Age of Trauma Onset and HPA Axis Dysregulation Among Trauma-Exposed Youth

The hypothalamic–pituitary–adrenal axis (HPA axis) is a pathway through which childhood trauma may increase risk for negative health outcomes. The HPA axis is sensitive to stress throughout development; however, few studies have examined whether timing of exposure to childhood trauma is related to differences in later HPA axis functioning. Therefore, we examined the association between age of first trauma and HPA axis functioning among adolescents, and whether these associations varied by sex. Parents of 97 youth (aged 9–16 years) completed the Early Trauma Inventory (ETI), and youth completed the Socially‐Evaluated Cold‐Pressor Task (SECPT). We measured salivary cortisol response to the SECPT, the cortisol awakening response, and diurnal regulation at home across 2 consecutive weekdays. Exposure to trauma during infancy related to delayed cortisol recovery from peak responses to acute stress, d = 0.23 to 0.42. Timing of trauma exposure related to diverging patterns of diurnal cortisol regulation for males, d = 0.55, and females, d = 0.57. Therefore, the HPA axis may be susceptible to developing acute stress dysregulation when exposed to trauma during infancy, whereas the consequences within circadian cortisol regulation may occur in the context of later trauma exposure and vary by sex. Further investigations are warranted to characterize HPA axis sensitivity to exposure to childhood trauma across child development. Resumen Spanish s by the Asociacion Chilena de Estres Traumatico El eje hipotalámico‐pituitaria‐adrenal (Eje HPA) es una vía a través de la cual el trauma infantil puede incrementar el riesgo de resultados negativos en salud. El Eje HPA es sensible al estrés durante el desarrollo; sin embargo, pocos estudios han examinado si la temporalidad de la exposición al trauma infantil se relaciona a diferencias en el funcionamiento posterior del Eje HPA. Por consiguiente, examinamos la asociación entre la edad del primer trauma y el funcionamiento del Eje HPA entre adolescentes, y si esa asociación variaba por sexo. Los padres de 97 jóvenes (de edades entre 9 y 16 años) completaron el Early Trauma Inventory (ETI) y los jóvenes completaron el Socially Evaluated Cold‐Pressor Task (SECPT). Medimos la respuesta del cortisol salival al SECPT, la respuesta de cortisol al despertar, y la variación diurna en el hogar entre 2 dias de semana consecutivos. La exposición a trauma durante la infancia se relacionó a recuperación retardada de cortisol desde la respues