The impact of child maltreatment and psychopathology on neuroendocrine functioning

“Several studies report elevated cortisol levels (7-9), while others report lower levels of morning cortisol and”

“Consistent with Cicchetti and Rogosch (2009), multiple Stress response in war-exposed children 945”

“Because research suggests possible sex differences in the biological correlates of aggression (Beauchaine, Hong, & Marsh, 2008; Cicchetti & Rogosch, 2001), we included relevant interactions with sex in the analyses.”

“This is in keeping with a substantial body of literature in humans suggesting this relation between suppressed HPA functioning and early adversity (e.g., Carpenter et al., 2007; Cicchetti & Rogosch, 2001; Fries, Hesse, Hellhammer, & Hellhammer , 2005; Gunnar & Vazquez, 2001; MacMillan et al., 2009).”

“…literature linking early maltreatment to behavioral, physiological, and neural changes in children indicating a heightened reactivity to threat (Cicchetti & Rogosch, 2001; Dannlowski et al., 2012; Fries, Ziegler, Kurian, Jacoris, & Pollak, 2005; Pollak & Tolley-Schell, 2003; Pollak, Vardi,…”

“In addition, integrative approaches that employ comprehensive biopsychosocial assessment strategies spanning multiple developmental stages (i.e., Cicchetti & Rogosch, 2001; Putnam & Trickett, 1997) can help isolate the unique contribution of childhood sexual abuse and trauma to the continued cycle…”

“On the basis of prior research indicating an association between aggression and neuroendocrine functioning (e.g., Blades & Susman, 2007; Cicchetti & Rogosch, 2001b; Dettling et al., 1999; McBurnett et al., 2000; Van Goozen et al., 1998), we predicted that high levels of both physical and relational…”

“…children with clinical-level internalizing problems demonstrated higher cortisol levels across the day than did other maltreated children and nonmaltreated children, and higher afternoon cortisol levels than did nonmaltreated children with internalizing problems (Cicchetti & Rogosch 2001b).”

“…with a combination of low MAOA activity and exposure to childhood maltreatment show dramatically increased rates of CD and violent offending relative to those with low MAOA activity but no exposure to social adversity, whereas the effect of maltreatment exposure is substantially weaker in those…”

“For example, hypothalamic–pituitary–adrenal (HPA) axis functioning has been shown to be sensitive to EA exposure (e.g., Cicchetti & Rogosch, 2001; Gunnar & Quevedo, 2007).”

“The majority of studies in the last decade report decreased levels of cortisol in response to a stressor in individuals with a history of early life stress and externalizing symptoms and elevated cortisol in those with internalizing symptoms (Cicchetti and Rogosch, 2001; Hinkelmann et al., 2013).”

“Other research has examined differences between extreme groups defined by ‘‘natural experiments,’’ such as child maltreatment and neglect (Cicchetti & Rogosch, 2001) and adoption and foster parenting (Dozier et al., 2006; Gunnar, Morison, Chisholm, & Schuder, 2001).”

“Traditional conceptualizations of early adversity focus on maladaptive outcomes (Cicchetti & Rogosch, 2001; Shonkoff & Garner, 2012), including heightened anxiety and attention to threat (Goff et al., 2012; Shackman, Shackman, & Pollak, 2007).”

“More recently, Cicchetti and Rogosch (2001) investigated cortisol levels in maltreated and control groups in conjunction with clinical level externalising and internalising problems.”

“Following Cicchetti and Rogosch (2001), we propose that both patterns of adrenocortical dysregulation (i.e., hyper- vs. hyporeactivity) are predicted by prenatal IPV exposure, but each cortisol pattern is differentially associated with specific types of behavioral problems.”

“…physiological state prompting aggressive and antisocial behavior (Raine et al., 1990), and where overstimulation in these systems may prompt internalizing behaviors (Cicchetti & Rogosch, 2001a; Mezzacappa et al., 1997), all with the aim of regulating or coping with these physiological states.”

“For example, physical and sexual abuse have been associated with high morning cortisol levels in children, and those who have suffered multiple types of abuse are more likely to exhibit high morning and afternoon cortisol levels (Cicchetti and Rogosch, 2001a).”

“In addition , because CSA may also be associated with internal emotional dysregulation (Cicchetti & Rogosch, 2001; Debellis, 2001), we also included a self-report measure of felt emotion during the interview.”

