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Shen X, Helion C, Smith DV, Murty VP. Motivation as a Lens for Understanding Information-seeking Behaviors. J Cogn Neurosci 2024; 36:362-376. [PMID: 37944120 DOI: 10.1162/jocn_a_02083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Most prior research characterizes information-seeking behaviors as serving utilitarian purposes, such as whether the obtained information can help solve practical problems. However, information-seeking behaviors are sensitive to different contexts (i.e., threat vs. curiosity), despite having equivalent utility. Furthermore, these search behaviors can be modulated by individuals' life history and personality traits. Yet the emphasis on utilitarian utility has precluded the development of a unified model, which explains when and how individuals actively seek information. To account for this variability and flexibility, we propose a unified information-seeking framework that examines information-seeking through the lens of motivation. This unified model accounts for integration across individuals' internal goal states and the salient features of the environment to influence information-seeking behavior. We propose that information-seeking is determined by motivation for information, invigorated either by instrumental utility or hedonic utility, wherein one's personal or environmental context moderates this relationship. Furthermore, we speculate that the final common denominator in guiding information-seeking is the engagement of different neuromodulatory circuits centered on dopaminergic and noradrenergic tone. Our framework provides a unified framework for information-seeking behaviors and generates several testable predictions for future studies.
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2
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Rudland JR, Jaye C, Tweed M, Wilkinson TJ. Identifying stressor criteria that hinder or challenge junior clinical medical student learning. MEDICAL TEACHER 2022; 44:1051-1059. [PMID: 35430927 DOI: 10.1080/0142159x.2022.2058382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION What makes something a stressor within clinical students' education is unclear. Medical students moving from a predominantly protected classroom environment to a situated-work environment provided an ideal transition point to explore the criteria that might make a learning experience a stressor and whether these stressors hinder or challenge learning. METHOD Data on the stressors associated with learning experiences in clinical education were collected from New Zealand undergraduate medical students. Free text comments, in a survey-based questionnaire were supplemented by focus group data. Using inductive thematic analysis with grounded theory, themes were generated about the characteristics of stressors; referred to here as stressor criteria. These stressor criteria were then classified according to their impact on perceived learning. RESULTS Under the broad headings of the nature of the learning task, external factors, internal factors, and social interaction; 12 stressor criteria groupings were defined. Some of these criteria were a positive challenge to learning (e.g. legitimacy of the task, novelty of the learning, social interactions) and others a hindrance. DISCUSSION Not all stressors hinder learning. Instead, and depending on their nature, many result in perceived assistance to learning. Stressors hindering learning need to be recognised by the teacher, especially those that can be converted from a hindrance to an assistance.
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Affiliation(s)
- J R Rudland
- Education Unit, Wellington Hospital, Newtown, New Zealand
| | - C Jaye
- Department General Practice and Rural Health, Dunedin Hospital, Dunedin, New Zealand
| | - M Tweed
- Department of Medicine, Wellington Hospital, Newtown, New Zealand
| | - T J Wilkinson
- Christchurch School of Medicine & Health Sciences, Christchurch Hospital, Christchurch, New Zealand
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Wen JH, Sin NL. Perceived control and reactivity to acute stressors: Variations by age, race and facets of control. Stress Health 2022; 38:419-434. [PMID: 34626157 DOI: 10.1002/smi.3103] [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: 02/11/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 11/12/2022]
Abstract
Greater perceived control is associated with better health and well-being outcomes, possibly through more adaptive stress processes. Yet little research has examined whether facets of perceived control (personal mastery and perceived constraints) predict psychological and physiological stress reactivity. The present study evaluated the associations of personal mastery and perceived constraints with changes in subjective stress and cortisol in response to acute laboratory stressors, with age and race as potential moderators. In the Midlife in the United States Refresher Study (N = 633 adults aged 25-75), participants completed a baseline perceived control measure and were subsequently recruited to participate in the laboratory stress protocol. The protocol consisted of completing two mental stress tasks (mental arithmetic and Stroop) as well as providing saliva samples and subjective stress ratings. Race moderated the association between perceived constraints and subjective stress reactivity, such that higher constraints predicted greater subjective stress responses in White participants, but no association was observed in Black participants. Higher personal mastery and perceived constraints each predicted greater increases in cortisol in response to the stress tasks (AUCi ) among younger but not older adults. These findings suggest that older adults were buffered against the association between facets of control and cortisol stress reactivity. Discussion on potential racial differences in the link between constraints and stress reactivity are elaborated further, as well as considerations for future work to distinguish between facets of control and examine age and racial differences.
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Affiliation(s)
- Jin H Wen
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Nancy L Sin
- University of British Columbia, Vancouver, British Columbia, Canada
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Meyer HC, Sangha S, Radley JJ, LaLumiere RT, Baratta MV. Environmental certainty influences the neural systems regulating responses to threat and stress. Neurosci Biobehav Rev 2021; 131:1037-1055. [PMID: 34673111 PMCID: PMC8642312 DOI: 10.1016/j.neubiorev.2021.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 10/20/2022]
Abstract
Flexible calibration of threat responding in accordance with the environment is an adaptive process that allows an animal to avoid harm while also maintaining engagement of other goal-directed actions. This calibration process, referred to as threat response regulation, requires an animal to calculate the probability that a given encounter will result in a threat so they can respond accordingly. Here we review the neural correlates of two highly studied forms of threat response suppression: extinction and safety conditioning. We focus on how relative levels of certainty or uncertainty in the surrounding environment alter the acquisition and application of these processes. We also discuss evidence indicating altered threat response regulation following stress exposure, including enhanced fear conditioning, and disrupted extinction and safety conditioning. To conclude, we discuss research using an animal model of coping that examines the impact of stressor controllability on threat responding, highlighting the potential for previous experiences with control, or other forms of coping, to protect against the effects of future adversity.
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Affiliation(s)
- Heidi C Meyer
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, 02215, USA.
| | - Susan Sangha
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, 47907, USA.
| | - Jason J Radley
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242, USA.
| | - Ryan T LaLumiere
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242, USA.
| | - Michael V Baratta
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, 80301, USA.
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Kaiser J, Buciuman M, Gigl S, Gentsch A, Schütz-Bosbach S. The Interplay Between Affective Processing and Sense of Agency During Action Regulation: A Review. Front Psychol 2021; 12:716220. [PMID: 34603140 PMCID: PMC8481378 DOI: 10.3389/fpsyg.2021.716220] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/20/2021] [Indexed: 01/10/2023] Open
Abstract
Sense of agency is the feeling of being in control of one's actions and their perceivable effects. Most previous research identified cognitive or sensory determinants of agency experience. However, it has been proposed that sense of agency is also bound to the processing of affective information. For example, during goal-directed actions or instrumental learning we often rely on positive feedback (e.g., rewards) or negative feedback (e.g., error messages) to determine our level of control over the current task. Nevertheless, we still lack a scientific model which adequately explains the relation between affective processing and sense of agency. In this article, we review current empirical findings on how affective information modulates agency experience, and, conversely, how sense of agency changes the processing of affective action outcomes. Furthermore, we discuss in how far agency-related changes in affective processing might influence the ability to enact cognitive control and action regulation during goal-directed behavior. A preliminary model is presented for describing the interplay between sense of agency, affective processing, and action regulation. We propose that affective processing could play a role in mediating the influence between subjective sense of agency and the objective ability to regulate one's behavior. Thus, determining the interrelation between affective processing and sense of agency will help us to understand the potential mechanistic basis of agency experience, as well as its functional significance for goal-directed behavior.
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Affiliation(s)
- Jakob Kaiser
- LMU Munich, Department of Psychology, General and Experimental Psychology, Munich, Germany
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Yang Y, Li Y, Zhang H, Xu Y, Wang B. The efficacy of computer-assisted cognitive behavioral therapy (cCBT) on psychobiological responses and perioperative outcomes in patients undergoing functional endoscopic sinus surgery: a randomized controlled trial. Perioper Med (Lond) 2021; 10:28. [PMID: 34407884 PMCID: PMC8375045 DOI: 10.1186/s13741-021-00195-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 05/31/2021] [Indexed: 01/06/2023] Open
Abstract
Background Functional endoscopic sinus surgery (FESS) is required to minimize bleeding to maintain a clear operative field during surgery, so it is important to preoperative anti-anxiety and stable hemodynamics. Initial evidence suggests cognitive behavioral therapy (CBT) is effective to minimize surgery-related stress and to speed up recovery. The study aimed to evaluate the efficacy of a newly developed computer-assisted CBT (cCBT) program on surgery-related psychobiological responses in patients undergoing FESS. Methods Participants were allocated to a CCBT group (cCBT; n = 50) or a UC group (usual care; n = 50) by random number table. The State Anxiety Inventory (SAI), Patients Health Questionnaire-9 (PHQ-9), Athens Insomnia Scale (AIS), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were assessed before intervention (T1), at 1 h before operation (T2), at postoperative 48 h (T3), and 96 h (T4: after intervention completed) respectively. The stress hormone was assayed at T1 and T2. The duration of surgery, anesthesia, and post-anesthesia care unit (PACU) were recorded. A satisfaction survey about nursing services was completed by participants before discharge. Results Compared to the UC group, the SAI scores at T2 and the AIS scores at T3 were lower in the CCBT group (p < 0.01 and p = 0.002). The positive rate of participants who were moderate and severe anxiety (SAI score > 37) at T2 were lower (72% vs. 88%, p = 0.04); the cortisol levels, SBP, DBP, and HR at T2 in the CCBT group were lower (p = 0.019 and all p < 0.01); the duration of anesthesia and PACU was shorter (p = 0.001 and p < 0.01); the CCBT group showed higher satisfaction scores. Conclusion The newly developed cCBT program was an effective non-pharmacological adjunctive treatment for improving the surgery-related psychosomatic responses and perioperative outcomes. Trial registration The study was registered with the Chinese Clinical Trial Registry (ChiCTR1900025994) on 17 September 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13741-021-00195-3.
