Cognitive Development and Neuroimaging Laboratory, The Brain and Mind Institute, Western University, London, ON, Canada.
Neurosci Biobehav Rev. 2021 Aug;127:54-135. doi: 10.1016/j.neubiorev.2021.04.006. Epub 2021 Apr 20.
Although there is an abundance of evidence linking the function of the hypothalamic-pituitary-adrenal (HPA) axis to adverse early-life experiences, the precise nature of the association remains unclear. Some evidence suggests early-life adversity leads to cortisol hyper-reactivity, while other evidence suggests adversity leads to cortisol hypo-reactivity. Here, we distinguish between trauma and adversity, and use p-curves to interrogate the conflicting literature. In Study 1, trauma was operationalized according to DSM-5 criteria; the p-curve analysis included 68 articles and revealed that the literature reporting associations between trauma and blunted cortisol reactivity contains evidential value. Study 2 examined the relationship between adversity and cortisol reactivity. Thirty articles were included in the analysis, and p-curve demonstrated that adversity is related to heightened cortisol reactivity. These results support an inverted U-shaped function relating severity of adversity and cortisol reactivity, and underscore the importance of distinguishing between "trauma" and "adversity".
虽然有大量证据表明下丘脑-垂体-肾上腺（HPA）轴的功能与不良的早期生活经历有关，但关联的确切性质仍不清楚。一些证据表明，早期生活逆境会导致皮质醇反应过度，而另一些证据则表明逆境会导致皮质醇反应不足。在这里，我们区分了创伤和逆境，并使用 p 曲线来探究相互矛盾的文献。在研究 1 中，根据 DSM-5 标准来操作创伤；p 曲线分析包括 68 篇文章，结果表明，报告创伤与皮质醇反应迟钝之间关联的文献具有证据价值。研究 2 检验了逆境与皮质醇反应之间的关系。分析中包括 30 篇文章，p 曲线表明，逆境与皮质醇反应增强有关。这些结果支持逆境严重程度与皮质醇反应之间呈倒 U 形关系的假设，并强调了区分“创伤”和“逆境”的重要性。
