The differential impacts of early physical and sexual abuse and internalizing problems on daytime cortisol rhythm in school-aged children

Abstract

The impact of early physical and sexual abuse (EPA/SA) occurring in the first 5 years of life was investigated in relation to depressive and internalizing symptomatology and diurnal cortisol regulation. In a summer camp context, school-aged maltreated (n = 265) and nonmaltreated (n = 288) children provided morning and late afternoon saliva samples on 5 consecutive days. Child self-report and adult observer reports of child internalizing and depressive symptoms were obtained. Children experiencing EPA/SA and high depressive or internalizing symptoms uniquely exhibited an attenuated diurnal decrease in cortisol, indicative of neuroendocrine dysregulation. These results were specific to EPA/SA rather than later onset physical or sexual abuse or early occurring neglect or emotional maltreatment.

Figures

Figure 1

Figure 1a. Children with low depressive and internalizing symptoms: Diurnal cortisol regulation in early abuse classification groups.

Note: Cortisol values are in µg/dl with log 10 transformation, adjusted for covariates. EPA/SA = early physical or sexual abuse, NEPA/SA = maltreated, but not early physical or sexual abuse.

Figure 1b. Children with high depressive or internalizing symptoms: Diurnal cortisol regulation in early abuse classification groups.

Figure 1

Figure 1a. Children with low depressive and internalizing symptoms: Diurnal cortisol regulation in early abuse classification groups.

Note: Cortisol values are in µg/dl with log 10 transformation, adjusted for covariates. EPA/SA = early physical or sexual abuse, NEPA/SA = maltreated, but not early physical or sexual abuse.

Figure 1b. Children with high depressive or internalizing symptoms: Diurnal cortisol regulation in early abuse classification groups.

Figure 2

Specificity of diurnal cortisol attenuation for early physical or sexual abuse and high symptoms: Comparisons with early neglect or emotional maltreatment and with later physical or sexual abuse

Note: Diurnal cortisol decrease values are adjusted for covariates; PA = physical abuse, SA = sexual abuse, PN = physical neglect, EM = emotional maltreatment, Sx. = internalizing and depression symptoms.