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Affiliation(s)
- Yang Yang
- Nursing College, Shanxi Medical University, Taiyuan, People's Republic of China.,Nursing Department, The First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China
| | - Yuling Li
- Nursing Department, The First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China
| | - Haibin Zhang
- Department of Anesthesia, The First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China
| | - Yong Xu
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China. .,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, The First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China.
| | - Binquan Wang
- Department of Otorhinolaryngology Head and Neck Surgery, The First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China. .,Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China.
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Negative Cognitive Style and Cortisol Reactivity to a Laboratory Stressor: a Preliminary Study. Int J Cogn Ther 2019. [DOI: 10.1007/s41811-019-00052-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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8
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Cortisol levels before and after cognitive behavioural therapy in patients with eating disorders reporting childhood abuse: A follow-up study. Psychiatry Res 2019; 275:269-275. [PMID: 30952070 DOI: 10.1016/j.psychres.2019.03.046] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 01/28/2023]
Abstract
The etiopathogenesis of eating disorders (EDs) is complex and still not well understood. Biological, psychological and environmental factors (e.g. childhood abuse) have all been considered to be involved in the onset and the persistence of EDs. The hypothalamic-pituitary-adrenal (HPA) axis is a relevant biological factor capable of influencing the onset and the course of EDs and not many information are available about the impact of a Cognitive Behavioral Therapy (CBT) on cortisol changes in EDs. The HPA-axis functioning has been evaluated before and after CBT in a group of patients with Anorexia Nervosa (n = 34) and Bulimia Nervosa (n = 35) according to the presence/absence of a history of sexual/physical abuse. At baseline, only patients reporting childhood abuse showed lower morning cortisol levels as compared with other patients of the same diagnostic group and Healthy Controls. After CBT, a variation of cortisol levels has been found only in patients without abuse, suggesting a role of childhood adversities in the persistence of HPA-axis alterations in Eating Disorders.
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9
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Campagne DM. Stress and perceived social isolation (loneliness). Arch Gerontol Geriatr 2019; 82:192-199. [DOI: 10.1016/j.archger.2019.02.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 01/29/2019] [Accepted: 02/16/2019] [Indexed: 12/25/2022]
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Khalsa SS, Adolphs R, Cameron OG, Critchley HD, Davenport PW, Feinstein JS, Feusner JD, Garfinkel SN, Lane RD, Mehling WE, Meuret AE, Nemeroff CB, Oppenheimer S, Petzschner FH, Pollatos O, Rhudy JL, Schramm LP, Simmons WK, Stein MB, Stephan KE, Van den Bergh O, Van Diest I, von Leupoldt A, Paulus MP. Interoception and Mental Health: A Roadmap. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:501-513. [PMID: 29884281 PMCID: PMC6054486 DOI: 10.1016/j.bpsc.2017.12.004] [Citation(s) in RCA: 391] [Impact Index Per Article: 65.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 11/20/2017] [Accepted: 12/10/2017] [Indexed: 12/29/2022]
Abstract
Interoception refers to the process by which the nervous system senses, interprets, and integrates signals originating from within the body, providing a moment-by-moment mapping of the body's internal landscape across conscious and unconscious levels. Interoceptive signaling has been considered a component process of reflexes, urges, feelings, drives, adaptive responses, and cognitive and emotional experiences, highlighting its contributions to the maintenance of homeostatic functioning, body regulation, and survival. Dysfunction of interoception is increasingly recognized as an important component of different mental health conditions, including anxiety disorders, mood disorders, eating disorders, addictive disorders, and somatic symptom disorders. However, a number of conceptual and methodological challenges have made it difficult for interoceptive constructs to be broadly applied in mental health research and treatment settings. In November 2016, the Laureate Institute for Brain Research organized the first Interoception Summit, a gathering of interoception experts from around the world, with the goal of accelerating progress in understanding the role of interoception in mental health. The discussions at the meeting were organized around four themes: interoceptive assessment, interoceptive integration, interoceptive psychopathology, and the generation of a roadmap that could serve as a guide for future endeavors. This review article presents an overview of the emerging consensus generated by the meeting.
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Affiliation(s)
- Sahib S Khalsa
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma.
| | - Ralph Adolphs
- California Institute of Technology, Pasadena, California
| | - Oliver G Cameron
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Hugo D Critchley
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
| | - Paul W Davenport
- Department of Physiology, University of Florida, Gainesville, Florida
| | - Justin S Feinstein
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma
| | - Jamie D Feusner
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Sarah N Garfinkel
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
| | - Richard D Lane
- Department of Psychiatry, University of Arizona, Tucson, Arizona
| | - Wolf E Mehling
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California
| | - Alicia E Meuret
- Department of Psychology, Southern Methodist University, Dallas, Texas
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, Florida
| | | | - Frederike H Petzschner
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland
| | - Olga Pollatos
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Jamie L Rhudy
- Department of Psychology, University of Tulsa, Tulsa, Oklahoma
| | - Lawrence P Schramm
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland; Department of Neuroscience, Johns Hopkins University, Baltimore, Maryland
| | - W Kyle Simmons
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma
| | - Murray B Stein
- Department of Psychiatry, University of California, San Diego, San Diego, California
| | - Klaas E Stephan
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland
| | | | - Ilse Van Diest
- Department of Health Psychology, University of Leuven, Leuven, Belgium
| | | | - Martin P Paulus
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma
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Petrakova L, Boy K, Kügler M, Benson S, Engler H, Möller L, Schedlowski M. Plasma cortisol response cannot be classically conditioned in a taste-endocrine paradigm in humans. Psychopharmacology (Berl) 2017; 234:3249-3257. [PMID: 28804807 DOI: 10.1007/s00213-017-4718-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 08/02/2017] [Indexed: 11/25/2022]
Abstract
RATIONALE Peripheral immune responses can be modified by associative learning procedures. Less is known, however, whether and to what extent neuroendocrine parameters can be classically conditioned. OBJECTIVES In this randomized double-blind study, we modified an established paradigm to behaviorally condition endocrine responses in humans. METHODS Thirty-one healthy male participants received a distinctively flavored green drink as the conditioned stimulus (CS) and intravenous injections of corticotropin-releasing hormone (CRH) (CRH group, N = 17) or NaCl (placebo group, N = 14) as the unconditioned stimulus (US) during two subsequent acquisition trials. Plasma levels of cortisol and noradrenaline, heart rate, and psychological parameters were analyzed before and 15, 30, 60, 120, and 180 min after injection. The two acquisition trials were followed by two evocation trials, during which participants underwent the same procedure but now receiving NaCl injections. RESULTS CRH administration induced pronounced increases in cortisol and noradrenaline plasma concentrations, heart rate, and anxiety levels. However, re-exposure to the CS during evocations trials did not provoke conditioned increases in neuroendocrine parameters. Median split of the CRH group based on the cortisol baseline level into "cort-high" and "cort-low" subgroups showed that the "cort-high" subgroup displayed a significantly increased cortisol production on evocation days compared to the "cort-low" subgroup and the placebo group. CONCLUSION This taste-endocrine paradigm employing CRH injection as the US in healthy male volunteers failed to induce a behaviorally conditioned cortisol release as a learned endocrine response. Future studies should clarify a possible role of higher baseline cortisol levels in perhaps facilitating a conditioned cortisol response.
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Affiliation(s)
- Liubov Petrakova
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Karoline Boy
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Marisa Kügler
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Sven Benson
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Harald Engler
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - Lars Möller
- Clinic for Endocrinology, University Hospital Essen, Essen, Germany
| | - Manfred Schedlowski
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany.