“…the multisystem reactive children came from families with higher scores on the composite adversity index, a pattern that parallels prior research revealing links between early life adversity and physiological dysregulation (Cicchetti & Rogosch, 2001; Natsuaki et al., 2009; Obradović et al., 2010).”

“…epigenome changes throughout life, and of particular relevance to brain development and risk for psychopathology are epigenetic modifications to genes involved in glucocorticoid regulation, leading to a blunted or enhanced hypothalamic–pituitary–adrenal (HPA) axis response to stress [185–188].”

“For example, in a large low-income sample of maltreated and nonmaltreated school-age children, Cicchetti and Rogosch (2001a) observed a pattern consistent with hypercortisolemia among children with sexual or multiple abuse histories, but a pattern suggestive of hypocortisolemia among physically…”

“This is the pattern most consistently found in past work, particularly when examining more normative ranges of contextual stress (e.g., Cicchetti & Rogosch, 2001; Evans & English, 2002; Lupien et al., 2000), but is counter to the findings of hypocortisolism in response to stressors found in more…”

“…Patterson, 2001; Keiley et al., 2001; Manly et al., 2001; Young et al., 1997), other studies report externalizing problems, such as aggression, impulsivity, conduct disorders or comorbid internalizing and externalizing problems (Cicchetti & Rogosch, 2001;Manly et al., 2001; McMillen et al., 2005).”

“…Meaney et al., 1996; Plotsky & Meaney, 1993; Rosenblum et al., 1994; Rosenblum & Paully, 1984; van Oers, de Kloet, & Levine, 1998), human children (Cicchetti & Rogosch, 2001a, 2001b; DeBellis, Chrousos, et al., 1994; De Bellis, Lefter, Trickett, & Putnam, 1994; Galvin et al., 1995; Hart, Gunnar,…”

“For example, Cicchetti and Rogosch (2001) found that maltreated children showed either depressed or elevated basal cortisol levels, depending on their behavioral symptomatology .”

“A rich body of evidence suggests that prolonged early adversity leads to hypoactivation of the stress circuitry and hyposecretion of the stress-hormone cortisol (Cicchetti and Rogosch, 2001; Gunnar and Donzella, 2001; Puetz et al., 2016a, 2016b).”

“…poverty, and parental mental illness, and they have been linked to an equally broad range of deleterious long-term mental and physical health consequences (e.g., Cicchetti & Rogosch, 2001; Cicchetti & Toth, 2005; Felitti et al., 1998; Green et al., 2010; McLaughlin et al., 2012).”

“…consisting of aggressive tendencies, ineffective and disruptive peer relations, social information processing deficits, and delinquent acts (e.g., Cicchetti & Rogosch, 2001; Cicchetti, Rogosch, & Thibodeau, 2012; Hong, Espelage, Grogan-Kaylor, & Allen-Meares, 2012; Jaffee, Caspi, Moffitt, &…”

“…2001; Boyce et al., 2006) while other studies indicate that externalizing symptoms may be linked to attenuated HPA axis activity (Tennes and Kreye, 1985; Scerbo and Kolko, 1994; van Goozen et al., 1998; Cicchetti and Rogosch, 2001; Smider et al., 2002; Shoal et al., 2003; Shirtcliff et al., 2005).”

“…that childhood maltreatment may have a detrimental effect on memory performance due to maltreatmentrelated sequelae (e.g., Bremner & Narayan, 1998; Cicchetti & Rogosch, 2001a, 2001b), as indicated by empirical findings that adults with maltreatment histories are more likely than comparable…”

“…research findings suggest that chronic activation of the neuroendocrine stress response system, which is often observed in maltreated children (Cicchetti & Rogosch, 2001; Gunnar & Vazquez, 2001), has adverse effects on many of the neurological structures believed to subserve executive…”

“…sexual and physical abuse, plus neglect and/or emotional abuse) have been found to exhibit substantial elevations in morning cortisol levels (Cicchetti & Rogosch, 2001a); children in the multiple abuse (sexual and physical) group also have been shown to display elevations in cortisol levels…”

“With humans, HPA axis abnormalities are prominent among children and adolescents who have experienced significant abuse ~Cicchetti & Rogosch, 2001!. Children and adolescents exposed to abusive or neglectful care demonstrated elevated baseline cortisol and loss of the normal diurnal cortisol…”

“Although the detailed mechanisms have not been identified, researchers are making continuous efforts to distinguish the different brain structures and neurobiological results by onset time and type of trauma (Cicchetti & Rogosch, 2001; Cirulli & Alleva, 2003).”

