BACKGROUND: Early trauma can lead to long-term downregulation of the HPA axis. However, Dehydroepiandrosterone (DHEA) has neuroprotective effects that may reduce the need for downregulation of the axis in response to stress. Furthermore, high DHEA/cortisol ratios are often conceptualized as reflecting a protective profile due to high availability of DHEA. In this study we explored if DHEA and DHEA/cortisol ratios moderated the association between early trauma and the cortisol response.

METHODS: The sample consisted of 80 adolescents (aged 12-16) who completed the Child Trauma Questionnaire (CTQ) and the Trier Social Stress Test. Cortisol was modeled using saliva samples at seven timepoints after the start of the TSST. Cortisol and DHEA ratios were examined at baseline and 35 minutes post-stress initiation.

RESULTS: Early trauma was associated with lower activation slope and peak levels but DHEA moderated this effect. Specifically, at high levels of DHEA, the impact of CTQ on cortisol peak levels was no longer significant. High DHEA/cortisol ratios were associated with an intensification of the impact of CTQ on peak levels.

CONCLUSIONS: Results suggest that DHEA can limit blunting of the HPA axis in response to early trauma. However, this protective effect was not reflected in high DHEA/cortisol ratios. Instead, high ratios were associated with a greater effect of early trauma. Therefore, high DHEA and high DHEA/cortisol ratios may reflect
different, and often opposite, processes. Our findings indicate that DHEA/cortisol ratios do not necessarily reflect a protective neuroendocrine profile.