Despite evidence that early life stress (ELS) can influence the functioning of the hypothalamic-pituitary-adrenal (HPA) axis and increase maladaptive behaviors in adolescence, less attention has been paid to the role of the coordinated effects of the two primary adrenal hormones, cortisol and dehydroepiandrosterone (DHEA), in these associations. 138 typically developing adolescents (76 females) reported the stressful events experienced during childhood and early adolescence across 30 domains. Two years later we assessed levels of externalizing problems and obtained salivary levels of cortisol and DHEA. Using causal moderated mediation analyses, we examined whether the ratio of cortisol to DHEA (CD ratio) mediates the association between ELS and subsequent externalizing problems. We found that ELS is associated with both a lower CD ratio and more externalizing problems. Importantly, a lower CD ratio mediated the association between ELS and externalizing problems in boys. An imbalance in adrenal hormones may be a mechanism through which ELS leads to an increase in externalizing problems in adolescent boys. These findings underscore the utility of using the CD ratio to index HPA-axis functioning.

中文翻译：

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皮质醇/DHEA 比率介导青春期男孩早期生活压力与外化问题之间的关联

尽管有证据表明早期生活压力（ELS）可以影响下丘脑-垂体-肾上腺（HPA）轴的功能并增加青春期的适应不良行为，但人们对两种主要肾上腺激素协调作用的作用的关注较少。皮质醇和脱氢表雄酮 (DHEA) 在这些关联中。 138 名正常发育的青少年（76 名女性）报告了在 30 个领域的童年和青春期早期经历的压力事件。两年后，我们评估了外化问题的水平，并获得了唾液中皮质醇和 DHEA 的水平。通过因果调节中介分析，我们检查了皮质醇与 DHEA 的比率（CD 比率）是否介导 ELS 与随后的外化问题之间的关联。我们发现 ELS 与较低的 CD 比率和更多的外部问题相关。重要的是，较低的 CD 比率介导了 ELS 与男孩外化问题之间的关联。肾上腺激素失衡可能是 ELS 导致青春期男孩外化问题增加的一种机制。这些发现强调了使用 CD 比率来衡量 HPA 轴功能的实用性。