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Erickson TM, Mayer SE, Lopez-Duran NL, Scarsella GM, McGuire AP, Crocker J, Abelson JL. Mediators of compassionate goal intervention effects on human neuroendocrine responses to the Trier Social Stress Test. Stress 2017; 20:533-540. [PMID: 28845716 PMCID: PMC7010267 DOI: 10.1080/10253890.2017.1368489] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES The hypothalamic-pituitary-adrenal (HPA) axis is thought to mediate the effects of stress on illness. Research has identified a limited number of psychological variables that modulate human HPA responses to stressors (e.g. perceived control and social support). Prosocial goals can reduce subjective stress, but have not been carefully examined in experimental settings where pathways of impact on biological stress markers may be traced. Recent work demonstrated that coaching individuals to strive to help others reduced HPA responses to the Trier Social Stress Test (TSST) relative to other cognitive interventions. However, identification of mediational pathways, which were not examined in the original study, is necessary to determine whether the HPA buffering effects were due to helping motivations (compassionate goals; CGs) rather than via previously identified variables such as control or support. METHODS In this new analysis, we combined the original cortisol data with novel observer ratings of interpersonal behavior and psychological variables during the stress task, and conducted new, theory-driven analyses to determine psychological mediators for the intervention's effect on cortisol responses (N = 54; 21 females, 33 males; 486 cortisol samples). RESULTS Control, support, and task ego-threat failed to account for the effects of the intervention. As hypothesized, self and observer-rated CGs, as well as observer-rated perceptions of participants' interpersonal behavior as morally desirable (but not as dominant or affiliative) were significant mediators of neuroendocrine responses. CONCLUSIONS The findings suggest that stress-reduction interventions based on prosocial behavior should target particular motivational and interpersonal features.
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Affiliation(s)
- Thane M Erickson
- a Department of Clinical Psychology , Seattle Pacific University , Seattle , WA , USA
| | - Stefanie E Mayer
- b Department of Psychiatry , University of California , San Francisco , CA , USA
| | | | - Gina M Scarsella
- a Department of Clinical Psychology , Seattle Pacific University , Seattle , WA , USA
| | - Adam P McGuire
- a Department of Clinical Psychology , Seattle Pacific University , Seattle , WA , USA
| | - Jennifer Crocker
- d Department of Psychology , Ohio State University , Columbus , OH , USA
| | - James L Abelson
- e Department of Psychiatry , University of Michigan , Ann Arbor , MI , USA
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Mayer SE, Snodgrass M, Liberzon I, Briggs H, Curtis GC, Abelson JL. The psychology of HPA axis activation: Examining subjective emotional distress and control in a phobic fear exposure model. Psychoneuroendocrinology 2017; 82:189-198. [PMID: 28233588 PMCID: PMC5478447 DOI: 10.1016/j.psyneuen.2017.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 02/03/2017] [Accepted: 02/05/2017] [Indexed: 12/11/2022]
Abstract
The HPA axis plays a key role in mediating the effects of "stress" on health, but clarifying mechanisms requires an understanding of psycho-biological linkages. There has long been an implicit assumption that subjective emotional distress (e.g., fear) should activate the HPA axis. Although this assumption was challenged 25 years ago (Curtis, 1976), laboratory studies in humans are limited. In this study we sought to replicate Curtis' findings and extend it by investigating if presence or absence of stressor control shapes HPA axis reactivity in a phobic fear exposure model. We recruited 19-45-year-old specific phobia participants (n=32 spider/snake phobia; n=14 claustrophobia) and gradually exposed them to their feared object or situation while measuring hormonal (ACTH and cortisol) and subjective (emotional distress, perceived control) responses. Utilizing a dyadic yoked design, we compared HPA reactivity when the pace of exposure was controlled by participants to identical exposure given to matched participants in the absence of control. Results showed that phobic fear exposure generated intense emotional distress without a corresponding increase in HPA axis activity. Although our actual manipulation of control failed to impact HPA responses, perceived control during exposure was associated with lower cortisol, an effect that was moderated by actual availability of stressor control. Our findings replicate Curtis' findings and challenge the still common but unsupported assumption that HPA axis activity reflects subjective distress. These results also highlight the importance of both perceived and actual aspects of stressor control in understanding what is truly "stressful" to the HPA axis system.
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Affiliation(s)
- Stefanie E. Mayer
- Department of Psychology, University of Michigan, 530 Church Street, Arbor, MI 48109, USA
| | - Michael Snodgrass
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Arbor, MI 48109, USA
| | - Israel Liberzon
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Arbor, MI 48109, USA
| | - Hedieh Briggs
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Arbor, MI 48109, USA
| | - George C. Curtis
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Arbor, MI 48109, USA
| | - James L. Abelson
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Arbor, MI 48109, USA,Corresponding author: James L. Abelson, M.D., Ph.D., 4250 Plymouth Rd (Box 5765, Rm. 2733) Ann Arbor, MI 48109-2700, Phone: 734-764-5348; fax: 734-936-7868,
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Hilliard ME, Yi-Frazier JP, Hessler D, Butler AM, Anderson BJ, Jaser S. Stress and A1c Among People with Diabetes Across the Lifespan. Curr Diab Rep 2016; 16:67. [PMID: 27287017 PMCID: PMC4936828 DOI: 10.1007/s11892-016-0761-3] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Stress is known to negatively affect health and is a potentially serious barrier to diabetes-related health outcomes. This paper synthesizes what is known about stress and glycemic control among people with type 1 and type 2 diabetes across the lifespan. Chronic stress-especially in relation to living with diabetes-was most strongly associated with A1c, particularly among subgroups that face disproportionate stress, such as minority groups or adolescents/young adults. Mechanisms of the stress-A1c association include physiological, psychological, behavioral, and environmental links. Understanding the dimensions of stress as they relate to health in diabetes can be of significant clinical importance, and interventions targeting mechanisms that either exacerbate or buffer stress have reported modest improvements in A1c.
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Affiliation(s)
- Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, 1102 Bates Ave, Suite 940, Houston, TX, 77004, USA.
| | | | - Danielle Hessler
- Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Ashley M Butler
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, 1102 Bates Ave, Suite 940, Houston, TX, 77004, USA
| | - Barbara J Anderson
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, 1102 Bates Ave, Suite 940, Houston, TX, 77004, USA
| | - Sarah Jaser
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
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15
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Rosnick CB, Wetherell JL, White KS, Andreescu C, Dixon D, Lenze EJ. Cognitive-behavioral therapy augmentation of SSRI reduces cortisol levels in older adults with generalized anxiety disorder: A randomized clinical trial. J Consult Clin Psychol 2016; 84:345-52. [PMID: 26881447 DOI: 10.1037/a0040113] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Elevated cortisol in stress and aging, such as has been seen in late-life anxiety disorders, is postulated to accelerate cognitive and physiological decline in this large and increasing population. Selective serotonin-reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) are both effective treatments for generalized anxiety disorder (GAD) in older adults. On the other hand, there is very little research examining the effect of combining these therapies on peak cortisol levels. For the current analyses, we examined the effectiveness of CBT augmentation on peak cortisol levels in older adults diagnosed with GAD. METHODS The sample consisted of 42 individuals with late-life GAD who received an acute course of the SSRI escitalopram and then entered a 16-week randomized phase. Twenty-one participants were randomized to receive 16 sessions of CBT in addition to continuing escitalopram and the remaining 21 participants continued on escitalopram without CBT. Generalized estimating equations were performed to assess the effectiveness of CBT augmentation on peak cortisol levels (30 min after waking). RESULTS Older adults with GAD who received both escitalopram and CBT demonstrated a significant reduction in peak cortisol levels at posttreatment compared to the group who received escitalopram without CBT augmentation. CONCLUSIONS CBT augmentation of SSRI treatment reduced peak cortisol levels for older adults with GAD. Since persistently high cortisol levels in aging are thought to increase age-related cognitive and medical problems, our findings suggest that there may be a benefit to health and cognition of CBT augmentation for late-life anxiety disorders.
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Affiliation(s)
| | | | - Kamila S White
- Department of Psychology, University of Missouri-St. Louis
| | - Carmen Andreescu
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - David Dixon
- Department of Psychiatry, Washington University School of Medicine
| | - Eric J Lenze
- Department of Psychiatry, Washington University School of Medicine
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16
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Sladek MR, Doane LD, Luecken LJ, Eisenberg N. Perceived stress, coping, and cortisol reactivity in daily life: A study of adolescents during the first year of college. Biol Psychol 2016; 117:8-15. [PMID: 26876116 DOI: 10.1016/j.biopsycho.2016.02.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 12/22/2015] [Accepted: 02/05/2016] [Indexed: 12/29/2022]
Abstract
Adolescents change how they cope with stress across different situations, but also differ from one another in their general capacity to cope. The current study examined whether cortisol reactivity to perceived daily stress varies with both situational (within-person) and individual (between-person) differences in coping. First-year college students (N=63; Mage=18.85) provided 15 stress-coping diaries and 15 corresponding saliva samples across 3 weekdays. Results from hierarchical linear growth models revealed that perceiving greater stress than usual in the last hour was significantly associated with elevations in cortisol (relative to diurnal patterning) only during situations characterized by greater than usual diary-reported engagement coping. Regarding individual differences, perceiving greater stress than usual was significantly associated with elevations in cortisol only for adolescents below average on trait measures of engagement coping or belief in their ability to handle stress. Findings indicate that cortisol reactivity to daily stress varies with both situational variation and individual differences in coping.
