Childhood maltreatment is a serious public health problem associated with both elevated and blunted cortisol measured in saliva and serum. Using a longitudinal, prospective study design, we aimed to determine whether childhood maltreatment predicts hair cortisol concentration (HCC), an index of stress physiology over extended periods. Individuals with documented histories of childhood maltreatment (ages 0–11 years) during the years 1967–1971 and a demographically matched group of children without those histories were followed up and interviewed over multiple time points from young adulthood until late midlife. Childhood maltreatment was assessed through review of official case records and retrospective self-reports in young adulthood. Stressful life events and lifetime traumas and victimization experiences were assessed at multiple interviews. Hair samples were collected at the last interview (2022–2023; Mage=59.4 years) and enzyme-linked immunosorbent assay was used to determine HCC. Inverse probability weighting was used to account for attrition bias. Results indicated that individuals with documented histories of child maltreatment differed significantly from controls in HCC levels in late midlife, with overall history of childhood maltreatment, physical abuse, and neglect associated with elevated HCC. Self-reports of childhood physical abuse predicted heightened HCC. Stressful life events and trauma/victimization across all timepoints assessed as well as cumulative life stress/trauma/victimization also predicted heightened HCC in late midlife. We observed a significant interaction between documented childhood maltreatment and cumulative stressful life events and traumas predicting HCC in midlife. Findings reveal associations between early life stressors and HCC in late midlife and illustrate the complexity of studying long-term consequences of maltreatment based on documented (objective) versus self-report measures of childhood adversities.
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