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date: 05 August 2020

Abstract and Keywords

Child maltreatment has significant impacts on developmental trajectories and is one of the most preventable early-life adversities. It shapes the development of many biological systems, with most research concentrating on its influence on stress response systems like the hypothalamic-pituitary-adrenal (HPA) axis. This chapter reviews associations between child maltreatment and HPA axis activity across development. One emerging pattern is that of flattened diurnal cortisol slopes in children, adolescents, and adults with childhood maltreatment histories. This effect was moderated by psychiatric diagnosis, maltreatment subtype, and genetic vulnerability in some studies. Effects on cortisol reactivity are more mixed, including reports of higher reactivity, lower reactivity, or no differences compared to nonmaltreated samples. Interventions that focus on enhancing the quality of parent–child relationships early in life may reverse some of the effects of maltreatment. This chapter discusses implications of maltreatment-related alterations in HPA axis function for mental and physical health and concludes with suggested future research directions.

Keywords: maltreatment, HPA axis, cortisol, early-life adversity, maternal stress, intervention

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