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Affiliation(s)
| | - Leah D Doane
- Department of Psychology, Arizona State University, USA
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17
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Khalsa SS, Lapidus RC. Can Interoception Improve the Pragmatic Search for Biomarkers in Psychiatry? Front Psychiatry 2016; 7:121. [PMID: 27504098 PMCID: PMC4958623 DOI: 10.3389/fpsyt.2016.00121] [Citation(s) in RCA: 178] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 06/21/2016] [Indexed: 01/04/2023] Open
Abstract
Disrupted interoception is a prominent feature of the diagnostic classification of several psychiatric disorders. However, progress in understanding the interoceptive basis of these disorders has been incremental, and the application of interoception in clinical treatment is currently limited to panic disorder. To examine the degree to which the scientific community has recognized interoception as a construct of interest, we identified and individually screened all articles published in the English language on interoception and associated root terms in Pubmed, Psychinfo, and ISI Web of Knowledge. This search revealed that interoception is a multifaceted process that is being increasingly studied within the fields of psychiatry, psychology, neuroscience, and biomedical science. To illustrate the multifaceted nature of interoception, we provide a focused review of one of the most commonly studied interoceptive channels, the cardiovascular system, and give a detailed comparison of the most popular methods used to study cardiac interoception. We subsequently review evidence of interoceptive dysfunction in panic disorder, depression, somatic symptom disorders, anorexia nervosa, and bulimia nervosa. For each disorder, we suggest how interoceptive predictions constructed by the brain may erroneously bias individuals to express key symptoms and behaviors, and outline questions that are suitable for the development of neuroscience-based mental health interventions. We conclude that interoception represents a viable avenue for clinical and translational research in psychiatry, with a well-established conceptual framework, a neural basis, measurable biomarkers, interdisciplinary appeal, and transdiagnostic targets for understanding and improving mental health outcomes.
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Affiliation(s)
- Sahib S Khalsa
- Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA; Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, USA
| | - Rachel C Lapidus
- Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA; Department of Psychology, University of Tulsa, Tulsa, OK, USA
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18
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Strahler J, Ziegert T. Psychobiological stress response to a simulated school shooting in police officers. Psychoneuroendocrinology 2015; 51:80-91. [PMID: 25290348 DOI: 10.1016/j.psyneuen.2014.09.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 09/02/2014] [Accepted: 09/17/2014] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Police work is one of the most demanding professions with various sources of high occupational stress. Among the most demanding tasks are amok situations, such as school shootings. Hardly anything is known about endocrine and cardiovascular markers in safety professionals during emergency situations in real life and how this relates to stress perception and management. This study will therefore explore police officers' stress responses to a reality-based school shooting simulation assessing neuroendocrine, cardiovascular, and psychological stress markers. METHODS A convenience sample of 50 police officers (39.5 ± 8.7 yrs, 9 women) participating in a basic or refresher amok training session for the German uniformed and criminal police were recruited. Saliva samples were collected shortly before the simulation task (school shooting), immediately after, 20 and 45 min after finishing the task for the assessment of cortisol and alpha-amylase (sAA), as markers of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system, respectively. Heart rate (variability) was assessed continuously. Officers rated their actual mood right before and 10 min after the simulation. Subjective experience of task stressfulness was assessed minutes after finishing the simulation. RESULTS Overall, the simulated school shooting did not result in changes of mood, tiredness, or calmness but higher restlessness was experienced during the basic training, which was also experienced as more controllable. Female officers reported to experience more strain and anxiety. Cortisol showed highest levels at the beginning of the training and steadily decreasing values thereafter. In contrast, sAA increased substantially right after the simulation with officers on the front position showing most pronounced changes. Cardiovascular reactivity was highest in officers acting on the side positions while advancing to find the suspect. Furthermore higher self-efficacy as well as, by trend, controllability and relevance of results correlated with cardiovascular measures. DISCUSSION Autonomic but not endocrine stress markers increased to a simulated school shooting, which were further related to the subjective experience of the simulation. Our results provide a more in-depth picture of stress responses in such situations, which will in the long run raise the possibility to refine training programs, design more effective stress-management strategies for these critical incidents, and improve performance but also coping with work-related stress.
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Affiliation(s)
- Jana Strahler
- Clinical Biopsychology, University of Marburg, Marburg, Germany.
| | - Thomas Ziegert
- University of Applied Police Science, Rothenburg/O.L., Germany
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19
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Coping with having a depressed mother: The role of stress and coping in hypothalamic–pituitary–adrenal axis dysfunction in girls at familial risk for major depression. Dev Psychopathol 2014; 26:1401-9. [DOI: 10.1017/s0954579414001102] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractHaving a depressed mother is one of the strongest predictors of depression in adolescence. We investigated whether the stress of having a mother with recurrent depression is associated with dysfunction in adolescents in the HPA axis and whether the tendency to use involuntary coping strategies in dealing with this stress is associated with exacerbation of dysfunction in this system. Sixty-four never-disordered daughters of mothers with recurrent depression (high risk) and 64 never-disordered daughters of never-disordered mothers (low risk) completed diurnal cortisol and stress assessments. High-risk girls secreted more diurnal cortisol than did low-risk girls. Whereas low-risk girls secreted higher levels of cortisol with increasing stress associated with having a depressed mother, no such relation was present in high-risk girls. Finally, in contrast to low-risk girls, girls at familial risk for depression who more frequently used involuntary versus voluntary coping exhibited the greatest elevations in diurnal cortisol. These findings indicate that a tendency to utilize involuntary, as opposed to voluntary, coping strategies in dealing with stress involving maternal depression exacerbates already high levels of cortisol in youth at risk for depression. Future research that examines whether interventions aimed at increasing the use of voluntary coping strategies normalizes HPA axis dysfunction is of interest.
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20
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Plag J, Gaudlitz K, Schumacher S, Dimeo F, Bobbert T, Kirschbaum C, Ströhle A. Effect of combined cognitive-behavioural therapy and endurance training on cortisol and salivary alpha-amylase in panic disorder. J Psychiatr Res 2014; 58:12-9. [PMID: 25085607 DOI: 10.1016/j.jpsychires.2014.07.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 06/10/2014] [Accepted: 07/11/2014] [Indexed: 01/29/2023]
Abstract
Current data point to an alteration of both the hypothalamo-pituitary-adrenal (HPA)-system and the peripheral transmission of catecholamines in anxiety disorders. There is also some evidence for the effect of several components of cognitive-behavioural interventions such as coping and control and for an effect of exercise training on the neuroendocrine stress response in healthy subjects as well as patients suffering from distinct (mental) disorders. This double-blind, controlled study investigated the effect of cognitive-behavioural therapy (CBT) in combination with either high-level endurance training or low-level exercise on salivary cortisol (sC) and on levels of salivary alpha-amylase (sAA) in patients suffering from panic disorder (PD) with and without agoraphobia. In comparison to the low-level exercise condition, there were significantly lower sC-levels in the experimental group performing high-level endurance training at a 7-month follow-up. In contrast, there were no group differences in sAA levels during the study period. In this trial, we found evidence for a decelerated effect of endurance-training on HPA-system's functioning in PD. Further studies addressing the alteration of sAA levels in this population might investigate physical exercise different in intensity and duration.
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Affiliation(s)
- Jens Plag
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - Katharina Gaudlitz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany.
| | - Sarah Schumacher
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - Fernando Dimeo
- Section of Sports Medicine, Charité - Universitätsmedizin Berlin, Germany
| | - Thomas Bobbert
- Department of Endocrinology, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
| | - Clemens Kirschbaum
- Department of Biological Psychology, Technical University Dresden, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Germany
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21
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Wirth MM. Hormones, stress, and cognition: The effects of glucocorticoids and oxytocin on memory. ADAPTIVE HUMAN BEHAVIOR AND PHYSIOLOGY 2014; 1:177-201. [PMID: 25893159 DOI: 10.1007/s40750-014-0010-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Hormones have nuanced effects on learning and memory processes. The degree and direction of the effect (e.g., is memory impaired or enhanced?) depends on the dose, type and stage of memory, and type of material being learned, among other factors. This review will focus on two specific topics within the realm of effects of hormones on memory: (1) How glucocorticoids (the output hormones of the hypothalamic-pituitary-adrenal axis) affect long-term memory consolidation, retrieval, and working memory, with a focus on neural mechanisms and effects of emotion; and (2) How oxytocin affects memory, with emphasis on a speculative hypothesis that oxytocin might exert its myriad effects on human social cognition and behavior via impacts on more general cognitive processes. Oxytocin-glucocorticoid interactions will be briefly addressed. These effects of hormones on memory will also be considered from an evolutionary perspective.
