Childhood trauma, cortisol reactivity to stress and resting cortisol in suicide attempters and ideators

Abstract

Background. Every 40 seconds a person dies by suicide somewhere in the world. The causes of suicidal behaviour are not fully understood. Dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, is one potential risk factor. The current study investigated whether childhood trauma was associated with low levels of cortisol reactivity to a laboratory stressor and resting cortisol levels in suicide attempters and ideators. Methods: One hundred and sixty participants were recruited to a previous attempt, suicidal ideation and a control. Participants completed background questionnaires, including the Childhood Trauma Questionnaire, before completing a stress task known as the Maastricht Acute Stress Test (MAST). Cortisol levels were assessed during rest and during the MAST. Findings: The highest levels of childhood trauma were reported in the attempter group (78.7%), followed by the ideator (37.7%) and then the control (17.8%) groups. Moreover, after controlling for covariates (age, gender, BMI, time, medication, smoking status), regression analyses showed that childhood trauma was a significant predictor of cortisol reactivity to stress and resting cortisol levels, such that high levels of trauma were associated with lower cortisol levels in suicide attempters and ideators. Discussion: These results are consistent with other findings that indicate that childhood trauma is associated with blunted HPA axis activity in vulnerable populations. The challenge for researchers is to elucidate the precise causal mechanisms linking trauma, cortisol and suicide risk and to investigate whether the effects of childhood trauma on cortisol levels are amendable to psychological intervention.