Stress-induced cortisol is associated with generation of non-negative interpretations during cognitive reappraisal

The antidepressant effect of cognitive reappraisal training on individuals cognitively vulnerable to depression: Could cognitive bias be modified through the prefrontal–amygdala circuits?

Cognitive reappraisal (CR) is one of the core treatment components of cognitive behavioral therapy (CBT) and is the gold standard treatment for major depressive disorders. Accumulating evidence indicates that cognitive reappraisal could function as a protective factor of cognitive vulnerability to depression. However, the neural mechanism by which CR training reduces cognitive vulnerability to depression is unclear. There is ample evidence that the prefrontal–amygdala circuit is involved in CR. This study proposes a novel cognitive bias model of CR training which hypothesizes that CR training may improve the generation ability of CR with altered prefrontal–amygdala functional activation/connectivity, thus reducing negative cognitive bias (negative attention bias, negative memory bias, negative interpretation bias, and/or negative rumination bias) and alleviating depressive symptoms. This study aims to (1) explore whether there is abnormal CR strategy generation ability in individuals who are cognitively vulnerable to depression; (2) test the hypothesis that CR training alleviates depressive symptoms through the mediators of cognitive bias (interpretation bias and/or rumination bias); (3) explore the neural mechanism by which CR training may enhance the ability of CR strategy generation; and (4) examine the short- and long-term effects of CR training on the reduction in depressive symptoms in individuals who are cognitively vulnerable to depression following intervention and 6 months later. The study is promising, providing theoretical and practical evidence for the early intervention of depression-vulnerable individuals.

Cortisol reactivity impairs suppression-induced forgetting

To some extent, we can shape our recollections by intentionally remembering certain experiences while trying to forget others, for example, by intentional suppression. Acute stress impairs suppression-induced forgetting of memories. It is unclear, however, whether these deficits are a direct consequence of the acute stress-induced cortisol response. The present study was designed to examine the stress-induced impairment in suppression-induced forgetting in a subgroup of cortisol responders. We exposed healthy participants to a stress (n = 55) or no-stress control (n = 32) version of the Maastricht Acute Stress Test before they performed the Think / No-Think task. Here, participants aimed to repeatedly retrieve or suppress memories of previously learned cue-target video clips to mimic the complexity of episodic memories. Results on the subsequent memory test revealed that, while the no-stress controls and cortisol non-responders demonstrated suppression-induced forgetting, this effect was absent in cortisol responders. Moreover, the magnitude of suppression-induced forgetting was negatively correlated to stress-induced cortisol increases. The current study extends findings on stress-induced impairments in suppression-induced forgetting by specifically focusing on cortisol reactivity. Furthermore, our findings show the importance of individual differences in cortisol responses as a driving mechanism behind stress-induced alterations in our capacity to actively control our memory.

Emotion Regulation and Diurnal Cortisol: A Longitudinal Study of Early Adolescents

Aberrant patterns of diurnal cortisol, a marker of stress reactivity, predict adverse physical and mental health among adolescents. However, the mechanisms underlying aberrant diurnal cortisol production are poorly understood. Thus, the objective of this study was to investigate, for the first time, whether the core emotion regulation (ER) strategies of rumination (brooding, reflection), reappraisal, and suppression were prospectively associated with individual differences in diurnal cortisol during the COVID-19 pandemic, a period of significant stress. A community sample of 48 early adolescents (M_age=13.45; 60% males) was recruited from British Columbia, Canada. Participants completed ER measures before the pandemic, and diurnal cortisol was assessed by collecting eight saliva samples over two days during the first COVID-19-related lockdown in the region. As expected, brooding predicted elevated waking cortisol and a blunted cortisol awakening response (CAR), whereas reflection predicted lower waking cortisol and suppression predicted a steeper CAR. Unexpectedly, reappraisal was not associated with diurnal cortisol production. Results indicate that ER strategies may represent a mechanism underlying individual differences in biological markers of wellbeing during stress.

