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Association between cortisol and cardiovascular reactivity varied in child maltreatment

Liangyi Zhang1, Wei Lü1

  • 1Shaanxi Key Laboratory of Behavior and Cognitive, Neuroscience, Shaanxi Key Research Center for Children Mental and Behavior Health, School of Psychology, Shaanxi Normal University, China.

Psychoneuroendocrinology
|May 29, 2026
PubMed

Insights

Child maltreatment disrupts the coordinated stress response between the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS) in adolescents. This study found symmetry in healthy adolescents, but asymmetry in those with a history of maltreatment.

Area of Science:

  • Neuroscience
  • Psychology
  • Endocrinology

Background:

  • Child maltreatment is linked to psychopathology through stress system dysregulation.
  • The coordination between the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS) in response to stress following maltreatment in adolescence is not well understood.

Purpose of the Study:

  • To investigate the association between HPA axis (cortisol) and ANS (cardiovascular) stress responses in adolescents with and without child maltreatment.
  • To examine how child maltreatment impacts the symmetry of HPA axis and ANS stress response coordination during adolescence.

Main Methods:

  • 116 adolescents (59 with child maltreatment, 57 comparison) completed the Childhood Trauma Questionnaire.
  • Participants underwent the Trier Social Stress Test (TSST) to measure cortisol, heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) reactivity.
  • Statistical analyses controlled for age, sex, body mass index, and socioeconomic status.

Main Results:

  • A symmetrical HPA axis and ANS stress response (positive correlation between cortisol and SBP/DBP reactivity) was observed in the comparison group.
  • An asymmetrical response was found in the child maltreatment group, characterized by a negative association between cortisol and DBP reactivity, and no association with SBP reactivity.
  • These findings indicate a disruption in the coordinated stress response due to child maltreatment.

Conclusions:

  • Child maltreatment alters the normal symmetry between the HPA axis and ANS stress responses in adolescents.
  • This disruption in physiological stress response coordination may be a key pathway linking maltreatment to psychopathology.
  • Understanding these neuroendocrine and autonomic changes is crucial for developing targeted interventions for maltreated adolescents.

Keywords:
AdolescentsCardiovascular responseChild maltreatmentCortisol responseSymmetry and asymmetry

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