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Ye X, Dou Z, Jiang M, Luo Z, Li M, Tang H, Huang X, Wang Y, Dong L, Mao X, Feng Y. Effects of Linpan nature therapy on health benefits in older women with and without hypertension. Front Public Health 2023; 11:1208481. [PMID: 38026306 PMCID: PMC10653337 DOI: 10.3389/fpubh.2023.1208481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background Nature therapy can significantly benefit the physiology and psychology of middle-aged and older people, but previous studies have focused on forest environments. The restoration potential of rural environments in urban fringe areas, which are more accessible to older people on a daily basis, has not been fully studied. This study assessed the effects of nature therapy on the physical and mental health of older women in a rural setting (locally known as Linpan) in the urban fringe area of Chengdu, China. Methods We recruited a total of 60 older women (65.3 ± 5.5 years old) living in cities for 3 days of nature therapy in the winter (30 subjects) and spring (30 subjects), including 20 hypertensive patients. Results The results showed that the overall blood pressure, pulse and sleep dysfunction rating scores of the participants were significantly lower than the pretest levels, and the finger blood oxygen saturation, mid-day salivary alpha-amylase and cortisol were increased post-treatment. Increases in these biomarker indicates and increase in stress. There were significant differences in the changes in systolic blood pressure between the hypertension group (HTN) and the normal group (normal) (HTN decreased by 8.8%, normal decreased by 5.4%), salivary alpha-amylase content (HTN decreased by 0.3%, normal increased by 16.9%), and sleep dysfunction rating scores (HTN decreased by 59.6%, normal decreased by 54%). The decreases in systolic blood pressure and pulse in the winter group were higher than those in the spring group by 1.8 and 4.4%, respectively, while the increases in salivary alpha-amylase content and salivary cortisol content were lower than those in the spring group by 11.7 and 11.2%, respectively, and the decrease in sleep dysfunction rating scores was lower than that in the spring group by 7.1%. Conclusion Our study concluded that nature therapy based on various health activities in the Linpan has significant health effects on older women. It can regulate blood pressure and pulse in older women, relieve cardiovascular disease, improve sleep quality. Meanwhile, older women with high blood pressure experienced a more significant effect than the healthy group.
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Affiliation(s)
- Xiang Ye
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Zhiwen Dou
- Railway Cultural Tourism Investment Group, Health Industry Co., Ltd., Chengdu, China
| | - Mingyan Jiang
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Zhenghua Luo
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Mao Li
- Railway Cultural Tourism Investment Group, Health Industry Co., Ltd., Chengdu, China
| | - Haixiong Tang
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Xiao Huang
- Railway Cultural Tourism Investment Group, Health Industry Co., Ltd., Chengdu, China
| | - Yuqian Wang
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Liwei Dong
- Railway Cultural Tourism Investment Group, Health Industry Co., Ltd., Chengdu, China
| | - Xiaoguang Mao
- Railway Cultural Tourism Investment Group, Health Industry Co., Ltd., Chengdu, China
| | - Yu Feng
- Railway Cultural Tourism Investment Group, Health Industry Co., Ltd., Chengdu, China
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Garrels E, Kainth T, Silva B, Yadav G, Gill G, Salehi M, Gunturu S. Pathophysiological mechanisms of post-myocardial infarction depression: a narrative review. Front Psychiatry 2023; 14:1225794. [PMID: 37599890 PMCID: PMC10436342 DOI: 10.3389/fpsyt.2023.1225794] [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: 05/19/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023] Open
Abstract
Myocardial infarction (MI) can have significant physical and mental consequences. Depression is a prevalent psychiatric condition after MI which can reduce the quality of life and increase the mortality rates of patients. However, the connection between MI and depression has remained under-appreciated. This review examines the potential connection between depression and MI by overviewing the possible pathophysiologic mechanisms including dysregulation of the hypothalamic-pituitary-adrenal axis and autonomic nervous system, coagulation system dysfunction, inflammation, environmental factors, as well as, genetic factors. Furthermore, depression can be an adverse event of medications used for MI treatment including beta-blockers, statins, or anti-platelet agents. The need for early detection and management of depression in patients with MI is, therefore, crucial for improving their overall prognosis. Adherence to treatments and regular follow-up visits can ensure the best response to treatment.
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Affiliation(s)
- Eric Garrels
- Department of Psychiatry, BronxCare Health System, New York, NY, United States
| | - Tejasvi Kainth
- Department of Psychiatry, BronxCare Health System, New York, NY, United States
| | - Briana Silva
- BronxCare Health System, New York, NY, United States
| | - Garima Yadav
- Department of Psychiatry, BronxCare Health System, New York, NY, United States
| | - Gurtej Gill
- Department of Psychiatry, BronxCare Health System, New York, NY, United States
| | - Mona Salehi
- BronxCare Health System, New York, NY, United States
| | - Sasidhar Gunturu
- Department of Psychiatry, BronxCare Health System, New York, NY, United States
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Niebla-Cárdenas A, Bareke H, Juanes-Velasco P, Landeira-Viñuela A, Hernández ÁP, Montalvillo E, Góngora R, Arroyo-Anlló E, Silvia Puente-González A, Méndez-Sánchez R, Fuentes M. Translational research into frailty from bench to bedside: Salivary biomarkers for inflammaging. Exp Gerontol 2023; 171:112040. [PMID: 36455696 DOI: 10.1016/j.exger.2022.112040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022]
Abstract
Frailty is a complex physiological syndrome associated with adverse ageing and decreased physiological reserves. Frailty leads to cognitive and physical disability and is a significant cause of morbidity, mortality and economic costs. The underlying cause of frailty is multifaceted, including immunosenescence and inflammaging, changes in microbiota and metabolic dysfunction. Currently, salivary biomarkers are used as early predictors for some clinical diseases, contributing to the effective prevention and treatment of diseases, including frailty. Sample collection for salivary analysis is non-invasive and simple, which are paramount factors for testing in the vulnerable frail population. The aim of this review is to describe the current knowledge on the association between frailty and the inflammatory process and discuss methods to identify putative biomarkers in salivary fluids to predict this syndrome. This study describes the relationship between i.-inflammatory process and frailty; ii.-infectious, chronic, skeletal, metabolic and cognitive diseases with inflammation and frailty; iii.-inflammatory biomarkers and salivary fluids. There is a limited number of previous studies focusing on the analysis of inflammatory salivary biomarkers and frailty syndrome; hence, the study of salivary fluids as a source for biomarkers is an open area of research with the potential to address the increasing demands for frailty-associated biomarkers.
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Affiliation(s)
- Alfonssina Niebla-Cárdenas
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
| | - Halin Bareke
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Institute of Health Sciences, Marmara University, Istanbul, Turkey; Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain
| | - Pablo Juanes-Velasco
- Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain
| | - Alicia Landeira-Viñuela
- Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain
| | - Ángela-Patricia Hernández
- Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain; Department of Pharmaceutical Sciences: Organic Chemistry, Faculty of Pharmacy, University of Salamanca, CIETUS, IBSAL, 37007 Salamanca, Spain
| | - Enrique Montalvillo
- Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain
| | - Rafael Góngora
- Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain
| | - Eva Arroyo-Anlló
- Department of Psychobiology, Neuroscience Institute of Castilla-León, Faculty of Psychology, University of Salamanca, 37007 Salamanca, Spain
| | - Ana Silvia Puente-González
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain; Institute of Biomedical Research of Salamanca. Primary Care, Public Health and Pharmacology Area, 37007 Salamanca, Spain.
| | - Roberto Méndez-Sánchez
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain; Institute of Biomedical Research of Salamanca. Primary Care, Public Health and Pharmacology Area, 37007 Salamanca, Spain
| | - Manuel Fuentes
- Department of Medicine and Cytometry General Service-Nucleus, CIBERONC CB16/12/00400, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), 37007 Salamanca, Spain; Proteomics Unit, Cancer Research Centre (IBMCC/CSIC/USAL/IBSAL), Salamanca, Spain.
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de Vries LP, van de Weijer MP, Bartels M. The human physiology of well-being: A systematic review on the association between neurotransmitters, hormones, inflammatory markers, the microbiome and well-being. Neurosci Biobehav Rev 2022; 139:104733. [PMID: 35697161 DOI: 10.1016/j.neubiorev.2022.104733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/09/2022] [Accepted: 06/07/2022] [Indexed: 02/08/2023]
Abstract
To understand the pathways through which well-being contributes to health, we performed a systematic review according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines on the association between well-being and physiological markers in four categories, neurotransmitters, hormones, inflammatory markers, and microbiome. We identified 91 studies. Neurotransmitter studies (knumber of studies=9) reported only a possible positive association between serotonin and well-being. For the hormone studies (k = 48), a lower momentary cortisol level was related to higher well-being (meta-analytic r = -0.06), and a steeper diurnal slope of cortisol levels. Inflammatory marker studies (k = 36) reported negative or non-significant relations with well-being, with meta-analytic estimates of respectively r = -0.07 and r = -0.05 for C-reactive protein and interleukin-6. Microbiome studies (k = 4) reported inconsistent associations between different bacteria abundance and well-being. The results indicate possible but small roles of serotonin, cortisol, and inflammatory markers in explaining differences in well-being. The inconsistent and limited results for other markers and microbiome require further research. Future directions for a complete picture of the physiological factors underlying well-being are proposed.
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Affiliation(s)
- Lianne P de Vries
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, the Netherlands.
| | - Margot P van de Weijer
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, the Netherlands
| | - Meike Bartels
- Department of Biological Psychology, Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, the Netherlands
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Parent-Lamarche A, Marchand A, Saade S. Does salivary cortisol secretion mediate the association of work-related stressors with workers' depression? Int Arch Occup Environ Health 2021; 95:477-487. [PMID: 34636976 DOI: 10.1007/s00420-021-01792-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/12/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study was to verify the mediating role salivary cortisol intensity plays between work organization conditions and depression. This study simultaneously considered psychological and physiological (salivary cortisol) stress indicators on workers' depression in a single model. METHODS We relied on cluster sampling of 341 workers in 34 Quebec establishments. Five saliva samples (on awakening, 30 min after awakening, at 2:00 p.m., 4:00 p.m., and bedtime) were collected per day. The weekly collection period spanned a period of 3 days (1 day off and 2 work days). We evaluated the main effects of work organization conditions on salivary cortisol intensity and depression, as well as the mediation effect of salivary cortisol intensity between work organization conditions and depression. To adjust for design effects, the direct and indirect (mediation) associations between the variables were evaluated while accounting for the non-independence of the data. RESULTS Skill utilization and job insecurity were associated with salivary cortisol intensity, while psychological demands and job insecurity were associated with higher depression levels. Work-related variables were not found to have an indirect effect on depression via worker's salivary cortisol (AUC) intensity. CONCLUSION Work-related stressors examined in this study did not indirectly affect worker's depression levels. Additional studies are necessary to be able to identify all work-related stressors that could potentially increase worker's depression levels through salivary cortisol.
