RESEARCH - Childhood maltreatment and diurnal cortisol patterns in women with chronic pain

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Psychosom Med. 2010 Jun;72(5):471-80. Epub 2010 May 13.

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

Nicolson NA, MC, Kruszewski D, Zautra AJ.

Department of Psychiatry and Neuropsychology, Maastricht University,

Maastricht, The Netherlands.

Abstract

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.

PMID: 20467005

http://www.ncbi.nlm.nih.gov/pubmed/20467005

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