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Affiliation(s)
- Michelle M Wirth
- Department of Psychology, University of Notre Dame, 123B Haggar Hall, Notre Dame, IN, 46556, USA,
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22
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Mayer SE, Abelson JL, Lopez-Duran NL. Effortful control and context interact in shaping neuroendocrine stress responses during childhood. Horm Behav 2014; 66:457-65. [PMID: 25019964 PMCID: PMC4148048 DOI: 10.1016/j.yhbeh.2014.06.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 06/26/2014] [Accepted: 06/27/2014] [Indexed: 11/15/2022]
Abstract
Trait and contextual factors can shape individual and group differences in hypothalamic-pituitary-adrenal (HPA) response to stress; but the ways in which these factors may interact with each other to modulate stress activity have rarely been examined. Here, we investigated whether the association between a temperamental self-regulatory trait - Effortful Control (EC) - and HPA axis stress response is moderated by type of laboratory stress in sixty-five children (35 boys). EC was measured at ages 3 and 6 using age-appropriate laboratory batteries as well as mother reports. HPA axis responses were measured at age 7 by randomly assigning children to one of two laboratory stress tasks (frustration vs. fear). Results indicated that EC interacted with stress context in predicting cortisol response. Specifically, lower EC was associated with greater cortisol response (steeper reactivity slopes) in the context of a frustration stressor but this was reversed in a fear context where lower EC was associated with flatter, more gradual activation. It is likely that different components of EC, such as emotion regulation and attention, differentially interact with the stress context. These types of effects and interactions need to be more thoroughly understood in order to meaningfully interpret cortisol reactivity data and better characterize the role of the HPA axis in human psychopathology.
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Affiliation(s)
- Stefanie E Mayer
- Department of Psychology, University of Michigan, 530 Church Street, 2261 East Hall, Ann Arbor, MI 48109, USA.
| | - James L Abelson
- Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA.
| | - Nestor L Lopez-Duran
- Department of Psychology, University of Michigan, 530 Church Street, 2257 East Hall, Ann Arbor, MI 48109, USA.
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Lopez-Duran NL, Mayer SE, Abelson JL. Modeling neuroendocrine stress reactivity in salivary cortisol: adjusting for peak latency variability. Stress 2014; 17:285-95. [PMID: 24754834 DOI: 10.3109/10253890.2014.915517] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In this report, we present growth curve modeling (GCM) with landmark registration as an alternative statistical approach for the analysis of time series cortisol data. This approach addresses an often-ignored but critical source of variability in salivary cortisol analyses: individual and group differences in the time latency of post-stress peak concentrations. It allows for the simultaneous examination of cortisol changes before and after the peak while controlling for timing differences, and thus provides additional information that can help elucidate group differences in the underlying biological processes (e.g., intensity of response, regulatory capacity). We tested whether GCM with landmark registration is more sensitive than traditional statistical approaches (e.g., repeated measures ANOVA--rANOVA) in identifying sex differences in salivary cortisol responses to a psychosocial stressor (Trier Social Stress Test--TSST) in healthy adults (mean age 23). We used plasma ACTH measures as our "standard" and show that the new approach confirms in salivary cortisol the ACTH finding that males had longer peak latencies, higher post-stress peaks but a more intense post-peak decline. This finding would have been missed if only saliva cortisol was available and only more traditional analytic methods were used. This new approach may provide neuroendocrine researchers with a highly sensitive complementary tool to examine the dynamics of the cortisol response in a way that reduces risk of false negative findings when blood samples are not feasible.
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24
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Porhomayon J, Kolesnikov S, Nader ND. The Impact of Stress Hormones on Post-traumatic Stress Disorders Symptoms and Memory in Cardiac Surgery Patients. J Cardiovasc Thorac Res 2014; 6:79-84. [PMID: 25031821 PMCID: PMC4097856 DOI: 10.5681/jcvtr.2014.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 06/02/2014] [Indexed: 11/24/2022] Open
Abstract
The relationship and interactions between stress hormones and post-traumatic stress disorder (PTSD) are well established from both animal and human research studies. This interaction is especially important in the post-operative phase of cardiac surgery where the development of PTSD symptoms will result in increased morbidity and mortality and prolong length of stay for critically ill cardiac surgery patients. Cardiopulmonary bypass itself will independently result in massive inflammation response and release of stress hormones in the perioperative period. Glucocorticoid may reduce this response and result in reduction of PTSD symptom clusters and therefore improve health outcome. In this review, we plan to conduct a systemic review and analysis of the literatures on this topic.
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25
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Abelson JL, Erickson TM, Mayer SE, Crocker J, Briggs H, Lopez-Duran NL, Liberzon I. Brief cognitive intervention can modulate neuroendocrine stress responses to the Trier Social Stress Test: buffering effects of a compassionate goal orientation. Psychoneuroendocrinology 2014; 44:60-70. [PMID: 24767620 PMCID: PMC4120861 DOI: 10.1016/j.psyneuen.2014.02.016] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 02/06/2014] [Accepted: 02/24/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND The hypothalamic-pituitary-adrenal (HPA) axis is a critical mediator linking stress to health. Understanding how to modulate its reactivity could potentially help reduce the detrimental health effects of HPA axis activation. Social evaluative threat is a potent activator of this system. Access to control and coping responses can reduce its reactivity to pharmacological activation. Compassionate or affiliative behaviors may also moderate stress reactivity. Impact of these moderators on social evaluative threat is unknown. Here, we tested the hypotheses that interventions to increase control, coping, or compassionate (versus competitive) goals could reduce HPA-axis response to social evaluative threat. METHODS Healthy participants (n=54) were exposed to social evaluative threat using the Trier Social Stress Test (TSST). They were randomly assigned to receive one of four different instructions prior to the stressor: Standard TSST instructions (SI), standard instructions with access to "control" (SI Control), or one of two cognitive interventions (CI) that (1) increased familiarity and helped participants prepare coping strategies (CI Coping), or (2) shifted goal orientation from self-promotion to helping others (CI Compassionate Goals). ACTH and cortisol were obtained before and after stress exposure via intravenous catheter. RESULTS Control alone had no effect. CI Compassionate Goals significantly reduced ACTH and cortisol responses to the TSST; CI Coping raised baseline levels. Compassionate Goals reduced hormonal responses without reducing subjective anxiety, stress or fear, while increasing expression of pro-social intentions and focus on helping others. CONCLUSIONS Brief intervention to shift focus from competitive self-promotion to a goal orientation of helping-others can reduce HPA-axis activation to a potent psychosocial stressor. This supports the potential for developing brief interventions as inoculation tools to reduce the impact of predictable stressors and lends support to growing evidence that compassion and altruistic goals can moderate the effects of stress.
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Affiliation(s)
- James L. Abelson
- University of Michigan Department of Psychiatry, United States,Corresponding author at: 4250 Plymouth Road (Box 5765, Room 2733), Ann Arbor, Ml 48109-2700, United States. Tel.: +1 734 764 5348; fax: +1 734 936 7868. (J.L. Abelson)
| | | | | | | | - Hedieh Briggs
- University of Michigan Department of Psychiatry, United States
| | | | - Israel Liberzon
- University of Michigan Department of Psychiatry, United States
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Levine ME, Stern RM, Koch KL. Enhanced perceptions of control and predictability reduce motion-induced nausea and gastric dysrhythmia. Exp Brain Res 2014; 232:2675-84. [PMID: 24748483 DOI: 10.1007/s00221-014-3950-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 04/03/2014] [Indexed: 12/01/2022]
Abstract
Nausea is a debilitating condition that is typically accompanied by gastric dysrhythmia. The enhancement of perceived control and predictability has generally been found to attenuate the physiological stress response. The aim of the present study was to test the effect of these psychosocial variables in the context of nausea, motion sickness, and gastric dysrhythmia. A 2x2, independent-groups, factorial design was employed in which perceived control and predictability were each provided at high or low levels to 80 participants before exposure to a rotating optokinetic drum. Ratings of nausea were obtained throughout a 6-min baseline period and a 16-min drum rotation period. Noninvasive recordings of the electrical activity of the stomach called electrogastrograms were also obtained throughout the study. Nausea scores were significantly lower among participants with high control than among those with low control, and were significantly lower among participants with high predictability than among those with low predictability. Estimates of gastric dysrhythmia obtained from the EGG during drum rotation were significantly lower among participants with high predictability than among those with low predictability. A significant interaction effect of control and predictability on gastric dysrhythmia was also observed, such that high control was only effective for arresting the development of gastric dysrhythmia when high predictability was also available. Stronger perceptions of control and predictability may temper the development of nausea and gastric dysrhythmia during exposure to provocative motion. Psychosocial interventions in a variety of nausea contexts may represent an alternative means of symptom control.