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Affiliation(s)
- Annick Parent-Lamarche
- Department of Human Resources Management, Université du Québec à Trois-Rivières, 3225, Albert-Tessier, Trois-Rivières, QC, G9A 5A7, Canada.
| | - Alain Marchand
- School of Industrial Relations, University of Montreal, Succ. Centre-ville, C.P. 6128, Montreal, QC, H3C 3J7, Canada
| | - Sabine Saade
- Department of Psychology, American University of Beirut, Jesup Hall, 102, Beirut, Lebanon
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Hirokawa K, Ohira T, Nagao M, Nagayoshi M, Kajiura M, Imano H, Kitamura A, Kiyama M, Okada T, Iso H. Associations Between Occupational Status, Support at Work, and Salivary Cortisol Levels. Int J Behav Med 2021; 29:299-307. [PMID: 34462898 DOI: 10.1007/s12529-021-10020-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The present study investigated associations between occupation, job stress, and salivary cortisol levels after psychological tasks. METHODS We examined 766 (273 men and 493 women) healthy employed Japanese participants aged 21 to 68 years (mean age = 46.4 years, standard deviation = 8.5) with three types of occupation: manager, teacher, and general worker. The Brief Job Stress Questionnaire was used to evaluate participants' job stress levels, including job demand, job control, support from supervisors, and support from coworkers. Salivary cortisol levels were measured at pre-session, post-stressful tasks, and post-relaxation. All samples were assayed using an enzyme-linked immunosorbent assay test. Natural log transformation was applied before statistical analyses. A multiple regression analysis and a repeated measures analysis of covariance were conducted to test associations between occupation and salivary cortisol levels, adjusting for confounding factors. Statistical analyses were conducted separately for men and women. RESULTS Among both men and women, general workers had higher cortisol levels than managers throughout the experimental session (men 0.6 μg/dL and 0.4 μg/dL, respectively; women 0.5 μg/dL and 0.4 μg/dL, respectively). Job control was positively associated with cortisol levels measured in all sessions, after adjusting for confounding factors (standardized beta 0.15, 0.21, and 0.18 for pre-session, post-stressful-tasks, and post-relaxation, respectively, all p < 0.05). Men with low support from coworkers had higher cortisol levels than those with high support through the sessions (0.6 μg/dL and 0.4 μg/dL, respectively). CONCLUSION Socioeconomic disparity according to occupational status was related to cortisol levels in Japanese workers. Support from coworkers may be effective for reducing cortisol secretion in men.
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Affiliation(s)
- Kumi Hirokawa
- Department of Nursing, Baika Women's University, 2-19-5 Shukunosho, Ibaraki, Osaka, 567-8578, Japan. .,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan.
| | - Tetsuya Ohira
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan. .,Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima, 960-1295, Japan.
| | - Masanori Nagao
- Radiation Medical Science Center for the Fukushima Health Management Survey Office of Epidemiology, Fukushima Medical University, 1 Hikariga-oka, Fukushima City Fukushima, Fukushima, 960-1295, Japan
| | - Mako Nagayoshi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Mitsugu Kajiura
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Akihiko Kitamura
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan
| | - Masahiko Kiyama
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan
| | - Takeo Okada
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
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Kische H, Ollmann TM, Voss C, Hoyer J, Rückert F, Pieper L, Kirschbaum C, Beesdo-Baum K. Associations of saliva cortisol and hair cortisol with generalized anxiety, social anxiety, and major depressive disorder: An epidemiological cohort study in adolescents and young adults. Psychoneuroendocrinology 2021; 126:105167. [PMID: 33592366 DOI: 10.1016/j.psyneuen.2021.105167] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Most of the observed associations of generalized anxiety disorder (GAD), social anxiety disorder (SAD) and major depressive disorder (MDD) with cortisol concentrations came from clinical and adult study samples, with inconsistent findings, partly due to method variance. We examined cross-sectional and longitudinal associations between GAD, SAD and MDD with saliva and hair cortisol as well as hair cortisol change in a population-based sample of adolescents and young adults, considering relevant co-factors. DESIGN Epidemiological cohort study in Dresden, Germany. Data of 1050 individuals (mean age: 17.2 years) assessed at baseline (11/2015-12/2016) and of 605 individuals assessed at 1-year follow-up (FU1) are used. METHODS Multivariable regression models were implemented to assess cross-sectional and longitudinal associations of DSM-5 defined 12-month diagnoses of GAD, SAD, and MDD, with short-term (saliva cortisol: cortisol awakening response (CAR) and area under the curve (AUC) as total cortisol) and long-term (hair cortisol) cortisol indices. Multivariable models were adjusted for age or "tanner" stage, waist circumference, tobacco and alcohol consumption, physical inactivity, and hair cortisol dependent confounder. Sex-specific analyses were additionally conducted. RESULTS Cross-sectional analyses revealed positive associations between SAD and baseline saliva cortisol in multivariable models (CAR: β-coefficient: 0.12; 95% CI: 0.01; 0.23) but could not be confirmed after adjusting for "tanner" stage or comorbid depression. Cross-sectional analyses concerning GAD and MDD in the full baseline sample yielded no significant associations. Sex-specific linear models revealed a significant inverse cross-sectional association between MDD (β-coefficient: - 2.21; 95% CI: - 3.64; - 0.79) as well as SAD (β-coefficient: - 2.21; 95% CI: - 4.03; - 0.38) with baseline hair cortisol in males, but not in females. In longitudinal analyses, no significant associations were found in the fully adjusted model, except for a positive association between hair cortisol change between baseline and FU1 and FU1-SAD (OR: 1.07; 95% CI: 1.02; 1.12). CONCLUSIONS Results confirmed sex-specificity and the role of pubertal development in the association between cortisol with SAD and MDD, while no association emerged regarding cortisol and GAD. Future research in adolescents focusing on the role of cortisol in the pathogenesis of anxiety and depressive disorders would benefit from considering factors like sex-specificity and puberty development as well as comorbidity.
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Affiliation(s)
- Hanna Kische
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Theresa Magdalena Ollmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Catharina Voss
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Jana Hoyer
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Centre for Obesity, Städtisches Klinikum Dresden, Dresden, Germany
| | - Frank Rückert
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Lars Pieper
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Department of Biopsychology, Technische Universität Dresden, Dresden, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Center for Clinical Epidemiology and Longitudinal Studies (CELOS), Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Shirtcliff E, Hanson J, Phan J, Ruttle P, Pollak S. Hyper- and hypo-cortisol functioning in post-institutionalized adolescents: The role of severity of neglect and context. Psychoneuroendocrinology 2021; 124:105067. [PMID: 33302238 PMCID: PMC8757590 DOI: 10.1016/j.psyneuen.2020.105067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 09/27/2020] [Accepted: 11/12/2020] [Indexed: 01/30/2023]
Abstract
Understanding the developmental timing of stress exposure may help inform mechanisms underlying how stress "gets under the skin" and influences the stress response system, including the HPA axis and its end-product cortisol. Early adversity may be particularly detrimental; however, it is difficult to disentangle the timing of adversity from its cumulative burden because there is typically high continuity between early and later adversity. Moreover, context and the different stressors inherent in various contexts may interact with stress exposure to influence psychophysiological functioning. To address this issue, we examined adolescents who had been reared in institutions and suffered neglect or social deprivation ranging from approximately six months to several years of life prior to adoption into U.S. homes. We focused on the stress hormone cortisol because it can reflect continued regulatory problems in youth, even years after youth transition to typical homes. We examined cortisol morning levels and diurnal rhythms across multiple contexts (home, school, lab) on 5 separate days in 41 post-institutionalized youth and 78 comparison youth. Employing hierarchical linear modeling, we found that when assessed in the lab, post-institutionalized (PI) youth displayed lower morning cortisol levels and flatter diurnal slopes than the control youth. Yet at home, PI youth displayed higher morning cortisol levels than the control youth. In addition to group effects, we also examined severity of early adversity and found that PI kids who had endured the most severe early adversity displayed lower home cortisol levels than controls. No significant predictors of diurnal cortisol on school days were identified. These data fit with the notion that the HPA axis is impacted by early adversity, even years after adoption, and with emerging theories that postulate that stress physiology calibrates within youth to help them adapt to their context. In the case of severe early adversity, the cost of such adaptation may not be desirable. It also highlights the important role of context when assessing HPA axis activity, particularly in post-institutionalized youth.
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Perez-Tejada J, Garmendia L, Labaka A, Vegas O, Gómez-Lazaro E, Arregi A. Active and Passive Coping Strategies: Comparing Psychological Distress, Cortisol, and Proinflammatory Cytokine Levels in Breast Cancer Survivors. Clin J Oncol Nurs 2019; 23:583-590. [DOI: 10.1188/19.cjon.583-590] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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10
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Karlamangla AS, Merkin SS, Almeida DM, Friedman EM, Mogle JA, Seeman TE. Early-Life Adversity and Dysregulation of Adult Diurnal Cortisol Rhythm. J Gerontol B Psychol Sci Soc Sci 2019; 74:160-169. [PMID: 30165409 DOI: 10.1093/geronb/gby097] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Indexed: 12/20/2022] Open
Abstract
Objectives Exposure to life stresses can lead to diminution in the capacity of stress response systems to mount a robust response to new challenges, with blunting of dynamic range-the spread between maximal attainable and minimal resting levels. We investigate the association between early-life adversity and the dynamic range of adult diurnal cortisol secretion. Method In 35- to 86-year-old adults, cortisol assayed from 16 saliva samples over 4 consecutive days was used to compute diurnal dynamic range and area under the curve (AUC). Economic adversity in childhood was indexed by recalled parental education, family welfare dependence, and perceived financial status; and childhood social adversity by parental separation, death, and abuse. Results Adjusted for age, gender, and race/ethnicity, both childhood adversities were strongly associated with smaller adult cortisol diurnal dynamic range, but not with AUC. The association with cortisol dynamic range was explained by adult social and economic variables. Discussion Early-life adversity appears to leave a long-term imprint on cortisol secretion dynamics, reducing diurnal dynamic range without increasing total secretion. This points to the importance of examining the adaptation capacity of physiological systems when studying the impact of early-life and chronic stresses on adult health.
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Affiliation(s)
- Arun S Karlamangla
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Sharon Stein Merkin
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - David M Almeida
- Department of Human Development and Family Studies, Pennsylvania State University, University Park
| | | | | | - Teresa E Seeman
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
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Seitz R, Vracotas N, Bechard-Evans L, King S, Abadi S, Joober R, Shah JL, Malla AK, Pruessner M. The Trier Social Stress Test in first episode psychosis patients: Impact of perceived stress, protective factors and childhood trauma. Psychoneuroendocrinology 2019; 105:155-163. [PMID: 30658856 DOI: 10.1016/j.psyneuen.2019.01.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 01/06/2019] [Accepted: 01/10/2019] [Indexed: 11/17/2022]
Abstract
Psychosis has been associated with abnormalities in hypothalamic-pituitary-adrenal axis functioning, which may emerge through heightened stress sensitivity following early life adversity - ultimately resulting in illness onset and progression. The present study assessed cortisol levels during an established psychosocial stress task and their association with current stress perception, putative protective factors and adverse childhood experiences in patients with a first episode of psychosis (FEP). A total of 100 volunteers participated in the study, 57 of whom were patients with a FEP (mean age 23.9 ± 3.8) and 43 healthy community controls (mean age 23.2 ± 3.9). Salivary cortisol, heart rate and blood pressure were measured at eight time points before and after the Trier Social Stress Test. Subjective stress and protective factors were assessed with the Perceived Stress Scale, the Self-Esteem Rating Scale and the Brief COPE. Early life adversity was assessed with the Childhood Trauma Questionnaire. Patients compared to controls showed significantly lower cortisol levels (F = 7.38; p = .008) throughout the afternoon testing period, but no difference in the cortisol response to the TSST. Heart rate was elevated and protective factors were lower in patients compared to controls. Attenuated cortisol levels were associated with higher levels of perceived stress, poor protective factors and more physical neglect during childhood. Our results suggest that attenuated baseline cortisol levels and not a blunted response during an acute stress task might be an indicator of heightened stress vulnerability and poor resilience in psychosis. The possible influence of childhood adversity and antipsychotic medication is discussed.
