Childhood adversity and the cortisol awakening response in depression: A meta-analysis
Bibliographic record
Abstract
Although cortisol awakening response (CAR) dysregulation is frequently documented among individuals with depression, there is conflicting evidence regarding the direction and degree of dysregulation, which impedes our ability to provide personalized and efficacious treatment. Childhood adversity is posited to explain variability within the CAR-depression literature, but the effect of childhood adversity on the CAR in depression has not yet been quantified. We meta-analyzed 19 studies (n = 2,053) examining the association between childhood adversity and the CAR among individuals with depression. Data were pooled using random-effects models for childhood adversity overall, childhood adversity characterized by threat, and childhood adversity characterized by deprivation. Among individuals with depression, greater exposure to childhood adversity was associated with a steeper CAR. Further, in line with hypotheses, among individuals with depression, greater exposure to childhood adversity characterized by threat was associated with a steeper CAR, whereas greater exposure to adversity characterized by deprivation was not. These results support the proposition that greater childhood adversity, and in particular adversity characterized by threat, could lead to a distinct presentation of depression characterized by dysregulated diurnal HPA axis activity, as evidenced by a steeper CAR. These findings suggest specificity in the associations between types of childhood adversity and the CAR and could inform growing efforts towards personalized medicine in the treatment of depression.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".