Child maltreatment and hypothalamic-pituitary-adrenal axis functioning: A systematic review and meta-analysis.

Schär, Selina; Mürner-Lavanchy, Ines; Schmidt, Stefanie J.; Koenig, Julian; Kaess, Michael (2022). Child maltreatment and hypothalamic-pituitary-adrenal axis functioning: A systematic review and meta-analysis. (In Press). Frontiers in neuroendocrinology, 66, p. 100987. Elsevier 10.1016/j.yfrne.2022.100987

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Alterations in hypothalamic-pituitary-adrenal (HPA) axis and its effector hormone cortisol have been proposed as one possible mechanism linking child maltreatment experiences to health disparities. In this series of meta-analyses, we aimed to quantify the existing evidence on the effect of child maltreatment on various measures of HPA axis activity. The systematic literature search yielded 1,858 records, of which 87 studies (k = 132) were included. Using random-effects models, we found evidence for blunted cortisol stress reactivity in individuals exposed to child maltreatment. In contrast, no overall differences were found in any of the other HPA axis activity measures (including measures of daily activity, cortisol assessed in the context of pharmacological challenges and cumulative measures of cortisol secretion). The impact of several moderators (e.g., sex, psychopathology, study quality), the role of methodological shortcomings of existing studies, as well as potential directions for future research are discussed.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > University Psychiatric Services > University Hospital of Child and Adolescent Psychiatry and Psychotherapy

UniBE Contributor:

Schär, Selina; Mürner-Lavanchy, Ines Mirjam; Schmidt, Stefanie Julia; Koenig, Julian and Kaess, Michael


600 Technology > 610 Medicine & health








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Date Deposited:

25 Feb 2022 12:31

Last Modified:

17 Mar 2022 00:15

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Uncontrolled Keywords:

child maltreatment combined dexamethasone-corticotropin releasing hormone test corticotropin-releasing hormone test cortisol awakening response dexamethasone suppression test diurnal cortisol hair cortisol hypothalamic-pituitary-adrenal axis meta-analysis stress reactivity systematic review urinary free cortisol




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