The Cortisol Paradox of Trauma-Related Disorders: Lower Phasic Responses but Higher Tonic Levels of Cortisol Are Associated with Sexual Abuse in Childhood

Schalinski, Inga; Elbert, Thomas; Steudte-Schmiedgen, Susann; Kirschbaum, Clemens

doi:10.1371/journal.pone.0136921

Cited by 83 publications

(61 citation statements)

References 54 publications

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“…Considering the length of the sensitive period, current results suggest relevant sensitive periods of at least two consecutive years of ACE exposure for stress-related symptoms, which is also in line with neurobiological findings [7, 8]. By supporting these periods of vulnerability and drawing attention to the particular sensitive for emotional and physical neglect, the present results encourage further research on the neuroendocrine mechanisms that might mediate ACE effects on brain function and structure [7, 8], hypothalamic-pituitary-adrenal-axis regulation [47] or epigenetic profiles [48], finally resulting in enhanced vulnerability for psychopathological developments.…”

Section: Discussionsupporting

confidence: 86%

Type and timing of adverse childhood experiences differentially affect severity of PTSD, dissociative and depressive symptoms in adult inpatients

Schalinski

Teicher

Nischk³

et al. 2016

BMC Psychiatry

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140

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BackgroundA dose-dependent effect of Adverse Childhood Experiences (ACE) on the course and severity of psychiatric disorders has been frequently reported. Recent evidence indicates additional impact of type and timing of distinct ACE on symptom severity experienced in adulthood, in support of stress-sensitive periods in (brain) development. The present study seeks to clarify the impact of ACE on symptoms that are often comorbid across various diagnostic groups: symptoms of posttraumatic stress disorder (PTSD), shutdown dissociation and depression. A key aim was to determine and compare the importance of dose-dependent versus type and timing specific prediction of ACE on symptom levels.MethodsExposure to ten types of maltreatment up to age 18 were retrospectively assessed in N = 129 psychiatric inpatients using the Maltreatment and Abuse Chronology of Exposure (MACE). Symptoms of PTSD, shutdown dissociation, and depression were related to type and timing of ACE. The predictive power of peak types and timings was compared to that of global MACE measures of duration, multiplicity and overall severity.ResultsA dose-dependent effect (MACE duration, multiplicity and overall severity) on severity of all symptoms confirmed earlier findings. Conditioned random forest regression verified that PTSD symptoms were best predicted by overall ACE severity, whereas type and timing specific effects showed stronger prediction for symptoms of dissociation and depression. In particular, physical neglect at age 5 and emotional neglect at ages 4–5 were related to increased symptoms of dissociation, whereas the emotional neglect at age 8–9 enhanced symptoms of depression.ConclusionIn support of the sensitive period of exposure model, present results indicate augmented vulnerability by type x timing of ACE, in particular emphasizing pre-school (age 4–5) and pre-adolescent (8–9) periods as sensitive for the impact of physical and emotional neglect. PTSD, the most severe stress-related disorder, varies with the amount of adverse experiences irrespective of age of experience. Considering type and timing of ACE improves understanding of vulnerability, and should inform diagnostics of psychopathology like PTSD, dissociation and depression in adult psychiatric patients.

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Section: Discussionsupporting

confidence: 86%

Type and timing of adverse childhood experiences differentially affect severity of PTSD, dissociative and depressive symptoms in adult inpatients

Schalinski

Teicher

Nischk³

et al. 2016

BMC Psychiatry

Self Cite

240

140

View full text Add to dashboard Cite

show abstract

“…Heightened negative affect, psychopathology, and related glucocorticoid dysregulation have been well documented in those with high adversity and traumatic backgrounds (Dunn et al, 2011; Hostinar, Lachman, Mroczek, Seeman, & Miller, 2015; Lagdon et al, 2014; Schalinski, Elbert, Steudte-Schmiedgen, & Kirschbaum, 2015). Within the smoking literature, it has also been found frequently, though not exclusively (Ceballos & al'Absi, 2006), that glucocorticoid dysregulation increases the likelihood of smoking during stress, changes the pattern of smoking, or increases the risk of relapse (al'Absi et al, 2005; al'Absi et al, 2015; McKee et al, 2011; Rasmusson, Wu, Paliwal, Anderson, & Krishnan-Sarin, 2006).…”

Section: Discussionmentioning

confidence: 99%

Life adversity is associated with smoking relapse after a quit attempt

Lemieux

Olson

Nakajima

et al. 2016

Addictive Behaviors

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Multiple cross-sectional studies have linked adverse childhood events and adult adversities to current smoking, lifetime smoking, and former smoking. To date, however, there have been no direct observation studies assessing the influence of adversities on smoking relapse. We prospectively followed 123 participants, 86 of whom were habitual smokers, from pre-quit ad libitum smoking to four weeks post quit. Thirty-seven non-smokers were also tested in parallel as a comparison group. Subjects provided biological samples for confirmation of abstinence status and self-report history of adversities such as abuse, neglect, family dysfunction, incarceration, and child-parent separation. They also completed mood and smoking withdrawal symptom measures. The results indicated that within non-smokers and smokers who relapsed within the first month of a quit attempt, but not abstainers, females had significantly higher adversity scores than males. Cigarette craving, which was independent from depressive affect, increased for low adversity participants, but not those with no adversity or high adversity. These results demonstrate that sex and relapse status interact to predict adversity and that craving for nicotine may be an important additional mediator of relapse. These results add further support to the previous cross-sectional evidence of an adversity and smoking relationship. Further studies to clarify how adversity complicates smoking cessation and impacts smoking behaviors are warranted.

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“…The estimate was based on raw data obtained from the analyzed studies (e.g. Schalinski et al 38 ) and robustness analysis 37 .…”

Section: Discussionmentioning

confidence: 99%

Are we overestimating the utility of hair glucocorticoids? A systematic review exploring the empirical evidence supporting hair glucocorticoids as a measure of stress

Kalliokoski

Murison

2018

Preprint

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Quantitating glucocorticoids (GCs) in hairs is a popular method for assessing chronic stress in studies of humans and animals alike. The cause-and-effect relationship between stress and elevated GC levels in hairs, sampled weeks later, is however hard to prove. This systematic review evaluated the evidence supporting hair glucocorticoids (hGCs) as a biomarker of stress.Only a relatively small number of controlled studies employing hGC analyses have been published, and the quality of the evidence is compromised by unchecked sources of bias. Subjects exposed to stress mostly demonstrate elevated levels of hGCs, and these concentrations correlate significantly with GC concentrations in serum, saliva and feces. This supports hGCs as a biomarker of stress, but the dataset provided no evidence that hGCs are a marker of historical stress. Only in cases where the stressor persisted at the time of hair sampling could a clear link between stress and hGCs be established.

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The Cortisol Paradox of Trauma-Related Disorders: Lower Phasic Responses but Higher Tonic Levels of Cortisol Are Associated with Sexual Abuse in Childhood

Cited by 83 publications

References 54 publications

Type and timing of adverse childhood experiences differentially affect severity of PTSD, dissociative and depressive symptoms in adult inpatients

Type and timing of adverse childhood experiences differentially affect severity of PTSD, dissociative and depressive symptoms in adult inpatients

Life adversity is associated with smoking relapse after a quit attempt

Are we overestimating the utility of hair glucocorticoids? A systematic review exploring the empirical evidence supporting hair glucocorticoids as a measure of stress

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