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Non-linear associations between HPA axis activity during infancy and mental health difficulties during early childhood among children in rural Pakistan

Published online by Cambridge University Press:  12 August 2022

Allison Frost Open the ORCID record for Allison Frost [Opens in a new window] ,
Ashley Hagaman ,
Victoria Baranov ,
Esther O. Chung ,
Sonia Bhalotra ,
Siham Sikander  and
Joanna Maselko
Allison Frost*
Affiliation:
Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
Ashley Hagaman
Affiliation:
Social Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA
Victoria Baranov
Affiliation:
Department of Economics, Faculty of Business and Economics, University of Melbourne, Australia
Esther O. Chung
Affiliation:
Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA
Sonia Bhalotra
Affiliation:
Department of Economics, University of Warwick, UK
Siham Sikander
Affiliation:
Human Development Research Foundation, Islamabad, Pakistan Health Services Academy, Islamabad, Pakistan
Joanna Maselko
Affiliation:
Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA
*
Corresponding author: Allison Frost, email: allisonfrost@unc.edu
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Abstract

Hypothalamic pituitary adrenal (HPA) axis activity may be a mechanism linking early adversity to child mental health difficulties. However, there is a dearth of longitudinal evidence for the association between HPA axis activity and mental health among children in low-resource contexts. The goal of this study is to examine linear and curvilinear associations between HPA axis activity during infancy and mental health difficulties in early childhood among children in rural Pakistan. Participants included 104 children (46% male) from the Bachpan study, a longitudinal cohort embedded within a maternal depression trial in Pakistan. We examined the associations between hair-derived cortisol and dehydroepiandosterone (DHEA) at 12 months old and mental health difficulties, measured with the Strengths and Difficulties Questionnaire (SDQ), at 36 months old. There was a significant quadratic association between hair cortisol and SDQ scores, with results showing a U-shaped relationship (i.e., having relatively high or low cortisol predicted increased mental health difficulties). DHEA showed a quadratic association with SDQ scores with an inverted U-shaped relationship (i.e., high and low DHEA was associated with decreased mental health difficulties). Results provide evidence of longitudinal and curvilinear effects of cortisol and DHEA during infancy on mental health difficulties in early childhood.

Keywords

cortisolDHEAearly childhoodHPA axismental health difficulties
Type
Regular Article
Information
Development and Psychopathology , Volume 35 , Issue 4 , October 2023 , pp. 2086 - 2095
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© The Author(s), 2022. Published by Cambridge University Press

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