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Levi E, Fischer S, Fisher H, Admon R, Zilcha-Mano S. Patient and Therapist In-Session Cortisol as Predictor of Post-Session Patient Reported Affect. Brain Sci 2021; 11:1483. [PMID: 34827482 PMCID: PMC8615903 DOI: 10.3390/brainsci11111483] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 12/25/2022] Open
Abstract
The importance of the role of affect in psychotherapy for major depressive disorder (MDD) is well established, but the common use of self-reported measures may limit our understanding of its underlying mechanisms. A promising predictor of patient affect is the stress hormone cortisol. To date, no studies have studied in-session changes in cortisol in psychotherapy for MDD. We investigated whether an increase in patient cortisol over the course of a session correlated with higher negative and lower positive affect. Given previous findings on healthy individuals on the contagious nature of stress, an additional aim was to examine whether these relationships are moderated by therapist cortisol. To this end, 40 dyads (including 6 therapists) provided saliva samples before and after four pre-specified sessions (616 samples). After each session, the patients provided retrospective reports of in-session affect. We found no association between patient cortisol and affect. However, increases in patient cortisol predicted negative affect when the therapists exhibited decreases in cortisol, and increases in patient cortisol predicted positive affect when the therapists showed increases. Our study provides initial evidence for the importance of the social context in the cortisol-affect relationship in MDD.
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Affiliation(s)
- Eyal Levi
- School of Psychological Sciences, University of Haifa, Mount Carmel, Haifa 31905, Israel; (E.L.); (H.F.); (R.A.)
| | - Susanne Fischer
- Institute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, 8050 Zürich, Switzerland;
| | - Hadar Fisher
- School of Psychological Sciences, University of Haifa, Mount Carmel, Haifa 31905, Israel; (E.L.); (H.F.); (R.A.)
| | - Roee Admon
- School of Psychological Sciences, University of Haifa, Mount Carmel, Haifa 31905, Israel; (E.L.); (H.F.); (R.A.)
- The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa 31905, Israel
| | - Sigal Zilcha-Mano
- School of Psychological Sciences, University of Haifa, Mount Carmel, Haifa 31905, Israel; (E.L.); (H.F.); (R.A.)
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Dotson VM, McClintock SM, Verhaeghen P, Kim JU, Draheim AA, Syzmkowicz SM, Gradone AM, Bogoian HR, Wit LD. Depression and Cognitive Control across the Lifespan: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2020; 30:461-476. [PMID: 32385756 DOI: 10.1007/s11065-020-09436-6] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 03/15/2020] [Indexed: 12/19/2022]
Abstract
Depression has been shown to negatively impact neurocognitive functions, particularly those governed by fronto-subcortical networks, such as executive functions. Converging evidence suggests that depression-related executive dysfunction is greater at older ages, however, this has not been previously confirmed by meta-analysis. We performed a systematic review and meta-analysis, using three-level models, on peer-reviewed studies that examined depression-related differences in cognitive control in healthy community-dwelling individuals of any age. We focused on studies of cognitive control as defined by the National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) framework, which centers on goal-directed behavior, such as goal selection (updating, representations, maintenance), response selection (inhibition or suppression), and performance monitoring. In 16,806 participants aged 7 to 97 across 76 studies, both clinical depression and subthreshold depressive symptoms were associated with cognitive control deficits (Hedges' g = -0.31). This relationship was stronger in study samples with an older mean age. Within studies with a mean age of 39 years or higher, which represents the median age in our analyses, the relationship was stronger in clinical compared to subthreshold depression and in individuals taking antidepressant medication. These findings highlight the importance of clinicians screening for cognitive control dysfunction in patients with depression, particularly in later stages of adulthood.
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Affiliation(s)
- Vonetta M Dotson
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA. .,Gerontology Institute, Georgia State University, Atlanta, GA, USA.
| | - Shawn M McClintock
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Paul Verhaeghen
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Joseph U Kim
- Department of Psychiatry, University of Utah School of Medicine, Lake City, UT, USA
| | - Amanda A Draheim
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Sarah M Syzmkowicz
- Department of Neurological Services, University of Nebraska Medical Center, Omaha, NE, USA
| | - Andrew M Gradone
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Hannah R Bogoian
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Liselotte De Wit
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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O'Shea DM, Dotson VM, Woods AJ, Porges EC, Williamson JB, O'Shea A, Cohen R. Depressive Symptom Dimensions and Their Association with Hippocampal and Entorhinal Cortex Volumes in Community Dwelling Older Adults. Front Aging Neurosci 2018. [PMID: 29515435 PMCID: PMC5826180 DOI: 10.3389/fnagi.2018.00040] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective: Research has shown that depression is a risk factor for Alzheimer’s disease (AD) and subsequent cognitive decline. This is compounded by evidence showing an association between depression and reduced hippocampal volumes; a primary structure implicated in the pathogenesis of the disease. Less is known about the relationship between depression and other AD vulnerable regions such as the entorhinal cortex. Given the heterogeneity of depressive symptom presentation, we examined whether symptom dimensions were associated with hippocampal and entorhinal cortex volumes in community dwelling older adults. Methods: Eighty-one community dwelling adults completed the Beck Depression Inventory – second edition and underwent structural neuroimaging. Measures of hippocampal and entorhinal cortex volumes were obtained using FreeSurfer software. Linear regression models included regions of interest as dependent variables, with depressive symptom dimensions, as independent variables, controlling for total intracranial volumes, age, education, and gender. Results: Somatic symptoms were negatively associated with total, right, and left hippocampal volumes. Affective symptoms were negatively associated with total entorhinal cortex volumes, with a marginal main effect on left entorhinal cortex volumes. Conclusion: Our findings provide support for examining depressive symptoms and their association with AD vulnerable regions along subdimensions of affective, cognitive, and somatic symptoms to better understand profiles of symptoms most associated with these regions. Conceptualizing depressive symptoms in this way may also better inform treatment approaches in terms of targeting types of symptoms that may be more closely linked to poorer brain and cognitive health outcomes.
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Affiliation(s)
- Deirdre M O'Shea
- Department of Aging and Geriatric Research, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Vonetta M Dotson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States.,Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Adam J Woods
- Department of Aging and Geriatric Research, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Eric C Porges
- Department of Aging and Geriatric Research, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - John B Williamson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States.,Brain Rehabilitation Research Center, Malcom Randall Veterans Affairs Medical Center, Gainesville, FL, United States
| | - Andrew O'Shea
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Ronald Cohen
- Department of Aging and Geriatric Research, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
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