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Affiliation(s)
- Raffaela Seitz
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Nadia Vracotas
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Department of Psychiatry, Montreal, Quebec, Canada
| | - Laura Bechard-Evans
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Department of Psychiatry, Montreal, Quebec, Canada
| | - Suzanne King
- Douglas Hospital Research Centre, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Sherezad Abadi
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Department of Psychiatry, Montreal, Quebec, Canada
| | - Ridha Joober
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Department of Psychiatry, Montreal, Quebec, Canada
| | - Jai L Shah
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Department of Psychiatry, Montreal, Quebec, Canada
| | - Ashok K Malla
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Department of Psychiatry, Montreal, Quebec, Canada
| | - Marita Pruessner
- Department of Psychology, University of Konstanz, Konstanz, Germany; Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, McGill University, Department of Psychiatry, Montreal, Quebec, Canada.
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12
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Kumpulainen SM, Heinonen K, Kaseva N, Andersson S, Lano A, Reynolds RM, Wolke D, Kajantie E, Eriksson JG, Räikkönen K. Maternal early pregnancy body mass index and diurnal salivary cortisol in young adult offspring. Psychoneuroendocrinology 2019; 104:89-99. [PMID: 30826632 DOI: 10.1016/j.psyneuen.2019.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 02/07/2019] [Accepted: 02/13/2019] [Indexed: 10/27/2022]
Abstract
Background Maternal early pregnancy overweight (body mass index [BMI] 25.0-29.9 kg/m2) and obesity (BMI ≥ 30 kg/m2) are associated with mental and physical health adversities in the offspring. Prenatal programming of the hypothalamic-pituitary-adrenal (HPA) axis has been put forward as one of the mechanisms that may play pathophysiological role. However, evidence linking maternal overweight and obesity with offspring HPA-axis activity is scarce. We studied if maternal early pregnancy BMI is associated with diurnal salivary cortisol, a marker of HPA-axis activity, in young adult offspring. Methods At a mean age of 25.3 (standard deviation [SD) = 0.6) years, 653 Arvo Ylppö Longitudinal Study participants collected saliva samples for cortisol analyses, at awakening, 15 and 30 min thereafter, 10:30AM, 12:00PM, 5:30PM and at bedtime. Maternal BMI was calculated from weight and height verified by a measurement in the first antenatal clinic visit before 12 weeks of gestation derived from healthcare records. Results Per each one kg/m2 higher maternal early pregnancy BMI offspring diurnal average salivary cortisol was -1.4% (95% CI:-2.6, -0.2, pFDR = 0.033) lower, at awakening it was -2.4% (95% CI:-4.0, -0.7, pFDR = 0.025) lower and the morning average salivary cortisol was -2.0% (95% CI:-3.4, -0.5, pFDR=0.017) lower. These associations were independent of the offspring's own young adulthood BMI, and other important covariates. Conclusion Our findings show that young adult offspring born to mothers with higher early pregnancy BMI show lower average levels of diurnal cortisol, especially in the morning. Whether these findings reflect prenatal programming of the offspring HPA-axis activity warrants further investigation.
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Affiliation(s)
- Satu M Kumpulainen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
| | - Kati Heinonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Nina Kaseva
- National Institute for Health and Welfare, Helsinki, Finland
| | - Sture Andersson
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Finland
| | - Aulikki Lano
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Finland
| | - Rebecca M Reynolds
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Dieter Wolke
- Department of Psychology, University of Warwick, UK
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland; Children's Hospital, Helsinki University Hospital and University of Helsinki, Finland; National Institute for Health and Welfare, Oulu, Finland; PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Finland
| | - Johan G Eriksson
- National Institute for Health and Welfare, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
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13
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Rector JL, Tay L, Wiese CW, Friedman EM. Relative sensitivity of cortisol indices to psychosocial and physical health factors. PLoS One 2019; 14:e0213513. [PMID: 30943214 PMCID: PMC6447160 DOI: 10.1371/journal.pone.0213513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 02/24/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Regulation of cortisol under resting conditions is widely used to assess physical and psychological status, but due to the diversity of possible assessments (e.g., cumulative levels; diurnal patterns), considering one or a few at a time hampers understanding and interpretation. Moreover, most studies of cortisol regulation focus on negatively-valanced experiences. This study examined the inter-correlations among cortisol indices and their relative contribution to the explained variance in diverse psychosocial and health factors, including positive functioning. METHODS Data are from midlife and older adults (N = 513; 47.2% male). Cortisol was assessed in urine (overnight) and saliva (at rest and over 4 consecutive days). Positive and negative psychosocial and health factors were assessed by self-report. In addition to examining associations among cortisol indices, relative weight analysis was used to determine which indices were most robustly linked to specific psychosocial factors. RESULTS Inter-correlations among indices were weak-to-moderate, suggesting that they measure different aspects of hypothalamic-pituitary-axis activity. Overall variance in psychosocial and health factors (R2) explained by the cortisol indices ranged from 0.01 to 0.07. Of this explained variance, relative weight analysis showed that waking cortisol contributed most to the variance in hedonic well-being (32.1%-38.2%), bedtime cortisol to depression-related factors (32.1%-46.9%), the cortisol awakening response to eudaimonic well-being (35.8%-50.5%), cortisol slope to perceived stress (29.2%), and urinary cortisol to physical factors (38.5% and 62.7%). CONCLUSIONS Positive and negative factors were related to largely non-overlapping cortisol indices. This study illuminates nuanced associations among cortisol indices and diverse aspects of mental and physical health, facilitating thoughtful examination of the complex role of hypothalamic-pituitary-axis activity in health.
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Affiliation(s)
- Jerrald L. Rector
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, United States of America
| | - Louis Tay
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, United States of America
| | - Christopher W. Wiese
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Elliot M. Friedman
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, United States of America
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14
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Parent-Lamarche A, Marchand A. Work stress, personality traits, and cortisol secretion: Testing a model for job burnout. Work 2018; 60:485-497. [DOI: 10.3233/wor-182755] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Annick Parent-Lamarche
- Department of Human Resources Management, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Alain Marchand
- School of Industrial Relations, Université de Montréal, QC, Canada
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15
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Abstract
OBJECTIVE To investigate associations between shiftwork and diurnal salivary cortisol among 319 police officers (77.7% men). METHODS Information on shiftwork was obtained from the City of Buffalo, NY electronic payroll records. Saliva was collected using Salivettes at seven time points and analyzed for free cortisol concentrations (nmol/L) using a chemiluminescence immunoassay. Mean slopes and areas under the curve were compared across shift schedule using analysis of variance (ANOVA)/analysis of covariance (ANCOVA). RESULTS Officers working primarily on the night shift had a significantly shallower slope. Mean slope (nmol/L/minutes) of the cortisol curve varied significantly across shifts (day: -0.00332 ± 0.00017, afternoon: -0.00313 ± 0.00018, night: -0.00257 ± 0.0002); adjusted P = 0.023. CONCLUSIONS Our results suggest that night shiftwork is a workplace factor that may alter the response of the hypothalamic-pituitary-adrenal (HPA) axis to the circadian cues responsible for the pattern of the diurnal cortisol curve.
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16
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Strahler J, Fischer S. Diurnal cortisol and alpha-amylase in the daily lives of older adults with vital exhaustion. Physiol Behav 2018; 185:39-45. [PMID: 29274349 DOI: 10.1016/j.physbeh.2017.12.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Vital exhaustion (VE) is characterised by unusual fatigue, increased irritability, and a feeling of demoralisation. It has been found a major risk factor for cardiovascular diseases, and one that is independent of subclinical or clinical manifestations of coronary heart disease or lifestyle-related risk factors. Stress-induced alterations in the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system may mediate the link between VE and increased cardiovascular risk. However, no studies have yet assessed both systems simultaneously and in high-risk populations, such as older adults. METHODS A total of 72 older adults (34 women, mean age 61.7±7.3) who were free of any major physical or mental illnesses filled out the Maastricht Vital Exhaustion Questionnaire (MVEQ) and the Perceived Stress Scale (PSS). To determine cortisol and alpha-amylase, participants collected saliva samples upon awakening, +30min thereafter, and at 11am, 3pm, and 8pm. RESULTS Participants with higher VE reported lower perceived stress (β=-0.515, p<0.001). Individuals reporting higher VE also exhibited more diminished cortisol concentrations across the day, although only by trend (β=-0.218, p=0.092). There was no significant association between VE and diurnal alpha-amylase activity. Moreover, women had lower diurnal cortisol (β=-0.381, p=0.004) and alpha-amylase (β=-0.329, p=0.011) when compared to men. CONCLUSIONS Our findings provide initial evidence for psychosocial stress to be linked to VE in older adults, while evidence for HPA alterations remains tentative. Future research is warranted to determine whether VE related hypocortisolaemia represents a specific stage of the stress adaptation process that may put individuals at risk for incident cardiovascular diseases.
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Affiliation(s)
- J Strahler
- Biological Psychology, Department of Psychology, University of Dresden, Germany.
| | - S Fischer
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Switzerland
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17
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Wang AW, Hoyt MA. Benefit finding and diurnal cortisol after prostate cancer: The mediating role of positive affect. Psychooncology 2018; 27:1200-1205. [PMID: 29351368 DOI: 10.1002/pon.4647] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 01/09/2018] [Accepted: 01/10/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Benefit finding (BF) has exhibited a salutary effect on psychological adjustment to cancer. However, few studies have examined its relationship with physiology or have examined BF in men with cancer. This study investigated whether BF is associated with hypothalamic-pituitary-adrenal axis activity (ie, diurnal salivary cortisol) in men treated for prostate cancer. Positive affect (PA) is proposed as a potential pathway linking BF to diurnal salivary cortisol. METHODS A sample of 66 men treated for localized prostate cancer within the prior 2 years completed questionnaires and collected salivary cortisol 3 times per day over 3 consecutive days. Hierarchical linear modeling was used for estimating the effects of BF and PA on cortisol responses as measured by diurnal slope and area under the curve (AUCg). Confidence intervals for indirect effects were estimated using the Monte Carlo method for mediation testing. RESULTS BF was significantly associated with diurnal cortisol slope, controlling for body mass index and age (B = -.12, P = .03), such that greater BF was associated with steeper cortisol slope. Analyses revealed that PA mediated the effect of BF on cortisol slope (Monte Carlo estimation 95% CI = -0.087, -0.001); negative affect did not mediate this relationship. BF was not significantly associated with AUCg. CONCLUSIONS Deriving more benefit from one's experience with prostate cancer is associated with a healthier diurnal cortisol rhythm. Through its potential to enhance PA, the relationship of BF and physiological processes underscores the health relevant value of BF in prostate cancer survivors.
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Affiliation(s)
- Ashley W Wang
- Department of Psychology, Hunter College, City University of New York, New York, NY, USA
| | - Michael A Hoyt
- Department of Psychology, Graduate Center, City University of New York, New York, NY, USA
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18
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Das S, Sengupta S, Pathak K, Sah D, Mehta S, Avinash PR, Baruah A, Deuri SK, Sarmah A, Gogoi V, Kalita KN, Hazarika J. Aggression as an independent entity even in psychosis - The role of cortisol. Psychiatry Res 2018; 259:405-411. [PMID: 29120850 DOI: 10.1016/j.psychres.2017.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 10/17/2017] [Accepted: 11/01/2017] [Indexed: 02/04/2023]
Abstract
Aggression is a common entity in psychiatric disorders, particularly psychotic disorders. Glucocorticoid hypofunction has been linked to abnormal forms of aggressive behavior in various studies in a 'possibly causal' role. We hypothesise that aggression, even among those having psychosis is associated with glucocorticoid alterations similar to those who are aggressive but not psychotic. To our knowledge, this is the first study attempting to look at the cortisol functioning in relation to both aggression and psychosis. The present study included 80 participants divided into four groups depending upon presence or absence of aggression and psychosis. Morning cortisol, afternoon cortisol and their variability were measured using ELISA. The groups were compared on measures of aggression, psychosis, morning cortisol, afternoon cortisol and their variability using standard statistical instruments. The present study found lower levels of morning cortisol, afternoon cortisol and cortisol variability among the aggressive group (vs. non aggressive group) and among the diseased group (vs. non diseased group). The differences were most marked for cortisol variability which was related to both aggression and psychosis independently. There were statistically significant correlation between cortisol variability and aggression, which was retained even after controlling for psychosis. There was no significant correlation of cortisol variability with psychosis severity (after controlling for aggression score) or with age, gender or duration of psychosis. We conclude that aggression, even among patients with psychosis, is an independent entity characterized by lower levels of morning cortisol and cortisol variability. The etio-pathology may lie in some altered neuro-immune parameters executed by cortisol and psychosis as trigger.