“Previous research has established a robust association between child maltreatment and depression (Cicchetti & Rogosch, 2001; Kim & Cicchetti, 2006; Manly et al., 2001; Scott et al., 2010; Toth et al., 1992; Widom et al., 2007).”

“A more dimensional approach focused on symptom dimensions might reveal varying patterns of adreno-cortical regulation (Cicchetti & Rogosch, 2001).”

“…disorders, aggressive, impulsive, and antisocial behavior, as well as conduct disorder, substance abuse, and attention-deficit/hyperactivity disorder (Cicchetti & Rogosch, 2001; Cicchetti, Rogosch, Gunnar, & Toth, 2010; Gunnar & Vazquez, 2006; Heim & Nemeroff, 2001; Teicher et al., 2002, 2003).”

“These studies, however, focused mainly on outcome – resilient functioning defined as the lack of psychiatric diagnosis or disabling psychopathology (Cicchetti & Rogosch, 2001).”

“…care predicts child neuroendocrine self-regulation outcomes (e.g., Adam, Klimes-Dougan, & Gunnar, 2007; Bugental, Martorell, & Barraza, 2003; Cicchetti & Rogosch, 2001), but less is known about precisely how this occurs, that is, which aspects of maternal behavior influence the unfolding of…”

“The assessment of biological correlates of early adversity is often complicated by the fact that such experiences are not monolithic because both “dosage” (ie, trauma severity) and type of exposure may have distinct influences on psychopathology and/or have different biological correlates depending on the context in w…”

“Among maltreated children specifically, internalizing problems have also been related to hypercortisolism (Cicchetti & Rogosch, 2001).”

“Children’s maladjustment associated with child maltreatment includes both internalizing symptomatology (Bolger & Patterson, 2001; Manly, Kim, Rogosch, & Cicchetti, 2001) and externalizing symptomatology (Cicchetti & Rogosch, 2001; Dodge, Pettit, & Bates, 1997).”

“This includes maternal depression and child maltreatment, both of which have been associated with disrupted patterns (Ashman et al., 2002; Cicchetti & Rogosch, 2001; Dougherty, Klein, Olino, Dyson & Rose, 2009).”

“…with abnormalities in waking and diurnal release of cortisol in children, though differential effects are evident as a function of maltreatment subtype and psychopathology (Carrion & Wong, 2012; Cic- chetti & Rogosch, 2001a, 2001b; Gunnar & Vazquez, 2001; Hart, Gunnar, & Cicchetti, 1995).”

“, depression and anxiety disorders), compared to non-maltreated children experiencing symptoms [19].”

“…research reporting negative associations between family risk factors (e.g., family conflict, maltreatment, and parenting difficulties) and child cortisol levels (e.g., Cicchetti & Rogosch, 2001a; 2001b; Cicchetti, Rogosch, Toth, & Sturge-Apple, 2011; Granger et al., 1998; Gunnar & Vazquez, 2001).”

“Thus, a within-person approach has been followed for the identification of pathways or mediational mechanisms that translate experiences of social dysfunction into developmental problems in adolescence (Bolger & Patterson, 2001; Cicchetti & Rogosch, 2001; Kiriakidis, 2006).”

“Cicchetti and Rogosch (2001a)6 Abuse (physical, emotional, sexual), Neglect Childhood Public records 7–12 years Maltreated children (167), comparison children (204) N/A HPA axis Morning (9 a.m.) and afternoon (4 p.m.) salivary cortisol collected at summer camp.”

“Thus, child maltreatment may create a context under which youths’ reactivity to stressors is developed and/or exasperated, which in turn, is associated with maladjustment (Cicchetti and Rogosch 2001).”

“Sexual abuse experienced in childhood or adolescence is a developmental stressor that can have profound, long-term physiologic and psychosocial effects (Banyard, Williams, & Siegel, 2001; Cicchetti & Rogosch, 2001; DeBellis, 2001).”

“These findings are similar to those in the present study, given that deviant cortisol patterns are linked to both insecure attachment (Luijk et al., 2010) and externalizing problems (Cicchetti & Rogosch, 2001).”