Childhood adversity and depression in Chinese populations: A multilevel meta-analysis of studies using the Childhood Trauma Questionnaire (CTQ).

To estimate the association between childhood adversity (CA) and depression in Chinese populations in studies using the Childhood Trauma Questionnaire (CTQ), a literature retrieval from established databases between 2005 and 2020 was conducted. A total 40 eligible studies with 145 effect sizes were included in subsequent analyses. Using a multi-level meta-analysis, we found a pooled effect size of r = 0.24, p < 0.001, CI = [0.20, 0.27] for the association between CA and depression. No publication bias was shown by Egger's test, t (160) = -0.27, p = 0.79. The between-study variance was moderate but significant, with 39.75% of the total variance attributable to differences between studies. Results of moderation analysis based on subtypes of CA showed that emotional abuse was associated most strongly with depression. In addition, results of moderation analysis focusing on geographic regions and CTQ subscales showed that the association between SA and depression was stronger in Southern than Central China. Our findings demonstrated clearly the advantages of using a multi-level approach to arrive at a more accurate estimate of pooled effect sizes. The differential associations between CTQ subscales and depression and the moderating effect of geographic regions on the association between sexual abuse and depression point clearly to the need of increased attention to the effects of CA subtypes and socio-cultural factors in future research on CA and mental disorders. These findings provide a preliminary empirical basis for researchers to address specific hypotheses of associations between CA subtypes and specific mental disorders in China.

Childhood Adversities and Salivary Cortisol Responses to the Trier Social Stress Test: A Systematic Review of Studies Using the Children Trauma Questionnaire (CTQ).

Alteration in cortisol response to acute social stressors has been hypothesized to mediate childhood adversities (CA) and increased morbidity in adulthood. However, the evidence supporting an association between CA and cortisol response to social stressors is inconclusive. The present review addressed this issue by reviewing the literature on CA and cortisol response to acute social stressors, with a focus on studies with adolescents or adults, using the Childhood Trauma Questionnaire (CTQ) to assess CA, and examining salivary cortisol response to the Trier Social Stress Test (TSST). Systematic searches of relevant articles in PsycINFO, PubMed, Web of Science and ScienceDirect in February and March 2020 identified 12 articles including 1196 participants with mean ages ranging from 15.3 to 52.3 yrs. across studies. CTQ scores were significantly associated with cortisol response in 2 studies. In addition, the physical abuse and emotional neglect subscales were associated with cortisol response respectively in 2 separate studies. The lack of association between CA and cortisol response calls for more longitudinal studies, and the use of formal records of maltreatment or informant reports in future research to complement information collected by retrospective measures. In addition, increased attention to biological mechanisms other than that associated with the regulation of cortisol in explaining the connection between CA and psychiatry morbidity is warranted.