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Affiliation(s)
- Max E Levine
- Department of Psychology, Siena College, Loudonville, NY, 12211, USA,
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27
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Hori H, Teraishi T, Ota M, Hattori K, Matsuo J, Kinoshita Y, Ishida I, Nagashima A, Koga N, Higuchi T, Kunugi H. Psychological coping in depressed outpatients: association with cortisol response to the combined dexamethasone/CRH test. J Affect Disord 2014; 152-154:441-7. [PMID: 24210627 DOI: 10.1016/j.jad.2013.10.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 10/08/2013] [Indexed: 01/29/2023]
Abstract
BACKGROUND Depression is associated with dysfunctional coping styles and dysregulated hypothalamic-pituitary-adrenal (HPA) axis function. Studies have shown that maladaptive coping strategies relate to abnormal HPA axis function; however, such a relationship has been under-studied in patients with depression. We aimed to examine whether dysfunctional coping styles in depression would be associated with abnormal cortisol reactivity. METHODS Seventy-four outpatients with major depressive disorder and 133 age- and sex-matched healthy individuals were recruited. Coping was assessed by the Ways of Coping Checklist. Psychological distress was assessed by the Hopkins Symptom Checklist. Cortisol reactivity was measured by the combined dexamethasone/corticotropin-releasing hormone test. RESULTS Compared to healthy individuals, depressed patients demonstrated significantly less use of problem-solving, positive reappraisal and social support coping styles and more use of self-blame and wishful thinking styles. Such a pattern of coping styles was significantly associated with patients' greater distress. Partial correlation analysis in patients, controlling for age and sex, revealed a significant correlation between more use of escape-avoidance coping and lower levels of reactive cortisol measures. A stepwise multiple regression analysis predicting cortisol reactivity from age, sex, distress, symptom severity and coping styles revealed that escape-avoidance coping was a significant predictor. LIMITATIONS The neuroendocrine challenge test was administered only once, based on a simple test protocol. CONCLUSIONS More use of escape-avoidance coping in depressed patients was associated with less cortisol reactivity. Our findings shed light on the heterogeneity of depression in terms of low and high levels of avoidance associated with exaggerated and blunted HPA axis reactivity, respectively.
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Affiliation(s)
- Hiroaki Hori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo 187-8502, Japan; CREST (Core Research of Evolutional Science & Technology), JST (Japan Science and Technology Agency), Tokyo, Japan.
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Morris MC, Rao U. Psychobiology of PTSD in the acute aftermath of trauma: Integrating research on coping, HPA function and sympathetic nervous system activity. Asian J Psychiatr 2013; 6:3-21. [PMID: 23380312 PMCID: PMC3565157 DOI: 10.1016/j.ajp.2012.07.012] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 07/28/2012] [Accepted: 07/30/2012] [Indexed: 12/11/2022]
Abstract
Research on the psychobiological sequelae of trauma has typically focused on long-term alterations in individuals with chronic posttraumatic stress disorder (PTSD). Far less is known about the nature and course of psychobiological risk factors for PTSD during the acute aftermath of trauma. In this review, we summarize data from prospective studies focusing on the relationships among sympathetic nervous system activity, hypothalamic-pituitary-adrenal function, coping strategies and PTSD symptoms during the early recovery (or non-recovery) phase. Findings from pertinent studies are integrated to inform psychobiological profiles of PTSD-risk in children and adults in the context of existing models of PTSD-onset and maintenance. Data regarding bidirectional relations between coping strategies and stress hormones is reviewed. Limitations of existing literature and recommendations for future research are discussed.
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Affiliation(s)
- Matthew C Morris
- Center for Molecular and Behavioral Neuroscience (MCM and UR) and the Department of Psychiatry and Behavioral Sciences (UR), Meharry Medical College, Nashville, TN 37208, United States.
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Duchesne A, Tessera E, Dedovic K, Engert V, Pruessner JC. Effects of panel sex composition on the physiological stress responses to psychosocial stress in healthy young men and women. Biol Psychol 2011; 89:99-106. [PMID: 22001447 DOI: 10.1016/j.biopsycho.2011.09.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 09/13/2011] [Accepted: 09/21/2011] [Indexed: 01/02/2023]
Abstract
Men and women differ in regard to psychosocial stress responses. Biological and contextual factors are known to mediate these differences; however, few studies investigated their interaction. In the present study, we examined contributions of both contextual and biological factors to the stress response of young healthy adults. Men and women were exposed to a modified version of Trier Social Stress Test. The participants gave a speech in front of a panel of judges, composed of either male or female panelists. Both men, and women presented a cortisol increase only when exposed to opposite sex panelists. Interestingly, this effect was only observed in women in their follicular phase. This finding showed that the induction of a psychosocial stress response does not strictly rely on direct social evaluation, but also depends on the sex composition of the panel. Implications for future studies are discussed.
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Affiliation(s)
- A Duchesne
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada.
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30
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Pietrzak RH, Southwick SM. Psychological resilience in OEF-OIF Veterans: application of a novel classification approach and examination of demographic and psychosocial correlates. J Affect Disord 2011; 133:560-8. [PMID: 21624683 DOI: 10.1016/j.jad.2011.04.028] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 03/18/2011] [Accepted: 04/26/2011] [Indexed: 11/15/2022]
Abstract
A growing number of studies have examined the prevalence and correlates of psychopathology in Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF), but few have examined determinants of resilience in this population. This study employed a novel approach to classify psychological resilience in a cross-sectional sample of OEF-OIF Veterans. A total of 272 predominantly older reserve/National Guard OEF/OIF Veterans completed a mail survey that assessed combat exposure, psychopathology, psychosocial functioning, and aspects of social support. Cluster analysis of scores on measures of combat exposure and PTSD symptoms revealed that a three-group solution best fit the data: Controls (low combat exposure, low PTSD symptoms); PTSD (high combat exposure, high PTSD symptoms); and Resilient (high combat exposure, low PTSD symptoms). Compared to the PTSD group, the Resilient group was more likely to be in a relationship and active duty; they also scored lower on a measure of psychosocial dysfunction, and higher on measures of psychological resilience and postdeployment social support. Logistic regression analysis revealed that being in a relationship, having fewer psychosocial difficulties, and reporting greater perceptions of purpose/control and family support and understanding were significantly associated with resilient group membership. Results of this study demonstrate a novel approach to classifying psychological resilience and suggest that interventions to mitigate psychosocial difficulties, enhance perceptions of purpose and control, and bolster family support and understanding may help promote resilience to combat-related PTSD in OEF-OIF Veterans.
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Affiliation(s)
- Robert H Pietrzak
- National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT 06516, USA.
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31
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Jacobs TL, Epel ES, Lin J, Blackburn EH, Wolkowitz OM, Bridwell DA, Zanesco AP, Aichele SR, Sahdra BK, MacLean KA, King BG, Shaver PR, Rosenberg EL, Ferrer E, Wallace BA, Saron CD. Intensive meditation training, immune cell telomerase activity, and psychological mediators. Psychoneuroendocrinology 2011; 36:664-81. [PMID: 21035949 DOI: 10.1016/j.psyneuen.2010.09.010] [Citation(s) in RCA: 279] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 08/28/2010] [Accepted: 09/17/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Telomerase activity is a predictor of long-term cellular viability, which decreases with chronic psychological distress (Epel et al., 2004). Buddhist traditions claim that meditation decreases psychological distress and promotes well-being (e.g., Dalai Lama and Cutler, 2009). Therefore, we investigated the effects of a 3-month meditation retreat on telomerase activity and two major contributors to the experience of stress: Perceived Control (associated with decreased stress) and Neuroticism (associated with increased subjective distress). We used mediation models to test whether changes in Perceived Control and Neuroticism explained meditation retreat effects on telomerase activity. In addition, we investigated whether two qualities developed by meditative practice, increased Mindfulness and Purpose in Life, accounted for retreat-related changes in the two stress-related variables and in telomerase activity. METHODS Retreat participants (n=30) meditated for ∼6 h daily for 3 months and were compared with a wait-list control group (n=30) matched for age, sex, body mass index, and prior meditation experience. Retreat participants received instruction in concentrative meditation techniques and complementary practices used to cultivate benevolent states of mind (Wallace, 2006). Psychological measures were assessed pre- and post-retreat. Peripheral blood mononuclear cell samples were collected post-retreat for telomerase activity. Because there were clear, a priori hypotheses, 1-tailed significance criteria were used throughout. RESULTS Telomerase activity was significantly greater in retreat participants than in controls at the end of the retreat (p<0.05). Increases in Perceived Control, decreases in Neuroticism, and increases in both Mindfulness and Purpose in Life were greater in the retreat group (p<0.01). Mediation analyses indicated that the effect of the retreat on telomerase was mediated by increased Perceived Control and decreased Neuroticism. In turn, changes in Perceived Control and Neuroticism were both partially mediated by increased Mindfulness and Purpose in Life. Additionally, increases in Purpose in Life directly mediated the telomerase group difference, whereas increases in Mindfulness did not. CONCLUSIONS This is the first study to link meditation and positive psychological change with telomerase activity. Although we did not measure baseline telomerase activity, the data suggest that increases in perceived control and decreases in negative affectivity contributed to an increase in telomerase activity, with implications for telomere length and immune cell longevity. Further, Purpose in Life is influenced by meditative practice and directly affects both perceived control and negative emotionality, affecting telomerase activity directly as well as indirectly.
