Schär Selina, Mürner-Lavanchy Ines, Schmidt Stefanie J, Koenig Julian, Kaess Michael
University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.
Front Neuroendocrinol. 2022 Jul;66:100987. doi: 10.1016/j.yfrne.2022.100987. Epub 2022 Feb 21.
Alterations in hypothalamic-pituitary-adrenal (HPA) axis and its effector hormone cortisol have been proposed as one possible mechanism linking child maltreatment experiences to health disparities. In this series of meta-analyses, we aimed to quantify the existing evidence on the effect of child maltreatment on various measures of HPA axis activity. The systematic literature search yielded 1,858 records, of which 87 studies (k = 132) were included. Using random-effects models, we found evidence for blunted cortisol stress reactivity in individuals exposed to child maltreatment. In contrast, no overall differences were found in any of the other HPA axis activity measures (including measures of daily activity, cortisol assessed in the context of pharmacological challenges and cumulative measures of cortisol secretion). The impact of several moderators (e.g., sex, psychopathology, study quality), the role of methodological shortcomings of existing studies, as well as potential directions for future research are discussed.
下丘脑-垂体-肾上腺（HPA）轴及其效应激素皮质醇的改变被认为是将儿童虐待经历与健康差距联系起来的一种可能机制。在这一系列的荟萃分析中，我们旨在量化现有关于儿童虐待对HPA轴活动各种指标影响的证据。系统的文献检索产生了1858条记录，其中87项研究（k = 132）被纳入。使用随机效应模型，我们发现有证据表明遭受儿童虐待的个体皮质醇应激反应迟钝。相比之下，在任何其他HPA轴活动指标（包括日常活动指标、在药理学挑战背景下评估的皮质醇以及皮质醇分泌的累积指标）中均未发现总体差异。讨论了几个调节因素（如性别、精神病理学、研究质量）的影响、现有研究方法学缺陷的作用以及未来研究的潜在方向。
