The impact of child maltreatment and psychopathology on neuroendocrine functioning

“Maltreated children with significant emotional problems showed higher morning, afternoon, and average daily cortisol levels across 1 week [79].”

“…CRF in youth who experience childhood trauma and depressive and anxiety symptoms [39, 41-47, 50, 78-80] or co-morbid internalizing and internalizing behaviors [42, 79]; while traumatized children with marked disruptive behavioral disorders or anti-social behaviors show lower cortisol levels [81].”

“Maltreated school-aged children with clinicallevel internalizing problems had elevated cortisol compared with controls.(98) Depressed preschool children showed increased cortisol response to separation stress.”

“…have examined the relationship symptoms to biological changes in maltreated children and adults who were maltreated as children (Choi et al., 2009; Cicchetti & Rogosch, 2001, 2007; Hart, Gunnar, & Cicchetti, 1995; Murray-Close, Han, Cicchetti, Crick, & Rogosch, 2008; Teicher, Samson, Polcari, &…”

“While this pattern of elevated cortisol also characterises non-maltreated children with affective disorders (e.g., Goodyer, Herbert, & Altham, 1998), it is not clear if maltreatment contributes an additional effect (Cicchetti & Rogosch, 2001; Cicchetti, Rogosch, & Cox Kearns, 2001).”

“In multiple investigations, researchers have linked early life stress, childhood maltreatment, or childhood physical or sexual trauma to elevated cerebrospinal fluid concentrations of CRH (Cicchetti & Rogosch, 2001; Gunnar & Quevedo, 2007; Heim & Nemeroff, 1999; Rogosch, Dackis, & Cicchetti, 2011).”

“Chronic alterations of HPA axis activity have been shown in rodents and non-human primates exposed to disruptions of parental care such as maternal separation [6,7] and maternal neglect [8], and in humans with childhood parental loss, and neglect or other forms of childhood maltreatment [2,9–17].”

“Moreover, the inclusion of other psychological and biological correlates (e.g. changes in HPA axis associated with exposure to traumatic events) may clarify mediating and modifying factors in the developmental psychopathology of PDs (Cicchetti & Rogosch, 2001).”

“…attributions of blame (McGee et al., 2001), maltreatment-induced traumatic brain injury (Miller, 1999), stress-induced neuroregulatory dysfunction (Cicchetti & Rogosch, 2001; De Bellis, 2001; Glaser, 2000), and potentially, difficulties in emotion recognition (Pollak, Cicchetti, Hornung, & Reed,…”

“…to severe child abuse and neglect or other types of severe trauma have higher levels of nonstress cortisol than comparison children (Carrion et al., 2002; Cicchetti & Rogosch, 2001b; De Bellis et al., 1999; Delahanty, Nugent, Christopher, & Walsh, 2005; Pfeffer, Altemus, Heo, & Jiang, 2007).”

“This finding is consistent with prior studies which have observed associations between child maltreatment and emotional reactivity using physiological measures of the autonomic nervous system and hypothalamic–pituitary–adrenal (HPA) axis among youth (Cicchetti and Rogosch 2001; De Bellis et al. 1999; Hart et al. 1996;…”

“In general, a similar lack of evidence of cortisol hyper-reactivity has been noted in the child literature among maltreated children who do not exhibit significant symptoms of depression or internalizing problems (see Cicchetti and Rogosch, 2001a,b).”

“This has been documented among children growing up in abusive families (Cicchetti & Rogosch, 2001; Hart, Gunnar, & Cicchetti, 1996) or in severely deprived institutional settings such as Romanian orphanages (Gunnar, 2000).”

“Finally, Cicchetti and Rogosch (2001) found that compared to symptomatic nonmaltreated children, maltreated children with clinical-level internalizing problems were distinguished by higher morning, afternoon, and average daily cortisol levels across a 5-day period, suggestive of HPA axis…”

“Several studies have reported elevated basal cortisol levels (De Bellis et al., 1999a; Cicchetti and Rogosch, 2001; Carrion et al., 2002) while others have reported cortical suppression (Hart et al.”

“…of cortisol than nonmaltreated children throughout daily functioning, which in turn, were associated with more internalizing behavior problems ~Cicchetti & Rogosch, 2001!. Similarly, Ramsay and Lewis ~1994! found that infants from low-trauma environments naturally habituated to stressors by…”

“…abuse, alcoholism) have typically been associated with low levels of cortisol production, although some studies have obtained contradictory results (Cicchetti & Rogosch, 2001b; Graham et al., 1999; McBurnett, Lahey, Rathouz, & Loeber, 2000; Pajer, Gardner, Rubin, Perel, & Neal, 2001; van Goozen,…”

“Studies of maltreated children suggest that only those who experience the most severe and prolonged maltreatment may have elevated cortisol levels (Cicchetti and Rogosch, 2001a; De Bellis et al., 1999a).”