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Affiliation(s)
- Sourav Das
- Somnos Sleep Clinic, Kolkata, WB, India.
| | - Soumik Sengupta
- Dept. of Psychiatry, LGB Regional Institute of Mental Health, Tezpur, Assam, India
| | - Kangkan Pathak
- Dept. of Psychiatry, LGB Regional Institute of Mental Health, Tezpur, Assam, India
| | - Divyashree Sah
- Dept. of Psychology, Kumaon University, Nainital, UK, India
| | - Sumit Mehta
- Dept. of Psychiatry, LGB Regional Institute of Mental Health, Tezpur, Assam, India
| | - Priya Ranjan Avinash
- Dept. of Psychiatry, LGB Regional Institute of Mental Health, Tezpur, Assam, India
| | - Aparajeeta Baruah
- Dept. of Psychiatry, LGB Regional Institute of Mental Health, Tezpur, Assam, India
| | | | - Anil Sarmah
- Dept. of Pathology, LGB Regional Institute of Mental Health, Tezpur, Assam, India
| | - Vijay Gogoi
- Dept. of Psychiatry, LGB Regional Institute of Mental Health, Tezpur, Assam, India
| | - Kamal Narayan Kalita
- Dept. of Psychiatry, LGB Regional Institute of Mental Health, Tezpur, Assam, India
| | - Jyoti Hazarika
- Dept. of Microbiology, LGB Regional Institute of Mental Health, Tezpur, Assam, India
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19
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The effects of six-day SSRI administration on diurnal cortisol secretion in healthy volunteers. Psychopharmacology (Berl) 2018; 235:3415-3422. [PMID: 30283981 PMCID: PMC6267127 DOI: 10.1007/s00213-018-5050-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 09/20/2018] [Indexed: 12/17/2022]
Abstract
RATIONALE Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis has been widely reported in depression, and evidence suggests that selective serotonin reuptake inhibitors (SSRIs) might exert their therapeutic effects through altering cortisol secretion. OBJECTIVE This study assessed the effects of SSRI administration on diurnal cortisol secretion in healthy volunteers. METHODS Sixty-four healthy men and women were randomised to receive either 10 mg escitalopram or placebo for six days in a double-blind fashion. On day six of medication, saliva samples were obtained at home for measurement of diurnal cortisol parameters (cortisol slope, cortisol awakening response, total daily cortisol output). RESULTS Women receiving escitalopram had significantly steeper cortisol slopes across the day compared with those receiving placebo (F(1, 36) = 7.54, p = 0.009). This alteration in cortisol slope was driven by increases in waking cortisol levels (F(1, 35) = 9.21, p = 0.005). Escitalopram did not have any significant effect on the cortisol awakening response or the total daily cortisol output. CONCLUSIONS Flattened cortisol slopes have been seen in depression. The results of this study suggest that escitalopram might exert its therapeutic effect in women in part through correction of a flattened diurnal cortisol rhythm.
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20
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Classroom social experiences in early elementary school relate to diurnal cortisol levels. Psychoneuroendocrinology 2018; 87:1-8. [PMID: 29032322 DOI: 10.1016/j.psyneuen.2017.09.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 09/28/2017] [Accepted: 09/29/2017] [Indexed: 11/23/2022]
Abstract
Social stress has been linked to altered hypothalamic-pituitary-adrenocorticol (HPA) axis activation. During elementary school, children can become exposed to negative peer relations, such as poor appraisal among classroom peers, which is considered a social stressor. However, little is known about the association between classroom peer appraisal and the physiological stress system in children. The goal of this study was to examine the association of peer acceptance and peer non-acceptance with diurnal cortisol concentrations in 222 children from 20 mainstream elementary schools (Mage=6.97years, SD=0.99, 55% boys) in the Netherlands. Saliva samples were collected at awakening, 30min post-awakening, at noon and at 8 pm during a weekend day. From these assessments, the Cortisol Awakening Response (CAR), diurnal cortisol concentration (AUCg) and diurnal cortisol slope were calculated. Peer nominations of peer acceptance (being liked), and peer non-acceptance (being disliked) were collected across a one year interval. Associations were controlled for peer victimization, age, sex and SES and children's levels of emotional problems and behavioural problems. Results showed that low peer acceptance was associated with heightened diurnal cortisol concentration (i.e., heightened AUGg), lower cortisol reductions across the day (i.e., less decreasing cortisol slope) and heightened cortisol awakening response (i.e., heightened CAR). Peer non-acceptance and the interaction between peer acceptance and peer non-acceptance (known as peer rejection) were not associated with AUCg, cortisol slope or the CAR. The findings emphasize the association between poor appraisal among classroom peers and children's heightened HPA-axis activation. This underscores the importance of the physiological stress system in studying the consequences of negative peer relations in children.
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Wilkowska A, Rynkiewicz A, Wdowczyk J, Landowski J. Morning and afternoon serum cortisol level in patients with post-myocardial infarction depression. Cardiol J 2017; 26:550-554. [PMID: 29064538 DOI: 10.5603/cj.a2017.0123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 09/09/2017] [Accepted: 09/10/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Post-myocardial depression is a highly prevalent condition which worsens the course and prognosis of coronary artery disease. One possible pathogenetic factor is dysregulation of the hypothalamic-pituitary-adrenal axis, resulting in cortisol profile disturbances. METHODS Thirty seven patients hospitalized due to a first myocardial infarction (MI) were enrolled in this study. The Beck Depression Inventory (BDI) was used to rate the severity of their depressive symptoms. Morning and afternoon serum cortisol samples were taken on the fifth day of the MI. RESULTS Depression, defined as BDI ≥ 10, was present in 34.4% of the patients. A statistically significant difference was observed between the mean morning and the evening plasma concentrations in patients with depression compared to the no-depression group: F (1.29) = 5.0405, p = 0.0328. CONCLUSIONS Patients with depressive symptoms directly after MI have a flattened diurnal serum cortisol profile. This is particularly expressed in patients with longer lasting symptoms.
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Affiliation(s)
- Alina Wilkowska
- Department of Adult Psychiatry, Medical University of Gdansk, Poland.
| | - Andrzej Rynkiewicz
- Department of Cardiology and Cardiosurgery, University of Warmia and Mazury, Olsztyn, Poland
| | - Joanna Wdowczyk
- First Department of Cardiology, Medical University of Gdansk, Poland
| | - Jerzy Landowski
- Department of Adult Psychiatry, Medical University of Gdansk, Poland
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Keneski E, Neff LA, Loving TJ. The Importance of a Few Good Friends: Perceived Network Support Moderates the Association Between Daily Marital Conflict and Diurnal Cortisol. SOCIAL PSYCHOLOGICAL AND PERSONALITY SCIENCE 2017. [DOI: 10.1177/1948550617731499] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined whether the extent to which spouses feel they have available and satisfying support outside their marriage buffers spouses from the potential negative physiological effects of conflict inside their marriage. Newlywed couples ( N = 214 spouses) reported occurrences of marital conflict in a daily diary and concurrently provided morning and evening saliva samples for the calculation of daily diurnal cortisol slopes. Extending prior work demonstrating links between marital conflict and acute cortisol responses in laboratory settings, results revealed that spouses exhibited flatter (i.e., less healthy) diurnal cortisol slopes on days of greater marital conflict. Although the quantity of spouses’ support network connections was not associated with physiological responses to conflict, the quality of perceived network support attenuated the association between daily marital conflict and diurnal cortisol slopes. Thus, maintaining a satisfying network of social connections outside a marriage may protect spouses’ well-being during periods of marital difficulty.
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Affiliation(s)
| | - Lisa A. Neff
- The University of Texas at Austin, Austin, TX, USA
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23
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Boggero IA, Hostinar CE, Haak EA, Murphy MLM, Segerstrom SC. Psychosocial functioning and the cortisol awakening response: Meta-analysis, P-curve analysis, and evaluation of the evidential value in existing studies. Biol Psychol 2017; 129:207-230. [PMID: 28870447 DOI: 10.1016/j.biopsycho.2017.08.058] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 07/05/2017] [Accepted: 08/29/2017] [Indexed: 01/13/2023]
Abstract
Cortisol levels rise immediately after awakening and peak approximately 30-45min thereafter. Psychosocial functioning influences this cortisol awakening response (CAR), but there is considerable heterogeneity in the literature. The current study used p-curve and meta-analysis on 709 findings from 212 studies to test the evidential value and estimate effect sizes of four sets of findings: those associating worse psychosocial functioning with higher or lower cortisol increase relative to the waking period (CARi) and to the output of the waking period (AUCw). All four sets of findings demonstrated evidential value. Psychosocial predictors explained 1%-3.6% of variance in CARi and AUCw responses. Based on these effect sizes, cross-sectional studies assessing CAR would need a minimum sample size of 617-783 to detect true effects with 80% power. Depression was linked to higher AUCw and posttraumatic stress to lower AUCw, whereas inconclusive results were obtained for predictor-specific effects on CARi. Suggestions for future CAR research are discussed.
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Affiliation(s)
- Ian A Boggero
- Department of Psychology, University of Kentucky, 125 Kastle Hall, Lexington, KY 40506, United States.
| | - Camelia E Hostinar
- Department of Psychology, University of California, Davis, 103 Young Hall, Davis, CA 95616, United States.
| | - Eric A Haak
- Department of Psychology, University of Kentucky, 125 Kastle Hall, Lexington, KY 40506, United States.
| | - Michael L M Murphy
- Department of Psychology, Carnegie Mellon University, 5000 Forbes Ave, Pittsburgh, PA 15213, United States.
| | - Suzanne C Segerstrom
- Department of Psychology, University of Kentucky, 125 Kastle Hall, Lexington, KY 40506, United States.
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Festin K, Thomas K, Ekberg J, Kristenson M. Choice of measure matters: A study of the relationship between socioeconomic status and psychosocial resources in a middle-aged normal population. PLoS One 2017; 12:e0178929. [PMID: 28832585 PMCID: PMC5568385 DOI: 10.1371/journal.pone.0178929] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 05/22/2017] [Indexed: 12/30/2022] Open
Abstract
Psychosocial resources may serve as an important link to explain socioeconomic differences in health. Earlier studies have demonstrated that education, income and occupational status cannot be used interchangeably as indicators of a hypothetical latent social dimension. In the same manner, it is important to disentangle the effect of measuring different constructs of psychosocial resources. The aim of this study was therefore to analyse if associations between socioeconomic status (SES) and psychosocial resources differ depending on the measures used. A cross-sectional population-based study of a random sample (n = 1007) of middle-aged individuals (45-69 years old, 50% women) in Sweden was performed using questionnaire and register data. SES was measured as education, occupation, household income and self-rated economy. Psychosocial resources were measured as social integration, social support, mastery, self-esteem, sense of coherence (SOC) and trust. Logistic regression models were applied to analyse the relationships controlling for the effects of possible confounders. The measures of SES were low or moderately correlated to each other as were the measures of psychosocial resources. After controlling for age, sex, country of birth and employment status, household income and self-rated economy were associated with all six psychosocial resources; occupation was associated with three (social integration, self-esteem and trust) and education with two (social integration and self-esteem). Social integration and self-esteem showed a significant and graded relationship with all SES measures; trust was associated with all SES measures except education, whereas SOC and mastery were only associated with household income and self-rated economy. After controlling for other SES measures, no associations with psychosocial resources remained for education or occupation. In conclusion, associations between SES and psychosocial resources did differ depending on the measures used. The findings illustrate the importance of the choice of measure when investigating SES as well as psychosocial resources.
