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Resting Hypothalamic-Pituitary-Adrenal Axis Activity in Childhood Following Maltreatment: A Meta-Analysis

Steven J Holochwost1, Lindsay A Gomes2, Amanda Wylie2

  • 1Department of Psychology, Lehman College, City University of New York, Gillet Hall, Bronx, New York, USA.

Developmental Psychobiology
|February 26, 2025
PubMed

Insights

Childhood maltreatment does not directly impact resting hypothalamic-pituitary-adrenal (HPA) axis activity. However, the association varies based on how maltreatment is reported and socioeconomic differences between groups.

Area of Science:

  • Neuroscience
  • Developmental Psychology
  • Child Health

Background:

  • Childhood maltreatment is linked to adverse developmental and health outcomes.
  • This may stem from the dysregulation of stress-response systems, such as the hypothalamic-pituitary-adrenal (HPA) axis.
  • Understanding the HPA axis's role is crucial for addressing the long-term effects of maltreatment.

Purpose of the Study:

  • To conduct the first meta-analysis on childhood maltreatment and resting HPA-axis activity in children.
  • To investigate "third variables" that may explain heterogeneity in this association.
  • To clarify the complex relationship between early life stress and neuroendocrine function.

Main Methods:

  • Meta-analysis of 18 studies involving 2216 children.
  • Examination of resting HPA-axis activity in maltreated versus non-maltreated children.
  • Statistical analysis to identify moderators of the maltreatment-HPA axis association.

Main Results:

  • No overall difference in resting HPA-axis activity between maltreated and non-maltreated children (SMD = 0.04).
  • Significant heterogeneity was observed across studies (I² = 58.60%, p = 0.001).
  • The association was moderated by the source of maltreatment information (B = 0.33, p = 0.002) and socioeconomic status differences (B = 0.39, p = 0.037).

Conclusions:

  • The direct link between childhood maltreatment and resting HPA-axis activity is not consistently significant.
  • Heterogeneity suggests that contextual factors, like reporting methods and socioeconomic status, are critical.
  • Future research should consider these moderators to better understand maltreatment's impact on HPA axis regulation.

Keywords:
abusecortisolhypothalamic–pituitary–adrenal (HPA) axismaltreatmentmaltreatment sourcemeta‐analysisneglectsocioeconomic status

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