“…slopes of change in children exposed to recent stressful life events and lower marital functioning (Bevans, Cerbone, & Overstreet, 2008; Pendry & Adam, 2007; Wolf, Nicholls, & Chen, 2008), and early physical and/or sexual abuse (Cicchetti & Rogosch, 2001; Cicchetti, Rogosch, Gunnar, & Toth, 2010).”

“Studies which have examined the diurnal rhythm have found that comorbid youth have the most blunted diurnal rhythms (Cicchetti & Rogosch, 2001) and that the afternoon cortisol decline was evident in control, but not internalizing or comorbid adolescents (KlimesDougan, Hastings, Granger, Usher, &…”

“In other words, no association between externalizing and cortisol patterns among maltreated youth has been identified (Cicchetti and Rogosch, 2001; Dozier et al , 2006).”

“…and trouble adapting successfully to school (Cicchetti and Barnett, 1991; Cicchetti and Toth, 2015, 2016; DePasquale et al., 2019; Pollak et al., 2000; Pollak et al., 1997; Schneider-Rosen and Cicchetti, 1984; Shields and Cicchetti, 1997, 2001; Toth and Cicchetti, 1996; Toth et al., 2000).”

“In some instances, for example, maltreatment may lead to elevated levels of cortisol production— elevations that are in turn associated with internalizing disorders of childhood (Cicchetti and Rogosch, 2001b).”

“Maltreated children also have been found to be at high risk for the development of depressive disorder and depressive symptomatology (Cicchetti & Rogosch, 2001b; Kaufman, 1991; Manly, Kim, Rogosch, & Cicchetti, 2001; Toth, Manly, & Cicchetti, 1992; Widom, DuMont, & Czaja, 2007).”

“Prior research on neuroendocrine regulation has indicated that physically abused children generally exhibit lower levels of morning cortisol secretion (Cicchetti & Rogosch, 2001a).”

“Research suggests that persistent exposure to traumatic experiences, such as bullying and abuse, may affect the stress regulation system: the hypothalamicpituitary-adrenal (HPA) axis [44-47].”

“In addition to these between-individual factors, the pattern of cortisol dysregulation within maltreated individuals may change over time (e.g., Cicchetti & Rogosch, 2001; Tricket, Noll, Susman, Shenk, & Putnam, 2010).”

“In the concurrent literature some studies report that higher cortisol levels are associated with internalizing behaviors (Cicchetti and Rogosch, 2001; Kaufman, 1991; Perez-Edgar et al., 2008), while others suggest that lower cortisol levels are associated with internalizing behaviors (De Bellis et…”

“In a later expansion of the previous study, Cicchetti and Rogosch (2001b) also found that cortisol dysregulation patterns were specific to the type of maltreatment experienced.”

“…of the hypercortisolism hypothesis, parental withdrawal, dysphoria, stress, and some forms of maltreatment (e.g., cooccurrence of physical and sexual abuse) have been linked with higher cortisol levels (Cicchetti & Rogosch, 2001a; 2001b; Essex, Klein, Cho, & Kalin, 2002; Pine & Charney, 2002).”

“…specifying that individual components of AL may not reveal large differences in stress-affected individuals independently, we have not found evidence for significant differences between maltreated and nonmaltreated children in global comparisons of cortisol regulation (Cicchetti & Rogosch, 2001a).”

“Timing and chronicity of maltreatment consistently relate to differential outcomes in childhood and adulthood (Barnett et al., 1993; English, Graham, Litrownik, Everson, & Bangdiwala, 2005; Manly, Cicchetti, & Barnett, 1994; Manly, Kim, Rogosch, & Cicchetti, 2001).”

“…can lead to allostatic load through a cascade of causes and sequelae that can damage the brain, organ systems, and the neurochemical balance that undergirds cognition, emotion, mood, personality, and behavior (Cicchetti & Rogosch, 2001a, 2001b; Cooper et al., 2007; Lupien et al., 2006).”

