Cortisol's Diurnal Rhythm Indexes the Neurobiological Impact of Child Adversity in Adolescence.

Adverse early life experiences, such as child maltreatment, shapes hypothalamic-pituitary-adrenal (HPA) activity. The impact of social context is often probed through laboratory stress reactivity, yet child maltreatment is a severe form of chronic stress that recalibrates even stable or relatively inflexible stress systems such as cortisol's diurnal rhythm. This study was designed to determine how different social contexts, which place divergent demands on children, shape cortisol's diurnal rhythm. Participants include 120 adolescents (9-14 years), including 42 youth with substantiated child physical abuse. Up to 32 saliva samples were obtained in the laboratory, on days youth stayed home, and on school days. A 3-level hierarchical linear model examined cortisol within each day and extracted the diurnal rhythm at level 1; across days at level 2; and between-individual differences in cortisol and its rhythm at level 3. While cortisol's diurnal rhythm was flattened when youth were in the novel laboratory context, the impact of maltreatment was observed within the home context such that maltreated children had persistently flattened diurnal rhythms. The effect of maltreatment overlapped with current chronic interpersonal family stress. Results are consistent with the idea that maltreatment exerts a robust, detrimental impact on the HPA axis and are interpreted in the context of less flexibility and rhythmicity. The HPA axis adapts by encoding signifiers of relevant harsh or unpredictable environments, and the extreme stress of physical abuse in the family setting may be one of these environments which calibrates the developing child's stress responsive system, even throughout a developmental stage in which the family takes on diminishing importance.