
- Linköping University (SE)
- Corresponding author
- Gustafsson, Per E.
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2010-10
- Volume
- 35
- Issue
- 9
- Pages
- 1410-1415
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W2024976250
- Cited by
- 73
- References
- 19
- Citations by year
- 2024: 2 · 2023: 4 · 2022: 2 · 2021: 4 · 2020: 3 · 2019: 5 · 2018: 4 · 2017: 11 · 2016: 2 · 2015: 7 · 2014: 3 · 2013: 9 · 2012: 7
- FWCI
- 3.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Vetenskapsrådet
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- cumulative adversity, salivary cortisol, cortisol awakening response, diurnal cortisol rhythm, children, stress exposure, socioeconomic deprivation, negative life events, adrenal insufficiency, cortisol dysregulation, twin studies
- MeSH terms
- Adolescent, Child, Circadian Rhythm, Cross-Sectional Studies, Health, Humans, Hydrocortisone, Life Change Events, Osmolar Concentration, Periodicity, Saliva, Stress, Psychological, Sweden, Wakefulness, Down-Regulation, Up-Regulation
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