“For example, the chronic stress associated with child maltreatment has been shown to influence neuroendocrine dysregulation (Cicchetti & Rogosch, 2001a, 2001b; Cicchetti, Rogosch, Gunnar, & Toth, 2010; DeBellis, 2001; Heim, Newport, Mletzko, Miller, & Nemeroff, 2008; Trickett, Noll, Susman, Shenk,…”

“In addition, Cohen et al. (2006) examined the relation between hippocampal abnormalities in adulthood and the experience of multiple traumatic events before age 12, such as severe family conflict, emotional abuse, physical abuse, and/or sexual abuse. No significant effect of traumatic events on hippocampal volume was…”

“In humans, high physiological reactivity has been linked to higher levels of anxious and vigilant behaviors among maltreated children (Cicchetti & Rogosch, 2001b; Tarullo & Gunnar, 2006), but for children facing life-threatening adversity, heightened arousal may be protective as it enables them to…”

“Traumatized children have been shown to have elevated cortisol levels (Cicchetti and Rogosch, 2001; De Bellis et al., 1999; Gunnar et al., 2001; Hart et al., 1996).”

“Whereas little research has been conducted on the relationship between the cortisol diurnal rhythm and early maltreatment, overall findings indicate that maltreatment is associated with a flatter diurnal slope (Cicchetti and Rogosch, 2001a; Weissbecker et al., 2006).”

“…who have been abused or neglected early in life also has revealed anomalies in their brain structure and functioning (Cicchetti & Curtis, in press; Cicchetti & Rogosch, 2001a, 2001b; DeBellis, 2001; Gunnar, Morison, Chisholm, & Schuder, 2001; S. W. Parker & Nelson, 2005b; Pollak, Cicchetti,…”

“Maltreated children have been shown to be at risk for developing antisocial behavior (Cicchetti & Rogosch, 2001; Jaffee, Caspi, Moffitt, & Taylor, 2004; Lansford et al., Address correspondence and reprint requests to: Dante Cicchetti, Institute of Child Development, University of Minnesota, 51 East…”

“…the likelihood that children will develop behavior problems early in life (Ackerman, Kogos, Youngstrom, Schoff, & Izard, 1999; Cicchetti, & Lynch, 1995; Cicchetti & Rogosch, 2001a,b; McLloyd, 1998; Sameroff, Bartko, Baldwin, Baldwin, & Seifer, 1998; Shaw, Keenan, & Vondra, 1994; Sroufe, 1997).”

“For young children, interparental aggression and insensitive harsh caregiving behaviors are regarded as particularly salient environmental pathogens by virtue of their pernicious implications for the preservation children’s personal safety and well-being (Cicchetti & Rogosch, 2001; Margolin, 2004).”

“Maltreated children, particularly those who exhibit atypical cortisol functioning, are at increased risk for developing both internalizing and externalizing disorders (Cicchetti & Rogosch, 2001; Kaufman, 1991).”

“Cicchetti and Rogosch (2001) found that maltreated children who had experienced physical and sexual abuse, as well as either neglect or emotional maltreatment, were differentiated from other maltreated children and nonmaltreated children by their cortisol regulation patterns that evidenced…”

“…1999; Ford & Kidd, 1998; van der Kolk et al., 1996) and is consistent with evidence that child abuse is associated with serious biopsychosocial dysregulation (Cicchetti & Rogosch, 2001; DeBellis, 2001; Heim & Nemeroff, 2001; Kaufman, Plotsky, Nemeroff, & Charney, 2000; Perry & Pollard, 1998).”

“A second group of studies is more closely related to the current study in that they control for family background factors such as poverty by using samples of twins in which one twin was maltreated and the other was not.”

“Cicchetti and Rogosch’s (2001) study suggests that HPA axis patterning may differ according to the type of maltreatment experienced, such that sexual abuse and sexual abuse combined with physical abuse may produce hypercortisolism, whereas physical abuse may lead to hypocortisolism.”

“However, Cicchetti and Rogosch (2001b) found that maltreated girls, particularly those with externalizing problems, had lower morning cortisol levels than maltreated girls without such problems.”

“Cicchetti and Rogosch (2001a, 2001b) observed elevated basal levels only among children who had experienced severe, multiple, and prolonged forms of abuse or those who had significant internalizing problems.”

“In contrast, nonmaltreated children with early-onset depression rarely display evidence of regulatory dysfunction of the HPA axis (Cicchetti & Rogosch, 2001b; Feder et al., 2004).”

“…dysregulated due to social stressors (Power et al., 2010), as suggested by studies of low SES and of maltreatment in childhood (Carlson and Earls, 1997; Lupien et al., 2000; Cicchetti and Rogosch, 2001; Gunnar et al., 2001; Gunnar and Vazquez, 2001; Ranjit et al., 2005; O’Connor et al., 2009).”