title: Multidimensional assessment of neuroendocrine and psychopathological profiles in maltreated youth.
abstract: It has been debated whether children who have experienced early life stress (ELS), such as early caregiver separation show elevated risk for stress-related psychiatric disorders and a multi-symptom psychopathological profile that is not fully reflected in categorical assessments. In this study, we investigated dimensional measures of stress-related psychopathology in children in permanent out-of-home care, taking into account potential neuroendocrine interactions. In the current study, 25 children who had been placed in permanent out-of-home care before age 3 (years) and 26 controls (aged 10.6 ± 1.75 years) were investigated with categorical (DSM-IV) and dimensional assessments (CBCL) of psychopathology and diurnal salivary cortisol levels were assessed. Semi-structured interviews (K-DIPS) revealed no significant group differences in full-scale psychiatric diagnoses, whereas dimensional assessment (CBCL) revealed significant group differences in externalizing and total problem behaviours within the clinical range for children with ELS. Only children with ELS showed a combined symptom profile of clinical-range internalizing and externalizing problems. Lower morning cortisol values and subsequent flatter decline was found in subjects with ELS children compared to controls, showing group differences in diurnal cortisol secretion. Lower morning cortisol values were associated with more problem behaviour in the ELS group. Results show that ELS children exhibited increased psychopathological symptom severity and complexity associated with lower morning cortisol levels, which was not fully reflected in categorical assessments. This highlights the importance of incorporating dimensional assessments and neurobiological factors into psychopathological evaluations of children in out-of-home care in order to facilitate early identification of children at high risk for stress-related disorders.
authors.affiliation: Division of Psychology and Language Sciences, University College London, 26 Bedford Way, London, WC1H 0AP, UK. v.puetz@ucl.ac.uk.|Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany. v.puetz@ucl.ac.uk.
authors.forename: Vanessa B
authors.initials: VB
authors.lastname: Puetz
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Jana
authors.initials: J
authors.lastname: Zweerings
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Dahmen
authors.affiliation: Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Caroline
authors.initials: C
authors.lastname: Ruf
authors.affiliation: Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Scharke
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany.|JARA Translational Brain Medicine, Aachen & Juelich, Germany.
authors.forename: Beate
authors.initials: B
authors.lastname: Herpertz-Dahlmann
authors.affiliation: Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany.|Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany.|JARA Translational Brain Medicine, Aachen & Juelich, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Konrad
mesh_terms: D000293:Adolescent; D000987:Antisocial Personality Disorder / Q000209:etiology* / Q000378:metabolism; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D002940:Circadian Rhythm / Q000502:physiology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007361:Intelligence Tests; D008297:Male; D011569:Psychiatric Status Rating Scales; D012463:Saliva / Q000378:metabolism*; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000209:etiology / Q000378:metabolism / Q000523:psychology
chemical_list: D006854:Hydrocortisone
keywords: Adoption; Aggression; CBCL; Cortisol; DSM; Dimensional assessments; Early caregiver separation; Early-life stress (ELS); Maltreatment