Testing Hair Cortisol as a Mediator between Childhood Abuse/Neglect and Adolescent Mental Health Problems

• In Event: 3-069 - Multimodal Investigation of Childhood Adversity, Stress System Regulation, and Adolescent Physical and Mental Health

Integrative Statement

Background: Chronic psychosocial stress in childhood has been linked to dysregulation in stress-mediating systems, which has been associated with a number of mental and physical health problems. Advances in cortisol assessment have led to the development of hair cortisol assays, which index chronic cortisol output over the past 3 months. High levels of hair cortisol are more common in individuals with major depression, while individuals with PTSD typically show decreased hair cortisol levels (Staufenbiel et al., 2012). There is growing evidence that hair cortisol levels may predict increases in symptomology following stress (Steudte-Schmiedgen et al., 2015). To our knowledge, no study has prospectively examined whether hair cortisol in adolescence may be a mediator between abuse and neglect during childhood and adolescent internalizing and externalizing problems. It is also unknown whether abuse vs. neglect and high vs. low levels of hair cortisol might lead to different types of problems following early stress.
Methods: Data from a subset of the Fragile Families and Child Wellbeing Study who provided hair samples at 15y were used (N = 171). The sample has been prospectively assessed since birth. The current sample is economically high-risk (75% of mothers not married at birth) and historically underrepresented (75% African American or Black). The primary caregiver and child (when appropriate) reported child-directed emotional and physical abuse and neglect at 3y, 5y, 9y, and 15y. The primary caregiver reported anxious/depressive, aggressive, and rule breaking problems via the Child Behavior Checklist at 9 and 15 years. Total hair cortisol across 3 months at 15y was the mediator. Longitudinal structural equation modeling in Mplus was used to test whether total hair cortisol across 3 months mediated the association between abuse and neglect from 3-15 years and changes in anxious depressive and externalizing problems (latent variable of rule breaking and aggressive problems) between 9 and 15 years, controlling for demographics, early risk (e.g., low maternal education), hair treatments, and current stress (e.g., poverty, home chaos).
Results: Greater cumulative abuse from 3-15y predicted higher hair cortisol at 15y (β= 0.17, 95% CI: 0.03 to 0.30, p<.05), while greater cumulative neglect predicted lower hair cortisol (β= -0.11, 95% CI: -0.21 to -0.001, p<.05; Figure 1). Lower hair cortisol at 15y predicted greater increases in anxious/depressive symptoms from 9 to 15 years (β= -0.19, 95% CI: -0.35 to -0.04, p<.05), but did not predict changes in externalizing problems, p>.05. Despite significant direct paths, indirect paths were non-significant, ps>.05. Cumulative abuse directly predicted increases in age 15 externalizing problems (β=0.29, 95% CI: 0.10 to 0.47, p<.01). Cumulative abuse and cumulative neglect from 3-15y predicted hair cortisol better than either early (3-5y) or late (9-15y) abuse or neglect.
Discussion: Childhood abuse and neglect were associated with different patterns of hair cortisol in adolescence, and low hair cortisol was associated with increases in anxious/depressive symptoms from 9 to 15 years. These findings add to knowledge of how different types of childhood stress are biologically embedded and inform identification of children at highest risk for mental health problems following stress.

Authors

• Jenalee Doom, University of Michigan
  Presenting Author

• Melissa Peckins, University of Michigan
  Non-Presenting Author

• Tyler Hein, University of Michigan
  Non-Presenting Author

• James L. Abelson, University of Michigan
  Non-Presenting Author

• Colter Mitchell, University of Michigan
  Non-Presenting Author

• Nestor L. Lopez-Duran, University of Michigan
  Non-Presenting Author

• Luke W. Hyde, University of Michigan
  Non-Presenting Author

• Jeanne Brooks-Gunn, Columbia University Teachers College
  Non-Presenting Author

• Sara McLanahan, Princeton University
  Non-Presenting Author

• Christopher Stephen Monk, University of Michigan – Ann Arbor
  Non-Presenting Author