Early-life stress and recurrent psychological distress over the lifecourse predict divergent cortisol reactivity patterns in adulthood.

Early-life stress (ELS) is associated with substantially increased lifetime risk for recurrent psychological problems, with evidence indicating that dysregulation of the physiological stress reactivity system may be partly responsible. However, some ELS-exposed people remain psychologically resilient. Although two distinct patterns of hypothalamic-pituitary-adrenal axis (HPA) stress reactivity have been observed in ELS-exposed samples (hyper- and hypo-reactive), the hypothesis that these patterns may be associated with long-term history of psychological problems has not been explored. We used healthy Whitehall II study subjects (n=543) who participated in the 2008 Heart Scan Study (HSS) to assess salivary cortisol responses to a cognitive stressor, ELS exposure, and other psychosocial factors. Mean age of the sample at the HSS was 63 years. HSS data were linked to nearly 20 years of participants' Whitehall data, including repeated measures of psychological distress (GHQ-28). Piecewise growth curve analyses revealed that ELS-exposed persons with a history of recurrent psychological distress in adulthood had significantly blunted cortisol reactivity compared to non-ELS-exposed participants, while ELS-exposed persons with little or no history of distress had significantly elevated baseline cortisol, prolonged responses, and greater total cortisol production. Our findings indicate that for ELS-exposed individuals, different trajectories in psychological health over their adult lifetimes predict different cortisol reactivity patterns. These findings have important implications for our understanding of ELS-related mental health risk and treatment of these disorders.