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Effects of childhood trauma, daily stress, and emotions on daily cortisol levels in individuals vulnerable to suicide.

O'Connor, Daryl B.; O'Carroll, Ronan E.; O'Connor, Rory C.; Branley-Bell, Dawn; Green, Jessica A.; Ferguson, Eamonn


Daryl B. O'Connor

Ronan E. O'Carroll

Rory C. O'Connor

Dawn Branley-Bell

Jessica A. Green

Eamonn Ferguson


Objectives: Suicide is a leading cause of mortality worldwide. Dysregulated hypothalamic-pituitary-adrenal axis activity, as measured by cortisol levels, has been identified as one potential risk factor. Evidence has indicated that childhood trauma is associated with dysregulated cortisol reactivity to stress in adulthood. The current study investigated for the first time whether childhood trauma and daily stressors and emotions were associated with diurnal cortisol levels over a 7-day study in individuals vulnerable to suicide. Methods: 142 participants were categorized according to their suicidal history into three groups: suicide attempt, suicidal ideation or control group. Participants completed questionnaires before commencing a 7-day study. Cortisol samples were provided immediately upon waking, at 15 mins, 30 mins, 45 mins, 3 hours, 6 hours, 9 hours and 12 hours on 7 consecutive days. Measures of daily stressors, mood, defeat and entrapment were completed at the end of each day. Results: Participants in the suicide attempt and ideation groups released significantly lower cortisol upon awakening (CAR) and had a tendency towards flatter wake-peak to 12 hour (WP-12) cortisol slopes compared to controls. Childhood trauma was found to be associated with significantly lower CAR and a tendency towards flatter WP-12 cortisol slope. Childhood trauma also had an indirect effect on suicide vulnerability group membership via lower daily CAR levels. Lower CAR was associated with increased suicide ideation at 1-month but not 6-months. Daily stress and emotion measures were not associated with cortisol levels. Conclusions: This is the first 7-day daily diary investigation of naturally fluctuating cortisol levels in individuals vulnerable to suicide. The results indicate that dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity is associated with suicidal ideation and behavior. Childhood trauma appears to be an important distal factor associated with HPA-axis dysregulation.

Journal Article Type Article
Publication Date Oct 28, 2019
Journal Journal of Abnormal Psychology
Print ISSN 0021-843X
Electronic ISSN 0021-843X
Publisher American Psychological Association
Peer Reviewed Peer Reviewed
Volume 129
Issue 1
Pages 92-107
APA6 Citation O'Connor, R. C., O'Carroll, R. E., O'Connor, D. B., Branley-Bell, D., Green, J. A., & Ferguson, E. (2019). Effects of childhood trauma, daily stress, and emotions on daily cortisol levels in individuals vulnerable to suicide. Journal of Abnormal Psychology, 129(1), 92-107.
Keywords Clinical Psychology
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Additional Information ©American Psychological Association, 2019. This paper is not the copy of record and may not exactly replicate the authoritative document published in the APA journal. Please do not copy or cite without author's permission. The final article is available, upon publication, at:


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