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Affiliation(s)
- Karin Festin
- Division of Community Medicine, Department of Medical and Health Sciences, Faculty of Medicine and Health, Linköping University, Linköping, Sweden
- * E-mail:
| | - Kristin Thomas
- Division of Community Medicine, Department of Medical and Health Sciences, Faculty of Medicine and Health, Linköping University, Linköping, Sweden
| | - Joakim Ekberg
- Unit for Health Analysis, Centre for Healthcare Development, Region Östergötland, Linköping, Sweden
| | - Margareta Kristenson
- Division of Community Medicine, Department of Medical and Health Sciences, Faculty of Medicine and Health, Linköping University, Linköping, Sweden
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Torrente P, Kinnunen U, Sianoja M, de Bloom J, Korpela K, Tuomisto MT, Lindfors P. The Effects of Relaxation Exercises and Park Walks During Workplace Lunch Breaks on Physiological Recovery. SCANDINAVIAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2017. [DOI: 10.16993/sjwop.19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Cortisol awakening response is blunted and pain perception is increased during menses in cyclic women. Psychoneuroendocrinology 2017; 77:158-164. [PMID: 28064085 DOI: 10.1016/j.psyneuen.2016.12.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 12/18/2016] [Accepted: 12/19/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS The incidence of menstrual symptoms is reported to be as high as 90% in cyclic women. These symptoms, including anxiety and pain, might be associated with cortisol, as its receptors are widely distributed in the brain areas associated with behavior. Therefore, the current study aimed to assess the cortisol awakening response (CAR) throughout the menstrual cycle and correlate it with pain perception and trait anxiety. MATERIALS AND METHODS CAR was assessed by measuring salivary cortisol at 0, 15, 30, and 60min following awakening in the same women (n=59, age 22.2±0.37years) at various stages of the menstrual cycle (menses, midcycle, luteal and premenstrual phases). Progesterone and estradiol concentrations were also determined in saliva samples to assess cyclic changes. Self-reported pain, trait anxiety, and menstrual symptoms were assessed by visual analog scale (VAS), state-trait anxiety inventory (STAI-T), and the Daily Record of Severity of Problems (DRSP), respectively. RESULTS Estradiol was significantly elevated during the midcycle period and remained high during the early luteal phase (p<0.05). Progesterone was increased during the luteal phase (p<0.05). Post-awakening cortisol values increased during midcycle, luteal phase, and premenstrual phase (p<0.05, classical CAR), but not during the menses (p>0.05, blunted or flat CAR). Positive and significant correlations were found between cortisol and estradiol (R2=0.322; p=0.000), cortisol and progesterone (R2=0.156; p=0.000), and estradiol and progesterone (R2=0.349; p=0.001). Premenstrual symptom scores were higher in the menses and premenstrual phases than in the midcycle and luteal phases (p<0.001). Pain perception was the highest during the menses followed by the premenstrual phase (p<0.01). CONCLUSIONS CAR was blunted during the menses, suggesting that cortisol might play a phase-specific role in the regulation of the cycle. Additionally, premenstrual symptoms, including pain, were more severe when ovarian steroid levels reduced (i.e., menses and the premenstrual phase).
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Joseph JJ, Golden SH. Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus. Ann N Y Acad Sci 2017; 1391:20-34. [PMID: 27750377 PMCID: PMC5334212 DOI: 10.1111/nyas.13217] [Citation(s) in RCA: 314] [Impact Index Per Article: 44.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Controversy exists over the role of stress and depression in the pathophysiology of type 2 diabetes mellitus. Depression has been shown to increase the risk for progressive insulin resistance and incident type 2 diabetes mellitus in multiple studies, whereas the association of stress with diabetes is less clear, owing to differences in study designs and in forms and ascertainment of stress. The biological systems involved in adaptation that mediate the link between stress and physiological functions include the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous and immune systems. The HPA axis is a tightly regulated system that represents one of the body's mechanisms for responding to acute and chronic stress. Depression is associated with cross-sectional and longitudinal alterations in the diurnal cortisol curve, including a blunted cortisol awakening response and flattening of the diurnal cortisol curve. Flattening of the diurnal cortisol curve is also associated with insulin resistance and type 2 diabetes mellitus. In this article, we review and summarize the evidence supporting HPA axis dysregulation as an important biological link between stress, depression, and type 2 diabetes mellitus.
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Affiliation(s)
- Joshua J Joseph
- Division of Endocrinology, Diabetes, and Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sherita H Golden
- Division of Endocrinology, Diabetes, and Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Sveinsdottir V, Eriksen HR, Ursin H, Hansen ÅM, Harris A. Cortisol, Health, and Coping in Patients with Nonspecific Low Back Pain. Appl Psychophysiol Biofeedback 2016; 41:9-16. [PMID: 26287577 DOI: 10.1007/s10484-015-9300-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Subjective health complaints (SHC), including nonspecific low back pain (LBP) as the most common single complaint, are the main reasons for long-term sick leave in many western countries. These complaints are often attributed to "stress". Cortisol has frequently been considered a biomarker reflecting sustained physiological HPA-axis activity, and is characterized by a high cortisol awakening response (CAR) and low evening values. The aim of the study was to investigate whether LBP patients had a normal characteristic cortisol profile, and whether possible deviations were related to coping and health. 305 patients on long-term sick leave for LBP participated in the study, and saliva cortisol profiles were compared to a reference population consisting of Danish workers. Cortisol was measured upon awakening, after 30 min, and in the evening. Additionally, patients answered questionnaires about SHC, fatigue, pain, coping, and social support. The patients showed a seemingly normal cortisol profile. However, CAR was larger among patients compared to the reference population. Patients with low cortisol reactivity had more SHC, pain, and fatigue, and those with higher evening cortisol reported higher scores on coping. The results are discussed in terms of theory, practical considerations, and possible mechanisms for the association between cortisol, health, and coping.
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Affiliation(s)
| | - Hege R Eriksen
- Uni Research Health, Uni Research, POB 7810, 5020, Bergen, Norway
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Holger Ursin
- Uni Research Health, Uni Research, POB 7810, 5020, Bergen, Norway
| | - Åse M Hansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Anette Harris
- Uni Research Health, Uni Research, POB 7810, 5020, Bergen, Norway
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
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Lu S, Gao W, Huang M, Li L, Xu Y. In search of the HPA axis activity in unipolar depression patients with childhood trauma: Combined cortisol awakening response and dexamethasone suppression test. J Psychiatr Res 2016; 78:24-30. [PMID: 27049575 DOI: 10.1016/j.jpsychires.2016.03.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 03/07/2016] [Accepted: 03/23/2016] [Indexed: 11/28/2022]
Abstract
The aim of the present study was to examine the impact of childhood trauma on HPA axis activity both in depression patients and healthy controls in order to determine the role of HPA axis abnormalities in depression and to find the differences in HPA axis functioning that may lead certain individuals more susceptible to the depressogenic effects of childhood trauma. Eighty subjects aged 18-45 years were recruited into four study groups (n = 18, depression patients with childhood trauma exposures, CTE/MDD; n = 17, depression patients without childhood adversity, non-CTE/MDD; n = 23, healthy persons with childhood trauma, CTE/non-MDD; and n = 22, healthy persons without childhood adversity, non-CTE/non-MDD). Each participant collected salivary samples in the morning at four time points: immediately upon awakening, 30, 45, and 60 min after awakening for the assessment of CAR and underwent a 1 mg-dexamethasone suppression test (DST). Regardless of depression, subjects with CTE exhibited an enhanced CAR and the CAR areas under the curve to ground (AUCg) were associated with their childhood trauma questionnaire (CTQ) physical neglect scores and CTQ total scores. In addition, the CTE/MDD group also showed a highest post-DST cortisol concentration and a decreased glucocorticoid feedback inhibition among four groups of subjects. The present findings suggested that childhood trauma was associated with hyperactivity of HPA axis as measured with CAR, potentially reflecting the vulnerability for developing depression after early life stress exposures. Moreover, dysfunction of the GR-mediated negative feedback control might contribute to the development of depression after CTE.
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Affiliation(s)
- Shaojia Lu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Weijia Gao
- Department of Child Psychology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Manli Huang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Lingjiang Li
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, China.
| | - Yi Xu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China.
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Sladek MR, Doane LD, Jewell SL, Luecken LJ. Social support coping style predicts women's cortisol in the laboratory and daily life: the moderating role of social attentional biases. ANXIETY STRESS AND COPING 2016; 30:66-81. [PMID: 27189781 DOI: 10.1080/10615806.2016.1181754] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Social stress and associated coping responses can profoundly influence women's stress physiology and health. Implicit social attentional biases can also influence psychological and physiological stress responses. The purpose of this study was to explore whether a coping style characterized by greater use of social support predicts indices of cortisol activity in laboratory and daily life contexts among female university students. We hypothesized that the relation of this coping style to cortisol activity would be moderated by women's attentional biases. METHODS Seventy-four women (Mage = 19.44, range: 17.8-27.8, 64% White) completed an interpersonal stress task and an attentional bias task in the lab, along with a self-report coping inventory. Participants provided five saliva samples during the lab protocol, followed by three saliva samples per day for three consecutive weekdays. Outcome measures included cortisol response to lab tasks (AUCg), diurnal cortisol slope, diurnal AUCg, and cortisol awakening response (CARi). RESULTS A coping style characterized by greater use of social support predicted lower lab AUCg and lower, flatter average diurnal cortisol slope for women with attentional avoidance compared to women with attentional vigilance (ps < .05). CONCLUSIONS Responding to stress by using social support is linked to lower cortisol responses to social stress and diurnal cortisol activity for women with implicit avoidance of social threat cues.
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Affiliation(s)
- Michael R Sladek
- a Department of Psychology , Arizona State University , Tempe , AZ , USA
| | - Leah D Doane
- a Department of Psychology , Arizona State University , Tempe , AZ , USA
| | - Shannon L Jewell
- a Department of Psychology , Arizona State University , Tempe , AZ , USA
| | - Linda J Luecken
- a Department of Psychology , Arizona State University , Tempe , AZ , USA
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Rudolph KE, Sánchez BN, Stuart EA, Greenberg B, Fujishiro K, Wand GS, Shrager S, Seeman T, Diez Roux AV, Golden SH. Job Strain and the Cortisol Diurnal Cycle in MESA: Accounting for Between- and Within-Day Variability. Am J Epidemiol 2016; 183:497-506. [PMID: 26905339 DOI: 10.1093/aje/kwv280] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 10/09/2015] [Indexed: 11/14/2022] Open
Abstract
Evidence of the link between job strain and cortisol levels has been inconsistent. This could be due to failure to account for cortisol variability leading to underestimated standard errors. Our objective was to model the relationship between job strain and the whole cortisol curve, accounting for sources of cortisol variability. Our functional mixed-model approach incorporated all available data-18 samples over 3 days-and uncertainty in estimated relationships. We used employed participants from the Multi-Ethnic Study of Atherosclerosis Stress I Study and data collected between 2002 and 2006. We used propensity score matching on an extensive set of variables to control for sources of confounding. We found that job strain was associated with lower salivary cortisol levels and lower total area under the curve. We found no relationship between job strain and the cortisol awakening response. Our findings differed from those of several previous studies. It is plausible that our results were unique to middle- to older-aged racially, ethnically, and occupationally diverse adults and were therefore not inconsistent with previous research among younger, mostly white samples. However, it is also plausible that previous findings were influenced by residual confounding and failure to propagate uncertainty (i.e., account for the multiple sources of variability) in estimating cortisol features.
