Cortisol Profile Mediates the Relation Between Childhood Neglect and Pain and Emotional Symptoms among Patients with Fibromyalgia.

BACKGROUND: The relation between childhood trauma and chronic pain and emotional symptoms in adulthood has been well-documented, although physiological mechanisms mediating this link have not been elaborated. PURPOSE: This study examined the mediating role of cortisol profile in the linkage between childhood maltreatment and pain and emotional symptoms in individuals with fibromyalgia (FM). METHODS: One hundred seventy-nine adults with FM first provided retrospective self-reports of childhood maltreatment, then attended a standardized session during which cortisol was sampled across 1.5 hours and, subsequently, completed assessments of daily pain, depressive symptoms, and anxiety. Latent growth curve modeling estimated the hypothesized mediation models. RESULTS: Childhood neglect predicted a flattened cortisol profile, which, in turn, predicted elevated daily pain and emotional symptoms. The cortisol profile partially mediated the neglect-symptom relation. CONCLUSIONS: Early maltreatment may exert enduring effects on endocrine regulation that contributes to pain and emotional symptoms in adults with chronic pain.

Does stress predict the development of internalizing symptoms in middle childhood? An examination of additive, mediated, and moderated effects of early family stress, daily interpersonal stress, and physiological stress.

Early life stress, daily life experiences, and the stress responsive hypothalamic-pituitary-adrenal (HPA) axis have each been examined as predictors of the development of psychopathology. Rarely have researchers attempted to understand the covariation or interaction among these stress domains using a longitudinal design in the prediction of symptoms of internalizing psychopathology, particularly during childhood. This study examined early family stress, daily interpersonal stress, indicators of diurnal cortisol, and internalizing symptoms in a racially/ethnically and socioeconomically diverse sample of twins (N = 970 children; Mage at outcome = 9.73; 52% female; 23.7% Hispanic/Latino, 58.8% White; 30% below middle class; Lemery-Chalfant et al., 2019). An additive model of stress, a stress mediation model, and a stress sensitization framework model each delineated potential pathways linking stress and internalizing symptoms. Supporting additive pathways, multilevel models showed that all 3 stress indicators uniquely predicted internalizing symptoms. There was a significant indirect path from early family stress to 9 year internalizing symptoms through interpersonal stress, supporting stress mediation. Family stress moderated the association between interpersonal stress and internalizing symptoms, though not in the direction that would support stress sensitization. Child stress, including daily interpersonal stress and HPA axis activity, and internalizing symptoms are prevalent and family stress is a significant precursor to child internalizing symptoms across child development. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Childhood maltreatment and diurnal cortisol patterns in women with chronic pain.

OBJECTIVE: To assess whether alleged childhood maltreatment is associated with daily cortisol secretion in women with chronic pain. METHOD: Women with fibromyalgia (FM group, n = 35) or with osteoarthritis only (OA group, n = 35) completed diaries and collected three saliva samples daily for 30 days, with compliance monitored electronically. Childhood abuse and neglect were assessed by self-report (Childhood Trauma Questionnaire-short form [CTQ-sf]). Multilevel regression analyses estimated associations between maltreatment and diurnal cortisol levels and slopes, controlling for depressive symptoms, posttraumatic stress disorder (PTSD), and daily experience variables. RESULTS: Women reporting more severe childhood maltreatment had higher cortisol throughout the day. The estimated effect of CTQ on log cortisol (beta = 0.007, p = .001) represents a 0.7% increase in raw cortisol level for every unit increase in maltreatment score, which ranged from 25 (no maltreatment) to 106 in this sample. Although different forms of maltreatment were interrelated, emotional and sexual abuse were most closely linked to cortisol levels. Fibromyalgia and osteoarthritis groups showed similar secretory patterns, and maltreatment was associated with elevated cortisol in both. Although maltreatment was related to symptoms of depression, PTSD, and averaged daily reports of positive and negative affect, none of these variables mediated the link between maltreatment and cortisol. CONCLUSIONS: In women with chronic pain, self-reported childhood maltreatment was associated with higher diurnal cortisol levels. These results add to the evidence that abuse in childhood can induce long-term changes in hypothalamic-pituitary-adrenocortical activity. They further underscore the importance of evaluating childhood maltreatment in fibromyalgia and other chronic pain conditions.

Gay and bisexual men who disclose their sexual orientations in the workplace have higher workday levels of salivary cortisol and negative affect.

BACKGROUND: Previous research has shown that gay and bisexual men who conceal their sexual orientation suffer more adverse physical health problems relative to men who are more "out." However, little is known about the physiological mechanisms underlying this association. PURPOSE: This study examined whether concealing sexual orientation in the workplace was associated with increased workday levels of salivary cortisol. METHODS: Seventy-three gay and bisexual men responded to questionnaires assessing the extent to which they are open about their sexual orientations at work and other aspects of their work environment. Men then provided saliva samples and reports of negative affect throughout 2 consecutive days--1 at home and 1 at work. RESULTS: Contrary to expectations, being more out at work was associated with higher workday levels of salivary cortisol (B = 0.21, SE B = 0.09, p < .05) and higher workday reports of negative affect (B = 0.14, SE B = 0.07, p < .05), controlling for home day values. CONCLUSIONS: These findings suggest that it is disclosure rather than nondisclosure of sexual orientation by gay men in the workplace that is associated with emotional and physiological activation; a pattern that may have implications for their long-term adaptation.