title: Effects of early childhood trauma on hypothalamic-pituitary-adrenal (HPA) axis function in patients with Chronic Fatigue Syndrome.
abstract: BACKGROUND
  There is a paucity of studies that have investigated the assumption that early childhood trauma is associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction in Chronic Fatigue Syndrome (CFS). The current study is the first to simultaneously investigate relationships among early childhood trauma, cortisol activity, and cortisol stress reactivity to psychosocial stress in a sample of well-screened CFS patients. We also examined whether self-critical perfectionism (SCP) plays a mediating role in the potential relationship between early trauma and neurobiological stress responses.
  
  
  METHODS
  A total of 40 female patients diagnosed with CFS were asked to provide morning saliva cortisol samples (after awakening, 30min later, and 1h later) for seven consecutive days as a measure of cortisol activity. In addition, patients were exposed to the Trier Social Stress Test, a well-validated stress test, to investigate the relationship between early childhood trauma and cortisol stress reactivity. Before the start of the study, patients completed the Childhood Trauma Questionnaire-Short form (CTQ-SF) as a measure of early childhood trauma (i.e. sexual, physical and emotional traumatic experiences). SCP was measured with the Depressive Experiences Questionnaire (DEQ). Data were analyzed by calculating several indices of cortisol secretion (i.e. Cortisol Awakening Response and Area Under the Curve).
  
  
  RESULTS
  There was no association between early childhood trauma and cortisol as measured over the 7-day period. However, emotional neglect was significantly negatively related to cortisol reactivity in the TSST. SCP did not significantly mediate this association.
  
  
  CONCLUSIONS
  Findings of this study suggest that emotional neglect is associated with blunted HPA axis reactivity, congruent with the assumption that CFS may reflect loss of adaptability of the neuroendocrine stress response system in at least a subgroup of patients.
authors.affiliation: Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium. Electronic address: stefan.kempke@ppw.kuleuven.be.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kempke
authors.affiliation: Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium; Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
authors.forename: Patrick
authors.initials: P
authors.lastname: Luyten
authors.affiliation: Biological Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Sarah
authors.initials: S
authors.lastname: De Coninck
authors.affiliation: Department of Psychiatry, University Hospitals Leuven, University of Leuven, Leuven, Belgium.
authors.forename: Boudewijn
authors.initials: B
authors.lastname: Van Houdenhove
authors.affiliation: Yale Child Study Center, Yale Medical School, Yale University, New Haven, USA.
authors.forename: Linda C
authors.initials: LC
authors.lastname: Mayes
authors.affiliation: Department of Psychiatry, University Hospitals Leuven, University of Leuven, Leuven, Belgium.
authors.forename: Stephan
authors.initials: S
authors.lastname: Claes
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse; D015673:Fatigue Syndrome, Chronic / Q000378:metabolism*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism*; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000378:metabolism*; D000067073:Psychological Trauma / Q000378:metabolism*; D013315:Stress, Psychological / Q000378:metabolism*
chemical_list: D006854:Hydrocortisone
keywords: Cortisol; Early adversity; Hypothalamic–pituitary–adrenal (HPA) axis; Stress; Trauma