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Zhang B, Ding X, Lu W, Zhao J, Lv Q, Yi Z, Zhang S, Chen Y. Effect of group cognitive-behavioral therapy on the quality of life and social functioning of patients with mild depression. SHANGHAI ARCHIVES OF PSYCHIATRY 2016; 28:18-27. [PMID: 27688640 PMCID: PMC4984610 DOI: 10.11919/j.issn.1002-0829.215116] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Several studies of moderate-to-severe depression have shown that combined treatment with individual cognitive behavioral therapy (CBT) and antidepressant medication is better than either CBT or antidepressants alone. Less research has focused on the outcomes of group-CBT and antidepressants in persons with mild depression. AIM Evaluate the effects of group-CBT in combination with antidepressants on the quality of life and social functioning of outpatients with mild depression. METHODS We randomized 62 outpatients with mild depression into a control group (n=30) that received antidepressant medication for 12 weeks and an intervention group (n=32) that received antidepressants and group-CBT for 12 weeks; both groups were then continued on antidepressants alone for one year. Blinded evaluators used Chinese versions of the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Social Disability Screening Schedule, Life Satisfaction Rating, Multidimensional Scale of Perceived Social Support, and Short Form Health Survey to assess participants after 12 weeks of treatment and at the end of one year of follow-up. RESULTS Repeated measures analysis of variance showed that the depressive and anxiety symptoms of both groups improved significantly during treatment and that the improvement was greater in the CBT+antidepressant experimental group. Almost all of the social functioning, social support, and quality of life measures also showed significantly greater improvement in the CBT+antidepressant group than in the antidepressant-only group. Moreover, even after adjusting for differences in baseline demographic and clinical characteristics and for changes in the severity of depression and anxiety over time using an analysis of covariance, the greater improvement in the CBT+antidepressant group remained statistically significant both after the 12 weeks of group-CBT treatment and one year after the group CBT had ended. CONCLUSION Antidepressants alone or combined treatment with antidepressants and group-CBT can effectively improve the social function, quality of life, and healthy functioning of individuals with mild depression. However, combined treatment with both antidepressants and group CBT is better than treatment with antidepressants alone, and these benefits persist for up to one year after the CBT sessions have ended.
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Affiliation(s)
| | | | - Weihong Lu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qinyu Lv
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenghui Yi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Yindi Chen
- Shanghai Kangping Hospital, Shanghai, China
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Mitchell AM, Pössel P, Van Voorhees BW, Eaton WW. Associations of depression status and hopelessness with breast cancer: A 24-year follow-up study. J Health Psychol 2016; 22:1322-1331. [DOI: 10.1177/1359105315626998] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study extended the literature by examining whether three profiles of depression predicted breast cancer status. In 1076 women of the Baltimore Epidemiologic Catchment Area study, depression status and hopelessness were measured at baseline and breast cancer status was ascertained 24 years later. Double depression, but not major depression or dysthymia, was associated with breast cancer. Hopelessness predicted fewer new cases of breast cancer. When double depression and hopelessness were simultaneously entered as predictors, the regression weights of both predictors increased. The role of severe and extended duration depression as well as possible explanations for unexpected findings are discussed.
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Parent-Lamarche A, Marchand A. The moderating role of personality traits in the relationship between work and salivary cortisol: a cross-sectional study of 401 employees in 34 Canadian companies. BMC Psychol 2015; 3:45. [PMID: 26666334 PMCID: PMC4678572 DOI: 10.1186/s40359-015-0102-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 12/07/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this study was to evaluate the contribution of personality traits in explaining the relationship between workplace stressors and variations in salivary cortisol concentrations. METHOD Multilevel regression analyses were performed on a sample of 401 employees from 34 Quebec firms. Saliva samples were collected five times a day (on awakening, 30 min after awakening, and at 2 p.m., 4 p.m., and bedtime). Sample collection was repeated on three days (1 rest day, 2 working days). Work-related variables comprised skill utilization, decision authority, psychological demands, physical demands, job insecurity, irregular schedule, number of working hours, and social support from coworkers and supervisors. Personality traits comprised self-esteem, locus of control, and the Big Five. RESULTS Cortisol levels at awakening and 30 min later were significantly higher for work days than for days off. Psychological demands and job insecurity were associated with lower cortisol levels at bedtime. Also, self-esteem moderated the relationship between physical demands and cortisol levels at awakening and 4 p.m. Agreeableness was associated with lower cortisol levels at awakening and at 2 p.m. and further moderated the relationship between number of hours worked and cortisol at 2 p.m. Neuroticism moderated the relationship between coworker support and cortisol at bedtime. CONCLUSION Specific working conditions and certain personality traits are associated with variations in salivary cortisol concentrations. In addition, certain personality traits moderate the relationship between stressors and salivary cortisol concentrations. In conclusion, salivary cortisol concentrations at work seem to be modulated in part by personality traits.
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Affiliation(s)
- Annick Parent-Lamarche
- School of Industrial Relations, University of Montreal, C.P. 6128, Succ. Centre-ville, Montreal, QC, H3C 3 J7, Canada.
| | - Alain Marchand
- School of Industrial Relations, University of Montreal, C.P. 6128, Succ. Centre-ville, Montreal, QC, H3C 3 J7, Canada.
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Miller-Graff LE, Cater ÅK, Howell KH, Graham-Bermann SA. Victimization in childhood: General and specific associations with physical health problems in young adulthood. J Psychosom Res 2015. [PMID: 26208402 DOI: 10.1016/j.jpsychores.2015.07.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The goal of the current study was to examine the direct relationship between diverse types of childhood victimization and physical health problems in early adulthood, controlling for other common factors that contribute to physical health problems, including psychopathology and health risk behaviors. The associations between types of victimization (e.g., physical assault) and specific health problems (e.g., pain) were also examined. METHODS 2500 Swedish young adults reported on their exposure to victimization in childhood and their current mental and physical health as adults. RESULTS Using multiple regression, results indicated that the amount of childhood victimization was a significant predictor of health problems in adulthood, controlling for the significant negative effects of health risk behaviors and mental health problems on physical health. Logistic regressions indicated that physical assaults and sexual abuse were associated with all types of health problems assessed. Sleep problems were associated with almost all types of victimization history. CONCLUSIONS The long-term effects of childhood victimization on physical health in adulthood are serious and warrant significant attention. Primary care providers should include assessments of past victimization as one way of screening for health risk. Health providers should also consider multiple points of intervention that may help to reduce physical illness. For example, providing a mental health intervention or social service support related to victimization experiences may not only address these difficulties, but also more broadly impact physical health as well.
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Affiliation(s)
- Laura E Miller-Graff
- Department of Psychology, Kroc Institute for International Peace Studies, University of Notre Dame, 107 Haggar Hall, Notre Dame, IN 46556, United States.
| | - Åsa Källström Cater
- School of Law, Psychology and Social Work, Örebro University, 701 82 Örebro, Sweden
| | - Kathryn H Howell
- Department of Psychology, University of Memphis, 202 Psychology Building, Memphis, TN 38152, United States
| | - Sandra A Graham-Bermann
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109-1043, United States
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Do depressive symptoms mediate the relationship between hopelessness and diurnal cortisol rhythm? Int J Behav Med 2015; 22:251-7. [PMID: 25475609 DOI: 10.1007/s12529-014-9422-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Research has revealed a well-established relationship of depressive symptoms and hopelessness with a variety of physical illnesses that are associated with a dysfunction of the hypothalamic-pituitary-adrenal-axis. PURPOSE The purpose of this study was to test if depressive symptoms mediate the relationship between hopelessness and cortisol, a measure of the hypothalamic-pituitary-adrenal-axis. METHODS Hopelessness, depressive symptoms, and diurnal cortisol rhythm were measured in 257 adults (128 women and 129 men; age range, 20-74 years) in this cross-sectional study. To test the hypothesis, two linear regression analyses and asymmetrical confidence intervals around the regression weights were conducted. A second set of analyses was calculated to be able to exclude the possibility of hopelessness as a mediator between depressive symptoms and cortisol. RESULTS As predicted, after adjusting for age, gender, awakening time, and medication use, more hopelessness predicted more depressive symptoms and more depressive symptoms predicted a flatter diurnal cortisol rhythm. The 95% confidence intervals revealed that the indirect relationship between hopelessness and diurnal cortisol rhythm was significant. The analyses with hopelessness as a potential mediator revealed that hopelessness does not mediate the association between depressive symptoms and cortisol. CONCLUSIONS While the relationship between hopelessness and cortisol was mediated by depressive symptoms in this cross-sectional study, many other risk factors of depression have not been examined. Thus, future longitudinal studies should examine the relationships between those risk factors of depression and the hypothalamic-pituitary-adrenal-axis.
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Messerli-Bürgy N, Molloy GJ, Poole L, Wikman A, Kaski JC, Steptoe A. Psychological coping and recurrent major adverse cardiac events following acute coronary syndrome. Br J Psychiatry 2015; 207:256-61. [PMID: 25953890 DOI: 10.1192/bjp.bp.114.154419] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 10/25/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND Depressed mood and stress are associated with recurrent adverse outcomes following acute coronary syndrome (ACS), but the impact of psychological coping style has not been evaluated in detail. AIMS We tested the relationship between task-oriented coping and event-free survival following ACS. METHOD We followed 158 patients with ACS for an average of 59.8 months for major adverse cardiac outcomes. Psychological coping was assessed with the Coping Inventory of Stressful Situations. RESULTS Compared with patients in the lower half of the distribution, those reporting higher task-oriented coping had a reduced hazard of adverse cardiac events (hazard ratio (HR) = 0.28, 95% CI 0.11-0.68, P = 0.005) independently of demographic, clinical and behavioural covariates. The combination of low task-oriented coping and high depressive symptoms showed a strong association with adverse outcomes (HR = 6.25, 95% CI 1.88-20.82, P = 0.003). CONCLUSIONS The tendency to cope using task-oriented strategies may promote event-free survival following ACS.
