Early life stress and HPA axis function independently predict adult depressive symptoms in metropolitan Cebu, Philippines

Andrew Wooyoung Kim*, Emma K. Adam, Sonny A. Bechayda, Christopher W. Kuzawa

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Objectives: Alterations in adult hypothalamic–pituitary–adrenal (HPA) axis activity have increasingly been linked with early life stress and adult depression, but a limited number of studies have used longitudinal data to explore HPA axis dysregulation as an underlying mechanism driving the long-term depressive impacts of early stressors. Here we address potential long-term impacts of early life, family-based stress on depressive symptoms among young adults in a longitudinal birth cohort study begun in 1983 in the Philippines. Materials and methods: We relate a composite measure of family-based stressors experienced between birth and adolescence to circadian dynamics in adult salivary cortisol and depressive risk measured at 21–22 years of age. Multiple regression analyses were conducted to examine the relationship between early life stress levels and risk of adult depressive symptoms, as well as the role of adult diurnal cortisol activity in this relationship. Results: Greater levels of early life familial stress predicted more severe depressive symptomatology at age 21–22 in a dose–response fashion (p '.0001) independent of adult diurnal cortisol patterns. Flatter diurnal cortisol slopes are directly associated with higher adult depressive symptoms, an effect mostly driven by evening cortisol levels (p =.004). When considering the cumulative effects of early life stress measures, however, exposure to more of these stressors during development is associated with even higher depressive symptoms. Discussion: The long-term depressive effects of early life familial stress extend to this large sample of Cebuano young adults, and early life stress and HPA axis function may shape adult depressive symptoms through independent pathways in this sample. Our findings provide further evidence that HPA axis activity is shaped by early life conditions and is associated with depressive symptoms.

Original languageEnglish (US)
Pages (from-to)448-462
Number of pages15
JournalAmerican Journal of Physical Anthropology
Volume173
Issue number3
DOIs
StatePublished - Nov 1 2020

Funding

National Institutes of Health ‐ R01‐ HD19983A, R01‐HD18880, P01‐HD28076, R01‐HD23182, R01‐TW05596, R01‐HL085144, R01‐DK078150, R01‐HD054501, and R03TW008133; Nestle Coordinating Center for Nutrition Research, Wyeth International, The Ford Foundation, The US National Academy of Science, The World Health Organization, The US Agency for International Development (via grants from Wellstart Interna‐ tional, the International Center for Research on Women, Family Health International, MEASURE), The Asian Development Bank, The World Bank, The Thrasher Research Fund, The Mellon Foundation, Nestle Research Foundation, and The Carolina Population Center Funding information We thank the many scholars and researchers at the Office of Population Studies, University of San Carlos, Cebu, Philippines, for their role in study design and data collection, and the Filipino participants who generously provided their time for this study.

Keywords

  • HPA axis
  • Philippines
  • depression
  • developmental origins of health and disease
  • early life stress
  • family stress
  • global mental health
  • low- and middle-income countries

ASJC Scopus subject areas

  • Anatomy
  • Anthropology

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