The association between adversity and hair cortisol levels in humans: A meta-analysis

PSYCHONEUROENDOCRINOLOGY

卷:103

Review

Khoury, Jennifer E.¹  Enlow, Michelle Bosquet²  Plamondon, Andre³  Lyons-Ruth, Karlen⁴ 

[1] Harvard Med Sch, Cambridge Hosp, 1035 Cambridge St, Cambridge, MA 02141 USA

[2] Harvard Med Sch, Boston Childrens Hosp, Cambridge, MA USA

[3] Univ Toronto Status Only, Univ Laval, Toronto, ON, Canada

[4] Harvard Med Sch, Cambridge Hosp, Cambridge, MA USA

关键词: Hair cortisol;    Chronic stress;    Adversity;    Adverse experiences;    Trauma;    Meta-analysis;   

DOI  :  10.1016/j.psyneuen.2019.01.009

来源: Elsevier

【 摘 要 】

Adverse life events are associated with a constellation of negative health outcomes. Theory and research suggest that the hypothalamic-pituitary-adrenal (HPA) axis acts as one mechanism connecting adverse experiences with negative health outcomes. However, this relation is complicated by the potential for adversity to be associated with both hyperactivity and hypoactivity of the HPA axis, as assessed in both animal and human studies. Over the past decade, methodological advances have enabled the sampling of cortisol stored in hair, which provides a marker of HPA axis activity over a several-month period. The present meta-analysis included 28 studies to assess the strength and direction of the relation between adverse experiences and hair cortisol levels. Analyses were conducted using multilevel modeling (MLM) to quantify the magnitude of effects and mixture modeling to identify distinct subgroups of studies. Results of MLM analyses indicated that the overall effect size was small but significant d = 0.213, 95% CI [0.034, 0.397]. There was also significant between-study variance (tau = 0.155, 95% CI [0.065, 0.367]). Mixture modeling to identify distinct classes of studies based on effect size and direction resulted in a 2-class model: The first class included four studies with an overall negative and moderate effect size (d = -0.478, 95% CI [-0.639,-0.318]), and the second class included the remaining 24 studies with an overall positive and significant, albeit small, effect size (d = 0.141, 95% CI [0.084, 0.199]). Moderator analyses indicated that the strength and direction of the association between adversity and hair cortisol were moderated by features of the adversity exposure (e.g., type of adversity, timing of adversity), characteristics of the samples (e.g., clinical status, racial distribution), and features of the publication (e.g., publication type, geographic region of study). The findings refine our understanding of the long-term impact of adversity on dysregulation of the HPA axis, particularly as reflected in hair cortisol measures.

【 授权许可】

Free