title: Longitudinal patterns of cortisol regulation differ in maltreated and nonmaltreated children.
abstract: OBJECTIVE
  Child maltreatment is associated with dysregulation of stress-mediating systems and an increased risk of mental and physical health problems. Specifically, disruptions in hypothalamic-pituitary-adrenal (HPA) axis regulation have been reported in maltreated children. The current study investigates whether increased cortisol variability is responsible for inconsistent patterns in the literature.
  
  
  METHODS
  This study modeled cortisol activity over 20 weeks in 187 maltreated and 154 nonmaltreated children (mean = 8.4 years, SD = 1.8 years) in order to capture week-to-week cortisol patterns. Maltreatment was assessed through coding of Department of Human Services records. Children attended an after-school program 1 day per week for 20 weeks, where saliva was collected at the same time each day and subsequently assayed for cortisol.
  
  
  RESULTS
  Multiple-group growth curves indicated that maltreated and non-maltreated children differ in longitudinal cortisol patterns. Maltreated children showed higher variance in the initial cortisol levels and slope over time compared to nonmaltreated children, indicating greater between-person variability in the maltreated group. Maltreated children with higher cortisol at the first assessment showed cortisol suppression over time, indicating potential HPA blunting after chronic high cortisol levels. The severity, timing, and number of subtypes of maltreatment predicted individuals' cortisol variability, and both maltreatment status and greater cortisol variability predicted more behavior problems.
  
  
  CONCLUSIONS
  Interventions for maltreated children may benefit from pre- and post-intervention HPA assessments to determine a component of treatment efficacy. As maltreatment dimensions predicted differential cortisol regulation, assessment of maltreatment experiences is necessary to understand alterations in behavior and HPA regulation post-intervention.
authors.affiliation: Institute of Child Development and the Center for Neurobehavioral Development, University of Minnesota, Minneapolis. Electronic address: doomx008@umn.edu.
authors.forename: Jenalee R
authors.initials: JR
authors.lastname: Doom
authors.affiliation: Institute of Child Development, University of Minnesota, and Mt. Hope Family Center, Rochester, NY.
authors.forename: Dante
authors.initials: D
authors.lastname: Cicchetti
authors.affiliation: Mt. Hope Family Center and the University of Rochester.
authors.forename: Fred A
authors.initials: FA
authors.lastname: Rogosch
mesh_terms: D000293:Adolescent; D001143:Arousal / Q000502:physiology; D016022:Case-Control Studies; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D002653:Child Behavior Disorders / Q000097:blood / Q000175:diagnosis / Q000523:psychology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D012307:Risk Factors; D012463:Saliva / Q000737:chemistry
chemical_list: D006854:Hydrocortisone
keywords: behavior problems; cortisol; maltreatment; middle childhood; structural equation modeling