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Affiliation(s)
- Tonya L Jacobs
- UC Davis Center for Mind and Brain, Davis, CA 95618, USA.
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Elevated cortisol in older adults with generalized anxiety disorder is reduced by treatment: a placebo-controlled evaluation of escitalopram. Am J Geriatr Psychiatry 2011; 19:482-90. [PMID: 20808146 PMCID: PMC3424606 DOI: 10.1097/jgp.0b013e3181ec806c] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is a common disorder in older adults, which has been linked to hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis in this age group. The authors examined whether treatment of GAD in older adults with a selective serotonin reuptake inhibitor (SSRI) corrects this HPA axis hyperactivity. METHODS The authors examined adults aged 60 years and older with GAD in a 12-week randomized controlled trial comparing the SSRI escitalopram with placebo. The authors collected salivary cortisol at six daily time points for 2 consecutive days to assess peak and total (area under the curve) cortisol, both at baseline and posttreatment. RESULTS Compared with placebo-treated patients, SSRI-treated patients had a significantly greater reduction in both peak and total cortisol. This reduction in cortisol was limited to patients with elevated (above the median) baseline cortisol, in whom SSRI-treated patients showed substantially greater reduction in cortisol than did placebo-treated patients. Reductions in cortisol were associated with improvements in anxiety. Additionally, genetic variability at the serotonin transporter promoter predicted cortisol changes. CONCLUSIONS SSRI treatment of GAD in older adults reduces HPA axis hyperactivity. Further research should determine whether these treatment-attributable changes are sustained and beneficial.
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33
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Lyubkin M, Giardino ND, Abelson JL. Relationship between respiratory, endocrine, and cognitive-emotional factors in response to a pharmacological panicogen. Depress Anxiety 2010; 27:1011-6. [PMID: 20721903 DOI: 10.1002/da.20725] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 05/26/2010] [Accepted: 05/29/2010] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The cholecystokinin agonist pentagastrin has been used to study panic attacks in the laboratory and to investigate hypothalamic-pituitary-adrenal axis activity. Its mechanism of panicogenesis remains unclear. Data from other models suggest that respiratory stimulation itself may induce panic, but pentagastrin's effects on respiration are not well established. Data from another model also suggest links between respiratory and HPA axis reactivity and cognitive modulation of both. To further explore these phenomena, we added respiratory measures to a study of cognitive modulation of HPA and anxiety responses to pentagastrin. METHODS Healthy subjects received pentagastrin and placebo injections, with measurement of cortisol and subjective responses, on two different laboratory visits. They were randomly assigned to receive standard instructions or one of two versions of previously studied cognitive interventions (to either facilitate coping or increase sense of control), given before each visit. Capnograph measures of heart rate (HR), respiratory rate (RR), and end-tidal pCO(2) were obtained on 24 subjects. RESULTS Relative to placebo, pentagastrin induced a significant decline in pCO(2) with no change in RR. Cortisol and HR increased, as expected. Cognitive intervention reduced the hyperventilatory response to pentagastrin. CONCLUSIONS Pentagastrin stimulates respiration, likely via increases in tidal volume. Respiratory stimulation could play a role in its panicogenic potency, though perhaps indirectly. As with HPA axis responses, higher-level brain processes may be capable of modulating pentagastrin-induced hyperventilation. This model may be useful for further study of cortical/cognitive control of interacting emotional, respiratory, and neuroendocrine sensitivities, with potential relevance to panic pathophysiology.
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Affiliation(s)
- Mark Lyubkin
- Department of Psychiatry, Trauma, Stress and Anxiety Research Group, University of Michigan, Ann Arbor, Michigan, USA
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34
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Turner-Cobb JM, Palmer J, Aronson D, Russell L, Purnell S, Osborn M, Jessop DS. Diurnal cortisol and coping responses in close relatives of persons with acquired brain injury: a longitudinal mixed methods study. Brain Inj 2010; 24:893-903. [PMID: 20433287 DOI: 10.3109/02699051003789211] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine the impact of having a close relative experience a severe brain injury. DESIGN Six-month longitudinal mixed methods concurrent embedded study. Quantitative data provided the primary database and qualitative data provided the secondary source. METHODS Assessment included psychosocial factors of perceived stress, traumatic stress symptoms, coping and social support in addition to salivary cortisol as a biological marker of stress. Written accounts of the experience were provided in response to an open-ended question. Participants composed 15 close relatives of adults with severe brain injury admitted to a specialist rehabilitation facility (mean age 49.4 years; SD 11.79). Assessments were conducted on admission, at 6 weeks, 3 months and 6 months post-admission. RESULTS Quantitative data revealed high traumatic stress at admission, with a non-significant decline at follow-up. Diurnal cortisol output declined significantly from baseline to all follow-up assessments. Coping sub-scales of acceptance and religion were repeated associated with cortisol indices at baseline, 6 weeks, 3 months and 6 months follow-up. Qualitative data revealed two themes; 'relational impact' and 'passage of time'. CONCLUSIONS Findings offer the potential for effective and timely intervention in family members of persons with severe brain injury.
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Tak LM, Rosmalen JGM. Dysfunction of stress responsive systems as a risk factor for functional somatic syndromes. J Psychosom Res 2010; 68:461-8. [PMID: 20403505 DOI: 10.1016/j.jpsychores.2009.12.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 12/08/2009] [Accepted: 12/08/2009] [Indexed: 11/27/2022]
Abstract
The etiology of functional somatic syndromes or disorders (FSDs) is generally considered to be a multifactorial interplay between psychological, biological, and social factors. One of the most investigated biological factors is stress responsive system dysfunction. Despite more than twenty years of research of the autonomic nervous system and the hypothalamic-pituitary-adrenal axis, however, it is yet unknown whether dysfunctions in these systems play a causal role in the etiology of FSDs and whether they are generic or FSD-specific. In this review, we will give an overview of available evidence on whether or not alterations in these stress responsive systems can be considered causal risk factors of FSDs. We conclude that although not necessary factors for FSDs in general, lowered cardiac vagal activity and hypocortisolism may be pivotal in the etiology and treatment strategy in subgroups of subjects with a FSD. Such subgroups need to be better identified.
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Affiliation(s)
- Lineke M Tak
- Interdisciplinary Center for Psychiatric Epidemiology, University Medical Center Groningen, University of Groningen, 9700 RB, Groningen, The Netherlands
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36
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Abelson JL, Khan S, Young EA, Liberzon I. Cognitive modulation of endocrine responses to CRH stimulation in healthy subjects. Psychoneuroendocrinology 2010; 35:451-9. [PMID: 19758763 PMCID: PMC2824051 DOI: 10.1016/j.psyneuen.2009.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 07/16/2009] [Accepted: 08/14/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND The hypothalamic-pituitary adrenal (HPA) axis is critical for biobehavioral adaptation to challenge and appears dysregulated in a range of psychiatric disorders. Its precise role in psychopathology remains unclear and discrepant and difficult to explain findings abound in the clinical literature. Basic research suggests this system is sensitive to psychosocial cues, but psychosocial milieu factors are rarely controlled or examined in psychiatric studies using biological probes of the HPA axis. To test the hypothesis that psychological factors might complicate HPA study results even in direct, pharmacological challenge paradigms, endocrine responses to corticotropin-releasing hormone (CRH) were examined under two different cognitive preparation conditions. METHODS Healthy subjects (n=32) received standard instructions or a cognitive intervention (CI) prior to injection with CRH and placebo, given on separate days in random order. The CI combined access to control over drug exposure with novelty reduction and coping enhancement. Blood samples were obtained via intravenous catheter before and after CRH. RESULTS Cognitive intervention reduced corticotropin (ACTH) levels, but only when CRH was given first (intervention by order interaction). It did not reduce cortisol response. The CI and visit (1st or 2nd) both impacted cortisol levels on placebo day. CONCLUSIONS Modifiable psychological factors may amplify or inhibit HPA axis activity in pharmacological activation paradigms, including CRH stimulation tests. The factors manipulated by the CI (novelty/familiarity, control and coping) may have particular salience to the HPA axis. Differential sensitivity to such factors could impact results in studies applying biological HPA probes to psychiatric populations.