Stress Influences the Effect of Obsessive-Compulsive Symptoms on Emotion Regulation

Obsessive-compulsive disorder (OCD) is associated with emotion regulation impairments, namely the frequent use of maladaptive strategies such as suppression and the decreased use of reappraisal strategies. Additionally, these patients exhibit elevated stress levels. Since stress exposure affects emotion regulation abilities, stress might influence the relationship between obsessive-compulsive symptoms and emotion regulation. In this study, we explored the effects of stress and obsessive-compulsive symptoms on emotion regulation in a sample of healthy and OCD individuals. We used self-reported psychometric scales to measure stress levels, obsessive-compulsive symptoms, and emotion reappraisal and suppression skills. We applied multiple regression and mediation analyses. Our results demonstrated that increased reappraisal scores were associated with higher suppression scores. Additionally, elevated stress values predicted increased scores for suppression and decreased scores for reappraisal. Furthermore, the reappraisal abilities resulted from a combination of a direct effect of obsessive-compulsive symptoms and an indirect effect of obsessive-compulsive symptoms mediated by stress. The reliance on suppression strategies and the difficulty in using reappraisal approaches are explained by stress levels and are not directly explained by obsessive-compulsive symptoms. This study highlights the necessity of targeting stress in current therapy-based treatments for OCD.

Gonadal hormones modulate the HPA-axis and the SNS in response to psychosocial stress

Exposure to stress activates both the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS). A growing body of research points to the contribution of sex hormones (testosterone, estrogen, and progesterone), the end products of the hypothalamus-pituitary-gonadal (HPG) axis, in modulating stress reactivity. The present study aimed at investigating the potential modulating role of sex hormones on HPA and SNS reactivity to psychosocial stress. The reactivity, induced by the Trier Social Stress Test, was analyzed by measuring the levels of cortisol and alpha-amylase (markers for SNS activity) in four saliva samples each of 21 men and 37 women (17 not using oral contraceptives and in their luteal phase, and 20 women using oral contraceptives). In addition, basal sex hormones were sampled prior to the psychosocial stress exposure. Results revealed that controlling for testosterone, estrogen, and progesterone diminished the impact of stress on cortisol reactivity and on alpha-amylase reactivity. Moreover, controlling for sex hormones also diminished the differential pattern of cortisol reactivity in each experimental group among responders. Furthermore, correlation analyses revealed differences between groups in the association between sex hormones and alpha-amylase. The present findings indicate a modulatory role for sex hormones in HPA and SNS reactivity and emphasize the need for control of sex hormone fluctuations when examining cortisol and alpha-amylase reactivity to stress.

Does Psychosocial Stress Impact Cognitive Reappraisal? Behavioral and Neural Evidence

Cognitive reappraisal (CR) is regarded as an effective emotion regulation strategy. Acute stress, however, is believed to impair the functioning of prefrontal-based neural systems, which could result in lessened effectiveness of CR under stress. This study tested the behavioral and neurobiological impact of acute stress on CR. While undergoing fMRI, adult participants ( n = 54) passively viewed or used CR to regulate their response to negative and neutral pictures and provided ratings of their negative affect in response to each picture. Half of the participants experienced an fMRI-adapted acute psychosocial stress manipulation similar to the Trier Social Stress Test, and a control group received parallel manipulations without the stressful components. Relative to the control group, the stress group exhibited heightened stress as indexed by self-report, heart rate, and salivary cortisol throughout the scan. Contrary to our hypothesis, we found that reappraisal success was equivalent in the control and stress groups, as was electrodermal response to the pictures. Heart rate deceleration, a physiological response typically evoked by aversive pictures, was blunted in response to negative pictures and heightened in response to neutral pictures in the stress group. In the brain, we found weak evidence of stress-induced increases of reappraisal-related activity in parts of the PFC and left amygdala, but these relationships were statistically fragile. Together, these findings suggest that both the self-reported and neural effects of CR may be robust to at least moderate levels of stress, informing theoretical models of stress effects on cognition and emotion.