title: Long term effects of childhood trauma on cortisol stress reactivity in adulthood and relationship to the occurrence of depression.
abstract: OBJECTIVE
  Childhood trauma may have longstanding effects on individuals' propensity to react adversely to stress, and also predisposes individuals to suffer from depression. The current study aimed to examine stress reactivity in individuals with and without a history of childhood trauma by measuring cortisol responses to the passive viewing of stressful images, specifically including images relevant to childhood trauma. In addition, participants with and without a diagnosis of current depression were studied to investigate whether cortisol stress reactivity may underlie resilience or vulnerability to depression.
  
  
  METHODS
  The study involved 17 healthy participants with and 24 without a history of childhood trauma; and 21 depressed patients with and 18 without a history of childhood trauma. Salivary cortisol was measured before, during and after participants were shown affectively laden images, including standardised scenes from the International Affective Picture System and also images suggestive of childhood abuse. Cortisol stress reactivity to the passive image viewing was compared between groups.
  
  
  RESULTS
  In those who had experienced childhood trauma, cortisol stress responses were overall low and the same in those who were depressed and those who were not (mean stress reactivity variable - depressed: 0.8 nmol/l; non-depressed: 0.72 nmol/l). In contrast, cortisol stress reactivity was raised in depressed subjects relative to those who were not depressed in those without a history of childhood trauma (mean stress reactivity variable - depressed: 3.75 nmol/l; non-depressed: 0.1 nmol/l).
  
  
  CONCLUSIONS
  A history of childhood trauma has longstanding effects on adulthood cortisol responses to stress, particularly in that depressed individuals with a history of childhood trauma show blunted cortisol responses. However, there were no differences between abused depressed and abused non-depressed subjects on cortisol stress responses, suggesting that such a finding does not explain subsequent susceptibility to depression. On the other hand, patients who experience depression without a history of childhood trauma show enhanced cortisol stress reactivity, which could help explain the aetiology of their depressive illnesses. Differences between the current findings and those using other pharmacological and stress challenge paradigms may relate to the type of stimuli used and to dysfunction at different levels of the hypothalamic-pituitary-adrenal (HPA) axis.
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London SE5 8AF, UK. Electronic address: akiko.suzuki@kcl.ac.uk.
authors.forename: Akiko
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: Affective Disorders Unit and Laboratory, South London and Maudsley NHS Trust, London BR3 3BX, UK.
authors.forename: Lucia
authors.initials: L
authors.lastname: Poon
authors.affiliation: Affective Disorders Unit and Laboratory, South London and Maudsley NHS Trust, London BR3 3BX, UK.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Papadopoulos
authors.affiliation: Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London SE5 8AF, UK.
authors.forename: Veena
authors.initials: V
authors.lastname: Kumari
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London SE5 8AF, UK.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Cleare
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D012463:Saliva / Q000737:chemistry; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology*
chemical_list: D006854:Hydrocortisone
keywords: Childhood trauma; Cortisol; Depression; HPA axis; Hormonal resilience; Image exposure; Stress reactivity