Study fails to find link between HPA axis problems and early childhood trauma


Founder of Health Rising and Phoenix Rising
Staff member
In contrast to other studies this study failed to find a link between early childhood trauma and low cortisol in ME/CFS but it did find a link between emotional neglect and cortisol "reactivity" It's well established that increased rates of childhood trauma are associated with all kind of disorders including autoimmune disorders later in life - so even if the association is positive, it wouldn't suggest that ME/CFS was a psychological disorder. Early trauma is now a well known instigator of many issues.

The authors did, however, go a bit far when they stated - findings of this study are largely congruent with a growing body of evidence that emotional trauma may be particularly important in CFS..

But then again the idea of a stressful event kicking off ME/CFS or, if you have ME/CFS - making it worse - is nothing new and in my opinion makes sense. The system is often too weak to handle many kinds of stresses including too much exercise, emotional issues, etc. - they are all depleters..

Note though that the main finding they were looking for - cortisol reduction - was not found - so the effects in at least in this study were decided secondary.

"Taken together, our findings seem to suggest that childhood emotional neglect is associated with a reduced ability to activate the neuroendocrine stress system when confronted with acute psychosocial stress, but not with a fundamental impairment in daily cortisol activity."

There is a paucity of studies that have investigated the assumption that early childhood trauma is associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction in Chronic Fatigue Syndrome (CFS). The current study is the first to simultaneously investigate relationships among early childhood trauma, cortisol activity, and cortisol stress reactivity to psychosocial stress in a sample of well-screened CFS patients. We also examined whether self-critical perfectionism (SCP) plays a mediating role in the potential relationship between early trauma and neurobiological stress responses.

A total of 40 female patients diagnosed with CFS were asked to provide morning saliva cortisol samples (after awakening, 30min later, and 1h later) for seven consecutive days as a measure of cortisol activity. In addition, patients were exposed to the Trier Social Stress Test, a well-validated stress test, to investigate the relationship between early childhood trauma and cortisol stress reactivity. Before the start of the study, patients completed the Childhood Trauma Questionnaire-Short form (CTQ-SF) as a measure of early childhood trauma (i.e. sexual, physical and emotional traumatic experiences). SCP was measured with the Depressive Experiences Questionnaire (DEQ). Data were analyzed by calculating several indices of cortisol secretion (i.e. Cortisol Awakening Response and Area Under the Curve).

There was no association between early childhood trauma and cortisol as measured over the 7-day period. However, emotional neglect was significantly negatively related to cortisol reactivity in the TSST. SCP did not significantly mediate this association.

Findings of this study suggest that emotional neglect is associated with blunted HPA axis reactivity, congruent with the assumption that CFS may reflect loss of adaptability of the neuroendocrine stress response system in at least a subgroup of patients.
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