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Abelson JL, Khan S, Giardino N. HPA axis, respiration and the airways in stress--a review in search of intersections. Biol Psychol 2010; 84:57-65. [PMID: 20144683 DOI: 10.1016/j.biopsycho.2010.01.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 01/27/2010] [Accepted: 01/31/2010] [Indexed: 10/19/2022]
Abstract
Given clear connections between respiratory distress and subjective anxiety, it is not surprising that respiratory psychophysiologists have been interested in the psychobiology of anxiety. Given parallel links between anxiety and stress, it is not surprising that the hypothalamic-pituitary adrenal (HPA) stress system has also been a focus in anxiety research. However, despite extensive work in respiratory psychophysiology and stress neuroendocrinology--and evidence that these systems are jointly dysregulated in anxiety disorders--direct studies of their interactions are rare. This paper reviews evidence for scientific intersections, providing an overview of the HPA axis, its psychobiology, and shared neural substrates for HPA and respiratory control. We examine HPA hormone effects on respiration, immune/inflammatory mediators, and lung maturation. We also examine respiratory/dyspnea effects on HPA axis. There are clear points of intersection in the neuroscience of respiration and stress. Given the importance of both systems to an organism's ability to survive and adapt in challenging and changing environments, further study of their interactions is needed.
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Affiliation(s)
- James L Abelson
- Stress and Anxiety Research Group, Department of Psychiatry Trauma, University of Michigan, Ann Arbor, MI 48109, USA.
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Bouchard S, Baus O, Bernier F, McCreary DR. Selection of Key Stressors to Develop Virtual Environments for Practicing Stress Management Skills with Military Personnel Prior to Deployment. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2010; 13:83-94. [DOI: 10.1089/cyber.2009.0336] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Stéphane Bouchard
- Université du Québec en Outaouais, Gatineau, Québec, Canada
- Laboratoire de Cyberpsychologie de l'UQO, Gatineau, Québec, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - Oliver Baus
- Laboratoire de Cyberpsychologie de l'UQO, Gatineau, Québec, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - François Bernier
- Defence Research and Development Canada–ValCartier, ValCartier, Québec, Canada
| | - Donald R. McCreary
- Defence Research and Development Canada–Toronto, Toronto, Ontario, Canada
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Abstract
Anxiety disorders are a significant problem in the community, and recent neuroimaging research has focused on determining the brain circuits that underlie them. Research on the neurocircuitry of anxiety disorders has its roots in the study of fear circuits in animal models and the study of brain responses to emotional stimuli in healthy humans. We review this research, as well as neuroimaging studies of anxiety disorders. In general, these studies have reported relatively heightened amygdala activation in response to disorder-relevant stimuli in post-traumatic stress disorder, social phobia, and specific phobia. Activation in the insular cortex appears to be heightened in many of the anxiety disorders. Unlike other anxiety disorders, post-traumatic stress disorder is associated with diminished responsivity in the rostral anterior cingulate cortex and adjacent ventral medial prefrontal cortex. Additional research will be needed to (1) clarify the exact role of each component of the fear circuitry in the anxiety disorders, (2) determine whether functional abnormalities identified in the anxiety disorders represent acquired signs of the disorders or vulnerability factors that increase the risk of developing them, (3) link the findings of functional neuroimaging studies with those of neurochemistry studies, and (4) use functional neuroimaging to predict treatment response and assess treatment-related changes in brain function.
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Pietrzak RH, Johnson DC, Goldstein MB, Malley JC, Southwick SM. Psychological resilience and postdeployment social support protect against traumatic stress and depressive symptoms in soldiers returning from Operations Enduring Freedom and Iraqi Freedom. Depress Anxiety 2009; 26:745-51. [PMID: 19306303 DOI: 10.1002/da.20558] [Citation(s) in RCA: 196] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND A number of studies have examined the prevalence and correlates of posttraumatic stress disorder (PTSD), depression, and related psychiatric conditions in soldiers returning from Operations Enduring Freedom and Iraqi Freedom (OEF/OIF), but none have examined whether factors such as psychological resilience and social support may protect against these conditions in this population. METHODS A total of 272 predominantly older reserve/National Guard OEF/OIF veterans completed a mail survey assessing traumatic stress and depressive symptoms, resilience, and social support. RESULTS Resilience scores in the full sample were comparable to those observed in civilian outpatient primary-care patients. Respondents with PTSD, however, scored significantly lower on this measure and on measures of unit support and postdeployment social support. A hierarchical regression analysis in the full sample suggested that resilience (specifically, increased personal control and positive acceptance of change) and postdeployment social support were negatively associated with traumatic stress and depressive symptoms, even after adjusting for demographic characteristics and combat exposure. CONCLUSIONS These results suggest that interventions to bolster psychological resilience and postdeployment social support may help reduce the severity of traumatic stress and depressive symptoms in OEF/OIF veterans.
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Affiliation(s)
- Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
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41
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Wittmann D, Montie JE, Hamstra DA, Sandler H, Wood DP. Counseling patients about sexual health when considering post-prostatectomy radiation treatment. Int J Impot Res 2009; 21:275-84. [PMID: 19609297 PMCID: PMC2834328 DOI: 10.1038/ijir.2009.32] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 06/08/2009] [Accepted: 06/12/2009] [Indexed: 01/08/2023]
Abstract
Prostate cancer is the second most frequently diagnosed cancer in men in the United States. Many men with clinically localized prostate cancer survive for 15 years or more. Although early detection and successful definitive treatments are increasingly common, a debate regarding how aggressively to treat prostate cancer is ongoing because of the effect of aggressive treatment on the quality of life, including sexual functioning. We examined current research on the effect of post-prostatectomy radiation treatment on sexual functioning, and suggest a way in which patient desired outcomes might be taken into consideration while making decisions with regard to the timing of radiation therapy after prostatectomy.
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Affiliation(s)
- D Wittmann
- Department of Urology, University of Michigan, Ann Arbor, MI 48109-5330, USA.
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42
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King AP, Abelson JL, Britton JC, Phan KL, Taylor SF, Liberzon I. Medial prefrontal cortex and right insula activity predict plasma ACTH response to trauma recall. Neuroimage 2009; 47:872-80. [DOI: 10.1016/j.neuroimage.2009.05.088] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Revised: 05/22/2009] [Accepted: 05/26/2009] [Indexed: 10/20/2022] Open
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43
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Regulation of natural killer cell redistribution by prefrontal cortex during stochastic learning. Neuroimage 2009; 47:897-907. [DOI: 10.1016/j.neuroimage.2009.04.088] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Revised: 04/09/2009] [Accepted: 04/28/2009] [Indexed: 12/30/2022] Open
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44
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King AP, Liberzon I. Assessing the neuroendocrine stress response in the functional neuroimaging context. Neuroimage 2009; 47:1116-24. [PMID: 19481160 DOI: 10.1016/j.neuroimage.2009.05.055] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Revised: 05/19/2009] [Accepted: 05/21/2009] [Indexed: 02/03/2023] Open
Abstract
Neural regulation of stress responses, and the feedback of stress hormones to the brain, reflect complex brain-body interactions that may underlie the effects of psychological stress on health. Elucidating the brain circuitry involved in the cortical control of limbic-hypothalamic-pituitary-adrenal axis, and the cortical "targets" of cortisol that in turn modulates brain function, requires careful assessment of glucocorticoid hormones, in the context of the neuroimaging paradigms. Here we discuss approaches for assessment of endocrine function in the context of neuroimaging, including methods of blood and saliva specimen collection, and methods for drug/hormone administration. We also briefly discuss important temporal considerations, including appropriate timing of sample collections for hormones with different time-courses of activation (e.g. ACTH vs. cortisol), the pharmacokinetics of both endogenous hormones and administered agents, and circadian considerations. These are crucial to experimental designs of rhythmic hormonal systems and multiple feedback loops. We briefly address psychological/behavioral 'activation' paradigms used for inducing endogenous LHPA axis responses within or in proximity to scanner, as well as strategies for administration of exogenous hormones or secretagogues. Finally, we discuss some of the analytical issues in terms of hormone responses (e.g. response and area under curve, diurnal variability) and strategies for linking measured levels of peripheral humoral factor to brain activity (e.g. hormone responses as between-subject regressors of BOLD activations, hormone levels as within-subject regressors in analyses of covariance of brain activity over time, etc.).
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Affiliation(s)
- Anthony P King
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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