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Serravalle L, Trespalacios F, Ellenbogen MA. Hypothalamic-pituitary-adrenal axis functioning in offspring of parents with a major affective disorder: a meta-analytic review. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02553-0. [PMID: 39207496 DOI: 10.1007/s00787-024-02553-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 08/01/2024] [Indexed: 09/04/2024]
Abstract
Because the offspring of parents with an affective disorder (OAD) are at high risk for developing mental disorders, and persons with an affective disorder (AD) show dysfunctional hypothalamic-pituitary-adrenal (HPA) axis activity, changes in HPA functioning in OAD might be an etiological risk factor that precedes the development of ADs. The primary aim of the meta-analysis was to quantitatively summarize the existing data on different indices of diurnal cortisol in the OAD. The secondary aim was to explore potential moderators of this relation. Following PRISMA guidelines, we included 26 studies (3052 offspring) on diurnal cortisol in our meta-analysis after an initial screening of 3408 articles. Intercept-only and meta-regression models were computed using the robust variance estimation method. Analyses examining mean cortisol levels at discrete timepoints, total cortisol output, and the cortisol rise in response to awakening (CAR) were conducted separately. The results demonstrated that the OAD had higher mean levels of cortisol at different timepoints throughout the day compared to controls (Hedge's g = 0.21). There was evidence of publication bias in studies examining CAR, such that effect sizes were positively biased. The present findings are consistent with a meta-analysis showing elevated cortisol in youth having an AD. Notable limitations across studies include the method of cortisol measurement and assessment of ADs. Altogether, these results highlight the fact that increased cortisol levels may act as a potential neuroendocrine antecedent and/or risk factor for the development of ADs among high risk youth.
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Affiliation(s)
- Lisa Serravalle
- Department of Psychology, Centre for Research in Human Development, Concordia University, 7141 Sherbrooke W., Montréal, QC, H4B 1R6, Canada
| | - Florencia Trespalacios
- Department of Psychology, Centre for Research in Human Development, Concordia University, 7141 Sherbrooke W., Montréal, QC, H4B 1R6, Canada
| | - Mark A Ellenbogen
- Department of Psychology, Centre for Research in Human Development, Concordia University, 7141 Sherbrooke W., Montréal, QC, H4B 1R6, Canada.
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Klimes-Dougan B, Papke V, Carosella KA, Wiglesworth A, Mirza SA, Espensen-Sturges TD, Meester C. Basal and reactive cortisol: A systematic literature review of offspring of parents with depressive and bipolar disorders. Neurosci Biobehav Rev 2022; 135:104528. [PMID: 35031342 DOI: 10.1016/j.neubiorev.2022.104528] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/19/2022]
Abstract
One of the most consistent biological findings in the study of affective disorders is that those with depression commonly show abnormal cortisol response, which suggests dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Children of parents with mood disorders offer the opportunity to explore the biological pathways that may confer risk for psychopathology. This review explores basal and reactive cortisol in the offspring of parents who are currently depressed or have had a history of a depressive or bipolar disorder. Using PRISMA guidelines, search terms yielded 2002 manuscripts. After screening, 87 of these manuscripts were included. Results from the literature suggest that while the degree and direction of dysregulation varies, offspring of a parent with depression tend to show elevations in both basal (particularly morning and evening) and reactive (tentatively for social stressors) cortisol levels. There were few studies focused on offspring of parents with bipolar disorder. This review also discusses implications and recommendations for future research regarding the HPA axis in the intergenerational transmission of depressive disorders.
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Affiliation(s)
- Bonnie Klimes-Dougan
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA.
| | - Victoria Papke
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Katherine A Carosella
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Andrea Wiglesworth
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Salahudeen A Mirza
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Tori D Espensen-Sturges
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
| | - Christina Meester
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA
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Lo SL, Riley HO, Sturza J, Vazquez DM, Rosenblum K, Kaciroti N, Lumeng JC, Miller AL. Cortisol in early childhood moderates the association between family routines and observed affective balance in children from low-income backgrounds. Dev Psychobiol 2021; 63:e22204. [PMID: 34813102 DOI: 10.1002/dev.22204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 11/10/2022]
Abstract
The study of emotion regulation often addresses control of negative emotion. Researchers have proposed that affective balance is an indicator of emotion regulation that incorporates the role of positive emotion in the context of negative emotional experiences. Environmental and individual factors, such as family processes and biological stress regulation, are known to shape emotion regulation. The present study investigated whether child diurnal cortisol, an indicator of biological stress regulation, moderated the association between family routines and observed affective balance. Children (N = 222; M age = 4.70 years, SD = 0.60) from low-income households provided saliva samples to measure diurnal cortisol and completed a behavioral task designed to elicit negative emotions. Affective balance was defined as the difference score between the proportion of positive and negative emotional expressions displayed during the task. A higher affective balance score indicated greater positive compared with negative emotional displays. Simple slope analyses indicated that for children with a low morning cortisol intercept, more frequent family routines were associated with more affective balance. This pattern was not observed in children with average or high morning cortisol. Positive family routines may play an important role in shaping affective balance among children with disrupted cortisol levels from low-income backgrounds.
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Affiliation(s)
- Sharon L Lo
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Hurley O Riley
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Julie Sturza
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Delia M Vazquez
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Katherine Rosenblum
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Niko Kaciroti
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Julie C Lumeng
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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