Meta-Analysis of Associations Between Childhood Adversity and Diurnal Cortisol Regulation

• In Event: Timing matters: Implications of Early-life and concurrent adversity for HPA axis activity across multiple timescales

Abstract

Introduction: Diurnal patterns of cortisol, a stress hormone regulated by the HPA-axis, have been associated with a variety of physical and mental health outcomes (Ruttle et al., 2013; Shirtcliff & Essex, 2008). As a result, identifying early contextual factors associated with dysregulated diurnal cortisol may be important in informing prevention efforts. Although the literature broadly indicates associations between childhood contextual factors and diurnal cortisol patterns (e.g., Koss & Gunnar, 2018), findings have yet to be aggregated using a meta-analytic approach. The present meta-analysis aims to examine whether childhood adversity is associated with stable patterns of diurnal cortisol and to identify whether the specific type of adversity, timing of adversity, or sample characteristics predict differences in these patterns.

Methods: A broad search was conducted in PsycINFO and PubMed for potentially relevant manuscripts. Screening for English-language peer-reviewed journal articles and doctoral dissertations that include at least one measure of childhood contextual adversity (community-level stressors, discrimination, family stress, financial strain, maltreatment, parenting difficulties, parental mental health, parental substance use, single parenthood, surrogate care, and cumulative adversity) and at least one measure of diurnal cortisol (wake level, cortisol awakening response, diurnal change, and bedtime level) yielded 303 manuscripts. A correlation coefficient was calculated for each effect size provided in the manuscripts. Manuscript authors were contacted for any effect sizes that were not reported. Within-study moderators for type of adversity, and age at the time of adversity were coded. Several sample-level moderators were also coded, including age, sex, race/ethnicity , study quality, number of days of cortisol collection, cortisol transformation, and timing of cortisol samples. A total of 439 effect sizes from 105 samples were extracted for meta-analyses that were utilized in multi-level, mixed-effects models.

Analyses and Results: Primary analyses examined whether childhood contextual adversity was associated with dysregulated diurnal cortisol patterns and whether associations were moderated by type of contextual adversity or sample characteristics. A significant overall effect was found between childhood adversity and higher bedtime cortisol, r = 0.054, 95% CI [0.005, 0.102], t = 2.187, p = 0.032, but associations between childhood adversity and wake level, cortisol awakening response, diurnal change were non-significant. Associations were not moderated by the type or timing of adversity.

Conclusions: These findings highlight that childhood adversity may particularly impact the ability to down-regulate cortisol levels throughout the day, resulting in higher bedtime levels. The lack of larger overall effects may reflect the importance of the timing and nature of childhood adversity to adversity’s impact on cortisol regulation. We offer specific recommendations for testing theoretical models linking early adversity and stress physiology. Such studies have great potential for increasing our understanding of the likely complex impact of childhood adversity on diurnal cortisol regulation.

Authors

• Kristin L Bernard, Stony Brook University
  Presenting Author

• Laura Perrone, Stony Brook Unviersity

• Daneele Thorpe, Stony Brook University

• Grace Shariat Panahi

• Yukihiro Kitagawa, University of Oregon

• Oliver Lindhiem, University of Pittsburgh