Decreased ACTH and Cortisol Responses to Stress in Healthy Adults Reporting Significant Childhood Maltreatment

Abstract

Background—Preclinical research findings suggest that exposure to stress and concomitant hypothalamus-pituitary-adrenal (HPA) axis activation during early development can have permanent and potentially deleterious effects. A history of early-life abuse or neglect appears to increase risk for mood and anxiety disorders. Abnormal HPA response to stress challenge has been reported in adult patients with Major Depressive Disorder and Post-Traumatic Stress Disorder. Methods—Plasma adrenocorticotropin (ACTH) and cortisol reactivity to the Trier Social Stress Test were examined in healthy adults (N=50) without current psychopathology. Subjects with a selfreported history of moderate to severe childhood maltreatment (MAL; n=23) as measured by the Childhood Trauma Questionnaire were compared with subjects without such a history (CTL; n=27). Results—Compared with CTLs, MAL subjects exhibited significantly lower cortisol and ACTH baseline-to-peak deltas. A significant group effect was seen in the (repeated measures) cortisol response to the stress challenge, reflecting lower concentrations among MAL subjects. A significant group × time effect characterized the relatively blunted ACTH response of the MAL group. Emotional Neglect (=−.34, p=.02) and Sexual Abuse (=+.31, p=.03) strongly predicted maximal cortisol release. Conclusions—In adults without diagnosable psychopathology, childhood maltreatment is associated with diminished HPA axis response to a psychosocial stressor. Possible explanations for the finding are discussed.