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Affiliation(s)
- Nadine Messerli-Bürgy
- Nadine Messerli-Bürgy, PhD, Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland; Gerard J. Molloy, PhD, School of Psychology, National University of Ireland, Galway, Ireland; Lydia Poole, PhD, Department of Epidemiology and Public Health, University College London, London, UK; Anna Wikman, PhD, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Joan Carlos Kaski, MD, Division of Cardiac and Vascular Sciences, St. George's, University of London, London, UK; Andrew Steptoe, DSc, Department of Epidemiology and Public Health, University College London, London, UK
| | - Gerard J Molloy
- Nadine Messerli-Bürgy, PhD, Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland; Gerard J. Molloy, PhD, School of Psychology, National University of Ireland, Galway, Ireland; Lydia Poole, PhD, Department of Epidemiology and Public Health, University College London, London, UK; Anna Wikman, PhD, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Joan Carlos Kaski, MD, Division of Cardiac and Vascular Sciences, St. George's, University of London, London, UK; Andrew Steptoe, DSc, Department of Epidemiology and Public Health, University College London, London, UK
| | - Lydia Poole
- Nadine Messerli-Bürgy, PhD, Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland; Gerard J. Molloy, PhD, School of Psychology, National University of Ireland, Galway, Ireland; Lydia Poole, PhD, Department of Epidemiology and Public Health, University College London, London, UK; Anna Wikman, PhD, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Joan Carlos Kaski, MD, Division of Cardiac and Vascular Sciences, St. George's, University of London, London, UK; Andrew Steptoe, DSc, Department of Epidemiology and Public Health, University College London, London, UK
| | - Anna Wikman
- Nadine Messerli-Bürgy, PhD, Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland; Gerard J. Molloy, PhD, School of Psychology, National University of Ireland, Galway, Ireland; Lydia Poole, PhD, Department of Epidemiology and Public Health, University College London, London, UK; Anna Wikman, PhD, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Joan Carlos Kaski, MD, Division of Cardiac and Vascular Sciences, St. George's, University of London, London, UK; Andrew Steptoe, DSc, Department of Epidemiology and Public Health, University College London, London, UK
| | - Juan Carlos Kaski
- Nadine Messerli-Bürgy, PhD, Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland; Gerard J. Molloy, PhD, School of Psychology, National University of Ireland, Galway, Ireland; Lydia Poole, PhD, Department of Epidemiology and Public Health, University College London, London, UK; Anna Wikman, PhD, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Joan Carlos Kaski, MD, Division of Cardiac and Vascular Sciences, St. George's, University of London, London, UK; Andrew Steptoe, DSc, Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrew Steptoe
- Nadine Messerli-Bürgy, PhD, Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland; Gerard J. Molloy, PhD, School of Psychology, National University of Ireland, Galway, Ireland; Lydia Poole, PhD, Department of Epidemiology and Public Health, University College London, London, UK; Anna Wikman, PhD, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Joan Carlos Kaski, MD, Division of Cardiac and Vascular Sciences, St. George's, University of London, London, UK; Andrew Steptoe, DSc, Department of Epidemiology and Public Health, University College London, London, UK
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The Cortisol Awakening Response in Patients with Poststroke Depression Is Blunted and Negatively Correlated with Depressive Mood. BIOMED RESEARCH INTERNATIONAL 2015; 2015:709230. [PMID: 26417598 PMCID: PMC4568330 DOI: 10.1155/2015/709230] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 01/12/2015] [Indexed: 12/13/2022]
Abstract
It is important to reduce poststroke depression (PSD) to improve the stroke outcomes and quality of life in stroke patients, but the underlying mechanisms of PSD are not completely understood. As many studies implicate dysregulation of hypothalamic-pituitary-adrenal axis in the etiology of major depression and stroke, we compared the cortisol awakening response (CAR) of 28 admitted PSD patients with that of 23 age-matched caregiver controls. Saliva samples for cortisol measurement were collected immediately, 15, 30, and 45 min after awakening for two consecutive days. Depressive mood status in PSD patients was determined with Beck Depression Inventory and Hamilton Depression Rating Scale. Salivary cortisol levels of PSD patients did not rise significantly at any sampling time, showing a somewhat flat curve. Caregiver controls showed significantly higher CAR at 15 and 30 min after awakening compared to PSD patients even though the two groups did not differ at awakening or 45 min after awakening. Area-under-the-curve analysis revealed a significant negative correlation between the CAR and the degree of depression in PSD patients. Thus, our findings suggest that poststroke depression is closely related with dysfunctional HPA axis indicated by blunted CAR.
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Psychological resources are associated with reduced incidence of coronary heart disease. An 8-year follow-up of a community-based Swedish sample. Int J Behav Med 2015; 22:77-84. [PMID: 24430130 PMCID: PMC4311061 DOI: 10.1007/s12529-014-9387-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND A large number of studies have provided clear evidence for a link between the risk of coronary heart disease and psychological risk factors. Much less attention has been given to the potential protective effect of psychological resources. PURPOSE The major aim of this study was to investigate the independent association between psychological resources and incidence of coronary heart disease (CHD) in an 8-year follow-up study of a Swedish community-based cohort. METHODS The cohort consisted of 484 men and 497 women, aged 45-69 years at baseline. The incidence of first-time major event of CHD was analysed in relation to baseline levels of psychological resources, including mastery, self-esteem, and sense of coherence as well as psychological risk factors including cynicism and hostile affect, vital exhaustion, hopelessness, and depressive symptoms. In Cox proportional hazard models, adjustments were made for age, sex, eight traditional cardiovascular risk factors, and depressive symptoms. RESULTS A total of 56 CHD events had occurred after the 8-year follow-up. After adjustment for age, sex, and eight traditional risk factors, a significantly decreased risk of CHD was found for mastery (HR 0.62 per SD, p = 0.003), self-esteem (HR 0.64, p = 0.004), and sense of coherence (HR 0.70, p = 0.031). An increased risk of CHD was found for vital exhaustion (HR 1.46, p = 0.014), hopelessness (HR 1.59, p = 0.003), and depressive symptoms (HR 1.45, p = 0.009). After further adjustment for depressive symptoms, significant associations remained for mastery (HR 0.67, p = 0.034), self-esteem (HR 0.69, p = 0.048), and hopelessness (HR 1.48, p = 0.023). CONCLUSIONS The psychological resources, mastery and self-esteem, showed robust protective effects on CHD, also after adjustment for established risk factors as well as depressive symptoms. In parallel, hopelessness was an independent risk factor for CHD. The results may have implications for novel approaches in preventive efforts.
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Abstract
OBJECTIVE Hostility is associated with cardiovascular mortality and morbidity, and one of the mechanisms may involve heightened reactivity to mental stress. However, little research has been conducted in populations at high risk for cardiovascular disease. The aim of the present study was to assess the relationship between hostility and acute stress responsivity in individuals with Type 2 diabetes. METHODS A total of 140 individuals (median age [standard deviation] 63.71 [7.00] years) with Type 2 diabetes took part in laboratory-based experimental stress testing. Systolic blood pressure, diastolic blood pressure, heart rate, plasma interleukin-6 (IL-6), and salivary cortisol were assessed at baseline, during two stress tasks, and 45 and 75 minutes later. Cynical hostility was assessed using the Cook Medley Cynical Hostility Scale. RESULTS Participants with greater hostility scores had heightened increases in IL-6 induced by the acute stress tasks (B = 0.082, p = .002), independent of age, sex, body mass index, smoking, household income, time of testing, medication, and baseline IL-6. Hostility was inversely associated with cortisol output poststress (B = -0.017, p = .002), independent of covariates. No associations between hostility and blood pressure or heart rate responses were observed. CONCLUSIONS Hostile individuals with Type 2 diabetes may be susceptible to stress-induced increases in inflammation. Further research is needed to understand if such changes increase the risk of cardiovascular disease in this population.
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Drake EC, Sladek MR, Doane LD. Daily cortisol activity, loneliness, and coping efficacy in late adolescence: A longitudinal study of the transition to college. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2015; 40:334-345. [PMID: 28979055 DOI: 10.1177/0165025415581914] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Many late adolescents who transition to the college environment perceive changes in psychosocial stress. One such stressor, loneliness, has been associated with numerous health problems among adolescents and adults. The hypothalamic-pituitary-adrenal axis is one mechanism through which loneliness may affect health. Guided by a risk and resilience framework, the present study investigated the association between longitudinal changes in loneliness from high school to college and diurnal cortisol activity (waking levels, cortisol awakening response, diurnal slope) by sampling saliva intensively 5 times a day for 3 weekdays in a US sample of late adolescents in their first semester of college (N = 70; Mage = 18.49, SD = 0.38). The present study also explored how the link between loneliness and cortisol might depend on coping efficacy-one's belief in successfully coping with future stressors or novel situations. Results from hierarchical linear growth curve models demonstrated that an increase in loneliness across this contextual transition was associated with steeper cortisol slopes in college. Coping efficacy at baseline (in high school) significantly moderated the relation between changes in loneliness and diurnal slopes, such that late adolescents with low levels of coping efficacy who reported increased loneliness across the transition exhibited significantly flatter diurnal slopes in college. Higher levels of coping efficacy at baseline also significantly predicted lower waking cortisol levels during the first semester of college. These results suggest that coping efficacy may serve as a protective factor by contributing to regulation of daily physiological stress activity for late adolescents as they struggle with loneliness across the transition to college.
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Kuhlman KR, Geiss EG, Vargas I, Lopez-Duran NL. Differential associations between childhood trauma subtypes and adolescent HPA-axis functioning. Psychoneuroendocrinology 2015; 54:103-14. [PMID: 25704913 PMCID: PMC4384935 DOI: 10.1016/j.psyneuen.2015.01.020] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 01/21/2015] [Accepted: 01/22/2015] [Indexed: 10/24/2022]
Abstract
UNLABELLED Studies examining the association between childhood trauma exposure and neuroendocrine functioning have returned inconsistent findings. To date, few studies have accounted for the role exposure to different types of childhood trauma may have on different neuroendocrine adaptations, and no study has examined this association using multiple indices of hypothalamic-pituitary-adrenal axis (HPA-axis) functioning. The purpose of this study was to characterize the unique associations between exposure to physical abuse, emotional abuse, and non-intentional trauma, and multiple indices of HPA-axis functioning. METHODS A community sample of 138 youth (aged 9-16) completed the Socially Evaluated Cold Pressor Task (SE-CPT) while their parents completed the Early Trauma Inventory (ETI). All youth then collected 4 diurnal salivary cortisol samples at home across 2 consecutive weekdays. RESULTS High reported exposure to non-intentional trauma was associated with intact diurnal regulation but elevated cortisol at bedtime, physical abuse was associated with faster reactivity to acute stress, and emotional abuse was associated with delayed recovery of cortisol following acute stress. Taken together, there was a heterogeneous relationship among different indices of HPA-axis functioning and trauma subtype. DISCUSSION Different types of childhood trauma exposure are related to distinct anomalies in HPA-axis functioning. This study underscores the importance of research incorporating multiple indices of HPA-axis functioning to inform our understanding of the underlying neuroendocrine dysregulation that may later lead to stress-related psychopathology.
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Affiliation(s)
- Kate R. Kuhlman
- University of California, Los Angles, Department of Psychology, Los Angeles, CA, United States,Corresponding author at: 502 Portola Plaza, University of California, Los Angeles, Los Angeles, CA 90095, United States. (K.R. Kuhlman)
| | - Elisa G. Geiss
- University of Michigan, Department of Psychology, Ann Arbor, MI, United States
| | - Ivan Vargas
- University of Michigan, Department of Psychology, Ann Arbor, MI, United States
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Lovell B, Moss M, Wetherell MA. The psychophysiological and health corollaries of child problem behaviours in caregivers of children with autism and ADHD. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:150-7. [PMID: 23889770 DOI: 10.1111/jir.12081] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/02/2013] [Indexed: 05/25/2023]
Abstract
BACKGROUND The positive relationship between problem behaviours of children with additional complex needs and psychological distress in their caregivers has been widely evidenced. Fewer studies, however, have assessed the relationship between care recipients' problem behaviours and key physiological processes, relevant for the physical health status of their care providers. This study examined the psychological, endocrine and health corollaries of child problem behaviours in caregivers of children with autism and attention deficit hyperactivity disorder. METHODS Caregivers (n = 18) completed self-report measures of psychological distress, child problem behaviours and incidences of commonly occurring ailments. To capture important parameters of the basal diurnal cortisol pattern, caregivers collected saliva samples at waking, 30 min post waking, 1200 h and 2200 h on two consecutive weekdays. RESULTS Data revealed a positive relationship between caregivers' perceived levels of stress and problems with child conduct behaviours. In addition, caregivers who reported more problems with child emotional and hyperactivity behaviours displayed atypical cortisol patterns characterised by flatter diurnal cortisol slopes and reduced cortisol awakening response magnitude. Subjective reports of commonly occurring ailments were also greater in caregivers experiencing more problems with child emotional behaviours. CONCLUSIONS These findings have implications for interventions that aim to improve the psychophysiological well-being of the caregiver by targeting problem behaviours of the care recipient.
