title: Childhood adversity modifies the relationship between anxiety disorders and cortisol secretion.
abstract: BACKGROUND
  Internalizing psychiatric disorders and early childhood adversity have both been associated with altered basal cortisol secretion. The aim of the present study is to investigate if early childhood adversity modifies the relationship between anxiety and mood disorders and cortisol secretion.
  
  
  METHODS
  A sample of 429 international adoptees was followed from childhood to adulthood. In childhood, adoptive parents provided information about abuse and neglect before adoption. As adults, adoptees completed a standardized psychiatric interview to assess internalizing disorders and collected saliva samples four times a day. Analyses of covariance were performed.
  
  
  RESULTS
  The relationship between anxiety disorders and cortisol secretion during 1 day, as measured by the area under the curve (AUC), was dependent on the experience of severe early maltreatment (p value of interaction = .03). In adoptees with an anxiety disorder, severe maltreatment was associated with lower daily cortisol secretion compared with nonmaltreated adoptees (respective AUC means: 28.19 and 36.96; difference = -8.78; confidence interval = -14.65 to -2.90; p = .004). In adoptees without an anxiety disorder, no difference in cortisol secretion was found between persons who did or did not experience severe maltreatment early in life (respective AUC means: 34.72 and 34.20; difference = .52; confidence interval = -1.92 to 2.96; p = .67). We found no modifying effect of severe early maltreatment on the relationship between mood disorders and daily cortisol secretion.
  
  
  CONCLUSIONS
  The experience of early adversities modifies the relationship between anxiety disorders and basal cortisol secretion in adults. To understand the relationship between anxiety disorders and cortisol secretion, early maltreatment has to be taken into account.
authors.affiliation: Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Esther J M
authors.initials: EJ
authors.lastname: van der Vegt
authors.forename: Jan
authors.initials: J
authors.lastname: van der Ende
authors.forename: Anja C
authors.initials: AC
authors.lastname: Huizink
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
mesh_terms: D000300:Adoption / Q000523:psychology; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D001008:Anxiety Disorders / Q000378:metabolism* / Q000523:psychology*; D019540:Area Under Curve; D002648:Child; D002649:Child Abuse / Q000523:psychology; D002675:Child, Preschool; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis / Q000378:metabolism*; D007223:Infant; D008016:Life Change Events; D012463:Saliva / Q000737:chemistry; D013315:Stress, Psychological / Q000378:metabolism / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D006854:Hydrocortisone