Childhood Maltreatment, Low Serum Cortisol Levels, and Non-Suicidal Self-Injury in Young Adults With Major Depressive Disorders

Abstract

BackgroundNon-suicidal self-injury (NSSI) is a serious public health problem widely present among young adults and adolescents. While finding risk factors associated with NSSI among young patients with major depressive disorder (MDD) is challenging, the current study aims to measure childhood adversity and serum cortisol levels and elucidate their relationship in MDD patients with NSSI.MethodsIn this cross-sectional study, 126 young patients with MDD (aged 16 to 35 years) were recruited. The depressive symptoms were assessed by the Beck Depression Inventory (BDI-II), and the childhood adversity was evaluated by the Chinese version of the Childhood Trauma Questionnaire (CTQ) scale. Serum cortisol levels were determined by the kits in patients.ResultsRelative to MDD patients without NSSI, MDD patients with NSSI had a higher CTQ total score and its four subscores. Moreover, the cortisol levels in patients with MDD/NSSI were significantly decreased than in MDD patients without NSSI. For patients with MDD/NSSI, there is a negative association between cortisol levels and emotional neglect, but not for MDD patients without NSSI. Further regression analysis showed that low cortisol levels, BDI-II, and emotional neglect were risk factors for NSSI in young patients with MDD.ConclusionOur findings suggest that young MDD patients with NSSI experience more childhood adversity and have lower cortisol levels. Also, lower cortisol levels were associated with childhood adversity but not with depressive symptoms. Further, lower cortisol levels, depressive symptoms, and emotional neglect were risk factors for NSSI in young patients with MDD.

Personality characteristics, defense styles, borderline symptoms, and non-suicidal self-injury in first-episode major depressive disorder

“…Research on the pathological mechanisms of depression with NSSI is still unclear, but some studies have found that having difficulties in emotion regulation, alexithymia, and childhood trauma may be risk factors for NSSI in adolescents with depression ( Taş Torun et al, 2021 ; Bordalo and Carvalho, 2022 ). Our previous study has also found that patients with depression and NSSI have a dysfunctional HPA axis ( Peng et al, 2022 ). Patients with depression and NSSI responded worse to antidepressant medication than those without NSSI ( Forbes et al, 2020 ).…”

Potential mechanisms of non-suicidal self-injury (NSSI) in major depressive disorder: a systematic review

“…The other study explored the association between childhood trauma and cortisol levels instead of measuring cortisol response during stress tests. 54 Peng et al reported that in comparison to subjects with MDD−NSSI, the resting level of serum cortisol was lower in those with MDD+NSSI after controlling for interference factors. Moreover, a significantly negative correlation between serum cortisol levels and emotional neglect was only found in the subjects with MDD+NSSI.…”

Symptoms mediate the relationship between childhood trauma and non‐suicidal self‐injury: A hospital‐based study of adolescents with mood disorder

“…Intuitively, this model indicated that childhood trauma may directly cause a series of symptoms in adolescents with psychiatric disorders (Peng et al, 2022). The deeper cause of the observed direct effects may be that childhood traumas alter children's ongoing biological and psychological development which leads to mental turbulences (Anda et al, 2006; Briggs et al, 2021).…”

“…Based on previous research, we constructed a consolidated path analysis model regarding "total CTQ score" as an exogenous variable and combined four childhood-trauma-related symptoms evaluated by proper scales in one delicate causal structure, whose comprehensiveness has seldom been seen in previous studies (see Figure 1). Intuitively, this model indicated that childhood trauma may directly cause a series of symptoms in adolescents with psychiatric disorders (Peng et al, 2022). The deeper cause of the observed direct effects may be that childhood traumas alter children's ongoing biological and psychological development which leads to mental turbulences (Anda et al, 2006;Briggs et al, 2021).…”