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Affiliation(s)
- B Lovell
- Department of Psychology, Stress Research Group, Northumbria University, Newcastle upon Tyne, UK
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Slatcher RB, Chi P, Li X, Zhao J, Zhao G, Ren X, Zhu J, Stanton B. Associations between coping and diurnal cortisol among children affected by parental HIV/AIDS. Health Psychol 2015; 34:802-10. [PMID: 25581701 DOI: 10.1037/hea0000169] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Prior research has shown that early life adversity is associated with physical health problems, but little is known about the health-related effects of coping in the context of having a parent with HIV/AIDS. The goal of this study was to investigate the associations between positive and negative coping strategies and diurnal cortisol among children affected by parental HIV/AIDS. METHOD Participants were 645 children aged 8-15 affected by parental HIV/AIDS, who provided 4 saliva samples per day over 3 days (2 weekdays and 1 weekend day) to assess diurnal cortisol. Positive and negative coping strategies were measured via self-report prior to saliva collection. Possible confounds of the associations between coping and diurnal cortisol also were assessed, including age, gender, socioeconomic status, parenting quality, parental death, other stressful life events, sleep quality, and perceived health status. RESULTS Greater positive coping (e.g., problem solving, cognitive reframing) was associated with children's higher morning cortisol (p = .037), whereas greater negative coping (e.g., fighting, breaking things) was independently associated with lower morning cortisol (p = .038) and a flatter diurnal cortisol slope (p = .003). These associations remained significant after controlling for potential confounds. Neither positive coping nor negative coping interacted with stressful life circumstances to predict cortisol (all ps > .27). CONCLUSION These findings indicate the extent to which a child's coping strategy is associated with indicators of stress biology in the context of having a parent with HIV/AIDS.
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Abstract
A vast body of literature has revealed that dysregulation of the hypothalamic-pituitary-adrenal (HPA) stress axis is associated with etiology of major depressive disorder (MDD). There are many ways that the dysregulation of the HPA axis can be assessed: by sampling diurnal basal secretion and/or in response to a stress task, pharmacological challenge, and awakening. Here, we focus on the association between cortisol awakening response (CAR), as one index of HPA axis function, and MDD, given that the nature of this association is particularly unclear. Indeed, in the following selective review, we attempt to reconcile sometimes-divergent evidence of the role of CAR in the pathway to depression. We first examine association of CAR with psychological factors that have been linked with increased vulnerability to develop depression. Then, we summarize the findings regarding the CAR profile in those with current depression, and evaluate evidence for the role of CAR following depression resolution and continued vulnerability. Finally, we showcase longitudinal studies showing the role of CAR in predicting depression onset and recurrence. Overall, the studies reveal an important, but complex, association between CAR and vulnerability to depression.
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Affiliation(s)
- Katarina Dedovic
- Department of Psychiatry, Douglas Hospital Research Centre, Montreal, QC, Canada ; Social and Affective Neuroscience Laboratory, University of California, Los Angeles, CA, USA
| | - Janice Ngiam
- Department of Psychology, McGill University, Montreal, QC, Canada
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Gassling V, Kessler H, Klein MO, Detjen AM, Koos B, Limbrecht-Ecklundt K, Traue HC, Wiltfang J, Gerber WD. Normal emotion regulation in adults with cleft lip and palate: An exploratory study. J Craniomaxillofac Surg 2014; 42:1271-6. [DOI: 10.1016/j.jcms.2014.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 12/27/2013] [Accepted: 03/10/2014] [Indexed: 11/29/2022] Open
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Merswolken M, Deter HC, Siebenhuener S, Orth-Gomér K, Weber CS. Anxiety as predictor of the cortisol awakening response in patients with coronary heart disease. Int J Behav Med 2014; 20:461-7. [PMID: 22476865 DOI: 10.1007/s12529-012-9233-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Anxiety is associated with worse outcomes in patients with coronary heart disease (CHD). A dysregulation of the HPA axis is a potential mechanism linking psychological factors and coronary disease. No study has yet investigated the relationship between anxiety and cortisol among patients with established CHD. PURPOSE The aim of this study was to assess the association between anxiety and the cortisol awakening response in patients with CHD. METHOD Four salivary cortisol samples were used to assess two measures of the cortisol awakening response (CAR) in 47 patients with established CHD. Anxiety was measured using the Hospital Anxiety and Depression Scale (HADS). RESULTS Higher anxiety values were associated with a higher total output of cortisol in the first hour after awakening (AUCg, area under the curve with respect to ground) (p = 0.04) and a nonsignificant trend towards a more pronounced increase (AUCi, area under the curve with respect to increase) (p = 0.08). In patients who had a history of myocardial infarction (MI), the cortisol output was lower compared to patients who had no previous MI (p = 0.02). In linear regression analyses, anxiety emerged as significant predictor of AUCg and AUCi after controlling for MI, ejection fraction (LVEF, left ventricular ejection fraction), and depression. CONCLUSIONS Our results provide further indications for an association between anxiety and a dysregulation of the HPA axis. History of MI emerged as second predictor of cortisol output in the morning.
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Affiliation(s)
- Melanie Merswolken
- Medical Clinic, Psychosomatic Medicine, Charité Universitätsmedizin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany,
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Chou KL, Cacioppo JT, Kumari M, Song YQ. Influence of social environment on loneliness in older adults: Moderation by polymorphism in the CRHR1. Am J Geriatr Psychiatry 2014; 22:510-8. [PMID: 23933425 DOI: 10.1016/j.jagp.2012.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 09/19/2012] [Accepted: 11/01/2012] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Both adverse social environments and genetic factors contribute to loneliness in old age. Mixed findings between older adults' social relations with their children and their levels of loneliness suggested that a gene × social environment interaction may be operating. We examine whether the effects of infrequent contact with children and low levels of perceived social support from children on loneliness in older adults are moderated by two candidate single nucleotide polymorphisms (i.e., rs1876831 and rs242938) in the corticotrophin releasing hormone receptor 1 (CRHR1) gene. DESIGN This was a longitudinal observational study. SETTING and PARTICIPANTS A population-based sub-sample of 1,374 community-dwelling older adults aged 65 years and older was examined from both the 2003-2004 and 2006-2007 English Longitudinal Study of Aging assessments. MEASUREMENTS Our main outcome measure is loneliness, which was assessed by four items extracted from the ULCA loneliness scale. RESULTS Compared with older adults carrying the CT/TT genotypes, individuals homozygous for the C allele of rs1876831 reported higher levels of loneliness in the context of infrequent social contact with children and lower levels of perceived social support from children. No gene × social environment interactions were found for loneliness between rs242938 and an adverse social environment related to children. CONCLUSIONS This study provides the first evidence in humans that the CRHR1 gene interacts with exposure to a negative social environment to predict loneliness in older adults.
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Affiliation(s)
- Kee-Lee Chou
- Department of Asian & Policy Studies, The Hong Kong Institute of Education, Hong Kong, SAR.
| | - John T Cacioppo
- Department of Psychology, University of Chicago, Chicago, IL
| | - Meena Kumari
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Y Q Song
- Department of Biochemistry, The University of Hong Kong, Hong Kong, China
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Sjörs A, Ljung T, Jonsdottir IH. Diurnal salivary cortisol in relation to perceived stress at home and at work in healthy men and women. Biol Psychol 2014; 99:193-7. [PMID: 24746849 DOI: 10.1016/j.biopsycho.2014.04.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 04/08/2014] [Accepted: 04/08/2014] [Indexed: 11/18/2022]
Abstract
This study investigated the association between diurnal salivary cortisol profile and perceived stress at work and at home. Healthy participants (N=180, 52% women) collected saliva cortisol samples immediately after waking up, 15 min later, 30 min later, and at 9:00, 12:00, 15:00, 18:00 and 21:00. The area under the cortisol awakening curve with respect to ground (AUCgCAR) and increase (AUCiCAR), and diurnal slope between 9:00 and 21:00 were analyzed. Perceived stress at work and at home was measured with the Stress-Energy Questionnaire. Participants reporting stress at home had significantly lower AUCgCAR and a flatter diurnal slope. When performing separate analyses for men and women, this association was only significant among women. Perceived stress at work was not associated with any cortisol measure. This study highlights the importance of stress outside the workplace. The sex differences may indicate an increased vulnerability to non-work stress in women.
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Affiliation(s)
- Anna Sjörs
- The Institute of Stress Medicine, Gothenburg, Sweden; Rehabilitation Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
| | - Thomas Ljung
- Department of Health Sciences, Mid Sweden University and County Council of Jämtland, Sweden
| | - Ingibjörg H Jonsdottir
- The Institute of Stress Medicine, Gothenburg, Sweden; Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Hsiao FH, Lai YM, Chen YT, Yang TT, Liao SC, Ho RTH, Ng SM, Chan CLW, Jow GM. Efficacy of psychotherapy on diurnal cortisol patterns and suicidal ideation in adjustment disorder with depressed mood. Gen Hosp Psychiatry 2014; 36:214-9. [PMID: 24342115 DOI: 10.1016/j.genhosppsych.2013.10.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 10/23/2013] [Accepted: 10/23/2013] [Indexed: 10/26/2022]
Abstract
AIMS The aims were to examine the effects of psychotherapy on depressive and anxiety symptoms, the occurrence of suicidal ideations and diurnal cortisol patterns in patients with adjustment disorder (AD) with depressed mood. METHODS Participants recruited from an outpatient department of psychiatry at a general hospital were randomly assigned to one of two groups: 34 in psychotherapy group and 37 in control group. The control group consisted of one-session psychoeducation. Psychotherapy included the eight-weekly body-mind-spirit (BMS) group psychotherapy. Measures included Beck Depression Inventory-II and State Trait Anxiety Inventory. Salivary cortisol samples were collected from the patients at their homes on awakening; 30 and 45 min after awakening; and at 1200, 1700 and 2100 h. Measurements were taken at baseline and at months 2 (end of intervention), 5, 8 and 14. RESULTS There was no differential change over time between the BMS and control groups in self-reported depression or anxiety symptoms. However, suicidal ideation appeared to be reduced in the psychotherapy group. Changes in diurnal cortisol patterns were also significantly different in group × time interactions, in favor of BMS group. CONCLUSIONS Psychotherapy likely provides improvements in psychobiological stress responses and decreases the occurrence of suicidal ideation in patients with AD.
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Affiliation(s)
- Fei-Hsiu Hsiao
- Department of Nursing, College of Medicine National Taiwan University, Taipei, Taiwan.
| | - Yu-Ming Lai
- School of Nursing, Chang-Gung University, Taiwan
| | - Yu-Ting Chen
- School of Nursing, Chang-Gung University, Taiwan
| | - Tsung-Tsair Yang
- Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital and Medical College, National Taiwan University
| | - Rainbow T H Ho
- Department of Social Work and Social Administration, Centre on Behavioral Health, The University of Hong Kong, Hong Kong
| | - Siu-Man Ng
- Department of Social Work and Social Administration, Centre on Behavioral Health, The University of Hong Kong, Hong Kong
| | - Cecilia L W Chan
- Department of Social Work and Social Administration, Centre on Behavioral Health, The University of Hong Kong, Hong Kong
| | - Guey-Mei Jow
- School of Medicine, Fu-Jen Catholic University, No 510 Chung-Cheng Road, Hsin-Chuang Dist, New Taipei City 24205, Taiwan.
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